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°U " Body Art Inspe(en Report Zt San Joaquin County Environmental Health Department 537531 Aaron Brockman "a 1868 E. Hazelton Ave., Stockton, CA 95205 (209) 468-3420 Krr-U�� WWW.SIOC1V.OfQ/ehd PR Number PRACTITIONER/ARTIST NAME 537538 Max Ackermann 537531 Aaron Brockman Observations and Corrective Actions: PR Number Date: 51114 Program PkS37 53-L Record: Program Element: 1. Each sterilization load shall be monitored with mechanical indicators for time, temperature and pressure, Sterilization shall be accomplished by steam autoclave, manufactured for the sterilization of medical instruments, and pass a Class V integrator test. HSC 119315(b) 2. Instruments or other reusable items shall be placed in a basin of water or cleaned, decontaminated, packaged, and sterilized immediately after each procedure. HSC 119309 If not being processed for immediate use, clean instruments shall be placed in sealed sterilization package that contains process indicator, name of instrument, date sterilized, and initial of person/operator. HSC 119315(a) 4. Sterilizer shall be spore -tested after initial installation, after major repair, and at least once per month. A written sterilization shall be maintained for 3 years. The log shall include spore -test results each sterilization cycle, date, contents, exposure time and temperature, results of the Class V integrator for every cycle/load, and evidence of a acceptable spore test before reuse of the sterilizer after a failed spore -test. HSC 119315(b) 5. Decontamination and sterilization areas shall be separated from procedure areas by a space of at least 5 feet or by a cleanable barrier and 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(c) 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) 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) 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) 13. Practitioner shall provide evidence of a completed, EHD approved, OSHA Bloodborne Pathogen Training consistent with section 119307. 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 Reinspecion on/about: A reinspection fee of $125 per hour may charged. Page 2 of 3 EH -04/2014