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05 / 04 / 2022 16 : 08 FAX 2094732214 DAVITA U0004 / 0010 <br /> SA <� AIEnvironmental Health Department <br /> r. .. <br /> Corrective Action Statement <br /> RE : April 29 , 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 /> DELTA SIERRA DIALYSIS CENTER , 7500 WEST LN , CERS ID : 10873174, PRO547248 <br /> Violation #11 - Failed to provide or document initial and /or refresher training to appropriate personnel . <br /> This violation was corrected ElThis violation will be corrected by ( date) , <br /> et Supporting documents included <br /> � <br /> Des <br /> J/ ribe a tions taken or will be t9kJen�to correct violation : _ j&Am� •� <br /> If'. 1TlG� <'1 ,'��V�CU�A �1 ��iC- n2= <br /> i9 . <br /> flog f'e � G <br /> Rev. 9/16/2020 Page 3 of 3 <br /> 1868 E . Hazelton Avenue I Stockton , California 95205 1 T 209 468 -3420 1 F 209 464 -0138 1 www. sjgov . org/EHD <br /> Received Time May , 4 . 2022 3 56PM No , 71 $ 0 <br />