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MEDICAL WASTASPECTION REPORTJ Date: IZ/S/201{ w �l San Joaquin County Environmental Health Department Program p j 1868 E. Hazelton Ave.,Stockton,CA 95205 Record: ` IZ 0.5 36\5 `p (209)468-3420 Program s Z� t;FOR�i www.s'ogv.org/ehd Element: Facility Name Address City Zip Code Lodi Nursing and Rehabilitation 1334 s. ham In. Lodi 95242 Facility Contact Title Phone Number Email Inspection Type Christian Marcheschi Administrator (209)334-3825 christianm@aspe Routine nskilledhealth.com 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 El 1 registered with the EA. ❑ 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 3' medical waste. 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 ❑ 6' issured by the EA. ❑ 22' section. HSC 117890-LQG shall notify EA 72 hours prior to ❑ 7. participating in temporary event. Containment/Storage HSC 117895-SQG shall notify EA 72 hours prior to HSC 117630-Biohazard bag shall meet the standards set forth ❑ 8' participatingin temporary event. ❑ 23. in this section. HSC 118275-Medical, biohazardous,sharps,trace chemo, Records/Documentation ❑ 24 pathology,or pharmaceutical waste shall be segregated and contained pursuant to this section. The container shall be r)ror)erlv labeled. ❑ 9. HSC 117935-Registered SQG shall file MWMP with the EA. ❑ 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 El 11. information document and transportation records for 3 years. E] 27. pursuant to this section. ❑ 12. HSC 117960-LQG shall file MWMP with the EA. ❑ 28 HSC 118305- Reuseable drums or conainters used for medical waste shall not be used for other storage. HSC 117975-LQG shall maintain treatment and shipping and 29HSC 118307- Intermediate storage area shall be secured and ® 13. tracking documents for 2 years. ❑ . marked with proper signage. Transportation '," ® 30 HSC 118310-Designated accumulation area shall be secured 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: Christian Marcheschi Signature: VVVIc- � Phone: (209)334-3825 Specialist: Print: Harprit Mattu,Sr REHS Signature: Phone: (209)468-3284 Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 1 of 2 EH-08/2015