Skin Penetration Inspection Report

• Audit Title

• Client / Site

• Address
  Address

• Phone Number

• Trim File No.

• Conducted on

  Date

• Inspection Result

  Select Satisfactory Unsatisfactory Unsatisfactory - reinspection required

  • Satisfactory
  • Unsatisfactory
  • Unsatisfactory - reinspection required

Business details

• Proprietor

• Email

• ABN

• Person interviewed

• Inspection type

  Annual

  Reinspection

  Pre-occupation

  Complaint

• Procedures

  Select Tattooing Body piercing Cosmetic tattooing Manicure/Pedicure Beauty Therapy Waxing Micro-dermabrasion Electrolysis Dry needling Body modification Colonic lavage

  • Tattooing
  • Body piercing
  • Cosmetic tattooing
  • Manicure/Pedicure
  • Beauty Therapy
  • Waxing
  • Micro-dermabrasion
  • Electrolysis
  • Dry needling
  • Body modification
  • Colonic lavage

• Other

Premises - Local Government (General) Regulation 2005 and Public Health Skin Penetration Regulation 2012

• Is the premises clean and hygienic

  Yes

  No

  N/A

• Fixtures and fittings are in a good state of repair, smooth, impervious and capable of being easily and effectively cleaned

  Yes

  No

  N/A

• Facilities that are adequate for the purpose of keeping beauty treatment appliances and utensils clean.

  Yes

  No

  N/A

• Equipment clean, dry and in good working order

  Yes

  No

  N/A

Handwash - Local Government (General) Regulation 2005 and Public Health Skin Penetration Regulation 2012

• Hand wash basin is provided with clean, warm, potable water through a single spout

  Yes

  No

  N/A

• A supply of liquid soap (or an alcohol-based hand cleaner) is available

  Yes

  No

  N/A

• Single-use towels or an automatic hand dryer is available

  Yes

  No

  N/A

Equipment cleaning sink - Public Health Skin Penetration Regulation 2012

• Premises equipped with a separate sink that has a supply of clean, warm water for cleaning equipment

  Yes

  No

  N/A

Hygiene - Public Health Skin Penetration Regulation 2012

• Hands washed between clients

  Yes

  No

  N/A

• Single use gloves used for skin penetration procedures (exemption for waxing)

  Yes

  No

  N/A

• Clean linen and gowns or aprons are available?

  Yes

  No

  N/A

Linen (NSW Health Best Practice Fact Sheet)

• Towels or other types of linen used for covering or protection during the procedure is clean at the start of each treatment

  Yes

  No

  N/A

• Linen is washed in detergent and hot water

  Yes

  No

  N/A

Waste (Clause 23 & Clause 25)

• Waste disposal bin provided

  Yes

  No

  N/A

• Sharps disposed into sharps container immediately after use

  Yes

  No

  N/A

• Licensed contractor used for the collection and disposal of sharps waste

  Yes

  No

  N/A

Cleaning and Sterilisation (Clause 26)

• Soiled and clean equipment are stored separately

  Yes

  No

  N/A

• Hospital grade disinfectant used

  Yes

  No

  N/A

• Detergent and water used to clean articles

  Yes

  No

  N/A

• Physical or mechanical action used when cleaning equipment ( i.e. scrubbing)

  Yes

  No

  N/A

• Rinsed with warm or hot water

  Yes

  No

  N/A

• Dried with lint free cloth or in drying cabinet

  Yes

  No

  N/A

• All reusable instruments that penetrate the skin sterilised

  Yes

  No

  N/A

• Items sterilised off site

  Yes

  No

  N/A

Use of needles, sharps and other skin penetration articles (Clause 27)

• Needles, sharps or other skin penetration articles used

  Off

  On

• All needles are single use

  Yes

  No

  N/A

• Packaged items in good condition

  Yes

  No

  N/A

• Storage of packaged items in clean, dry area, away from sunlight

  Yes

  No

  N/A

• Needles/sharps are disposed of in the appropriate sharps container immediately after completing the procedure

  Yes

  No

  N/A

• Cuticle Cutters in use

  Off

  On

• Are the cuticle cutter sterilised correctly

  Yes

  No

  N/A

Sterilisation of articles (Clause 26)

• Premises sterilises articles using bench top steriliser

  Off

  On

• Is there manual recording of the steriliser or print out recorder (as per the Regulation and AS 4815:2006)

  Yes

  No

  N/A

• All items packaged appropriately

  Yes

  No

  N/A

• Training in use of steriliser

  Yes

  No

  N/A

• Records of sterilisation including date, time, temperature and pressure levels, level of time autoclaved

  Yes

  No

  N/A

• Sterilisation records kept for 12 months

  Yes

  No

  N/A

• Maintenance records and annual performance validation of steriliser

  Yes

  No

  N/A

• Date Validated and name and address

Use of Ink and Pigments (Clause 29)

• Ink and pigments used

  Off

  On

• Liquids/gels are dispensed into single use containers

  Yes

  No

  N/A

Waxing (Clause 30)

• Premises conducts waxing

  Off

  On

• Wax, and any instrument used to apply the wax (such as a spatula), immediately disposed of after use

  Yes

  No

  N/A

Inspection results

• Forms to be submitted to Council

  Select Autoclave service report Records of sterilisation Business registration form

  • Autoclave service report
  • Records of sterilisation
  • Business registration form

• Inspection rating

  Satisfactory

  Unsatisfactory

  Unsatisfactory - reinspection required

• Follow up

  Select Warning letter Reinspection Improvement notice PIN Prohibition order

  • Warning letter
  • Reinspection
  • Improvement notice
  • PIN
  • Prohibition order

• Comments

• Owner/Employee Signature

  Sign

Council details

• Name of officer

  Select Thelma Marr - 4429 3445 Melissa Moyle 4429 3391 Bethany Meehan 4429 3430 Tom Roose 4429 3202 Kamran Khodaverdi 4429 8935 Greg Howarth 4429 8928 Mark Sneesby 4429 3466

  • Thelma Marr - 4429 3445
  • Melissa Moyle 4429 3391
  • Bethany Meehan 4429 3430
  • Tom Roose 4429 3202
  • Kamran Khodaverdi 4429 8935
  • Greg Howarth 4429 8928
  • Mark Sneesby 4429 3466

• Officer Signature

  Sign

• Phone: (02) 4429 3610
  Fax: (02) 44221816
  Email: council@shoalhaven.nsw.gov.au