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l� OG Body Art Inspeco Report • Date: (3 / I G/13 .Z San Joaquin County Environmental Health Department Program H103 1868 E. Hazelton Ave., Stockton, CA 95205 Record: �t➢FORa� (209) 468-3420 www.siogv.org/ehd Program Element: / S_OUbyG2 V PR Number I PRACTITIONER/ARTIST NAME Ravnelle Precaido 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) — Provide a copy of the sterilization certificate for the needles use by the practitioner. Provide proof of purchase for the purchased needles. 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) — Sharps waste container should be within arm's reach and labeled with the word "sharp waste" or with the biohazard symbol and the word "Biohazard" on the container. 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) — Provide a wall -mounted, touchless paper -towel dispenser in the restroom. 16. Client shall be at least 18 years of age to receive a tattoo, permanent cosmetics, or branding. Body piercing, unless performed in the presence of parent or guardian, the client, must be 18 years of age. HSC 119302 — Maintain a copy of the client Driver's License with their records. Include the lot number and expiration date of the needle uses on the client with their records. 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 —Include the following statements on the medical questionnaire: 1. Hemophilia or other bleeding disorders 2. Other risk factors for blood borne pathogens 27. Products applied to skin prior to tattooing or application of permanent cosmetics, including, but not limited to, stencils, marking and transfer agents, shall be single use and discarded into a waste container at the end of the procedure. HSC 119311(a) — All products applied to the skin should be single -use. 31. A body art facility shall be separated from any residential areas used for sleeping, bathing, or meal preparation and shall not share a common entrance or toilet facility with residence. The toilet facility must have a sink with hot and cold water, containerized liquid soap, and single -use paper towels that are dispensed from a wall -mounted, touchless dispenser. HSC 119314 — Provide paper towel dispenser that is covered to prevent contamination. Note: 1. Provide a copy of the sterilization certificate of purchased needles to the EHD. 2. Provide a copy of the invoice for any purchased needles. Reinspecion on/about: A reinspection fee of $152 per hour may be charged. EH -11/17 (r Page 2 of 3