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Body Art InspeAn Report Date: Z/2 <br />Aiift San Joaquin County Environmental Health Department Program <br />1868 E. Hazelton Ave., Stockton, CA 95205 Record: rR <br />(209) 468-3420 Program <br />q' '• www.s o v.o /hd <br />.> >i eElement: L1/ 2.O <br />PR Number <br />PRACTITIONER/ARTIST NAME <br />PR0541731 <br />Raynelle Preciado-permit available, not posted; BBP - <br />available, not posted <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) <br />7. The sharps waste container shall be within arm's reach and labeled with the word "sharps waste" or with the biohazard <br />symbol and the word "Biohazard". Sharp waste containers shall be disposed by a licensed waste hauler or approved mail back <br />system. Documentation of proper disposal shall be maintained for 3 years. HSC 119314(e) <br />13. Practitioner shall provide evidence of a completed, EHD approved, OSHA Bloodborne Pathogen Training consistent with <br />section 119307. <br />16. Client shall be at least 18 years of age to receive a tattoo, permanent cosmetics, or branding. Body piercing, unless <br />performed in the presence of parent or guardian, the client, must be 18 years of age. HSC 119302- Provide copy of driver's <br />license/identification with client records. <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- Consent forms incomplete, be sure to include lot number. <br />33. All surfaces and objects in the procedure area, including chairs, armrests, tables, countertops, and trays, shall be in good <br />repair and capable of being disinfected. All counter surfaces and service trays in the procedure area shall have a smooth, <br />durable, and nonabsorbent finish. HSC 119314- Keep pillows at five feet distance from procedure area. <br />34. Certificate of registration and health permit shall be posted in a conspicuous place. HSC 119306 and 119312 <br />Notes: <br />1) Bloodborne pathogen training certification expires February 27th, 2018. Maintain current bloodborne pathogen <br />training certification, and post in a conspicuous place. <br />2) Post health permit in a conspicuous place. <br />Unless otherwise noted, correct all violations by February 16th, 2018. <br />Reinspecion on/about: A reinspection fee of $152 per hour may be charged. <br />EH -11/17 F/ <br />Page 2 of 2 <br />