Chapter 4.35
TATTOO ESTABLISHMENTS
Sections:
4.35.010 Declaration of purpose.
4.35.030 Infection prevention and control plan.
4.35.040 Maintenance of premises.
4.35.050 Maintenance of supplies and equipment.
4.35.060 Pre-sterilized equipment.
4.35.070 Registration and compliance with county requirements.
4.35.080 Client hygiene and consent.
4.35.090 Regulation of practitioners.
4.35.110 Tattoo and permanent cosmetic application.
4.35.140 Management of operations.
4.35.150 Visibility requirements.
4.35.010 Declaration of purpose.
The city council finds that tattoo establishments can, if carelessly operated, spread bloodborne pathogens and transmit communicable diseases through various means. In order to ensure that tattoo establishments operate safely, the city council finds that it is necessary for such establishments to be regulated in various ways, including licensing and registration of proprietors and operators and adoption of operating standards to ensure the safety of customers and employees. It is the intent of the city council for the Orange County health care agency to continue its regulatory functions with respect to tattoo establishments, and for the regulations codified in this chapter to supplement requirements imposed by the county. [Ord. 2010-126 § 1 (Exh. A)].
4.35.020 Definitions.
The following definitions apply to the use of these terms for purposes of this chapter:
“Antiseptic” means a liquid or semi-liquid substance that is approved by the U.S. Food and Drug Administration, as indicated on the label, to reduce the number of microorganisms present on the skin and on mucosal surfaces.
“Bloodborne pathogen(s)” means disease causing microorganisms that, when present in the blood, can be transmitted to humans. These microorganisms include, but are not limited to, Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV).
“Body art” means the practice of physical body adornment including, but not limited to, the following techniques: body piercing, tattooing, or application of permanent cosmetics.
“Body art facility” means the area within a building or other location in which a practitioner performs body art, including the preparation and procedure area, as defined in this chapter.
“Body piercing” means the creation of an opening in the human body for the purpose of inserting jewelry or decorative objects. This includes but is not limited to piercing of an ear, lip, tongue, nose, belly button, cheek, forehead, or eyebrow. Body piercing does not, for the purpose of this chapter, include piercing the leading edge or earlobe of the ear with a sterile, disposable, single-use stud or solid needle that is applied using a mechanical device to force the needle or stud through the ear.
“Client” means any individual who receives body art from a practitioner as defined in this chapter.
“Disinfectant” means a product that is approved by the U.S. Environmental Protection Agency, as indicated on the label, to reduce or eliminate the presence of disease causing microorganisms.
“Health officer” means the Orange County health officer or his or her designee.
“Instrument” means any body art equipment or device that comes into contact with intact skin, nonintact skin, or mucosal surfaces. Such equipment includes, but is not limited to, needles, needle bars, needle tubes, forceps, hemostats, tweezers, razors, razor blades, or other tools and devices used to insert pigment or pierce the skin or mucosal surfaces of the human body. Such equipment also includes studs, hoops, rings, or other decorative jewelry, materials or apparatuses inserted into any part of the body for the intended purpose of placement in a hole resulting from piercing.
“Permanent cosmetics” means the application of pigments inserted into or under the surface of human skin for the purpose of permanently changing the color or appearance of the skin. This includes, but is not limited to, permanent eyeliner, eye shadow, or lip color.
“Practitioner” means an individual that performs or applies body art as defined in this chapter.
“Preparation area” means a room or a designated portion of a room that is used to clean and sterilize reusable instruments that are used for tattooing, body piercing or permanent cosmetics.
“Procedure area” means a room or a designated portion of a room where body art is performed or applied.
“Proprietor” means the person having general control and management over the conduct of business at a body art facility, or the person operating such establishment, whether or not such person is the legal owner of the premises or the business.
“Purchased pre-sterilized equipment” means any individually packaged, single-use instruments, devices and/or needles that are obtained after processing to render them free of all microbial life forms. Each package shall have the manufacturer’s processing identification number and date of expiration.
“Sharps waste” means any instrument or object, including but not limited to needles or razor blades, that has been used to penetrate the skin or mucosa to perform or apply body art, or otherwise contaminated by coming into contact with blood or surfaces that have not been disinfected or sterilized.
“Sterilization” means the complete destruction of all microbial life forms including spores. Sterilization includes the use of an appropriate and approved method of testing so as to ensure sterilization.
