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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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CALIFORNIA
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1805
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4100 – Safe Body Art
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PR0541625
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COMPLIANCE INFO
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Entry Properties
Last modified
3/31/2023 12:44:55 PM
Creation date
7/3/2020 10:13:57 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0541625
PE
4120
FACILITY_ID
FA0023858
FACILITY_NAME
NATHAN A KLUDT MD INC (JOHNSON, HEIDI)
STREET_NUMBER
1805
Direction
N
STREET_NAME
CALIFORNIA
STREET_TYPE
ST
City
STOCKTON
Zip
95204
CURRENT_STATUS
02
SITE_LOCATION
1805 N CALIFORNIA ST STE 407
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\BA\BA_4120_PR0541625_1805 N CALIFORNIA_.tif
Tags
EHD - Public
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0 i <br /> N. Handwashing Sink: List the locations of the handwash sinks and describe the items supplied at <br /> each sink. <br /> C 0 <br /> i <br /> O. Aftercare Procedure: Describe the written recommendations and care provided to the client after <br /> I <br /> a body art procedure. List the type of bandages or wrappings provided after a body art j <br /> procedure. <br /> i F <br /> t <br /> -A'I% f5 cly YAC' " <br /> I VW MU-UW. GUY\ ;SLAP j SGt,UAO-, i e- CD XR.Y C GC Duw -7-1 <br /> P. Procedure for an Accidental Spill: Describe the clean-up and disinfection procedure taken when -.----:z7 <br /> ther is an a cidental spi I of sharps or biohazargqu waste. <br /> 1 <br /> Y <br /> 10 U <br /> ANUP115 �D VA EL Ito <br /> Q. Tras R ceptacles and discal of contaminated trash List the type of trash receptacles and <br /> E <br /> their location throughout the body art facility. Describe the procedure for the disposal of <br /> contamin ted items;such as gloves. <br /> �G M8 rte ,r c.:�r�nca Itch �►;�P� <br /> R. Negative/Failed Spore Test: Describe the procedure conducted when a monthly spore test <br /> has failed. <br /> M <br /> C <br /> I <br /> r 1 <br /> e 1 <br /> Maintain a copy of this document in your files. Submit one copy to the Ventura County Environmental <br /> Health Division (address shown at the top of page 1). <br /> 0 <br /> 1 hereby certify that to the best of my knowledge R atements made herein are correct j <br /> and true. i <br /> l <br /> Signatur : Date: I-Iq-20I 7 <br /> s <br /> ja:RB G:\Admin\HAZMAT\FORMS\MEDICAL WASTE&BODY ART\Infection Prevention and Control Plan Page 6 of 9 <br /> 1 <br /> I <br />
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