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Body Art Inspection Report Date: 3 ��is I;I <br /> y �1i San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: mo 64 5 3?0 <br /> •r Pl (209)468-3420 Program <br /> fF t?N" www.sFogv.org/ehd Element: 41IN <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PR0545463 Michelle Tabancura(BBP 3/18/22 <br /> Observations and Corrective Actions: <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)—The sterilization certificate was not available for Elie Marie needles (lot <br /> #E0040825). Provide sterilization certificate for the Elie Marie needles. Ensure sterilization certificates are kept for at <br /> least 90 days. <br /> 33. All surfaces and objects in the procedure area, including chairs, armrests, tables, countertops, and trays, shall be in good <br /> repair and capable of being disinfected. All counter surfaces and service trays in the procedure area shall have a smooth, <br /> durable, and nonabsorbent finish. HSC 119314—The curtain in the procedure room is of absorbent material. Remove or <br /> replace absorbent curtain. <br /> Correct all violations by April 1, 2021, submit corrections to the EHD. <br /> NOTES: <br /> 1. Inspection report was emailed to facility owner, Michelle Tabancura, at mstabancura(d-)gmail.com. <br /> 2. Post permits in a conspicuous place, when received. <br /> 3. Ensure sharps waste is disposed of when container is full or one time a year. <br /> 4. A copy of a current Bloodborne Pathogen Certificate and the Infection Prevention and Control Plan was provided. <br /> DATE: 3/18/21 PROGRAM RECORD: PR0545320 PROGRAM ELEMENT: 4120 <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 2 of 2 <br /> EH-11/17 <br />