BILL NUMBER: AB 517AMENDED BILL TEXT AMENDED IN SENATE JULY 2, 2009 AMENDED IN ASSEMBLY APRIL 13, 2009 INTRODUCED BY Assembly Member Ma FEBRUARY 24, 2009 An act to repeal and add Chapter 7 (commencing with Section 119300) of Part 15 of Division 104 of the Health and Safety Code, relating to body art. LEGISLATIVE COUNSEL'S DIGEST AB 517, as amended, Ma. Safe Body Art Act. Under existing law, every person engaged in the business of tattooing, body piercing, or permanent cosmetics is required to register with the county in which that business is conducted, obtain a copy of the county's sterilization, sanitation, and safety standards, as established by the California Conference of Local Health Officers and distributed by the State Department of Public Health, as specified, and pay a one-time registration fee of $25. Existing law allows the county to charge an additional fee if necessary to cover the cost of registration and inspection and allows a county to adopt regulations that do not conflict with, or are more comprehensive than, standards adopted by the department. Under existing law, a person who fails to register or who violates the sterilization, sanitation, and safety standards is liable for a civil penalty of up to $500, to be collected in an action brought by the prosecuting attorney of the county or city and county in which the violation occurred. This bill would repeal these provisions and, instead, enact the Safe Body Art Act. The act wouldrequire all practitioners who performprohibit a person from performing body art, as defined,to registerafter June 1, 2010, without registering with the county local enforcement agency,. The bill would require practitioners to comply with specified requirements, including, among other things, client information and questionnaires, vaccination, bloodborne pathogen training, and sanitation. The bill would also require the owner of a body art facility, as defined, to obtain a health permit from the county local enforcement agency, as specified, and to maintain the body art facility in a specified manner. This bill would exempt from the definition of body art the piercing of an ear with a disposable, single-use, presterilized stud or solid needle that is applied using a mechanical device to force the needle or stud through the ear but would impose specified regulations on that practice. The bill would allow the county to set the fee amount for registration at an amount sufficient to cover the actual costs of administering the program. This bill would regulate the performance of body art in vehicles, temporary booths, and at body art events and would require a person sponsoring a body art event to obtain a permit and fulfill specified requirements. The bill would allow inspection by an enforcement officer, and would provide for the suspension or revocation of a certificate of registration or a health permit in specified circumstances. The bill would make performing body art without being registered, operation of a body art facility without a health permit, or operation of a temporary body art event without a permit a misdemeanor and would allow the local enforcement agency to assess an administrative penalty, in an amount not less than $25 and not more than $1,000 for violating a provision of the chapter. This bill would allow a city, county, or city and county to adopt regulations or ordinances that do not conflict with, or are morecomprehensivestringent than, the provisions of the act as those p rovisions relate to body art .The bill would specify that a regulation or ordinance enacted by a local jurisdiction that conflicts with the provisions of the bill would remain in effect, to the exclusion of the conflicting provision, until January 1, 2012.Because this bill would place the inspection and enforcement requirements on local governments and because it creates a new crime, it would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for specified reasons. Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Chapter 7 (commencing with Section 119300) of Part 15 of Division 104 of the Health and Safety Code is repealed. SEC. 2. Chapter 7 (commencing with Section 119300) is added to Part 15 of Division 104 of the Health and Safety Code, to read: CHAPTER 7. BODY ART Article 1. General Provisions 119300. (a) This chapter shall be known, and may be cited, as the Safe Body Art Act. (b) The purpose of this chapter is to provide minimum statewide standards for the regulation of persons engaged in the business of tattooing, body piercing, and the application of permanent cosmetics in California. These requirements are intended to protect both the practitioner and the client from transmission of infectious diseases through the application of proper body art procedures and the control of cross-contamination of instruments and supplies. 119301. For purposes of this chapter, the following definitions shall apply: (a) "Antiseptic solution" means a liquid or semiliquid substance that is approved by the federal Food and Drug Administration, as indicated on the label,to reduce the number of microorganisms present on the skin and on mucosal surfaces. (b) "Bloodborne pathogen" meansa disease causingdisease-causing microorganism that, when present in the blood, can be transmitted to humans, including, but not limited to, hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). (c) "Body art" means body piercing, tattooing, or application of permanent cosmetics. (d) "Body art facility" means the specified building, section of a building, or vehicle in which a practitioner performs body art, including reception areas, the procedure area, and the cleaning and sterilization area. "Body art facility" does not include a facility that only pierces theearlobeear with a disposable, single-use , presterilized clasp and stud or solid needle that is applied using a mechanical device to force the needle or stud through the ear. (e) "Body piercing" means the creation of an opening in the body of a human being for the purpose of inserting jewelry or other decoration. "Body piercing" includes, but is not limited to, piercing of an ear, lip, tongue, nose, or eyebrow. "Body piercing" does