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/pig U n� '0.' `�� Body Art Inspection Report Date: December 29,2021 x a San Joaquin County Environmental Health Department Program 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: PR0515394 (209)468-3420 Program n Q' www.siogv.org/ehd Element: 4120 PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME PRO515393 Jon Highland BBP ex 6/8/22 PRO541902 Jessica Orsua(BBP ex 7/23/22 PR0537371 Daniel Juge BBP ex 3/22/22 PR0539346 Kristal Betancourt BBP ex 6/10/22 PR0546830 Ashley Hess(BBP ex 4/5/22 PR0537374 Ricardo Cardenas BBP ex 3/18/22 Observations and Corrective Actions: 6. A facility that uses single use instruments shall maintain record of purchase, log of procedures, names of practitioner and client, date of procedure, instruments used, and written evidence from the manufacture that the instruments have undergone sterilization. The record of purchase, evidence of sterilization, type and number of instruments used shall be maintained for a minimum of 90 days after use. HSC 119315(f)—The sterilization certificates for CHEYENNEE— NEEDLE CARTRIDGE 5- LINER LOT#2020-47-050 and KWADRON—MEMBRANE CARTRIDGE NEEDLE LOT#4/2025 0525 were not available. Provide EHD with sterilization certificates for the needles. 18. The facilities client consent form and medical questionnaire must include all of the information listed in Form B, and are available for inspection. HSC 119303—Medical questionnaire missing the following items: "Hemophilia or other bleeding disorders" and "Requirements for antibiotics prior to surgery or dental procedures." Make corrections on the medical questionnaire to include the missing items. Provide EHD with proof of corrections. 32. A body art facility shall have floors, walls, and ceilings that are smooth, nonabsorbent, free of open holes, and washable. The body art facility shall be free of insect and rodent infestation. The procedure area must be separated, by a wall, ceiling to floor, from nail and hair activities and be separated from all business not related to body art. Approval of co-located body art facilities are at the discretion of the LEA. A procedure area must be equipped with adequate light to perform a procedure. Each procedure area shall have lined waste containers. HSC 119314& 119317—Waste containers in Daniel Juge and Ricardo Cardena's procedure area did not have liners. A section of Daniel Juge wall is damaged and open. Provide liners for waste containers, repair drywall in Daniel Juge's procedure area, and provide photographic proof to EHD. 33. All surfaces and objects in the procedure area, including chairs, armrests, tables, countertops, and trays, shall be in good repair and capable of being disinfected. All counter surfaces and service trays in the procedure area shall have a smooth, durable, and nonabsorbent finish. HSC 119314—The procedure chair in Daniel Juge's area need to be repaired/replaced due to tare on both sides. Provide EHD with photographic proof of correction. 37. A body art facility shall not conduct business without a valid health permit. A person shall not perform body art without a valid registration and a permitted facility. A body art facility shall notify the LEA in writing within 30 days of resignation, termination of a practitioner. A new hire or apprentice must be registered the EHD prior to performing body art at the facility. HSC 119312 & 119306—Practitioner Kristal Betancourt is performing body art at the facility with an expired health permit at time of inspection. All practitioners must have a valid health permit in order to perform body art. Provide EHD with proof of payment in order to bring health permit current. noted, correct all violations and submit corrections to EHD b Januar 12 2022. Unless otherwise e , Y Y 1. Sharp's container last picked up 5/25/21 by Stericycle. Reinspection on/about: A reinspection fee of$152 per hour may be charged. Page 2 of 2 EH-11/17