Source: Tennessee Code : TITLE 39 CRIMINAL OFFENSES
: CHAPTER 15 OFFENSES AGAINST THE FAMILY
Terms: tattooing (Edit Search) (Search lexis.com®)
December, 2000 (Revised) 1
TENNESSEE DEPARTMENT OF HEALTH
BUREAU OF HEALTH SERVICES ADMINISTRATION
DIVISION OF GENERAL ENVIRONMENTAL HEALTH
CHAPTER 1200-23-3
TATTOO ARTIST AND TATTOO ESTABLISHMENT
TABLE OF CONTENTS
1200-23-3-.01 Definitions 1200-23-3-.06 Tattoo Artist Licensing
1200-23-3-.02 Prohibited Acts 1200-23-3-.07 Licensing and Permitting
Fees
1200-23-3-.03 Minimum Standards for Tattoo Establishments 1200-23-3-.08
Loss of Permit Document
1200-23-3-.04 Tattoo Operation 1200-23-3-.09 General Provisions
1200-23-3-.05 Establishment Permitting and Inspection System
1200-23-3-.01 DEFINITIONS
(1) "Antibacterial solution" means any solution used
to retard the growth of bacteria approved for the
application to human skin and includes all products so labeled.
(2) "Antiseptic" means a substance that will inhibit
the growth and development of microorganisms without
necessarily destroying them.
(3) "Approved" means being accepted by the Commissioner
or local health officer, as appropriate under the
law.
(4) "Aseptic technique" means to render or maintain
free from infectious material.
(5) "Autoclave" means a device which automatically
holds the temperature, pressure, and time for the
purpose of sterilization.
(6) "Autoclave indicator" means chemical detection
strips, markers, or tape.
(7) "Biohazardous waste" means "regulated waste"
(see definition No. 46).
(8) "Blood" means human blood, human blood components,
and products made from human blood.
(9) "Bloodborne pathogens" means pathogenic microorganisms
present in human blood that can cause
disease in humans. These pathogens include, but are not limited
to, Hepatitis B virus (HBV) and human
immunodeficiency virus (HIV).
(10) "Chemical detection strips, markers or tape" means
the use of detection devices placed on items for
sterilization to facilitate in determining that the item has
been subjected to steam sterilization process.
(11) "Client" means any person desiring to receive
a tattoo.
(12) "Commissioner" means the Commissioner of the Department
of Health.
(13) "Contaminated" means the presence or the reasonably
anticipated presence of blood or other potentially
infectious materials on an item or surface.
(14) "Contaminated laundry" means laundry which has
been soiled with blood or other potentially infectious
materials or which may contain sharps.
(15) "Contaminated sharps" means any contaminated object
that can penetrate the skin including, but not
limited to, needles, scalpels, or broken glass.
TATTOO ARTIST AND TATTOO ESTABLISHMENT CHAPTER 1200-23-3
(Rule 1200-23-3-.01, continued)
December, 2000 (Revised) 2
(16) "Critical item(s)" means those aspects of operation
or conditions which, if in violation, constitute the
greatest hazards to health and safety, including imminent health
hazards. Critical violations shall include
the following:
(a) autoclave does not meet minimum time, pressure or temperature
requirements;
(b) lack of a monthly negative spore or microbiological monitoring
test for quality control;
(c) nondisposable tubes and needles are not sterilized or were
sterilized greater than one (1) year ago;
(d) work room is not equipped as required or is not stocked;
(e) reuse of single use articles;
(f) sterile instruments are not properly handled;
(g) reusable instruments are not handled properly;
(h) employees with infectious lesions on hands not restricted
from tattooing;
(i) employees not practicing proper cleanliness and good hygiene
practices;
(j) water supply not approved, hot and cold running water under
pressure not available;
(k) approved sewage and liquid waste disposal not available;
(l) cross connection allowing back-siphonage present in plumbing
system;
(m) toilet and hand washing facilities not available for employees;
(n) insect and rodent evidence, harborage, or outer opening present;
or
(o) toxic items not properly stored, labeled, or used.
(17) "Decontamination" means the use of physical or
chemical means to remove, inactivate, or destroy
bloodborne pathogens on a surface or item to the point where
they are no longer capable of transmitting
infectious particles and the surface or item is rendered safe
for handling, use, or disposal.
(18) "Department" means the Department of Health.
(19) "Disinfectant" means a solution intended to destroy
or inactivate specific viruses, bacteria, or fungi on
clean, inanimate surfaces [e.g., 1:10 bleach solution] or commercially
labeled disinfectant.
(20) "Easily cleanable" means that surfaces are readily
accessible and made of such materials and finish and so
fabricated that residue may be effectively removed by normal
cleaning methods.
(21) "Engineering controls" mean controls (e.g., sharps
disposal containers) that isolate or remove the
bloodborne pathogens hazard from the workplace.
(22) "Exposure incident" means a specific eye, mouth,
other mucous membrane, non-intact skin, or parenteral
contact with blood or other potentially infectious materials
that results from the performance of an
employee’s duties.
TATTOO ARTIST AND TATTOO ESTABLISHMENT CHAPTER 1200-23-3
(Rule 1200-23-3-.01, continued)
December, 2000 (Revised) 3
(23) "Extensively remodeled" means alteration to affect
the increase or decrease of floor space or the
alteration of walls in a work area.
(24) "Germicide" means an agent that kills pathogenic
microorganisms.
(25) "Germicidal solution" means any solution which
destroys microorganisms and is so labeled.
(26) "Handwashing facilities" means a facility providing
an adequate supply of running potable water, soap
dispenser, soap, and single use towels or automatic dryer.
(27) "Health officer" means an individual appointed
by the Commissioner pursuant to T.C.A. 68-2-603.
(28) "Imminent health hazard" means any condition,
deficiency, or practice, as defined by the health officer,
which, if not corrected, is very likely to result in illness,
injury, or loss of life to any person.
(29) "Infectious waste" means "regulated waste"
(see definition No. 48).
(30) "Law" means any applicable provision of the State
of Tennessee statutes and rules of any department or
agency.
(31) "License" means the issuance of a license to perform
tattooing to any individual, partnership, firm or
corporation. "License" further means to allow or authorize
any person who has satisfactorily completed
all requirements set forth by law or by the local health officer
to engage in the practice or business or
tattooing.
(32) "Local health department" means the agency defined
in T.C.A. 68-2-601 et. seq.
(33) "Microbiological monitoring for quality control"
means the use of a standard spore, Bacillus
stearothermophilus to challenge the sterilization process.
(34) "Occupational exposure" is synonymous with "exposure
incident" (see definition No. 21).
(35) "Other potentially infectious material" means
the following human body fluids: semen, vaginal
secretions, saliva, and any body fluid visibly contaminated with
blood.
(36) "Owner/Operator" means the applicant, permittee,
or other person or persons in charge of a facility.
(37) "Parenteral" means piercing mucous membranes or
the skin barrier through such events as needle sticks,
human bites, cuts, and abrasions.
(38) "Patron or customer" is synonymous with "client"
(see definition No. 11).
(39) "Percutaneous" means infectious materials may
enter the body through compromised skin surfaces (e.g.,
needle sticks, acne, cuts, lesions).
(40) "Permit" means the issuance of a permit to a tattoo
studio or establishment to allow or authorize a tattoo
establishment to be operated for the purpose of engaging in the
practice or business of tattooing.
(41) "Person" means tattoo operator and/or any individual,
partnership, firm, corporation, agency,
municipality, or state or political subdivisions, or the federal
government and its agencies and
departments, depending on the context within the rules.
(42) "Personnel" means the permit holder, any person
who tattoos, individuals having supervisory or
management duties, or any other person employed or working in
a tattoo establishment. This individual
may or may be a tattoo artist.
TATTOO ARTIST AND TATTOO ESTABLISHMENT CHAPTER 1200-23-3
(Rule 1200-23-3-.01, continued)
December, 2000 (Revised) 4
(43) "Person in charge" means the individual present
in a tattoo establishment who is the apparent supervisor
at the time of inspection, or, if no individual is the apparent
supervisor, then any employee present.
(44) "Personal protective equipment" means specialized
clothing or equipment, such as gloves or lapcloth,
worn by an employee for protection against a hazard. General
work clothes not intended to function as
protection against a hazard are not considered to be personal
protective equipment.
(45) "Potable water" means water that is safe for drinking.
(46) "Regional Health Director" means an individual
who directs the operations of a Tennessee Department of
Health Region or the Regional Director's designee.
(47) "Registration" means license or permit, as applicable.
(48) "Regulated waste" means liquid or semi-liquid
blood or other potentially infectious materials,
contaminated items that would release blood, or other potentially
infectious materials in a liquid or semiliquid
state, if compressed, and contaminated sharps.
(49) "Safe materials" means articles manufactured and
used in accordance with law.
(50) "Sanitary" means clean and free of agents of infection.
(51) "Sanitization" means an effective germicidal treatment
by a process that provides enough accumulative
heat or concentration of chemicals for enough time to reduce
the microorganism level, including
pathogens, to a safe level on utensils and equipment.
(52) "Sewage" means human excreta, all water carried
waste, and household wastes from residences,
buildings, or commercial and industrial establishments.
(53) "Single use" means a disposable item that is used
one (1) time on one (1) client and then is properly
disposed of by appropriate measures.
(54) "Solid waste" means refuse, garbage, trash, rubbish,
and any other item(s) which could cause an
unsanitary condition or undesirable health and safety conditions.
(55) "Sterilization" means holding in an autoclave
for fifteen (15) minutes, at fifteen (15) pounds pressure, and
at a temperature of two hundred fifty degrees (250° F ) Fahrenheit
or one hundred twenty-one degrees
(121°C) Celsius.
(56) "Tattoo" means any method of placing designs,
letters, figures, symbols, cosmetics, or any other marks
under the skin of a person using ink or color with the aid of
needles or instruments.
(57) "Tattoo artist" means any person, regardless of
age, who engages in the practice/service of tattooing
regardless of the type of tattoo or area to be tattooed.
(58) "Tattoo artist registration" means the issuance
of a State license authorizing the person named thereon to
engage in the practice/service of tattooing in the State of Tennessee
after fulfilling the requirements in
T.C.A. Title 62, Chapter 38 and these rules.
(59) "Tattoo establishment" means any room or space
where tattooing is performed or where the business of
tattooing, or any part thereof, is conducted. The term is synonymous
with "tattoo parlor" and "tattoo
studio".
TATTOO ARTIST AND TATTOO ESTABLISHMENT CHAPTER 1200-23-3
(Rule 1200-23-3-.01, continued)
December, 2000 (Revised) 5
(60) "Tattoo operator" means any person who controls,
operates, conducts, or manages any tattoo studio,
whether actually engaging in tattooing or not.
(61) "Tattoo parlor" means "tattoo establishment"
(see definition No. 59).
(62) "Tattoo studio" means any room or space where
tattooing is practiced or where the service of tattooing is
performed.
(63) "Universal precautions" means treating all blood
and body fluids as if they contain bloodborne pathogens
and taking proper precautions to prevent the spread of any bloodborne
pathogens.
