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Body Art Inspection Report <br /> Date: 03/26/2025 <br /> San Joaquin County Environmental Health Department Program <br /> Q' <br /> _ 1868 E.Hazelton Ave.,Stockton,CA 95205 <br /> ' 1 Record: PR0548339 <br /> (209)468-3420 Program <br /> www.siogv.org/ehd Element: 4120 <br /> R Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PR0540999 Gerardo Cortes Padron(BBP Exp.3/12/2026 <br /> PR0548934 Miguel Andrade(BBP exp. 10/18/2025 <br /> PR2400249 David Loza-Watkins(BBP exp.05/24/2025 <br /> Observations and Corrective Actions: <br /> #6. HSC 119315 - Invoices and log kept for disposable, pre-sterilized equipment <br /> OBSERVATION: Sterilization certificates for Cheyenne needle cartridge lot numbers 2022-18-044 and 2022-35-004 were not <br /> available at the time of the inspection. <br /> CORRECTIVE ACTION: Submit to the EHD sterilization certificates for the lot numbers listed above. Facilities utilizing <br /> disposable, single-use, pre-sterilized instruments shall maintain written proof on company or laboratory letterhead showing that <br /> the pre-sterilized instruments have undergone a sterilization process. Written proof shall clearly identify the instruments sterilized <br /> by name or item number and shall identify the lot or batch number of the sterilizer run. <br /> #18. HSC 119303 -Client records approved and available -Consent form and questionnaire <br /> OBSERVATION: The client consent form and records are inadequate. The consent form does not include a description of the <br /> procedure and a description of what the client should expect following the procedure. Client records are missing photo IDS. <br /> CORRECTIVE ACTION: Ensure the client consent form includes the missing elements and all items listed in section 119303. <br /> Submit the revised consent form to the EHD. Moving forward, ensure to maintain copies of client photo IDS with client records. <br /> #35. HSC 119313 -Operation and employee training records present <br /> OBSERVATION: The Infection Prevention Control Plan (IPCP) is incomplete. The IPCP does not address procedures for <br /> cleaning &decontaminating environmental surfaces, techniques to prevent the contamination of instruments or the procedure <br /> site during the performance of body art, and procedures for safe handling and disposal of sharps waste. There is also no record <br /> of annual IPCP training. <br /> CORRETIVE ACTION: Ensure the IPCP includes all required elements listed in 119313. Submit revised IPCP and training <br /> record to the EHD. <br /> Submit evidence of corrections to the EHD by <br /> 04/26/2025 <br /> Notes: <br /> 1. Inspection report emailed to facility owner, Gerardo Cortes Padron, kumbiaink(a�gmail.com <br /> 2. Reviewed ICPC, client consent forms, medical questionnaire, after-care instructions, and client records. <br /> 3. The facility will utilize Rynocare for sharps waste disposal. Per Gerardo, they have not had any waste pick-up since the <br /> last inspection. Ensure to maintain disposal records for a minimum of 3 years. <br /> 4. Per Gerardo, since the last inspection, the following practitioners have left this facility: Fernando Hurtado, Jennifer Lua, <br /> Jessica Parker, and Erick Dominguez. A new practitioner, David Loza-Watkins, has started and is already registered <br /> with the EHD. <br /> 5. Ensure to provide IPCP training annually and keep records for a minimum of 3 years. <br /> Reinspection on/about: A reinspection fee of$172 per hour may be charged. Page 2 of 2 <br /> EH-11/17 <br />