not include piercing anearlobeear with a disposable, single-use , presterilized stud or solid needle that is applied using a mechanical device to force the needle or stud through the ear. (f) "Cleaning and sterilization area" means a room, or specific section of a room, that is set apart and used only tocleandecontaminate and sterilize instruments. (g) "Client" means any individual upon whom a practitioner performs body art. (h) "Department" means the State Department of Public Health. (i) "Decontamination" means the use of physical or chemical means to remove, inactivate, or destroy bloodborne pathogens on a surface or item to the point where the pathogens are no longer capable of transmitting infectious particles and the surface or item is rendered safe for handling, use, or disposal. (j) "Disinfectant" means a hospital tuberculocidal product or hospital product that is registered by the federal Environmental Protection Agency and labeled as effective against human immunodeficiancy virus (HIV) and hepatitis B virus (HBV) for use in decontaminating work surfaces. (k) "Enforcement officer" means all local health officers, directors of environmental health, and duly authorized environmental health specialists and environmental health specialist trainees. (l) "Hand hygiene" means either of the following: (1) Washing all surfaces of the hands and fingers with soap and warm water. (2) In the absence of contamination with blood or other body fluids, or obvious soiling, rubbing all the surfaces of the hands and fingers with an antiseptic solution. (m) "Instrument" means any nonmedical tattooing, body piercing, or permanent cosmetics application device, including, but not limited to, needles, needle bars, needle tubes, forceps, hemostats, tweezers, razors, or razor blades, that is used to insert pigment into, or pierce the skin or mucosal surfaces of, the humanbody or that otherwise comes into contact with intact skin, nonintact skin, or mucosal surfaces.body. (n) "Local enforcement agency" means the local health agency of the county, city, or city and county. In jurisdictions where the local health agency and the environmental health agency are separate departments, the jurisdiction shall specify which entity will be the local enforcement agency for purposes of this chapter. (o) "Mucosal surface" means the moisture-secreting membrane lining of all body cavities or passages that communicates with the exterior, including, but not limited to, the nose, mouth, vagina, and urethra. (p) "Owner" means either of the following: (1) The person or persons whose name or names appears on the health permit, business license, property deed, or rental agreement of the body art facility. (2) A person, acting as a principal of a corporation or partnership, who employs practitioners to perform body art or any other activity regulated by this chapter. (q) "Permanent cosmetics" means the application of pigmentsunderin the skin of a human being for the purpose of permanently changing the color or other appearance of the skin. This includes, but is not limited to, permanent eyeliner, eyebrow, or lip color. (r) "Potable water" means water that complies with the standards for transient noncommunity water systems pursuant to the California Safe Drinking Water Act (Chapter 4 (commencing with Section 116275) of Part 12). (s) "Practitioner" means a person who performs body art on a client. (t) "Procedure area" means a room, or designated portion of a room, that is set apart and only used to perform body art. (u) "Procedure site" means the area or location on the human body selected for the placement of body art. (v) "Sharps waste" means any object or device having acute rigid corners, edges, or protuberances capable of putting or piercing, including, but not limited to, tattooing needles and needle bars, piercing needles, or razors. (w) "Sterilization" means the complete destruction of all microbial life forms, including spores. (x) "Tattooing" means the insertion of pigment under the surface of the skin of a human being, by pricking with a needle or otherwise, to produce an indelible mark or figure visible through the skin. (y) "Workstation" means the area within a procedure area where a practitioner performs body art. The workstation includes, but is not limited to, the client chair or table, counter, mayo stand, instrument tray, storage drawer, and practitioner's chair. Article 2. Restrictions on the Performance of Body Art 119302. (a) Pursuant to Section 653 of the Penal Code, a client shall be at least 18 years of age to be offered or to receive a tattoo or permanent cosmetics application, regardless of parental consent. (b) Pursuant to Section 652 of the Penal Code, persons under 18 years of age shall not be offered or receive a body piercing or earlobe piercing unless the piercing is performed in the presence of, or as directed by a notarized writing by, his or her parent or guardian. (c) The branding, piercing, tattooing, or application of permanent cosmetics to the nipples or genitals of a minor is prohibited. The appl ication of permanent cosmetics to the nipples of a minor is authorized when applied by a registered permanent cosmetic technician with the consent of the minor's parent or guardian and as directed by a physician.