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Body Art Inspection Report Date: October 25,2023 <br /> ec San Joaquin County Environmental Health Department Program <br /> N: 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: 4120 <br /> (209)468-3420 Program <br /> www.siogv.org/ehd <br /> Element: PR0545146 <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> Suwichada Kanmaneekun BBP Expires 4/28/2024 <br /> Blolo ix <br /> Observations and Corrective Actions: <br /> 6. Invoices and log kept for disposable, pre-sterilized equipment.A facility that uses single use instruments shall <br /> maintain record of purchase, log of procedures, names of practitioner and client, date of procedure, instruments used, <br /> and written evidence from the manufacture that the instruments have undergone sterilization. The record of purchase, <br /> evidence of sterilization,type and number of instruments used shall be maintained for a minimum of 90 days after use. <br /> HSC 119315(f) <br /> OBSERVATION: Sterilization certificate is lacking for Mast Pro Cartridge needle with lot number 2023 02 01 <br /> CORRECTIVE ACTION: Provide sterilization certificate for needles with this lot number. <br /> 18. Client records approved and available -Consent form and questionnaire.The facilities client consent form and <br /> medical questionnaire must include all of the information listed in Form B, and are available for inspection. HSC <br /> 119303 <br /> OBSERVATION: The statement"other risk factors for blood borne pathogens" is not on the medical questionnaire. <br /> CORRECTIVE ACTION: Provide this statement on the medical questionnaire as listed in Form B <br /> OBSERVATION: Client consent forms are lacking. <br /> CORRECTIVE ACTION: Maintain client consent forms. <br /> 27. Products applied to skin are single use/dispensed aseptically. <br /> Products applied to skin prior to tattooing or application of permanent cosmetics, including, but not limited to, stencils, <br /> marking and transfer agents,shall be single use and discarded into a waste container at the end of the procedure. HSC <br /> 119311(a) <br /> OBSERVATION: Body marking pencils are not single use. <br /> CORRECTIVE ACTION: Provide single use body marking products. <br /> 31. A body art facility shall be separated from any residential areas used for sleeping, bathing, or meal preparation and <br /> shall not share a common entrance or toilet facility with residence. The toilet facility must have a sink with hot and cold <br /> water, containerized liquid soap, and single-use paper towels that are dispensed from a wall-mounted,touchless <br /> dispenser. HSC 119314 <br /> OBSERVATION: Paper towels are not in the paper towel dispenser in the restroom. <br /> CORRECTIVE ACTION: Provide paper towels in the touchless paper towel dispenser observed in the restroom. <br /> Reinspection on/about: A reinspection fee of$162 per hour may be charged. Page 2 of 3 <br /> EH-11/17 <br />