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Body Art Inspection Report Date: February 5,2026 <br /> N {� San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: PR2500169 <br /> (209)468-3420 Program <br /> www.sioov.org/ehd <br /> � ;'9er4 Element: 4120 <br /> R Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PR0537482 Dennis Escalante—Cathie Montie(expires 2/4/27 <br /> PR0547075 Carlo Vela—Cathie Montie expires 4/14/26 <br /> PR0547868 Taylor Valente—Cathie Montie(expires 6/4/26 <br /> Observations and Corrective Actions: <br /> 6. HSC 119315(f)(3) —A body art facility shall conform to the following sterilization procedures: (f)A body art facility <br /> that does not afford access to a decontamination and sterilization area or that does not have sterilization equipment <br /> shall use only purchased disposable, single-use, pre-sterilized instruments. In place of the requirements for <br /> maintaining sterilization records, the following records shall be kept and maintained for a minimum of 90 days <br /> following the use of the instruments at the site of practice for the purpose of verifying the use of disposable, single- <br /> use, presterilized instruments: (3)Written proof on company or laboratory letterhead showing that the pre-sterilized <br /> instruments have undergone a sterilization process. Written proof shall clearly identify the instruments sterilized by <br /> name or item number and shall identify the lot or batch number of the sterilizer run. <br /> OBSERVATIONS: <br /> 1. Observed on site KingPin needle tube with the lot number 20240430. No sterilization certificate was provided for this <br /> disposable instrument. <br /> 2. Observed Black Claw 9 shader with lot number 023. No sterilization certificate was provided for this disposable <br /> instrument. <br /> 3. Observed a client consent form in which a needle tube was used with the batch number 20241130. No brand was noted <br /> down on the client consent form. No sterilization certificate was provided for this disposable instrument. <br /> CORRECTIVE ACTIONS: <br /> 1. Provide the sterilization certificates for the disposable instruments noted above. <br /> 18. HSC 119303(a)—(a) Prior to the performance of body art, the client shall read, complete, and sign an informed <br /> consent form that shall include all of the information listed in this section. <br /> OBSERVATIONS: <br /> 1. Observed a client consent from that had the incorrect date of of"9/7/26"filled out on the consent form with no correction <br /> made. <br /> CORRECTIVE ACTIONS: <br /> 1. Practitioner is to assure that the client consent forms are being filled out completely and correctly before commencing <br /> the body art procedure. <br /> 19. HSC 119303 (a)(5)(B) —(a) Prior to the performance of body art, the client shall read, complete, and sign an informed <br /> consent form that shall include, but not be limited to, all of the following information: (5) Post procedure instructions <br /> that include all of the following: (B) Restrictions on physical activities such as bathing, recreational water activities, <br /> ciardenincl, or contact with animals, and the duration of the restrictions. <br /> OBSERVATIONS: <br /> 1. The aftercare instructions form that is given to the clients does not include the elements of gardening or contact with <br /> animals and their specific durations of the restrictions. <br /> CORRECTIVE ACTIONS: <br /> 1. Include the missing elements noted above into the aftercare instructions form. <br /> Reinspection on/about: A reinspection fee of$179 per hour may be charged. Page 2 of 3 <br /> EH-7-1-25 <br />