Tattoo Artists and Tattoo Parlors (216-RICR-40-10-15)
These regulations are promulgated pursuant to the authority conferred under R.I. Gen. Laws §§ 23-1-39(a) and 23-1-39(b), and are established for the purpose of adopting minimum requirements for the registration of tattoo artists and tattoo parlors in this state.
15.2 Incorporated Materials
These regulations hereby adopt and incorporate 29 C.F.R. § 1910.1030 (1994) by reference, not including any further editions or amendments thereof and only to the extent that the provisions therein are not inconsistent with these regulations.
A. Wherever used in these rules and regulations, the terms listed below shall be construed as follows:
1. "Act" means R.I. Gen. Laws § 23-1-39, entitled "Tattooing and/or Body Piercing"
2. “Apprentice” means a trainee tattoo/permanent makeup artist working under the supervision of a Rhode Island licensed tattoo/permanent makeup artist within a Rhode Island licensed tattoo parlor.
3. "Aseptic technique" means the practice of preventing the transmission of infectious agents into the human body by using standard aseptic procedures.
4. "Communicable disease" means any disease caused by an infectious agent which may be transmitted directly or indirectly from one individual to another.
5. "Director" means the Director of the Rhode Island Department of Health.
6. "Division" means the Division of Customer Services at the Rhode Island Department of Health.
7. "Person" means any individual, trust or estate, partnership, corporation (including but not limited to associations, joint stock companies,) state, or political subdivision or instrumentality of the state.
8. "Registration agency" means the Rhode Island Department of Health.
9. “Repigmentation” means recoloration of the skin as a result of the following:
a. Dermabrasion, chemical peels, removal or resolution of birthmarks, vitiligo or other skin conditions which result in the loss of melanin to the skin;
b. Scars as a result of surgical procedures, such as cosmetic facial surgery, mole or wart removal, cauterization, etc.;
c. Recoloration to burn grafts and other skin irregularities as a result of burns or photo- damage;
d. Recreation of an areola or nipple, following mastectomy; or
e. Irregularly pigmented skin which may require cheek blush or other blending of pigments into the skin to camouflage.
10. "Tattoo" means to mark or color the skin by introduction of non-toxic dyes or pigments into the skin. For the purposes of these rules and regulations, “tattooing” includes cosmetic procedures such as eye lining, lip lining, microblading, or repigmentation, as defined in this Part.
11. "Tattoo artist" means an individual who is registered in this state to practice tattooing or permanent makeup in accordance with the requirements of this Part.
12. "Tattoo parlor/shop" means any establishment operated by any person for the purpose of offering or conducting tattooing and/or permanent makeup procedures.
15.4 Registration Requirements for Tattoo/Permanent Makeup Artists
Pursuant to R.I. Gen. Laws § 23-1-39, no person shall engage in the practice of tattooing or hold himself/herself as a tattoo artist in this state unless he/she is registered in this state under the statutory and regulatory provisions of this Part. Provided, that physicians duly licensed to practice medicine in the state of Rhode Island under the provisions of R.I. Gen Laws Chapter 5-37, shall be exempt from this registration requirement. However, a physician engaged in the practice of tattooing in his/her private office shall be required to register the site as a tattoo parlor/shop and meet the requirements of § 15.5 of this Part.
A. Any applicant seeking registration in this state must:
1. Be over 18 years of age;
2. Be of good moral character;
3. Demonstrate knowledge of aseptic tattooing technique via inspection, as indicated in § 15.4.3 of this Part; and
4. Have completed an apprenticeship program as outlined in this Part or has shown equivalent documentation of education/experience in the art of tattooing/permanent makeup.
A. Application for registration shall be made on forms provided by the Division including, if applicable, a request for inspection form, which shall be completed and submitted to the Division. Such application shall be accompanied by the following documents:
1. For U.S citizens: a certified copy of birth certificate;
2. For non-U.S. citizens: proof of lawful entry into the United States and proof of lawful eligibility for employment in the United States;
3. A registration fee as set forth in the rules and regulations pertaining to the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title);
4. A recent identification photograph of the applicant, head and shoulders, front view, approximately 2x3 inches in size; and,
5. A completed "Inspection Request" form.
a. Said inspection will be completed within ninety (90) days of application.
