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Body Art Inspection Report <br /> Date: 03/20/2025 <br /> N {� San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: PR0547582 <br /> (209)468-3420 Program <br /> � www.sioov.org/ehd� ;'�er4 Element: 4120 <br /> R Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PR0539338 Andrew Soldana(BBP exp.09/17/2025 <br /> AP2501747 Jorge Ayala Guevara(BBP exp.2/15/26 <br /> Observations and Corrective Actions: <br /> 18. HSC 119303-Client records approved and available-Consent form and questionnaire <br /> 1. OBSERVATION:Client records were inadequate. Multiple consent forms were missing the description of the procedure and the client's photo IDs to <br /> verify age of the client. <br /> 2. CORRECTIVE ACTION: Moving forward,ensure to maintain adequate client records to include the description of the procedure,client photo IDs,and <br /> all items listed in HSC 119303. <br /> 33. HSC 119314-Workstation,surfaces,including chairs,armrests,etc.in good repair <br /> 1. OBSERVATIONS: Absorbent surfaces were observed in the procedure area: rug,chair,pillow,&light stand.The chair,pillow,and light stand was <br /> moved to the front waiting area. <br /> 2. CORRECTIVE ACTION: Remove the rug from the procedure area. In order to maintain a clean and sanitary environment,all surfaces in the procedure <br /> area must be non-absorbent to allow for proper cleaning and disinfecting. <br /> Submit evidence of corrections to the EHD by <br /> 04/20/2025 <br /> NOTES: <br /> 1. Inspection report emailed to facility owner,Andrew Soldana at artisticbinge@gmail.com on 03/24/2025. <br /> 2. Leanna Martinez-Tait is no longer a practitioner at this location. Per Brittney Soldano,Leanna moved to Orange County. <br /> 3. New practitioner Jorge Ayala Guevara will be starting soon. He has Iready registered with the EHD and his PR number is pending.BBP is up to date. <br /> 4. Reviewed ICPC and annual ICPC training record.Ensure to keep records for 3yrs. <br /> 5. Reviewed client consent forms,medical questionnaire,after-care instructions,and client records. <br /> 6. Reviewed sterilization certificates for Cheyenne needle cartridge lot numbers 2023-39-026 and 2024-11-017. <br /> 7. The facility utilizes Stericycle's mail back system for their sharps disposal. Reviewed records on site. Ensure to keep records for 3yrs. <br /> Reinspection on/about: A reinspection fee of$172 per hour may be charged. Page 2 of 2 <br /> EH-11/17 <br />