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a° cod Body Art Inspection Report <br />y% San Joaquin County Environmental Health Department <br />1868 E. Hazelton Ave., Stockton, CA 95205 <br />(209)468-3420 <br />w siogv.org/ehd <br />PR Number <br />PRACTITIONER/ARTIST NAME <br />PRO542533 <br />Alexa Cox-Halsel (BBP exp. 6/18/21 <br />PRO537962 <br />AnthonyBottom <br />Observations and Corrective Actions: <br />Date: June 16, 2021 <br />Program <br />Record: PRO542186 <br />Program <br />Element: 4121 <br />PR Number <br />PRACTITIONER/ARTIST NAME <br />PR054409 <br />Cody Stanfill BBP exp. 6/22121 <br />PR0545110 <br />Joseph Behn (BBP exp, 6/20/21 <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) — Sterilization certificates were not available for the Cheyenne needle <br />cartridges with the lot numbers 202144414 and 202043-064. Provide EHD with sterilization certificates for the needles <br />mentioned. <br />9. No food, drink, tobacco product, or personal effects are permitted in the procedure area. HSC 119309 — A bowl of lollipops <br />was sitting on Alexa's room partition to the procedure room. — Corrected on site. <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 facility uses Google Sheets for client records, which is then transferred to a <br />spreadsheet on Google Drive. Client records recorded after 6127120 were missing information. — Corrected on site. <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 medical questionnaire and consent forms did not include all of the <br />information from Form B — Corrected on site. <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 — The paint in Alexa's procedure room, the front <br />right booth and Anthony's procedure room is peeling. Repaint the rooms and provide EHD with photographic evidence. <br />35. Operation and employee training records shall be maintained for 3 years and made available for inspection. A written <br />Infection Prevention and Control Plan (IPCP) shall be maintained, followed and updated. HSC 119373 — A current IPCP <br />training record was not available. The last training was conducted in 2019. Provide a copy of the current training record <br />to the EHD. <br />Unless otherwise noted correct all violations and provide evidence of corrections to_ <br />the EHD by JuIV 1, 2021. <br />Reinspection onlabout: A reinspection fee of $152 per hour may be charged. Page 2 of 3 <br />EH -11/17 <br />