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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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HAMMER
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3422
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4100 – Safe Body Art
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PR0544020
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COMPLIANCE INFO
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Entry Properties
Last modified
3/5/2025 3:16:53 PM
Creation date
7/3/2020 10:14:34 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0544020
PE
4120
FACILITY_ID
FA0025032
FACILITY_NAME
DREAMSCAPE BROWS (VANG, FONG)
STREET_NUMBER
3422
Direction
W
STREET_NAME
HAMMER
STREET_TYPE
LN
City
STOCKTON
Zip
95219
CURRENT_STATUS
01
SITE_LOCATION
3422 W HAMMER LN UNIT F
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\BA\BA_4120_PR0544020_3422 W HAMMER_.tif
Tags
EHD - Public
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Body Art Inspecte Report Date: 10/2 <br /> San Joaquin County Environmental Health Department <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 ProgramP�GSLf H02- <br /> Record: <br /> (209)468-3420 <br /> •cOR�`p• www.siogv.org/ehd Program L�'2 <br /> Element: <br /> Facility Name Address City Zip Code <br /> Dreamscape Brows 3422 w.hammer lane suite j Stockton 95219 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Fong Vang 6/30/20 Routine <br /> The above facility is inspected for compliance with Division 104,Part 15,Chapter 7 of California Health and Safety Code(HSC). <br /> V=Violation C=Corrected On Site <br /> V CLEANING AND STERILIZATION C V MACHINE SAFETY AND SANITATION(cont.) C <br /> ❑ 1 Autoclave:approved and effective-passed integrator ❑ ❑ 22 Parts replaced between clients-grommets,elastic bands, ❑ <br /> test etc. <br /> ❑ <br /> Items washed,disinfected,packaged,labeled,and 2. sterilized El CROSS-CONTAMINATION <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated ❑ <br /> ❑ 4. Integrators used/monthly spore test/log maintained ❑ ❑ 24. Appropriate chemical disinfectant used <br /> Decontamination/sanitation area separated and supplied ❑ <br /> ❑ 5' ElChemical used: <br /> appropriately <br /> 6. <br /> ro riatel <br /> ® <br /> Invoices and log kept for disposable,pre-sterilized 6. equipment El ❑ 25. Disinfectant used appropriately/sufficient contact time <br /> Sharps containers labeled,used,and disposed of ❑ <br /> ❑ 7 El Wet contact time provided: <br /> appropriately <br /> ❑ 8 Jewelry,tattoo and piercing equipment-clean and ❑ ❑ 26. Barriers used ❑ <br /> sterilized <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE ❑ 27' ase ticall El <br /> ❑ 9. No eating,drinking or smoking-clean clothes ❑ ❑ 28. Storage of inks,pigments,needles,tubes,etc. ❑ <br /> ❑ 10. Hands washed effectively and timely ❑ ❑ 29. Jewelry,Inks,Needles etc approved and used correctly ❑ <br /> Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of <br /> El 11. warm water [I ❑ 30' procedure El <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen training ❑ 31. Areas separated/no living or sleeping quarters ❑ <br /> El <br /> Source: ❑ 32. Floors and walls clean and in good repair,adequate light ❑ <br /> ❑ <br /> Appropriate personal protective equipment available and Workstation,surfaces,including chairs,armrests,etc.in 14. used El ❑ 33' good repair <br /> El <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> ❑ <br /> Branding is completed with no other customers in 15. El 35. Operation and employee training records present E]rocedure area <br /> ❑ 16. Customers eighteen(18)years of age or older ❑ COMPLIANCE AND ENFORCEMENT <br /> ❑ 17. Skin adequately prepared for procedure ❑ ❑ 36. Plan(s)submitted for review ❑ <br /> Client records approved and available-Consent form <br /> El 18. and uestionnaire El F137. Permits obtained and available El <br /> ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ <br /> MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled ❑ <br /> ❑ 20. 1 Safe machine design ❑ ❑ 40. Closure ❑ <br /> ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ 41. ❑ <br /> Received by(Print): Fong Vang Received by(Signature): - Phone:(916)715-8401 <br /> Specialist(Print): Mai Vue Specialist(Signature): ���/� -�� Phone: (209)468-3284 <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />
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