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Pq-.0 11y� Body Art Inspection Report Date: San Joaquin County Environmental Health Departmentxi 1868 E. Hazelton Ave., Stockton, CA 95205 Program `..�, Record: j (209) 468-3420 Program i?! wwv.siogv.org/ehd Element: Observations and Corrective Actions: October 21. 2021 SR0084211 4103 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 the following instruments: Perpetual with lot #10701010106L.1, BioMaser with lot # E0020893 and Universal with lot # 200401. Submit sterilization certificates for the mentioned instruments to the EHD. 11. The procedure area shall be equipped with a sink with hot and cold running water, containerized liquid soap, and single use paper towels dispensed from a wall -mounted, touchless dispenser that is readily accessible to practitioner. HSC 119314(b) — The paper towel dispenser has an opening on top. Cover the top of the paper towel dispenser and provide evidence of correction to the EHD. 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 — The medical questionnaire did not include all of the information listed in Form B. Include the following: - History of hemophilia or other bleeding disorders. 31. A body art facility shall be separated from any residential areas used for sleeping, bathing, or meal preparation and shall not share a common entrance or toilet facility with residence. The toilet facility must have a sink with hot and cold water, containerized liquid soap, and single -use paper towels that are dispensed from a wall -mounted, touchless dispenser. HSC 119314 — The paper towel dispensers in the restrooms did not contain paper towels. Ensure the restrooms are supplied with paper towels. Unless otherwise noted, submit all corrections to the EHD by November 4, 2021 and Pay all applicable fees prior to scheduling the routine inspection. Note: 1. Inspection report emailed to facility owner, Jenna Spadafore, at jenna.spadaforeca'�gmail.com. 2. Sharps Assure is used for sharps waste mail back. 3. An updated IPCP was provided to the EHD. Reinspection on/about: A reinspection fee of $152 per hour may be charged. Page 2 of 2 EH -11/17