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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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PESCADERO
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1005
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4100 – Safe Body Art
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PR2500286
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COMPLIANCE INFO
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Entry Properties
Last modified
3/20/2026 10:00:04 AM
Creation date
10/20/2025 11:59:41 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR2500286
PE
4120 - Single Use
FACILITY_ID
FA0027261
FACILITY_NAME
STUDIO 111 (CHAVES, FABIAN)
STREET_NUMBER
1005
Direction
E
STREET_NAME
PESCADERO
STREET_TYPE
AVE
City
TRACY
Zip
95304
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
Site Address
1005 155 E PESCADERO AVE TRACY 95304
Suite #
155
Tags
EHD - Public
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AFTERCARE INSTRUCTIONS <br /> The following verbal and/or written instructions were communicated to the client: <br /> 1. Information on the care of the procedure site. <br /> 2. Restrictions on physical activities such as bathing, recreational water activities, gardening, or contact with animals, and <br /> the duration of the restrictions. <br /> 3. Signs and symptoms of infection including but not limited to redness, swelling, tenderness of the procedure site, red <br /> streaks going from the procedure site towards the heart, elevated body temperature, or purulent drainage from the <br /> procedure site. <br /> 4. Instructions to call a physician if any of the addressed signs and symptoms appear or for any other reason related to <br /> the Body Art procedure(s). <br /> 5. If physician care is required by the client related to the Body Art procedure(s), the client is to notify the Body Art facility <br /> and practitioner of the problem and the resolution by a physician or clinic. This information shall be placed in the <br /> client's file. <br /> I acknowledge that I will be responsible to seek medical care from a physician or doctor if any symptoms arise while the <br /> tattoo appears to be Infected,swollen, redness, tenderness or palmUl to Ine toucli. I will reacri out to the artist irs Tor any <br /> nonrerns that are not life thrpatpning I undprMand crnhhinq is a natural nrnrrass in healing and i will not mink at the srah <br /> This may lead to an infection if wound is re-exposed and delaying of healing time. SEEK MEDICAL ADVICE FROM A <br /> have received aftercare instructions: <br /> Client Signature: Date: <br /> For Additional Visits of Client:Aftercare has been re-explained and new instructions have been provided. <br /> ❑ No changes in medical history and informed consent <br /> Printed Client Name: Signature of Client: Date: <br /> ❑ No changes in medical history and informed consent <br /> Printed Client Name: Signature of Client: Date: <br /> ❑ No changes in medical history and informed consent <br /> Printed Client Name: Signature of Client: Date: <br /> PLEASE SEE ATTACHED PAGES <br /> FOR AFTERCARE INSTRUCTIONS <br /> CPD BAP-013 Page 2 of 3 01/24 <br />
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