Laserfiche WebLink
C <br /> oG Body Art Inspection Report Date: May 12,2025 <br /> y2{ San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: PR0548626 <br /> (209)468-3420 Program <br /> O �P/ www.siogv.orglehd <br /> q�iFORa/ Element: 4120 <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PR0546640 Jennifer Bou(BBP Ex 8/31/25 <br /> Observations and Corrective Actions: <br /> 18. HSC 119303 -Client records approved and available -Consent form and questionnaire <br /> OBSERVATIONS: <br /> The client consent form does not have all items listed on Form B <br /> CORRECTIVE ACTIONS: <br /> The facility's client consent form and medical questionnaire must include all of the information listed in Form B, and are available <br /> for inspection. Include the following on the consent form and provide a copy to the EHD: <br /> -Client is at least 18 years of age. <br /> -Description of what the client should expect following the procedure. <br /> 33. HSC 119314 -Workstation, surfaces, including chairs, armrests, etc. in good repair <br /> OBSERVATIONS: <br /> 1. The curtains on the door and windows are absorbent. <br /> 2. The canvas decorations in the room are absorbent. <br /> CORRECTIVE ACTIONS: <br /> 1. All surfaces and objects in the procedure area, including chairs, armrests, tables, countertops, and trays, shall be in good <br /> repair and capable of being disinfected. All counter surfaces and service trays in the procedure area shall have a smooth, <br /> durable, and nonabsorbent finish. Remove absorbent curtains from the procedure room. Provide EHD with photographic <br /> evidence of correction. <br /> 2. All surfaces and objects in the procedure area, including chairs, armrests, tables, countertops, and trays, shall be in good <br /> repair and capable of being disinfected. All counter surfaces and service trays in the procedure area shall have a smooth, <br /> durable, and nonabsorbent finish. Remove absorbent decorations or apply product to the decorations to make them resistant to <br /> liquid absorption. Provide EHD with photographic evidence of correction. <br /> Correct all violations and provide evidence of corrections to the EHD <br /> by May 28, 2025. <br /> Notes: <br /> 1. Inspection report emailed to owner, Jennifer Bou, at adorn beautyink(a)gmail.com. <br /> 2. A mini fridge containing beverages and a pack of water was observed inside of the procedure room. Ms. Bou was informed <br /> that drinking is not permitted within the facility. <br /> 3. The Infection Prevention and Control Plan was recently updated. Ms. Bou is to provide the EHD with a copy. <br /> 4. Sharps waste was mailed to Solutions on May 9, 2025. The facility will begin utilizing Pureway for sharps disposal. <br /> 5. JotForm is used for electronic client records. <br /> 6. Sterilization certificates were provided for the Aqua needle cartridges with the lot numbers 202502 and 202409. <br /> 7. Ms. Bou provides tattoo and permanent cosmetic services to clients. <br /> Reinspection on/about: A reinspection fee of$172 per hour may be charged. Page 2 of 2 <br /> EH-11/17 <br />