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Body Art Inspect Report San Joaquin County Environmental Health Department 1868 E. Hazelton Ave., Stockton, CA 95205 (209) 468-3420 c°clFoaa`P www.siogv.org/ehd PR Number PRACTITIONER/ARTIST NAME Observations and Corrective Actions: Date: I Z 1 Program Record: Program Element: PR Number PRACTITIONER/ARTIST NAME 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) 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) 11. The procedure area shall be equipped with a sink with hot and cold running water, containerized liquid soap, and single use paper towels dispensed from a wall -mounted, touchless dispenser that is readily accessible to practitioner. HSC 119314(b) 18. The facilities client consent form and medical questionnaire must include all of the information listed in Form B, and are available for inspection. HSC 119303 19. At the completion of the procedure, the practitioner shall provide postprocedure instructions that include all elements listed in Form B. HSC 119308(b) 24. Disinfectant shall have ability to reduce or eliminate the presence of disease -causing microorganisms, including HIV and hepatitis B virus. HSC 119301(k) 25. Disinfectant shall be used according to the manufacturer's instructions. HSC 119309(b) 26. Any part of a tattooing machine that may touch the practitioner during procedure shall be covered with a disposable plastic sheath. HSC 119311(h) 32. A body art facility shall have floors, walls, and ceilings that are smooth, nonabsorbent, free of open holes, and washable. The body art facility shall be free of insect and rodent infestation. The procedure area must be separated, by a wall, ceiling to floor, from nail and hair activities and be separated from all business not related to body art. Approval of co -located body art facilites are at the discretion of the LEA. A procedure area must be equipped with adequate light to perform a procedure. Each procedure area shall have lined waste containers. HSC 119314 & 119317 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 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 All violations noted above must be corrected prior to final consultation. Reinspecion on/about: A reinspection fee of $130 per hour may be charged. Page 2 of 3 EH -03/2015