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4100 – Safe Body Art
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PR0515394
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COMPLIANCE INFO
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Last modified
2/27/2024 2:49:34 PM
Creation date
7/3/2020 10:13:06 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0515394
PE
4120
FACILITY_ID
FA0012119
FACILITY_NAME
12 MONKEYS TATTOO STUDIO (HIGHLAND, JON)
STREET_NUMBER
911
STREET_NAME
CENTRAL
STREET_TYPE
AVE
City
TRACY
Zip
95376
APN
23505611
CURRENT_STATUS
01
SITE_LOCATION
911 CENTRAL AVE
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\BA\BA_4120_PR0515394_911 CENTRAL_.tif
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EHD - Public
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U`" Body Art InspecOn Report Date: <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 9 P2o S1S3 <br /> Record: <br /> (209)468-3420 <br /> Program <br /> c4�,FOR`'`P www.sjogv.org/ehd Element: <br /> PR Number PRACTITIONER)ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PRO515393 Jon Highland PRO537374 Ricardo Cardenas-no registration <br /> PRO539338 Andrew Soldana-no longer working here PRO537376 Nephtali Bru ueras <br /> PR0537375 Shawn Edwards-no registration <br /> PR0539346 Kristal Betancourt-no registration <br /> Observations and Corrective Actions: <br /> 6. A facility that uses single use instruments shall maintain record of purchase, log of procedures, names of practitioner and <br /> client, date of procedure, instruments used, and written evidence from the manufacture that the instruments have undergone <br /> sterilization. The record of purchase, evidence of sterilization, type and number of instruments used shall be maintained for a <br /> minimum of 90 days after use. HSC 119315(f) <br /> 11. The procedure area shall be equipped with a sink with hot and cold running water, containerized liquid soap, and single use <br /> paper towels dispensed from a wall-mounted, touchless dispenser that is readily accessible to practitioner. HSC 119314(b) <br /> 18. The facilities client consent form and medical questionnaire must include all of the information listed in Form B, and are <br /> available for inspection. HSC 119303 <br /> 34. Certificate of registration and health permit shall be posted in a conspicuous place. HSC 119306 and 119312 <br /> Notes: 1. Only sterile dressings can be used. <br /> Unless otherwise noted, Corrective Action Due in 30 days. <br /> Reinspecion on/about: A reinspection fee of$125 per hour may charged. Page 2 of 2 <br /> EH-04/2014 <br />
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