Hospital Standards Self-Evaluation Checklist

Hospital Standards Self-Evaluation Checklist

July 2017

The Hospital Standards Self-Evaluation Checklist was developed by the Veterinary Medical Board (Board) and its Multidisciplinary Advisory Committee with input from the public and profession in order to assist Hospital Directors’ review of minimum standards to achieve compliance with the law. The Board strongly recommends involvement of the entire staff in a team effort to become familiar with and maintain the minimum standards of practice.

Hospital Standards Self-Evaluation Checklist i

Contents

IntroductIon 1

General 3 1. AfterHoursReferral/HospitalClosure. . . . . . . . . . . . . . . . . 3 2. License/PermitDisplayed. . . . . . . . . . . . . . . . . . . . . . . 4 3.CorrectAddress. . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 4.NoticeofNoStaffonPremises. . . . . . . . . . . . . . . . . . . . 7

FacIlItIes 9 5. GeneralSanitaryConditionsn . . . . . . . . . . . . . . . . . . . . . 9 6. TemperatureandVentilation. . . . . . . . . . . . . . . . . . . . . . 10 7. Lighting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 8. Reception/Office . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 9. ExamRooms . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1110.Food&Beverage . . . . . . . . . . . . . . . . . . . . . . . . . . .1111.FirePrecautions. . . . . . . . . . . . . . . . . . . . . . . . . . . .1212.OxygenEquipment . . . . . . . . . . . . . . . . . . . . . . . . . . 1313.EmergencyDrugsandEquipment. . . . . . . . . . . . . . . . . . . 1314.LaboratoryServices. . . . . . . . . . . . . . . . . . . . . . . . . . 1315.X-ray. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1416.X-rayIdentification. . . . . . . . . . . . . . . . . . . . . . . . . . . 1517.X-raySafetyTrainingforUnregisteredAssistants . . . . . . . . . . . 1618.WasteDisposal . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1619.DisposalofAnimals . . . . . . . . . . . . . . . . . . . . . . . . . .1720.Freezer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1721.Compartments . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1822.ExerciseRuns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1823.ContagiousFacilities. . . . . . . . . . . . . . . . . . . . . . . . . . 19

surGery 21 24.SeparateSurgery . . . . . . . . . . . . . . . . . . . . . . . . . . . 2125.SurgeryLighting/X-ray/Emergency . . . . . . . . . . . . . . . . . . 2226.SurgeryFloors,TablesandCountertop . . . . . . . . . . . . . . . . 2327.EndotrachealTubes . . . . . . . . . . . . . . . . . . . . . . . . . . 2328.ResuscitationBags . . . . . . . . . . . . . . . . . . . . . . . . . . 2329.AnestheticEquipment . . . . . . . . . . . . . . . . . . . . . . . . . 2430.AnestheticMonitoring . . . . . . . . . . . . . . . . . . . . . . . . . 2431.SurgicalPacksandSterileIndicators . . . . . . . . . . . . . . . . . 2532.SterilizationofEquipment. . . . . . . . . . . . . . . . . . . . . . . 2633.SanitaryAttire. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Veterinary Medical Boardii

danGerous druGs/controlled substances 2934.ExpiredDrug. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2935.DrugSecurityControls . . . . . . . . . . . . . . . . . . . . . . . . 3036.DrugLogs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3037.VeterinaryAssistantControlledSubstancePermit . . . . . . . . . . 3238.ControlledSubstanceUtilizationandReview System(CURES)Reporting . . . . . . . . . . . . . . . . . . . . 3339.CurrentDEA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

PractIce ManaGeMent 3740.ManagingLicensee . . . . . . . . . . . . . . . . . . . . . . . . . . 3741.VeterinaryReferenceLibrary . . . . . . . . . . . . . . . . . . . . . 3842.RecordKeeping . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

sMall anIMal MobIle clInIc 42 43. HotandColdWater . . . . . . . . . . . . . . . . . . . . . . . . . . 4244. 110-VoltPower . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4245. CollectionTankforWaste. . . . . . . . . . . . . . . . . . . . . . . 4246. Floors,TableTopsandCounterTops . . . . . . . . . . . . . . . . . 42

