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"'" Body Art Inspectieport 41 Date: rza San Joaquin County Environmental Health Department Program t� 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: (209)468-3420 Program I `� FoaN�,' • www.slogv.org/ehd Element: 1' V PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME Jessica Hernandez PRO543458-Permit and BBP Current and Posted Mimi Chaves Permit and BBP Not Posted Alanna Chao PRO542011 -Permit and BBP Not Posted Carol Chao PRO542012-Permit and BBP Not Posted Annie Mehrten PRO543650-Permit and BBP Current and Posted Observations and Corrective Actions: 13. Practitioner shall provide evidence of a completed, EHD approved, OSHA Bloodborne Pathogen Training consistent with section 119307. —Make sure that all practitioners working at the facility post their Bloodborne Pathogen Training Certificate in a conspicuous place. 16. Client shall be at least 18 years of age to receive a tattoo, permanent cosmetics, or branding. Body piercing, unless performed in the presence of parent or guardian, the client, must be 18 years of age. HSC 119302—Always provide a copy of the client's driver's license with their record. 18. The facilities client consent form and medical questionnaire must include all of the information listed in Form B, and are available for inspection. HSC 119303—Include the following statements in the medical questionnaire: "current medications"and "history of hemophilia or other bleeding disorders." 27. Products applied to skin prior to tattooing or application of permanent cosmetics, including, but not limited to, stencils, marking and transfer agents, shall be single use and discarded into a waste container at the end of the procedure. HSC 119311(a)—All products applied to the skin must be single use. Observed pre-draw pencil being used.They must be single use. 33. All surfaces and objects in the procedure area, including chairs, armrests, tables, countertops, and trays, shall be in good repair and capable of being disinfected. All counter surfaces and service trays in the procedure area shall have a smooth, durable, and nonabsorbent finish. HSC 119314—Observed rugs in between the massage beds. Rugs must be nonabosorbent to prevent contamination from occurring. Corrected on site. 34. Certificate of registration and health permit shall be posted in a conspicuous place. HSC 119306 and 119312 -Mimi Chaves started working at the facility recently. Her permit is not posted. Mimi is not her real name.Jessica Hernandez does not know her real name. Amanda Adams's practitioner permit stated that she works at this facility.Jessica Hernandez is unaware of her and has no contract with her. Make sure that all practitioners working at the facility post their permit in a conspicuous place. Correct all violations prior to April 15, 2019. Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 2 of 2 EH-11/17