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pAqu,N.� Body eco Re y Y Art Ins P Port Date: San Joaquin County Environmental Health Department Program �. 1868 E.Hazelton Ave.,Stockton,CA 95205 9 t (209)ase-sato Recons: www.sioay.org/ehd Program Element: PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME PR0537423 Chris McPherson,BBP-CM 7/8/2019 PRO541191 Joel Mei a,BBP-AT-7/1 1/19 PRO541032 Vince Menchaca,BBP-AT 7/2/2019 Observations and Corrective Actions: 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 (1)The medical questionnaire asks about"heart conditions." The questionnaire should ask about"cardiac valve disease." HSC 119303(b)2 Submit evidence of revision of the medical questionnaire to ask about"cardiac valve disease"to the EHD by 7/512019. (2) The medical questionnaire suggests contacting the facility for advice on when to seek medical attention. Submit evidence of revision of the medical questionnaire to indicate when a client should seek medical attention as required by HSC 119303(a)(5)(d)to the EHD by 7/5/2019. 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 and facility permits were not posted. Joel Meija's bloodborne pathogens training certificate was available for review but not posted. Submit evidence of posting practitioner and facility permits and evidence of bloodborne pathogens training in the facility to the EHD by 7/5/2019. All corrections are due by 7/5/2019. All Evidence of corrections can be submitted to the EHD by email at ieasterCa�si4ov.orq Failure to submit evidence of correction to the EHD by 7/5/2019 will result in a re-inspection charged at the departmental hourly rate of$152 per hour. Notes: 1. Chris McPherson's mailing address has changed to 615 Connie Court, Manteca, CA 95336. 2_ Sharps Compliance is used for mail-back sharps disposal. Records are available for two disposals in the last year on 5/18/2018 and 6/26/2018. 3. Sterilization certificates were available for review. Three boxes of TatSoul needles in use in the facility were matched to a sterilization record for lot#2016-11. 4. Client records were available for review. The package for the needle was attached to the client form. 5. The IPCP was available for review. The EHD's file copy is current. Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 2 of 2 EH-11/17