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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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KNICKERBOCKER
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1517
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4500 - Medical Waste Program
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PR0536182
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COMPLIANCE INFO
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Entry Properties
Last modified
7/15/2025 3:48:44 PM
Creation date
7/3/2020 10:19:58 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4500 - Medical Waste Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0536182
PE
4524 - SKILLED NURSING FACILITY
FACILITY_ID
FA0009746
FACILITY_NAME
Kindred Transitional Care and Rehabilitation Valley Gardens
STREET_NUMBER
1517
STREET_NAME
KNICKERBOCKER
STREET_TYPE
DR
City
STOCKTON
Zip
95210
APN
09056004
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\MW\MW_4524_PR0536182_1517 KNICKERBOCKER_.tif
Site Address
1517 KNICKERBOCKER DR STOCKTON 95210
Tags
EHD - Public
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2015-11-02 12:25 <br />M 2094688392 P 5/5 <br />Describe how reusable medical waste carts or containers are cleaned and decontaminated (see below for <br />Approved cleaning methods include agitation to remove visible soil combined with one of the following: <br />1. Exposure to hot water of at least 82 degrees Centigrade: (1.80 degrees Fahrenheit) for a minimum <br />of 15 seconds. <br />2. Exposure to chemical sanitizer by rinsing with, or immersion in, one of the following for a <br />minimum of three minutes: <br />• Hypochlorite solution (500 ppnt available chlorine) <br />• Phenolic solution (500 ppm active agent) <br />• Iodoform solution (100 ppm available iodine) <br />• Quaternary ammonium solution (400 ppm active agent) <br />m. Describe, if medical waste is treated onsite, a closure plan for the termination of treatment, using at a <br />minimum, one of the above referenced approved cleaning methods: <br />I hereby certify to the best of nay knowledge and belief that the statements made herein are correct and true. <br />r <br />F1-rl'� a5_n� <br />Received Time Nov, 2, 2015 12:41PM No -1407 8 <br />Signature: �..' <br />Date: <br />
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