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4100 – Safe Body Art
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PR0523952
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Entry Properties
Last modified
8/7/2025 12:04:22 PM
Creation date
4/25/2023 12:53:45 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0523952
PE
4121 - BODY ART FACILITY-STERILIZATION
FACILITY_ID
FA0014791
FACILITY_NAME
CANVAS TATTOO (BAMBILLA-SANTOS, MELISSA)
STREET_NUMBER
304
Direction
W
STREET_NAME
HARDING
STREET_TYPE
WAY
City
STOCKTON
Zip
95204
APN
13708003
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
Site Address
304 B W HARDING WAY STOCKTON 95204
Suite #
B
Tags
EHD - Public
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UN Body Art InspectieReport <br />Date: I l l <br />oZ <br />San Joaquin County Environmental Health Department Program <br />1868 E. Hazelton Ave., Stockton, CA 95205 Rerd: Ax (� S Z3 C1 S <br />\ Q (209) 4683420 Program <br />,,,FORa' www.siogv.org/ehd <br />Element: c-cf <br />PR Number <br />PRACTITIONER/ARTIST NAME <br />PR0523951 <br />Melissa Santos -CM 4/15/2020 <br />PR0537369 <br />Michael Benjamin Wright No longer works at shop) <br />Observations and Corrective Actions: <br />PR <br />6. A facility that uses single use instruments shall maintain record of purchase, log of procedures, names of practitioner <br />and client, date of procedure, instruments used, and written evidence from the manufacture that the instruments have <br />undergone sterilization. The record of purchase, evidence of sterilization, type and number of instruments used shall be <br />maintained for a minimum of 90 days after use. HSC 119315(f) <br />Sterilization records were not available for lots in use in the facility. Submit photographs of two lots currently in <br />use in the facility along with matching sterilization certificates to the EHD by 12/6/2019. <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 />The artist signature and lot numbers are missing from several client forms. Effective immediately, the artist is to <br />sign the client consent forms and record the lot numbers for equipment used at the time of the procedure. <br />31. A body art facility shall be separated from any residential areas used for sleeping, bathing, or meal preparation and shall not <br />share a common entrance or toilet facility with residence. The toilet facility must have a sink with hot and cold water, <br />containerized liquid soap, and single -use paper towels that are dispensed from a wall -mounted, touchless dispenser. HSC <br />119314 <br />The touchless paper towel dispenser required restocking. Submit evidence of correction to the EHD by 12/6/2019. <br />32. A body art facility shall have floors, walls, and ceilings that are smooth, nonabsorbent, free of open holes, and <br />washable. The body art facility shall be free of insect and rodent infestation. The procedure area must be separated, by a <br />wall, ceiling to floor, from nail and hair activities and be separated from all business not related to body art. Approval of co - <br />located body art facilities are at the discretion of the LEA. A procedure area must be equipped with adequate light to <br />perform a procedure. Each procedure area shall have lined waste containers. HSC 119314 & 119317 <br />An area of the wall near the procedure area is absorbent. Submit evidence of repair to the EHD by 12/6/2019. <br />35. Operation and employee training records shall be maintained for 3 years and made available for inspection. A written <br />Infection Prevention and Control Plan (IPCP) shall be maintained, followed and updated. HSC 119313 <br />The Infection Prevention and Control Plan requires updating with the current sharps disposal method/hauler and <br />the wet contact time for the disinfectant. Submit evidence of correction to the EHD by 12/6/2019. <br />All evidence of correction is due to the EHD by 12/6/2019. <br />Failure to provide evidence of correction to the EHD by 12/6/2019 will result in a re -inspection charged at the department's <br />hourly rate of $152 per hour. All evidence of correction can be submitted to the department by email at ieaster(�s1gov.org <br />Reinspecion on/about: A reinspection fee of $152 per hour may be charged. Page 2 of 3 <br />EH -11/17 <br />
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