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SAN41JOAQUIN Environmental Health Department <br /> COUNT'S` <br /> Greatness 9rows here_ <br /> Corrective Action Statement <br /> RE: March 30, 2022, Hazardous Materials inspection report <br /> For each violation listed below, indicate if the violation has been corrected or will be corrected by a certain date. <br /> Also, describe what was done to correct the violation in the space provided below each violation. Submit this <br /> completed form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, <br /> please contact Robert Lopez at (209) 953-6214 or rlopez@sjgov.org. <br /> CREEKSIDE CARE CENTER, 9107 N DAVIS RD, CERS ID: 10184127, PR0520784 <br /> Violation #11 - Failed to provide or document initial and/or refresher training to appropriate personnel. <br /> W This violation was corrected ❑ This violation will be corrected by(date): <br /> Qf Supporting documents included <br /> Describe action taken or will betaken to correct violation• <br /> k/ers-e p K A ficc/ Xe I c o. A ?vA'-. o ds <br /> 111 �� 60Y)ACICfs, <br /> hoyl <br /> 5 <br /> �w�ed vis �r n �►� wa� Ctj,�d��-� � mac. �� ��oIn <br /> � 4) '4-) 7-0Z,?, <br /> Page 3 of 3 <br /> Rev.9/1612020 <br /> 1868 E. Hazelton Avenue Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />