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Environmental Health - Public
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EHD Program Facility Records by Street Name
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1110
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4100 – Safe Body Art
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PR0542329
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COMPLIANCE INFO
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Last modified
6/15/2023 8:55:39 AM
Creation date
7/3/2020 10:14:05 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0542329
PE
4120
FACILITY_ID
FA0024314
FACILITY_NAME
THE FRECKLED ROSE TATTOO (BRYANT, DANIEL)
STREET_NUMBER
1110
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95242
CURRENT_STATUS
02
SITE_LOCATION
1110 W KETTLEMAN LN STE 20B
P_LOCATION
02
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\BA\BA_4120_PR0542329_1110 W KETTLEMAN_.tif
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EHD - Public
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Body Art InspeAn Report Date: Vlo�tL <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: P2DS�103`TI <br /> +P (209)468-3420 ram Prog <br /> t� baa www.siogv.org/ehd t' <br /> Element: L4 Il b <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONERAARTIST NAME <br /> PRO537386 Daniel Bryant <br /> PR0540798 Vincent Bryant <br /> Observations and Corrective Actions: <br /> 6. A facility that uses single use instruments shall maintain record of purchase, log of procedures, names of practitioner and <br /> client, date of procedure, instruments used, and written evidence from the manufacture that the instruments have undergone <br /> sterilization. The record of purchase, evidence of sterilization, type and number of instruments used shall be maintained for a <br /> minimum of 90 days after use. HSC 119315(f) <br /> 9. No food, drink, tobacco product, or personal effects are permitted in the procedure area. HSC 119309 <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 <br /> 19. At the completion of the procedure, the practitioner shall provide postprocedure instructions that include all elements listed in <br /> Form B. HSC 119308(b) <br /> 28. Sterilized instrument packs, equipment and jewelry shall be stored in a labeled container or cabinet that is protected from <br /> dust or moisture. Sterile instrument packs shall be evaluated before use; instrument packs shall be discarded or reprocessed if <br /> condition is compromised. HSC 119315 <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 /> Unless otherwise noted, Corrective Action Due in 30 days. <br /> Reinspecion onlabout: A reinspection fee of$130 per hour may be charged. Page 2 of 2 <br /> EH-0312015 <br />
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