Laserfiche WebLink
Body Art Inspedfin Report Date: I)� <br /> San Joaquin County Environmental Health Department Program <br /> kt <br /> St <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 P>zo S3'7 D l <br /> Record: <br /> (209 468-3420 Program <br /> www.siogv.orq/ehd Element: 1 <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <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 /> 11. The procedure area shall be equipped with a sink with hot and cold running water, containerized liquid soap, and single use <br /> paper towels dispensed from a wall-mounted, touchless dispenser that is readily accessible to practitioner. HSC 119314(b) <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 <br /> 19. At the completion of the procedure, the practitioner shall provide postprocedure instructions that include all elements listed in <br /> Form B. HSC 119308(b) <br /> 28. Sterilized instrument packs, equipment and jewelry shall be stored in a labeled container or cabinet that is protected from <br /> dust or moisture. Sterile instrument packs shall be evaluated before use; instrument packs shall be discarded or reprocessed if <br /> condition is compromised. HSC 119315 <br /> 31. A body art facility shall be separated from any residential areas used for sleeping, bathing, or meal preparation and shall not <br /> share a common entrance or toilet facility with residence. The toilet facility must have a sink with hot and cold water, <br /> containerized liquid soap, and single-use paper towels that are dispensed from a wall-mounted, touchless dispenser. HSC <br /> 119314 <br /> 35. Operation and employee training records shall be maintained for 3 years and made available for inspection. A written <br /> Infection Prevention and Control Plan (IPCP)shall be maintained, followed and updated. HSC 119313 <br /> Notes: 1. Saul must come in to the EHD and register as a practitioner <br /> 2. Consent forms must indicate when appropriate when no tattoo was done <br /> 3. Barnett is the sharps hauler. <br /> 4. Move the autoclave and store away <br /> All Corrective Actions must be submitted within 30 days <br /> Reinspecion on/about: A reinspection fee of$125 per hour may charged. Page 2 of 2 <br /> EH-04/2014 <br />