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,0Body Art Inspectn Report Date: S(2ZIiIj <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: <br /> P�S3h(A(o-( <br /> c P' (209)468-3420 Program <br /> www.slogy.org/ehd U <br /> Element: (��'a <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> 530665 Eddy Reyes <br /> 538646 Billy Dias <br /> 537476 Adame Marcos <br /> 537907 Eddy Reyes Jr <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) <br /> 7. The sharps waste container shall be within arm's reach and labeled with the word"sharps waste" or with the biohazard symbol <br /> and the word"Biohazard". Sharp waste containers shall be disposed by a licensed waste hauler or approved mail back system. <br /> Documentation of proper disposal shall be maintained for 3 years. HSC 119314(e) <br /> 11. The procedure area shall be equipped with a sink with hot and cold running water, containerized liquid soap, and single use <br /> paper towels dispensed from a wall-mounted, touch less dispenser that is readily accessible to practitioner. HSC 119314(b) <br /> 13. Practitioner shall provide evidence of a completed, EHD approved, OSHA Bloodborne Pathogen Training consistent with <br /> section 119307. <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 <br /> 19. At the completion of the procedure, the practitioner shall provide postprocedure instructions that include all elements listed in <br /> Form B. HSC 119308(b) <br /> 28. , 111115 stored in a laDeledcon 11"i ii or ca Inet t a Is pro e <br /> u , <br /> 31. A body art facility shall be separated from any residential areas used for sleeping, bathing, or meal preparation and shall not <br /> share a common entrance or toilet facility with residence. The toilet facility must have a sink with hot and cold water, <br /> containerized liquid soap, and single-use paper towels that are dispensed from a wall-mounted, touchless dispenser. HSC <br /> 119314 <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 <br /> Unless otherwise noted, Corrective Action Due in 30 days. <br /> Reinspecion on/about: A reinspection fee of$125 per hour may charged. Page 2 of 3 <br /> EH-04/2014 <br />