(64) "Utensil" means any implement, tool, or other
similar device used in the storage, preparation, operation,
or processing of a tattoo.
(65) "Waste" means solid waste, sewage, blood and body
fluids or other waste resulting from the operation of
a tattoo studio.
(66) "Work area" means an area where clients are tattooed.
(67) "Work practice controls" means controls that reduce
the likelihood of exposure by altering the manner in
which a task is performed.
(68) "Work station" means a work area (see definition
No. 66).
Authority: T.C.A. 4-5-202, 62-38-201 et seq., and 68-1-103. Administrative
History: Original rule filed
September 26, 2000; effective December 10, 2000.
1200-23-3-.02 PROHIBITED ACTS
(1) No person under the age of eighteen (18) years shall tattoo
another person.
(2) No person shall tattoo another person who is under the influence
of drugs or alcohol.
(3) No person shall tattoo another person who is under the age
of eighteen (18) years. However, a minor
sixteen (16) years or older may be tattooed with the written
consent of a parent or legal guardian to cover
up an existing tattoo, and a parent or legal guardian of such
minor shall be present during the procedure.
(4) No person shall tattoo any site in which the skin surface
exhibits any evidence of unhealthy conditions.
(5) No person except a duly licensed physician shall remove or
attempt to remove any tattoo.
(6) During all studio operating hours, tattooing shall not be
performed unless there is a currently licensed
tattoo artist present in the facility.
Authority: T.C.A. 4-5-202, 62-38-201 et seq., and 68-1-103. Administrative
History: Original rule filed September
26, 2000; effective December 10, 2000.
1200-23-3-.03 MINIMUM STANDARDS FOR TATTOO ESTABLISHMENTS
(1) Each studio where tattoos are administered shall provide
a work area separate from observers or visitors.
A work area shall have a sink equipped with hot and cold running
water for hand washing and cleaning
instruments, apart from a bathroom sink.
TATTOO ARTIST AND TATTOO ESTABLISHMENT CHAPTER 1200-23-3
(Rule 1200-23-3-.03, continued)
December, 2000 (Revised) 6
(2) Each tattoo establishment shall be equipped with an autoclave
or steam sterilizer, a sterilizing device
capable of meeting sterilization as defined in 1200-23-3-.01(55).
The autoclave shall be used to sterilize
all nondisposable or reusable tattooing equipment.
(3) Each location shall have the facilities to properly dispose
of all waste material. All materials (e.g.,
needles) must be disposed of in accordance with the Code of Federal
Regulations, Title 29, Part 1910,
Occupational Safety and Health Act, Bloodborne Pathogens and/or
accepted universal precaution
guidelines.
(4) The use of common towels is prohibited. Handsinks shall be
equipped with a soap dispenser and single
use towels.
(5) Water Supply.
(a) Enough potable water for the needs of the tattoo studio shall
be provided from a source constructed
and operated according to law.
(b) Sewage. All sewage, including liquid water, shall be disposed
of by a public sewerage system or by
a sewerage disposal system constructed and operated according
to law.
(c) Plumbing. Plumbing shall be sized, installed, and maintained
according to law. There shall be no
cross-connection between the potable water supply and any other
water supply or other source of
contamination.
(6) Toilet Facilities.
(a) Toilet installation. Toilet facilities shall be designed,
installed, and maintained according to law.
There shall be sufficient toilet rooms and/or toilet fixtures
to accommodate clients and operators.
(b) Toilet rooms. Toilet rooms opening directly into work or
customer waiting areas shall be
completely enclosed and shall have tight-fitting, solid doors,
which shall be closed except during
cleaning or maintenance.
(c) Toilet fixtures. Toilet fixtures shall be kept clean and
in good repair. A supply of toilet tissue shall
be provided at each toilet at all times. Easily cleanable receptacles
shall be provided for waste
materials. Toilet rooms shall have at least one covered waste
receptacle.
(7) Lavatory Facilities.
(a) Lavatory installation. Lavatory facilities shall be designed,
installed, and maintained according to
law. Facilities shall be of sufficient number and location to
permit convenient use by clients and
operators.
(b) Lavatory faucets. Each lavatory shall be provided with hot
and cold water tempered by means of a
mixing valve or combination faucet. Any self-closing, slow-closing,
or metering faucet used shall
be designed to provide a flow of water for at least 15 seconds
without the need to reactivate the
faucet.
(c) Lavatory supplies. A soap dispenser and a supply of antiseptic,
hand-cleaning soap or detergent
shall be available at each lavatory. A supply of single use sanitary
towels or a hand-drying device
providing heated air shall be conveniently located near each
lavatory. If disposable towels are used,
easily cleanable waste receptacles shall be conveniently located
near the handwashing facilities.
TATTOO ARTIST AND TATTOO ESTABLISHMENT CHAPTER 1200-23-3
(Rule 1200-23-3-.03, continued)
December, 2000 (Revised) 7
(d) Lavatory maintenance. Lavatories, soap dispensers, hand-drying
devices, and all related fixtures
shall be kept clean and in good repair.
(8) Solid Waste
(a) Containers.
1. Garbage and refuse shall be kept in durable, easily cleaned
containers that do not leak and do
not absorb liquids. Containers shall be kept in a clean and sound
condition and disposed of
according to law.
2. Containers used in work areas shall be kept covered when not
in use and after they are filled.
3. There shall be a sufficient number of containers to hold all
the garbage and refuse that
accumulate.
(b) Garbage and refuse shall be disposed of at such frequency
to prevent the development of odor and
the attraction of insects, rodents, or vermin.
