SOUTHERN NEVADA HEALTH DISTRICT REGULATIONS

SOUTHERN NEVADA HEALTH DISTRICT

REGULATIONS GOVERNING

THE SANITATION AND SAFETY

BODY ART ESTABLISHMENTS

Adopted by the Southern Nevada Health District Board of Health

March 24, 2022

Approved by the Nevada State Board of Health

June 3, 2022

Effective July 1, 2022

These regulations sunset the following regulations:

2005 Southern Nevada Health District Regulations Governing the Sanitation and Safety of Tattoo

Establishments

Southern Nevada Health District Regulations Governing the Sanitation of Body Piercing Establishments

280 S. Decatur Blvd. Las Vegas, NV 89107

SOUTHERN NEVADA HEALTH DISTRICT REGULATIONS GOVERNING

THE SANITATION AND SAFETY OF BODY ART ESTABLISHMENTS

WHEREAS, the Southern Nevada Health District is a public health authority organized

pursuant to Nevada Revised Statutes, Chapter 439 with jurisdiction over all public

health matters within Clark County, Nevada; and

WHEREAS, the Southern Nevada District Board of Health is the Southern Nevada

Health District’s governing body and is authorized to adopt Regulations to protect and

promote the public health and safety in the geographical area subject to its jurisdiction;

and

WHEREAS, in accordance with the authority granted pursuant to Nevada Revised

Statutes, Chapter 439, the Board hereby adopts Regulations to attain standards that

promote the sanitary and safe practice of body art and in body art establishments to

prevent and control the spread of communicable disease; and

WHEREAS, the Board believes that the following Regulations are designed to protect

and promote the public health and safety, it does therefore publish, promulgate and

order compliance within Clark County, Nevada with the substantive and procedural

requirements hereinafter set forth.

SOUTHERN NEVADA HEALTH DISTRICT REGULATIONS GOVERNING THE

SANITATION AND SAFETY OF BODY ART ESTABLISHMENTS

TABLE OF CONTENTS

Section 1 DEFINITIONS ........................................................................................................................6

Section 2 IMMINENT HEALTH HAZARDS TO PUBLIC HEALTH AND SAFETY............................................. 10

Section 3 FACILITIES AND EQUIPMENT .............................................................................................. 12

3.1 Body art workstations ....................................................................................................... 12

3.2 Floors, Walls, Ceilings......................................................................................................... 12

3.3 Furniture ........................................................................................................................... 12

3.4 Lighting ............................................................................................................................. 12

3.5 Hand sinks ......................................................................................................................... 13

3.6 Water supply ..................................................................................................................... 13

3.7 Plumbing ........................................................................................................................... 13

3.8 Sewage Disposal ................................................................................................................ 13

3.9 Solid waste disposal........................................................................................................... 14

3.10 Biohazardous waste disposal .............................................................................................. 14

3.11 Sharps and sharps containers..................................................................................... 16

3.12 Labeling ............................................................................................................................ 17

3.13 Equipment processing room............................................................................................... 17

Section 4 GENERAL SANITATION ........................................................................................................ 19

4.1 Public areas ....................................................................................................................... 19

4.2 Service animals .................................................................................................................. 19

4.3 Cleaning and disinfecting ................................................................................................... 19

4.4 Sterilization ....................................................................................................................... 19

4.5 Sterilizer testing ................................................................................................................ 21

4.6 Single-use equipment ........................................................................................................ 22

4.7 Dyes and pigments............................................................................................................. 23

4.8 Materials used in body art work preparation and application ............................................... 23

4.9 Equipment used for practice .............................................................................................. 23

Section 5 RESPONSIBLE PERSON, BODY ARTISTS, PERMIT HOLDERS AND VISITING BODY ARTISTS ......... 25

5.1 Responsible person ........................................................................................................... 25

5.2 Body artist ........................................................................................................................ 25

5.3 Permit holders .................................................................................................................. 26

5.4 Visiting body artists ........................................................................................................... 26

Section 6 PATRONS .......................................................................................................................... 28

6.1 Patron age requirements and other age restrictions ............................................................ 28

6.2 Patron consent form .......................................................................................................... 28

6.3 Contents of patron consent form........................................................................................ 28

6.4 Patron assessments ........................................................................................................... 30

6.5 Record keeping .................................................................................................................. 30

Section 7 BODY ART PROCEDURES .................................................................................................... 32

7.1 General procedures ........................................................................................................... 32

7.2 Glove use .......................................................................................................................... 32

7.3 Preparing for tattoo procedure........................................................................................... 33

7.4 Piercing procedures ........................................................................................................... 33

7.5 Single-use items-rules and prohibitions ............................................................................... 35

7.6 Contamination of items...................................................................................................... 36

7.7 Reusable Spatulas .............................................................................................................. 36

7.8 Unused dye or pigment ...................................................................................................... 36

7.9 Linens ............................................................................................................................... 36

7.10 Bandaging ......................................................................................................................... 36

7.11 Aftercare instructions......................................................................................................... 36

7.12 Infection control plan contents ........................................................................................... 37

7.13 Infection reporting required ............................................................................................... 38

7.14 Reporting adverse events ................................................................................................... 38

7.15 Food ................................................................................................................................. 38

7.16 Prohibited acts .................................................................................................................. 39

Section 8 BODY ART CARD REQUIREMENTS AND FEES ........................................................................ 40

8.1 Purpose............................................................................................................................. 40

8.2 Application for body art card .............................................................................................. 40

8.3 Items required for application ............................................................................................ 40

8.4 Written exam .................................................................................................................... 41

8.5 Exam study and organizational materials............................................................................. 41

8.6 Microblading card ............................................................................................................. 41

8.7 Mentor body artist card..................................................................................................... 41

8.8 Body art card, mentor body artist card and microblading card renewal ............................... 41

8.9 Expired body art cards mentor body artist and microblading card cards............................... 42

8.10 Valid card in body artist’s possession .................................................................................. 42

8.11 Issuance of an apprentice body art, body art or mentor body artist cards ............................ 42

8.12 Body art and mentor body artist card transfer prohibition................................................... 43

8.13 Existing body art cards ....................................................................................................... 43

8.14 Existing apprentice cards ................................................................................................... 43

8.15 Permit holder’s joint responsibility ..................................................................................... 43

Section 9 BODY ART SPECIAL EVENTS ................................................................................................. 44

9.1 Special event body artist application .................................................................................. 44

9.2 Special Event Coordinator .................................................................................................. 44

9.3 Special event operational requirements.............................................................................. 45

9.4 Event permit suspension .................................................................................................... 46

Section 10 HEALTH PERMIT, CHANGE OF PERMIT HOLDER, AND WAIVERS, AND FEES........................... 47

10.1 Health permit required ...................................................................................................... 47

10.2 Health permit exemptions and prohibitions ........................................................................ 47

10.3 New and remodeled body art establishments permits......................................................... 47

10.4 Permit conditions .............................................................................................................. 48

10.5 Change of permit holder of an operating body art establishment ......................................... 49

10.6 Waivers............................................................................................................................. 49

10.7 Health permit payment of fees........................................................................................... 50

10.8 Prohibition of the transfer of the health permit................................................................... 50

10.9 Permit modifications .......................................................................................................... 50

10.10 Health permit posted...................................................................................................... 50

10.11 Deletion of the health permit ......................................................................................... 50

Section 11 ENFORCEMENT AND INSPECTIONS ................................................................................... 51

11.1 Documentation of conditions ............................................................................................. 51

11.2 Failure to correct a deficiency ............................................................................................. 51

11.3 Responsibilities .................................................................................................................. 51

11.4 Inspections ........................................................................................................................ 52

11.5 Interfering with the Health Authority ................................................................................. 53

11.6 Issuing report and obtaining acknowledgment of receipt ..................................................... 53

11.7 Inspection frequency ......................................................................................................... 53

11.8 Follow-up inspection .......................................................................................................... 54

11.9 Public information ............................................................................................................. 54

11.10 Appeal process ............................................................................................................... 54

Section 12 PERMIT SUSPENSION, REVOCATION, HEARINGS ................................................................. 55

12.1 Summary suspension; reinstatement of suspended permit .................................................. 55

12.2 Suspension and revocation ................................................................................................. 55

12.3 Suspension or revocation of an apprentice body art card, a body art card, microblading card

or mentor body artist card ............................................................................................................ 56

12.4 Notice and service of notice ............................................................................................... 57

12.5 Reinstatement ................................................................................................................... 57

12.6 Hearings and appeals ......................................................................................................... 57

12.7 Post suspension action ....................................................................................................... 57

Section 13 MISCELLANEOUS .............................................................................................................. 58

13.1 Severability clause ............................................................................................................. 58

13.2 Effective date .................................................................................................................... 58

Section 1

DEFINITIONS

1.1 Agency of jurisdiction means the local building department, safety authority,

fire marshal, business licensing, police or other federal, state or local health

agency, federal regulatory agencies, or departments of agriculture that have

jurisdiction concerning construction, operation, maintenance, and public safety

of a body art establishment.

1.2 Apprentice means a person who is registered with the Health Authority to

work under the direct supervision of a body artist in learning the occupation of

body artist.

1.3 Approved means acceptable to the Health Authority or agency of

jurisdiction based on compliance with the law, conformance with appropriate,

accepted, or recognized industry standards and good public health practice.

1.4 Bloodborne pathogen means infectious microorganisms that are present in

human blood and can cause disease in humans. These pathogens include, but

are not limited to, hepatitis B virus (HBV), hepatitis C virus (HCV), and human

immunodeficiency virus (HIV) [Occupational Safety and Health Administration

[OSHA] definition at 29 CFR 1910.1030(b)].

1.5 Body art means the practice of physical body adornment by permitted body

art establishments and body artists using, without limitation, the following

techniques: piercing, tattooing, camouflage, micropigmentation, permanent

makeup, and microblading. This definition does not include practices that are

considered medical procedures or extreme body modifications, which are

prohibited in body art establishments.

1.6 Body art establishment means a place of business, where body art is

performed, offered, sold or given regardless of profit status of the business.

1.7 Body artist means a person issued a body art or microblading card under

the provisions of these Regulations set forth in Section 8.

1.8 Branding means the process in which a mark or marks are burned into human

skin tissue with the intention of leaving a permanent mark.

1.9 Camouflage means a method of disguising or concealing permanently blotchy

or irregularly pigmented skin, acne scarring, existing tattoos or other

permanent skin irregularities by blending pigments into the skin using

tattooing methods or use of saline during tattoo procedures to cover up,

mask, or alter an existing tattoo so that it is either rendered less noticeable or

takes on a different design, thereby obliterating the original design.

1.10 Class V chemical indicator means a quality control indicator that reacts to

temperature and pressure over a certain time interval to indicate sterilization

conditions were met inside the pack.

1.11 Communicable disease means a disease which is caused by a specific

infectious agent or its toxic products, and which can be transmitted, either

directly or indirectly, from a reservoir of infectious agents to a susceptible host

organism.

1.12 Contamination means the presence or potential presence of blood, infectious

materials or other types of impure materials that have been introduced or

potentially introduced to any work surfaces, equipment or devices rendering

the surface, equipment or device unsafe for use.

1.13 Cross-contamination means the transfer of bacteria, viruses,

microorganisms, or other harmful substances from one surface to another

through improper or unsanitary equipment, procedures, or products.

1.14 Device means any or all instruments, apparatus and contrivances, including

their components, parts and accessories, intended to pierce or create a semi-

permanent or permanent mark on the skin.

1.15 Disinfect means to destroy or inhibit pathogenic and other kinds of

microorganisms by physical and/or chemical means.

1.16 Disinfectant means a product that is a registered with the United States

Environmental Protection Agency that destroys, neutralizes or inhibits the

growth of infectious microorganisms, including the human immunodeficiency

virus, the hepatitis B virus and Mycobacterium tuberculosis.

1.17 Environmental surface means the surface of any furniture, equipment,

fixtures, walls, floors, ceilings, lavatories, toilets, tables, countertops, cabinets,

or similar surface which is part of a body art establishment.

1.18 Equipment means all machinery, containers, vessels, tools, devices,

implements, storage areas, and sinks fixtures that are used in conjunction with

the storage or application of body art or are used within the equipment

processing room.

1.19 Health Authority means the officers and agents Southern Nevada Health

District.

1.20 Health permit means the document issued by the Health Authority that

authorizes a person to operate a body art establishment.

1.21 Hot water means water temperature between 90 degrees and 120 degrees

Fahrenheit (°F).

1.22 Jewelry means any personal ornament inserted into a pierced area.

1.23 Mentor body artist means a person who has held a body art card for four or

more years.

1.24 Linens means sheets, covers, blankets, pillowcases, drapes, towels, or any

other similar item used to cover a table, mat, or a patron during a body art

procedure.

1.25 Microblading means a technique in which incisions are made into the dermis

using a manual tool equipped with needles. The incisions are then filled with

pigment to mimic natural hair. Microblading is limited to the parts of the face

and may be permanent.

1.26 Microblading artist means a person issued a microblading card under the

provisions of these Regulations set forth in Section 8.

1.27 Microblading card means a card issued by the Health Authority to a person

who is limited to practicing microblading.

1.28 Nuisance includes any unlawful act(s) or omission(s), which annoys, injures or

endangers the safety, health, comfort or repose of any considerable number of

persons, offends public decency, or in any way renders a considerable number

of persons insecure in life or the use of property as defined by NRS 202.450.

1.29 Owner means any person, individual, partnership, corporation, company,

association or like entity that owns, leases, or proposes to own or lease a

body art establishment.

1.30 Patron means anyone, including employees of the body art establishment,

who are undergoing a body art procedure.

1.31 Permanent makeup means a tattoo, whether permanent, semipermanent, or

temporary, which includes eyebrows, eyelids, lips, and other parts of the body

for beauty marks, hair imitation, , or areola re-pigmentation. This term includes

any procedures whether referred to as, without limitation, permanent makeup,

micro-derma-pigmentation, micro-pigment implantation, microblading, micro-

needling with the use of pigment, derma-graphics, cosmetic tattooing, or any

other similar procedures and for the purpose of these Regulations has the

same meaning as tattoo.

