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- ' Body Art Inspection Report PR0537458 Gustavo Hurtado (BBP exp. San Joaquin County Environmental Health Department Date: PR0539504 Jose Hernandez BBP exp. EXPIRED Program Michae Hardman (BBP exp. 12/10/22 1368 E. Hazelton Ave., Stockton, CA 95205 Record: ;209) 468-3420 www.siogv.org/ehd Program -0 ' Element: PR Number PRACTITIONER/ARTIST NAME PR0537458 Gustavo Hurtado (BBP exp. PRO537640 Fernando Hurtado (BBP exp. PR0539504 Jose Hernandez BBP exp. EXPIRED PR0547361 Michae Hardman (BBP exp. 12/10/22 Observations and Corrective Actions: 6/14/22 PRO540884 4120 PR Number PRACTITIONER/ARTIST NAME PR0547166 Erika Caballero BBP exp. 7/28/22) 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) — The invoice and sterilization certificate for instrument KWARDON 35/7RLLT LOT # 1019 were not available. Provide EHD with the invoice and sterilization certificates for the instrument. 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) — Sharps waste disposal receipt was not available at the time of inspection. Provide EHD with sharps waste disposal receipt. 13. Practitioner shall provide evidence of a completed, EHD approved, OSHA Bloodborne Pathogen Training consistent with section 119307. - Need Bloodborne Pathogen certificate for Gustavo Hurtado, Fernando Hurtado, and Jose Hernandez. Provide EHD with current Bloodborne Pathogen certificates. 18. The facilities cliert consent form and medical questionnaire must include all of the information listed in Form B, and are available for inspection. HSC 119303 — Client records missing LOT # for instruments used. Ensure all client records are complete. 33. All surfaces and objects in the procedure area, including chairs, armrests, tables, countertops, and trays, shall be in good repair and capable of being disinfected. All counter surfaces and service trays in the procedure area shall have a smooth, durable, and nonabsorbent finish. HSC 119314 — Procedure table in the front of the shop is peeling in some areas. Repair/replace procedure table and provide photographic proof to EHD. 34. Certificate of-egistration and health permit shall be posted in a conspicuous place. HSC 119306 and 119312 - Certificate of registration was not posted at the time of inspection. Provide EHD with photographic proof of health permit posted. 35. Operation and employee training records shall be maintained for 3 years and made available for inspection. A written Infection Prevention and Control Plan (IPCP) shall be maintained, followed and updated. HSC 119313 — IPCP and training records were not available at the time of inspection. Provide EHD with IPCP and training records. Reinspection on/about A reinspection fee of $152 per hour may be charged. Page 2 of 3 EH -11/17