B. Any applicant who has not previously been issued a registration by the registration agency will be required to submit to a technique inspection, as set forth in § 15.4.3 of this Part, before a registration shall be issued.
A. By Examination
1. Applicants and apprentices who have completed an apprenticeship program, seeking registration as a tattoo/permanent makeup artist, shall be required to demonstrate aseptic tattooing technique via an examination administered by the registration agency, to test the applicant's fitness to engage in the practice of tattooing/permanent makeup. Such examination shall test the applicant's knowledge and practices of infection control and such other areas as may be deemed necessary, and shall be administered upon completion and review of the application.
a. Applicants who have not satisfactorily met the application requirements of this Part relating to the examination described in § 15.4.3(A)(1) of this Part will be given two (2) additional opportunities to demonstrate tattooing technique. Failure to meet all technique requirements will result in denial of registration.
b. Applicants wishing to reapply for registration may do so after a six (6) month waiting period between attempts at the examination.
1. Persons wishing to begin an apprenticeship program at an established tattoo parlor must register with the registration agency within thirty (30) days of beginning a tattoo parlor’s apprenticeship training program.
2. A tattoo parlor’s apprenticeship training program must span eighteen (18) months from the apprentice registration date and should be inclusive of the following:
a. Practical Operation: 150 hours
b. Aseptic Tattooing Technique: 50 hours
c. Anatomy and Physiology: 30 hours
d. Skin and Skin Disorders: 20 hours
e. Aftercare Instruction: 10 hours
f. Equipment and Supplies: 20 hours
g. Rhode Island Rules and Regulations for Tattoo Artists and Tattoo Parlors: 20 hours
3. Upon completion of a tattoo parlor’s training program, documentation of training must be presented with the tattoo license application to the registration agency for review and processing.
4. Parlor patrons receiving a tattoo/permanent make up procedure from an apprentice must be informed prior to the tattoo/permanent makeup procedure in writing, and acknowledge via a dated signature, that they willfully accept the tattoo/permanent makeup procedure to be performed by an apprentice.
5. The licensed tattoo artist trainer must be present at all times during procedures performed by the apprentice.
15.4.4 Issuance and Renewal of Registration and Fee
A. The Director shall issue to applicants who have satisfactorily met the application and examination requirements of this Part, a registration to practice tattooing in the state. This registration, unless sooner suspended or revoked, shall expire on December 31st of each year.
B. On or before the first day of December in each year, an application for online renewal of registration shall be mailed to every person to whom a registration has been issued during the current year.
C. Every person so registered who desires to renew his/her registration shall electronically file with the Division:
1. An online renewal acknowledgement of adherence to the requirements of this Part.
2. The fee as set forth in the rules and regulations pertaining to the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title).
D. Lapsed Registration
1. Any registrant who allows the registration to lapse may have same reinstated by submitting to the registration agency, an application and accompanying documents, as required in § 15.4.2 of this Part.
2. Any registrant whose registration lapses for two (2) or more years shall be required to submit to the practical examination of aseptic tattooing technique administered by the registration agency.
15.4.5 Tattooing Practice
A. A registered tattoo artist shall maintain sanitary and safe practice in accordance with prevailing standards contained in this Part.
1. Dyes, Pigments, Transfer Paper, and Stencils:
a. All dyes and pigments shall be manufactured for the purpose of tattooing and used according to the manufacturer’s specifications.
b. In preparing dyes or pigments, non-toxic materials shall be used.
c. Single-use, sterile, individual containers for dyes or pigments shall be used for each patron.
d. The stencil, unless composed of acetate, shall be used for a single tattoo procedure only. Acetate stencils may be disinfected and re-used.
e. Transfer paper shall be one time use and shall be used per manufacturer’s specifications.
2. Tattoo Procedures:
a. A tattoo artist shall conduct his/her tattooing practice so as to prevent the transmission of communicable diseases from client to client and from artist to client. Tattoo artists shall maintain at least the following minimum standards in the practice of tattooing:
(1) The area of the body to be tattooed, and all parts of the body which are visible, shall be examined for signs of intravenous drug use, open sores, lesions, oozing wounds, and skin diseases. If such are found, or suspected, the person shall not be tattooed.
(2) Each tattoo artist shall wear a clean outer garment. If the garment is visibly contaminated with blood, it shall be changed between clients.
