Personal Services Settings Inspection

Policy

Category: Control of Infectious Diseases
Subject: Personal Services Settings Inspection
Division: N/A
Policy Number: CA.82.01.102
Effective Date: July 4, 2012

POLICY STATEMENT

It is the policy of Wellington Dufferin Guelph Public Health (WDGPH) that compliance inspections of personal services settings are completed at least once per year.

Personal service settings are not currently subject to specific regulation.  Control of Infectious Diseases (CID) team members are currently guided in their inspections by the provincial Infection Prevention and Control Best Practices for Personal Services Settings (January, 2009) and Infection Prevention and Control in Personal Services Settings Protocol, 2008 (or as current)  in accordance with the Ontario Public Health Standards.  The PIDAC document entitled Best Practices for Cleaning, Disinfection and Sterilization of Medical Equipment Devices in All Health Care Settings (February 2010) will also be used as information for inspections.

At this time, the Ministry of Health and Long Term Care does not provide direction on extreme body modification services.  Until direction is provided, WDGPH will inspect only the infection control practices of extreme body modification services, and will not inspect the procedure processes or provide advice on the technical process of extreme body modification services.  Operators who offer, or intend to offer, extreme body modification services will be sent letters (HPDCD(L)7) that state solely the infection control practices will be inspected, and will also include recommendations for infection control practices.

SCOPE

This policy applies to all Control of Infectious Diseases (CID) Public Health Inspectors (PHIs) and Public Health Nurses (PHNs) who conduct inspections of personal services settings.

RESPONSIBILITIES

CID PHIs and PHNs will:

  • Conduct all annual inspections of personal services settings, including any necessary follow up;
  • Provide education during inspections in the form of infection control training or fact sheets, for example; and
  • Issue media releases as needed to inform the public when personal services settings have not followed appropriate infection control measures or are offering uninspected services.

DEFINITIONS

Personal Services Settings – Any business that offers aesthetic services including, but not limited to: hair salons and barber shops, nail salons, tattoo and body piercing studios, electrolysis, acupuncture, and unregistered massage parlours.

Extreme Body Modification – Services that include, but are not limited to branding, scarification, implants, ear shaping, tongue splitting, and tooth filing.

REFERENCES AND RELATED FORMS, POLICIES AND PROCEDURES

Corresponding Procedure:  CA.82.02.102  Personal Services Settings Inspection 
Infection Prevention and Control Best Practices for Personal Services Settings (January, 2009)
Infection Prevention and Control in Personal Services Settings Protocol (2008)
Practices for Cleaning, Disinfection and Sterilization of Medical Equipment Devices in All Health Care Settings

APPROVED BY

Rob Thompson 


Procedure

Category: Control of  Infectious Diseases
Subject: Personal Services Settings Inspection
Division: N/A
Procedure Number: CA.82.02.102
Effective Date: July 4, 2012

PROCEDURE

A Control of Infectious Diseases (CID) Public Health Inspector (PHI) or Public Health Nurse (PHN) will conduct inspections or re-inspections of personal service settings (PSS).

A CID PHI will inspect:

  • High-risk settings: tattoo, body piercing, and extreme body modification establishments; and
  • Medium-risk settings: manicure/pedicure establishments, aesthetics (waxing, facials, etc.), ear piercing, electrolysis, and acupuncture provided by non-regulated professionals.

Either a CID PHI or PHN will inspect:

  • Low-risk settings: hair salons, barbershops, tanning establishments, and holistic premises (aromatherapy, reflexology, massage).

Compliance Inspections:

  1. Follow the Infection Prevention and Control Best Practices for Personal Services Settings, 2009 (or as current) to conduct the compliance inspection.
    http://www.health.gov.on.ca/english/providers/program/pubhealth/oph_stan…
  2. Use the personal services settings inspection report in Hedgehog to complete the inspection.
  3. All personal service settings inspections will be unannounced (unscheduled) unless the PSS is located within the operator’s personal residence or has the capacity to deal with a single client at a time (e.g., one treatment room).  If a home-based PSS inspection is scheduled, it should occur at a time arranged with the operator.

The CID team member shall:

  1. Identify him/herself to the owner/operator verbally and with photo identification and state the reason for the visit. The owner/operator or designate present is provided the opportunity to accompany the CID team member during the inspection.
  2. Confirm ownership of the premises by observing the operator’s business license and/or other posted licenses or permits (i.e. vendor’s permit, city/township license) if possible.  This information should be included in the comments section of the inspection report.
  3. Review documentation of consents (if applicable) and the appointment log book to ensure information is of sufficient quality to allow notification of clients (e.g. address, phone number and permanent address), if required.

Note:  Personal service settings that offer medium, high-risk or extreme body modification (EBM) procedures must keep records for all clients who receive these services.  Records must be kept on site for one year and on file for five years.  They must include the date of procedure, client’s full name, address, contact numbers, age, next of kin or emergency contact name and number, and client signature.

