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Body Art Inspece Report <br />Z San Joaquin County Environmental Health Department <br />.a <br />m < <br />1868 E. Hazelton Ave., Stockton, CA 95205 <br />(209) 468-3420 <br />www.sogv.org/ehd <br />PR Number PRACTITIONER/ARTIST NAME <br />Romaldo Rodriguez - BBP Posted, unregistered <br />PR0542035 Blanca Rodriguez - BBP Posted, permit posted <br />Observations and Corrective Actions: <br />Date: <br />Program <br />Record: <br />Program <br />Element: <br />I PR Number I PRACTITIONER/ARTIST NAME I <br />6. A facility that uses single use instruments shall maintain record of purchase, log of procedures, names of practitioner and <br />client, date of procedure, instruments used, and written evidence from the manufacture that the instruments have undergone <br />sterilization. The record of purchase, evidence of sterilization, type and number of instruments used shall be maintained for a <br />minimum of 90 days after use. HSC 119315(f) <br />7. The sharps waste container shall be within arm's reach and labeled with the word "sharps waste" or with the biohazard symbol <br />and the word "Biohazard". Sharp waste containers shall be disposed by a licensed waste hauler or approved mail back system. <br />Documentation of proper disposal shall be maintained for 3 years. HSC 119314(e) <br />18. The facilities client consent form and medical questionnaire must include all of the information listed in Form B, and are <br />available for inspection. HSC 119303 <br />19. At the completion of the procedure, the practitioner shall provide postprocedure instructions that include all elements listed in <br />Form B. HSC 119308(b) <br />Correct all violations noted above prior to final consultation. <br />Notes: 1.) Prior to final consultation: <br />-Pay for facility permit and practitioner registration (Romaldo). <br />-Correct all items listed above. <br />-Contact EHD for final consultation inspection. <br />2.) Blanca is moving from "The Lash Bar and Beauty Studio." <br />Reinspecion on/about: A reinspection fee of $152 per hour may be charged. Page 2 of 2 <br />EH -11/17 <br />