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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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PR0544944
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COMPLIANCE INFO
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Entry Properties
Last modified
1/28/2025 4:05:13 PM
Creation date
7/3/2020 10:16:15 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0544944
PE
4121
FACILITY_ID
FA0025552
FACILITY_NAME
PORT CITY INK (CORREA-AMAYA, MARISA)
STREET_NUMBER
1412
STREET_NAME
ROSEMARIE
STREET_TYPE
LN
City
STOCKTON
Zip
95207
CURRENT_STATUS
01
SITE_LOCATION
1412 ROSEMARIE LN #A
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\BA\BA_4121_PR0544944_1412 ROSEMARIE_.tif
Tags
EHD - Public
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PR Number <br />PRACTITIONER/ARTIST NAME <br />PR0539729 <br />Humberto Granados - No BBP, Permit held <br />Body Art InspectoReport <br />Date: <br />a <br />San Joaquin County Environmental Health Department <br />Program <br />• <br />1868 E. Hazelton Ave., Stockton, CA 95205 <br />Record: <br />,� <br />(209) 468-3420 <br />Program <br />www -siogvorg/ehd <br />Element: <br />PR Number <br />PRACTITIONER/ARTIST NAME <br />PR0539729 <br />Humberto Granados - No BBP, Permit held <br />PR0539785 <br />Raul Granados - No Permit, No BBP <br />PR0539789 <br />Gerardo Rivera - Permit + BBP Posted <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 />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. Sharps containers are full. Contact hauler and submit <br />evidence of disposal. HSC 119314(e) <br />13. Practitioner shall provide evidence of a completed, EHD approved, OSHA Bloodborne Pathogen Training consistent with <br />section 119307. <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 />25. Disinfectant shall be used according to the manufacturer's instructions. HSC 119309(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. Inks and machines must stored in a manner which keeps them free from dust accumulation. HSC <br />119315 <br />34. Certificate of registration and health permit shall be posted in a conspicuous place. Post facility permit (Marissa Correa- <br />Amaya) and registration for Raul Granados. HSC 119306 and 119312 <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 on/about: A reinspection fee of $130 per hour may be charged. Page 2 of 2 <br />EH -03/2015 <br />
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