  1. A water sample of foot baths may be taken, especially if it has re-circulation plumbing.  Provide assistance to the operator regarding interpretation of water sample results.
  2. Provide educational materials to the owner/operator to facilitate understanding of infection control issues (use language-appropriate resources for operators).
  3. Complete the inspection form, recording any infractions. In the space provided, record any observed violations, the required action(s) and the expected compliance date for each item. If the item was corrected while the PHI or PHN was present, record that the violation was corrected at the time of inspection. 
  4. Review the inspection report and other applicable forms, discussing and explaining the public health significance of the inspection, findings, violations and requirements to comply with the Health Protection and Promotion Act and the Infection Prevention and Control Best Practices for Personal Services Settings.
  5. Advise the owner/operator of the expected dates of compliance for correction of violations. Give the owner/operator an opportunity to ask questions or clarify concerns. Inform the owner/operator of the consequences if violations are not resolved by the date indicated on the inspection report.
  6. Ask the owner/operator to sign the inspection report. The CID team member will also sign the inspection report. A copy of the inspection form(s) shall be provided to the owner/operator by email, fax, mail or hand-delivery.

Note: The owner/operator signature is not required for completion of the inspection form(s). Make note on the inspection form that the recipient declined to sign the form.

  1. Expected Compliance Dates:  If a re-inspection is required, visit the premises on or about the date compliance was requested by Wellington-Dufferin-Guelph Public Health (WDGPH).
  2. If, on re-inspection, item(s) are still outstanding, the CID PHI, in consultation with the CID Program Manager, may conduct an additional re-inspection, or proceed directly with the issuance of a Section 13 order.
  3. Review the details of the order with the owner/operator or staff.  Ensure that the owner/operator understands that failure to comply with the order can result in a charge under the Health Protection and Promotion Act (HPPA). Also ensure the owner/operator is aware they have the right to appeal and knows the procedure they are to follow if they wish to appeal the order.
  4. If the items listed on the compliance inspection report, as well as the re-inspection report(s), are not corrected by the date stipulated in the order, the person, operator and/or owner of the establishment is guilty of an offence as they have failed to obey an order made under Section 13 of the HPPA. As a result, a Part 3 summons under the Provincial Offences Act shall be issued.
  5. Complete all required documentation and information required to lay information (Part 3 summons). Consult with the CID Program Manager.
  6. Forward all documentation pertaining to seizures, orders to close, or pending legal action to the CID Program Manager for review.

New Personal Service Settings:

New personal service settings will not receive an opening inspection by WDGPH unless floor plans have been reviewed and approved by WDGPH and WDGPH has received proof of a Business License Application from the local municipality if a business license is required.  The floor plans should clearly identify all plumbing fixtures and identify the separate hand basin used for hand washing, the sink used for utensil cleaning and disinfection, hair wash stations, pedicure foot baths, washrooms and work stations.  Premises intending to perform Extreme Body Modification procedures must follow all biohazardous waste guidelines, as specified in Ministry of the Environment’s Guideline C-4, The Management of Biomedical Waste in Ontario (2009 or as current).
http://www.health.gov.on.ca/english/providers/program/pubhealth/oph_stan…

Complaint Investigation:

  1. All complaints received are to be investigated within 24 hours or as time permits.
  2. Complete a CSR in Hedgehog following the Hedgehog user guide.
  3. Conduct complaint investigation and risk inspection at the premise in question.
  4. Follow compliance inspection procedure.
  5. Relay findings to the complainant after the investigation is complete.  Once Hedgehog documentation is completed, a printed report should be signed and kept as the legal documentation of the complaint.
  6. Ensure the CID Program Manager reviews the complaint investigation.
  7. If a complaint is received over the phone involving poor infection control procedures at an establishment, the CID team member can request that the complainant make a formal written complaint detailing what he/she saw while at the establishment (e.g. piercing of ear cartilage). Once the written complaint is received, the PHI can issue a written order. If the infraction is then observed by the CID team member during an inspection, a Part 3 summons can be issued.

City of Guelph Business License By-Law:

  1. The CID team member, through the Program Assistant, shall send a monthly report to the City of Guelph, indicating which facilities have passed their annual compliance inspection, so that they may renew their business license.
  2. If there is continued non-compliance regarding a City of Guelph licensing inspection request in a personal services setting, notify the City of Guelph By-Law Enforcement Division via the CID Program Assistant and/or City of Guelph Licensing Coordinator. The City of Guelph can lay a charge for operating without a license in addition to any charges laid by WDGPH.

Enforcement:

Enforcement of the Infection Prevention and Control Best Practices for Personal Services Settings is achieved if necessary through the issuance of verbal and/or written orders by the PHI under Section 13 of the Health Protection and Promotion Act, R.S.O. 1990 C.H. 7. Orders, once prepared, are hand delivered by the PHI to the owner/operator of the premises and an electronic copy of the order is attached to the documents section of the premises file in Hedgehog.

Premises engaging in serious contraventions of the Infection Prevention and Control Best Practices for Personal Services Settings (e.g. failure to adequately sterilize or disinfect critical/semi-critical equipment) may be ordered to close or cease and desist specific services until corrections are made.  Depending on the infection control issue identified, a public health investigation may be necessary.  A media release may be issued to alert clients who received personal services that they may be at risk of a blood borne disease.

Continued non-compliance with the Infection Prevention and Control Best Practices for Personal Services Settings can be enforced through Part 3 summons under the Provincial Offences Act.

Sample Order is attached.

 

REFERENCES AND RELATED FORMS, POLICIES AND PROCEDURES

Corresponding Policy:  CA.82.01.102  Personal Services Settings Inspection
Health Protection and Promotion Act
Provincial Offences Act
Infection Prevention and Control Best Practices for Personal Services Settings
Infection Prevention and Control in Personal Services Settings Protocol
Practices for Cleaning, Disinfection and Sterilization of Medical Equipment Devices in All Health Care Settings

APPROVED BY

Rob Thompson