(d) Clearance is required, in writing from a physician and surgeon licensed under Chapter 5 (commencing with Section 2000) of Division 2 of the Business and Professions Code, prior to the performance of body art, if the client has received a recommendation from a physician and surgeon that he or she receive antibiotics prior to dental or surgical procedures.119303. (a) Prior to the performance of body art, the client shall read, complete, and sign an informed consent form that shall include, but not be limited to, all of the following information: (1) A description of the procedure. (2) A description of what the client should expect following the procedure, including suggested care and any medical complications that may occur as a result of the procedure. (3) A statement regarding the permanent nature of body art. (4) Postprocedure instructions that include all of the following: (A) Information on the care of the procedure site. (B) Restrictions on physical activities such as bathing, recreational water activities, gardening, or contact with animals, and the duration of the restrictions. (C) Signs and symptoms of infection, including, but not limited to, redness, swelling, tenderness of the procedure site, red streaks going from the procedure site towards the heart, elevated body temperaturegreater than 99.6*F, or, or purulent drainage from the procedure site. (D) Signs and symptoms that indicate the need to seek medical care. (b) Prior to the performance of body art, the client shall receive, complete, and sign a questionnaire that includes all of the following information: (1) Whether the client may be pregnant. (2) Whether the client has a history of herpes infection at the proposed procedure site, diabetes, allergic reactions to latex or antibiotics, hemophilia or any other bleeding disorder, or cardiac valve disease. (3) Whether the client has a history of medication use or is currently using medication, including being prescribed antibiotics prior to dental or surgical procedures. (4) Any other risk factors for bloodborne pathogen exposure. 119304. The piercing of theearlobeear that does not constitute bodypiercingart shall be subject to the following requirements: (a) A site at whichearlobeear piercing is conducted shall be safe and sanitary and not constitute a threat to public health and safety as determined by the local enforcement agency. (b) A site at whichearlobeear piercing is conducted shall be registered with the local enforcement agency in whose jurisdiction the site is located. (c) A person performingearlobeear piercing shall meet the following requirements before providing services to the public: (1) Be 18 years of age or older. (2) Receive training on how to use the ear piercing device. (3) Receive a minimum of one hour of training on types of bloodborne pathogens and other communicable diseases, the modes of transmission, and methods to control exposure. (4) Receive training on proper hand hygiene and the use of single-use equipment, including, but not limited to, gloves, towels, and disinfectant wipes. (d) The part of the mechanical ear stud device that contacts the skin shall be single use or shall be sterilized after each client.(e) All studs or jewelry used in earlobe piercing shall meet all applicable body piercing jewelry requirements.(e) A single-use, presterilized clasp and stud used in ear piercing pursuant to this section shall meet all applicable jewelry requirements in subdivisions (a) and (b) of Section 119310. 119305. This chapter does not restrict the activities of any physician and surgeon licensed under Chapter 5 (commencing with Section 2000) of Division 2 of the Business and Professions Code. Nothing in this chapter authorizes a practitioner to perform activities that are restricted under Chapter 5 (commencing with Section 2000) of Division 2 of the Business and Professions Code. Article 3. Practitioner Registration119306. (a) No later than June 1, 2010, every practitioner shall register with the local enforcement agency. Commencing April119306. (a) Commencing January 1, 2010, a person shall not perform body art if he or she is not registered with the local enforcement agency. (b) As a condition of registration, the applicant shall provide all of the following: (1) Evidence of current hepatitis B vaccination, including applicable boosters, unless the practitioner can demonstrate hepatitis B immunity or has complied with current federal OSHA hepatitis B vaccination declination requirements . (2) Evidence of completion of OSHA Bloodborne Pathogen Training consistent with Section 119307 and pursuant to paragraph (2) of subdivision (g) of Section 5193 of Title 8 of the California Code of Regulations or its successor. (3) Evidence of completion of a four-hour first aid and CPR training course approved by the local enforcement agency. (4) Proof that he or she is 18 years of age or older. (5) Self-certification of, knowledge of, and commitment to meet state law and relevant local regulations pertaining to body art safety. (6) His or her business address and the address at which he or she will perform any activity regulated by this chapter. (7) Payment of a registration fee directly to the local enforcement agency. The local enforcement agency shall set the fee at an amount sufficient to cover the actual costs of administering the program. (c) A practitioner shall display, in a place readily visible to the public at the body art facility where the practitioner is performing body art, the certificate confirming registration with the local enforcement agency in the jurisdiction in which that practice is conducted. (d) A valid and current registration issued by a local enforcement agency shall be valid in any other jurisdiction for no more than five consecutive days, or 15 days total, in any one calendar year. 119307. (a) Prior to registering with the local enforcement agency, a practitioner shall complete a Bloodborne Pathogens Exposure Control Training program that is specific to his or her practice. (b) An owner shall provide Bloodborne Pathogens Exposure Control Training pursuant to the requirements of paragraph (2) of subdivision (g) of Section 5193 of Title 8 of the California Code of Regulations, or its successor, for all employees, contractors, and volunteers who perform duties within the cleaning and sterilization area or procedure area. (c) The Bloodborne Pathogens Exposure Control Training shall meet all of the following criteria: (1) Training shall be conducted by a person or persons who are knowledgeable in exposure control and infection prevention in the body art setting and who have a minimum of five years of experience in performing body art and have successfully completed a Bloodborne Pathogens Exposure Control Training course. (2) Training and training materials shall be specific to performing body art. (3) Training and training materials shall be in the primary language of the trainee. (4) Training and training materials shall be provided at the grade 10 vocabulary level or lower. (5) Training shall consist of not less than eight hours