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q_ Body Art Inspects Report Date: <br /> /Z1 A <br /> y San Joaquin County Environmental Health Department Program �J <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: F IZ d s z 31 C)5 <br /> (209)468-3420 Program <br /> •°� P www.sioov.oro/ehd Element: �2\ <br /> �lFORt� <br /> UP W,ODOM HURTRIM <br /> PR0523104 Cesar Flores-Permit+BBP onsite <br /> PRO523590 Paul Bellinger-BBP onsite <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 <br /> 34. Certificate of registration and health permit shall be posted in a conspicuous place. HSC 119306 and 119312 <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 /> Unless otherwise noted, all violations must be corrected within 30 days. <br /> Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 2 of 2 <br /> EH-03/2015 <br />