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QUN <br /> �o ro Body Art Inspecle Report 41 Date: .5- <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: 9"5371 <br /> c, (209)468-3420 Program <br /> q<icoR`'` www.siogv.org/ehd g I•{I�p <br /> Element: <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PR0537098 Lieu Thi Nguyen-Hep.B and BBP <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, touchless dispenser that is readily accessible to practitioner. HSC 119314(b) <br /> 12. Practitioner shall provide evidence of current hepatitis B vaccination or hepatitis B immunity or comply with current federal <br /> OSHA hepatitis B vaccination declination requirements. HSC 119306(c) <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 /> 26. Any part of a tattooing machine that may touch the practitioner during procedure shall be covered with a disposable plastic <br /> sheath. HSC 119311(h) <br /> 27. Products applied to skin prior to tattooing or application of permanent cosmetics, including, but not limited to, stencils, <br /> marking and transfer agents, shall be single use and discarded into a waste container at the end of the procedure. HSC <br /> 119311(a) <br /> 29. Only jewelry made of approved material and commercially manufactured inks, dyes, and pigments shall be used. Only <br /> single-use needles and needle bars shall be used in tattooing and the application of permanent cosmetics. Needles and needle <br /> bars must be pre-sterilized. HSC 119310& 119311 <br /> 32. A body art facility shall have floors,walls, and ceilings that are smooth, nonabsorbent, free of open holes, and washable. <br /> The body art facility shall be free of insect and rodent infestation. The procedure area must be separated, by a wall, ceiling to <br /> floor, from nail and hair activities and be separated from all business not related to body art. Approval of co-located body art <br /> facilites are at the discretion of the LEA. A procedure area must be equipped with adequate light to perform a procedure. Each <br /> procedure area shall have lined waste containers. HSC 119314 & 119317 <br /> Reinspecion on/about: 10/4 A reinspection fee of$130 per hour may be charged. Page 2 of 3 <br /> EH-03/2015 <br />