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u ° c�c Body Art Inspection Report Date: April 25 2022 y{ San Joaquin County Environmental Health Department Program 1869 E. Hazelton Ave., Stockton, CA 95205 Record: PR0539655 (209) 468-3420 w .sioov.orn/ehd Program C4dog�� Element: 4120 PR Number PRACTITIONERlARTIST NAME PR0541076 Ian Goff (BBP exp. 3/23/23 PR0546909 Robert Franco (BBP exp. 2/23/23 followed and updated. HSC 179313 —A current training record was not available for review. Provide EHD with a current training record. Observations and Corrective Actions: PR Number PRACTITIONER/ARTIST NAME PR0537417 Vernon Rin BBP exp. 4/5/23 Infection Prevention and Control Plan (IPCP) shall be maintained, followed and updated. HSC 179313 —A current training record was not available for review. Provide EHD with a current training record. 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) —A sterilization certificate was not available for Janel Parra's (guest artist) needles with lot number VC92102. Provide a copy of Ms. Parra's sterilization certificate to the EHD. 18. The facility's client consent form and medical questionnaire must include all of the information listed in Form B, and are available for inspection. HSC 119303—The Smartwaiver program is utilized to store client records. Client ID number is entered on the record, but a physical copy of the ID is not kept. Ensure a physical copy of the ID is kept with the client records. 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 —Areas of the floor is damaged, exposing concrete. Seal damaged areas and provide photographic evidence to the EHD. 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 179313 —A current training record was not available for review. Provide EHD with a current training record. Page 2 Correct all violations and provide evidence of corrections to the EHD by May 10, 2022. Notes: 1. Inspection report emailed to facility owners, Ian Goff and Wesley Fareas, at deathravtattooto-�amail.com. 2. Smartwaiver is utilized for digital record keeping. 3. Replace old permits with new permits when received. 4. Per operator, Kindra Goff and Michael Forst are not practicing at the facility. 5. Sharps waste was last disposed (mailed back) on 3/23/21. Sharps waste shall be disposed when container is full or once a year to a licensed waste hauler or to an approved mail back system. 6. Operator plans on installing new flooring in the future. Ensure the material used for the floor is commercial grade and approved by the EHD. Operator shall communicate any changes to the EHD. Reinspection onlabout: A reinspection fee of $152 per hour may be charged. Page 2 of 2 EH -11!17