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As D. Elam, MD <br />Physician -in -Chief <br />Corwin N. Harper, MHA, FACHE <br />Senior Vice PresidenVArea Manager <br />Central Valley Service Area <br />Corrective Action Statements and Supporting Documentation <br />Violation: HSC Section 18275 MW — MW red bags, path, chemo shall be labeled properly. - This <br />facility is storing medical waste in a non -red biohazard bag. Clear bags do not have appropriate medical <br />waste labels. <br />a- Inspector observed a clear plastic bag inside a biohazardous waste container in the designated <br />accumulation area. <br />b- Inspector observed path waste placed in a clear plastic bag in a path waste container in the <br />pathology room. <br />Corrective Statement: Submit documentation showing corrective action that will prevent <br />future incidences by 6/5/11. <br />Supporting Photo Documentation: Environmental Services staff for Stockton was trained on <br />May 23 & 24; the sign -in sheet from that training is attached below. For those employees that <br />are on a Leave of Absence (LOA), vacation or medical leave, they will be trained within 30 days <br />of their return back to work. Environmental Services and Pathology departments worked <br />together on implementing the correct waste containers for pathology waste. <br />a-EVS Staff Training Roster: <br />u; <br />PM SHIFT <br />i nature <br />Gilb art Florey <br />200 <br />Celia Valencia <br />201 ;v.--- - ^- <br />Oee Torry <br />202 ....._ <br />Anita Chancl <br />203 .. < -c...-. <br />... �y....,,�y> <br />Tricia Chong <br />204 <br />Tore- Crow <br />206 <br />Pr7acilla <br />Emrllo Villa nuava <br />207 {`j pj FSI �':IJ 7(',.%4 � q_L�-" ��/#_--- <br />206 <br />' <br />Ken Shankle <br />209 _.. _ �> <br />..-,... f.'-4 <br />- --._... <br />Maria Ortega <br />210 �}. <br />Al.. C.—P.. <br />211 <br />Carol CMar <br />212L-1. <br />Mo.— Moores <br />213 O" <br />Qufaha Tatum <br />214 <br />E-1cia Martinez <br />Marla Zaragoza <br />. <br />SerOlo Torres <br />_ - <br />�..,. ". ,i;w' <br />Kim Emery <br />dat.. <br />'_y s„ <br />- 1,X. <br />Robert McLaughlin <br />J­f� <br />Marfa Ruv l..baMiKe Russell <br />Jorge Soto <br />Alf.n.- Varela <br />Eddie Corona <br />225 - <br />Ritesh Nand <br />226 ,f.:n.-i,"." <br />Ysabeile Modina <br />227 <br />Juan uri.ta <br />229 <br />Sal Rivera <br />230 <br />Le#Ic is aag, GoLisa AncleraoBarry MillarroCuffiPatica <br />Agui <br />Pagel of 3 <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 />