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r? o� Body Art Inspection Report Date: August 10, 2022 y. San Joaquin County Environmental Health Department Program 1866 E. Hazelton Ave., Stockton, CA 95205 Record: SR0085619 (209)468 3420 •'O NP W .slogy.ore/eh6 Program Element: 4103 PR Number PRACTITIONER/ARTIST NAME PRO546189 Amanda Brown—Not permitted PRO541234 Jose Carballo (BBP Exp 12/14/19 be charged. Page 2 of 4 EH -11f17 PR Number PRACTITIONER/ARTIST NAME PR0540594 Kyle Thaw (BBP Ex 9/5/21 PR0543461 Klara Guerrero (BBP Ex 6/19/23 be charged. Page 2 of 4 EH -11f17 Observations and Corrective Actions: 3. Sterilizer shall be loaded, operated, decontaminated, and maintained according to manufacturer's recommendations. HSG 119315(b) — A manual was not available for the autoclave. Provide EHD with a manual for the autoclave and keep a copy at the facility. 4. Sterilizer shall be spore -tested after initial installation, after major repair, and at least once per month. A written sterilization shall be maintained for 3 years. The log shall include spore -test results each sterilization cycle, date, contents, exposure time and temperature, results of the Class V integrator for every cycle/load, and evidence of an acceptable spore test before reuse of the sterilizer after a failed spore -test. HSC 119315(b) — Spore test results were not available for review. Ensure spore tests results are kept at the facility for a minimum of 3 years. Provide a copy of the spore test to EHD. 11. The procedure area shall be equipped with a sink with hot and cold running water, containerized liquid soap, and single use paper towels dispensed from a wall -mounted, touchless dispenser that is readily accessible to practitioner. HSC 119314(b) — The procedure rooms did not consist of wall -mounted, touchless paper towel dispensers. The sinks consisted of knobs to turn on the water. Ensure all procedure areas consist of a wall -mounted, touchless paper towel dispenser. Replace the knobs on the sinks to handles. Provide EHD with photographic evidence. 13. Practitioner shall provide evidence of a completed, EHD approved, OSHA Bloodborne Pathogen Training consistent with section 119307. —A current Bloodborne Pathogen Training certificate were not available for Kyle Thaw, Jose Carballo or Amanda Brown. Provide EHD with a current copy of the practitioners BBP certificates. 18. The facility's client consent form and medical questionnaire must include all of the information listed in Form B, and are available for inspection. HSC 119303 —The client consent form and medical questionnaire did not include all of the information listed on Form B. Include the following information on the forms and provide an updated copy to the EHD: Client Consent Form - Client is at least 18 years of age. - Description of procedure. - Description of what the client should expect following the procedure. (For tattoos) - Statement regarding permanent nature of procedure. Medical Questionnaire -History of herpes infection at the procedure site. - History of hemophilia or other bleeding disorders. - History of cardiac valve disease. - Other risk factors for bloodborne pathogens. 19. At the completion of the procedure, the practitioner shall provide post procedure instructions that include all elements listed in Form B. HSC 119308(b) —Post procedure instructions were not provided for tattoo procedures, only for piercings. The piercing post procedure instructions did not include all of the elements from Form B. Include the following information on the form and provide an updated copy to the EHD: - Signs and symptoms of infection. - Indications when to seek medical attention. Reinspection on/about: A reinspection fee of $156 per hour may be charged. Page 2 of 4 EH -11f17