Orange City Council Skin Penetration Premises Inspection Report v2.1

• Business Name

• Conducted on

  Date

Business Details

• Inspection type:

  Select Routine. Re-inspection. Complaint.

  • Routine.
  • Re-inspection.
  • Complaint.

• Proprietor or Company Name

• ABN

• Business Trading Name

• Business Premises Address

• Business Postal Address (if different to above)

• Business Contact Number

• Business Contact Email

• Business Representative Interviewed

Procedures Conducted on Premises

• Type of procedure(s) undertaken at the premises

  Select Acupuncture Dry Needling Cuticle Cutting Ear Piercing Body Piercing Waxing Tattooing Cosmetic Tattooing Other Beauty Therapies Colonic Lavage

  • Acupuncture
  • Dry Needling
  • Cuticle Cutting
  • Ear Piercing
  • Body Piercing
  • Waxing
  • Tattooing
  • Cosmetic Tattooing
  • Other Beauty Therapies
  • Colonic Lavage

Cleanliness & Hygiene

• Premises are clean and hygienic

  Yes

  No

  N/A

• Premises has a hand washing basin with a supply of clean, warm, potable water

  Yes

  No

  N/A

• Hand washing basin is equipped with soap and paper towels (or automatic hand dryer)

  Yes

  No

  N/A

• Hand washing basin is unobstructed and only used for hand washing

  Yes

  No

  N/A

• Premises has alcohol-based hand sanitiser available for use

  Yes

  No

  N/A

• Premises has a supply of single-use gloves, clean linens, and gowns or aprons appropriate for the procedures carried out

  Yes

  No

  N/A

• Is equipment used in skin penetration premises cleaned on the premises?

  Yes

  No

  N/A

• Is a separate sink available with clean, warm, potable water for the cleaning of equipment?

  Yes

  No

  N/A

• A waste disposal bin is available

  Yes

  No

  N/A

Equipment

• Equipment is in good working order

  Yes

  No

  N/A

• Equipment is effectively cleaned and dried after use

  Yes

  No

  N/A

• Equipment is stored in a clean and dry condition

  Yes

  No

  N/A

• Are sharps in use at the premises?

  Yes

  No

• Is a sharps bin available for sharps disposal that complies with either AS/NZS 4261-1994 (reusable) or AS/NZS 4031-1992 (non-reusable)?

  Yes

  No

  N/A

• Are needles used at the premises?

  Yes

  No

• Is there an adequate supply of sterile, single-use needles?

  Yes

  No

  N/A

Sterilisation

• Are reusable articles used to penetrate the skin in use at the premises?

  Yes

  No

• Are reusable articles sterilised on-site or off-site?

  Sterilised on the premises

  Sterilised off-site

• An autoclave is in use for sterilising reusable articles?

  Yes

  No

  N/A

• The person undertaking the sterilisation is appropriately trained in the operation of the autoclave?

  Yes

  No

  N/A

• The autoclave is calbirated at least once every 12 months? (records available)

  Yes

  No

  N/A

• Are records of each sterilisation being kept for the last 12 months and are available for inspection?

  Yes

  No

  N/A

• Is the date and time the article was autoclaved recorded?

  Yes

  No

  N/A

• Is the length of time the article was autoclaved recorded?

  Yes

  No

  N/A

• Is the temperature and pressure level reached during autoclaving recorded?

  Yes

  No

  N/A

• Are records of the date on which articles were sent for sterilisation over the last 12 months being kept?

  Yes

  No

  N/A

• Are the contact details of the person or company who sterilised the articles recorded?

  Yes

  No

  N/A

• Are sterilisation reports being kept for the last 12 months and are available for inspection?

  Yes

  No

  N/A

General Requirements for Procedures

• Gloves are in use and changed after every procedure

  Yes

  No

  N/A

• A clean gown or apron is in use during the procedure (made of impermeable material if colonic lavage undertaken)

  Yes

  No

  N/A

• Needles are not re-used and are immediately disposed of after completing the procedure

  Yes

  No

  N/A

• Single-use sharps are immediately disposed of after completing the procedure

  Yes

  No

  N/A

• All articles are clean and sterilised, and stored in a sterile environment

  Yes

  No

  N/A

Requirements for Specific Procedures

• Is colonic lavage undertaken at the premises?

  Yes

  No

• Is a toilet available for client use only and not the general public?

  Yes

  No

  N/A

• Is the procedure using a closed or open system?

  Closed system

  Open system

• The toilet is located close to the room in which the procedure is carried out

  Yes

  No

  N/A

• The toilet is located within the room and immediate area in which the procedure is carried out

  Yes

  No

  N/A

• Are inks or pigments in use at the premises?

  Yes

  No

• Is the ink or pigment decanted into a single-use container for each procedure, applied with a single-use applicator, and then discarded after completing the procedure?

  Yes

  No

  N/A

• Is waxing undertaken at the premises?

  Yes

  No

• Is the wax and spatula used in the procedure immediately disposed of after completing the procedure?

  Yes

  No

  N/A

Comments:

• Further action required:

  Select Nil - Premises satisfactory. No reinspection required - ensure all abovementioned non compliances are attended to prior to next routine inspection. Reinspection required Warning letter. Other.

  • Nil - Premises satisfactory.
  • No reinspection required - ensure all abovementioned non compliances are attended to prior to next routine inspection.
  • Reinspection required
  • Warning letter.
  • Other.

• Business Representative Name

• Business Representative Signature

  Sign

• Authorised Officer

  Greg Perry

  Lyndal Gray

  Lily Escreet

• Authorised Officer Signature

  Sign