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PR Number <br />Body Art InspectiReport <br />PRO542065 <br />San Joaquin County Environmental Health Department <br />PRO543565 <br />Michael Fox (BBP exp. 6/10/20 <br />1868 E. Hazelton Ave., Stockton, CA 95205 <br />(209) 468-3420 <br />r'c��FoeRe��p <br />WWW.siogy.of /gehd <br />PR Number <br />PRACTITIONER/ARTIST NAME <br />PRO542065 <br />Casey Price (BBP exp. 6/19/20 <br />PRO543565 <br />Michael Fox (BBP exp. 6/10/20 <br />Observations and Corrective Actions: <br />PR Number <br />Date: )0/ <br />b4 <br />Program <br />Record: pitoswiI.BS4 <br />Program <br />Element: 4JAf <br />3. Sterilizer shall be loaded, operated, decontaminated, and maintained according to manufacturer's recommendations. HSC <br />119315(b) — The instruction manual for the autoclave was not available. Keep the autoclave instruction manual in the <br />sterilization room. <br />6. A facility that uses single use instruments shall maintain record of purchase, log of procedures, names of practitioner and <br />client, date of procedure, instruments used, and written evidence from the manufacture that the instruments have undergone <br />sterilization. The record of purchase, evidence of sterilization, type and number of instruments used shall be maintained for a <br />minimum of 90 days after use. HSC 119315(f) —Casey Price did not have invoices or sterilization certificates for needles <br />and other equipment used. Provide EHD with invoices and sterilization certificate(s) of needles and other equipments <br />used. <br />13. Practitioner shall provide evidence of a completed, EHD approved, OSHA Bloodborne Pathogen Training consistent with <br />section 119307. — A current Bloodborne Pathogen (BBP) Training Certificate was not posted at the practitioners <br />procedure area. Post BBP certificate at the practitioners procedure area. <br />18. The facilities client consent form and medical questionnaire must include all of the information listed in Form B, and are <br />available for inspection. HSC 119303 —The consent form and medical questionnaire does not include all of the <br />information listed on Form B. <br />Include the following on the body art client consent form: <br />a.) A description of what the client should expect following the procedure. <br />b.) Notice that inks are not FDA approved and "health consequences are unknown." <br />Include the following on the body art and piercing medical questionnaires: <br />a.) History of "herpes infection at the procedure site." <br />b.) History of hemophilia "or other bleeding disorders." <br />c.) Other risk factors for blood borne pathogens. <br />d.) History of cardiac "valve disease." <br />19. At the completion of the procedure, the practitioner shall provide postprocedure instructions that include all elements listed in <br />Form B. HSC 119308(b) —The piercing postprocedure instructions does not have the signs and symptoms of infection. <br />Edit the postprocedure instructions to include the signs and symptoms of infection. <br />32. A body art facility shall have floors, walls, and ceilings that are smooth, nonabsorbent, free of open holes, and washable. <br />The body art facility shall be free of insect and rodent infestation. The procedure area must be separated, by a wall, ceiling to <br />floor, from nail and hair activities and be separated from all business not related to body art. Approval of co -located body art <br />facilites are at the discretion of the LEA. A procedure area must be equipped with adequate light to perform a procedure. Each <br />procedure area shall have lined waste containers. HSC 119314 & 119317 —A hole and peeled paint was observed in the <br />piercing room. Peeled paint was also observed in the 3rd procedure area on the right. Repair the hole in the piercing <br />area and repaint areas where the paint is peeling. Provide evidence to the EHD. <br />Reinspecion on/about: A reinspection fee of $152 per hour may be charged. Page 2 of 3 <br />EH -11/17 <br />