(3) Before working on each client, each tattoo artist shall clean his/her own fingernails with a brush and shall thoroughly wash and scrub hands with hot running water, using germicidal soap from a dispenser. Hands must also be washed after each rest room use, before putting on gloves and after taking off gloves.
3. Tattoo Materials:
a. All materials necessary for the tattooing process shall be set up on a single-use disposable sterile cloth (e.g., polycloth). All autoclaved/sterile packs shall be opened ready for use without touching the interior of the pack. Single-use or collapsible tubes shall be used for lubricants.
b. Any shaving shall be done with a single use razor blade or razor.
c. The skin shall be prepared first by thoroughly soaping with an antiseptic soap and rinsing with tap water. Following this cleansing, a germicidal solution (such as 70% isopropyl alcohol) shall be applied to the skin using a sterile swab.
d. Stencil transfer medium shall be applied (if applicable) using sterile swabs and prepared clean transfer paper/stencil shall be applied to the skin.
e. After applying the stencil, the tattoo artist shall remove and discard gloves and again wash and scrub his/her hands with soap and water and dry hands using paper towels.
f. Prior to commencing application of the tattoo, the tattoo artist shall then re-glove.
g. If there is a need to rinse the tube and needle between colors, this shall be done with ninety-one percent (91%) isopropyl alcohol or sterile water in sterile single-use disposable containers or non-disposable sterilized containers.
h. As the tattoo operation progresses, any excess dye or pigment applied to the skin shall be removed with sterile, lint-free material.
i. The tattoo shall be allowed to dry. After drying, a sterile lubricant shall be applied from a collapsible metal or plastic tube, and the entire area covered with a piece of sterile gauze or similar sterile porous material.
j. Needles and microblades shall be immediately deposited into a puncture-resistant infectious waste sharps container. Needles and microblades shall not be reused.
k. All used sharps and any blood soaked material shall be handled and discarded according to the Medical Waste Regulations (250-RICR-140-15-1). All other material shall be discarded appropriately.
l. Unless one time use and disposable, all tubes must be rinsed with tap water and then placed in a germicidal solution (e.g., Cidex) or directly into an ultrasonic cleaner.
m. Gloves shall be removed and discarded in accordance with the requirements of the Medical Waste Regulations (250-RICR-140-15-1) .
n. Immediately after tattooing, the tattoo artist shall advise the patron, both verbally and in writing, on the care of the tattoo and shall instruct the patron to consult a physician at the first sign of infection (such as excessive pain, redness, swelling, or discharge) in the area of the tattoo.
o. All work surfaces and non-autoclaved equipment (e.g., tattoo machine and pliers) used in the tattoo process shall be cleaned with an EPA-approved bactericidal, virucidal, fungicidal, tuberculocidal surface disinfectant/decontaminant cleaner between clients. Gloves shall be used in the cleaning process. Subsequently, the artist shall wash his/her hands with a germicidal soap after cleaning work surfaces and equipment.
p. After tattooing, the remaining unused dye or pigment shall be discarded in accordance with the requirements of the Medical Waste Regulations (250-RICR-140-15-1). Non-disposable individual containers shall be resterilized, according to specifications in § 15.4.5(A)(5) of this Part.
4. Tattoo Equipment:
a. A set of individual, single-use sterilized needle bars shall be used for each new patron. Before each use, the open end of the reusable needle tube of the tattooing machine shall be cleaned and sterilized in an approved manner as set forth in § 15.4.5(A)(5) of this Part.
b. Unless one time use and disposable, the needle tubes shall be cleaned by use of an ultrasonic cleaner and sterilizer. Immersion time for all equipment shall be five (5) minutes. Ultrasonic cleaning tank detergent shall be changed daily. The tank shall be scrubbed thoroughly with a ninety-one percent (91%) solution of isopropyl alcohol between detergent changes.
c. Adequate numbers of sterilized needles, tubes and/or microblades shall be on hand for each operator for the entire day or night operation, based on the average number of clients per day. Failure to maintain an adequate number of sterilized needles, tubes, and/or microblades shall require the artist to cease operations until such time as an adequate number becomes available.
d. All items of equipment which may be touched during the tattoo process, such as clip cords, machine heads, spray bottles, etc., shall be capable of being sheathed easily with a disposable impervious covering.