“Tattooing” means to pierce or puncture the human skin with a needle or other instrument for the purpose of the application of pigments or the inserting of pigment under the surface of the skin; the application of pigments or inks inserted into or under the skin for the purpose of producing a mark or by production of scars. [Ord. 2010-126 § 1 (Exh. A)].
Cross-reference: definitions generally, AVMC 1.02.010.
4.35.030 Infection prevention and control plan.
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 to perform or apply body art.
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. A copy of the written infection prevention and control plan shall be kept on the premises at all times.
D. The infection prevention and control plan shall be revised by the proprietor whenever changes in practices or procedures are made.
E. The proprietor shall be responsible for ensuring that the infection prevention and control plan is followed. [Ord. 2010-126 § 1 (Exh. A)].
4.35.040 Maintenance of premises.
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 body art 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 degrees Fahrenheit minimum) and cold running water.
H. A sink shall be provided that is readily accessible to the body art practitioner 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 chapter, 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. 2010-126 § 1 (Exh. A)].
4.35.050 Maintenance of supplies and equipment.
A. Instruments that pierce the skin or touch nonintact 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 six 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 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. 2010-126 § 1 (Exh. A)].
4.35.060 Pre-sterilized equipment.
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 on site 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. 2010-126 § 1 (Exh. A)].
4.35.070 Registration and compliance with county requirements.
A. Every practitioner as defined in this chapter 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 pursuant to the regulations contained in the California Health and Safety Code.
B. Registration of all practitioners is required every three years.
C. Proprietors and operators shall comply with all licensing, operating, and other regulatory requirements imposed by the city and the county of Orange with respect to tattoo establishments. [Ord. 2010-126 § 1 (Exh. A)].
4.35.080 Client hygiene and consent.
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 body art, 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 on site 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 art.
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 body art.
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. 2010-126 § 1 (Exh. A)].
4.35.090 Regulation of practitioners.
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 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. 2010-126 § 1 (Exh. A)].
4.35.100 Skin preparation.
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. 2010-126 § 1 (Exh. A)].
4.35.110 Tattoo and permanent cosmetic application.
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. 2010-126 § 1 (Exh. A)].
4.35.120 Body piercing.
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. 2010-126 § 1 (Exh. A)].
4.35.130 Sharps disposal.
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 performing or applying the body art 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. Removed and disposed of 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. 2010-126 § 1 (Exh. A)].
Cross-reference: solid waste disposal, Chapter 7.05 AVMC.
4.35.140 Management of operations.
A. Each body art facility shall have a manager on the premises during all hours of operation who shall be responsible for the operations and maintenance of the facility, for compliance with all licensing requirements and to observe and supervise the actions of all persons on the premises.
B. Each body art facility shall provide a lobby or other seating area where customers and other invitees of the business may be seated while waiting or otherwise not having body art applied.
C. No body art facility shall knowingly permit loud, boisterous, lewd, violent or threatening behavior by clients or staff while in the facility or in any parking lot or other adjacent area under the control of the body art facility. [Ord. 2010-126 § 1 (Exh. A)].
4.35.150 Visibility requirements.
A. Tattoo designs and styles shall not be displayed on storefront windows or the exterior of any building housing a tattoo establishment. Only the name of the business shall be advertised on the building’s exterior.
B. Customers receiving tattoos shall be screened from the main entrance or lobby and from any storefront window by privacy walls.
C. Storefront windows of a tattoo establishment shall not be painted or covered in any manner that prevents exterior visibility into the premises. [Ord. 2010-126 § 1 (Exh. A)].
4.35.160 Hours of operation.
A. No body art facility shall operate except between the hours of 8:00 a.m. and 10:00 p.m. daily and 8:00 a.m. and 12:00 a.m. on Friday and Saturday, or as otherwise specified in any land use permit for such facility.
B. The hours of operation shall be posted in a conspicuous place in the lobby of the establishment and in a window or other location visible from the outside. [Ord. 2010-126 § 1 (Exh. A)].
4.35.170 Nuisance.
A. No body art facility shall be operated in a manner which constitutes a nuisance.
B. Operation of a body art facility in violation of this chapter or applicable penal or health statute of the state of California shall constitute a public nuisance.
C. A body art facility may be found to be a nuisance on the basis of multiple violations of this chapter, or any penal or health statute of the state of California or of multiple complaints which have been resolved against the proprietor. [Ord. 2010-126 § 1 (Exh. A)].
Cross-reference: violations and penalties generally, Chapter 1.06 AVMC.