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Body Art Inspection Report Date: April 10,2025 <br /> y: San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: PRO548664 <br /> (209)468-3420 <br /> www.siociv.org/ehd Program <br /> a�f F ORS Element: 4120 <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PR0548665 Lynda Diaz BBP Ex 7/21/25 <br /> Observations and Corrective Actions: <br /> 18. HSC 119303 -Client records approved and available-Consent form and questionnaire <br /> OBSERVATIONS: <br /> 1. The medical questionnaire did not have all items from Form B. -Corrected <br /> 2. Client photo IDs were not attached to the client records. <br /> CORRECTIVE ACTIONS: <br /> 1. The facility's client consent form and medical questionnaire must include all of the information listed in Form B, and are <br /> available for inspection. <br /> 2. The facility's client consent form and medical questionnaire must include all of the information listed in Form B, and are <br /> available for inspection. Ensure photo IDs are attached to client records. <br /> Notes: <br /> 1. Inspection report emailed to facility owner, Lynda Diaz, at Iyndadiaz(a-)-gmail.com. <br /> 2.Absorbent curtains were observed in the procedure area. Facility owner is to either remove the curtains or place them behind <br /> the plastic wall covering. <br /> 3. Sharps waste has not been disposed since the facility opened. Sharps waste shall be disposed either when the container is <br /> full or once a year. <br /> 4. Sharps Compliance is used for sharps waste disposal. <br /> 5. There is only one practitioner at the facility. <br /> 6. Above Training was used for the Bloodborne Pathogen Training. Practitioner was informed that the course is no longer <br /> approved by the EHD and a list of approved courses was provided. <br /> 7. Sterilization certificates were provided for the Tina Davies blades with the lot#14C-305 and the Tina Davies needle cartridges <br /> with the lot#082024. <br /> Reinspection on/about: A reinspection fee of$172 per hour may be charged. Page 2 of 2 <br /> EH-11/17 <br />