(c) Disposal of infectious waste such as blood, fluids, used
inks, or other liquid waste may be deposited
directly into a drain connected to a sanitary sewer system. Disposable
needles, scalpels, or other
sharp items shall be placed intact into puncture-resistant containers
with a biohazard label before
disposal. Filled sharps containers shall be considered regulated
waste and must be disposed of in
accordance with Solid Waste Processing and Disposal Regulations
(1200-1-7).
(d) Waste potentially contaminated with small amounts of blood
or other infectious body fluids (e.g.,
gauze, wipes, disposable lap cloths), which do not meet the definition
of regulated waste, shall be
placed in sealed, impervious bags to prevent leakage of the contained
items. These bags shall be of
sufficient strength to prevent breakage or leakage and shall
not contain any sharps. The waste bags
shall be containerized and disposed of in an approved sanitary
landfill.
(9) The premises shall be kept in such condition as to prevent
the entrance, harborage, or feeding of insects,
rodents, or vermin.
(10) Floors
(a) Floor construction. Floors and floor coverings of all work
areas, dressing rooms, locker rooms,
toilet rooms and vestibules shall be constructed of smooth, nonabsorbent,
durable material and
maintained in good repair. Carpeting, if used as a floor covering,
shall be of closely woven
construction, properly installed, easily cleanable, and maintained
in good repair. Carpeting is
allowed in work areas, dressing rooms, locker rooms, and toilet
rooms. Carpeted flooring around
the operating chair and work table in the work area must be covered
by vinyl or rubber sheeting or
mats so as to preclude any spillage that may occur during the
tattoo operation.
(b) Mats. Mats shall be of nonabsorbent, grease resistant materials
and of such size, design, and
construction as to facilitate their being easily cleanable.
(11) Walls and Ceilings
(a) Maintenance. Walls and ceilings, including doors, windows,
skylight, and similar closures shall be
constructed of smooth, nonabsorbent, durable material and be
maintained in good repair.
(b) Attachments. Light fixtures, vent covers, wall-mounted fans,
and similar equipment attached to
walls and ceilings shall be easily cleanable and maintained in
good repair.
TATTOO ARTIST AND TATTOO ESTABLISHMENT CHAPTER 1200-23-3
(Rule 1200-23-3-.03, continued)
December, 2000 (Revised) 8
(12) Physical Facilities. Floors, mats, walls, ceilings, and
attached equipment and decorative materials shall be
kept clean.
(13) Lighting
(a) Permanently fixed artificial light sources shall be installed
to provide at least 50 foot candles of light
on all work area surfaces and at equipment washing work levels.
(b) Permanently fixed artificial light sources shall be installed
to provide at a distance of 30 inches from
the floor at least 10 foot candles of light in all other areas.
(14) Ventilation. All rooms shall have sufficient ventilation
to keep them free of excessive heat, steam,
condensation, vapors, obnoxious odors, smoke, and fumes.
(15) Living areas. No operation of a tattoo establishment shall
be conducted in any room used as living or
sleeping quarters.
(16) Poisonous or Toxic Materials
(a) Materials permitted. There shall be present in the tattoo
studio only those poisonous or toxic
materials necessary for maintaining the establishment and cleaning
or sanitizing equipment, as well
as controlling insects and rodents.
(b) Labeling of materials. Containers of poisonous or toxic materials
shall be prominently and distinctly
labeled according to law for easy identification of contents.
(c) Toxic items shall be separated from other forms of materials
used in the process of tattooing.
(17) Premises
(a) Tattoo establishments shall be kept neat, clean, and free
of litter and rubbish.
(b) Only articles necessary for the operation and maintenance
of the tattoo establishment shall be stored
on or within the establishment.
(18) Animals. Live animals of all species shall be excluded from
within the tattoo studio operational premises
and from adjacent areas within the facility under the control
of the permit holder. However, this
exclusion does not apply to fish in aquariums. Service animals
accompanying blind or deaf persons shall
be permitted in the establishment.
(19) Equipment and Utensils
(a) Materials
1. Multi-use equipment and utensils shall be constructed and
repaired with safe materials,
including finishing materials; they shall be corrosion resistant
and nonabsorbent; and they shall
be smooth, easily cleanable, and durable under conditions of
normal use. Single-service
articles shall be made from clean, sanitary, and safe materials.
2. Re-use of single service articles is prohibited.
(b) Design and Fabrication
TATTOO ARTIST AND TATTOO ESTABLISHMENT CHAPTER 1200-23-3
(Rule 1200-23-3-.03, continued)
December, 2000 (Revised) 9
1. General. All equipment and utensils, including plasticware,
shall be designed and fabricated
for durability under conditions of normal use and shall be resistant
to denting, buckling,
pitting, and chipping.
(i) Tattooing and operational surfaces shall be easily cleanable,
smooth, and free of breaks,
open seams, cracks, chips, pits, and similar imperfections, as
well as free of difficult-toclean
internal corners and crevices.
(ii) Sinks and drain boards shall be self-draining.
2. Non-tattooing or operational surfaces. Surfaces of equipment
not intended as operational
surfaces, but which are exposed to splash or debris or which
otherwise require frequent
cleaning, shall be designed and fabricated to be smooth, washable,
free of unnecessary ledges,
projections, or crevices and readily accessible for cleaning.
Such surfaces shall be of material
and in such repair as to be easily maintained in a clean and
sanitary condition.
3. Needles, needle bars, dyes, or pigments shall be designed
and manufactured for the sole
purpose of tattooing.
(20) Aisles and working spaces. Aisles and working spaces between
units of equipment and walls shall be
unobstructed and of sufficient width to permit employees to perform
their duties readily without
contamination of equipment or of operational surfaces by clothing
or personal contact.
