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Body Art Inspection Report Date: January 25, 2024 <br />San Joaquin County Environmental Health Department Program <br />1868 E. Hazelton Ave., Stockton, CA 95205 Record: PR0523952 <br />(209)468-3420 <br />www.s6ogv.org/ehd Program <br />Element: 4121 <br />PR Number PRACTITIONER/ARTIST NAME <br />PR Number <br />PRACTITIONER/ARTIST NAME <br />PR0523951 Melissa Bambula-Santos BBP Ex .1/23/2025 <br />PR0536973 <br />Jose Zuni a (BBP Exp. 6/15/24 <br />PR0548913 Katrina Bamula-Santos BPP Exp. 1/24/2025 <br />Observations and Corrective Actions: <br />3. HSC 119315 - Autoclave loaded correctly/packages allowed to dry <br />OBSERVATION: <br />Piercing Room: <br />1. Observed sterilized instruments on top of counter. <br />2. Sterilized instruments lack the proper labeling requirements. <br />CORRECTIVE ACTION: <br />1. Sterilize equipment as described in HSC 119315 (a) Clean instruments to be sterilized shall first be sealed in sterilization <br />packaging that contain either a sterilizer indicator or process indicator, unless instruments are being processed for immediate <br />use. <br />2. Provide proper labeling requirements as described in HSC 119315 (a) the outside of the pack shall be labeled with the name <br />of the instrument if not immediately identifiable, the date sterilized, and the initials of the person operating the sterilizing <br />equipment unless instruments are being sterilized for immediate use. ✓- <br />6. HSC 119315 - Invoices and log kept for disposable, pre -sterilized equipment. <br />OBSERVATION: <br />Sterilization certificate is lacking Kwadron needle lot # 0807. <br />CORRECTIVE ACTION: <br />Provide sterilization certificate for this needle. <br />5. HSC 119314 - Decontamination/sanitation area separated and supplied appropriately. <br />OBSERVATION: <br />Piercing Room: <br />Soap is lacking in the wall mounted dispenser in the decontamination room. <br />CORRECTIVE ACTION: <br />Provide soap in dispenser as described in HSC 119314(c)(2). <br />9. HSC 119309 - No eating, drinking or smoking - clean clothes <br />OBSERVATION: <br />Permanent Cosmetics Room: <br />Observed a microwave and a mini refrigerator and soda on the floor of the permanent cosmetics room. <br />CORRECTIVE ACTION: <br />Food and drinks are not permitted in procedure area. Remove all food and drinks from the procedure area. Corrected onsite <br />items removed from the procedure area. I <br />18. HSC 119303 - Client records approved and available - Consent form and questionnaire <br />OBSERVATION: <br />IPCP is outdated and lacks information. <br />CORRECTIVE ACTION: <br />Update IPCP to include piercing and permanent cosmetics to plan. <br />OBSERVATION(S): <br />Consent form lacks information as seen on Form B. <br />CORRECTIVE ACTION(S) <br />Reinspection on/about: A reinspection fee of $162 per hour may be charged. Page 2 of 4 <br />EH -11/17 <br />