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" .. Body Art Inspect Report Date: fC��� <br /> San Joaquin County Environmental Health Department Program P�OSy02 <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: <br /> •: <br /> c P; (209)468-3420 Program <br /> 4�;Foa�` www.siogv.org/ehd I2-0 <br /> Element: <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PRO539789 Gerardo Rivera:BBP&Permit Current and Posted Leslie Terrones: BBP&Permit Current and Posted <br /> PR0543740 Yecenia Rosas:BBP&Permit Current and Posted <br /> Alexis Castillo-Rocha:BBP&Permit Current and <br /> PR0543495 Posted <br /> Gabriel Flores Alcauter:BBP&Permit Current and <br /> PR0544557 Posted <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)—Provide copies of all the sterilization certificates and invoices for all <br /> practitioners working at the facility. <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—Review the IPCP with <br /> all new practitioners once they start working at the facility.Review the IPCP with all practitioners annually and have <br /> them sign and date the IPCP. <br /> PROVIDE A COPY OF THEIR SIGNATURE AND THE DATE THEY REVIEW THE IPCP TO THE EHD. <br /> Notes: <br /> 1. One sink PER every two practitioners.A hand wash sink will need to be added if there is more than four <br /> practitioners working at the facility. <br /> 2. Once Leslie Terrones receives her health permit, post the health permit in a conspicuous place. <br /> 3. Alexis Castillo-Rocha is planning to work at the facility.She only does piercing. <br /> 4. Alexis Castillo-Rocha will need to provide sterilization certificates for all the supplies she uses for piercing. <br /> 5. When the sharp container is full and is mail back to the mail-back company, retain a copy of the manifest at the <br /> facility. <br /> 6. Maintain a copy of the clients'Driver's License with their client consent form. <br /> CORRECT ALL VIOLATIONS PRIOR TO OCTOBER 4, 2019. <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 2 of 2 <br /> EH-11/17 <br />