(21) Work Area. The work room is to be equipped or stocked in
the following manner:
(a) a minimum of six (6) sterilized needles, six (6) needle bars,
and six (6) needle tubes;
(b) a minimum of one extra package of disposable towels other
than the package that is being used;
(c) a minimum of one extra box of disposable gloves other than
the box being used; and
(d) an extra supply of bandages, ointment or gel, and antibacterial
soap.
Authority: T.C.A. 4-5-202, 62-38-201 et seq., and 68-1-103. Administrative
History: Original rule filed September
26, 2000; effective December 10, 2000.
1200-23-3-.04 TATTOO OPERATION
(1) Universal precautions, as defined in these rules, shall be
observed to prevent contact with blood or other
potentially infectious materials. Employees shall be trained
in universal precautions.
(a) Assume all human blood, plasma, serum, body fluids (semen,
saliva, breast milk, vaginal secretions
and any fluid contaminated with blood) and tissues to be contaminated
with Human
Immunodeficiency Virus (HIV) and/or Hepatitis viruses (e.g.,
HBV).
(b) The most susceptible route of occupational infection for
HIV and HBV is by accidental needle
sticks, contamination of the mucous membranes, or through broken,
abraded, or irritated skin. Use
appropriate caution and maximum protection to prevent such contact.
(c) Proper decontamination procedures, emergency biohazard spill
management, and proper use of
biosafety equipment shall be utilized.
(d) Use aseptic technique. Thorough hand washing is essential
after client contact, after handling blood
and body fluids, after wearing gloves, and prior to exiting the
work area.
TATTOO ARTIST AND TATTOO ESTABLISHMENT CHAPTER 1200-23-3
(Rule 1200-23-3-.04, continued)
December, 2000 (Revised) 10
(e) Needles and needle bar assemblies shall be sterilized prior
to use. It is permissible to use sterilized
disposable needles and disposable needle bar assemblies for tattooing.
(f) Nondisposable needle and nondisposable needle bar assemblies
shall be soaked in a disinfectant
solution for a minimum of thirty (30) minutes prior to removing
the needle. Do not remove a used
needle from a needle bar by hand. Needles shall be removed from
needle bars through the use of
gloves and pliers or similar means to prevent accidental puncture.
Dispose of needles and other
sharps in puncture proof, autoclavable containers, or disposable
biohazard containers.
(g) After soldering a new needle to the needle bar, the completed
assembly (needle and needle bar) shall
be sterilized.
(h) All regulated wastes shall be disposed of in labeled, manufacturer's
color-coded waste containers.
(i) A spill kit (bleach, leak proof container, paper towels,
gloves, spray bottle) is to be used to clean up
infectious material spills. Small spills can be wiped up, after
donning protective gloves, with paper
towels and sprayed with freshly made ten percent (10%) bleach
solution.
(j) Clean all work areas and equipment used in handling human
biohazardous materials with proven
disinfectant (e.g., 10% dilution of bleach) when concluding work
to protect personnel from
accidental infection.
(k) Eating, drinking, smoking, and applying cosmetics or lip
balm are not permitted in the work area.
Food shall be stored in cabinets or refrigerators designated
and used for this purpose only. Food
storage cabinets or refrigerators shall be located outside the
work area.
(l) All procedures shall be performed carefully to minimize the
creation of aerosols.
(m) Report all work related accidents, incidents, and unexplained
illness to your supervisor and/or
physician immediately.
(n) Used gloves shall be removed after each operation and prior
to contacting work surfaces, door
knobs, wall switches, or telephones. Dispose of used gloves in
a bagged, trash container.
(2) Personnel of a tattoo establishment
(a) The tattoo establishment operator shall make available, at
no cost to the personnel, Hepatitis B
vaccination series, as well as any routine booster dose(s) to
every person who may have
occupational exposure to blood or other potentially infectious
material. For new personnel the
vaccine shall be made available within ten (10) working days
of initial work assignment.
(b) Personnel who decline to accept the Hepatitis B vaccination
series must sign a form indicating their
refusal.
(c) The outer clothing of all personnel shall be clean.
(d) Each tattoo artist shall use a single use lap cloth.
(e) Tattoo artist/operators shall wash their hands with antiseptic
soap before and after treating each
client (i.e., before glove placement and after glove removal)
and after barehanded touching of
inanimate objects likely to be contaminated by blood, saliva,
or respiratory secretions. Hands shall
be washed after removal of gloves, smoking, eating, drinking,
or using the toilet.
(f) Tattoo artist/operators who have exudative lesions or weeping
dermatitis, particularly on the hands,
shall refrain from all direct client contact and from handling
equipment until the condition resolves.
TATTOO ARTIST AND TATTOO ESTABLISHMENT CHAPTER 1200-23-3
(Rule 1200-23-3-.04, continued)
December, 2000 (Revised) 11
(g) Personnel shall consume food only in approved, designated
areas. There shall be no eating or
drinking in the operation area of the establishment.
(h) Personnel shall not use tobacco in any form while engaged
in the operation or process of tattooing,
nor while in areas used for equipment or utensil washing. Personnel
shall use tobacco only in
approved, designated areas.
(i) Personnel shall maintain a high degree of personal cleanliness
and shall conform to good hygienic
practices during all working periods in tattoo studios.
(3) Implementation of infection-control practices
(a) Disposable latex or vinyl examination gloves shall be worn
by a tattoo artist at all times while
administering any tattoo. Gloves shall be changed and properly
disposed of each time there is an
interruption in the application of a tattoo, or whenever their
ability to function as a barrier is
compromised. Gloves shall be changed between clients and used
gloves shall be properly disposed
of as provided in these rules.
