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L8IS 'IN NO 01 6101 ll -unr a ;AIaaa� "' MEDICALWASTE INSPECTION REPORT , q '° ®ate: aSan Joaquin County EClVItOt,f1119iItal Health Department program 1, 18to 138 E.Haxahon Ave.,Stockton,CA 95205 Ft®cord_ (d (209)488.5420 Program r I " www,sl�ly.oralQhd Element: _ LI5 Z7 Facillty Name Address city Zip Gode Windsor Elmhaven Care Center 6940 pacific avenue Stockton 95207 Facility Contact Title Phone Number Email Inspection Type Frank Juarez Maintenance Supervisor 2084774817 quarezQwindsorc Routine aMs.wm The above facility is inspected for comptlance with Olvision 104,Part 14 of Caltfomia Health and Safety Code(HSC). ffgj� Qn Tim ® 1 HSC 117690-No LOG shalt gonamis medical waste.unless ® 17, HSC 1181'.90-AU onalte medical waste treatment facilities shall registered with the EA. be permitted by the F.A. ❑ 2 MSC 117860-LOG shall m9l3ter with the EA.prior to generating medical waste. ® 18, HSC 1118166-AU treatment records shall be kept for 3 years. ® 3 HSC 117903-Permit from the.lEA is required prior to treating ❑ 19, HSC 118215-All medical waste shall be treated pursuant.to medical waste. this section. HSC 117926-SQG that treats medical waste onsite shall; HSC 1113220-Pathology waste of a human—nature shall be ❑ 4• feglster with the FA. ❑ 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 NOT exern tion. by incineration or an,approved alternative, ® 5 HSC 117928-Common Storage Facility shall have permit ® 22 HSC 118225-Sharps waste shall be treated pursuant to this issured by the EA. section. ® 7 HSC 117090-LOG shall notify EA 72 hours prior to .' ora participating In tempry event. !�i.0..4. : B 8 ® 8 HSC 117896-8Q.G shall notify FA 72 hours prior to ❑ 23 HSC 117630-131ohazard bag shall meet the standards set forth artic atin In tem event. in this section. HSC 118275-Medical,biohazardous,sharps,trace chemo, Records/Docuaventation ® 24pathology,or pharmaceutical waste shall be Segregated and containedpursuant to this*action. The container shall be properly labeled. ❑ 9. HSC 117996-Registered SQG shall file MWMP with the EA. ❑ 25. HPC 116280- Biohazard bags shall be contalnerized and stored pursuant to this section. ® 10 HSC 117943-SQG required to register shall maintain ® 26 HSC 118286-Sharps waste shall be contalne�ed and stored treatment and shipping and tracking records for 3 years. pursuant to this section, ❑ 11, HSC 117945-SQG not require¢to register shall maintain ® 27 HSC 118286-Containers shall be washed and decontaminateo Information document and transportation records for 3 years_ pursuant to this section. MSC 118806.- Reuseable drums or conainters used for medical ® 12. HSC 117980-LQG shelf file MWMP with the EA, ❑ 28. wasteshall not be used for other storage. I� HSC 117976-LOG shall maintain treatment and shipping and HSC 118807- Inteuediete storage area shall be secured and 13, tracking documents for 2 years. ® 29' m marked with proper signage. Tf1n8 h ❑ 30. HSC 110310-Designated accumulation area shall be secured, end marked with proper.si na e. E] 14. MSC 117946-MOT exemption requirements for SQG. Other ❑ 15. HSC 117976-MOT exemption requirements for LQG. ® 31. Unapproved.use of biobazardoys waste labels Cl 16. HSC 110032-Pharmaceutical waste hauling exemption, ❑ 92. Received by: Print: Signature: Phone;200-477-0817 Segelaller! Prink J. Easter Signature: P Phone: 209-953-7310 Reinapeclon on/about A reinspection fee of$162 per hour may be charged. Page 1 of 3 EH-11117