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Body Art Inspect Report Date: ` 41. San Joaquin County Environmental Health Department Program �. 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: c F.i (209)468-3420 Program YiFoaa`, wwwsiogv.org/ehd Element: PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME Observations and Corrective Actions: 6. A facility that uses single use instruments shall maintain record of purchase, log of procedures, names of practitioner and client, date of procedure, instruments used, and written evidence from the manufacture that the instruments have undergone sterilization. The record of purchase, evidence of sterilization, type and number of instruments used shall be maintained for a minimum of 90 days after use. HSC 119315(f) 7. The sharps waste container shall be within arm's reach and labeled with the word"sharps waste"or with the biohazard symbol and the word"Biohazard". Sharp waste containers shall be disposed by a licensed waste hauler or approved mail back system. Documentation of proper disposal shall be maintained for 3 years. HSC 119314(e) 11. The procedure area shall be equipped with a sink with hot and cold running water, containerized liquid soap, and single use paper towels dispensed from a wall-mounted, touchless dispenser that is readily accessible to practitioner. HSC 119314(b) 13. Practitioner shall provide evidence of a completed, EHD approved, OSHA Bloodborne Pathogen Training consistent with section 119307. 14. Practitioner shall put on appropriate personal protective equipment, including gloves, aprons, lap pads, etc. Gloves shall be worn throughout the procedure. HSC 119308(a) 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 19. At the completion of the procedure, the practitioner shall provide postprocedure instructions that include all elements listed in Form B. HSC 119308(b) 24. Disinfectant shall have ability to reduce or eliminate the presence of disease-causing microorganisms, including HIV and hepatitis B virus. HSC 119301(k) 25. Disinfectant shall be used according to the manufacturer's instructions. HSC 119309(b) 26. Any part of a tattooing machine that may touch the practitioner during procedure shall be covered with a disposable plastic sheath. HSC 119311(h) 28. Sterilized instrument packs, equipment and jewelry shall be stored in a labeled container or cabinet that is protected from dust or moisture. Sterile instrument packs shall be evaluated before use; instrument packs shall be discarded or reprocessed if condition is compromised. HSC 119315 Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 2 of 3 EH-03/2015