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Body Art Inspection Report <br /> Date: 7/1 l02 C� <br /> { San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 <br /> (209)468-3420 Record: PR 06 il.2©3 3 <br /> �,•. -. <br /> Program <br /> www.siogv.orq/ehd g <br /> Element: 14 1 d o <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PR0545888 Georgina Ana a <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)—A sterilization certificate was not available for the Phi Brows blades. <br /> Provide EHD with a sterilization certificate for the Phi Brows blades (lot#0719). <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)—Facility is not contracted with a sharps <br /> waste disposal company. Submit a contract or receipt from a sharps waste mail back system or a sharps waste hauler. <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—The client consent form and medical questionnaire did not contain all the <br /> information listed in Form B. Update the consent form and the medical questionnaire to include all items from Form B. <br /> 19. At the completion of the procedure, the practitioner shall provide postprocedure instructions that include all elements listed in <br /> Form B. HSC 119308(b)—The aftercare instruction was not available for review. Submit aftercare instructions to the <br /> EHD for review. <br /> 32. A body art facility shall have floors, walls, and ceilings that are smooth, nonabsorbent, free of open holes, and washable. <br /> The body art facility shall be free of insect and rodent infestation. The procedure area must be separated, by a wall, ceiling to <br /> floor, from nail and hair activities and be separated from all business not related to body art. Approval of co-located body art <br /> facilites are at the discretion of the LEA. A procedure area must be equipped with adequate light to perform a procedure. Each <br /> procedure area shall have lined waste containers. HSC 119314& 119317—The trash container was not lined in the <br /> procedure room. The walls were not smooth or free of holes. Line the waste container, patch holes and touch up the <br /> paint in the procedure rooms and provide photographic evidence to the EHD. <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—Update the IPCP and <br /> provide a copy to the EHD. <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 2 of 3 <br /> EH-11/17 <br />