of classroom training that includes all of the following: (A) A copy and explanation of the California Occupational Safety and Health Administration Bloodborne Pathogens Standard contained in Section 5193 of Title 8 of the California Code of Regulations, or its successor. (B) A copy and explanation of Subchapter 11 of Title 17 of the California Code of Regulations. (C) A copy and explanation of applicable county or city ordinances that pertain to bloodborne pathogen transmission control in body art. (D) Discussion of transmission, control, and symptoms of the diseases caused by bloodborne pathogens. (E) Discussion of tasks involved in performing body art and how those tasks may lead to exposure to bloodborne pathogens for the client or practitioner. (F) Discussion of the types and uses of personal protective equipment, such as disposable gloves, including an explanation of the limitations of the equipment. (G) Discussion of the types of tasks, proper task technique, and order of tasks before and after putting on and removing personal protective equipment, to avoid contamination. (H) Discussion of the importance of hand hygiene and a demonstration of proper hand hygiene techniques. (I) Discussion of choice, use, and storage of disinfectants and antiseptics. (J) Information on the signage required for biohazard materials and the importance of properly labeling chemicals and supplies. (K) Information on hepatitis B vaccine, including safety and accessibility. (L) Discussion of what constitutes a bloodborne pathogen exposure incident, including all of the following: (i) Examples of bloodborne pathogen exposure, how the exposure occurred, and what actions to take to prevent or minimize future exposures. (ii) Risk of infection following a bloodborne pathogen exposure incident. (iii) Procedures to be followed after an exposure incident, including medical followup. (M) Opportunities for interactive questions and answers with the instructor. (d) Each person required to complete a Bloodborne Pathogens Exposure Control Training program pursuant to this section shall annually complete a minimum of two hours of Bloodborne Pathogens Exposure Control Training update presented by a local enforcement agency approved trainer. (e) Records of training required pursuant to this section shall be maintained for three years and shall be available for inspection upon request of the enforcement officer. 119308. (a) Before performing body art, the practitioner shall do all of the following: (1) Wash his or her hands as follows: (A) Rinse his or her hands under running water. (B) Lather his or her hands with soap and use friction to clean all surfaces of the hands and fingers for at least 15 seconds and re-rinse his or her hands under running water to completely remove soap. (C) Dry his or her hands thoroughly with a single-use towel. (D) Turn off the tap by using a towel or by elbow- or foot-operated taps. (2) Put on a clean apron, bib, or lap pad over clean, dry clothing. (3) Put on personal protective equipment that is appropriate for the task. (4) Don clean, previously unused, disposable examination gloves on both hands just prior to the procedure. Gloves shall be worn throughout the procedure. If gloves come into contact with any object or surface other than the client's prepared skin or material to be used for the procedure, or if a glove is torn or punctured, both gloves shall be removed, hand hygiene performed, and new, clean, previously unused, disposable examination gloves shall be donned. If gloves are removed for any reason during a procedure, hand hygiene shall be performed prior to donning new, clean, previously unused, disposable examination gloves. (5) If the skin at the procedure site is to be shaved, the skin shall be first washed with soap and water. A single-use, disposable razor shall be used to shave the procedure site and then discarded into a sharps container. (6) Immediately prior to performing the body art, the client's skin shall be prepared with an antiseptic solution, antimicrobial, or microbicide, according to manufacturer's instructions, or with 70 percent isopropyl alcohol applied with a folded paper towel, cotton ball, gauze, or swab using a circular motion, gradually increasing the size of the circle until the entire procedure site is cleaned. The item used for application shall be discarded after use. (b) At the completion of the procedure, the practitioner shall do all of the following: (1) Answer questions regarding the procedure site. (2) Provide postprocedure instructions. (3) Place all used or discarded sharps waste in a sharps waste container. (4) Wash and disinfect reusable instruments as provided in subdivisions (d) and (e) of Section 119309. (5) Package and sterilize reusable instruments that may have come in contact with nonintact skin or mucosal surfaces. (6) Decontaminate the workstation and procedure area. 119309. (a) The practitioner shall maintain a clean and sanitary environment. (b) All solid surfaces and objects in the procedure area and the cleaning and sterilization area that have come into contact with the client or the materials used in performing the body art, including, but not limited to, chairs, armrests, tables, countertops, and trays, shall be immediately decontaminated after each use and then disinfected by application of either of the following: (1) A disinfectant, used according to manufacturer's directions. (2) A proprietary hypochlorite product, registered with the federal Environmental Protection Agency and used according to the manufacturer's directions, or a 1:100 dilution of hypochlorite, prepared by mixing one part household bleach with 100 parts water, mixed within the past 24 hours. If the dilution of hypochlorite is used, the solution shall be left on the surface for 10 to 20 minutes before rinsing with water. (c) The surfaces and objects in the procedure area shall be disinfected again before use if the area has been used for any activity following its previous disinfection. (d) The practitioner shall wear disposable gloves on both hands when touching, cleaning, or handling a surface, object, instrument, or jewelry that is soiled or that is