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Mf a� MEDICAL WASTE INSPECTION REPORT gate: L <br /> Sen Joac{u(n COurt4ynviPonmerafial k�ealth De�sartment Program <br /> 1868 E.Hazefton Ave„Stockton,CA 95205 Record: r6 J <br /> (209)468-3420 <br /> Program <br /> VA'Vw.siogv.orotehd Element: 7524 <br /> Facility flame Address City Zip Code <br /> Golden Living Canter-Chateau 1221 rosemarie lane Stockton 95207 <br /> Facility Contact Title Phone Number Email Inspection Type <br /> Judy Treloar Facility Administrator 209-477-266¢ Routine <br /> The above facility is inspected for cornpilance with Division 104,Fart 14 of California Health and Safety Code(HSC). <br /> Registration Treatr»en$ <br /> ® 1 HSC 117890-No LOG shag generate medical waste unless ❑ 17. HSC 118130-All onsite medical waste treatment facilities shall <br /> registered with the EA. be permitted by the EA. <br /> : <br /> HSG 117550-LQG shaft register with the EA prior to <br /> El 2' generating medical waste. ❑ 18. HSC 118165-All treatment records shall be kept for 3 years. <br /> ❑ 3. HSC 117903-Permit from the EA is required prior to treating ® 19. HSC 118215-All medical waste shall be treated pursuant to <br /> medical waste. this section. <br /> ❑ 4 I HSC 117925-SQG that treats medical waste onsite shell HSC 118220-Pathology waste of a human nature shall be 4 <br /> register with the EA. ❑ 2€7, disposed of by interment,incineration,or an approved <br /> r aftema`;ive. <br /> HSC 117900-Shall not medical waste unless registered, HSC 118222-Contaminated pathology waste,trace chemo <br /> ❑ 5. common carrier,trauma scene practitioner,or exempted ❑ 21. waste,or pharm waste from health care settings shalt be treated <br /> under the MOT exemption. I I bv incineration or an app d alternative. <br /> ❑ 6 HSC 117528-Common Storage Facility shall have permit ❑ HSC 1"•.$225-Sharps waste shall be treated pursuant to this <br /> I insured by the EA, section_ <br /> ❑ 7. HSC 117890-LQG shaft notify EA 72 hours prior to Con$ail!trrien$f5tora � <br /> parifcipating in temporary event. g. <br /> ❑ 8. HSC 117895-SQG shall notify EA 72 hours prior to 23HSC 117630-Biohazard bag shall meet the standards set fo±th <br /> artici tin in tem ora. .event. in this section. <br /> HSC 118275-Medical,biahazardous,sharps,trace chemo, <br /> RecorciSliDciptAi' ent. ion 24. pathology,or pharmacauticai waste shaft be segregated and <br /> confined pursuarA to this section. The container shall be <br /> proper{ laled. <br /> ❑ 9. HSC 117935-Registered SQG shall file MrWlP with the EA. 25. HSC 118280- Biohazard bags shalt be containerized and <br /> stored pursuant to this section. <br /> ❑ 10. HSC 117943-SOG required to register shall rnaintaln HSC 118285-Sharps waste shall be c ontainarized and stored <br /> treatment and shipping and tracking records for 3 years. I ❑ 2&' pursuant to this section. <br /> © 11. HSC 117945-SQG not required to register shall maintain ❑ <br /> information document and transportation records for 3 year27. HSC 118295-Containers shall be washed and decontaminated <br /> s. i pursuant to this section. <br /> } 12. HSG 117960-LQG shall file MWMP with the FA. ❑ 28. k HSC 118305"- Reuseable drums Dr conafnters used for medical <br /> ! waste shall not be used for other storage. <br /> ® 13. HSC 117975-LQG shall maintain treatment and shipping and ❑ 29. HSC 118307- Intermediate storage area shall be secured and <br /> tracking documents for 2 years- marked with proper signage. <br /> Transportati+oa30. HSC 118310-Designated accumulation area shall be secured <br /> and marked with proper signage. <br /> ❑ 14. HSC 117946-MOT exemption requirements for SQG. P E $hg <br /> l ❑ 15_ HSC 117976-NIOT exemption requirements for LQG. ❑ 31. - <br /> ❑ 16. HSC 118032-Pharmaceutical waste hauling exemption. ❑ 32. <br /> Received by: Print: Judy Treloar Signature, Phone: <br /> Specialist: Print: J.Easter Signature., Phone: 209-953-7310 <br /> Reiitspeclon onlabout: A reinspection fee of$152 per hour may be changed. Pae 1 of 3 <br /> EH-11/17 g <br />