1.32 Permit holder means the person or entity that is legally responsible for the

operation of the body art establishment.

1.33 Personnel means anyone employed or contracted within the body art

establishment.

1.34 Piercing means the act of penetrating the skin or mucous membranes, to

make, generally permanent in nature, a hole to attach jewelry.

1.35 Responsible person means the individual designated by the permit holder

as being responsible for acting on the permit holder’s behalf and assuring the

body art establishment and body artists are in compliance with these

Regulations.

1.36 Sewage means the water-carried waste created in and to be conducted away

from residences, industrial establishments and public buildings.

1.37 Sharps means any object that can purposely or accidentally cut or penetrate

the skin or mucosa, including without limitation pre-sterilized, single-use

needles; scalpel blades; and razor blades.

1.38 Sharps container means a closable, puncture-resistant, leakproof (on sides

and bottom) container made specifically to be a sharps container that meets

National Institute for Occupational Safety & Health standards and that can be

closed for handling, storage, transportation, and disposal.

1.39 Spore test means a bacterial endospore test designed to assess whether

sterilization has occurred. It is also known as biological spore test or

biological spore monitor.

1.40 Solid waste means all waste that is not liquid waste or biohazardous waste

generated by the facility.

1.41 Special event means a public gathering that is temporary and held for a

specific purpose, and which includes body art activities.

1.42 Standard precautions mean the minimum infection prevention practices that

apply to all individual care, regardless of suspected or confirmed infection

status of the patron or body artist in any setting where body art is delivered.

These practices are designed to protect both the body artist and patron from

spreading communicable diseases. Standard precautions include hand

hygiene, use of personal protective equipment (e.g., gloves and masks),

cough etiquette, the safe handling of sharps, the use of sterile instruments

and devices, and ensuring clean, disinfected environmental surfaces.

1.43 Sterilize means a cleaning process which results in the total destruction of all

forms of microbial life.

1.44 Sterilizer means an autoclave or similar device that can sterilize reusable

equipment using heat, pressure or chemicals and meets ANSI/AAMI ST79 as

described in NAC 444.00759.

1.45 Tattoo means any act of placing ink or other pigment into or under the skin or

mucosa by the use of needles or any other method used to puncture the skin,

resulting in permanent or temporary colorization of the skin or mucosa. This

includes all forms of permanent cosmetics.

1.46 Ultrasonic cleaner means any medical grade machine that uses ultrasonic

acoustic wavelengths and aqueous solutions to remove contamination from

instruments.

1.47 Visiting body artist means a body artist who does not reside or routinely

operate within the jurisdiction of the Health Authority, but who may

occasionally perform body art procedures during a limited timeframe in a

sponsoring body art establishment. Such individuals must be sponsored by

a body art establishment, which holds a current health permit in good

standing issued by the Health Authority.

1.48 Workstation means an area where body art procedures are performed.

1.49 Waiver means a written agreement between the Health Authority and the

permit holder that authorizes a modification of one or more regulatory

requirements in these Regulations and has no impact on the health and safety

of patrons.

Section 2

IMMINENT HEALTH HAZARDS TO PUBLIC HEALTH

AND SAFETY

2.1 Imminent hazards to public health and safety include, but are not limited to:

2.1.1 Substantial damage to the body art establishment caused by

accident, or natural disaster, such as earthquake, wind, fire, rain, or

flood.

2.1.2 Loss of electrical power to critical systems, such as lighting or

sterilization equipment for a period of two or more hours.

2.1.3 A water outage that impacts the body art establishment for a period

of two or more hours.

2.1.4 A water supply that is not approved by the Health Authority or which

has a cross connection, back flow, or back siphonage condition.

2.1.5 Sewage that is not disposed of in an approved and sanitary manner.

2.1.6 Nonfunctioning or lack of toilet or hand washing facilities.

2.1.7 Infestation, harborage, or propagation of vermin.

2.1.8 The presence of toxic or noxious gases, vapors, fumes, mists, or

particulates in concentrations immediately dangerous to life or health,

or in concentrations sufficient to cause harm or a public nuisance.

2.1.9 A body artist or other employee infected with a communicable

disease that can be transmitted as a result of performing the body art

procedure.

2.1.10 Responsible persons or body artists not practicing strict standards

of cleanliness, personal hygiene, and standard precautions.

2.1.11 Equipment that by condition, design, construction, or use poses an

immediate risk of entrapment, fall, pinch, crush, tip, or other cause of

injury.

2.1.12 Environmental surfaces, furnishings, mats, procedure tables, pillows,

cushions, linens, robes, garments, chairs, or other items within body

art establishment that are stained with blood or bodily fluids, soiled,

or infested with vermin; or are in an otherwise unsanitary condition.

2.1.13 The presence of uncontrolled solid waste within or on the premises of

a body art establishment in quantity and duration as to create a

nuisance.

2.1.14 Improper disposal of biohazardous waste or sharps.

2.1.15 Any sharp instrument such as a needle or razor that is not

appropriately placed in a sharps container immediately after use.

2.1.16 Reuse of single-use equipment or pigments on another patron or on

the same patron during a different body art session.

2.1.17 Lack of properly sterilized instruments, equipment or needles that

come in contact with pigment or the skin.

2.1.18 A lack of adequate, currently tested, and fully functional sterilization

equipment on the premises unless exclusively using pre-sterilized

equipment, instruments or needles.

2.1.19 Any other item determined to be an imminent health hazard by the

Health Authority.

2.2 Presence of imminent health hazard

If the imminent health hazard affects people or is unmitigated, then the permit

holder or responsible person must

2.2.1 Immediately notify the Health Authority by either phone or e-mail.

2.2.2 Cease operations of the body art establishment until the hazard can

be mitigated.

2.2.3 Notify the Health Authority once the hazard has been mitigated and

that the facility will be resuming operation.

2.2.4 Failure to notify Health Authority may result in summary suspension

of the health permit.

Section 3

FACILITIES AND EQUIPMENT

3.1 Body art workstations

3.1.1 Each body artist must have a workstation which has a minimum area

of 80 square feet.

3.1.2 Each body art establishment must have at least one workstation that

can be screened from the public and other patrons to provide privacy.

3.2 Floors, Walls, Ceilings

3.2.1 Floors, walls, and ceilings less than 10 feet high in workstations or

restrooms must be made of a smooth, durable, nonabsorbent,

nonporous material that is easily cleanable.

3.2.2 Carpet is prohibited in workstations and restroom areas.

3.2.3 Floors must be kept clean and in good repair and disinfected if

contaminated with bodily fluids or other biohazardous spills.

3.2.4 The materials used in constructing the walls and ceilings must be joined

along the edges so there are no open spaces or cracks.

3.2.5 Floor and wall junctures in workstations and restroom areas must be

coved.

3.2.6 Studs, joists, rafters, and beams, if under 10 feet high, must not be left

exposed in body art work areas or restrooms.

3.2.7 The body art establishment must be separated from any food

establishment or room where food is prepared, or any adjacent

businesses by walls extending from floor to ceiling.

3.2.8 The body art establishment cannot be located within a private

residence, including, without limitation, an apartment, condominium or

other multi-family dwelling or a single-family dwelling.

3.3 Furniture

3.3.1 Tables, chairs, cushions or any similar items used in the workstation

must be constructed of smooth, durable, and easily cleanable material

that is free of cuts and tears.

3.4 Lighting

3.4.1 At least 50 lumens per square foot of light must be provided in the

workstation at the level where the body art work is to occur. At least

20 lumens per square foot of light, measured at 30 inches above the

floor, shall be provided in all other areas of the body art

establishment.

3.4.2 Overhead lights and lights used in the body art workstations must be

shielded or constructed of shatterproof materials.

3.5 Hand sinks

Hand sinks must:

3.5.1 Be permanently plumbed to potable water and sewer,

3.5.2 Provide cold and hot water,

3.5.3 Be supplied with liquid soap and single-use paper towels in dispensers

and

3.5.4 Be sized at a minimum of 10 inches by 10 inches by 8 inches deep to

prevent contamination of the areas outside of the sink basin.

3.5.5 Lined, covered solid waste containers must be provided adjacent to

each hand sink. These containers must have self-closing lids with

hands-free control and must be easily cleanable, kept clean, and be

emptied daily.

Hand sinks in workstations

3.5.6 Workstation hand sinks must be unobstructed (e.g., no doors), such

that the body artists can easily access the hand sinks without having

to touch any surface with their hands while travelling to and from the

hand sink.

3.5.7 A minimum of one hand sink for every four workstations is required.

3.5.8 The maximum distance from any procedure table to a workstation

hand sink is 15 feet unless otherwise approved by the Health

Authority.

Hand sinks in restrooms

3.5.9 All restrooms must have a hand sink that meets the requirements of

sections 3.5.1 to 3.5.5.

3.6 Water supply

3.6.1 The water supply for each body art establishment must be from a

permitted public water system.

3.7 Plumbing

3.7.1 The plumbing system must be installed and maintained in such a

manner that there is no cross connection between potable and non-

potable water systems.

3.7.2 Adequate backflow or back siphonage protection must be installed on

the water system in compliance with all applicable codes.

3.7.3 Plumbing fixtures must be permanently installed in compliance with all

applicable codes.

3.8 Sewage Disposal

3.8.1 Sewage must be disposed of by means of an approved municipal

sewer system or other permitted sewage Disposal System which is

approved by the Health Authority.

3.8.2 Sewage spills must be remediated in a manner that eliminates potential

disease transmission, offensive odors, sewage solids, and sewage

litter.

3.8.3 Sewage discharge, sewer pipe leaks, spills, or backflow onto the

ground must be stopped and/or contained within four hours and the

body art establishment must cease operations until the leak, spill, or

backflow has been remediated

3.9 Solid waste disposal

3.9.1 Each body art establishment must have waste receptacles of

sufficient number and size inside the establishment to store solid

waste so that the waste does not exceed the capacity of the containers

3.9.2 Indoor waste receptacles must be:

3.9.2.1 Emptied at a frequency that prevents waste from becoming

a nuisance.

3.9.2.2 Lined and maintained clean.

3.9.2.3 At least one waste receptacle must be located within each

workstation and equipment processing room.

3.9.3 Outside waste receptacles must be:

3.9.3.1 Designed and constructed to have tight-fitting lids, doors,

or covers.

3.9.3.2 Constructed and installed so that accumulation of debris,

and pest attraction and harborage, are minimized and

effective cleaning of the area can be performed,

3.9.3.3 Emptied at a frequency so that the waste receptacle does

not become a nuisance.

3.10 Biohazardous waste disposal

3.10.1 Each body art establishment must implement a written operating plan

to manage biohazardous waste in accordance with these Regulations.

This written operating plan must be available for review by the Health

Authority and body art establishment personnel. The operating plan

must include the following:

3.10.1.1 Description of training for personnel and body artists on

handling and disposal of biohazardous waste;

3.10.1.2 Procedures for segregating, labeling, packaging,

transporting, storing, and treating biohazardous waste;

3.10.1.3 Procedures for decontaminating biohazardous waste spills;

3.10.2 Body art establishments that offer both tattooing and piercing

services must include waste management procedures specific to each

specialty, if procedures vary. The written operating plans must be

updated when Regulations, body art establishment policies, or

procedures change.

3.10.2.1 Each permit holder or responsible person must train

new personnel on the operating plan as part of their work

responsibilities. This training must be provided prior to

commencement of duties. Refresher training must be

completed annually by all personnel.

3.10.2.2 All biohazardous waste management records must be

maintained onsite for 3 years and must be available for

review by the Health Authority.

3.10.3 Biohazardous waste which may release liquid blood or bodily fluids

when compressed or may release bodily fluids when handled must be

contained in an appropriate red or orange bag and labeled with the

international biohazard symbol. The bag and its waste must then be

disposed of by a waste hauler authorized to dispose of biohazardous

waste. Contaminated waste which does not release liquid or dried

bodily fluids when handled may be contained in a covered receptacle

and disposed of through normal, approved disposal methods.

3.10.4 Surfaces contaminated with biohazardous waste must be

decontaminated as part of the cleaning process.

3.10.5 In the event of blood flow, products used to absorb blood, must be

3.10.5.1 single-use and

3.10.5.2 If considered a biohazardous waste as described in 3.10.3

be disposed of immediately after use in covered

biohazardous waste containers

3.10.6 Gauze or other absorbent material used to absorb fluids during the process of

tattooing:

3.10.6.1 can be used continuously until the session ends or the

material is no longer absorbing; and

3.10.6.2 must be properly disposed of.

3.10.7 Storage and Containment

3.10.7.1 Bags: Biohazardous waste (except sharps) must be

packaged and sealed at the point of origin in impermeable,

red plastic bags. The international biological hazard symbol

must be at least 6 inches in diameter on bags 19 by 14

inches or larger, and at least 1 inch in diameter on bags

smaller than 19 by 14 inches.

3.10.7.2 Storage: Storage of biohazardous waste in the body art

establishment must not exceed 30 days. The 30-day

period begins when the first item of biohazardous waste is

placed into a red bag or when a sharps container is

sealed.

3.10.7.3 Storage areas for biohazardous waste must have restricted

access and be designated in the written operating plan.

They must be located away from pedestrian traffic, be pest

free, and be maintained in a sanitary condition.

3.10.7.4 Containment: Packages of biohazardous waste must

remain sealed until picked up by biohazardous waste

hauler, except when compacted in accordance with the

requirements of these Regulations. Ruptured or leaking

packages of biohazardous waste must be placed into

larger packaging without disturbing the original seal.

3.10.7.5 All packages containing biohazardous waste must be

visibly identifiable with the international biological hazard

symbol and one of the following phrases: “biohazardous

waste,” “biohazard,” “infectious waste,” or “infectious

substance.” The symbol must be red, orange, or black and

the background color must contrast with that of the symbol

or comply with the requirements cited in 29 CFR

subparagraph 1910.1030(g)(1)(B) and (C), Occupational

Exposure to Bloodborne Pathogen Standard.

3.11 Sharps and sharps containers

3.11.1 Sharps must be discarded at the point of origin into an approved

sharps container. Sharps containers must be sealed when full. A

sharps container is considered full when materials placed into it reach

the designated fill line.

3.11.2 Permanently mounted sharps container holders must bear the phrase

and the international biological hazard symbol if this information on the

sharps container is concealed by the holder/mount.

3.11.3 All outer containers must be rigid, leak resistant and puncture resistant.

Reusable outer containers must be constructed of smooth, easily

cleanable materials and must be decontaminated prior to replacing the

inner container.

3.11.4 The international biological hazard symbol must be at least 6 inches in

diameter on outer containers 19 by 14 inches or larger, and at least 1

inch in diameter on outer containers less than 19 by 14 inches.

3.11.5 A sharps container must be provided in each workstation for disposal

of sharp objects that come in contact with blood and/or bodily fluids.

3.11.6 Sharps containers must be properly disposed of as described in the

written operating plan required by these Regulations.

3.12 Labeling

3.12.1 Biohazardous waste bags and sharps containers must be labeled with

the name and address of the body art establishment and address.

3.12.2 If a bag or sharps container is placed into a larger bag prior to

transport, the label for the exterior bag must comply with the same

labeling requirements listed above.

3.13 Equipment processing room

3.13.1 This Section does not apply to body art establishments that

exclusively use prepackaged, single-use, sterilized equipment and

supplies.

3.13.2 Equipment processing and sterilization must be performed in a

separate room that meets the following requirements:

3.13.2.1 Separated and isolated from the work stations, lounging

areas, retail areas, food preparation or other activities that

may cause contamination of equipment or work

surfaces,

3.13.2.2 Properly identified with signs that include the universal

symbol for biohazard waste and secured to prevent

unauthorized persons from entering.

3.13.2.3 Surfaces, cabinets and drawers made of smooth

nonporous, nonabsorbent easily cleanable materials.

3.13.2.4 Has distinct, separate areas for the cleaning, wrapping,

packaging, handling and storage of sterilized equipment.

3.13.2.5 Equipped with at least one, two-compartment utility sink

with cold and hot water used exclusively for cleaning and

disinfecting instruments.

3.13.2.5.1 The utility sink must not be used for hand

washing.

3.13.2.5.2 3.13.2.5 does not apply to body art

establishments constructed prior to the

effective date of these Regulations.

3.13.2.6 Equipped with an ultrasonic cleaner that must be covered

during the cleaning process to minimize aerosolization of

its contents and is of sufficient size to fully submerge the

largest instruments being sterilized.

3.13.2.7 Equipped with a sterilizer.

3.13.2.8 The sterilizer may be kept at the workstation if

3.13.2.8.1 The sterilizer does not require any water

supply or sewage connections and

3.13.2.8.2 The reusable equipment and/or jewelry is

3.13.2.8.2.1 Cleaned in a procedure room

3.13.2.8.2.2 Stored in a manner that prevents

contamination

3.13.2.8.2.3 Is sterilized unwrapped and

3.13.2.8.2.4 Used immediately after sterilizing

3.13.2.9 Equipped with a sterilization log.

3.13.2.10 A copy of the operational manuals for all sterilization and

cleaning equipment must be kept on the premises of the

establishment.

3.13.2.11 Provide a physical separation of at least 18 inches

between the each of the following: sterilizer, ultrasonic

cleaner and utility sink used for rinsing and scrubbing

contaminated tools. Subsequent to Health Authority

approval, a nonporous barrier may be installed to prevent

cross-contamination.

3.13.2.12 No other services such as retail sales, piercing or

tattooing must occur within the equipment processing

room.

3.13.3 Equipment and devices used to clean and sterilize body art materials

and reusable instruments must be suitable for their intended use. The

equipment and devices must be, kept clean, well maintained and used

according to manufacturer’s instructions.

Section 4

GENERAL SANITATION

4.1 Public areas

The entire premises of the body art establishment must be kept clean, sanitary

and in good physical condition at all times.

4.1.1 The body art establishment must be free of pests, including insects,

rodents, and vermin.

4.1.2 body art establishments must be in compliance with the Nevada

Clean Indoor Air Act, NRS 202.2483.

4.2 Service animals

No animals of any kind are allowed in a body art establishment except service

animals used by persons with disabilities in accordance with the Americans with

Disabilities Act of 1990 Regulations and fish in aquariums.

4.3 Cleaning and disinfecting

4.3.1 Furniture, fixtures, surfaces and equipment which cannot be

submerged in liquid, including, without limitation, the motor housing of a

tattoo machine, must be cleaned in accordance with the manufacturer’s

directions then disinfected by manually wiping the surface with a

disinfectant.

4.3.2 Disinfectant must be used in accordance with the manufacturer’s

instructions, including, prescribed contact time.

4.3.3 All reusable instruments are to be cleaned and sterilized after each use

in the equipment processing room. Instruments must be:

4.3.3.1 Soaked in an enzymatic or other appropriate cleaning

solution, scrubbed to remove debris,

4.3.3.2 Rinsed and inspected,

4.3.3.3 Processed through an ultrasonic cleaner,

4.3.3.4 Rinsed,

4.3.3.5 Air-dried before being stored in a clean place or before

sterilization,

4.3.3.6 inspected for wear and cleanliness, and

4.3.3.7 If needed, placed in a sealed sterilization package with a

class V chemical indicator or class VI chemical indicator.

4.3.3.8 Items 4.2.3.1-4.2.3.6 may be accomplished using an

automated instrument washer.

4.4 Sterilization

4.4.1 Sterilizers must be kept clean, in good working order and must either

4.4.1.1 be operated in the equipment processing room

4.4.1.2 or at the workstation if the requirements of section

3.13.2.8 are met.

4.4.2 After being cleaned, all reusable instruments must be sterilized by one

of the below methods:

4.4.2.1 Contained in sterilization packaging and subsequently

sterilized, then stored or

4.4.2.2 If unwrapped or unpackaged, subsequently sterilized, then

used immediately.

4.4.3 After the sterilization process is complete,

4.4.3.1 The sterilization indicators must be inspected to determine

if the equipment was adequately processed.

4.4.3.2 The packages, if used, must be marked with date of

sterilization and the initials of the person who performed

the sterilization.

4.4.3.3 If the sterilized tools are not immediately used, they must

be stored inside their sterile packages and placed in a

cabinet, drawer, or tightly covered container used only for

the storage of packaged, sterilized instruments.

4.4.3.4 At the conclusion of the sterilization cycle, the following

information must be written into the sterilization log:

4.4.3.4.1 The date of the load;

4.4.3.4.2 A list of the contents of the load;

4.4.3.4.3 The exposure time and temperature;

4.4.3.4.4 Name of the individual performing the

sterilization; and

4.4.3.4.5 For cycles of positive biological indicators,

how the items were cleaned and proof of a

negative test before reuse

4.4.4 Equipment packed in peel-packs or heat-sealed plastic and sterilized

at a permitted body art establishment will be considered sterile for a

maximum of three months. Commercially available single-use ethylene

oxide or gamma radiation sterilized equipment must be used in

accordance with the manufacturer’s recommendations and expiration

dates.

4.4.5 Sterilizers are not required in body art establishments that

exclusively use prepackaged, single-use, sterilized equipment and

supplies and are approved by the Health Authority to operate without

a sterilizer.

4.4.6 Body art establishments that do not use prepackaged, single-use,

sterilized equipment and supplies will need to meet the requirements

of this sections 3.14, 4.4 and 4.5 of these Regulations. Installation of

equipment to meet the requirements must be done in compliance with

section 10.3 of these Regulations.

4.5 Sterilizer testing

4.5.1 This Section does not apply to body art establishments that

exclusively use prepackaged, single-use, sterilized equipment and

supplies.

4.5.2 The sterilizer must be tested after the initial installation, any

subsequent service or repair and at least once each month using a

spore test. The spore test must be verified by an independent

laboratory.

4.5.3 Two years of spore test records must be kept on premises available for

immediate review. Three years of spore test records must be available

to the Health Authority upon request. The most recent test must be

made available to the public upon request.

4.5.4 The operator of the sterilizer must verify the spore test is not expired

prior to use.

4.5.5 The sterilizer must be loaded, operated, and maintained according to

the manufacturer’s specifications.

4.5.6 Procedure for Responding to a Positive spore test

4.5.6.1 If the mechanical (e.g., time, temperature, pressure) and

chemical (internal or external) indicators suggest that the

sterilizer is not functioning properly, the sterilizer must be

removed from service and sterilization operating

procedures reviewed to determine if operator error could

be responsible.

4.5.6.2 Procedures taken to remedy the situation must be

documented in the sterilization log referenced in section

4.4.3.4.

4.5.6.3 Reprocess all items processed since the last negative

spore test in a separate sterilizer that has negative spore

test results.

4.5.6.4 Retest the sterilizer with a spore test and appropriate

mechanical, and chemical indicators after correcting any

identified procedural problems.

4.5.6.5 If the repeat spore test is negative, and mechanical and

chemical indicators are within normal limits, the sterilizer

may be put back in service.

4.5.6.6 The following are required if the repeat spore test is

positive:

4.5.6.6.1 The sterilizer must be removed from service

until it has been inspected or repaired and the

exact reason for the positive test has been

determined. Repairs must be performed by a

factory authorized service professional, who is

certified to repair and maintain the specific

sterilizer being serviced.

4.5.6.6.2 Before placing the sterilizer back in service,

rechallenge the sterilizer with biological

indicator tests in three consecutive empty

chamber sterilization cycles after the cause of

the sterilizer failure has been determined and

corrected.

4.6 Single-use equipment

4.6.1 Single-use, prepackaged, pre-sterilized equipment and supplies must

obtained from commercial suppliers or manufacturers.

4.6.1.1 Maintain receipts of purchase for all disposable, single-use

and pre-sterilized instruments for a minimum of 90 days

after use.

4.6.1.2 Receipts must be made available to the Health Authority

upon request.

4.6.2 Single-use items must not be reused for any reason.

4.6.3 Single-use items must not be re-sterilized if expired.

4.6.4 Single-use items must be kept dry, and stored in a closed cabinet,

drawer, or tightly covered container reserved for the storage of such

items.

4.6.5 The Health Authority must be notified by the permit holder in writing

before a body art establishment changes from using single- use

equipment to reusable equipment.

4.6.5.1 The permit holder must provide an approved sterilizer.

4.6.5.2 The approved sterilizer must have a negative spore test

that is no older than 30 days.; and

4.6.5.3 The sterilizer must not be used until it has been approved

by the Health Authority,

4.6.5.4 Until the Health Authority approves the sterilizer, the

body art establishment must continue to use

prepackaged, single-use, pre-sterilized equipment and

supplies.

4.7 Dyes and pigments

4.7.1 All inks, dyes, and pigments must be specifically manufactured for

performing body art procedures.

4.7.2 Inks, dyes and pigments must be used prior to expiration dates.

4.7.3 Inks, dyes and pigments must be commercially manufactured.

4.7.4 Only distilled water or sterile water dispensed from an unopened single-

use container can be used for the mixing of inks, dyes, or pigments.

Diluting with potable water is not acceptable. Such dilution must be

single-use for the individual procedure. Immediately before a tattoo is

applied, the quantity of the dye to be used must be transferred from the

dye bottle and placed into single-use plastic cups or caps.

4.7.5 Upon completion of a tattoo, all single-use items and their contents

must be discarded. Including unused portions of inks, dyes and

pigments.

4.7.6 For individuals performing microblading or manual procedures, once

the needle grouping (blade) is attached to the handpiece it cannot be

removed and the entire assembly must be disposed of into the sharps

container.

4.8 Materials used in body art work preparation and application

Materials such as mimeograph paper, markers, alcohol, lubricants,

razors, etc. used in preparation for the application of a body art work

must be kept clean and in good condition.

4.8.1 All materials which are designed for multiple use (e.g., markers) must

only be applied directly to clean, unbroken skin. If such materials come

into contact with blood or bodily fluids, they cannot be reused and must

be immediately discarded.

4.9 Equipment used for practice

4.9.1 Equipment used for practice must be set aside in a designated

location.

4.9.2 Single-use equipment that has expired may be set aside to use for

practice if the following conditions are met:

4.9.3 Equipment is labeled “EXPIRED. FOR PRACTICE ONLY. NOT FOR

USE ON PATRONS” on the outside of the container.

4.9.3.1 Expired equipment is not to be used on patrons.

4.9.3.2 Expired equipment is not kept in the same area as the

equipment to be used for patrons.

Section 5

RESPONSIBLE PERSON, BODY ARTISTS, PERMIT

HOLDERS AND VISITING BODY ARTISTS

5 5

5.1 Responsible person

5.1.1 The permit holder must designate a responsible person or persons

to act on their behalf within the body art establishment. A

responsible person must be present during all hours of operation and

any time a body art procedure is being performed.

5.1.2 The responsible person must ensure that all applicable permits,

certifications and licenses that are required are visible to patrons and

the public and are properly displayed in the locations indicated by the

Health Authority and other AGENCIES OF JURISDICTION.

5.1.3 The responsible person is held accountable for compliance with all

requirements of these regulations

5.1.4 Violation of any one or a combination of these Regulations by the body

art establishment, the responsible person, any personnel, body

artist, or visiting body artist may result in the summary suspension,

pending revocation, of the health permit and interruption of business

operations while the matter is resolved with the Health Authority.

5.1.5 The responsible person may also act as an Event Coordinator during

a body art special event.

5.2 Body artist

5.2.1 All body artists must complete training and obtain a body art card as

described in section 8 of these Regulations prior to working as a body

artist.

5.2.2 Body artists, while on duty, must:

5.2.2.1 Utilize or wear effective hair restraints if they have hair over

the ears;

5.2.2.2 Have clean hands and fingernails;

5.2.2.3 Wear clean outer garments; and

5.2.2.4 Have good personal hygiene.

5.2.3 The body artist must be free of any skin rash, sores, viral or bacterial

infection or other illness that may be transmitted to a patron as result of

carrying out the body art procedure.

5.2.4 Body artists cannot perform body art services outside of the permitted

body art establishment or body art special event.

5.2.5 Body artists must not perform body art procedures while under the

influence of an intoxicating substance, including without limitation

alcohol or cannabis. Alcoholic beverages are not permitted in the

workstation. Evidence that the body artist is applying body art while

inebriated is sufficient cause for summary suspension and possible

revocation of the body art card.

5.3 Permit holders

5.3.1 Permit holders are required to comply with the State of Nevada

Occupational Safety and Health Standards for General Industry (29

CFR Part 1910.1030) regarding occupational exposure to bloodborne

pathogens.

5.3.2 Permit holders or the responsible person are responsible for:

5.3.2.1 Ensuring that body artists have a current body art card

and comply with all applicable health, safety, sanitation and

sterilization Regulations of the Health Authority and other

agencies.

5.3.2.2 Maintaining a list of all body artists who currently work at

the establishment and who have worked at the

establishment within the preceding two years. The list

shall include the legal name, date of birth, residential and

mailing address, phone number, description of duties, and

copy of the body art card for each body artist.

5.3.3 It is the responsibility of the permit holder or responsible person to

ensure that all personnel, contractors, and agents of the body art

establishment understand and adhere to the Regulations.

5.4 Visiting body artists

5.4.1 The permit holder may also hire body artists who have been

approved to work as visiting body artists by the Health Authority.

5.4.2 Visiting body artists from other jurisdictions must be hosted by a body

art establishment with a valid health permit for a period of time no

longer than 14 consecutive days.

5.4.3 Each visiting body artist must make application to the Health

Authority for each time interval in which they would like to participate.

5.4.4 While performing body art procedures within the jurisdiction of the

Health Authority, visiting body artists must comply with all applicable

Regulations. Failure to do so may result in revocation of permission to

participate.

5.4.5 Visiting body artists must not perform procedures in any location

outside of the body art establishment or special event for which they

are registered.

5.4.6 Once the approved visitation period ends, the visiting body artist is

no longer permitted to practice body art in Clark County.

Section 6

PATRONS

6.1 Patron age requirements and other age restrictions

6.1.1 The age of all patrons must be verified by

6.1.1.1 reviewing a government issued identification document that

has

6.1.1.1.1 Not expired

6.1.1.1.2 Contains a photograph of the patron, and

6.1.1.1.3 Contains the patron’s birthdate.

6.1.2

6.1.3

6.1.4

6.1.5

6.1.1.2 review of the patron’s identification must be indicated on

the patron consent form prior to performing the procedure.

The photographic identification document of patrons who are 21 years

of age or younger must be photocopied and kept with the patron’s

paperwork.

If the patron is less than 18 years of age and is not an emancipated

minor, the parent or legal guardian must present their photographic

identification document and a copy of the proof of custody or

guardianship to the body artist prior to the procedure. A copy of the of

the photographic identification of the patron, and their parent or legal

guardian along with the proof of custody or guardianship must be

attached to the completed consent form.

If the client is an emancipated minor, a certified copy of the decree of

emancipation issued to the minor pursuant to NRS 129.080 to 129.140,

inclusive. A copy of the photographic identification and copy of the

decree of emancipation must be attached to the completed consent

form.

Body art establishments are prohibited from applying body art not

specifically exempted by these regulations to persons less than

fourteen years old.

6.2 Patron consent form

Before administering body art, the patron must complete a patron consent

form.

6.3 Contents of patron consent form

The patron consent form must contain the following:

6.3.1 Patron’s name, date of birth, phone number and address;

6.3.2 Documentation of parental or custodial consent for patrons who are

less than 18 years of age;

6.3.3 Body artist’s name as indicated on body art card;

6.3.4 A risk notification section that provides information detailing the risks

and possible consequences of a body art procedure must include risks

including, but not limited to, the following:

6.3.4.1 Body art can cause swelling, bruising, discomfort,

bleeding, and pain;

6.3.4.2 Body art can cause allergic reactions;

6.3.4.3 Body art can cause irreversible changes to the human

body; and body art has a risk of infection.

6.3.4.4 Any effective removal of the body art work may leave

permanent scarring and disfigurement.

6.3.5 Patron evaluation section that asks at a minimum the following

questions that evaluate Patron’s condition for receiving body art

without violating their medical privacy. This section must include the

following statement: Consult a physician prior to the procedure if you

have any concerns about any of the questions below:

6.3.5.1 Have you eaten within the past 4 hours?

6.3.5.2 Are you under the influence of drugs or alcohol?

6.3.5.3 Have you ingested anticoagulants (such as heparin or

warfarin), antiplatelet drugs, or nonsteroidal anti-

inflammatory drugs (NSAIDS) (such as aspirin, ibuprofen,

etc.) in the last 24 hours?

6.3.5.4 Have you ingested any medication that can inhibit the

ability to heal a skin wound?

6.3.5.5 Do you have any allergies or adverse reactions to dyes,

pigments, latex, iodine, or other such products?

6.3.5.6 Do you have hemophilia, epilepsy, a history of seizure,

fainting, narcolepsy, or other conditions that could interfere

with the body art procedure?

6.3.5.7 Do you have a history of skin diseases that might inhibit

the healing of the body art procedure?

6.3.5.8 Do you have any communicable diseases (i.e., hepatitis

A, hepatitis B, HIV, or any other disease that could be

transmitted to another person during the procedure)?

6.3.5.9 Do you have diabetes, high blood pressure, heart

condition, heart disease, or any other conditions that could

interfere with the body art procedure?

6.3.6 A work section that documents the following:

6.3.6.1 Type of body art procedure,

6.3.6.2 Location on body,

6.3.6.3 Design, if applicable,

6.3.6.4 Jewelry styles and sizes, if applicable,

6.3.6.5 Expiration date and batch and/or lot number of all

sterilized equipment used or pre-sterilized that will be

applied to or inserted under the skin,

6.3.6.6 Expiration date, brand, color, batch and/or lot number of all

inks, dyes, and pigments used in the body art procedure,

6.3.6.7 Date of body art procedure,

6.3.6.8 Any complications that occurred during the body art

procedure, and

6.3.6.9 Signature of body artist.

6.3.7 An informed consent section that includes the following:

6.3.7.1 Patrons are voluntarily obtaining services of their own free

will and volition,

6.3.7.2 Patrons have had the opportunity to read and understand

the document,

6.3.7.3 Patrons have the ability to ask questions about the

procedure,

6.3.7.4 Patrons have received and understand written and verbal

aftercare.

6.3.8 The patron must sign a copy of the notice, or, if the patron is less than

18 years of age and is not an emancipated minor, the parent or legal

guardian consenting to the body art procedure must sign the patron

consent form.

6.4 Patron assessments

6.4.1 Body art must not be administered to any person under the influence of

drugs or alcohol. The body artist and responsible person are

responsible for making reasonable observations and inquiries to

determine that the patron is sober, and not under the influence of

intoxicating substances.

6.4.2 The skin surface where the body art will be applied must be visibly free

of rash, pimples, or infection or any other visible condition which would

interfere with the healing process.

6.5 Record keeping

6.5.1 Patron consent forms must be:

6.5.1.1 At the physical location of the body art establishment

unless written permission is granted otherwise by the

Health Authority;

6.5.1.2 Maintained in an orderly manner, filed by month and year,

to facilitate retrieval of records;

6.5.1.3 Kept on premises for a minimum of two years and

6.5.1.4 Made available to the Health Authority upon request.

Section 7

BODY ART PROCEDURES

7 7General procedures

7.1.1 Aseptic techniques must be used for all body art procedures and when

handling any clean or sterilized body art equipment.

7.1.2 Before performing body art procedures, body artists must thoroughly

wash their hands in a hand sink in the following manner:

7.1.2.1 Remove all rings, watches, and bracelets surrounding

hands. Turn on warm water, wet hands, and apply soap;

7.1.2.2 Rub hands together, outside the stream of water, for 20

seconds while making a soapy lather;

7.1.2.3 Rinse hands with fingers pointed up toward the faucet and

rinse down to your wrists; and

7.1.2.4 Pat dry with a clean disposable towel.

7.1.3 Use a new clean disposable towel to turn off the handles of the sink.

7.1.4 Body artists must wash their hands if, at any point, there is an

interruption which causes the procedure to cease. Upon returning to the

patron, body artists must again wash their hands before donning fresh

gloves.

7.2 Glove use

7.2.1 During body art procedures and prior to handling sterilized

equipment, body artists must wear latex, nitrile or vinyl exam gloves.

These gloves must be discarded after each procedure to prevent

cross--contamination and when damaged, or when interruptions occur

in the procedure.

7.2.1.1 Prior to, during, and after a body art procedure, the body

artist must wear exam gloves and use aseptic techniques

to ensure that the instruments and gloves are not

contaminated. This includes, but is not limited to:

7.2.1.1.1 When setting up the procedure area. This set

up includes touching containers, ink bottles

barrier films, and exteriors of sterile

packaging.

7.2.1.1.2 When prepping skin, applying stencils, or

drawing designs on the skin.

7.2.1.1.3 Once the procedure is completed, cleaning or

applying dressings to the procedure site.

7.2.1.1.4 When tearing down and disinfecting the

procedure area.

7.3 Preparing for tattoo procedure

7.3.1 All body art workstations, surfaces of equipment, furnishings, and

articles used during a body art procedure must be covered with a

protective, impermeable barrier. Barriers must be single-use and

discarded after each patron.

7.3.2 If shaving is necessary, single-use razors or safety razors with single-

service blades must be used. Blades must be discarded in an

appropriate sharps container after each use, and reusable holders

must be sterilized after use.

7.3.3 Before a tattoo procedure is performed, the procedure site must be

prepped with an antiseptic in accordance with the manufacturer’s

instructions.

7.3.4 Substances applied to the patron’s skin to transfer designs from a

stencil or paper must be dispensed from containers in a manner to

prevent contamination of the unused portion. Use of a spray bottle to

apply liquid to the skin is acceptable. All creams and other semi-solid

substances must be removed from containers with a spatula. Individual

portions of dyes or pigments in clean single-use containers must be

used for each patron. Any remaining unused dye or pigment and the

single-use container(s) must be discarded immediately following

service.

7.3.5 Large batch containers of dyes or pigments that are used to dispense

product into the single-use containers are permitted. Dye or pigment

must not be reintroduced for any reason into these batch containers

after it has been dispensed for single-use, even if unused.

7.4 Piercing procedures

7.4.1 Before a piercing procedure is performed, the procedure site must be

prepped with an antiseptic applied in accordance with the antiseptic

manufacturer’s instructions.

7.4.2 Piercing needles must be individually packaged and sterilized, used

once, then immediately disposed of in a sharps container.

7.4.3 Piercing needles are not reusable under any circumstances.

7.4.4 All jewelry and instruments that directly aid in the piercing, or that may

come in contact with instruments that are used during the piercing,

such as forceps or needle holders, must be properly sterilized in

accordance with the procedures described in section 4.4.

7.4.5 The body artist must wear new exam gloves during each procedure.

7.4.6 Piercing guns are permitted exclusively for ear lobe piercing and are

not to be used for other body piercings.

7.4.7 Jewelry

All jewelry used for initial piercings must be obtained from a

commercial jewelry supplier

All custom manufactured jewelry used for initial piercings must meet

the following standards:

7.4.7.1 Made of materials that meet ASTM, ISO or equivalent

standards for implantation. Examples of these include but

are not limited to:

7.4.7.1.1 steel that is ASTM F138 compliant or ISO

5832-1 compliant,

7.4.7.1.2 steel that is ISO 10993-6, 10993-10, and/or

10993-11 compliant,

7.4.7.1.3 unalloyed titanium that is ASTM F67 or ISO

5832-2 compliant,

7.4.7.1.4 alloyed titanium (Ti6Al4V ELI) that is ASTM

F136 compliant or ISO 5832-3 compliant,

7.4.7.1.5 alloyed titanium (Ti6Al7Nb ELI) that is ASTM

F1295 compliant or ISO 5832-11 compliant,

and

7.4.7.1.6 any polymer or plastic material that is ISO

10993-6, 10993-10, and/or 10993-11

compliant and/or meets the U.S.

Pharmacopeia (USP) Class VI classification.

This includes but is not limited to

polytetrafluoroethylene (PTFE) that is ASTM

F754 compliant.

7.4.7.2 Solid 14 karat or higher yellow, white, or rose gold that is

nickel free and cadmium free. Gold jewelry used for initial

piercing cannot be:

7.4.7.2.1 plated,

7.4.7.2.2 gold filled, or

7.4.7.2.3 gold overlay/vermeil.

7.4.7.3 Solid unalloyed or alloyed platinum that is nickel free and

cadmium free.

7.4.7.4 Unalloyed niobium (Nb) that is ASTM B392 compliant. This

includes but is not limited to:

7.4.7.4.1 commercial grade 2 niobium and

7.4.7.4.2 commercial grade 4 niobium that contains 1%

zirconium.

7.4.7.5 Glass that is lead free. This includes, but is not limited to:

7.4.7.5.1 quartz,

7.4.7.5.2 borosilicate, and

7.4.7.5.3 soda-lime.

7.4.7.6 All threaded or press-fit jewelry used for initial piercings

must not expose any threads or other crevices after final

assembly.

7.4.7.7 For body jewelry purposes, surfaces and ends must be

smooth, free of nicks, scratches, burrs, stamps, hallmarks,

and polishing compounds.

7.4.7.8 Metals must have a consistent mirror finish on surfaces

that frequently come in contact with tissue.

7.4.7.9 All jewelry used for initial piercing on people older than 12

years must be ASTM F2999 compliant.

7.4.7.10 All jewelry used for initial piercing on people 12 and

younger must be ASTM F2923 compliant.

