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88 (STATE ROUTE 88)
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4100 – Safe Body Art
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PR0537651
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COMPLIANCE INFO
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Last modified
11/20/2024 9:23:08 AM
Creation date
5/18/2023 10:58:24 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0537651
PE
4110
FACILITY_ID
FA0023492
FACILITY_NAME
FORSAKEN TATTOO (HENSON, ANTHONY)
STREET_NUMBER
13500
STREET_NAME
STATE ROUTE 88
City
LOCKEFORD
Zip
95237
CURRENT_STATUS
02
SITE_LOCATION
13500 HWY 88
QC Status
Approved
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EHD - Public
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Body Art Inspec Report Date: .218(16 <br />.y San Joaquin County Environmental Health Department Program <br />1868 E. Hazelton Ave., Stockton, CA 95205 Record: SR o4i l 3110 <br />(209) 468-3420 Program <br />r` <br />• �`P • v/ehd <br />www.sioo.oro �J <br />LA V1 <br />4c/'FqR Element: <br />PR Number <br />PRACTITIONERIARTIST NAME <br />PRO537651 <br />Tony Henson <br />PR0540070 <br />Jarod Estrada <br />PRO539693 <br />Thomas Garrison <br />Observations and Corrective Actions: <br />5. Decontamination and sterilization areas shall be separated from procedure areas by a space of at least 5 feet or by a <br />cleanable barrier and equipped with a sink with hot and cold running water, containerized liquid soap, and single use paper <br />towels dispensed from a wall -mounted, touchless dispenser that is readily accessible to practitioner. HSC 119314(c) <br />7. The sharps waste container shall be within arm's reach and labeled with the word "sharps waste" or with the biohazard symbol <br />and the word "Biohazard". Sharp waste containers shall be disposed by a licensed waste hauler or approved mail back system. <br />Documentation of proper disposal shall be maintained for 3 years. HSC 119314(e) <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 />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 />All of the above mentioned observations must be corrected <br />prior to the routine inspection. Facility may now begin <br />operation. <br />Reinspecion on/about: A reinspection flee of $130 per hour may be charged. Page 2 of 2 <br />EH -03/2015 <br />
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