sMall anIMal VaccInatIon clInIc 4447. VeterinarianOnSite. . . . . . . . . . . . . . . . . . . . . . . . . . 4448. AdequateEquipment . . . . . . . . . . . . . . . . . . . . . . . . . 4449. FreshCleanWater . . . . . . . . . . . . . . . . . . . . . . . . . . . 4450. ListofEmergencyServices. . . . . . . . . . . . . . . . . . . . . . 44

aPPendIx 46

Hospital Standards Self-Evaluation Checklist 1

IntroduCtIonAuthority and Requirement to Inspect

TheBoardhastheauthoritytoinspectveterinaryhospitalsundertheBusinessandProfessionsCode(BPC)andtheCaliforniaCodeofRegulations,Title16,Division20(CCR).PleasereferencetheAppendixforspecificBPCandCCRsections.Additionally,everyveterinaryhospitalisrequiredtobeincompliancewiththeminimumstandardsrequiredbylawatalltimes.

The Inspection Program

TheBoardhastwotypesofinspections:randomroutineinspectionsandcomplaint-initiatedinspections.InspectionsareperformedinasimilarmannerandallitemsontheInspectionReportareinspectedinbothtypesofinspections.However,duringacomplaintinitiatedinspection,particularattentionmaybedirectedtowardaspecificissue,and/oraDivisionofInvestigationinvestigatormayaccompanytheinspectortoperforminterviews.Licensedveterinariansandregisteredveterinarytechniciansingoodstandingmaybehospitalinspectorsandarerequiredtosuccessfullycompleteathoroughtrainingprogramaswellasparticipateinperiodicupdates.Ifyouareinterestedinbecominganinspector,contacttheBoardformoreinformation.

The Inspection

Oncetheinspectioniscomplete,theinspectorwillreviewthereportwiththemanaginglicenseeordesignatedrepresentative.PartoftheInspectionReportisdedicatedtoidentifyingdeficiencies,listingindividualcorrections,listingwhatitemsarerequiredtobesubmittedtodemonstratecompliance(e.g.,pictures,receipts,writtennarratives,photocopies,etc.),anddiscussingtheircorrectiontomeettheminimumstandardsrequirements.Theinspectormayalsohaveeducationalmaterialsavailabletoassistwiththecorrectionofcertainissues.Questionsareencouragedsothatthemanaginglicenseeand/orstaffareclearoneachissue.ThehospitalinspectorsareprofessionalsrepresentingtheBoard;assuch,theyareexpectedtotreatveterinarians,staffmembers,andthefacilityinaprofessionalmanneratalltimes.

ThroughouttheHospital Standards Self-Evaluation Checklist,objectivesarecitedandexamplesforcompliancearegiven.Theseexamplesaremerelysuggestionsandastartingpointtohelptheveterinaryhospitalmeetminimumstandardsrequirements.

Examplescitedareneitherprescriptivenortheonlymeansindividualveterinaryhospitalsmaymeetminimumstandardrequirements.

Veterinary Medical Board2


General

1. After Hours Referral/Hospital ClosureObjective(s)

□ Visible,obvious,postedsignoutsidetheprimaryentrancewithtelephonenumberandlocationwhereemergencyafterhoursveterinarycareisavailable.

□ Notifythepublicviaansweringmachineorservicewhenpremiseswillbereopenedandwhereafterhoursemergencyveterinarycareisavailable.

□ FulldisclosurepriortorenderingservicesifNOafterhoursemergencycareisavailable.

Example(s) of Compliance

f Afterhourscareinformationvisiblypostedonsignoutsideprimaryentrance.

CCR § 2030(e)(e) Whenaveterinarypremisesisclosed,asignshallbepostedandvisible

outside the primary entrance with a telephone number and locationwhere emergency care is available. An answering machine or serviceshallbeusedtonotifythepublicwhentheveterinarypremiseswillbere-openedandwhereafterhoursemergencycareisavailable.Ifnoafterhoursemergencycareisavailable,fulldisclosureshallbeprovidedtothepublicpriortorenderingservices.


2. License/Permit DisplayedObjective(s)

□ Displayoforiginalpremisepermit,veterinarylicense,and/orveterinarytechnicianregistrationatprincipalplaceofemploymentwhereeasilyvisibleandreadabletoconsumer.VeterinaryAssistantControlledSubstancesPermit(VACSP)holdersshalldisplaypermitorwearappropriateidentificationbadge.

□ Originallicenseshallnotbedefaced.

□ Displayinareascommonlyusedbytheconsumer.