7.4.8 Jewelry Receipts

Purchase records for jewelry purchased for initial piercings must:

7.4.8.1 Be maintained on premises for a minimum of 90 days after

purchase.

7.4.8.2 Be retained for a minimum of two years. All two years of

records must be available to Health Authority upon

request.

7.4.8.3 Be made available to the Health Authority upon request.

7.4.8.4 List the name of the seller

7.4.8.5 List the number and type of jewelry purchased

7.4.8.6 List the name of the manufacturer of the jewelry

purchased

7.4.8.7 List the country of origin of the jewelry

7.4.8.8 Contain information indicating date of jewelry

manufacturing and jewelry material composition.

7.5 Single-use items-rules and prohibitions

7.5.1 Single-use items must not be reused for any reason. After use, all

needles, razors and other sharps must be immediately disposed of in

sharps containers.

7.5.2 A single body art session that is interrupted for a brief amount of time,

such as, to use the RESTROOM or break for drinking water, does not

require disposal of all single- use items being used on a single patron.

Using the same supplies to complete the body art session on a single

patron does not constitute a case of reuse.

7.5.3 Products used in the application of stencils must be dispensed and

applied on the area to be tattooed with a suitable clean, single-use

product and used in a manner to prevent contamination of the original

container and its contents.

7.6 Contamination of items

Any item or instrument used for body art that becomes contaminated during the

procedure must be immediately removed from the procedure area and replaced

before the procedure resumes

7.7 Reusable Spatulas

Spatulas made of a washable, non-absorbent material and designed for multiple

use may be sterilized and used again. Spatulas made of wood or otherwise

designed for single-use must be discarded after a single-use. Single-use tubes

or containers must be discarded following the tattoo procedure.

7.8 Unused dye or pigment

Any remaining unused dye or pigment and the single-use container(s) must be

discarded immediately following service.

7.9 Linens

7.9.1 If linens are used, clean linens must be used for each patron and

laundered after each use.

7.9.2 Clean linens, tissues or single-use paper products must be stored in a

clean, enclosed storage area until needed for immediate use.

7.9.3 Used linens must be stored in a closed or covered container until

laundered.

7.9.4 Used linens must be laundered in a washing machine with laundry

detergent and chlorine bleach or by a commercial laundry service.

7.10 Bandaging

Any bandaging or other products applied to the area of the body on which the

procedure was performed must be single-use and manufactured for the sole

purpose of wound care, cleaning or medical care.

7.11 Aftercare instructions

7.11.1 The written aftercare instructions must include the following;

7.11.1.1 The name, address and telephone number of the body art

establishment.

7.11.1.2 The name of the body artist who performed the procedure

as it appears on their body art card;

7.11.1.3 A detailed description of how to care for the body art,

including a description of any necessary cleaning and

bandaging;

7.11.1.4 Possible side effects from the body art procedure;

7.11.1.5 Any restrictions on various activities;

7.11.1.6 Instructions on, signs of an infection or allergic reaction

and when to consult a physician;

7.11.1.7 The expected duration for healing; and

7.11.1.8 A statement in the same font and size as the facility’s

aftercare instructions that states: “If an infection or adverse

reaction occurs at your procedure site, contact your

personal physician for treatment and report to the Southern

Nevada Health District special programs at (702) 759-0677

or bodyart@snhd.org.”

7.11.2 The body artist will provide both verbal and written aftercare

instructions to each patron following each procedure

7.11.3 The written aftercare instructions can be provided in either a print or

digital form.

7.11.4 Written aftercare instructions must also be posted in a prominent and

conspicuous area where it can be readily observed by patrons.

7.11.5 The content of the written aftercare instructions must be approved by

the Health Authority.

7.12 Infection control plan contents

Pursuant to NAC 444.00777, an infection control plan must:

7.12.1 Be reviewed annually by all personnel.

7.12.2 Be submitted to the Health Authority for approval when any change is

made to the infection control program.

7.12.3 Be provided to the Health Authority upon request.

7.12.4 Include the following:

7.12.4.1 The types body art procedures performed in the body art

establishment;

7.12.4.2 Procedures for cleaning and disinfecting surfaces;

7.12.4.3 Procedures for cleaning, disinfecting, packaging,

sterilizing and storing reusable instruments and

equipment;

7.12.4.4 Procedures for protecting clean instruments and sterile

instrument packs from exposure to dust and moisture

during storage;

7.12.4.5 A set-up and tear-down procedure for all body art

procedures performed in the body art establishment;

7.12.4.6 Techniques and procedures to prevent the contamination

of instruments, equipment, surfaces or the procedure area

during a body art procedure;

7.12.4.7 Procedures for the safe handling and disposal of sharps

and biohazardous waste;

7.12.4.8 The records required to be maintained by the responsible

person to demonstrate that the infection control plan is

properly operated and managed; and

7.12.4.9 Any additional scientific data or other information, as

required by the Health Authority, to support the

determination that the infection control plan and the

operations of the body art establishment are sufficient to

protect the public health.

7.13 Infection reporting required

7.13.1 Any infection resulting from the body art procedure, which becomes

known to the body artist or the body art establishment, must be

immediately reported to the Health Authority by phone or by e-mail.

7.14 Reporting adverse events

7.14.1 Body artists must report all adverse events relating to or suspected of

being related to materials used during a body art procedure to the

Health Authority, including the name of the body artist, patron

information, description of adverse event(s), and a complete description

of materials involved including lot and/or batch codes. This reporting will

help identify outbreaks and identify products with manufacturing

defects. A record of this reporting must be maintained with the

complaint of injury form in patron records.

7.14.2 Copies of reports for all adverse events that occurred at the body art

establishment must be maintained by the body art establishment,

available upon request, for three years after the event. Adverse

reactions that occur when using Federal Drug Administration (FDA)-

regulated products should be reported to the FDA MedWatch program

and noted in the MedWatch Individual Case Safety Report ID (ICSR).

7.15 Food

7.15.1 Eating or drinking by anyone is prohibited in the workstation and any

other location where instruments or supplies are stored or cleaned such

as the equipment processing room.

7.15.2 An enclosed beverage, such as bottled water, is allowed at the

workstation while the body artist is working on patron.

7.16 Prohibited acts

The following acts are expressly prohibited by the Health Authority in body art

establishments and body art special events:

7.16.1 Any extreme body modification such as

7.16.1.1 Scarification

7.16.1.2 Branding

7.16.1.3 Cutting

7.16.1.4 Skin peeling

7.16.1.5 Implantation,

7.16.1.6 Suspension piercing,

7.16.1.7 Dermal punching,

7.16.1.8 Single point piercing,

7.16.1.9 Voluntary amputation

7.16.1.10 Tongue and/or penis splitting,

7.16.1.11 Neck rings,

7.16.1.12 Or otherwise determined by the Health Authority.

7.16.2 Tattoo or permanent makeup removal by means of:

7.16.2.1 Surgery,

7.16.2.2 Treatment with a chemical or substance (e.g. tattoo

remover), or

7.16.2.3 Medical device such as infrared coagulator or laser.

7.16.3 The injection into the human body of:

7.16.3.1 Botulinum toxin,

7.16.3.2 Prescription numbing agents, or

7.16.3.3 Any substance other than dyes or pigments approved for

tattooing.

Section 8

BODY ART CARD REQUIREMENTS AND FEES

8.1 Purpose

The purpose of this section is to ensure that each body artist has a base level of

knowledge regarding the spread of disease through the practice of body art.

This is done through using an apprentice/mentor body artist training system.

8.2 Application for body art card

Application for a body art card must be made to the Health Authority on forms

approved by the Health Authority.

8.3 Items required for application

In addition to the body art card application form, the following items must be

provided to the Health Authority:

8.3.1 Proof of completion of the American Red Cross training in Preventing

Disease Transmission (PDT) or equivalent training.

8.3.2 A government issued identification document that has

8.3.2.1 Not expired;

8.3.2.2 Contains a photograph of the applicant and

8.3.2.3 Contains the applicant’s birthdate, showing that the

applicant is at least 18 years of age.

8.3.3 Fees for the written exam (non-refundable) and body art card as

determined by the Health Authority Fee Schedule.

8.3.4 Proof of training

8.3.4.1 If the applicant has not completed a minimum of six

months of training or experience or if documentation of

training or experience is unavailable,

8.3.4.1.1 The applicant must enter into a Health and

Sanitation apprenticeship with a mentor

body artist at a permitted body art

establishment within Clark County.

8.3.4.1.2 The name of the mentor body artist and their

mentor body artist body art card number

sponsoring the apprenticeship must be

indicated on the “Body Art Card Application”

form.

8.3.4.1.3 Upon completion of a minimum of six months

training, the applicant must return to the

Health Authority with written proof from their

mentor of training and experience in order to

obtain their body art card.

8.3.4.2 If the applicant has worked in a body art establishment

outside of Clark County, written proof from a previous

employer that the applicant has a minimum of six months

experience or training as a body artist in a permitted body

art establishment will be accepted. The written proof

must:

8.3.4.2.1 Show current date,

8.3.4.2.2 Be on company letterhead of former employer,

8.3.4.2.3 List specific dates of experience or training,

8.3.4.2.4 Contain printed name and signature of the

person writing the letter of proof,

8.3.4.2.5 If the applicant is/was the owner of the

establishment that is outside of Clark County,

a copy of the establishment’s business license

with the applicant’s name on it will meet the

requirements of proof of experience.

8.4 Written exam

8.4.1 After an application for a new body art card has been accepted the

applicant will take a written exam.

8.4.2 A passing score for the exam is 80% or higher correctly answered

questions.

8.4.3 If an applicant does not pass the written exam, a new appointment to

retake the exam can be made; however, the exam fee must be paid

again.

8.5 Exam study and organizational materials

The applicant may access study materials to assist in preparing for the body art

card exam by visiting the Health Authority’s website:

www.southernnevadahealthdistrict.org in the body art card section.

8.6 Microblading card

8.6.1 A person who limits their practice to microblading only parts of the

face may apply for a microblading card following the steps outlined in

8.2 to 8.5 of these regulations, except:

8.6.2 A microblading card is not a body art card.

8.7 Mentor body artist card

A mentor body artist may sponsor

8.7.1 no more than five apprentices at any one time

8.7.2 no more than fifteen microblading apprentices at any one time.

8.8 Body art card, mentor body artist card and microblading card renewal

Body art cards mentor body artist cards and microblading card must be

renewed every two years.

8.9 Expired body art cards mentor body artist and microblading card cards

8.9.1 Body artists mentor body artists and microblading artists must not

perform body art procedures if their card is expired. Performing body art

procedures with an expired body art, mentor body artist or

microblading card is a violation of these Regulations and is subject to

enforcement provisions of Section 11 of these Regulations, up to and

including denial of a future body art card or mentor body artist or

microblading card.

8.9.2 If the body artist allows their body art card or microblading card to

expire for more than 1 year, they will be required to repeat the

application process, including retaking the basic sanitation examination

with a passing score and paying all applicable fees.

8.9.3 If a mentor body artist allows their card to expire for more than 1

year, they will

8.9.3.1 Be required to repeat the application process (including

retaking the basic sanitation examination with a passing

score and paying all applicable fees).

8.9.3.2 Be issued a body art card upon successful completion of

the application process.

8.9.3.3 No longer be able to sponsor apprentices for a period of

two years.

8.10 Valid card in body artist’s possession

A valid body art, mentor body art or microblading card must be in the body

artist’s possession, either on their person or readily available in their personal

affects, at all times while engaged in the practice of body art work.

8.11 Issuance of an apprentice body art, body art or mentor body artist cards

8.11.1

8.11.2

8.11.3

8.11.4

Apprentice body art cards will be issued for applicants who have not

completed the six-month training requirement but have passed other

requirements.

Microblading apprentice cards will be issued for applicants who have

not completed the six-month training requirement but have passed

other requirements

The permanent body art or microblading card will be issued after

documentation of the required six-month experience has been received.

A mentor body artist card can be issued upon request after providing

evidence of four consecutive years of experience. Evidence can be

shown by holding a body art card issued by the Health Authority, and/

or by providing evidence of experience in a jurisdiction

outside of the Health Authority.

8.11.5 Issuance of the body art card or mentor body artist card is conditional

upon full compliance with these Regulations.

8.12 Body art and mentor body artist card transfer prohibition

All cards are issued to an individual and are not transferable from person to

person.

8.13 Existing body art cards

A body artist who holds a body art card at the time these Regulations are

adopted can apply for a mentor body artist card without the four years’

experience before June 30, 2023.

8.14 Existing apprentice cards

Any apprentice who received their body art card prior to the adoption these

Regulations may continue as an apprentice until they meet the requirements of

being eligible to apply for their body art card.

8.15 Permit holder’s joint responsibility

The permit holder has joint responsibility with the body artist in ensuring that

each individual they hire or consent to take as an apprentice obtains a body art

card in accordance with these Regulations. Allowing individuals to practice as a

body artist within a body art establishment without a valid body art card is

grounds for enforcement action, up to and including suspension of the health

permit for the body art establishment.

Section 9

BODY ART SPECIAL EVENTS

9.1 Special event body artist application

9.1.1 An event permit may be issued by the Health Authority for

educational, sales, or convention purposes.

9.1.2 The event permit can be valid from 1 to 14 days. The length of an

event determines the necessary fees based on the Health Authority’s

current Fee Schedule.

9.1.3 An application must be accompanied by payment of applicable fees at

least 30 days prior to the start of the event. A late fee will be assessed

if the application and fee are not received a minimum of 30 days prior to

the start date of the event. Applications submitted less than 30 days

prior to the start of the event may not be accepted, subject to the

discretion of the Health Authority.

9.1.4 During the special event, all body art procedures must be conducted

inside an approved location that has the sanitary facilities as described

in section 9.3.

