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<br /> <br />Reinspection on/about:__________________. A reinspection fee of $17 per hour may be charged. Page 2 of 2 <br />EH-11/17 <br /> Body Art Inspection Report <br />San Joaquin County Environmental Health Department <br />1868 E. Hazelton Ave., Stockton, CA 95205 <br />(209) 468-3420 <br />www.sjogv.org/ehd <br /> <br />Date: 03/11/2025 <br />Program <br />Record: PR0546374 <br />Program <br />Element: 4120 <br /> <br />PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br />PR0544308 Marian Chavez (BBP exp. 03/10/2026) <br />PR2500170 Vilma Zuniga (BBP exp. 01/23/2026) <br /> <br /> <br /> <br />Observations and Corrective Actions: <br /> <br />#18. HSC 119303 - Client records approved and available - Consent form and questionnaire <br />Prior to the performance of body art, the client shall read, complete, and sign an informed consent form that shall include, but <br />not be limited to, all of the following information: <br />(1) A description of the procedure. <br />(2) A description of what the client should expect following the procedure, including sug-gested care and any medical <br />complications that may occur as a result of the procedure. <br />(3) A statement regarding the permanent nature of body art. <br />(4) Notice that tattoo inks, dyes, and pigments have not been approved by the federal Food and Drug Administration <br />and that the health consequences of using these products are unknown. <br /> <br />OBSERVATION: Client consent forms do not include all required information. A description of the procedure is missing on <br />the client consent forms. <br /> <br />CORRRECTION: Update client consent form to include the missing information and submit the revised copy to the <br />Environmental Health Department. <br /> <br /> <br /> <br /> <br /> Correct all violations and provide documentation to the EHD by <br />04/11/2025. <br /> <br /> <br /> <br />NOTES: <br />1. Inspection report emailed to facility owner, Marian Chavez, at mjc4u2008@yahoo.com on 3/12/2025. <br />2. Facility uses Stericycle’s malback program for sharps waste disposal. Ensure to maintain records for 3yrs. <br />3. Facility utilizes Citrus II and Cavicide as disinfectant. Unable to verify Cavicide disinfectant capabilities and contact time because <br />they did not have it in stock at the time of the inspection. Ensure all disinfectants are registered by the federal EPA and the Dept <br />of Pesticide Regulation and will reduce/eliminate the presence of disease-causing microoganisms, including immunodeficiency <br />virus (HIV) and hepatitis B (HBV). <br />4. The facility did not have any client records available for review at the time fo the inspection. Per Mariam, Jessica Klein is no <br />longer with the facility and Vilma Zuniga will not start performing body art until April. <br />5. Ensure to provide Infection Prevention Control Plan (ICPC) training to Vilma Zuniga and maintain records for 3yrs. ICPC training <br />should be conducted initially, when there is a change in the ICPC and at minimum annually. <br /> <br /> <br /> <br />