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MEDICAL WASTOSPECTION REPORT • Date: 1 i San Joaquin County Environmental Health Department Program j 1868 E. Hazelton Ave.,Stockton,CA 95205 Record: 22 (209)468-3420 trF Program /� a� www.s4ogv.org/ehd Element: "1 5 2� Facility Name Address City Zip Code Vienna Convalescent Hospital 800 s. ham lane Lodi 90242 Facility Contact Title Phone Number Email Inspection Type Ida Ventura Director of Staff 209-368-7141 - Routine Development L Vel�vrA®VleX0 0 5K)IIad&r6l"A,j.Cod) The above facility is inspected for compliance with Division 104, Part 14 of California Health and Safety Code(HSC). Registration Treatment ❑ HSC 117890-No LQG shall generate medical waste unless HSC 118130-All onsite medical waste treatment facilities shall 1' registered with the EA. E] 17. be permitted by the EA. ❑ HSC 117950-LQG shall register with the EA prior to 2 ❑ 18. HSC 118165 All treatment records shall be kept for 3 years. generating medical waste. HSC 117903-Permit from the EA is required prior to treating HSC 118215-All medical waste shall be treated pursuant to El 3' medical waste. El 19. this section. HSC 117925-SQG that treats medical waste onsite shall HSC 118220-Pathology waste of a human nature shall be ❑ 4. register with the EA. ❑ 20. disposed of by interment, incineration,or an approved alternative. HSC 117900-Shall not haul medical waste unless registered, HSC 118222-Contaminated pathology waste,trace chemo ❑ 5. common carrier,trauma scene practitioner, or exempted ❑ 21. waste, or pharm waste from health care settings shall be treated under the MOT exemption. by incineration or an approved alternative. HSC 117928-Common Storage Facility shall have permit HSC 118225-Sharps waste shall be treated pursuant to this El 6' issured by the EA. ❑ 22' section. ❑ 7 HSC 117890-LQG shall notify EA 72 hours prior to Containment/Storage participating in temporary event. HSC 117895-SQG shall notify EA 72 hours prior to HSC 117630-Biohazard bag shall meet the standards set forth ❑ 8' participatingin temporary event. El 23. in this section. HSC 118275-Medical,biohazardous,sharps,trace chemo, Records/Documentation E 24 pathology, or pharmaceutical waste shall be segregated and contained pursuant to this section. The container shall be properly labeled. ❑ 9. HSC 117935-Registered SQG shall file MWMP with the EA. E 25 HSC 118280- Biohazard bags shall be containerized and stored pursuant to this section. HSC 117943-SQG required to register shall maintain HSC 118285-Sharps waste shall be containerized and stored El 10. 26 treatment and shipping and tracking records for 3 years. ❑ . pursuant to this section. HSC 117945-SQG not required to register shall maintain HSC 118295-Containers shall be washed and decontaminated ❑ 11. 27 information document and transportation records for 3 years. ❑ . pursuant to this section. HSC 118305- Reuseable drums or conainters used for medical E 12. HSC 117960 LQG shall file MWMP with the EA. F1 28. waste shall not be used for other storage. HSC 117975-LQG shall maintain treatment and shipping and HSC 118307- Intermediate storage area shall be secured and ❑ 13. tracking documents for 2 years. ❑ 29. marked with proper signage. HSC 118310-Designated accumulation area shall be secured Transportation ❑ 30. and marked with proper signage. ❑ 14. HSC 117946-MOT exemption requirements for SQG. Other. ❑ 15. HSC 117976-MOT exemption requirements for LQG. ❑ 31. ❑ 16. HSC 118032-Pharmaceutical waste hauling exemption. ❑ 32. Received by: Print: Ida Ventura Signature: /CU Phone:209-368-7141 Specialist: Print: J. Easter Signature: Phone: 209-953-7310 Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of 2 EH-11/17 t/