9.1.5 A person who wishes to obtain an event permit must:

9.1.5.1 Submit a completed “Special Event Permit Application” to

the Health Authority, at least 30 days prior to the event

9.1.5.2 Provide proof of experience by any of the following ways:

9.1.5.2.1 Provide a copy of their registration or body art

card issued by another Health Authority,

9.1.5.2.2 Provide a copy of a current business license

of the body art establishment that they

currently working at, or

9.1.5.2.3 A letter from the Event Coordinator that states

that the artist has the minimum experience

specified in section 8.5.1.

9.1.5.3 Pay the appropriate fees

9.2 Special Event Coordinator

9.2.1 If more than one body artist will be participating, each entity hosting a

special event must designate a Special Event Coordinator (Event

Coordinator) who is responsible for each artist’s compliance with the

applicable Regulations and operational procedures over the span of the

special event.

9.2.2 The Event Coordinator must make application and pay all applicable

fees designated by the Health Authority.

9.2.3 The Event Coordinator must provide equipment and supplies to

correctly dispose of all sharps and biohazardous waste.

9.2.4 The Event Coordinator or designee must be available during the

inspection of the body artists and throughout the duration of the

special event.

9.2.5 If the special event exclusively uses single-use, prepackaged,

sterilized equipment obtained from commercial manufacturers then

sterilization equipment is not necessary.

9.2.6 If any sterilization equipment is used to sterilize reusable

equipment, then a spore test must be performed and passed for no

more than seven days prior to the date of the event. A copy of the

spore test must be provided to the Health Authority prior to the start

of the special event.

9.2.7 The Event Coordinator must provide an appropriate number of

conveniently located hand washing facilities with liquid soap, paper

towels and hot and cold water under adequate pressure and drained in

accordance with local plumbing codes.

9.2.8 When submitting an application for a special event, the Event

Coordinator must provide to the Health Authority

9.2.8.1 A copy of the patron consent form and patron aftercare.

These forms must:

9.2.8.1.1 Meet the requirements outlined in sections

6.2, 6.3 and 7.11 of these Regulations.

9.2.8.1.2 Must be used by all body artists at the event

for consent and aftercare.

9.2.8.2 A floor plan of the event that indicate the location of booths

that may have body artists. Each booth must be at least

50 square feet of floor space for each working body artist.

9.2.8.3 The type of flooring in the booths.

9.2.8.4 The location of the hand washing facilities.

9.2.8.5 If provided, the location of sterilizer and cleaning facilities

9.2.8.6 A copy of the agreement between the Event Coordinator

and biohazardous waste hauler for the appropriate

disposal of all sharps and other biohazardous waste.

9.2.8.7 Water supply and wastewater disposal methods.

9.3 Special event operational requirements

9.3.1 The event permit will consist of a wrist band that must be worn on the

wrist by the artist during the entirety of the special event.

9.3.2 Compliance is required with all of the requirements of these

Regulations, including without limitation:

9.3.2.1 Provision of disinfecting single-use hand wipes,

approved by the Health Authority, in addition to the hand

washing requirements of this Section;

9.3.2.2 At least 50 lumens per foot of light in a fixture shielded with

a solid barrier or a bulb constructed of shatterproof

materials at the level where the body art work is being

applied.

9.3.2.3 Provision of equipment and supplies to properly clean and

disinfect the area used for body art work.

9.3.2.4 Ability to clean and sterilize reusable equipment using the

equipment provided by the Event Coordinator.

9.3.2.5 Provision of equipment and supplies to correctly dispose

of all sharps and biohazardous waste.

9.3.2.6 Provision of equipment and supplies to dispose of all non-

hazardous solid waste.

9.3.2.7 Smooth, nonabsorbent flooring that can be cleaned and

disinfected or disposed of.

9.3.3 All areas where body art takes place will be inspected and body

artists will be interviewed by the Health Authority.

9.3.4 Upon successful completion of the inspection and interview, an event

permit will be issued.

9.3.5 No body art procedures can be performed until after the Event Permit

is issued.

9.3.6 The approved event consent form and aftercare instructions will be

used to provide consent and aftercare instructions to the patrons.

9.4 Event permit suspension

Event permits issued under the provisions of these Regulations may be

suspended by the Health Authority for failure of the Event Coordinator, or

permitted event body artists, to comply with the requirements of these

Regulations.

Section 10

HEALTH PERMIT, CHANGE OF PERMIT HOLDER, AND

WAIVERS, AND FEES

10.1 Health permit required

All body art establishments must have a valid health permit issued by the

Health Authority in order to operate.

10.2 Health permit exemptions and prohibitions

10.2.1 A physician, or a person working under the direct supervision of a

physician, performing body art work in the physician’s office or clinic, is

exempt from these Regulations.

10.2.2 No health permits will be issued to private residences, including

apartments, condominiums, multi-family or single-family dwellings for

body art work activities.

10.2.3 Body art performed in a location other than a permitted, body art

establishment or special event is in violation of these Regulations and

will be ordered to cease and desist all activities. If the individual also

holds a body art card, the body art card is subject to suspension or

revocation.

10.3 New and remodeled body art establishments permits

10.3.1 To qualify for a permit, an applicant must:

10.3.1.1 Be an owner, prospective owner, person legally in charge,

owner designee, or an officer of the legal ownership of the

body art establishment;

10.3.1.2 Pay the applicable fees at the time the application is

submitted; and

10.3.1.3 Comply with the requirements of these Regulations.

10.3.2 Application submission

10.3.2.1 Applications for a permit must be made in a manner

required by the Health Authority.

10.3.2.2 Applications must be submitted at least 30 days before:

10.3.2.2.1 Construction begins, if the facility has not yet

been built;

10.3.2.2.2 The opening date of any body art

establishment if located inside existing

construction; and/or

10.3.2.2.3 The effective date of a change of permit

holder.

10.3.3 Contents of the application

The application must include:

10.3.3.1 Proof of location, such as a lease, deed, or other legally

executable document,

10.3.3.2 Equipment specifications, such as the name and model

number of the sterilizer, if applicable,

10.3.3.3 A written infection control plan designed to eliminate or

minimize personnel exposure to blood or OPIM as

required in 29 CFR 1910.1030(b),

10.3.3.4 Copy of a current body art card of a responsible person,

10.3.3.5 A proposed patron consent form that meets the

requirements of 6.2 and 6.3,

10.3.3.6 Proposed aftercare instructions that meet the requirements

of section 7.11,

10.3.3.7 For new or remodeled body art establishments, plans

must be submitted that include the dimension of each

workstation, the location of plumbing fixtures, floor, wall

and ceiling materials, light levels, locations of sharps

containers, and the locations of the sterilizer and

ultrasonic cleaner, if used, in equipment processing

room.

10.4 Permit conditions

10.4.1 Permit approval for a body art establishment is contingent upon

compliance with applicable laws and Regulations including local

building ordinances and codes. In the event that there are any conflicts

between these requirements, the more stringent requirement must be

met.

10.4.2 Pre-approval inspection

At the time of the final permitting inspection, the permit holder or

responsible person must provide the following,

10.4.2.1 Equipment to be used in the facility to administer body art

10.4.2.2 The results of a spore test conducted after the sterilizer

was installed. The spore test must have been performed

no earlier than 30 days prior to the inspection and must

indicate that the sterilizer is functioning adequately

10.4.3 If the Health Authority determines, after inspection, that the proposed

body art establishment can be operated in accordance with the

provisions of these Regulations, a health permit will be issued to the

applicant.

10.5 Change of permit holder of an operating body art establishment

10.5.1 An existing body art establishment, at the time of change of permit

holder, must meet the requirements of these Regulations prior to

issuance of a permit.

10.5.2 The Health Authority may issue a permit to a new permit holder of an

existing body art establishment after a properly completed application

is submitted and reviewed, fees are paid, and an inspection is passed.

10.5.3 A facility will be required to bring any aspect of the body art

establishment into compliance with the current Regulations, laws and

codes when ownership changes.

10.5.4 Notification of Health Authority

The owner or permit holder will notify the Health Authority in writing

by e-mail or letter of any changes in the permit holder.

10.6 Waivers

10.6.1 Conditions of waiver

The Health Authority may grant a waiver by modifying or waiving the

requirements of these Regulations if, in the opinion of the Health

Authority, public health and safety will not be impacted as a result of

an approved waiver.

10.6.1.1 The Health Authority may impose conditions on the body

art establishment relating to the mitigation of hazards.

10.6.1.2 If the waiver is granted, the permit holder must comply

with all operational plans, procedures, and conditions

stipulated in the waiver.

10.6.1.3 Failure to meet any the waiver conditions may result in

immediate closure pending revocation of the waiver and

violations against the health permit.

10.6.2 Documentation of proposed waiver and justification

A body art establishment seeking a waiver must apply in the manner

required by the Health Authority. The application must include, but not

be limited to:

10.6.2.1 A statement of the proposed waiver of the regulatory

requirement citing relevant Regulation section numbers.

10.6.2.2 A statement of how the intent of the Regulations will be

met with regard to elimination or mitigation of the any

hazards resulting from waiver of the Regulation and the

reasons why public health and safety would not be

jeopardized if the waiver was granted.

10.6.2.3 An operational plan, if required, that includes information

relevant to the waiver requested.

10.6.2.4 Approvals from other agencies having jurisdiction.

10.6.2.5 Any other information required by the Health Authority to

make a determination on the waiver

10.6.3 A health permit cannot be issued until a waiver determination is made.

10.6.4 If additional information is requested by the Health Authority, but not

provided within ten business days, the waiver application may be

denied.

10.6.5 Waivers are not transferrable from one business owner or location to

another.

10.6.6 The appeal process of denial of a waiver is to submit a variance

petition to the District Board of Health.

10.7 Health permit payment of fees

10.7.1 Health permit fees must be paid annually.

10.8 Prohibition of the transfer of the health permit

Health permits are not transferable from person to person or location to location.

10.9 Permit modifications

Proposed modifications in the type of operations to be conducted by a body art

establishment are not be allowed unless approved by the Health Authority.

The modification process may include, but not be limited to, submission of a

construction or waiver application, complete with plans and information

describing the proposed modifications in design, equipment, and operations.

10.10 Health permit posted

10.10.1 The current health permit must be posted in plain view of the general

public and must not be altered or defaced in any manner.

10.10.2 The permit holder must also post, in public view within the premises,

next to the health permit, in a plain font with a minimum 0.5 inch height

the following statement: “This facility is permitted by the Southern

Nevada Health District (SNHD). Resources and information can be

found on SNHD’s website using the QR code below. SNHD can be

reached at 702 759 0677 or bodyart@snhd.org.” and a QR code at

least 1 inch square that links to the Health Authority’s website on

body art regulation.

10.11 Deletion of the health permit

To remove a body art establishment from regulatory oversight and have the

associated health permit deleted, the owner or permit holder must notify the

Health Authority in writing of permanent closure of the establishment.

Section 11

ENFORCEMENT AND INSPECTIONS

11.1 Documentation of conditions

11.1.1 The Health Authority shall address conditions necessary to protect

public health and may impose specific requirements in addition to the

requirements specified in these Regulations.

11.1.2 The Health Authority shall prepare a report describing any deficiencies

discovered during the inspection including corrective actions, and

applicable deadlines for compliance.

11.1.3 The Health Authority shall document the conditions that necessitate

the imposition of additional requirements and the underlying public

health rationale.

11.1.4 A copy of the completed report will be furnished to the permit holder,

responsible person or body artist, and a copy of the report will be

maintained in the Health Authority’s file in accordance with its records

retention policy.

11.2 Failure to correct a deficiency

11.2.1 Failure to correct a deficiency within the period specified in the written

report is a violation of these Regulations.

11.2.2 Violations that constitute an imminent threat to public health and safety

are addressed in Section 2 of these Regulations and are a violation of

these Regulations.

11.2.3 Health permits may be revoked or suspended for violation of these

Regulations in accordance with the procedures set forth in section 12.

11.3 Responsibilities

11.3.1 Responsibilities of the Health Authority

11.3.1.1 The responsibilities of the Health Authority include

informing the permit holder how to obtain a copy of these

Regulations, and that the permit holder is responsible for

compliance with these Regulations.

11.3.1.2 Failure to provide the above information does not prevent

the Health Authority from taking authorized action, or

seeking remedies, if the permit holder fails to comply with

these Regulations or an order, warning, or directive of the

Health Authority.

11.3.2 Responsibilities of the permit holder

To retain the permit, the permit holder must:

11.3.2.1 Post the health permit in a location in the body art

establishment that is clearly conspicuous to the patron.

11.3.2.2 Immediately discontinue operations and notify the Health

Authority if an imminent health hazard exists.

11.3.2.3 Allow the Health Authority access to the body art

establishment during normal operating hours or upon

request.

11.3.2.4 Comply with directives of the Health Authority, including,

without limitation, time frames for corrective actions

specified in inspection reports, supervisory conferences,

compliance schedules, notices, orders, warnings, and

other directives issued by the Health Authority concerning

the permit holder's body art establishment.

11.3.2.5 Comply with all applicable federal, state and local

governmental requirements as related to the operation of a

body art establishment. The responsibility of upholding

these requirements falls solely on the permit holder, and

failure to do so may result in permit suspension or

revocation.

11.3.2.6 Accept notices issued and served by the Health Authority.

11.4 Inspections

11.4.1 Inspection authority

11.4.1.1 Upon presenting proper identification, the Health

Authority must have the right of access, entrance,

inspection, and investigation of any body art

establishment permitted by these Regulations.

11.4.1.2 The right of access pursuant to this Section, includes, but,

is not limited to access for the purpose of:

11.4.1.2.1 Routine inspection;

11.4.1.2.2 Inspection or investigation to determine if

there has been a violation of NAC Chapter

444 or these Regulations;

11.4.1.2.3 Verification of compliance with previously

written violation notices;

11.4.1.2.4 Collection of samples or specimens;

11.4.1.2.5 Examination, review, and copying of relevant

documents and records;

11.4.1.2.6 Obtaining photographic or other evidence

needed to enforce these Regulations; and

11.4.1.2.7 Questioning any personnel present.

11.4.1.3 If the Health Authority is refused access, the Health

Authority must:

11.4.1.3.1 Inform the person that access is a condition of

the acceptance and retention of the health

permit; and

11.4.1.3.2 Provide details of the denial of access on an

inspection report form and the body art

establishment will be posted as closed.

