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°P••• �'/2'' °c\ Body Art Inspection Report Date: 5/24l22 San Joaquin County Environmental Health Department Program 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: PR0544621 (209)468-3420 c• �'. www.siop Programv.orglehd Element: 4120 PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME PR0544621 Christina Ramirez(BBP exp. PR0541001 John Herrera(BBP exp.8/13/22 PR0537482 Dennis Escalante(BBP exp. PR0538823 Erick Jimenez BBP exp. PR0539819 Mark Escalante(BBP exp. PR0537653 Jessie Witt(BBP exp. 5/23/23 PR0547379 Luz Gaxiola BBP ex . 12/20/22 PR0544783 Nicholas Tofanelli BBP exp. 5/3/23 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)—The invoice and sterilization certificate for Jessie Witt instruments CHEYENNE MAGNUM LOT#2022-05-073 and Erick Jimenez instruments CHEYENNE 9-POWER LOT# 2020-02-092 were not available. Provide EHD with the invoice and sterilization certificates for the instruments. 13. Practitioner shall provide evidence of a completed, EHD approved, OSHA Bloodborne Pathogen Training consistent with section 119307. Need Bloodborne Pathogen certificate for Christina Ramirez, Dennis Escalante, Mark Escalante, and Erick Jimenez. Provide EHD with current Bloodborne Pathogen certificates. 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—Client consent form missing the following: photo I.D., LOT#of instruments used, artist signature, and description of tattoo. Ensure all client records are complete. 19. At the completion of the procedure, the practitioner shall provide postprocedure instructions that include all elements listed in Form B. HSC 119308(b)—After care instructions was not available at time of inspection. Provide EHD with after care instructions to review. 32. A body art facility shall have floors, walls, and ceilings that are smooth, nonabsorbent, free of open holes, and washable. T-ie 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 facilities 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— Restroom waste container was not lined at time of inspection. Corrected on site. 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—Procedure table in the piercer room was covered with stickers. Previous inspection conducted on 4l8/21 shows the procedure table have tears on it(see attached photo). Reupholster/Replace the procedure table in the piercer room. Provide EHD with photographic proof of correction. 34. Certificate of registration and health permit shall be posted in a conspicuous place. HSC 119306 and 119312—Certificate of registration was not posted at the time of inspection. Provide EHD with photographic proof of health permit posted. 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—Training record was not up to date with employee signatures. Provide EHD with training records signed by all employees. Reinspection on/about: A reinspection fee of$152 per hour may be charged. Page 2 of 3 EH-11/1