potentially soiled with human blood. (e) Any instrument or other reusable item that comes into contact with nonintact skin or mucosal surfaces shall either be single use or be washed, disinfected, packaged, and sterilized after each procedure. Sterilization shall be accomplished pursuant to the procedures established in Section 119315 by steam autoclave. (f) An instrument or reusable item that does not come into contact with nonintact skin or mucosal surfaces shall be washed with a solution of soap and water, using a brush that is small enough to clean the interior surfaces, and decontaminated after each procedure. (g) A reusable item that cannot be immediately washed, disinfected, and sterilized following completion of the body art procedure shall be placed in a basin of water with or without detergent. (h) Sterile instrument packs shall be evaluated before use, and if the integrity of a pack is compromised in any way, including, but not limited to, being torn, punctured, wet, or having evidence of potential moisture contamination, the instrument pack shall be discarded or reprocessed before use. (i) No food, drink, tobacco product, or personal effects are permitted in the procedure area. The practitioner shall not eat, drink, or smoke while performing a procedure. If a client requests to eat, drink, or smoke, the procedure shall be stopped and the procedure site shall be protected from possible contamination while the client leaves the procedure area to eat, drink, or smoke. 119310. (a) Jewelry placed in newly pierced skin shall be sterilized prior to piercing as specified in Section 119315 or shall be purchased presterilized. Sterile jewelry packs shall be evaluated before use and, if the integrity of a pack is compromised, including, but not limited to, being torn, wet, or punctured, the pack shall be discarded or reprocessed before use. (b) Only jewelry made of ASTM F138, ISO 5832-1, and AISI 316L or AISI 316LVM implant grade stainless steel, solid 14-karat through 18-karat yellow or white gold, niobium, ASTM F 136 6A4V titanium, platinum, or other materials found to be equally biocompatible shall be placed in newly pierced skin.(c) A spring-loaded action tool used most commonly for making an opening or a hole in the leading edge and lobe of the ear shall not be used to perform body piercing.(c) Ear piercing equipment with a disposable, single-use, presterilized clasp and stud may be used only for piercing the ear pursuant to Section 119304. (d) If measuring the body piercing site is necessary, clean calipers shall be used and the skin marked using clean toothpicks and ink. 119311. (a) A product applied to the skin prior to tattooing or application of permanent cosmetics, including, but not limited to, stencils and marking and transfer agents, including pens, shall be single use and discarded into a waste container at the end of the procedure unless the product can be disinfected for reuse. (b) Only commercially manufactured inks, dyes, and pigments shall be used. (c) Inks, pigments, soaps, and other products inmultiple usemultiple-use containers shall be dispensed in a manner to prevent contamination of the storage container and its remaining contents through the use of a single-use receptacle . (d) Inks and pigments shall be placed into a clean, single-usecups or caps. Cups or caps and thereceptacle. The inks and pigments remaining in thecups or capsreceptacle shall be discarded immediately upon completion of the procedure. (e) If a tray is used for inks or pigments, it shall be decontaminated after each procedure. (f) Only single-use needles and needle bars shall be used in tattooing and the application of permanent cosmetics. Needles and needle bars that are purchased in a nonsterilized state, shall be sterilized, pursuant to the process required by Section 119315. (g) Needles, needle bars, grommets, and razors shall be discarded into a sharps waste container immediately upon completion of the procedure. (h) Any part of a tattooing machine that may be touched by the practitioner during the procedure shall be covered with a disposable plastic sheath that is discarded upon completion of the procedure, and the machine shall be decontaminated upon completion of the procedure. (i) A machine used to insert pigments shall be designed with removable tip parts between the tip and motor housing, and in a manner that will prevent backflow into enclosed parts of the motor housing. (j) A hand tool used to insert pigment shall bedisposable or shall have autoclavable handles and use single-use needles.disposed of in a sharps container, with the sharps intact, unless the needle can be mechanically ejected from the hand tool. Article 4. Permanent Body Art Facilities 119312. (a) A body art facility shall not conduct business without a valid health permit. (b) The application for a health permit for a body art facility shall include all of the following: (1) A copy of the facility's infection prevention control plan, as required by Section 119313. (2) A fee, as set by the local enforcement agency at an amount sufficient to cover the actual costs of administration of the program. Fees established by this section shall be used exclusively in support of activities pursuant to this chapter. (c) The local enforcement agency shall issue a health permit after an investigation has determined that the proposed body art facility and its method of operation meets the specifications of the approved plans or conforms to the requirements of this article. (d) A health permit is valid only for the location of the facility and the time period indicated on the permit and may not be transferred to another owner or facility. (e) The health permit shall be posted in a conspicuous place at the body art facility. Certificates of registration for all practitioners performing body art in that facility shall also be prominently displayed either near the health permit or at the individual practitioner's procedure area if each practitioner has a designated area. (f) A person proposing to construct a practice site or mobile practice site, other than a temporary body art event booth, shall submit plans to the Plan Review Unit of the local enforcement agency, and pay a fee set by the local enforcement agency at an amount sufficient to cover the actual costs of the plan review process. The plans shall be approved in advance of the issuance of any building, plumbing, or electrical permit. All required corrections must be made and the body art facility approved to open before any body art can be performed in the facility. 