11.5 Interfering with the Health Authority

11.5.1 It is a violation of these Regulations for a person to interfere with, deny,

or delay an inspection conducted by the Health Authority.

11.5.2 As specified in NRS 199.300, it is unlawful for any person to directly or

indirectly intimidate a public employee.

11.6 Issuing report and obtaining acknowledgment of receipt

11.6.1 At the conclusion of the inspection, the Health Authority must:

11.6.1.1 Review a copy of the completed inspection report, and any

corresponding notice to correct violations with the permit

holder or the responsible person; and

11.6.1.2 Obtain a signed acknowledgement of receipt on the report.

If an electronic report, the acknowledgement may be by

other means.

11.6.2 Refusal to sign acknowledgement

11.6.2.1 Should the permit holder or responsible person refuse

to sign the acknowledgment on the report, the Health

Authority must inform the refusing party that:

11.6.2.1.1 Refusal to sign an acknowledgment does not

nullify the inspection report or the permit

holder's obligation to correct the violations

noted in the inspection report within the time

frames specified, and

11.6.2.1.2 An acknowledgment of receipt does not

constitute an agreement with findings.

11.6.2.2 The refusal will be documented on the report.

11.6.2.3 The inspector will provide a copy of the inspection report to

the permit holder or responsible person.

11.7 Inspection frequency

11.7.1 The inspection frequency will be a minimum of once per calendar year.

11.7.2 The frequency may be increased based upon non-compliance of the

body art establishment.

11.8 Follow-up inspection

11.8.1 The Health Authority will inspect the premises after any failed

inspection upon notification that the hazard has been eliminated, after

the time designated to correct the violation has lapsed or to remove the

closure signs after verifying corrections of violations. The Health

Authority, in its sole discretion, may accept other evidence of

correction of the hazard in lieu of inspecting the premises.

11.8.2 Failure to correct the violations that resulted in the failed inspection or

after the body art establishment was posted closed by the Health

Authority, will result in additional follow-up inspections and assessment

of the appropriate fees and continued closure if appropriate.

11.9 Public information

11.9.1 The Health Authority shall treat the inspection report as a public

document and shall make it available for disclosure to a person who

requests it pursuant to NRS 239.

11.10 Appeal process

11.10.1 A person aggrieved by an action taken by the Health Authority may

request a meeting in writing with the inspector responsible for the action

and the program supervisor within 10 business days from the date of

the inspection or investigation.

11.10.2 If the meeting does not resolve the issue, the aggrieved person may

submit a written request for a meeting with the division director or

section manager within 10 business days from receipt of the request for

a meeting.

Section 12

PERMIT SUSPENSION, REVOCATION, HEARINGS

12.1 Summary suspension; reinstatement of suspended permit

12.1.1 The Health Authority may suspend a health permit for failure of the

permit holder to comply with the requirements of these Regulations.

12.1.2 The Health Authority may post a body art establishment closed for

the following:

12.1.2.1 If conditions exist at a body art establishment which

present an imminent health hazard, the Health Authority

may, upon written notice, immediately suspend the

operating permit and order the immediate closure of the

body art establishment or

12.1.2.2 For repeated violations of these Regulations during a

follow-up inspection of a failed routine inspection. The

closure is effective upon receipt of the written notice by the

responsible person or permit holder. The closure

statement on the inspection report constitutes written

notice.

12.1.3 Closure signs must be conspicuously posted at each entrance leading

into the body art establishment.

12.1.4 Concealment, mutilation, alteration, or removal of Closure signs by any

person without permission from the Health Authority constitutes a

violation of these Regulations.

12.1.5 The Health Authority shall conduct a re-inspection of the body art

establishment for which the permit was summarily suspended within

two business day after receiving notice from the permit holder stating

that the conditions cited in the summary suspension order no longer

exist.

12.2 Suspension and revocation

12.2.1 The permit holder may request a hearing within five business days of

the summary suspension.

12.2.2 The Health Authority shall hold a hearing, if requested, within ten (10)

business days of receipt of the request for hearing.

12.2.3 The Health Authority will permanently revoke a permit, unless a

request for a hearing is filed with the Health Authority by permit

holder within five business days.

12.2.4 The Health Authority may, after a hearing, suspend or revoke a body

art establishment for violation of NRS Chapter 444, these Regulations,

or an order issued by the Health Authority.

12.2.5 Unless a hearing is requested as required herein, the suspension or

revocation order shall take effect 15 calendar days after the date of

issuance of the notice of suspension or revocation.

12.2.6 A notice of suspension or revocation must include the following:

12.2.6.1 The reasons for the suspension or revocation with

reference to the specific provisions of NRS Chapter 444,

and these Regulations.

12.2.6.2 The body art establishment has a right to request a

hearing within 15 calendar days after issuance of the

notice;

12.2.6.3 The suspended permit shall be revoked after fifteen

calendar days after receipt of the suspension notice have

lapsed unless a hearing is requested.

12.3 Suspension or revocation of an apprentice body art card, a body art card,

microblading card or mentor body artist card

12.3.1 The Health Authority may suspend or revoke an apprentice body art

card, a body art card, microblading card or mentor body artist card

if the body artist performed in such a manner as to create on-going or

egregious unsanitary, unsafe, or unhealthful conditions.

12.3.2 Body artist may request a hearing within five business days of the

summary suspension.

12.3.3 The Health Authority shall hold a hearing, if requested, within ten

business days of the receipt of the request for hearing.

12.3.4 The Health Authority will permanently revoke an apprentice body art

card, a body art card, microblading card or mentor body artist card,

unless a request for a hearing is filled with the Health Authority by the

body artist within five business days.

12.3.5 The Health Authority may, after a hearing, suspend or revoke an

apprentice body art card, body art card, microblading card or

mentor body artist card for violation of NRS Chapter 444, these

Regulations, or an order issued by the Health Authority.

12.3.6 Unless a hearing is requested as required herein, the suspension or

revocation order shall take effect 15 calendar days after the date of

issuance of the notice of suspension or revocation.

12.3.7 A notice of suspension or revocation must include the following:

12.3.7.1 The reasons for the suspension or revocation with

reference to the specific provisions of NRS Chapter 444

and these Regulations;

12.3.7.2 The body artist has a right to request a hearing within five

calendar days after issuance of the notice;

12.3.7.3 The apprentice body art card, body art card,

microblading card or mentor body artist shall be

revoked fifteen calendar days after receipt of the

suspension notice and the body artist shall cease

practicing body art at that time unless a hearing is

requested.

12.4 Notice and service of notice

12.4.1 A notice issued in accordance with these Regulations is considered

properly served if it is served by one of the following methods:

12.4.1.1 The notice is personally served by the Health Authority to

the responsible person or permit owner; and/or

12.4.1.2 Sending the notice by registered or certified mail, return

receipt requested, to the last known address of the owner.

12.4.2 The Health Authority shall file a copy of the notice in the permit

holder’s file.

12.5 Reinstatement

12.5.1 When a permit has been suspended or revoked, an application may be

made for reinstatement. Such application must include a verified

statement declaring that the reason for the suspension or revocation of

the permit has been eliminated.

12.5.2 If upon investigation by the Health Authority, it is determined that all

reasons for suspension or revocation have been eliminated and all

provisions of these Regulations have been complied with, the Health

Authority shall reinstate said permit.

12.6 Hearings and appeals

12.6.1 All hearings provided for in these Regulations shall be conducted in

accordance with NRS Chapter 233B.

12.6.2 Nothing herein contained shall be construed as denying the rights of

appeal to the courts after administrative remedies as herein above have

been exhausted.

12.7 Post suspension action

Once the permit has been suspended, as specified in Section 12.2 of

these Regulations, the permit holder must discontinue all activity

associated with the body art establishment in question. Failure to do

so may result in the Health Authority requesting an injunction from the

District Court of Jurisdiction against continued operation by the permit

holder.

Section 13

MISCELLANEOUS

13.1 Severability clause

Should any section, paragraph, sentence, phrase, or provision of these

Regulations be held invalid for any reason, the remainder of these Regulations

must not be affected.

13.2 Effective date

13.2.1 These Regulations became effective upon approval by the Nevada

State Board of Health.

13.2.2 These Regulations were adopted at a duly noticed public hearing.

Southern Nevada District Board of Health Meeting – Minutes – March 24, 2022

Page 1 of 7

MINUTES

SOUTHERN NEVADA DISTRICT BOARD OF HEALTH MEETING

March 24, 2022 – 9:00 a.m.

Meeting was conducted In-person and via Webex Event

Southern Nevada Health District, 280 S. Decatur Boulevard, Las Vegas, NV 89107

Red Rock Trail Rooms A and B

MEMBERS PRESENT:

Scott Black – Chair, Council Member, City of North Las Vegas (in-person)

Brian Knudsen – Vice-Chair, Council Member, City of Las Vegas (in-person)

James Adams – Council Member, City of Boulder City (in-person)

Olivia Diaz – Council Member, City of Las Vegas (via Webex)

Karen Dutkowski – Council Member, City of Mesquite (via Webex)

Marilyn Kirkpatrick – Commissioner, Clark County (in-person)

Frank Nemec – At-Large Member, Physician (in-person)

Scott Nielson – At-Large Member, Gaming (via Webex)

Michelle Romero – Council Member, City of Henderson (via Webex)

ABSENT:

Bobbette Bond – At-Large Member, Regulated Business/Industry

Tick Segerblom – Commissioner, Clark County

ALSO PRESENT:

(In Audience)

Georgi Collins, Dawn Christensen, Kim Dokken, Maya Holmes, Breanna Huber,

Jonathan Rodriguez, David Ruiz, Stacie Sasso, Irene Skarlatos

LEGAL COUNSEL:

Heather Anderson-Fintak, General Counsel

EXECUTIVE SECRETARY:

Fermin Leguen, MD, MPH, District Health Officer

STAFF:

Elizabeth Adelman, Erik Anderson, Maria Azzarelli, Josephine Baltazar,

Stephanie Bethel, Haley Blake, Will Broer, Amanda Brown, Lori Bryan, Anna

Burgess, Cory Burgess, Nikki Burns-Savage, Victoria Burris, Jonathan Bustinza,

Dee Cabinte, Eliana Camacho, Monica Carcamo, Symaron Ciccone, Andria

Cordovez Mulet, Stephanie Cortes, Rebecca Cruz-Nanez, Beverly Cuasito,

Aaron DelCotto, Audrey de Oliveira, Karnjit Dhillon, Jessica Dietz, Amanda

DiGoregorio, Lily Dominguez, Vincent Fenimore, Jennifer, Fennema, Gimmeko

Fisher-Armstrong, Jason Frame, Dominick Franchino, Kimberly Franich, Peter

Froio, Monica Galaviz, Cecilia Garay, Tina Gilliam, Michelle Goodsell, Sandra

Gordon, Nicole Grandt, John Hammond, Heather Hanoff, Victoria Harding,

Jeremy Harper, Richard Hazeltine, Valerie Herzog, Donna Houston, Carmen

Hua, Victoria Hughes, Danielle Jamerson, Brenda Jamison, Jessica Johnson,

Bria Jones, David Kahananui, Candice Konold, Theresa Ladd, Kevin Lam,

Cassius Lockett, Cort Lohff, Chris Elaine Mariano, Dante Merriweather, Betsy

McLellan, Kim Monahan, Deborah Moran, Jim Muth, Monika Nelson, Linda

Nguyen, Francine Oakley, Erin O’Malley, Veralynn Orewyler, Epifania Paman-

Lobo, Kyle Parkson, Luann Province, Cheryl Radeloff, Misty Robinson, Larry

Rogers, Alexis Romero, Stephanie Ruiz, Christopher Saxton, Karla Shoup,

Candice Sims, Jennifer Sizemore, Margo Slater, Marnita Smith-Dent, Jackie

Southam, Amy Stines, Tiffany Tate, Ronique Tatum-Penegar, Victoria Taylor,

Deshawn Thompson, Louis Thompson, Will Thompson, Randall Ulrich, Laura

Valentino, Leo Vega, Jorge Viote, Brian Weissenburger, Candyce White, Karen

White, Hayden Williams, Ken Williams, Edward Wynder, Pojung Yang

APPROVED BY THE SOUTHERN NEVADA DISTRICT BOARD OF HEALTH

APRIL 28, 2022

Board of Health Minutes Page 2 of 7

March 24, 2022

I. CALL TO ORDER and ROLL CALL

The Chair called the Southern Nevada District Board of Health Meeting to order at 9:02 a.m. Andria

Cordovez Mulet, Executive Assistant, administered the roll call and confirmed quorum.

II. PLEDGE OF ALLEGIANCE

III. RECOGNITION

• Public Health Accreditation

Chair Black advised that, earlier this month, the Health District was awarded 5-year accreditation status

through the Public Health Accreditation Board (PHAB). This milestone accomplishment is official

recognition that SNHD meets the rigorous standards of PHAB, which works to advance and transform

public health practice by championing performance improvement, strong infrastructure, and innovation.

Accreditation means that SNHD is committed to continuous quality improvement so that it can meet our

community’s needs as effectively as possible. The initial Accreditation start date was in 2016, the Action

Plan was received in 2019 and, due to the pandemic, an extension to respond was granted. All

documentation was submitted to PHAB on January 4, 2022. There has been an enormous amount of

time, work, dedication and support put into the entire process starting from 2016 to present day. On

behalf of the Board of Health, Chair Black thanked all those that worked on Accreditation in the past,

present, and future, including Richard Hazeltine, Carmen Hua, Cheryl Radeloff, Devin Raman, Emily

Elzeftawy, Heather Anderson-Fintak, Jeff Quinn, Jennifer Bowers, Jennifer Sizemore, Karla Shoup,

Kimberly Franich, Kyle Parkson, Larry Rogers, Laura Valentino, Michael Polintan, Randall Ulrich,

Rebecca Cruz-Nanez, Stephanie Cortes, and Victoria Harding. Further, Chair Black advised that the

Health District is now the 3rd Accredited Health District in Nevada!

