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.)OPgUIN. CO <br /> Body Art Inspection Report Date: June 19,2024 <br /> cZjl San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: SR0087836 <br /> 1� (209)468-3420 <br /> www.smogv.ora/ehd Program <br /> �iFoR`'' Element: 4103 <br /> -Current medications. <br /> - Requirements for antibiotics prior to surgery or dental procedures. <br /> 3. The facilities client consent form and medical questionnaire must include all of the information listed in Form B, and are <br /> available for inspection. Ensure a copy of the client's photo ID is attached to the consent form and the lot number is either written <br /> or attached to the form. <br /> 19. HSC 119303, 119308 -Appropriate aftercare instructions given to client <br /> OBSERVATIONS: <br /> The aftercare instructions did not have all the items from Form B. <br /> CORRECTIVE ACTIONS: <br /> At the completion of the procedure, the practitioner shall provide postprocedure instructions that include all elements listed in <br /> Form B. Include the following on the aftercare instructions and provide a copy to the EHD: <br /> -Signs and symptoms of infections. <br /> - Indications when to seek medical care. <br /> 33. HSC 119314-Workstation,surfaces, including chairs, armrests, etc. in good repair <br /> OBSERVATIONS: <br /> Some of the decorations throughout the facility were absorbent. <br /> CORRECTIVE ACTIONS: <br /> All surfaces and objects in the procedure area, including chairs, armrests, tables, countertops, and trays, shall be in good repair <br /> and capable of being disinfected. All counter surfaces and service trays in the procedure area shall have a smooth, durable, and <br /> nonabsorbent finish. Remove all absorbent decorations from the procedure area. <br /> 35. HSC 119313 -Operation and employee training records present <br /> OBSERVATIONS: <br /> Training records were not available during the inspection. <br /> CORRECTIVE ACTIONS: <br /> Operation and employee training records shall be maintained for 3 years and made available for inspection. A written Infection <br /> Prevention and Control Plan (IPCP) shall be maintained, followed and updated. Ensure all practitioners are trained on the IPCP. <br /> Provide a copy of the training record to the EHD. <br /> Correct all observations by July 4, 2024 and pay all applicable fees <br /> prior to scheduling the final inspection. <br /> Notes: <br /> 1. The inspection report was emailed to facility owner, Krystalyn Jimenez, at ianlyn90(aD_yahoo.com. <br /> 2. Stericycle will be used for sharps waste disposal. <br /> 3. Currently there is only one practitioner at the facility. The facility may not have more than six practitioners practicing at the <br /> facility at any given time. <br /> Reinspection on/about: A reinspection fee of$162 per hour may be charged. Page 3 of 3 <br /> EH-11/17 <br />