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COMPLIANCE INFO_2016-2020
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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4500 - Medical Waste Program
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PR0540777
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COMPLIANCE INFO_2016-2020
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Entry Properties
Last modified
12/29/2022 11:24:58 AM
Creation date
7/3/2020 10:22:01 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4500 - Medical Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2016-2020
RECORD_ID
PR0540777
PE
4530
FACILITY_ID
FA0023311
FACILITY_NAME
DE YOUNG MEMORIAL CHAPEL
STREET_NUMBER
601
Direction
N
STREET_NAME
CALIFORNIA
STREET_TYPE
ST
City
STOCKTON
Zip
95202
CURRENT_STATUS
01
SITE_LOCATION
601 N CALIFORNIA ST
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\MW\MW_4530_PR0540777_601 N CALIFORNIA_.tif
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EHD - Public
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Field Operations Policy and Procedures <br />Identification Acknowledgement <br />The Identification Acknowledgement Form (FIN-CS003) has two parts. Use the top portion of <br />this form, the Visual Identification Confirmation, when a representative of the decedent's family <br />visually identifies the decedent. Use the bottom portion, the Confirmation of Identification <br />Without Viewing, when the decedent's family declines to make a visual identification and <br />authorizes a funeral home representative to confirm identification of the decedent using some <br />other reliable form of identification, such as a recent photograph or a distinctive scar, tattoo or <br />other physical feature. <br />Incorrect/Incomplete Identification Band <br />The Incorrect/Incomplete Identification Band Form (FIN-CS005) is used any time the white <br />identification band is determined to be incorrect or incomplete. Information such as middle <br />initial or middle name may be written on the white identification band as long as it can be added <br />legibly. Two Company representatives must participate in any change to or replacement of the <br />white identification band. <br />Initial Condition Analysis <br />The Initial Condition Analysis Form (FIN-CS106)is used to document the physical condition of <br />the decedent at the time of check-in at the PCC. Specific conditions such as amputation, <br />decomposition, rigor mortis and others must be documented on the form along with any <br />markings on the decedent (i.e. tattoos, scars). The form also documents if an autopsy was <br />performed—and what type—plus if the decedent was an organ donor. <br />Initial Notification Form <br />The Initial Notification Form (FIN-CS051) is used to gather decedent information during a first <br />call notifying the Company that a death has occurred and removal and mortuary services are <br />required. <br />Merchandise Order Form <br />The Merchandise Order Form is used to document the ordering of caskets, containers or other <br />items and must be compared to delivery receipts upon receipt of merchandise. <br />Merchandise Order Log <br />The Merchandise Order Loa is used to keep track of caskets, containers or other items that have <br />been ordered and delivered to funeral homes or PCCs. <br />Personal Effects Inventory Form <br />The Personal Effects Inventory (FIN-CS006) is used to document personal effects (e.g. <br />clothing, jewelry, hearing aids) that accompany a decedent to a funeral home or PCC or for items <br />that are delivered to the funeral home or PCC after the decedent has arrived. Each item must be <br />listed on the form and the form must be signed by the Authorized Representative or next-of-kin. <br />A copy of the form must be attached to the decedent's clothing and/or to a bag containing small <br />or valuable items. <br />Version 2.1 Page 67 of 70 Revised: 07/10/2015 <br />Document Owner: Operations Support 0 2015 SCI Funeral & Cemetery Purchasing Cooperative, Inc. <br />
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