□ Reliefstaffmaycarrywalletcopy.


f Displayoforiginallicense/permitinwaitingroom.

f Displayoforiginallicense/permitinreception/lobbyarea.

f Displayoforiginallicense/permitincheck-in/check-outarea.

f Addressonlicensemaybecovered,butmustbeviewableduringaninspection.

BPC § 119Anypersonwhodoesanyofthefollowingisguiltyofamisdemeanor:

(a) Displays or causes or permits to be displayed or has in his or herpossessioneitherofthefollowing:

(1) Acanceled,revoked,suspended,orfraudulentlyalteredlicense.

(2) Afictitiouslicenseoranydocumentsimulatingalicenseorpurportingtobeorhavebeenissuedasalicense.

(b) Lendshisorherlicensetoanyotherpersonorknowinglypermitstheusethereofbyanother.

(c) Displaysorrepresentsanylicensenotissuedtohimorherasbeinghisorherlicense.

(d) Fails or refuses to surrender to the issuing authority upon its lawfulwrittendemandanylicense,registration,permit,orcertificatewhichhasbeensuspended,revoked,orcanceled.

(e) Knowinglypermitsanyunlawfuluseofalicenseissuedtohimorher.


(f) Photographs, photostats, duplicates, manufactures, or in any wayreproducesanylicenseorfacsimilethereofinamannerthatitcouldbemistakenforavalidlicense,ordisplaysorhasinhisorherpossessionanysuchphotograph,photostat,duplicate,reproduction,orfacsimileunlessauthorizedbythiscode.

(g) Buysorreceivesafraudulent,forged,orcounterfeitedlicenseknowingthat it is fraudulent, forged, or counterfeited. For purposes of thissubdivision, “fraudulent” means containing any misrepresentation offact.

As used in this section, “license” includes “certificate,” “permit,”“authority,”and“registration”oranyotherindiciagivingauthorizationtoengageinabusinessorprofessionregulatedbythiscodeorreferredtoinSection1000or3600.

BPC § 4850Every person holding a license under this chapter shall conspicuouslydisplaythelicenseinhisorherprincipalplaceofbusiness.

CCR § 2087.3(a) & (b)(a) EveryCaliforniapermitholdershallwearanametaginatleast18point

type.Thename tagshall include thename that thepermitholderhasfiled with the board and the term “VACSP Number,” followed by theVACSPnumberissuedtothepermitholderbytheboard.

(b) PermitholdersneednotwearanametagiftheirVACSPisprominentlydisplayedinanareaoftheanimalhospitalsettingthatiseasilyaccessibletoallmembersofthepublicatall timesthepremise isopen.VACSPsshallnotbealteredinanymannernorshallanyinformationcontainedontheVACSPbeobscuredorobliterated.


3. Correct AddressObjective(s)

□ AddresschangemustbereportedtotheBoardwithin30days.Failuretodosocouldresultina$25.00penaltyfee.

BPC § 4852EverypersonholdingalicenseissuedunderthischapterwhochangeshisorhermailingaddressshallnotifytheBoardofhisorhernewmailingaddresswithin30daysofthechange.Theboardshallnotrenewthelicenseofanyperson who fails to comply with this section unless the person pays thepenalty fee prescribed in Section 4905. An applicant for the renewal of alicenseshallspecifyinhisorherapplicationwhetherheorshehaschangedhis or her mailing address and the board may accept that statement asevidenceofthefact.

CCR § 2004Each person holding a certificate of registration, license, permit or otherauthority issuedbytheboardshallnotifytheboardat itsprincipalofficeofanychangesofmailingaddresswithinthirty(30)daysafteranysuchchange.


4. Notice of No Staff on PremisesObjective(s)

□ Ifnopersonnelwillbeonthepremisesduringanytimewhenanimalpatientsarehousedorleftatthepremises,NOTICEshallbegiventoclientpriortoinitiatingtreatment.

□ Aconspicuouslypostedsignmayserveasnoticetoclients.Conspicuouspostingareasinclude,butarenotlimitedto,thelobbyandreceptionarea.


f Examplesignage:“Theremaybetimeswhennopersonnelareonthepremises.”

f Noticeofnostaffonpremisesnotedonadmittanceform.

f Noticeofnostaffonpremisesnotedonestimate/receipts.

CCR § 2030(d)(3)(d) If animals arehousedor retained for treatment, the followingshall be

provided:

(3) Iftherearetobenopersonnelonthepremisesduringanytimeananimalisleftattheveterinaryfacility,priornoticeofthisfactshallbegiventotheclient.Forpurposesofthisparagraph,priornoticemaybeaccomplishedbypostingasigninaplaceandmannerconspicuoustotheclientsofthepremises,statingthattheremaybetimeswhenthereisnopersonnelonthepremises.



FaCIlItIes

5. General Sanitary ConditionsObjective(s)

□ Practiceinstrumentskeptcleanandsanitaryatalltimes.

□ Practiceapparatuskeptcleanandsanitaryatalltimes.

□ Practiceapparelkeptcleanandsanitaryatalltimes.

□ Premisesmustbekeptcleanandsanitary.


f Shelvesandcountertopsarecleantothetouch.

f Trashcansareemptiedonaregularbasis.

f Floorsaremopped/scrubbedregularly.

f Maintainacleaningschedule.

BPC § 4854All premises where veterinary medicine, veterinary dentistry, or veterinarysurgeryisbeingpracticed,andallinstruments,apparatusandapparelusedinconnectionwiththosepractices,shallbekeptcleanandsanitaryatalltimes,andshallconformtothoseminimumstandardsestablishedbytheBoard.

CCR § 2030“Allfixedpremiseswhereveterinarymedicineanditsvariousbranchesarebeingpracticed,andallinstruments,apparatusandapparelusedinconnectionwiththosepractices,shallbekeptcleanandsanitaryatall timesandshallconformtoorpossessthefollowingminimumstandards…”


6. Temperature and VentilationObjective(s)

□ Temperatureandventilationshallbemaintainedtoassurethecomfortofallpatients.

CCR § 2030(f)(2)(f) Theveterinarypremisesshallmeetthefollowingstandards:

(2) Thefacility,itstemperature,andventilationshallbemaintainedsoastoassurethecomfortofallpatients.

7. LightingObjective(s)

□ Indoorlightingforhalls,wards,receptionareas,examinationandsurgicalroomsshallbeadequateandfunctional.

CCR § 2030(a)(a) Indoorlightingforhalls,wards,receptionareas,examiningandsurgical

roomsshallbeadequatefortheirintendedpurpose.

8. Reception/OfficeObjective(s)

□ Thepremiseshasareceptionroomandoffice.Acombinationofthetwoisacceptable.

CCR § 2030(b)Allfixedpremiseswhereveterinarymedicineand its variousbranchesarebeingpracticed,andallinstruments,apparatusandapparelusedinconnectionwiththosepractices,shallbekeptcleanandsanitaryatall timesandshallconformtoorpossessthefollowingminimumstandards:

(b) Areceptionroomandoffice,oracombinationofthetwo.


9. Exam RoomsObjective(s)

□ Examroomsseparatefromotherareasofthefacility.

□ Examroomsareofsufficientsizetoaccommodatetheveterinarian,anassistant,thepatient,andclient.

CCR § 2030(c)Allfixedpremiseswhereveterinarymedicineand its variousbranchesarebeingpracticed,andallinstruments,apparatusandapparelusedinconnectionwiththosepractices,shallbekeptcleanandsanitaryatall timesandshallconformtoorpossessthefollowingminimumstandards:

(c) An examination room separate from other areas of the facility and ofsufficientsizetoaccommodatethedoctor,assistant,patientandclient.

10. Food and BeverageObjective(s)

□ Alldrugsandbiologicalsshallbemaintained,administered,dispensed,andprescribedincompliancewithstateandfederallaws.

□ Nohumanfoodorbeveragesshallbestorednearanydrugsorbiologicals.

□ Humanfoodorbeveragesarestoredandconsumedindesignatedareasonly;awayfromanimalandlaboratoryareas.


f Nohumanfoodorbeverageslocatedinrefrigerators,treatmentareas,pharmacy,orlaboratory.

f Separaterefrigeratorsforhumanfoodmustbemarked.


(6) All drugs and biologicals shall be maintained, administered,dispensed,andprescribedincompliancewithstateandfederallaws.


Title 8, CCR § 3368 (a) and (b)(a) Application.ThisSectionshallapplyonlywhereemployeesarepermitted

toconsumefoodorbeverages,orboth,onthepremises.

(b) ProhibitedAreas.Foodandbeveragesshallnotbestoredorconsumedinatoiletroomorinanareawheretheymaybecontaminatedbyanytoxicmaterial.

11. Fire PrecautionsObjective(s)

□ MeetrequirementsoflocalandStatefirepreventioncodes.


f FireextinguishersareinspectedandincompliancewithlocalState,andfirepreventioncodes.


(1) FireprecautionsshallmeettherequirementsoflocalandStatefirepreventioncodes.

Title 8, CCR § 6151(c)(1)(c) GeneralRequirements.

(1) The employer shall provide portable fire extinguishers and shallmount,locateandidentifythemsothattheyarereadilyaccessibletoemployeeswithoutsubjectingtheemployeestopossibleinjury.

Title 8, CCR § 6151(e)(3)(e)Inspection,MaintenanceandTesting.

(3) Portablefireextinguishersshallbesubjectedtoanannualmaintenancecheck. Stored pressure extinguishers do not require an internalexamination.Theemployershallrecordtheannualmaintenancedateandretainthisrecordforoneyearafterthelastentryorthelifeoftheshell,whicheverisless.TherecordshallbeavailabletotheChiefuponrequest.


12. Oxygen EquipmentObjective(s)

□ Provideforthedeliveryofoxygeninemergencysituations.


f Ambubag.

f Resuscitationbag.

f Oxygenviaanestheticmachine.


(11)Theveterinarypremisesshallhaveequipmenttodeliveroxygen inemergencysituations.

13. Emergency Drugs and EquipmentObjective(s)

□ Regularlymaintainedemergencydrugsandequipmentshallbereadilyavailable.


(12)Appropriatedrugsandequipmentshallbereadilyavailabletotreatananimalemergency.

14. Laboratory ServicesObjective(s)

□ Clinicalpathologyandhistopathologydiagnosticlaboratoryservicesshallbeavailableonpremisesoroutsideserviceswillsuffice.



(5) Clinicalpathologyandhistopathologydiagnosticlaboratoryservicesshallbeavailablewithintheveterinarypremisesorthroughoutsideservices.

15. X-rayObjective(s)

□ MeetrequirementsforCaliforniaCodeofRegulations,Title17.


f Nohumanbodypartsarevisibleintheradiographordigitalimage.

f Radiographsdemonstratepropercollimation.

f Radiographequipmentmustberegisteredwiththestate(andlocalagenciesasnecessary)andcheckedregularlyanddocumented.Documentationmustbeavailableforinspection.

f Equipment,gloves,andapronsareusedandregularlymonitoredfortears/holes.

f Allstaffallowedtotakeradiographshavepersonalmonitoringbadges.

f Propersignagepostingoutsideradiographarea(atentrance-notinside).

f Requiredsignagedisplayedinallareaswithfixedradiographicequipmenttoincludefixed(wallmounted)dentalradiographicequipmentas:

1. “CAUTIONX-RAYAREA.”

2. PostingofTitle17orthelocationofTitle17regulationinthex-rayarea.

3. California Department of Public Health Form RH-2364, “Notice toEmployees.”


(4) Theveterinarypremisesshallhavethecapacitytorenderdiagnosticradiological services, either on the premises or through othercommercial facilities.Radiological procedures shall be conducted inaccordancewithHealthandSafetyCodestandards.


Title 17, CCR § 30255(b)(2)(b) Eachusershall:

(2) Conspicuously post a current copy of this regulation, a copy ofapplicablelicensesforradioactivematerial,andacopyofoperatingand emergency procedures applicable to work with sources ofradiation.Ifpostingofdocumentsspecifiedinthisparagraphisnotpracticabletheusermaypostanoticewhichdescribethedocumentsandstateswhereitmaybeexamined.

16. X-ray IdentificationObjective(s)

□ Radiographanddigitalimagesshallincludehospitalorveterinarian’sname,clientname,patientname,andthedateradiographwastaken.

□ Allexposedradiographsanddigitalimages,exceptforintraoralradiographs,shallhavelegible,permanentidentificationincorporatedintotheradiographatthetimeofprocessing.


f Identificationforradiographsmustbeembeddedintheradiographand,fordigitalimages,mustbeattachedtothefile.

f Thehospitalinspectormayreviewradiographsordigitalimagesselectedatrandomforverification.

