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t Body Art InspecOn Report ®ate: 1 <br /> San Joaquin Coun nvironmental Health Department ® Program <br /> Y 1868 E.Hazelton Ave.,Stockton,CA 95205 Recons: <br /> y (209)468-3420 Program <br /> vmw.s1oay.o�ehd Element: <br /> u/21 <br /> Tanisha Green <br /> Observations and Corrective Actions: <br /> 6. A facility that uses single use instruments shall maintain record of purchase,log of procedures, names of <br /> practitioner and client,date of procedure,instruments used, and written evidence from the manufacture that the <br /> instruments have undergone sterilization.The record of purchase,evidence of sterilization,type and number of <br /> instruments used shall be maintained for a minimum of 90 days after use. HSC 119315(f) <br /> Provide sterilization certificates for the pre-sterilized equipment to be used in the facility. <br /> 9.iVo foal,drink,tobacco prodt,ct..or pe of eff is are permitted in the;prbcle area:HSC.1 93tl <br /> 18. The facilities client consent form and medical questionnaire must include all of the information listed in Form <br /> B,and are available for inspection. HSC 119303 <br /> Submit a copy of the client consent form and medical questionnaire to the EMD. <br /> 19. At the completion of the procedure,the practitioner shall provide post-procedure instructions that include all <br /> elements listed in Form B. HSC 119308(b) <br /> Submit a copy of the aftercare Instructions to the EHD. <br /> 32. - .`sty shall`have-_, rs,+ Il ,. rl ,. ,!sings s... t , io�a er►ts# , +p <br /> W's Wile <br /> The body art facility shall be free of insect and rodent infestation. The procedure area must be <br /> separated, by a wail,ceiling to floor,from nail and hair activities and be separated from all business not related to <br /> body art. Approval of co-located body art facilities are at the discretion of the LEA A procedure area must be <br /> equipped with adequate light to perform a procedure, Each pr- ' urtr res ki . va 1s ate conte <br /> HSC 119314& 119317 <br /> The wall adjacent to the hand wash sink has absorbent areas. The waste container Is unlined. Paint <br /> absorbent areas and provide a lined waste container prior to opening. <br /> 34. CB to of ragisfraon t1d`t}sltft + (f il:' te .in s tas piaier HSC 119306 and 119312 <br /> Post current bloodborne pathogens certificate,and facility and artist permits once received. <br /> Reinspecion onfabout: A reinspection fee of$152 per hour may be charged. Page 2 of 3 <br /> EH-11117 <br />