§ 4.12

(7)

The types, proper technique and order of tasks before and after putting on and removing gloves to avoid cross-contamination.

(8)

Activities that compromise a disinfected work area, a sterile procedure site, inks and pigments, sterile instruments and disinfected skin area.

(9)

Choosing, using and storing disinfectants and antiseptics.

(10)

Signs required for contaminated materials and the importance of labeling chemicals and supplies.

(11)

Information on Hepatitis B vaccine, including its efficacy, safety and method of administration.

(12)

What constitutes a bloodborne pathogen exposure incident, including:

a.

How the exposure occurred and what actions are to be taken to prevent or minimize future exposures.

b.

Risk of infection following a bloodborne pathogen exposure incident.

c.

Procedures to be followed after an exposure incident, including medical follow-up.

d.

Opportunity for interactive questions and answers with the instructor.

(Ord. No. 05-012, § 2, 6-7-05)

(a)

Each proprietor shall establish, maintain and follow, at each body art facility, a written Infection Prevention and Control Plan.

(b)

The Infection Prevention and Control Plan shall include, at a minimum, the following:

(1)

Procedures for cleaning and disinfection of surfaces in the preparation and procedure areas.

(2)

Procedures for maintaining the sterility or integrity of instruments, equipment and other material used during tattooing, body piercing, or permanent cosmetics.

(3)

Procedures for cleaning, packaging, sterilizing, and storing reusable instruments, and equipment.

(4)

Procedures for safe handling and disposal of sharps waste.

(5)

Inventory (names, manufacturers, container size) of all chemicals and disinfectants and their intended use.

(c)

The Infection Prevention and Control Plan shall be revised by the proprietor whenever changes in practices or procedures are made.

(d)

The proprietor shall be responsible for ensuring that the Infection Prevention and Control Plan is followed.

(Ord. No. 05-012, § 3, 6-7-05)

(a)

The health permit shall be posted in a conspicuous place in the lobby of the body art facility.

(b)

Body art facilities shall not be used as a food establishment, for human habitation or any other use which may cause contamination of instruments or equipment used for body art activities.

(c)

The floors, furnishings and equipment of body art facilities shall be kept clean at all times during business hours.

(d)

Adequate lighting and ventilation shall be provided in the preparation and procedure areas.

(e)

Adequate toilet facilities shall be available. Toilet rooms and bathrooms shall not be used for the storage of instruments, or other supplies used for body art activities.

(f)

Rooms used for tattooing, body piercing or permanent cosmetic procedures shall be separated by a wall or partition from those areas used for nail, hair and other activities.

(g)

All sinks shall be supplied with hot (110°F minimum) and cold running water.

(h)

A sink that is readily accessible to the body art practitioner shall be provided and equipped with liquid soap and single use paper towels dispensed from wall-mounted dispensers that protect the supply from contamination.

(i)

Pets or other animals shall not be allowed in the body art facility, except for trained guide or assistance animals for the disabled. No trained guide or assistance animal shall be allowed in the procedure or preparation area.

(j)

No person shall utilize or maintain in a body art facility body art equipment that does not comply with the requirements of this division, unless that equipment is maintained in an appropriately secure viewing area maintained for historical purposes only.

(k)

The proprietor shall maintain the body art facility and the general premises under the control of the proprietor in a clean and sanitary manner.

(l)

All solid surfaces and objects in the procedure area and preparation area shall be immediately cleaned and disinfected after each use with an appropriate bleach solution or other Environmental Protection Agency (EPA) registered disinfectant that is labeled as tuberculocidal. Manufacturer's instructions for concentration, contact time, and disposal requirements for all disinfectants must be observed.

(m)

The practitioner shall wear disposable gloves on both hands when touching, cleaning or handling a surface or object soiled or potentially soiled with blood. Disposable gloves worn by the body art practitioner shall be promptly removed, and hands immediately washed whenever the practitioner leaves a procedure or preparation area.

(n)

Each procedure and preparation area shall have waste receptacles, which are lined with plastic bags manufactured for use in waste containers that fold over the top margin of the waste container.

