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SR0085959
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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QUAIL LAKES
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4525
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4100 – Safe Body Art
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SR0085959
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Entry Properties
Last modified
8/22/2023 12:39:01 PM
Creation date
8/22/2023 11:46:26 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
SR0085959
PE
4103
STREET_NUMBER
4525
STREET_NAME
QUAIL LAKES
STREET_TYPE
DR
City
STOCKTON
Zip
95207
APN
11222003
ENTERED_DATE
10/27/2022 12:00:00 AM
SITE_LOCATION
4525 QUAIL LAKES DR STE A
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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SJGOV\cfield
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EHD - Public
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7. Tables: Madacide <br />8. Tattoo machine and Clip Cord: Madacide <br />9. Reusable instruments, calipers, needle tubes, etc. portable light fixtures or other: Madacide <br />10. Permanent Cosmetic Machine: Equipment Cover and Madacide if exposed <br />o. Reusable Instruments or Disposable: Describe the procedures used for decontaminating, <br />sterilizing, packaging Cl"d storing of reusable instruments. Include the procedures for labeling <br />of sterilized peel -pack. Indicate whether the body art facility uses all pre -sterilized, single -use <br />and disposable instruments. Describe the record keeping logs and procedure logs maintained <br />on-site when using 100% pre -sterilized, single -use and disposable instruments (California <br />Health and Safety Code 119309 and 119315). <br />1. Needle tubes: Pre -sterilized and Disposable <br />2. Calipers: N/A <br />3. Other instruments: Pre -sterilized and Disposable <br />�;. Storage: Describe the storage location and equipment used for the storage of clean and <br />sterilized instrument peel packs to protect the packages from exposure to dust and moisture <br />(California Health and Safety Code 119315 (c)). <br />I:�. Set Up and Tear Down of Workstation: Describe the procedure for setting up and tearing <br />down the workstation for the following procedures (California Health and Safety Code 119308, <br />119309 (c), 119311, and 119313 (b)(4)). <br />1. Tattoo: N/A <br />2. Piercing: N/A <br />3. Permanent Cosmetics: Table Paper; Poly Towel over plastic sterile covered pillow; Poly <br />Towels over any leg -propping cushion., light fixture cover; Machine or Tool cover, Poly Towel <br />over sanitized aluminum tray; sterile supplies; Pre -sterilized and Disposable needles & <br />accessories; Germicide tray w/ Benz -all chemical disinfection solution. <br />4. Branding: N/A <br />I. Prevention of Cross Contamination: <br />Describe the techniques used to prevent the contamination of instruments, tattoo machines, <br />traYs, tables, chairs, clip cords, power supplies, squeeze bottles, inks, pigments, lamps, stools, <br />soaps, procedure sites and additional areas of potential contamination during body art <br />procedures. Include barriers provided to prevent cross contamination. Describe how <br />
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