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Body Art Ins ectle Report t /� <br /> Date: 11 S <br /> r <br /> * z <br /> 4. San Joaquin County Environmental Health Department <br /> Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: S R G O 7 7,S g <br /> (209)468-3420 Program <br /> q<,F`0 www.siogv.org/ehd Element: y 103 <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONERIARTIST NAME <br /> PR0537458 Gustavo Hurtado-practitioner permit+BBP posted <br /> Jamie Avila-no BBP or permit posted(registered) <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 /> 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 /> 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 /> -11-11 havelliMite containers. HSC 119314& 119317 <br /> 33. All surfaces and objects in the procedure area, including chairs, armrests, tables, countertops, and trays, shall be in goad <br /> repair and capable of being disinfected. All counter surfaces and service trays in the procedure area shall have a smooth, <br /> durable, and nonabsorbent finish. HSC 119314 <br /> 36. Design plans shall be submitted to EHD for approval prior to constructing or remodeling body art facility. HSC 119312 <br /> 37. A body art facility shall not conduct business without a valid health permit. A person shall not perform body art without a valid <br /> registration and a permitted facility. A body art facility shall notify the LEA in writing within 30 days of resignation, termination of a <br /> practitioner. Anew hire or apprentice must be registered the EHD prior to performing body art at the facility. HSC 119312 & <br /> 119306 <br /> All violations must be corrected and EHD must be contacted for a final inspection prior to opening facility. <br /> Reinspecion onlabout: A reinspection fee of$130 per hour may be charged. Page 2 of 2 <br /> EH-03/2015 <br />