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Pau'"a� Body Art Ins e n Report Y p P date: <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: F'�S 3 `1 Z► <br /> (209)468-3420 <br /> °4Y;F cc) P www.siogv.orq/ehd Program <br /> Element: <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> Lieu Thi Nguyen-permit posted,BBP not posted and <br /> PR0537098 expired <br /> Observations and Corrective ActionF-. <br /> 8. 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)-Contact manufacturer(Organic Permanent Makeup)for sterilization <br /> certificates. <br /> 7. The sharps waste container shall be within arm's reach and labeled with the word"sharps waste"or with the biohazard symbc <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)-Maintain sharps waste container within <br /> arm's reach,and maintain documentation of proper disposal. <br /> 13. Practitioner shall provide evidence of a completed, EHD approved, OSHA Bloodborne Pathogen Training consistent with <br /> section 119307.-Bloodborne pathogen training certification expired as of June 17"', 2017. Keep current bloodborne <br /> pathogen training certification and post on wall in procedure area. <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- Medical questionnaire must include other risk factors for bloodborne pathogens. <br /> 19. At the completion of the procedure, the practitioner shall provide postprocedure instructions that include all elements listed it <br /> Form B. HSC 119308(b)- Postprocedure instructions needs to include restrictions on physical activities,signs and <br /> symptoms of infection, and indications when to seek medical care. <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 /> 35. Operation and employee training records shall be maintained for 3 years and made available for inspection. A written <br /> Infection Prevention and Control Plan (IPCP)shall be maintained, followed and updated. HSC 119313 <br /> Notes: <br /> 1) Maintain current bloodborne pathogen training certification,and post in a conspicuous place. <br /> 2) Maintain an updated copy of the Infection Prevention and Control Plan on site. <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 2 of <br /> EH-11/17 <br />