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KAISER PERMANENTE® <br />July 31, 2006 <br />Kasey Foley, Program Coordinator <br />Environmental Health Department <br />San Joaquin County <br />304 East Weber Avenue, Third Floor <br />Stockton, CA 95202 <br />Dear Ms. Foley, <br />Moses D. Elam, MD <br />Physician -in -Chief <br />Corwin N. Harper, MHA, CHE <br />Senior Vice President/Area Manager <br />2006 -AUG —I MQU26-y,Service Area <br />SAN .13 1 C lriN CG,U NTY <br />'ENV I R 0 N M E N T A L <br />HEALTH DEPtRTHENT <br />Please accept this correspondence as an addendum to the previous response submitted on July 7, 2006 <br />from Kaiser Permanente Stockton Medical Offices, 7373 West Lane regarding your findings and notice of <br />violation on June 27, 2006. <br />After further review of your findings with senior leadership, our compliance oversight committee, and <br />dialog with yourself, we would like to submit the following revised recommendations regarding the plan of <br />action. <br />We are committed to adhering to the California Medical Waste Management Act, and in doing so would <br />like to resume the use of our Sanipak, upon your approval, by implementing the following processes: <br />1. The Engineering Department will: <br />a. Support all functions of the Sanipak. This includes being familiar with standard <br />written operating procedures. One engineer has been to a week-long training course <br />for operating the Sanipak. The Sanipak has a built-in software program to detect and <br />notify our facility of any functions operating outside or normal parameters. <br />b. Be responsible for maintaining Sanipak documentation for three years including: <br />time, temperature, pressure, and dates of loads run. <br />c. Perform and document biological indicator testing. <br />2. The Environmental Services Department will: <br />a. Confirm and document the recording (emperature of each complete cycle to ensure <br />the attainment of 121 degrees Celsius, and will document such action. <br />b. Confirm and document the heat sensitive tape on the autoclave bags has changed <br />color indicating sterilization of the waste. <br />c. Assist Engineering with the Biological Indicator testing to the following extent: <br />i. Loading waste around the test ampule <br />ii. Ensuring loads are not processed during the test, loads will only be <br />processed upon confirmation the test indicates the spore was sterilized. <br />d. Inform Engineering of any issues in regards to improper function of the Sanipak. <br />Stockton Medical Office Manteca Medical Center Tracy Medical Offices Modesto Medical Offices <br />7373 West Lane, Stockton, CA 95210 1777 W. Yosemite Avenue, Manteca, CA 95337 2185 W. Grant Line Road, Tracy, CA 95377 Post Office Box 577680, Modesto, CA 95357 <br />