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u <br /> ° °cBodY Art Inspection Report <br /> Date: July 16,2024 <br /> a :< San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: AP2400709 <br /> (209)468-3420 <br /> v .siow.oto/ehd Program <br /> Cr r;oRN� Element: 4103 <br /> 2.At the completion of the procedure, the practitioner shall provide postprocedure instructions that include all elements listed in <br /> Form B. Include the following on the permanent cosmetics (electronic format) aftercare instructions and provide a copy to the <br /> EHD: <br /> -Signs and symptoms of infection. <br /> 31. HSC 119314-Areas separated/no living or sleeping quarters <br /> OBSERVATIONS: <br /> The women's and men's restroom did not have a wall-mounted,touchless paper towel dispenser. <br /> CORRECTIVE ACTIONS <br /> The toilet facility must have a sink with hot and cold water, containerized liquid soap, and single-use paper towels that are <br /> dispensed from a wall-mounted, touchless dispenser. Replace the paper towel dispensers in the restrooms with wall-mounted, <br /> touchless dispensers. <br /> 33. HSC 119314-Workstation,surfaces, including chairs, armrests, etc. in good repair—Corrected on site. <br /> OBSERVATIONS: <br /> Absorbent furniture observed in the procedure area. <br /> CORRECTIVE ACTIONS: <br /> All surfaces and objects in the procedure area, including chairs, armrests,tables, countertops, and trays, shall be in good repair <br /> and capable of being disinfected. All counter surfaces and service trays in the procedure area shall have a smooth, durable, and <br /> nonabsorbent finish. <br /> Correct all observations and provide evidence of corrections to the EHD <br /> by July 31, 2024. <br /> Notes: <br /> 1. Inspection report emailed to facility owner,Alekxis Mondragon, at elusivepmuAgmail.com. <br /> 2. Sharps Assure mail-back system will be used for sharps disposal. <br /> 3. Facility owner intends to use electronic formats of consent forms, medical questionnaires and aftercare instructions. EHD <br /> approval is required prior to using the electronic forms. <br /> 4. Practitioner will be offering tattoos and permanent cosmetics. <br /> 5.An updated IPCP was provided to the EHD. <br /> Reinspection on/about: A reinspection fee of$172 per hour may be charged. Page 4 of 4 <br /> EH-11/17 <br />