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Body Art Inspects Report Date: S l J <br /> San Joaquin County Environmental Health Department Program ,^ <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: Ps-to�"161 <br /> (209)468-3420 <br /> PO <br /> www.siogv.org/ehd Program <br /> Element: <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PRO530665 Eddy Reyes <br /> PR0537477 Jose Garcia <br /> PR0537907 Eddy Reyes Jr. <br /> PR0537476 Marcos Adame <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 /> 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-Not many were available for review. Ensure during subsequent inspections, more <br /> consent forms and medical questionnaires are available for inspection. <br /> 28. Sterilized instrument packs, equipment and jewelry shall be stored in a labeled container or cabinet that is protected from <br /> dust or moisture. Sterile instrument packs shall be evaluated before use; instrument packs shall be discarded or reprocessed if <br /> condition is compromised. HSC 119315-Submit photographic evidence. <br /> Notes: 1. The owner, Eddy Reyes, expressed interest in having an autoclave in the shop. The regulations pertaining to onsite <br /> autoclaving was discussed (i.e. decontamination and sterilization area and records). Eddy was instructed to contact <br /> the EHD and submit plans/drawings for implementing an onsite autoclave first. <br /> Unless Otherwise Noted, Corrective Action Due in 30 dans. <br /> Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 2 of 2 <br /> EH-03/2015 <br />