MDHHS Body Art Facility Plan Review Checklist

2010 PA 375;MCL 333.13101 et seq

Date:_____

Body Art Facility Name:

Address: City: Zip Code ______

Phone Number: ______

Type of Facility Proposed (check all that apply): :Tattoo______: Cosmetic Tattoo

: Body Piercing

: Branding

For new body art facilities and for body art facilities undergoing renovations, attach an 8 ½ X 11 or larger scale drawing and floor plan of the proposed facility or the proposed renovation of the facility.

Manufacture specification sheets or brochures for all equipment, new and used

ITEM / N/A / SATISFACTORY / NEED MORE INFO. / COMMENTS
Separation from living area
Self- Closing doors/windows
Body art procedure area separated from customer waiting
Minimum 45 sq.ft. floor space per technician
Walls and floors easily cleanable and in good repair.
Procedure surfaces easily cleanable
Facility ventilation
Lighting adequate: 20 ft. candles-3ft. off ground, 100 ft. candles in procedure area
Lighting protected in procedure area
Hand washing sink (no other purpose) accessible and served no more than 3-technicians
Minimum 1 lavatory/sink
ITEM / N/A / SATISFACTORY / NEED MORE INFO. / COMMENTS
Separate room for cleaning/disinfecting /sanitizing tools and equipment
Utility sink for scrubbing instruments
Disinfection tub and EPA registered tuberculocidal disinfectant
Ultrasonic cleaner approved
Approved autoclave
Approved peel packs with chemical/temperature/humidity tapes, strips, or pellets
Approved storage cabinet for sterilized equipment
Covered waste receptacle in procedure area
Approved sharps containers
No animals
Free of insects/vermin/rodents
Approved water supply
Approved sewage disposal
Bloodborne Pathogens Training for all technicians-certificates valid
Independent lab spore test contract
Log book for sterilization records
Log book/file for employee records
Aftercare instructions for body art procedures to be performed in the facility
DEQ Regulated Waste Certificate of Registration as a Medical Waste Producer
Submitted license application and fee to MDCH
Copy of Requirements for Body Art Facilities
Approved Consent Forms
ITEM / N/A / SATISFACTORY / NEED MORE INFO. / COMMENTS
Disclosure Statement and Notice for Filing Complaints
Hepatitis B vaccination/declination
Non-smoking signage
Files for body art facilities
Exposure control plan
Annual industry specific training
Annual site specific training
Files for each technician
Record retention (locked cabinet/room)
Razors single use
Pigments/ink approved
Pigments/ink dispensing-no reuse
Pigment/ink bottle storage area approved
Single use sterile needles
Single use stencils
Approved gloves
Jewelry implant grade (sterilized)
Cosmetic tattooing rotary pen approved
Equipment barriers provided (i.e. cord/lamp covers)

Reviewed by: Date:

Title: Agency:

Notes: