Every person who operates a tattooing establishment within the City of Reading shall comply with the following requirements:
A. Records required.
(1) In order for the operator to properly assess the client's condition for receiving body art procedures and not violate the client's rights or confidential medical information, the operator must obtain a client record containing the following information regarding each client:
(a) Name, address, date of birth and photocopy of ID (acceptable forms of ID are driver's license, passport, state ID or military ID);
(b) Any known allergies;
(c) Any condition that may affect/hamper the healing process;
(d) The name of the artist who performed the procedure;
(e) The date of the procedure;
(f) The location of the procedure on the client's body;
(g) A description of the type of procedure provided;
(h) A description of any unusual circumstances or complications occurring during the procedure.
(2) The following forms must be completed by each client and kept as part of the client record:
(a) Signed statement by client acknowledging that he or she may be temporarily prohibited from donating blood under rules and regulations of the Red Cross;
(b) Signed statement by client attesting that, at the time of the procedure, he or she is not intoxicated from legal or illegal drug use or alcohol consumption;
(c) For all persons under the age of 18, signed consent of the minor's parent or legal guardian permitting the minor to undergo the body art procedure. (For anyone under the age of 18, a notarized affidavit and a copy of the parent/guardian ID is required).
(3) The holder of a body art establishment permit must ensure that the foregoing client records are kept and retained for a minimum of four years and shall be made available to the Health Officer or designee upon request.
(4) All infections or complications resulting from body art performed by the establishment which become known to the establishment shall be recorded in the client file, and the details of the infection or complication must be promptly reported to the Property Maintenance Division.
B. General provisions. The holder of a body art establishment permit must ensure that the body art establishment conforms at all times with the following requirements:
(1) The levels where body art procedures are being performed and where instruments and sharps are assembled shall be well-lit at all times with an artificial light source.
(2) All walls, floors and procedure surfaces in rooms or areas where body art procedures are performed must be smooth, nonporous, washable, and in good repair. Floors shall be cleaned daily. Cleaning shall not occur while procedures are being performed.
(3) All body art establishments must have a dedicated physical address.
(4) All body art establishments must have:
(a) An entrance leading directly into the establishment;
(b) No direct opening between the establishment and any building or portion of a building used as living or sleeping quarters or as a food, liquor, or tobacco establishment; and
(c) Notwithstanding the foregoing, body art establishments located in a nail salon, barbershop or cosmetology salon may share an entrance into the establishment. However, the body art portion of the establishment must be separated by a wall extending from floor to ceiling.
(5) Each establishment shall have an area that will be screened from public view for customers requesting privacy or for all genitalia body art procedures. Dividers, curtains or partitions at a minimum shall separate multiple body art stations.
(6) A consistent fresh air supply must be provided to the establishment. Furnace or air conditioners shall be maintained to allow for airflow. Filters shall be cleaned or replaced annually or more frequently if necessary.
(7) No domestic or wild animals of any kind shall be present in a body art establishment; fish aquariums and service animals used by persons with disabilities are permitted in nonprocedural areas.
(8) The doors to the establishment shall be self-closing and kept closed to prevent entrance by vermin and foreign particles.
(9) The establishment must at all times have a supply of hot and cold running water in sufficient quantities to conduct the facility in a sanitary manner.
(10) The establishment must have emergency exits marked for easy escape.
(11) Electrical appliances or apparatus must be clean and have no worn or bare wiring to avoid fires, shocks and electrocution and all electrical outlets in operator areas, cleaning areas and bathroom facilities must be equipped with ground fault (GF) protected receptacles.
(12) Water or product spills on the floor shall be removed immediately and the floor dried to avoid falls.
C. Equipment. The establishment must have the following equipment, all of which shall be in good repair, easily cleanable and kept in a sanitary manner at all times:
(1) Sinks. A minimum of two sinks, one designated for handwashing and the other for employee use only to clean equipment. Both must be kept clean and include:
(a) Hot and cold running water, preferably with wrist- or foot-operated controls;
(b) Liquid pump soap;
(c) Single-use paper towels; and
(d) Waste receptacle.
(2) Sharps container. Contaminated sharps must be disposed of in an approved sharps container to prevent cross-contamination.
(3) Biohazard waste container. Biohazard waste must be disposed of in an approved biohazard waste container to prevent cross-contamination.
(4) Autoclave(s). The autoclave shall be used, cleaned and maintained according to the manufacturer's instructions. A copy of the manufacturer's recommended procedures for the operation of the autoclave must be available for inspection by the Health Officer. Autoclaves shall be positioned away from workstations or areas available to the public. Cleaning and logbooks are to be available for inspection. Each owner of the body art establishment shall demonstrate that the autoclave is capable of attaining sterilization by monthly spore tests. These tests shall be verified through an independent laboratory. These records shall be kept by the owner for three years and made available to the Health Officer or his designee upon request. Each body art establishment is to be equipped with an autoclave which is a design, style or
(5) Alternate sterilizing equipment may only be used when specifically approved in writing by the Property Maintenance Division. After each use and before use on another customer, all needle bars, grips and tubes and needles shall be processed by the following procedure: cleaned, packaged in a self-sealing autoclave bag which is dated with an expiration date not to exceed six months, and arranged in an autoclave which is operated in strict accordance with the manufacturer's recommendations. As the operation time of the autoclave may vary with the type of instrument, the packaging of that item and the arrangement of items in the autoclave, it is critical that the manufacturer's operation manual be followed. This will assure that each item placed in the autoclave achieves the proper temperature for sterilization. Temperature-sensitive autoclave tape, autoclave bags with a chemical color indicator on the bag or any other temperature-sensitive medium approved for autoclaves by the Property Maintenance Division must be applied to each load every time the autoclave is used. To further confirm that the autoclave is operated in a manner to assure sterility of the processed instruments, it must be tested monthly using a biological indicator such as spore strips or spore suspensions which are processed by a laboratory. The operator must maintain records documenting such testing for three years. A copy of the manufacturer's recommended procedures for the operation of the autoclave is to be available for inspection by the Property Maintenance Division. An autoclave, which has received a positive spore test, must be immediately removed from service and all instruments allegedly sterilized by that autoclave shall not be utilized on any client. Prior to using, the operator must ensure that there is evidence of one negative spore test. If the autoclave requires repair work, it cannot be utilized until it has received two negative spore tests. Autoclaves must be cleaned and serviced at the frequency recommended by the manufacturer. A copy of the manufacturer's cleaning and servicing instructions must be maintained in the body art establishment.
(6) Waste receptacles. Each workstation shall have a waste receptacle, which is covered and lined with a disposable bag.
(7) Disposable ink caps. Ink caps are required if providing tattooing and permanent color technology procedures. Ink cap holders shall be smooth, nonporous and disposable.
(8) First aid kit. Body art establishments are required to have a complete first aid kit. Chairs. All chairs for operators, as well as clients, shall be made of smooth, cleanable materials. Cloth is not permitted.
(9) Cabinets or containers for storage. All cabinets and containers shall be maintained and shall be kept in a clean and sanitary manner.
(10) Toilet facilities. Toilet facilities shall be offered and conveniently located during all business hours for all operators, employees and clients. A hand wash sink shall be offered, and signage shall be visible reminding employees to wash their hands.
D. Special requirements for single-use items, inks, dyes and pigments.
(1) All products applied to the skin, including but not limited to body art stencils, applicators, gauze, razors and markers, shall be considered single-use items.
(2) Single-use items shall not be used on more than one client for any reason.
(3) Single-use sharps shall be immediately disposed of in an approved sharps container.
(4) Hollow bore needles or needles with cannula shall not be reused, whether on the same client or a different client, unless it is a single piercing.
(5) All inks, dyes, pigments, solid core needles, and equipment shall be specifically manufactured for performing body art procedures and shall be used according to the manufacturer's instructions.
(6) Inks, dyes, or pigments may be mixed and may only be diluted with water from an approved potable source.
(7) Immediately before a tattoo is applied, the quantity of the dye to be used shall be transferred from the dye bottle and placed into single-use paper or plastic cups or caps. Upon completion of the tattoo, these single-use cups or caps and their contents shall be discarded.
(8) The holder of the body art establishment permit shall maintain all the furniture and equipment in the establishment in good working order and keep it in a clean and sanitary manner.
(9) The holder of the body art establishment permit must ensure that storage within the establishment and body artists comply with the following requirements:
(a) Flammable and combustible chemicals shall be stored away from potential sources of ignition such as an open flame or an electrical device.
(b) All chemicals shall be stored in closed bottles or containers and clearly labeled.
(c) No cleaning/sterilizing products shall be stored:
[1] Where food is kept;
[2] In the restroom, unless in a locked cabinet; or
[3] With single-use supplies.
(d) Storage units. All cabinets, drawers, and containers used for storage of supplies, instruments and towels shall be kept clean.
(e) Supplies.
[1] Unused supplies shall be stored in a clean, enclosed container or drawer;
[2] Used/soiled disposable supplies shall be discarded immediately in a clean, closed waste receptacle with a plastic liner; and
[3] Shall be labeled accordingly.
(f) Instrument storage.
[1] Instruments that have been used on a client or soiled in any manner shall be placed in a properly labeled covered receptacle until sterilized;
[2] Sterilized instruments shall be individually packed and stored in a clean, closed container or drawer until used and are to be stored six to 12 inches off the floor, dated with an expiration date not to exceed 180 days; and
[3] Sterile instruments may not be used if the package has been breached or after the expiration date without first resterilizing.
(g) Contaminated sharps must be stored and disposed of in approved sharps container to prevent cross-contamination.
(h) Infectious waste must be:
[1] Handled and stored so that human exposure is prevented;
[2] Discarded in double-lined plastic bags in a covered waste receptacle or in an approved red bag marked with the international biohazard symbol and stored safely until transported by a licensed infectious waste hauler to an appropriate treatment or disposal facility; and
[3] Records of infectious waste disposed of shall be retained for one year.
(10) The holder of a body art establishment permit must ensure that the use of towels/ linens in the establishment meets the following requirements and that body artists working therein comply with the following requirements:
(a) Cloth linens, after use, shall be disposed of in a labeled receptacle that has a cover;
(b) Used cloth linens shall not be used again until they are laundered and sanitized;
(c) Single-use towels may be used for body art procedures and must be discarded in a labeled receptacle that has a cover, with a disposable plastic liner, immediately following each body art procedure; and
(d) Linens to be laundered shall be laundered either by a commercial washer which includes immersion in laundry detergent and either chlorine bleach or water at 160° F., for not less than 15 minutes during the washing and rinsing operation. Linen service from a source approved by the Health Officer or his designee may be substituted as an alternative method.
(11) The holder of a body art establishment permit must ensure that the use of products in the establishment meets the following requirements and that all body artists providing services therein comply with the following requirements:
(a) All liquids, cosmetics, creams, gels, pastes, powders, and other products are kept in clean, closed containers;
(b) Original product bottles and containers have an original manufacturer label;
(c) When only a portion of the product is to be used on a client, the product shall be removed from the container by a spatula, scoop, spoon, or dropper so that the product does not come in direct contact with the client and to assure that the remaining product is not contaminated;
(d) If a product is poured into another container, such as a shaker, dispenser pump container, or spray container, the container is labeled to identify the product;
(e) Supplies and implements which come in direct contact with a client and cannot be disinfected, such as cotton pads, cotton balls, pads, Q-tips, sponges, bandages, tapes, surgical dressing and other similar items, shall be disposed of in a covered waste receptacle, with a plastic liner, or, if contaminated with body fluids, in a hazardous waste container, immediately after use;
(f) All products applied to the skin, including stencils, must be single-use and disposable. Petroleum jellies, soaps, and other products used in the application of stencils must be dispensed and applied on the area to be tattooed with sterile gauze or in a manner to prevent contamination; and
(g) Only petroleum jelly, United States Pharmacopoeia or National Formulary shall be applied to the area to be tattooed and it shall be in a collapsible metal or plastic tube. The application may be spread by the use of sterile gauze or another sterile object but not directly with the fingers.
(12) All permit holders must ensure that after use by each operator and/or a client, all nondisposable instruments and procedure work surfaces are cleaned and sterilized with a sanitizer that has a demonstrated antimicrobial activity, as indicated by the product label and that the following requirements are complied with:
(a) Jewelry used for new body piercing must be sterilized with an autoclave or chem-clave. Acrylic jewelry cannot be used for a new piercing. Jewelry used in healed body piercing does not have to be sterilized, but must be used according to product label;
(b) Clippers must be disinfected with a liquid chemical sterilant after each use;
(c) All nondisposable instruments used for body art must be cleansed and sterilized after each use. Autoclave or chem-clave sterilization must be conducted for the cycle of time and corresponding operating pressure recommended by the manufacturer of the autoclave. Sanitizers used in the cleaning process must have demonstrated antimicrobial activity, as indicated by the product label and be registered with the U.S. Environmental Protection Agency;
(d) Instruments that are to be autoclaved within the facility must be packed in a single-use autoclave bag with the date of sterilization. The expiration date must not exceed 90 days from the date autoclaved;
(e) All sterilized instruments must remain stored in sterilized packages until just prior to performing a body art procedure. Where several instruments are sterilized at the same time in the same package, such as in a single-use setup, once the container is opened any instrument not used immediately in a procedure must be resterilized;
(f) Every batch of sterilized equipment must be monitored for sterilization by use of a heat-sensitive indicator that is capable of indicating approximate time and temperature achieved; and scratches or irregular surfaces and which has been properly sterilized prior to use may be inserted into a newly pierced area.
(13) Pigments, colors and dyes used from stock solutions for each client must be placed in a single-use receptacle and the receptacle and remaining solution must be discarded and disposed of after each use.
(a) All dyes, inks and pigments shall be from a source of supply which complies with applicable U.S. Food and Drug Administration regulations when available. Dyes, inks and pigments are to be used in accordance with the manufacturer's directions and are not to be adulterated with any substance not recommended by the manufacturer.
(b) A client must not receive body art procedures on areas which are irritated/ inflamed or have moles, rash, broken skin, infection or any other evidence of an unhealthy condition such as TB, influenza, HIV, impetigo, syphilis, mumps, hepatitis, scleral jaundice or rubella.
(c) Permit holders and all other operators must be able to demonstrate knowledge in anatomy and skin diseases, infections, disease control and universal precautions.
(14) Every body artist must wash his/her hands thoroughly with liquid antibacterial soap and water and dry them with single-use disposable towels, before and after serving each client and at any time during the procedure when the hands may become contaminated.
(15) The owner of a body art establishment must ensure that each employee wears gloves, and each operator shall wear gloves in accordance with the following:
(a) When performing body art procedures, the operator must wash his/her hands prior to gloving;
(b) Gloves must be disposed of after the completion of each procedure on each client; and
(c) If gloves become torn, punctured or otherwise contaminated, operators must remove and dispose of the gloves, wash his/her hands with liquid soap and water, and dry with a disposable towel, and then put on a new pair of gloves before resuming the body art procedure.
(16) Single-use items must not be used on more than one client. After use, all single- use needles, razors, razor blades and other sharps must be immediately disposed of in an approved sharps disposal container in accordance with medical waste removal guidelines as applicable.
(17) No body art procedure shall be performed until the following inspections, shavings and preparations of the body art area have occurred:
(a) No body piercing shall be done on skin surfaces which have any rash, pimples, boils, infections or any other evidence of an unhealthy condition;
(b) If the skin is to be shaved, the skin surface must first be washed with soap and warm water. Disposable razors, for each client, shall be used for preparation of the areas to be pierced;
(c) Prior to piercing, the area to be pierced shall be gently scrubbed with an approved surgical scrub material or a sterile gauze pad soaked in a germicidal preparation registered with the Environmental Protection Agency and applied in accordance with the manufacturer's recommendations;
(d) Only medical grade markers or ink and sterile toothpicks are to be used to identify the areas to be pierced. Gentian violet may be utilized for marking oral piercings; and
(e) The use of styptic pencils, alum blocks or other solid styptic to check the flow of blood is prohibited.
(18) All permit holders must ensure that the body art establishment, operators and employees use liquid chemical germicide solution in accordance with the manufacturer's directions. Body artists must comply with the following requirements:
(a) Label the liquid chemical germicide solution; and
(b) Keep the liquid chemical germicide solution covered at all times.
(19) While in the body art establishment, permit holders must not engage in or allow any other person to engage in any of the following activities:
(a) Consuming food or beverages in any area where body art is performed;
(b) Storing food in the same area where chemical supplies are used or stored;
(c) Using, consuming, serving, or in any manner possessing or distributing intoxicating beverages or controlled substances upon its premises during the hours the facility is open to the public and/or any body art procedures are being performed; and
(d) Performing body art when she/he is under the influence of alcohol, narcotic drugs, stimulants, or depressants or on any person who appears to be under the influence of alcohol, narcotic drugs, stimulants, or depressants.
(20) All jewelry to be used in body art procedures is to be made from one of the following grades: 316LVM and/or surgical implant grade stainless steel AST F138; solid yellow or white gold which is 14K or 18K; titanium meeting ASTM TiA4V ELI, F136; niobium; platinum; high-density, low-porosity nontoxic plastics meeting FDA standards where applicable (Tygon and PTFE); and autoclavable borosilicate glass (Pyrex). Certification of the quality of the jewelry is to be obtained from the manufacturer/supplier and made available for inspection. Substandard jewelry such as that which is damaged, scratched, intended for earlobes or not expressly designed for body piercing, jewelry made of silver, gold plated or filled or other corrosive metal shall not be used. When stored in a closed clean, dry container, jewelry stored in paper autoclave bags may be stored up to three months and up to one year when a full plastic autoclave bag is used.
(21) No person may perform a body art procedure on or to any person under 18 years of age without prior written consent of the parent or court-appointed guardian of such person. The person giving consent must be present during the procedure.
(a) The person providing the body art procedure must retain a copy of the consent for four years.
(b) Artists have the right to refuse to perform body art procedures on a person at their discretion.
(22) All recipients of a body art procedure shall receive from the body artist and/or the body art establishment both written and verbal aftercare which shall include, inter alia, circumstances under which the client should seek medical treatment.
(23) Only dentists/physicians can split tongues.
(24) All patrons must be given verbal and written instructions or pictures demonstrating care of the tattooed area and a recommendation to consult a physician in the event of any sign of infection.
(25) Artists shall also be free of skin and infectious diseases to include:
(a) Boils.
(b) Infected wounds.
(c) Open sores.
(d) Acute respiratory infection.
(e) Other communicable disease or condition.
(f) Nausea.
(g) Vomiting.
(h) Diarrhea.
(26) Artists cannot work on a customer if, in the artist's opinion, that person is intoxicated from drug or alcohol use.
(27) The use of styptic pencils, alum blocks, or other solid styptics to check the flow of blood is prohibited.
(28) Artists cannot administer anesthetic injections or other medications or prescription drugs.
(29) Liquid chemical germicide solutions must be labeled and dated at time of opening, covered at all times and changed weekly (daily in the case of a hypochlorite solution) or when it becomes visibly cloudy or dirty.
(30) Items in autoclave bags must have date sterilized and date of expiration and may not be used more than 180 days after sterilization date.
(31) MSDS sheets for all compounds utilized must be available to all employees and to patrons if requested.
(32) Animals may not be tattooed with any of the instruments used in tattooing human patrons.
E. Updating of chapter. In order to carry out the intent of this chapter, the Board of Health in consultation with the Health Officer may promulgate, from time to time, rules and regulations pertaining to the requirements of sanitation, cleanliness, adequacy of facilities, equipment, and operation of a tattooing establishment consistent with current good practices and this chapter.