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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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88 (STATE ROUTE 88)
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13500
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4100 – Safe Body Art
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PR0537651
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COMPLIANCE INFO
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Entry Properties
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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N. Handwashing Sink: List the locations of the handwash sinks and describe the items supplied at <br /> each sink. (California Health and safety Code 119314 (b)(3)) <br /> W ik(el H <br /> O. Aftercare Procedure: Describe the written recommendations and care provided to the client after <br /> a body art procedure. List the type of bandages or wrappings provided after a body art <br /> procedure. (California Health and safety Code 119303 (4) and 119308 (b)) <br /> Ws, iAAytc payva®rsy Ad A c ae4rr 14At , 94%�K r7r- <br /> _$sL9..1 1���.kL--T-�-f.�:-►� '1-A l,-^—l��t.v�I��, r45 A- U t���S f®wl �lp�- l A' 4 "� <br /> Cru s,rre�,N1► �_ �"3 T�FtLty_ w �}+ '7—I•A pr_yY� <br /> P. Procedure for an Accidental Spill: Describe the clean-up and disinfection procedure taken when <br /> there is an accidental spill of sharps. (California Health and safety Code 119309 (a)(b)(c)) <br /> JM it t iC L- ALD A_ A/ Z6r J <br /> at f® GT <br /> Q. Trash Receptacles and disposal of contaminated trash: List the type of trash receptacles and <br /> their location throughout the body art facility. Describe the procedure for the disposal of <br /> contaminated items, such as gloves. (California Health and safety Code 119311 (a) and 119314 <br /> (d)) <br /> we vA AJc- e %4 e 2NY10 t M�5 -r.N A-T Arm H-A M D6 F _ 7 4-t g*-r- ",) A <br /> �'�✓Yt Pri�f� �,A-G�} �,1�-r '�?L��1-o n�fir.n�wl��.�zf ��,.,�F�� <br /> R. Negative/Failed Spore Test: Describe the procedure conducted when a monthly spore test <br /> has failed. Indicate whether the facility maintains a spore test log on-site. (California Health and <br /> safety Code 119315 (b)(2)(4)) <br /> IF FAIL_ -T_u!� 12 Mg., L u <br /> S. Commercial Ink or Pigment Manufacturers: List the manufacturer for the inks or pigments <br /> used at the body art facility. Describe the procedure for dilution of inks. Only sterile water should <br /> be used for dilution of inks or pigments. (California Health and Safety Code 119311 (b)(c)(d)(e)) <br /> ws r, -nA a m Aj 1&19- r V' 1 opt t l k— T eA�3:: awo R F; o®urd�MD tAD %,- K <br /> 12 ST►1 W'n La Awa- <br /> T. Permanent Cosmetic Machine Name and Manufacturer: Provide the model name and number <br /> for the Ap�erm/}anent cosmetic machine used. (California Health and Safety Code 119311 (i)O)) <br /> PaV <br /> 6 .r' s <br /> Page 6 of 10 <br />
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