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Body Art Inspection Report Date: June 30, 2022. ay' San Joaquin County Environmental Health Department Program 1868 E. Hazellon Ave., Stockton, CA 95205 Record: PR0546559 (209) 460-3420 ' P • YANy.siogy.omiehd Program IF Element: 4120 PR Number PRACTITIONERIARTIST NAME PRO546578 Erika Valdez (BBP Ex 7/18/22 per hour may be charged. Page 2 Observations and Corrective Actions: PR Number PRACTITIONER/ARTIST NAME PR0547540 Noelle Huena BBP Ex 5/3/23 per hour may be charged. Page 2 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 information in the medical questionnaire and provide a copy to the EHD: - Requirements for antibiotics prior to surgery or dental procedures. 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 — A few of the client records were missing client signatures and were incomplete. The client records did not have photo IDs attached and the lot number of the needles were not written or attached to the records. Ensure all information on the client records are complete, client photo IN are attached and the instrument lot numbers are written or attached to the forms. 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 —There are gaps between the baseboard and the floor, next to the procedure room door. Gaps were observed between a couple of the floor planks and the baseboard is in need of paint. Repair/ seal gaps between the baseboard and floor, seal spaces in the floor planks and paint the baseboards. 34. Certificate of registration and health permit shall be posted in a conspicuous place. HSC 119306 and 119312 — A current Bloodborne Pathogen Training Certificate was not posted for Erika Valdez or for Noelle Huerta. Noelle Huerta's permit was not posted. Ensure the BBP Certificates and permits are posted in a conspicuous place. Provide photographic evidence of correction 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 119313 — A training record was not available. Ensure all practitioners are trained on the IPCP and evidence of training is kept at the site. Provide EHD with training records. Correct all violations and provide evidence of corrections to the EHD bML July 149 2022. NOTES: 1. Inspection report emailed to facility owner, Sylver DeHart, at svlverdeharfCa�pmail.com. 2. EHD informed Sara Miller is no longer a practitioner at the facility. 3. A sterilization certificate and invoice were provided for the Inked cartridge with lot number 102102. 4. The practitioners are using the same brand of cartridges. 5. Sharps waste is mailed back to Sharps Assure. The last mail back was on 4/4/22. Reinspection on/about: A reinspection fee of $152 per hour may be charged. Page 2 of 2 EH -11/17