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PR Number PRACTITIONER/ARTIST NAME PR0537449 Phillip Mendoza (BBP exp. 6/8/24 Body Art Inspection Report Garrett Fransen BBP exp. 6/12/24 Q {'� San Joaquin County Environmental Health Department Date: Program 1868 E. Hazelton Ave., Stockton, . i ��'• CA 95205 Record: (209) 468-3420 `;O •• P,•' 4��F www.siogv.onp/ehd Program ORS` Element: PR Number PRACTITIONER/ARTIST NAME PR0537449 Phillip Mendoza (BBP exp. 6/8/24 PR0548517 Garrett Fransen BBP exp. 6/12/24 Observations and Corrective Actions: June 28, 2023 SR0086863 4103 PR Number PRACTITIONER/ARTIST NAME PR0538099 Mario Morales BBP exp. 6/12/24 6. A facility that uses single use instruments shall maintain record of purchase, log of procedures, names of practitioner and client, date of procedure, instruments used, and written evidence from the manufacture that the instruments have undergone sterilization. The record of purchase, evidence of sterilization, type and number of instruments used shall be maintained for a minimum of 90 days after use. HSC 119315(f) — Sterilization certificates were not provided for Phillip Mendoza's XXX needle cartridges with lot number 21-12 and the Hawk Ink needle cartridges with lot number 220802. Provide EHD with the sterilization certificates for the needles mentioned. 7. The sharps waste container shall be within arm's reach and labeled with the word "sharps waste" or with the biohazard symbol and the word "Biohazard". Sharp waste containers shall be disposed by a licensed waste hauler or approved mail back system. Documentation of proper disposal shall be maintained for 3 years. HSC 119314(e) — Facility will be utilizing a licensed waste hauler. A contract was not available for review. Provide EHD with a contract from a licensed waste hauler. 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, touch less dispenser that is readily accessible to practitioner. HSC 119314(b) — Hot running water was not available at the procedure area. Repair or replace the hot water heater prior to the final inspection. 18. The facilities client consent form and medical questionnaire must include all of the information listed in Form B, and are available for inspection. HSC 119303 — The consent form did not include all of the information listed on Form B. Include the "description of the procedure" on the form and provide a copy to the EHD. 19. At the completion of the procedure, the practitioner shall provide postprocedure instructions that include all elements listed in Form B. HSC 119308(b) — The postprocedure instructions did not include all elements listed on Form B. Include the following on the aftercare instructions and provide a copy to the EHD: - Signs and symptoms of infection. - indications when to seek medical care. 32. A body art facility shall have floors, walls, and ceilings that are smooth, nonabsorbent, free of open holes, and washable. The body art facility shall be free of insect and rodent infestation. The procedure area must be separated, by a wall, ceiling to floor, from nail and hair activities and be separated from all business not related to body art. Approval of co -located body art facilities are at the discretion of the LEA. A procedure area must be equipped with adequate light to perform a procedure. Each procedure area shall have lined waste containers. HSC 119314 & 119317 —There is a gap between the floor and the baseboard. Seal all gaps prior to the final inspection. 35. Operation and employee training records shall be maintained for 3 years and made available for inspection. A written Infection Prevention and Control Plan (IPCP) shall be maintained, followed and updated. HSC 119313 — The IPCP was not available during the inspection. Ensure the IPCP is on site for review by EHD. Correct all observations by July 5, 2023. Reinspection on/about: A reinspection fee of $156 per hour may be charged. Page 2 of 3 EH -11/17