119313. (a) A body art facility shall maintain and follow a written Infection Prevention and Control Plan, provided by the owner or established by the practitioners, specifying the procedures to achieve compliance with each applicable requirement of this chapter. (b) The Infection Prevention and Control Plan shall include all of the following: (1) Procedures for cleaning and disinfecting environmental surfaces. (2) Procedures for cleaning, packaging, sterilizing, and storing reusable instruments. (3) Procedures for protecting clean instruments and sterile instrument packs from exposure to dust and moisture during storage. (4) A set up and tear down procedure for any form of body art performed at the body art facility. (5) Techniques to prevent the contamination of instruments or the procedure site during the performance of body art. (6) Procedures for safe handling and disposal of sharps waste.(7) An inventory, including names, manufacturers, container size, and material safety data sheets, of all chemicals and disinfectants, and their intended use.(c) The Infection Prevention and Control Plan shall be revised when any changes are made in infection prevention practices, procedures, or tasks. (d) Training on the facility's Infection Prevention and Control Plan shall take place when tasks where occupational exposure may occur are initially assigned, any time there are changes in the procedures or tasks, and when new technology is adopted for use in the facility, but not less than once each year. (e) Records of training required pursuant to this section shall be maintained for three years and shall be available for inspection upon request of the enforcement officer. 119314. (a) With the exception of a temporary demonstration booth and a mobile site, as specified in Sections 119317 and 119318, a body art facility shall comply with all of the following: (1) Have floors, walls, and ceilings that are smooth,nonporousfree of open holes , and washable. (2) Be free of insect and rodent infestation. (3) Be separate from any residential areas used for sleeping, bathing, or meal preparation. A body art facility associated with a residential dwelling shall have a separate entrance and toilet facility, and shall not have a door allowing direct access between the body art facility and the residential dwelling. (b) Procedure areas in a body art facility shall meet all of the following standards: (1) Be equipped with a light source of least 150 foot-candles of light at the procedure area. (2) Be separated, by a wall or ceiling-to-floor partition, from nail and hair activities. (3) Be equipped with a sink supplied with hot and cold running water, containerized liquid soap, and single-use paper towels that are dispensed from a wall-mounted, touchless dispenser that is accessible to the practitioner. (c) Cleaning and sanitation areas within a body art facility shall meet all of the following requirements: (1) Be separated from procedure areas by a space of at least five feet. (2) Be equipped with a sink, hot and cold running water, liquid soap in a wall-mounted dispenser, and single-use paper towels dispensed from a wall-mounted, touchless dispenser that is readily accessible to the practitioner. (d) Each procedure area and cleaning and sterilization area shall have waste containers lined with plastic bags specifically manufactured for use in waste containers and large enough to fold over the top rim of the waste container by a minimum of one inch. (e) Each procedure area and cleaning and sterilization area shall have a container for the disposal of sharps waste that meets the following requirements: (1) The sharps waste container shall be portable, if portability is necessary to ensure that the sharps waste container is within arm' s reach of the practitioner. (2) The sharps waste container shall be labeled with the words "sharps waste" or with the international biohazard symbol and the word "BIOHAZARD." (3) All sharps waste produced during the process of tattooing, body piercing, or the application of permanent cosmetics shall be disposed by either of the following methods: (A) Removal and disposal by a company, or removal and transportation,through a mail-back system approved by the local enforcement agency, or by other means in accordance with the Medical Waste Management Act (Part 14 (commencing with Section 117600)). (B) As solid waste after being disinfected by a method approved by either the department pursuant to paragraph (3) of subdivision (a) of Section 118215 or by the local enforcement agency as a condition of registration. (f) No animals shall be allowed in the procedure area or the cleaning and sterilization area. 119315. A body art facility shall conform to the following sterilization procedures: (a) Clean instruments to be sterilized shall first be sealed in peel-packs that contain either a sterilizer indicator or internal temperature indicator. The outside of the pack shall be labeled with the name of the instrument, the date sterilized, and the initials of the person operating the sterilizing equipment. (b) Sterilizers shall be loaded, operated, cleaned, and maintained according to manufacturer's directions, and shall meet all of the following standards: (1) Only equipment manufactured for the sterilization of medical instruments shall be used. (2) Sterilization equipment shall be tested using a commercial biological indicator monitoring system after the initial installation, after any major repair, and at least once per week. The expiration date of the monitor shall be checked prior to each use. (3) Each sterilization load shall be monitored with mechanical indicators for time, temperature, pressure, and chemical integrators. Each individual sterilization pack shall have a chemical indicator. (4) Biological