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Body Art Inspeco Report Date: <br /> '` +r San Joaquin County Environmental Health Department Program <br /> 1w <I 9 <br /> k 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: ��� • ��� <br /> 1 (209)468-3420 <br /> P� Program www.sFogv.org/ehd Element: <br /> .A <br /> # F4CFIIOM1IERIARTISTNAME ta <br /> PRNumb. 1V kfAE�, NAME ��., ? , rm .„ <br /> Gerardo Rivera <br /> Yecenia Rojas <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 EHD with sterilization certificates for presterilized needles and <br /> blades. <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)-Provide EHD with documentation for mail- <br /> back services for sharps disposal. <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.-Provide EHD with bloodborne pathogen training certificates, and post in a conspicuous place. <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-Include in medical questionnaire: history of herpes infection at the procedure site <br /> 33. All surfaces and objects in the procedure area, including chairs, armrests, tables, countertops, and trays, shall be in good <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 /> 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-Include sharps disposal <br /> information in IPCP. <br /> Notes: <br /> 1) Provide EHD with sharps disposal written agreement with mail back system. <br /> 2) Provide EHD with sterilization certificates for needles and blades. <br /> 3) Provide EHD with bloodborne pathogen training certificates and post in a conspicuous place. <br /> 4) Submit an updated (signed/dated) IPCP for EHD's records. <br /> Unless otherwise noted, correct all violations prior to final inspection. <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 2 of 2 <br /> EH-11/17 <br />