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COMPLIANCE INFO
Environmental Health - Public
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4100 – Safe Body Art
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PR0523952
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COMPLIANCE INFO
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Entry Properties
Last modified
4/17/2026 2:33:54 PM
Creation date
4/25/2023 12:53:45 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0523952
PE
4121 - BODY ART FACILITY-STERILIZATION
FACILITY_ID
FA0014791
FACILITY_NAME
CANVAS TATTOO (BAMBULA-SANTOS, MELISSA)
STREET_NUMBER
304
Direction
W
STREET_NAME
HARDING
STREET_TYPE
WAY
City
STOCKTON
Zip
95204
APN
13708003
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\kblackwell
Supplemental fields
Site Address
304 B W HARDING WAY STOCKTON 95204
Suite #
B
Tags
EHD - Public
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5.1 Body Art Inspection Report Date: April 14, 2025 <br />{\� San Joaquin County Environmental Health Department Program <br />1868 E. Hazelton Ave., Stockton, CA 95205 Record: PR0523952 <br />(209) 468-3420 Pro9 <br />ram <br />..., �j�? www.sjogv.org/ehd <br />_F o.- Element: 4121 <br />CORRECTIVE ACTIONS: <br />Practitioner shall provide evidence of a completed, EHD approved, OSHA Bloodborne Pathogen Training consistent with section <br />119307. Provide EHD with a current BBP Certificate for Katrina Bambula-Santos. <br />18. HSC 119303 - Client records approved and available - Consent form and questionnaire <br />OBSERVATIONS: <br />The tattoo consent form did not include all of the items from Form B. <br />CORRECTIVE ACTIONS: <br />The facilities client consent form and medical questionnaire must include all of the information listed in Form B and are available <br />for inspection. Include the following on the consent form and provide a copy to the EHD: <br />- Description of what the client should expect following the procedure. <br />19. HSC 119303, 119308 - Appropriate aftercare instructions given to client <br />OBSERVATIONS: <br />The permanent makeup aftercare instructions did not include all of the items from Form B. <br />CORRECTIVE ACTIONS: <br />At the completion of the procedure, the practitioner shall provide postprocedure instructions that include all elements listed in <br />Form B. Include the following on the aftercare instructions and provide a copy to the EHD: <br />- Indications when to seek medical care. <br />32. HSC 119314 - Floors and walls clean and in good repair, adequate light <br />OBSERVATIONS: <br />1. Damaged tiles were observed in the tattoo procedure area and in the permanent makeup procedure area. — Corrected. <br />2. The baseboard in the permanent makeup procedure area and outside of the piercing room needs repair. — Corrected. <br />CORRECTIVE ACTIONS: <br />A body art facility shall have floors, walls, and ceilings that are smooth, nonabsorbent, free of open holes, and washable. <br />35. HSC 119313 - Operation and employee training records present <br />OBSERVATIONS: <br />The Infection Prevention and Control Plan was not updated to reflect Stericycle as the new sharps waste hauler. <br />CORRECTIVE ACTIONS: <br />Operation and employee training records shall be maintained for 3 years and made available for inspection. A written Infection <br />Prevention and Control Plan (IPCP) shall be maintained, followed and updated. Updated the IPCP to add Stericycle as the new <br />sharps waste hauler and train practitioners on the new information. Provide EHD with an updated IPCP and training record. <br />Correct All Violations and Provide EHD with Evidence of Corrections by <br />May 1, 2025. <br />Reinspection on/about: A reinspection fee of $172 per hour may be charged. Page 3 of 4 <br />EH -11/17 <br />
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