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UN Body Art Inspectieeport Date: N I San Joaquin County Environmental Health Department Program 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: P�(�S Z3 C1 S \ Q (209)4683420 Program L� www.siogv.org/ehd 7 /�—(f Element: c-cf PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONEWARTIST NAME PR0523951 Melissa Santos-CM 4/15/2020 PR0537369 Michael Benjamin Wright No longer works at shop) 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) Sterilization records were not available for lots in use in the facility. Submit photographs of two lots currently in use in the facility along with matching sterilization certificates to the EHD by 12/6/2019. 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 The artist signature and lot numbers are missing from several client forms. Effective immediately,the artist is to sign the client consent forms and record the lot numbers for equipment used at the time of the procedure. 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 The touchless paper towel dispenser required restocking. Submit evidence of correction to the EHD by 12/6/2019. 32. A body art facility shall have floors, walls, and ceilings that are smooth, nonabsorbent, free of open holes, and washable. The body art facility shall be free of insect and rodent infestation. The procedure area must be separated, by a wall, ceiling to floor, from nail and hair activities and be separated from all business not related to body art.Approval of co- located body art facilities are at the discretion of the LEA.A procedure area must be equipped with adequate light to perform a procedure. Each procedure area shall have lined waste containers. HSC 119314 & 119317 An area of the wall near the procedure area is absorbent. Submit evidence of repair to the EHD by 12/6/2019. 35. Operation and employee training records shall be maintained for 3 years and made available for inspection. A written Infection Prevention and Control Plan (IPCP) shall be maintained, followed and updated. HSC 119313 The Infection Prevention and Control Plan requires updating with the current sharps disposal method/hauler and the wet contact time for the disinfectant. Submit evidence of correction to the EHD by 12/6/2019. All evidence of correction is due to the EHD by 12/6/2019. Failure to provide evidence of correction to the EHD by 12/6/2019 will result in a re-inspection charged at the department's hourly rate of$152 per hour. All evidence of correction can be submitted to the department by email at ieaster(�s1gov.org Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 2 of 3 EH-11/17