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s oG Body Art Inspection Report Date: 5/26/22 <br /> w2 San Joaquin County Environmental Health Department Program <br /> 1868 E. Hazelton Ave., Stockton, CA 95205 <br /> Record: PR0547232 <br /> (209) 468-3420 <br /> •� C - P .+ w .siow.ora/ehd Program <br /> Element: 4120 <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PRO545459 Liana Hoang BBP exp. 5/16/23 <br /> PRO547258 Fraulien Campos (BBP exp. 7/16/22 <br /> PRO543783 Ludda Her (BBP ex , . <br /> PRO547396 Chantra Ruthsmith (BBP exp. <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) — The invoice and sterilization certificate for instruments KWADRON LOT # <br /> 1018 were not available. Provide EHD with the invoice and sterilization certificates for the instruments. <br /> 7. The sharps waste container shall be within arm's reach and labeled with the word "sharps waste" or with the biohazard symbol <br /> and the word "Biohazard". Sharp waste containers shall be disposed by a licensed waste hauler or approved mail back system . <br /> Documentation of proper disposal shall be maintained for 3 years. HSC 119314(e) — Sharps waste container was last picked <br /> up in 2021 prior to opening of shop. Ensure sharps container is picked up at least once annually. <br /> 13. Practitioner shall provide evidence of a completed , EHD approved , OSHA Bloodborne Pathogen Training consistent with <br /> section 119307. — Need Bloodborne Pathogen certificate for Ludda Her and Chantra Ruthsmith. Provide EHD with <br /> current Bloodborne Pathogen certificates. <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 — Client records is missing photo I.D. and instrument LOT #. Ensure all client <br /> records are complete. <br /> Unless otherwise noted , correct all violations and provide evidence of corrections to <br /> the EHD by June 27 , 2022 . <br /> Notes : <br /> 1 . Inspection report was emailed to Liana Hoang , at Iianahoano209(a)omail.com <br /> 2. Sharps waste container is picked up by GRP & Associates, Inc. <br /> Reinspection on/about: A reinspection fee of $152 per hour may be charged. Page 2 of 2 <br /> EH-11117 <br />