e. Storage cabinets shall be maintained in a sanitary condition and all instruments, dyes, pigments, stencils and other equipment, when not in use, shall be stored in an orderly manner.
a. Sterilizing of instruments: Operational sterilizers shall be available in each tattoo parlor unless all materials are one time use and disposable. All multiuse grips and needle tubes shall be sterilized after each use by autoclaving per manufacturer's specifications.
b. If in use, autoclave units shall be checked monthly, using a standard spore test, with results maintained on file for inspection. Autoclave units shall be maintained in accordance with manufacturer’s specifications. Records of said monthly checks shall be maintained for a minimum of two (2) years.
c. A log book shall be maintained for the results of said monthly inspections and shall include no less than the following items:
(1) Date of inspection;
(2) Results of inspection; and
(3) The signature of the tattoo artist who conducted the inspection.
d. The sterilizing date shall be noted, and evidence of sterilization shall be demonstrated by color indicator or equivalent. Packs shall be used within thirty (30) days or resterilized.
B. Restrictions: All tattoo patrons must meet the age eligibility requirements of R.I. Gen. Laws § 11-9-15.
15.5.1 Registration Requirements
A. No person, acting severally or jointly with any other person, shall conduct, maintain, or operate a tattoo parlor/shop in the state without a registration issued by the registration agency.
B. No person, firm, partnership or corporation shall describe its services in any manner under the title "Tattoo" unless such services as defined in this Part are performed in a parlor/shop that is registered with the registration agency in accordance with the provisions of this Part.
15.5.2 Application for Registration and Fee
A. Application for a registration to conduct, maintain, or operate a tattoo parlor/shop shall be made in writing on forms provided by the Division and shall be submitted at least ninety (90) days prior to the opening of the tattoo parlor/shop.
B. The application for registration shall include:
1. The address of the place of business;
2. The address of the owner and/or manager;
3. The name of the manager who shall be registered with the registration agency;
4. Written documentation that the owner and/or manager is at least eighteen (18) years of age;
5. Criminal convictions of the corporation, owner and/or manager, if any, except minor traffic violations;
6. A list of all owners and partners;
7. A list of owners holding fifty percent (50%) or more stock;
8. The fee as set forth in the rules and regulations pertaining to the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title).
9. A list of all equipment;
10. A floor plan of the tattoo parlor/shop;
11. Appropriate certificates of compliance with all applicable local and state codes;
12. Written operating policies and procedures pertaining to such matters as hours of business operation, nature of services, sanitation, and safety procedures established for the protection of patrons and employees.
15.5.3 Issuance and Renewal of Registration and Fee
A. Upon approval, the Division shall issue a registration. Said registration, unless sooner suspended or revoked, shall expire by limitation on March 31st following its issuance and may be renewed from year to year after inspection and/or approval by the registration agency, provided the applicant meets the appropriate statutory and regulatory requirements herein.
B. A registration shall be issued only to a specific applicant for a specific location, and shall not be transferable.
C. The annual registration renewal fee as set forth in the rules and regulations pertaining to the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2) shall accompany the application for the annual license renewal.
D. Any registrant who allows the registration to lapse may have the same reinstated by submitting an application, the accompanying documents, the fee as required in the rules and regulations pertaining to the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title) and other such documentation as deemed appropriate.
15.5.4 Change of Ownership, Operation and/or Location
A. When a change of ownership, operation, location, or discontinuation of business of a tattoo parlor/shop is contemplated, the owner and/or manager shall notify the registration agency in writing prior to the proposed action.
B. When there is a change in ownership, or in the operation or control of a registered tattoo parlor/shop, the registration shall immediately become void and shall be returned to the registration agency. However, the registration agency reserves the right to extend the expiration date of such registration, allowing the facility to operate under the same conditions which applied to the prior registrant for such time as shall be required for the processing of a new application, but not to exceed thirty (30) days.
A. Duly authorized representatives of the registration agency shall, at all reasonable times, have the authority to enter upon any and all parts of the premises on which any tattoo parlor/shop is located (and of the premises appurtenant thereto) to make any investigation or inspection to determine conformity with the statutory and regulatory provisions of this Part.
