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Body Art Inspection Report Date: March 3,2025 <br /> San Joaquin County Environmental Health Department Pro gram <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: PR0541621 <br /> (209)468-3420� Program www.s600v.org/ehd g <br /> Element: 4120 <br /> R Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PR0541622 Erica Frese-Green, BBP Exp 3/2/2026 <br /> Observations and Corrective Actions: <br /> 6. A body art facility that uses single use, disposable, pre-sterilized equipment must maintain for 90 days, records of the <br /> use of instruments at the site of practice for the purpose of verifying the use of presterilized equipment.A body art <br /> facility must also maintain written proof on company or laboratory letterhead showing that the presterilized instruments <br /> have undergone a steriliziation process. Written proof shall clearly identify the instruments sterilized by name or item <br /> number and shall identify the lot or batch number of the sterilizer run. HSC 119315(f) <br /> OBSERVATIONS: <br /> 1. No sterilization certificates were provided for Cyber Mast Cartridge with lot number 2023-06-01. <br /> CORRECTIVE ACTIONS: <br /> 1. Provide sterilization certificates for the needle mentioned above to EHD. <br /> 18. Prior to the performance of body art, the client shall read, complete, and sign an informed consent form that shall <br /> include: A questionnaire that includes "Other risk factors for bloodborne pathogen exposure". HSC 119303 <br /> OBSERVATIONS: <br /> 1. Client consent forms were not being full completed by the clients <br /> 2. Photo copy of IDs were not being taken and included onto the client consent forms <br /> 3. Client consent forms were missing the question asked to the client of"Other risk factors for bloodborne pathogen <br /> exposure" <br /> CORRECTIVE ACTIONS <br /> 1. Assure that clients are fully completing the client consent forms prior to performing any body art <br /> 2. Assure that the practitioner is obtaining photo copy of IDs and attaching them to the client consent forms <br /> 3. Update client consent form medical questionnaire to include the question of"Other risk factors for bloodborne pathogen <br /> exposure" <br /> 31. A body art facility shall be separated, by a wall or ceiling to floor partition from nail and hair acitivities, and be <br /> separated from all business not related to body art at the discretion of the local enforcement agency. HSC 119314 (b)(2) <br /> and (b)(3). <br /> OBSERVATIONS: <br /> 1. Pracitioner mentioned that other services that are being performed within the facility are waxing and facials. <br /> CORRECTIVE ACTIONS: <br /> 1. Separate all hair and facial acitivities from the procedure area where body art is being performed. <br /> Reinspection on/about: A reinspection fee of$172 per hour may be charged. Page 2 of 3 <br /> EH-12-4-23 <br />