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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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4100 – Safe Body Art
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PR0541656
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COMPLIANCE INFO
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Entry Properties
Last modified
6/20/2024 11:32:48 AM
Creation date
7/3/2020 10:13:58 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0541656
PE
4120
FACILITY_ID
FA0023874
FACILITY_NAME
FLAWLOUS (DEGENSTEIN, PAULA KELI)
STREET_NUMBER
806
Direction
W
STREET_NAME
LODI
STREET_TYPE
AVE
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
806 W LODI AVE
P_LOCATION
02
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\BA\BA_4120_PR0541656_806 W LODI_.tif
Tags
EHD - Public
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r <br /> Body Art InspeLiLlon Report <br /> Date : 2il6*3 l W <br /> San Joaquin County Environmental Health Department <br /> Program <br /> 1868 E. Hazelton Ave. , Stockton , CA 95205 <br /> 209 468-3420 Record : 5� (o <br /> ( ) <br /> r-0V ysvw. siogvOf (] . - Program <br /> Element : La � b <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> Paula Keli Degenstein : permit posted , BBP posted - <br /> PR0541657 expired <br /> Observations and Corrective Actions : <br /> 13 . Practitioner shall provide evidence of a completed , EHD approved , OSHA Bloodborne Pathogen Training consistent with <br /> section 119307 . - Bloodborne pathogen training has expired , maintain current certificate . <br /> 16 . Client shall be at least 18 years of age to receive a tattoo , permanent cosmetics , or branding . Body piercing , unless <br /> performed in the presence of parent or guardian , the client , must be 18 years of age . HSC 119302 - Provide copy of driver's <br /> license/identification with client records . <br /> 18 . The facilities client consent form and medical questionnaire must include all of the information listed in Form B , and are <br /> available for inspection . HSC 119303- Include other risk factors for bloodborne pathogens on medical questionnaire . <br /> 35 . Operation and employee training records shall be maintained for 3 years and made available for inspection . A written <br /> Infection Prevention and Control Plan ( IPCP ) shall be maintained , followed and updated . HSC 119313 <br /> Notes : <br /> 1 ) Bloodborne pathogen training certificate expired November 3 , 2017 . Keep bloodborne pathogen training <br /> certificate current , and post in a conspicuous place . <br /> 2 ) Maintain updated copy of the Infection Prevention and Control Plan on site . <br /> Reinspecion on/about : A reinspection fee of $ 152 per hour may be charged . Page 2 of <br /> EH - 11 / 17 <br />
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