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4100 – Safe Body Art
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PR0537413
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COMPLIANCE INFO
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Last modified
3/8/2024 10:00:12 AM
Creation date
7/3/2020 10:15:23 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0537413
PE
4121
FACILITY_ID
FA0021512
FACILITY_NAME
IN 2 SKIN TATTOO (AGUIRRE, SANDY)
STREET_NUMBER
2738
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95204
APN
12504002
CURRENT_STATUS
01
SITE_LOCATION
2738 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\BA\BA_4121_PR0537413_2738 PACIFIC_.tif
Tags
EHD - Public
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' <br />Body Art InSL Wn Report <br />3/ <br />= <br />San Joaquin County Environmental Health Department <br />Program <br />1868 E. Hazelton Ave., Stockton, CA 95205 <br />Record: <br />(209) 468-3420 <br />www.siogv_orglehd <br />Program <br />A 2-1 <br />r �B.• <br />Element: <br />13. Practitioner shall provide evidence of a completed, EHD approved, OSHA Bloodborne Pathogen Training <br />consistent with section 119307. -For Phil: provide current BBP training certificate. For Stevie: keep BBP posted <br />in conspicuous place. <br />18. The facilities client consent form and medical questionnaire must include all of the information listed in Form B, <br />and are available for inspection. HSC 119303 -Include in medical questionnaire: other risk factors for bloodborne <br />pathogens. <br />29. Only jewelry made of approved material and commercially manufactured inks, dyes, and pigments shall be used. <br />Only single -use needles and needle bars shall be used in tattooing and the application of permanent cosmetics. <br />Needles and needle bars must be pre -sterilized. HSC 119310 & 119311 -Verify with manufacturer provided <br />sterilization records that needles are pre -sterilized. <br />35. Operation and employee training records shall be maintained for 3 years and made available for inspection. A <br />written Infection Prevention and Control Plan (IPCP) shall be maintained, followed and updated. HSC 119313 - <br />Maintain updated copy of IPCP on site. Keep IPCP training records current, signed/dated on annual basis as <br />well as after a new hire. <br />36. Design plans shall be submitted to EHD for approval prior to constructing or remodeling body art <br />facility. HSC 119312 -Provide EHD an updated floor plan for the facility. <br />Notes: <br />1) Angel M. Le, Mark A. Escalante, and Nathan Phasavath are no longer working at this facility. <br />2) Maintain updated IPCP. <br />3) Provide current BBP for Phil. <br />Provide spore test results as well as sterilization records for presterilized needles <br />by April 12, 2018, or reinspection will be conducted at the rate of $152 per hour. <br />Reinspecion on/about: A reinspection fee of $152 per hour may be charged. <br />Page 3 of 3 <br />EH -11/17 <br />
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