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4100 – Safe Body Art
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PR0546555
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Last modified
3/5/2025 2:35:41 PM
Creation date
7/3/2020 10:14:43 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0546555
PE
4120
FACILITY_ID
FA0026404
FACILITY_NAME
ONE TIME TATTOO STUDIO (GARIBAY, JESUS)
STREET_NUMBER
407
Direction
N
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95336
CURRENT_STATUS
01
SITE_LOCATION
407 N MAIN ST
P_LOCATION
04
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\BA\BA_4120_PR0544223_1818 LUCERNE_.tif
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EHD - Public
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Body Art Insetion Report Date: <br /> San Joaquin County Environmental Health Department Program <br /> ilf 1868 E.Hazelton Ave.,Stockton,CA 95205Record: s�oagw Z U <br /> (209)468-3420 <br /> Program �u3 <br /> www.sio.lv.org/ehd Element: <br /> PR Number PRACTITIONERIARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> Emmanuel Maldonado <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)—Provide record of purchase and evidence of sterilization for needles. <br /> Record of purchase and evidence of sterilization should be maintain at the facility at all time. <br /> 7. The sharps waste container shall be within arm's reach and labeled with the word"sharps waste"or with the biohazard symbol <br /> and the word "Biohazard". Sharp waste containers shall be disposed by a licensed waste hauler or approved mail back system. <br /> Documentation of proper disposal shall be maintained for 3 years. HSC 119314(e)—Provide a written agreement or contract <br /> with a mail-back system or licensed waste hauler. <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—All client should be at <br /> least 18 years old. <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 /> Include the following statements to the medical questionnaire: <br /> 1.current medications <br /> 2. requirements for antibiotics prior to surgery or dental procedure <br /> 3. other risk factors for blood borne pathogens <br /> On the consent form make sure to include the lot number of the blades use on the client. <br /> 23. All surfaces and objects in the procedure, decontamination and sterilization area that come in contact with the client or the <br /> materials used during procedure, including chairs, armrests, tables, countertops, and trays, shall be immediately cleaned and <br /> decontaminated after each use. HSC 119309—Chairs and tables should be nonabsorbent material in order to be <br /> cleanable. <br /> 24. Disinfectant shall have ability to reduce or eliminate the presence of disease-causing microorganisms, including HIV and <br /> hepatitis B virus. HSC 119301(k)— <br /> 25. Disinfectant shall be used according to the manufacturer's instructions. HSC 119309(b)-Make sure to allow adequate <br /> time for the surfaces to remain wet to disinfect the surfaces. <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 /> 32. A body art facility shall have floors, walls, and ceilings that are smooth, nonabsorbent, free of open holes, and washable. <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 2 of 3 <br /> EH-11/17 <br />
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