PLAN REVIEW APPLICATION PACKET BODY ART ESTABLISHMENTS

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PLAN REVIEW APPLICATION PACKET BODY ART ESTABLISHMENTS Greene County Public Health 360 Wilson Drive Xenia, OH 45385 (937) 374-5600 / (937) 374-5607 www.gcph.info Submit completed plan review packet, Infection Prevention & Control Plan Questionnaire, and related documents and $200.00 plan review fee

CONTENT REQUIREMENT OF PLANS Plan Review Type: New facility Remodel/Alteration Water Supply: City Other Specify Sewer: Sanitary Sewer Other Specify 1. Plans and specifications of the place of business shall include the following: (a) The total area to be used for the business; (if the procedure room is located within a building that offers other services, submit a floor plan showing the area of entry, to the procedure room, including reception area, restrooms and storage & utility closets.) Note: The premises in which body art services are conducted shall have an area of at least 100 square feet. The floor space for each individual performing body art services shall have an area of at least 36 square feet; To assure space requirements are met, the floor plan should be drawn to scale. (b) All entrances and exits to the procedure room, and building; (c) Number, location and types of plumbing fixtures, including all water supply facilities (hand washing sinks, restroom facilities, mop sinks, etc.); A hand sink located separate from the restroom is required to be installed in close proximity of each body artist performing a procedure. Additional sinks for cleaning of non-disposable instruments or equipment may be required if the artist is not using all disposable needles/blades/tubes/instruments etc. (d) Lighting requirements: The body art establishment shall be equipped with artificial light sources equivalent to at least 20 foot-candles at a distance of 30 inches above the floor throughout the establishment; and, A minimum of 40 foot-candles of light shall be provided at the level where the body art services are being performed. Spotlighting fixtures are permissible to achieve this degree of illumination. Types and locations of light fixtures must be placed on the set of plans submitted. Verification of foot-candles can be conducted by the inspector at the pre-licensing inspection. (e) A list of finished materials for all surfaces in the procedure room; All floors directly under equipment used for body art activities shall be an impervious, smooth, washable surface; and shall have a minimum area of 36 square feet. List all floor, wall and ceiling finishes on the set of plans. List materials for any countertops or cabinets.

2. Provide answers to the questions listed on the Infection prevention & control plan you received. The information includes such items as: Decontaminating and disinfecting environmental services; Decontaminating, packaging, sterilizing, and storing reusable equipment and instruments; Protecting clean instruments and sterile instruments from contamination during storage; Ensuring that standard precautions and aseptic techniques are utilized during all body art procedures; Safe handling and disposal of needles; Aftercare guidelines. 3. Submit a patron record document. This record shall include but is not limited to the following: (a) the patron s date of service, (b) age, (c) name, (d) address, and (e) telephone number (recommended) (f) Be sure to include: if the patron is receiving a tattoo or body piercing, the body location of the tattoo or piercing, the tattoo color and ink lot number Jewelry used, including size, material composition, and manufacturer. 4. Submit written documentation of each piece of equipment to be utilized by the business, including the manufacturer s name, make and model number. Manufacturer s cut sheets must be provided. As of September 2014, all steam sterilizers shall be equipped with a mechanical drying cycle. One or more ultrasonic cleaning units are required when piercing, and for those tattooing with non-disposable equipment. The following must be submitted for each artist conducting tattooing or piercing: Records of completion of courses or seminars in body art offered by authorities recognized by the board of health as qualified; or Written statement of attestation by individuals offering body art apprenticeship indicating that the person has received sufficient training of adequate duration to completely perform body art services; or Other documentation acceptable to the board of health that pertain to the artist s knowledge of body art procedures. Each of the following must be submitted for each artist performing body art: First Aid certification; and Standard precautions for preventing transmission of blood borne and other infectious diseases.

Body Art Establishment Plan Review Greene County Public Health Date: Type: Tattoo Piercing Both Establishment Information: Name of Establishment: Type of business: Association Corporation Partnership Name every person who has an ownership interest of 5% or more: Occupation of the Operator: Business Address: City State Zip Code Telephone at facility: Owner Information: Owner s Name(s): Home address(s): City State Zip Code Telephone(s): Home Cell Days/Hours of Operation: Plans Submitted To: Building Dept. Fire Dept. Plumbing Division Please list the names of the artists that will be performing body art below:

INFECTION PREVENTION AND CONTROL PLAN In accordance with Ohio Administrative Code 3701-9-04 (N), a body art facility shall maintain and follow a written infection Prevention and Control Plan, provided by the owner specifying procedures to achieve compliance with safe practices. A copy shall be maintained in the body art facility. The body art facility owner shall provide onsite training on the facility s Infection Prevention and Control Plan to the employees. A. Decontamination and Disinfection: Describe the procedures for decontaminating and disinfecting of workstation and surfaces, including the disinfectant products used: 1. Workstation surfaces/counter tops/chairs & stools/ trays B. Set up and tear down of Workstation: Describe the procedure for setting up and tearing down the workstation for the following procedures. Include techniques used to prevent contamination to sterilized items in a peel pack, instruments, tattoo machines, trays, chairs, clip cords, power supplies, squeeze bottles, inks, pigments, lamps, stools and soaps: 1. Tattooing: 2. Permanent Makeup/Micro Blading: 3. Piercing: C. Hand Washing Procedure: Describe when handwashing is required and your procedure for proper handwashing. List what type of gloves will be used by the artist during the procedure: D. Sterilization and decontamination: Tattooing/Piercing/Permanent Make-up: Describe the equipment used and procedure for decontaminating instruments, tubes, and/or needles prior to placing in the autoclave. Indicate whether instruments are manually washed or cleaned in an ultrasonic, and what solutions are used to soak soiled instruments. Decontamination and sterilization shall be conducted in a separate room from the procedure room. A separate sink from the handwashing sink shall be used for decontamination and located in the vicinity of the decontamination area: Piercing: Describe the procedure for sterilization of jewelry prior to placing into newly pierced skin:

E. Sterilization peel packs for new jewelry and reusable instruments, tubes, needles: Describe the procedure for labeling of sterilized peel packs to ensure the date, batch number and/or jewelry manufacturer is properly maintained with the item. Describe how jewelry can be traced back to the manufacturer, and how the Mill Certificate that comes from the manufacturer is maintained: F. Protecting clean and sterile instruments during storage: Describe the location sterilized instruments are stored to protect from environmental contamination: G. Negative/Failed Spore Tests: List the time, temperature and psi the autoclave you will be using requires for sterilization of instruments. (All autoclaves must have a drying cycle) Describe the procedure conducted when a monthly spore test has failed. Include in your procedure the removal of contaminated instruments and tubes in storage, and how to contact clients who may have been affected by the contaminated instruments due to the failed spore test: H. Safe handling and disposal of needles: Describe how you will dispose of needles & needle bars in the facility. List the type of trash receptacles and their location throughout the body art facility. Describe the procedure for the disposal of contaminated gloves, razors, gauze etc. OTHER ITEMS Record keeping: Describe how the information from the peel pack is recorded and maintained on the client s card. Describe where the ink lots and colors are recorded on the patron s card. Indicate where the size, material composition, and manufacturer of the jewelry is placed on the client s card for piercing: You may attach a client record card. Aftercare instructions: Instructions must be given to the client verbally and in writing.