(Ord. No. 05-012, § 4, 6-7-05)

The provisions of this division are intended to supplement applicable state law and to be in addition to, and not in conflict with such laws. Each provision shall remain in effect until the enactment of state laws or the promulgation of state regulations that conflict with or otherwise preempt the authority of the County of Orange to control the conduct described in this division.

(Ord. No. 05-012, § 5, 6-7-05)

(a)

Instruments that pierce the skin or touch non-intact skin that will be reused shall be cleaned, packaged in appropriately labeled sterilizer pouches and sterilized prior to reuse.

(b)

Used instruments that will be sterilized and reused shall be placed in a container of clean water until cleaned and sterilized. Used instruments must be kept physically separated from sterilized or unused disposable instruments. Disposable instruments must be disposed of directly into a sharps container or into the appropriate trash receptacle after use.

(c)

Ultrasonic cleaners, if used, shall be maintained and operated according to manufacturer's instructions.

(d)

If an ultrasonic cleaner is not available, instruments shall be cleaned and disinfected manually by scrubbing with a brush and a disinfectant used according to manufacturer's instructions.

(e)

Clean instruments to be sterilized shall be first placed in sterilizer pouches that contain either a sterilizer indicator or internal temperature indicator. Each pack shall contain instruments for not more than one client. The outside of the pack shall be labeled with the name of the instrument, date sterilized and initials of the person operating the equipment.

(f)

Instruments must be repackaged and re-sterilized if the pouch is torn or otherwise compromised, if the indicator shows that adequate temperature was not reached or if the item is not used within 6 months of the date of sterilization.

(g)

Sterilized instruments must be maintained and stored in sterilized pouches until use.

(h)

Sterilizers shall be operated according to manufacturer's instructions. If manufacturer's instructions cannot be obtained, steam sterilization shall be accomplished in an autoclave with at least 15 pounds of pressure per square inch at a temperature of 250 degrees Fahrenheit for at least 30 minutes or as instructed by the local Health Officer should the standards for sterilization change from time to time.

(i)

Liquid sterilants shall not be used to sterilize instruments.

(j)

Sterilized instruments shall be placed in clean, dry, labeled containers or stored in a labeled cabinet that is protected from dust and water contamination.

(k)

Sterilization equipment shall meet the following requirements:

(1)

Only sterilizers intended for medical instruments shall be used. Sterilization equipment shall be cleaned, and maintained according to manufacturer's instructions.

(2)

Sterilization equipment shall be tested after the initial installation, after any major repair, and at the frequency recommended by the manufacturer. If no manufacturer's recommendation can be found, then the unit shall be tested at least weekly utilizing a biological monitoring system appropriate for the sterilizer type.

(3)

Biological indicator test results shall be maintained on site and available for review for a period of two years subsequent to the date of the results.

(l)

A written log of each sterilization cycle shall be maintained on-site and available for review for a period of two years, and shall include the following information:

(1)

Date of load.

(2)

The contents of the load.

(3)

The exposure time and temperature.

(4)

The results of the chemical indicator.

(Ord. No. 05-012, § 6, 6-7-05)

(a)

A practitioner using only purchased, disposable, single use and pre-sterilized instruments shall not be required to have sterilization equipment.

(b)

Invoices for the purchase of all pre-sterilized instruments must be maintained onsite and available for review for a period of two years after purchase. Required invoices include but are not limited to combo couplers, needle chambers, barrels, casings, tips and needles.

(Ord. No. 05-012, § 7, 6-7-05)

(a)

No body art procedures shall be performed on skin surface areas containing any rash, pimples, boils, or infection or otherwise manifesting any evidence of unhealthy conditions including but not limited to any evidence of inflammation, such as redness, swelling, infection, or open or draining lesions.

(b)

Prior to receiving a tattoo, body piercing, or permanent cosmetics, the client shall read, sign and receive a copy of an informed consent form and post-procedure instructions appropriate to the procedure.

(c)

A copy of the signed informed consent form and post procedure instructions for all body art procedures must be maintained onsite and available for review for a period of two years after the procedure is performed.

