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Body Art Inspection Report Date: San Joaquin County Environmental Health Department Program 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: (209)468-3420 Program • '4'_r6 " vrmvsioavomlehd Element: PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONERIARTIST NAME PR0544524 Jessie Witt BBP exp. 10/3/21 PRO537482 Dennis Escalante BBP ex .4/8/22 PR0537653 Jesse Quezada PRO538823 Erick Jimenez BBP exp. 1017/21. PRO539819 Mark Escalante BBP ex .9117121 PR0541001 John Herrera BBP exp.6/26/21 PR0544783 Nicholas Tofanelli BBP exp.9/21/21 PR0546438 Spencer Thomas(BBP exp. 12/9/21 Observations and Corrective Actions: 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)—A sterilization certificate was not available for the Metal Mafia needles used by Mark Escalante with lot#2012 01 and the Cheyenne needles used by Erick Jimenez with lot#2020-51-049. Provide EHD with sterilization certificates for the needles stated above. 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)—A manifest for sharps waste disposal was not available during the inspection. Provide a copy of the manifest of the last sharps waste pick up to the EHD. 12. Practitioner shall provide evidence of current hepatitis B vaccination or hepatitis B immunity or comply with current federal OSHA hepatitis B vaccination declination requirements. HSC 119306(c)—Evidence of current Hepatitis B vaccination, immunity or declination form is not on file at the EHD for Jesse Quezada. Provide a copy of immunization record or declination form to the EHD. 13. Practitioner shall provide evidence of a completed, EHD approved, OSHA Bloodborne Pathogen Training consistent with section 119307.A current Bloodborne Pathogen Training Certificate (BBP)was not available for Jesse Quezada. Provide EHD with a current BBP Certificate. 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—The client records were incomplete.The name of the artist and the instrument information (name/item#and lot/batch#)were not provided on the client records. 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—The procedure table in Mark's room had a tear. Repair or replace the procedure table in Mark's room. 35. Operation and employee training records shall be maintained for 3 years and made available for inspection. Awritten Infection Prevention and Control Plan (IPCP) shall be maintained, followed and updated. HSC 119313—The employee training records were not available for review. Ensure all employees sign the training record, provide a copy to the EHD. Unless otherwise noted provide all corrections to the EHD by April 22, 2021. Reinspecion on/about: . A reinspection fee of$152 per hour may be charged. Page 2 of 3 EHA 1/17