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(I C-1 BodyArt Ins eco Report `� L 5 � '<- P P 0 Cate: N San Joaquin County Environmental Health Department Program 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: IU (209)468-3420 Program p / 4�,-F-aRa wWW.slogy.orq/ehd Element: fW S3 �I L 55 PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME PRO541076 Ian Goff,BBP expired 5/1/2019 PRO542031 Kindra Goff,BBP-CM 7/10/2019 PRO537417 Vernon Ring,BBP-CM 5/31/2019 PRO543583 Richard Ruiz,1313P-CM 7/24/19 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 unavailable for review for lots currently in inventory in the facility. Submit evidence of sterilization for 3 lots currently in inventory with photographs of the equipment to the EHD by 6/23/2019. 13. Practitioner shall provide evidence of a completed, EHD approved, OSHA Bloodborne Pathogen Training consistent with section 119307. Bloodborne pathogens training for Ian Goff expired on 5/1/2019. Submit evidence training to the EHD by 6/23/2019. 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 Some of the client information forms do not contain lot numbers for the equipment used during the procedure. Include lot numbers on the client forms at the time of the procedure. 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 IPCP requires updating with contact times for disinfectant. No record of recent training with the IPCP was available at the time of the inspection. Submit an updated copy of the IPCP with evidence of staff training to the EHD by 6/23/2019. All evidence of correction is due by 6/23/2019. Failure to provide evidence of correction to the department by 6/23/2019 will result in a re- inspection charged at$152 per hour. Notes: 1. Client consent forms, medical questionnaire, and aftercare procedure have the required information. 2. The IPCP from the prior business was available onsite but requires updating by the current owner and evidence of training as noted in violation #35. Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 2 of 2 EH-11/17