(d)

The consent form and post-procedure instructions shall include at a minimum, the following:

(1)

Record of information from the client's picture identification showing the name, date of birth, gender, address of client, and driver's license or identification card number.

(2)

A summary, including the date, location and description of the procedure.

(3)

What to expect following the procedure, including any medical complications that may occur as a result of the procedure.

(4)

A statement regarding the permanent nature of body piercing, tattooing or permanent cosmetics.

(5)

A questionnaire regarding a client history of herpes, diabetes, allergic reactions to latex or antibiotics, hemophilia or any other bleeding disorder or the use of anticoagulants, which might affect the healing of the tattoo, and of cardiac valve disease or of being prescribed antibiotics prior to dental or surgical procedures.

(6)

Post-procedure instructions on the care of the site of the tattoo, body piercing or permanent cosmetics.

(7)

Post-procedure restrictions on activities such as bathing, swimming, gardening or contact with animals.

(8)

Information regarding signs and symptoms of infection and to immediately consult a physician if any of the listed signs and symptoms of infection occur.

(Ord. No. 05-012, § 8, 6-7-05)

(a)

No body art operations shall be performed unless the practitioner is free of pustular skin lesions and any communicable diseases that could be transmitted in the normal practice of body art.

(b)

No practitioner shall eat, drink or smoke while performing a body art procedure.

(c)

No practitioner shall perform a body art procedure with unclean hands. For purposes of this section, hands shall not be considered clean unless they have been thoroughly washed with soap from a single service dispenser and warm water vigorously rubbing all surfaces of lathered hands for at least ten (10) seconds, followed by thorough rinsing under a stream of water. Hands shall be dried using single service towels from a sanitary dispenser or hot air blower. Practitioners shall wear new, disposable exam gloves for every client

during the procedure. Gloves shall be discarded between each client, and hands shall be washed each time gloves are changed. If a glove is pierced, torn, or contaminated by coming into contact with any other person, or contaminated surface, both gloves shall be removed and discarded. A single pair of gloves shall not be used on more than one person.

(Ord. No. 05-012, § 9, 6-7-05)

No body art operation shall be performed unless the skin is adequately prepared prior to the operation. For purposes of this section, skin shall be considered properly prepared if it is thoroughly cleaned with an antiseptic according to manufacturer's instructions. If necessary, the skin shall be shaved with a new, single use disposable razor.

(Ord. No. 05-012, § 10, 6-7-05)

(a)

All inks, pigments, petroleum jellies, soaps, and other reusable products used in a procedure shall be dispensed from containers in a manner to prevent contamination of the original container and its contents.

(b)

Pigments shall be placed into clean single use cups or caps that shall be disposed of immediately upon completion of the procedure.

(c)

Single-use rinse cups shall be disposed of immediately upon completion of the procedure.

(d)

Reusable rinse cups shall be cleaned and disinfected upon completion of the procedure.

(e)

All inks, dyes or pigments used shall be commercially manufactured for the procedure and shall be used according to manufacturer's instructions.

(f)

All products applied to the skin including stencils shall be single use and disposed into a waste receptacle after the procedure.

(g)

Needles and needle bars shall be sterilized prior to tattooing or shall be purchased pre-sterilized. Needles shall be used only once and then disposed of. When the needle bar is to be reused the used needles shall be either carefully removed from the needle bar to reduce the risk of needle stick injury to the practitioner

and disposed of in a sharps container, or the needle bar and needles shall be first cleaned by soaking in a disinfectant and cleaning with a brush or cleaning in an ultrasonic cleaner, and then the needles removed from the needle bar and disposed of in a sharps container.

(h)

If a rotary pen, or traditional coil machine that reuses components is used, then the use of sterilization equipment shall be required for sterilization of the reusable parts that make contact with the client or blood.

(i)

All rotary pens and other devices used to apply pigments must be designed and used to prevent backflow of pigments into the machine.

(Ord. No. 05-012, § 11, 6-7-05)

(a)

All jewelry or other objects to be placed in newly pierced skin shall be sterilized, or purchased pre- sterilized, be in good condition, and be designed and manufactured for insertion into the intended body part.

