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Body Art Inspection Report Date: June 30,2025 <br /> N {� San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: PR0548695 <br /> (209)468-3420 Program <br /> � www.siogv.org/ehd L.i� ;'�er4 Element: 4120 <br /> R Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PR0548696 Nicole Barber <br /> Observations and Corrective Actions: <br /> 6. A body art facility that uses single use instruments shall maintain record of purchase, log of procedures, names of <br /> practitioner and client, date of procedure, instruments used, and written evidence from the manufacturer that the <br /> instruments have undergone sterilization. The record of purchase, evidence of sterilization, type and number of <br /> instruments used shall be maintained for a minimum of 90 days after use. HSC 119315(f) <br /> OBSERVATIONS: <br /> 1. No sterilization certificate was provided during inspection for the presterilized jewelry with lot number 00665. <br /> 2. The forceps used for piercing do not have any identifiable numbers on the packaging to match the associated sterile <br /> certificate that was provided during the inspection. <br /> 3. No sterilization certificate provided for 3-RL tattoo cartridge with lot number E0025306. <br /> CORRECTIVE ACTIONS: <br /> 1. Please provide a sterilization certificate for the jewelry with the matching lot numbers and item description. <br /> 2. Please provide proof that the tools used for piercing are sterilized or remove the tools from the facility if no proof of <br /> sterilization can be provided. <br /> 3. Provide sterilization certificate for tattoo cartridge with lot number E0025306 <br /> 13. Each person required to complete a Bloodborne Pathogen (BBP) Training program shall complete it annually. <br /> OBSERVATIONS: <br /> 1. During the inspection, no bloodborne pathogen training was posted within the facility. Practitioner noted that they <br /> completed bloodborne pathogen training. Practitioner showed on the phone that they did have a completed course with <br /> the date of completion being 6/29/25, but the associated PDF file for the certificate shows the expired BBP. <br /> CORRECTIVE ACTIONS: <br /> 1. Provide proof of a valid BBP certificate and have it posted within the facility. <br /> 18. Prior to the performance of body art, the client shall read, complete, and sign an informed consent form that shall <br /> include, but not be limited to all the following information within this section. HSC 119303 <br /> OBSERVATIONS: <br /> 1. Client consent forms for piercing and for permanent make up did not include all of the information within HSC 119303. <br /> CORRECTIVE ACTIONS: <br /> 1. Please update the piercing client consent forms to include the following information or questions: <br /> a. Client question regarding "History of herpes at the procedure site" <br /> b. Client question regarding "History of cardiac valve disease" <br /> c. Client question regarding "History of being prescribed antibiotics prior to dental or surgical procedures" <br /> d. Client question regarding "Other risk factors for bloodborne pathogens" <br /> 2. Please update the permanent make-up client consent forms to include the following information or questions: <br /> a. Client question regarding the "History of hemophilia or other bleeding disorders" <br /> b. Client question regarding the "History of cardiac valve disease" <br /> c. Client question regarding current medications <br /> d. Client question regarding "Requirements for antibiotics prior to surgery or dental procedures" <br /> Reinspection on/about: A reinspection fee of$179 per hour may be charged. Page 2 of 3 <br /> EH-7-1-25 <br />