B. Refusal to permit inspection or investigation shall constitute valid grounds for registration denial or revocation.
C. Applicants who have not satisfactorily met the requirements of this Part related to the inspection described in § 15.5.5 of this Part will be given one (1) additional facility inspection. Failure to meet all requirements will result in denial of registration.
1. Applicants wishing to reapply for registration may do so after a one (1) year waiting period.
15.5.6 General Operational Requirements
1. Each facility shall submit to the registration agency the name of the owner and/or manager who shall be responsible for:
a. The management and control of the operation and the maintenance of the facility;
b. The facility's conformity with state and local laws and regulations pertaining to fire, safety, building sanitation, personnel and other relevant statutory and regulatory provisions; and,
c. The establishment of policies and procedures, including but not limited to, the practice of tattooing, sanitation protocols, infection control, the nature of services provided and other such policies and procedures as may be required.
2. Persons engaged in the practice of tattooing shall comply with the Occupational Safety and Health Administration's (OSHA) Blood Borne Pathogen Standards, incorporated above at § 15.2(A) of this Part, in order to protect themselves (and any employees) against occupational exposure to bloodborne pathogens. Compliance shall include, but not be limited to:
a. A written exposure control plan;
b. Staff training;
c. Engineering and work practice controls;
d. Adoption of universal precautions;
e. Personal protective equipment;
f. Hepatitis B vaccinations; and,
g. A protocol for evaluation in the event that an exposure occurs.
3. Only individuals who hold current Rhode Island registration as a tattoo artist or a duly licensed physician shall practice tattooing and use the title "tattoo artist" in accordance with the regulatory provisions of this Part.
4. If the owner and/or manager of a facility is not a registered tattoo artist, a registered tattoo artist shall be designated as the agent of the manager and/or owner, responsible for the direct supervision of all personnel and services related to the practice of tattooing. The name of said designated individual shall be submitted to the registration agency.
B. Environment and Maintenance
1. Each tattoo parlor/shop shall be required to meet the following provisions:
a. The facility shall be maintained in a sanitary condition free from hazards.
b. All walls, ceilings, and floors shall be smooth and easily cleanable and have a non-absorbent surface. There shall be no carpeting in the tattooing area. Walls and ceilings are to be painted in a light color. Walls, ceilings and floors shall be kept clean and in good repair, free from dust and debris. Floors, walls or ceilings shall not be swept or cleaned while tattooing is being performed.
c. Adequate light and ventilation shall be provided.
d. Each tattoo parlor/shop shall contain a hand sink in the tattooing area for the exclusive use of the tattoo artist. The sink shall have hot and cold running water. At the sink, there shall also be available:
(1) A soap dispenser;
(2) Disposable towels; and
(3) Refuse containers.
(4) In facilities in which there are multiple tattooing workstations, there shall be a minimum of one (1) sink per every two (2) workstations. Each sink shall meet the requirements of § 15.5.6(B)(1)(d) of this Part.
e. Toilets and hand-washing facilities shall conform with the Rhode Island State Building Code, R.I. Gen. Laws Chapter 23-27.3.
f. All work surfaces shall be smooth, non-porous and easily cleanable.
g. The facility shall be arranged so that work areas are separated from waiting customers by providing a separate room for tattooing or by providing at least ten (10) feet between work areas and partitioning the areas with panels (or other barriers) at least six (6) feet high. The panel may be constructed of solid opaque plastic or similar material.
h. Equipment and supplies shall be properly stored in designated storage cabinets.
i. No smoking, eating or drinking shall be permitted in the tattooing area.
C. Waste Disposal
1. Medical waste shall be managed in accordance with the Medical Waste Regulations (250-RICR-140-15-1).
15.5.7 Retention of Records
A. The owner of a tattooing parlor/shop shall maintain proper records for each patron. A record of each patron shall include:
1. The date on which he/she was tattooed;
2. His/her name, address, telephone number and age;
3. The location and design of the tattoo; and,
4. The name of the tattoo artist.
B. These records shall be permanently entered in a book with pre-numbered pages, kept solely for this purpose. Records that cannot be physically stored in this pre-numbered book (e.g., copies of proof of age as required in § 15.5.7(A)(2)(a) of this Part) may be stored elsewhere in the facility. These records shall be available for inspection by the registration agency. These records shall be maintained for a minimum of five (5) years after the date on which the patron was tattooed.