(b)

Only jewelry or other objects made of implant grade stainless steel, solid 14K through 24K gold, niobium, titanium, platinum or other materials determined to be equally bio-compatible shall be placed in newly pierced skin.

(Ord. No. 05-012, § 12, 6-7-05)

(a)

Each procedure area shall have a container for the disposal of sharps waste that is rigid, puncture resistant, leak proof and that is closeable and sealable so that when sealed, the container cannot be reopened without great difficulty. The container must be labeled with the words "sharps waste" or with the international biohazard symbol and the word "BIOHAZARD."

(b)

All sharps waste produced during the process of tattooing, body piercing and permanent cosmetics shall be disposed of by one of the following methods:

(1)

Steam sterilized on-site and disposed of as solid waste. If this method is utilized, a chemical indicator strip or tape that indicates that the container has been treated must be affixed prior to sterilization, and shall

stay affixed to the container when it is disposed.

(2)

Treated on-site by a method approved by the Health Officer, and disposed of as solid waste.

(3)

Removal and disposal through use of a Registered Medical Waste Hauler in accordance with the provisions of the California Medical Waste Management Act. Tracking documents must be maintained on-site and be available for review for a period of two years from the date of removal from the body art facility.

(Ord. No. 05-012, § 13, 6-7-05)

A practitioner may practice, for no more than seven (7) days in a ninety-day period, in a temporary booth that:

(a)

Is constructed with a barrier or partition at least three (3) feet high separating the procedure area from the public.

(b)

Has adequate light where the practitioner is performing tattooing, body piercing or the application of permanent cosmetics.

(c)

Is equipped with hand washing equipment that, at a minimum consists of liquid soap, single use paper towels, and a container of potable water with a spigot and a closeable container to catch the wastewater. The potable water container shall be filled regularly to ensure an adequate supply of water for hand washing.

(d)

Either utilizes only purchased pre-sterilized instruments, or sterilization equipment that is accessible by means of a centrally located autoclave that any body art practitioner may use or an individual autoclave at the booth.

(e)

Temporary body art facilities are exempt from the provisions of Sections 4-12-2 and 4-12-3.

(Ord. No. 05-012, § 14, 6-7-05)

In addition to the permit issued for each body art temporary booth, the person or organization that is in control of any event at which two (2) or more temporary booths operate shall obtain a permit. This permit shall specify all the areas and facilities at the event site to be utilized by the temporary booths and the responsibilities of the person or organization issued the permit, including but not limited to ensuring compliance with this division by the temporary booths at the event. The person or organization in control of or sponsoring the event shall submit a permit application and a site plan to the Health Officer at least two (2) weeks prior to the event. The site plan shall show the proposed locations of the temporary booths, restrooms, and all shared equipment such as autoclaves.

(Ord. No. 05-012, § 15, 6-7-05)

A practitioner may practice in a vehicle if:

(a)

The vehicle is equipped with a restroom that has a working sink supplied with warm running water for hand washing and is supplied with liquid soap and single use paper towels in dispensers which protect the supply from contamination. If the vehicle does not have a restroom, the vehicle must be located within 200 feet of a public restroom that meets these standards at all times that any practitioner is working with clients.

(b)

All liquid wastes are stored in a storage tank and discharged into the sewer as necessary.

(c)

The vehicle is used exclusively for performing tattooing, body piercing or the application of permanent cosmetics. No habitation or cooking shall be permitted within the vehicle.

(d)

All other requirements as delineated in this division including but not limited to sharps disposal, disinfection and training are also met.

(Ord. No. 05-012, § 16, 6-7-05)

The Health Officer or his or her designee is charged with the enforcement of this division, except for Sections 4-12-22, 4-12-23 and 4-12-24. The Sheriff and Code Enforcement Officer are also authorized to enforce this ordinance. The Health Officer may, during the establishment's hours of operation and other reasonable times, enter, inspect, search and secure samples, photographs, or other evidence from any body art facility, or any location suspected of being a body art facility, for the purpose of enforcing this division. It is a violation of this division for any person to refuse to permit entry or inspection, the taking of samples or other evidence, or access to the facility in order to copy any record as authorized by this division, or to conceal any samples or evidence, or withhold evidence concerning them. A written report of

the inspection shall be made and a copy shall be supplied or mailed to the proprietor or practitioner of the body art facility.