CCR § 2032.3(c)(2)(c)(2)Radiographsanddigitalimages,exceptforintraoralradiographs,shall

haveapermanent identification legiblyexposed in the radiographorattachedtothedigitalfile,whichshallincludethefollowing:

(A) Thehospitalorclinicnameand/ortheveterinarian’sname,

(B) Clientidentification,

(C) Patientidentification,and

(D) Thedatetheradiographwastaken.


17. X-ray Safety Training for Unregistered AssistantsObjective(s)

□ Unlicensedstaffwhoareallowedtotakex-raysmustcompletex-raysafetytraining.TheRadiationSafetyExaminationinthePracticeActmaybeusedtomeetthisrequirement.

□ Alltrainingdocumentationismaintainedandavailableforinspection.

BPC § 4840.7(a) Aregisteredveterinarytechnicianwhohasbeenexaminedbytheboard

intheareaofradiationsafetyandtechniquesmayoperateradiographicequipmentundertheindirectsupervisionofalicensedveterinarian.

(b)(1)Aveterinaryassistantwhohasbeentrainedintheareaofradiationsafetyandtechniquesmayoperateradiographicequipmentunderthedirect supervision of a registered veterinary technician or a licensedveterinarian.

(2)The responsible managing licensee of a veterinary premises shallmaintainrecordsofthetrainingdescribedinparagraph(1).Aveterinaryassistantforwhomrecordsofthistrainingdonotexistshallnotoperateradiographicequipment.

(3)Thetrainingrecordsdescribedinparagraph(2)shallbemadeavailableto the board upon request and at the time of any inspection of theveterinarypremises.

18. Waste DisposalObjective(s)

□ DisposalofhazardouswastematerialsshallcomplywithallapplicableState,Federalandlocallawsandregulations.


f Maintainacontractwithanapprovedwastecontrolservicetodisposeofhazardouswaste.

f Appropriatelysizedsharpscontainersareavailableandmaintainedthroughoutthepremises.



(3) Thedisposalofwastematerialshallcomplywithallapplicablestate,federalandlocallawsandregulations.

19. Disposal of AnimalsObjective(s)

□ Sanitarymethodsforthedisposalofdeceasedanimalpatientsisprovidedandmaintained.

□ Maintainnameofdisposalserviceonfile.

□ Wheretheclientofadeceasedpatienthasnotgivenauthorizationtodisposeofhisorheranimal,thecarcassmustberetainedinafreezerforatleast14days.


(7) Sanitary methods for the disposal of deceased animals shall beprovidedandmaintained.

CCR § 2030.1(b)(b) Whentheclienthasnotgiventheveterinarianauthorizationtodisposeof

hisorherdeceasedanimal,theveterinarianshallberequiredtoretainthecarcassinafreezerforatleast14dayspriortodisposal.

20. FreezerObjective(s)

□ Maintainaworkingfreezerofsufficientsizeforstorageofdeceasedanimalsorhaveaccesstosuchequipment.

CCR § 2030.1(b)(b) Whentheclienthasnotgiventheveterinarianauthorizationtodisposeof

hisorherdeceasedanimal,theveterinarianshallberequiredtoretainthecarcassinafreezerforatleast14dayspriortodisposal.


21. CompartmentsObjective(s)

□ Maintaincleanlinessandsanitationofcompartmentshousinganimals.


f Preventcross-contaminationthrougheffectiveseparationofanimalsandtheirwasteproducts.

f Surfacesaresolidandnon-porous.


provided:

(1) Compartments for animals which are maintained in a comfortableandsanitarymanner.

22. Exercise RunsObjective(s)

□ Maintaincleanlinessandsanitationofexerciseruns.

□ Provideeffectiveseparationofanimalsandtheirwasteproducts.

□ Provideforoutdoorwalksifnoexerciserunsareavailable.


f Individualdrainsorcoveredcommondrainsiflocatedwithintheruns.

f Updateoldergates/runstopreventinjurytoanimals.

CCR § 2030.1(a)For purposes of these rules and regulations, a “small animal fixedpremises”shallmeanafixedveterinarypremiseswhichconcentratesinprovidingveterinaryservicestocommondomestichouseholdpets.