A. The Director is authorized to deny an application, revoke or suspend a registration for failure of an applicant or registrant to comply with the provisions of the rules and regulations herein.
B. Whenever an action shall be proposed to deny an application, revoke or suspend a registration, the Director shall notify the person by certified mail, setting forth the reason(s) for the proposed action.
C. The applicant or registrant shall be given an opportunity for a prompt and fair hearing in accordance with the provisions of R.I. Gen. Laws Chapter 42-35, and the rules and regulations regarding Practices and Procedures Before the Department of Health (Part 10-05-4 of this Title) and Access to Public Records (Part 10-05-1 of this Title).
D. If it is determined that a person is violating any provisions of this Part, the Director may issue an order to secure compliance in accordance with the provisions of R.I. Gen. Laws §§ 23-1-20 through 23-1-25.
A. The registration agency shall notify the governing body or other legal authority of a facility of violations of this Part through a notice of deficiencies which shall be forwarded to the facility within fifteen (15) days of inspection of the facility. If the Director determines that immediate action is necessary to protect the health, welfare, or safety of the public, she/he may issue an immediate compliance order in accordance with R.I. Gen. Laws § 23-1-21.
B. A facility that has received a notice of deficiencies shall submit a plan of correction to the registration agency within fifteen (15) days of the date of the notice of deficiencies. The plan of correction shall detail any requests for variances as well as document the reasons therefore.
C. The registration agency shall be required to approve or reject the plan of correction submitted by a facility in accordance with § 15.7(B) of this Part within fifteen (15) days of receipt of the plan of correction.
D. If the registration agency rejects the plan of correction, or if the facility does not provide a plan of correction within the fifteen (15) day period stipulated in § 15.7(B) of this Part, or if a facility whose plan of correction has been approved by the registration agency fails to execute its plan within a reasonable time, the registration agency may invoke the sanctions referenced in § 15.6 of this Part.
E. If the facility is aggrieved by the sanctions of the registration agency, the facility may appeal the decision and request a hearing in accordance with the provisions of R.I. Gen. Laws Chapter 42-35, and the rules and regulations regarding Practices and Procedures Before the Department of Health (Part 10-05-4 of this Title) and Access to Public Records (Part 10-05-1)..
15.8 Variance Procedures
A. The registration agency may grant a variance either upon its own motion or upon request of the applicant from the provisions of any rule or regulation in a specific case if it finds that a literal enforcement of such provision will result in unnecessary hardship to the applicant and that such a variance will not be contrary to the public interest, public health and/or health and safety of clients.
B. A request for a variance shall be filed by an applicant in writing, setting forth in detail the basis upon which the request is made.
C. Upon the filing of each request for variance with the registration agency, and within thirty (30) days thereafter, the registration agency shall notify the applicant by certified mail of its approval or in the case of a denial, a hearing date, time and place may be scheduled if the facility appeals the denial and in accordance with the provisions of § 15.7 of this Part.
|Title||216||Rhode Island Department of Health|
|Chapter||40||Professional Licensing and Facility Regulation|
|Part||15||Tattoo Artists and Tattoo Parlors (216-RICR-40-10-15)|
|Type of Filing||Amendment|
Regulation Authority :
R.I. Gen. Laws §§ 23-1-39(a) and (b)
Purpose and Reason :
In accordance with the Administrative Procedures Act, R.I. Gen. Laws Section 42-35-3(a)(1), the following is a concise statement regarding this rulemaking for Tattoo Artists and Tattoo Parlors (216-RICR-40-10-15). This amendment to the regulations creates Authority and Incorporated Materials sections, creates procedures for tattoo artist apprenticeship, revises term utilized to refer to RIDOH and Division of Customer Services for consistency, clarifies requirements for tattooing practice, include microblading and permanent makeup in tattoo requirements, and removes superfluous language. No comments were received during the public comment period; therefore no non-technical revisions were made to the regulations posted for public comment, and no justification for not implementing suggested revisions is required. In the development of this rule, consideration was given to: 1) alternative approaches; 2) overlap or duplication with other statutory and regulatory provisions; and 3) significant economic impact on small business. No alternative approach, duplication, or overlap was identified based on available information. RIDOH has determined that the benefits of this rule justify its costs.