indicator monitoring test results shall be recorded in a log that shall be kept on site for two years after the date of the results. (5) A written log of each sterilization cycle shall be retained on site for two years and shall include all of the following information: (A) The date of the load. (B) A list of the contents of the load. (C) The exposure time and temperature. (D) The results of the biological indicator monitoring test. (E) For cycles where the results of the biological indicator monitoring test are positive, how the items were cleaned, and proof of a negative test before reuse. (c) Clean instruments and sterilized instrument packs shall be placed in clean, dry, labeled containers, or stored in a labeled cabinet that is protected from dust and moisture. (d) Sterilized instruments shall be stored in the intact peel-packs until time of use. (e) Sterile instrument packs shall be evaluated at the time of storage and before use. If the integrity of a pack is compromised, including, but not limited to, cases where the pack is torn, punctured, wet, or displaying any evidence of moisture contamination, the pack shall be discarded or reprocessed before use. (f) A body art facility that does not afford access to a cleaning and sterilization area that meets the standards of subdivision (c) of Section 119314 or that does not have sterilization equipment shall use only purchased disposable, single-use, presterilized instruments. In place of the requirements for maintaining sterilization records, the following records shall be kept and maintained for one year following the use of the instruments at the site of practice for the purpose of verifying the use of disposable, single-use, presterilized instruments : (1) A record ofreceipt and use ofpurchase and use of all single-use instruments.(2) Invoices for the purchase of all purchased disposable, single-use, presterilized instruments for the previous year.(3)(2) A log of all procedures, including the names of the practitioner and client and the date of the procedure. 119316. (a) If a practitioner performs body art in a vehicle, a health permit is required if the practitioner will practice in the vehicle in the jurisdiction for more than seven days in a 90-day period. To obtain a health permit, the vehicle shall meet the requirements set forth in subdivisions (b) to (g), inclusive, of Section 119317. (b) If the vehicle will be operating in the jurisdiction for less than seven days in a consecutive 90-day period, the vehicle shall be treated as a temporary booth and will be subject to Section 119317. Article 5. Temporary Body Art Facilities 119317. A practitioner may, in the local jurisdiction of registration, practice in a temporary demonstration booth for no more than seven days in a 90-day period. The demonstration booth shall meet all of the following requirements: (a) Be located within a building that has hand washing facilities with hot and cold running water, soap, and single-use paper towels. (b) Constructed with a partition of at least three feet in height separating the procedure area from the public. (c) Be free of insect or rodent infestation. (d) Used exclusively for performing body art. (e) Equipped with at least 150 foot-candles of light available at the level where the practitioner is performing body art. (f) Equipped with hand washing equipment that, at a minimum, consists of containerized liquid soap, single-use paper towels, a five-gallon or larger container of potable water accessible via spigot, and awaste waterwastewater collection and holding tank of corresponding size. Potable water shall be refilled and the holding tank evacuated at least every four procedures or every four hours, whichever occurs first. (g) Not allow animals within the confines of the demonstration booth. 119318. (a) The sponsor of a temporary body art event shall apply for and obtain a sponsor's permit from the local enforcement agency in the jurisdiction where the event will be held. (b) The sponsor of a temporary body art event shall be responsible for ensuring the availability of support facilities and supplies for practitioners and vendors, including, but not limited to: (1) Access to a potable water supply. (2) Restrooms that have flush toilets supplied with toilet paper, and hand wash sinks supplied with hot and cold potable running water, soap, and single-use paper towels. (3) Sharps waste containers for each demonstration booth. (4) The use of a licensed medical waste disposal company for removal of all sharps waste containers used during the body art event. (5) Frequent trash pickup from demonstration booths. (6) An eye wash station. (7) A cleaning and sterilization area. (8) Adequate backup supplies that can be purchased by practitioners, including, but not limited to: (A) Presterilized tattoo needles. (B) Presterilized needle tubes. (C) Presterilized piercing instruments, including, but not limited to, needles, receiving tubes, corks, marking tools, and forceps. (D) Plastic bags, barrier film, clip cord covers, and plastic wrap. (E) Ink cups. (F) Nitrile and latex gloves. (G) Single-use tubes of water-based and petroleum-based lubricants. (H) Absorbent dressing materials. (c) The name, telephone number, and directions to an emergency room near thebody art temporarytemporary body art event shall be posted in a conspicuous location. (d) Each practitioner working in a booth at a temporary body art event shall display his or her certificate of registration, or keep the certificate in a folder that is available for inspection upon request of the enforcement officer or a client. Article 6. Enforcement 119319. (a) An enforcement officer may enter a body art facility during the facility's hours of operation and other reasonable times to do any of the following: (1) Conduct inspections, issue citations, and secure samples, photographs, or other evidence from a body art facility, or any facility suspected of being a body art facility. (2) Check the Infection Prevention and Control Plan, required pursuant to Section 119313, to determine if persons working in the facility are following the plan, and to determine if the plan is in compliance with this