(b) Only single use supplies (or sterilized equipment) may be
used to apply a tattoo and shall be
disposed of after each tattoo. This subsection includes single
use disposable razors; single use
towels or wipes; lubricants removed from a collapsible tube;
and single use paper stencils or plastic
stencils soaked in a germicidal solution. If the design is drawn
directly onto the skin, it shall be
applied only with a single use article. Single use or individual
portions of dye and ink pots or trays
shall be used. After tattooing, single use items, dyes, and containers
shall be discarded and the
tattoo work area disinfected.
(c) When it is necessary to shave the area to be tattooed, a
new blade for each patron or customer shall
be used when a safety razor is employed, and the permanent part
of such razor shall be treated as
hereinafter set forth for the care of the straight razor or disposable
safety razor. If a straight razor is
used, it shall be cleaned with soap and water, rinsed in clear
water, and then sterilized in an
autoclave.
(d) A sterile set of needles, needle bar, and tube shall be used
for each patron or customer. Dried inks
and other materials on instruments must be removed by either
ultrasonic cleanser or by soaking in
either detergent or disinfectant solution followed by rinsing
in clean water prior to sterilization.
(e) All tubes, needles, and needle bars shall be sealed for individual
client use in autoclave bags with a
chemical or autoclave indicator and date (month and year) of
sterilization clearly visible. After
tattooing, used non-disposable instruments such as tubes shall
be kept in a separate, puncture
resistant container until properly cleaned, disinfected, and
sterilized using universal precautions and
recognized medical methods. The needle tube of the tattooing
machine shall be cleaned and
sterilized in a similar method after use.
(f) Microbiological monitoring for adequate functioning of each
autoclave will be done at least monthly
using a commercial source of Bacillus stearothermophilus which
is then tested in an accredited
commercial laboratory. All laboratory reports will be logged
and kept for two years and shall be
available for inspection.
(g) Upon notification of a positive microbiological monitoring
report (detection of viable spores), the
sterilizer shall be immediately checked for proper use and function.
A repeat test shall be performed
within three (3) days. Upon a subsequent positive result from
a repeat test, discontinue use of the
sterilizer until properly serviced and a negative result obtained.
TATTOO ARTIST AND TATTOO ESTABLISHMENT CHAPTER 1200-23-3
(Rule 1200-23-3-.04, continued)
December, 2000 (Revised) 12
(h) Sterilizer indicator tape and/or sterilizer bags with indicator
tape areas which change color will be
used with all items sterilized to indicate the item has been
autoclaved. All items shall be marked
with the date of sterilization.
(i) Sterilized items in the sealed, autoclaved bags shall be
stored in a clean, dry place, until used, for no
more than one (1) year.
(j) Sterilization indicators must change color or discontinue
use of autoclave until a negative spore
sample is obtained.
(k) The requirement for an autoclave shall be exempt in cases
where there is only the use of
manufactured, pre-sterilized single use, preassembled needle
and needle bar, disposable needles,
needle bars and needle tubes and similar tattooing equipment,
and/or the use of no other equipment
or tools requiring sterilization.
(4) Minimum standards for tattooing
(a) After shaving the area to be tattooed, or if the area does
not need to be shaved, the site of the tattoo
shall be cleaned with soap and water, rinsed with clean water,
and germicidal solution applied or
wiped with alcohol in a sanitary manner before the design is
placed on the skin.
(b) Single-use towels or gauze shall be used in preparing the
site to be tattooed and shall be disposed of
after use on each patron or customer. The use of roll-on or stick
deodorants for tattoo site
preparation is prohibited.
(c) Excess dye applied to the skin shall be removed with single-use
gauze pads, towels, or cotton only.
The entire site shall be covered with a sterile gauze dressing
or telfa pad.
(d) The stencil for transferring the design to the skin shall
be maintained in a clean, sanitary condition.
(e) Records showing the date of the client’s visit, printed
name, signature, address, age, design of the
tattoo, its location on the body, and tattooist’s name
shall be kept on the establishment premises for
a minimum of 2 years.
(f) After each tattooing, written instructions shall be given
to each patron or customer on the care of the
skin of the tattooed site to prevent infection. A copy of these
instructions shall be posted in a
conspicuous place in the tattoo establishment, clearly visible
to the customer or patron being
tattooed. These instructions shall include, but are not limited
to, bandaging, cleaning, sun exposure,
scratching, and wearing of clothing over or around the tattoo
site.
Authority: T.C.A. 4-5-202, 62-38-201 et seq., and 68-1-103. Administrative
History: Original rule filed
September 26, 2000; effective December 10, 2000.
1200-23-3-.05 ESTABLISHMENT PERMITTING AND INSPECTION SYSTEM
(1) Application Procedures
(a) Any person planning to operate a tattoo establishment shall
obtain a written application for a permit
on a form provided by the local health officer through the local
county health department prior to
operating a tattoo establishment. A new or initial application
is required for tattoo establishments
that have not previously been permitted or for instances when
ownership changes.
(b) The local health department shall issue a tattoo establishment
permit
TATTOO ARTIST AND TATTOO ESTABLISHMENT CHAPTER 1200-23-3
(Rule 1200-23-3-.05, continued)
December, 2000 (Revised) 13
1. after an inspection of the proposed facility reveals that
the facility is in compliance with
requirements of these rules and
2. upon receiving a completed application with applicable fees.
(2) Inspection results - Reporting and Scoring
(a) Inspection results for tattoo establishments shall be recorded
on standard departmental forms which
summarize the requirements of the law and rules and regulations.
(b) The scoring system shall include a weighted point value for
each requirement in which critical items
are assigned values of either four (4) or five (5) points, with
minor violations having assigned values
of either one (1) or two (2) points.
