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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
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EHD - Public
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u"{ �o Body Art Inspects Report 0 <br />San Joaquin County Environmental Health Department <br />1868 E. Hazelton Ave., Stockton, CA 95205 <br />(209) 468-3420 <br />c4�iFOR `P www.siogv.org/ehd <br />PR Number <br />PRACTITIONER/ARTIST NAME <br />PR0539729 <br />Humberto Granados (BBP exp. 8-22-20 <br />PR0539785 <br />Raul Granados BBP exp. 8-23-20 <br />PR0542569 <br />Robert Vierra (BBP exp. 4-3-20 <br />Observations and Corrective Actions: <br />Date: 10/10 f I cl <br />Program <br />Record: SiZUOg la -13 <br />Program <br />Element: x-1103 <br />I PR Number I PRACTITIONER/ARTIST NAME I <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) — Receipt of sharps disposal not on site. <br />Provide EHD with copy of sharps disposal receipt. <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 — Body art medical questionnaire needs to include the statement "history of herpes <br />infection at the procedure site." Provide copy of corrected medical questionnaire to the EHD. <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) — The aftercare instructions does not have written instructions of the proper care for the <br />procedure site. Include in the aftercare a written instruction on the proper care for the procedure site. <br />32. A body art facility shall have floors, walls, and ceilings that are smooth, nonabsorbent, free of open holes, and washable. <br />The body art facility shall be free of insect and rodent infestation. The procedure area must be separated, by a wall, ceiling to <br />floor, from nail and hair activities and be separated from all business not related to body art. Approval of co -located body art <br />facilites are at the discretion of the LEA. A procedure area must be equipped with adequate light to perform a procedure. Each <br />procedure area shall have lined waste containers. HSC 119314 & 119317 — The body art room located left of the entrance is <br />missing an outlet cover and there are holes on the wall. There is a hole under the sink in the reception area and small <br />holes on the wall. The piercing room has holes on the wall, a hole under the sink, and the plastic wall panel is not <br />attached to the wall. The body art room located in the back on the left has gaps in the floorboard and holes in the wall. <br />The restroom is missing an outlet cover. Repair all holes, place covers on outlets, fill the gaps on the floorboards and <br />attach the plastic wall panel to the wall. <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 — The Infection <br />Prevention Control Plan was not available. Update the IPCP to include sterilization information. Provide an updated <br />copy of the IPCP to the EHD and keep a copy on site. <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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