• Disease Surveillance and Control COVID-19 Contact Tracing Team

Chair Black recognized Dr. Cassius Lockett, Kimberly Franich, Danielle Jamerson, Victoria Hughes,

Candyce White, Haley Blake, Alice Ngari, Karnjit Dhillon, Symaron Ciccone, Kent Williams, Toria Taylor,

and Peter Froio as the internal COVID-19 Contact Tracing Team. Chair Black noted that the contact

tracing team had been and continues to be the direct line of communication for people who are suffering

from COVID-19 and those that have been exposed. This team had led the Health District’s effort with

case interviewing, contact tracing and data collection for the most vulnerable and high-risk populations

in Southern Nevada and has interviewed thousands and thousands of cases. This internal team of

contact tracers are assigned the most challenging, complex, and sensitive cases. This work required

compassion, for those most deeply affected by the pandemic.

IV. FIRST PUBLIC COMMENT: A period devoted to comments by the general public about those items

appearing on the agenda. Comments will be limited to five (5) minutes per speaker. Please clearly

state your name and address and spell your last name for the record. If any member of the Board

wishes to extend the length of a presentation, this may be done by the Chair or the Board by majority

vote.

Seeing no one, the Chair closed the First Public Comment portion.

V. ADOPTION OF THE MARCH 24, 2022 MEETING AGENDA (for possible action)

The Chair requested that the presentation on the 2020 Southern Nevada Trauma System Report, under

Item X, be postponed to the April Board of Health meeting.

A motion was made by Member Knudsen, seconded by Member Kirkpatrick and carried unanimously to

approve the March 24, 2022 Agenda, as amended.

Board of Health Minutes Page 3 of 7

March 24, 2022

VI. CONSENT AGENDA: Items for action to be considered by the Southern Nevada District Board of

Health which may be enacted by one motion. Any item may be discussed separately per Board

Member request before action. Any exceptions to the Consent Agenda must be stated prior to

approval.

1. APPROVE MINUTES/BOARD OF HEALTH MEETING: February 24, 2022 (for possible action)

2. PETITION #32-22: Approval of an Amendment to the Interlocal Agreement between the

Southern Nevada Health District and the Nevada Division of Public and Behavioral Health to

provide Resilience Ambassadors to the Office of Disease Surveillance as part of Nevada’s

Resiliency Project in response to the COVID-19 pandemic; direct staff accordingly or take other

action as deemed necessary (for possible action)

3. PETITION #33-22: Approval of an Interlocal Agreement between the Southern Nevada Health

District and Clark County, Nevada on behalf of the Department of Family Services for

services provided to the Thrive by Zero to Three Prevention Services Program for the period

from April 2022 (date of award) to September 30, 2022; direct staff accordingly or take other

action as deemed necessary (for possible action)

4. PETITION #34-22: Approval of an Amendment to the Interlocal Agreement between the

Southern Nevada Health District and Clark County, Nevada for medical core and support

services for HIV/AIDS infected and affected clients in Las Vegas, Ryan White, transitional

grant area; direct staff accordingly or take other action as deemed necessary (for possible action)

A motion was made by Member Knudsen, seconded by Member Adams and carried unanimously to

approve the March 24, 2022 Consent Agenda, as presented.

VII. PUBLIC HEARING / ACTION: Members of the public are allowed to speak on Public Hearing / Action

items after the Board’s discussion and prior to their vote. Each speaker will be given five (5) minutes to

address the Board on the pending topic. No person may yield his or her time to another person. In

those situations where large groups of people desire to address the Board on the same matter, the

Chair may request that those groups select only one or two speakers from the group to address the

Board on behalf of the group. Once the public hearing is closed, no additional public comment will be

accepted.

1. MEMORANDUM #02-22: Review, Discuss and Approve Environmental Health Proposed Body

Art Regulations; direct staff accordingly or take other action as deemed necessary (for possible

action)

Karla Shoup, Environmental Health Manager, and Dante Merriweather, Senior Environmental Health

Supervisor, presented the Proposed Body Art Regulations. Ms. Shoup advised that currently there

were two sets of regulations, which will sunset upon approval of the Proposed Body Art

Regulations, and the proposal was to combine the regulations and bring them in alignment with the

Nevada Administration Code 444 on Invasive Body Decoration Establishment. Ms. Shoup further

advise that the Proposed Body Art Regulations would be presented to the State Board of Health in

June, with an implementation of July 1, 2022.

Chair Black opened Public Comment.

Bruce Woodbury, attorney for Microbladers which is a permanent make-up training facility. Mr.

Woodbury advised that they were pleased with the status of the proposed regulations. Mr.

Woodbury stated that they had suggested some amendments but advised they were no longer

necessary and was confident in the assurances received. Mr. Woodbury further expressed

appreciation for the staff, and members of the Board of Health, for their time and efforts provided to

his clients.

Board of Health Minutes Page 4 of 7

March 24, 2022

David Ruiz, Beloved Family Tattoos, inquired as to the proposed regulations related to the sink

requirements. Ms. Shoup advised that the proposed regulations was amended for the sink ratios to

be one sink per four workstations, which was a request from the industry.

Seeing no one further, the Chair closed the Public Comment portion.

Member Knudsen inquired as the presentation at the State Board of Health. Ms. Shoup advised that

if the Board of Health approved the proposed regulations, a presentation would be made to the

State Board of Health for final approval.

Member Kirkpatrick inquired whether the sink requirements had to wait until July 1

. Ms. Shoup

advised that if the Board of Health approved the proposed regulations, staff would work with

industry on the sink requirements prior to July 1

Member Kirkpatrick further advised that the body art industry was the easiest to work with during the

COVID-19 restriction closures, as they were already the cleanest and most sanitary. Member

Kirkpatrick thanked staff and industry on working together.

A motion was made by Member Adams seconded by Member Kirkpatrick and carried unanimously

to approve the Environment Health Proposed Body Art Regulations, and the sunset of the current

regulations.

VIII. REPORT / DISCUSSION / ACTION

1. Receive and Approve Recommendations from the March 21, 2022 Finance Committee

meeting regarding the FY2022-2023 Budget; direct staff accordingly or take other action as

deemed necessary (for possible action)

Karen White, Chief Financial Officer, presented the FY2022-2023 Budget, which begins on July 1,

2022 and ends on June 30, 2023, with the following highlights:

Overview

• Staffing is projected to grow from 780.1 FTE to 8.25.1 FTE, a 5.8% increase

• 78 positions that were vacant for over 6 months were eliminated and 40 contact tracers are

outsourced

• Combined revenues was projected at $148.4M, a 12.3% increase

• Informatics Department has been reorganized and will be under the Disease Surveillance &

Control Division

Revenues – General

• Property tax allocation projected at $29.7M, an increase of 5.0%

• Charges for Services revenues is $26.3M, flat compared to current fiscal year; any increase will

be reflected in a budget augmentation planned during the next fiscal year

Revenues – Special Revenue

• Grant revenues are projected at $104M, an increase of 45.7%

• Community Health Grants are projected at $50.4M, an increase of $37.9M; ELC Covid Grant

total is $41.3M

• All grants issued on or before 02/28/2022 are included in this budget, a budget augmentation to

include future grants will occur next fiscal year

Board of Health Minutes Page 5 of 7

March 24, 2022

Revenues – Combined Revenues by Source

• Intergovernmental (Grants) – $104M – 58%

• Other – $1.7M – 1%

• Licenses/Permits – $18.9M – 10%

• Charges for Services – $26.3M 15%

• Property Taxes – $29.7M – 16%

Expenditures – Combined Expenditures

• General Fund expenditures is $76.7M, a decrease of 1.1% compared to FY2022

• Combined expenditures for all funds add up to $180.6M

• Total salaries and benefits for all funds are projected at $89.6M, about 50% of total

expenditures

Ms. White reviewed the Expenditures and Revenues vs. Expenditures by Division. Ms. White then

reviewed a 2-year fund reserve projection with the fund reserve percentage. Ms. White outlined and

compared the FY2022 and FY2023 Fund Balance for the General Fund, Capital Projects Fund,

Bond Reserve (Building) Fund, and Insurance Liability Fund. Ms. White further reviewed the FTE

Staffing by Division, comparing FY2022 and FY2023.

Member Nielson provided a summary of the March 21, 2022 Finance Committee meeting.

Dr. Leguen confirmed that the contact tracer positions that were eliminated were contract positions.

A motion was made by Member Nielson, seconded by Chair Black and carried unanimously to

accept the recommendations from the Finance Committee and approve the FY2023 Budget, as

presented.

2. Receive, Discuss and Approve Billing Fee Schedule Updates; direct staff accordingly or take

other action as deemed necessary (for possible action)

Ms. White provided the Clinical Billing Fee Schedule Update and advised that, as there was a more

comprehensive review done last year, this year there were only a few fees that needed to be

updated, which are mostly new codes or fees that have not been used in the past. Ms. White

outlined the updated fees for primary care services and medications and confirmed that patients on

the sliding fee scale pay between $7 and $22 for medications. Ms. White further outlined two new

vaccines that the Community Health Center will start to offer.

Commissioner Kirkpatrick raised the high prices of medications and suggested that the Health

District encourage the legislature and/or congressional delegation to bring to light the rising cost of

medications. Chair Black suggested that Bradley Mayer could prepare an approach for the Board of

Health with the appropriate information/questions to assist the Board of Health to advocate at the

state and federal level on the rising cost of medications.

Member Nemec suggested that the Health District providers should only prescribe generic

medication. The Board was supportive of a recommendation for Health District physicians, as

applicable and as appropriate given their medical training and knowledge, prescribe generic

medication, unless there was something contraindicative, before the name-brand medication. Dr.

Leguen advised that the recommendation would be used as an educational tool as the best option

for the population the Health District served.

A motion was made by Member Knudsen, seconded by Member Adams and carried unanimously to

approve the Clinical Billing Fee Schedule Updates, and recommended that Health District

physicians, as applicable and as appropriate given their medical training and knowledge, prescribe

generic medication, unless there was something contraindicative, before a name-brand medication.

Board of Health Minutes Page 6 of 7

March 24, 2022

IX. BOARD REPORTS: The Southern Nevada District Board of Health members may identify and

comment on Health District related issues. Comments made by individual Board members during this

portion of the agenda will not be acted upon by the Southern Nevada District Board of Health unless

that subject is on the agenda and scheduled for action. (Information Only)

Member Adams advised of a recent visit to the Immunization Clinic and recognized staff. Member

Adams advised that a question on the form referred to ‘hearing impaired’ and advised that was an

outdated term and should be amended to either ‘deaf’ or ‘hard of hearing’.

X. HEALTH OFFICER & STAFF REPORTS (Information Only)

• DHO Comments

In addition to the DHO Monthly Report, Dr. Leguen advised that today marked World TB Day, which

was celebrated all over the world. Here in Clark County, the Health District’s TB Clinic offers TB

management services to the community and serves as a reference source to providers. Further, the

TB Clinic offers preventive therapy for TB and participates in screening as part of the Refugee

Program.

Dr. Leguen advised that the investigation in the Secrets of Siam restaurant was concluded by law

enforcement. The Environmental Health Division and Epidemiology Team are still finalizing their

investigation.

Dr. Leguen further advised that Clark County was selected for a national study in nutrition, which

will approach Clark County residents and offer physical exams and surveys on nutrition. This study

will complement the study being conducted by the Federal government across the country. Further

to an inquiry from Member Kirkpatrick, Dr. Leguen advised that the residents will be selected

randomly.

• 2020 Southern Nevada Trauma System Report

This item was postponed to the April Board of Health meeting.

• Updates to Aquatic Venue Drain Cover Standards

Jeremy Harper, Environmental Health Supervisor, and Candice Konold, Senior Environmental

Health Specialist, presented an update on the changes to national standards that impact how drain

covers used in pools and spas are tested.

• COVID-19 Surveillance and Contact Tracing Update

Dr. Cassius Lockett, Director Disease Surveillance & Control, advised that, from March 6

to 19

the 7-day moving average of COVID-19 cases declined by 35.7%, with the most cases remaining

unvaccinated. The 7-day moving average of hospitalizations, from March 9

to 22

, declined by

38%, from 184 to 114, with approximately 62% being unvaccinated and of the fully vaccinated 60%

being over the age of 65. The 7-day moving average of deaths declined by 34%, from 5.3 to 3.5,

71% being unvaccinated and of the fully vaccinated 100% being over the age of 65. The test

positivity rate has declined by 14%.

Board of Health Minutes Page 7 of 7

March 24, 2022

Member Kirkpatrick inquired whether the Health District was ready in the event there was another

surge. Dr. Lockett confirmed that the Health District was ready to respond in short order.

Member Knudsen inquired whether an after-action review would be completed. Member Kirkpatrick

advised that one was done on the MACC, with 144 participants that would be submitted to the State

for September 1

, and she would share the report.

Dr. Leguen advised that State Senator Donate was also preparing a report on the local response

and needs related to the pandemic.

XI. INFORMATIONAL ITEMS

1. Administration Monthly Activity Report

2. Community Health Monthly Activity Report

3. Disease Surveillance and Control Monthly Activity Report

4. Environmental Health Monthly Activity Report

5. Primary & Preventive Care Monthly Activity Report

XII. SECOND PUBLIC COMMENT: A period devoted to comments by the general public, if any, and

discussion of those comments, about matters relevant to the Board’s jurisdiction will be held. Comments

will be limited to five (5) minutes per speaker. If any member of the Board wishes to extend the length

of a presentation, this may be done by the Chair or the Board by majority vote.

Seeing no one, the Chair closed the Second Public Comment portion.

XIII. ADJOURNMENT

The Chair adjourned the meeting at 10:46 a.m.

Fermin Leguen, MD, MPH

District Health Officer/Executive Secretary

/acm