(c) The rating score of the facilities shall be the total of
the weighted point values for all violations
subtracted from one hundred (100).
(3) Violation Correction
(a) In accordance with T.C.A. 62-38-202, correction of critical
and minor violations shall be within
seven (7) and fourteen (14) calendar days, respectively.
(b) Upon declaration of an imminent health hazard by the local
health officer acting consistent with the
provisions of Tennessee Code Annotated, Section 68-2-608 (b),
the local health officer shall issue
an order requiring the facility to immediately cease operations
until authorized to reopen. In the
event of any such closure order, the operator shall be afforded
an opportunity for a hearing, if
requested by the operator, as promptly as is reasonable under
the circumstances.
(c) In the case of temporary tattoo facilities, all critical
violations shall be corrected within twenty-four
(24) hours. If critical violations are not corrected within twenty-four
(24) hours, the establishment
shall immediately cease tattoo operation until authorized to
resume by the local health officer or his
duly authorized representative. Upon declaration of an imminent
health hazard by the local health
officer acting consistent with the provisions of Tennessee Code
Annotated, Section 68-2-608 (b),
the health officer shall issue an order requiring the facility
to immediately cease operations until
authorized to reopen. In the event of any such closure order,
the operator shall be afforded an
opportunity for a hearing, if requested by the operator, as promptly
as is reasonable under the
circumstances.
(4) The inspection report shall state that failure to comply
with any time limits for correction may result in
cessation of operations. An opportunity for a review concerning
the inspection and/or inspection report
and/or on the ordered corrective action will be provided if written
request is filed with the local health
department in the county of the affected establishment within
ten (10) calendar days following the
inspection. If a request for a review is received, a review shall
be held within fourteen (14) days after
receipt of the request. The decision of the local health officer
shall be final.
(5) If a second violation of any critical item (identical or
otherwise) is committed within the period of one (1)
year (calendar or otherwise), the tattoo studio shall be subject
to a civil penalty of up to five hundred
dollars ($500) and the tattoo studio’s permit may be revoked.
(6) Permit Revocation
(a) After providing an opportunity for a hearing, the local health
officer or his duly authorized
representative may revoke a permit for serious or repeated violations
of requirements of this part or
for interference with the local health department in the performance
of their duty. The violation of
TATTOO ARTIST AND TATTOO ESTABLISHMENT CHAPTER 1200-23-3
(Rule 1200-23-3-.05, continued)
December, 2000 (Revised) 14
two (2) or more critical items within a twelve (12) month period
may result in revocation of the
tattoo establishment permit.
(b) Prior to revocation, the local health officer or his duly
authorized representative shall notify, in
writing, the permittee of the specific reason(s) for which the
permit is to be revoked, and that the
permit shall be revoked at the end of ten (10) days following
service of such notice unless a written
request for a hearing is filed with the local health officer
within such ten-day period. If no request
for hearing is filed within the ten-day period, the revocation
of the permit becomes final.
(7) License Revocation
(a) After providing an opportunity for a hearing, the local health
officer or his duly authorized
representative may revoke an artist or operator’s license
for serious or repeated violations of
requirements of this part or for interference with the local
health officer or his duly authorized
representative in the performance of his duty.
(b) Prior to revocation, the local health officer or his duly
authorized representative shall notify, in
writing, the licensee of the specific reason (s) for which the
license is to be revoked, and that the
license shall be revoked at the end of ten (10) days following
service of such notice, unless a written
request for a hearing is filed with the local health officer
within such ten-day period. If no request
for hearing is filed within the ten-day period, the revocation
of the license becomes final.
(c) When a tattoo artist or operator’s license is revoked
by the local health officer, a new license shall
be issued upon meeting all requirements for a new license and
the submission of a new application
with applicable fees.
(8) Civil penalties shall be assessed in accordance with T.C.A.
62-38-202.
(9) Whenever a facility is required under this section to cease
operations, it shall not resume operations until
it is shown on re-inspection that conditions responsible for
the order to cease operations no longer exist.
Opportunity for re-inspection shall be offered within a reasonable
time by the local health officer.
(10) Any suspension or revocation of a permit or license may
be appealed to the local health officer who shall
then conduct a hearing of such appeal in accordance with the
Uniform Administrative Procedures Act in
Title 4 of the Tennessee Code Annotated. The decision made by
the local health officer concerning the
appeal may be appealed to the commissioner, such appeal to the
commissioner being limited to the issue
of determining whether a material error of law was made at the
hearing level.
(11) Submission of plans and specifications - Review - Approval.
(a) No tattoo establishment shall be constructed, extensively
remodeled, or converted except in
accordance with plans and specifications approved by the local
health department or its duly
authorized representative.
(b) Whenever a tattoo establishment is constructed or extensively
remodeled and whenever an existing
structure is converted to use as a tattoo establishment, plans
and specifications shall be submitted to
the local health department for review and approval before construction,
remodeling, or conversion
is begun. The plans and specifications shall indicate the proposed
layout arrangement, mechanical
plans, construction materials, work areas, and the type and model
of proposed fixed equipment and
facilities. The local health department shall approve the plans
and specifications if they meet the
requirements of the law, rules, and regulations.
Authority: T.C.A. 4-5-202, 62-38-201 et seq., and 68-1-103, and
68-2-608. Administrative History: Original rule
filed September 26, 2000; effective December 10, 2000.
TATTOO ARTIST AND TATTOO ESTABLISHMENT CHAPTER 1200-23-3
December, 2000 (Revised) 15
1200-23-3-.06 TATTOO ARTIST LICENSING
(1) Apprentice Tattoo Artist
(a) Any tattoo artist not in business or operating prior to October
1, 1996, shall be required to obtain an
apprentice license and operate from an approved tattoo establishment.