(Ord. No. 05-012, § 17, 6-7-05)

(a)

Every practitioner as defined in this division shall register with the County Health Department and shall have on display so as to be readily visible to the public proof that shows that the practitioner has registered, as specified in Health and Safety Code Section 119303.

(b)

Registration of all practitioners is required every three years.

(Ord. No. 05-012, § 18, 6-7-05)

A body art facility, temporary booth, or mobile site shall not be open for business without a valid health permit. The Health Officer shall issue a health permit when inspection has determined that the proposed body art facility and its method of operation will conform to the requirements of this division. A health permit, once issued, is nontransferable. A health permit shall be valid only for the proprietor and location approved. The Board of Supervisors shall adopt fees for the health permit, practitioner registration, and related services. Fees shall be sufficient to cover the actual expenses of administering and enforcing this program.

(Ord. No. 05-012, § 19, 6-7-05)

Violation of any section of this division by the proprietor or practitioner shall constitute a misdemeanor and upon conviction thereof shall be punishable by a fine not to exceed one thousand dollars ($1,000.00) per day per violation or by imprisonment in the county jail for a term not exceeding six (6) months, or both such fine and imprisonment. Each day the violation continues and is not corrected shall be a treated as a separate and distinct violation.

(Ord. No. 05-012, § 20, 6-7-05)

(a)

Whenever the Health Officer finds that a body art facility is not in compliance with the requirements of this division, a written inspection notice shall be issued to the proprietor. If the proprietor fails to comply, the Health Officer shall issue to the proprietor, a notice of violation setting forth the acts or omissions with which the proprietor is charged. Failure to comply with the Notice of Violation within the noted timeframe may result in permit suspension.

(b)

If any immediate danger to the public health or safety is found, unless the danger is immediately corrected, the Health Officer may temporarily suspend the permit and order the body art facility immediately closed. Immediate danger means any condition, based upon inspection findings or other evidence that may cause disease transmission, including, but not limited to:

(1)

Inadequate sterilization of equipment;

(2)

Sewage contamination;

(3)

Lack of potable water supply;

(4)

Or any other condition, which in the opinion of the Health Officer, causes immediate danger to public health and safety and requires temporary suspension as noted above.

(c)

Whenever a health permit is suspended as the result of an immediate danger to the public health or safety, the Health Officer shall issue to the proprietor a notice setting forth the acts or omissions with which the proprietor is charged.

(d)

Any body art facility for which the health permit has been suspended shall close and remain closed until the health permit has been reinstated.

(e)

Where grounds for denial, suspension, nonrenewal or revocation of a permit exist, the Sheriff, Health Officer or Code Enforcement Officer shall serve the applicant or permit holder with a notice which shall state the reasons for the proposed action, the effective date of the action, and of the right to appeal the action.

(f)

Appeal shall be made by filing a written notice of appeal setting out the action appealed from, the grounds of the appeal and the facts upon which the appeal is based. The notice of appeal shall be filed with the Clerk of the Board of Supervisors not more than thirty (30) days after service of the notice of proposed action. A copy of the notice appealed from shall be attached to the notice of appeal. Notice of the date, time, and place of the hearing on the appeal shall be mailed at least ten (10) days prior to the date of the hearing by certified mail, return receipt requested, with proof of service attached, addressed to the address on the permit.

(g)

Hearing on the appeal shall be conducted by a Hearing Officer who shall preside over the hearing, take evidence on the appeal and determine whether, on the basis of a preponderance of the evidence, the appealed action shall be upheld. The Hearing Officer shall render a written decision not less than forty-five (45) days after the date of the appeal hearing. The decision of the Hearing Officer shall be final.

(Ord. No. 05-012, § 21, 6-7-05)