chapter. (3) Secure as evidence any documents, or copies of documents, including the Infection Prevention and Control Plan, or any record, file, paper, process, invoice, or receipt for the purpose of determining compliance with this chapter. (b) A written report shall be made and a copy shall be supplied or mailed to the owner or practitioner at the completion of an inspection or investigation. (c) Based upon inspection findings or other evidence, an enforcement officer may impound instruments that are found to be unsafe to use. Within 30 days, the local enforcement agency that has impounded the equipment shall commence proceedings to release the instrument or to seek administrative or legal remedy for its disposal. (d) It is a violation of this chapter for the owner or any person working in a body art facility, to do any of the following: (1) Conceal any records or evidence, or to withhold evidence. (2) Interfere with the performance of the duties of an enforcement officer. (3) Make a false statement, representation, certification, record, report, or otherwise falsify information required to be submitted or maintained pursuant to this chapter. 119320. (a) A certificate of registration or a health permit may be suspended by a local enforcement agency for a violation of this chapter. (b) A body art facility or practitioner whose certificate of registration or health permit has been suspended shall cease doing business until the certificate or permit has been reinstated. Suspension of the registration of one practitioner in a body art facility does not affect the status of other practitioners in the facility unless the violation or violations are for conditions or equipment that affects the ability of all the practitioners in the facility to comply with the provisions of this chapter. (c) Any body art facility for which the health permit has been revoked shall close and remain closed until a new health permit has been issued. (d) Whenever an enforcement officer finds that a practitioner or body art facility is not in compliance with the requirements of this chapter, a written notice to comply shall be issued to the registrant or permitholder. If the registrant or permitholder fails to comply, the enforcement officer shall issue a notice of violation to the registrant or permitholder setting forth the acts or omissions with which the registrant or permitholder is charged, and informing him or her of a right to a hearing, if requested, to show cause why the registration or permit should not be suspended or revoked. (e) (1) A written request for a hearing shall be made by the registrant or permitholder within 15 calendar days after receipt of the notice. (2) The hearing shall be held within 15 calendar days of the receipt of a request for a hearing. Upon written request of the registrant or permitholder, the hearing officer may postpone a hearing date, if circumstances warrant the action. (f) A failure to request a hearing within 15 calendar days after receipt of the notice shall be deemed a waiver of the right to a hearing. (g) The hearing officer shall issue a written notice of decision to the registrant or permitholder within five working days following the hearing. In the event of a suspension or revocation, the notice shall specify the acts or omissions with which the registrant or permitholder is charged, and shall state the terms of the suspension or that the registration or health permit has been revoked. (h) A certificate of registration or health permit may be reinstated or a new certificate of registration or health permit issued if the local enforcement agency determines that the conditions that prompted the suspension or revocation no longer exist. 119321. If an imminent health hazard is found, the enforcement officer may suspend a registration temporarily and order the practitioner to cease operation if the hazard is not corrected. If the hazard affects the entire body art facility, then the entire facility may be closed immediately. Whenever a registration or health permit is suspended as the result of an imminent health hazard, the enforcement officer shall issue to the registrant or permitholder a notice setting forth the acts or omissions being charged, specifying the pertinent code section, and informing the registrant or permitholder of the right to a hearing. 119322. The local enforcement agency may, after providing opportunity for a hearing, modify, suspend, or revoke a certificate of registration or a health permit for serious or repeated violations of any requirement of this chapter or for interference in the performance of the duty of the enforcement officer. 119323. Performing body art without being registered, operating a body art facility without a health permit, or operating a temporary body art event without a permit shall be a misdemeanor. The local enforcement agency may also assess an administrative penalty in an amount not less than twenty-five dollars ($25) and not more than one thousand dollars ($1,000) for violation of a provision of this chapter. All fines are to be retained by the local enforcement agency for enforcement of the provisions of this chapter. 119324. A city, county, or city and county may adopt regulations or ordinances that do not conflict with, or are morecomprehensivestringent than, the provisions of this chapter as they relate to body art .A regulation or ordinance enacted by a local jurisdiction that conflicts with the provisions of this chapter shall remain in effect, to the exclusion of the conflicting provision of this chapter, until January 1, 2012.SEC. 3. No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution for certain costs that may be incurred under this act because a local agency or school district has the authority to levy service charges, fees, or assessments sufficient to pay for the program or level of service mandated by this act, within the meaning of Section 17556 of the Government Code. No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitutionbecause the onlyfor those costs that may be incurred by a local agency or school districtwill be incurredbecause this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.