(b) A tattoo apprentice artist license shall be issued upon submitting
an application with the appropriate
fee.
(2) A tattoo operator or tattoo artist shall undergo a training
program before receiving a permit either to
operate a tattoo establishment or to apply a tattoo. The training
shall include at least one of the following:
(a) the Alliance of Professional Tattooist course in sterilization;
(b) an approved local or state health department program;
(c) a course approved by the local health department in methods
and techniques for the proper
sterilization of instruments and materials used in tattooing;
or
(d) present acceptable evidence of having satisfactorily completed
an approved course of instruction in
sterilization techniques and methods through a college medical
sterilization course.
(3) The tattoo operator and/or tattoo artist shall be required
to take and pass an examination concerning the
provisions of T.C.A. Title 62, Chapter 38 before a license shall
be issued. Such examination shall be
either a written exam prescribed by the local health department
or documentation of a similar exam given
with a course as required in 1200-23-3-.06(2)(a), (c), or (d).
After passing such examination and
complying with the other provisions of the law and these rules,
a license shall be issued.
(4) The tattoo artist license shall be issued upon proof of
(a) having passed a written examination as specified in 1200-23-3-.06(3)
and/or 1200-23-3-.06(2) and
(b) having submitted an application with the appropriate fee
and completion of a one year
apprenticeship.
(c) Any tattoo artist in business in the state of Tennessee on
October 1, 1996, shall not be required to
meet the prerequisite of a tattoo apprentice. Proof of business
may be a copy of a business license,
tax records, copy of another state's tattoo artist license, or
other similar city, county, state, or federal
documents which show the prospective applicant as having been
in business or operating on
October 1, 1996, or a combination, acceptable to the State, of
such documents. The local health
officer shall have final approval on other forms of documentation
submitted as evidence or proof.
(5) Any individual desiring to tattoo who is a physician licensed
by the State of Tennessee or any person
under the supervision of a physician licensed by the State of
Tennessee shall be exempt from the
requirements of these regulations. In order to receive such exemption,
a person, other than a licensed
physician, shall submit a letter stating that any and all tattooing
is performed under the supervision of a
licensed physician and such letter shall be signed by the supervising
physician and shall be notarized.
Authority: T.C.A. 4-5-202, 62-38-201 et seq., and 68-1-103. Administrative
History: Original rule filed September
26, 2000; effective December 10, 2000.
1200-23-3-.07 LICENSE AND PERMIT FEES
(1) As written, the law uses the terms "license" and
"permit" interchangeably. For example, the law refers
to
the tattoo artist as being issued a license, but further refers
to the tattoo artist as having to pass an
TATTOO ARTIST AND TATTOO ESTABLISHMENT CHAPTER 1200-23-3
(Rule 1200-23-3-.07, continued)
December, 2000 (Revised) 16
examination to receive a permit. Consequently, the Department
of Health has determined that individuals
shall be issued licenses and that a tattoo operation shall be
issued a permit.
(2) License Fees
(a) A Tattoo Artist and an Apprentice Artist shall be assessed
an initial licensing fee and a renewal
licensing fee of fifty dollars ($50.00) each.
(b) A Tattoo Operator shall have an initial license fee and an
annual renewal license fee of twenty-five
dollars ($25.00) each.
(c) A late penalty fee of twenty-five dollars ($25.00) shall
be assessed on all artist license renewal
applications which are postmarked after January 31st of each
permitting year.
(d) A Temporary Artist shall pay a temporary artist license fee
of fifty dollars ($50.00).
(3) Permit Fees
(a) A Tattoo establishment shall be assessed an initial fee and
a renewal permit fee of one hundred
dollars ($100.00) each.
(b) A Temporary tattoo establishment shall be assessed a temporary
permit fee of fifty dollars ($50.00).
Authority: T.C.A. 4-5-202, 62-38-201 et seq., and 68-1-103. Administrative
History: Original rule filed September
26, 2000; effective December 10, 2000.
1200-23-3-.08 LOSS OF PERMIT DOCUMENT
(1) Any establishment or operator that loses, misplaces, or destroys
a permit or license shall immediately
apply for a duplicate, as soon as the fact becomes apparent.
The fee for the duplicate shall be three
dollars ($3.00). This fee shall accompany the application for
such duplicate.
Authority: T.C.A. 4-5-202, 62-38-201 et seq., and 68-1-103. Administrative
History: Original rule filed September
26, 2000; effective December 10, 2000.
1200-23-3-.09 GENERAL PROVISIONS
(1) Applicability. Chapter 1200-23-3 applies to tattoo artists
and tattoo establishments. All tattoo artists and
tattoo establishments shall comply with all applicable provisions
of these rules at all times.
(2) Permit Revocation. When a permit to operate a tattoo establishment
is revoked by the Commissioner, a
new permit shall be issued upon meeting all requirements for
a new permit and the submission of a new
application with applicable fees.
(3) Posting of permit. T.C.A. Section 62-38-206 requires posting
of tattoo establishment permits "in a
conspicuous place where it may be readily observed by the public."
This shall mean a place so
designated by the inspector at the time of inspection. No person
except an authorized representative of
the local health officer shall modify, remove, cover up, or otherwise
make the permit less conspicuous in
any way.
(4) Severability. If any provision or application of any provision
of these rules is held invalid, that invalidity
shall not affect other provisions or applications of these rules.
Authority: T.C.A. 4-5-202, 62-38-201 et seq., and 68-1-103. Administrative
History: Original rule filed September
26, 2000; effective December 10, 2000.