In addition to the requirements in section 2030, small animal fixedpremisesshallprovide:


(a) Whereanimalsarekeptontheveterinarypremisesfor24hoursormore,the animals shall beprovided with an opportunity for proper exercise.Compliancewith this sectionmaybeachievedby theuseofexerciserunsorbyprovidingtheanimalwiththeopportunityforoutdoorwalks.Whereapremiseshasexerciseruns,theyshallbecleanandsanitaryandprovideforeffectiveseparationofanimalsandtheirwasteproducts.

23. Contagious FacilitiesObjective(s)

□ Maintainseparationofcontagiousorsuspectedcontagiousanimalshousedatthefacilitytoavoidspreadofcontagiousdiseases.

□ Maintainproperisolationseparatefromcommonareasorhaveawrittenprotocolinplaceforshort-termisolation.


f Protocolsareinplacetopreventspreadofinfectiousdisease.


provided:

(2) Effectiveseparationofknownorsuspectedcontagiousanimals.


surGery

24. Separate SurgeryObjective(s)

□ Preventinfection.

□ Thesurgeryroomthatisusedforasepticsurgeryisseparateanddistinctfromotherroomsinthefacility.

□ Equipmentandmaterialshoused/storedinthesurgeryroomarelimitedtoitemsdirectlyrelatedtotheperformanceofasepticsurgery.


f Keepdoorsclosedatalltimes.

f Thesurgeryroomiscompletelyenclosedwithsolidwallsfloortoceilingandhasnoaccessviawindowordoortotheimmediateoutside.

f Alldoorsleadingfromtheinteriorofthefacilitytothesurgeryroomaremadeofnon-porousmaterial,areeasilycleanedandhaveagoodsealwhenclosed.

f Noopenshelvingispresentinthesurgeryroom.

f Thesurgeryroomshallnothaveafunctionalsinkwithanopendrain.

CCR § 2030(g)(1) – (5)(g) A veterinary premises which provides aseptic surgical services shall

complywiththefollowing:

(1) Aroom,separateanddistinctfromallotherroomsshallbereservedforasepticsurgicalprocedureswhichrequireasepticpreparation.Aveterinarian may perform emergency aseptic surgical proceduresin another roomwhen the roomdesignated for aseptic surgery isoccupiedortemporarilyunavailable.

(2) Storageinthesurgeryroomshallbelimitedtoitemsandequipmentnormallyrelatedtoasepticsurgeryorsurgicalprocedures.Equipmentnotnormallyrelatedtosurgeryandsurgicalprocedureincludes,butisnotlimitedto,equipmentusedfordentalprophylaxis,autoclavesandnon-surgicalradiographicequipment.


(3) Openshelvingisprohibitedinthesurgicalroom.

(4) Thesurgery roomshallnotcontaina functionalsinkwithanopendrain.

(5) The doors into the surgery room must be able to be fully closed,fill theentiredoorspacebemadeofnon-porousmaterial andnotprovideaccessfromoutsidethehospital.Incaseswherethesizeoftheanimalpreventsentrytothehospitalviaaregularly-sizeddoor,doors foroutsideaccessarepermittedas longas suchdoors areabletobefullyclosed,filltheentiredoorspaceandbemadeofnon-porousmaterial.

25. Surgery Lighting/X-ray/EmergencyObjective(s)

□ Thesurgeryroomiswell-lighted.

□ Thesurgeryroomhasequipmentforviewingradiographsinsurgeryroomappropriateforsituation(lightbox,tablet,laptop,etc.).

□ Surgeryroommusthaveeffectiveemergencylighting.


f Maintainfunctional,emergencylightingandemergencybackupbattery-operatedlightingsufficienttoilluminatesurgicalfield.

CCR § 2030(g)(6)(g) A veterinary premises which provides aseptic surgical services shall


(6) The surgery room shall be well-lighted, shall have equipment forreviewing radiographs and shall have effective emergency lightingwithaviablepowersource.


26. Surgery Floors, Tables and CountertopObjective(s)

□ Thefloors,tabletops,andcountertopsofthesurgeryroomshallbeofanon-porousmaterialsuitableforregulardisinfectingandcleaning,andaredisinfectedregularly.

CCR § 2030(g)(7)(g) A veterinary premises which provides aseptic surgical services shall


(7) Thefloors, table tops,andcounter topsof thesurgery roomshallbe of a non-porous material suitable for regular disinfecting, andcleaning,andshallbecleanedanddisinfectedregularly.

27. Endotracheal TubesObjective(s)

□ Endotrachealtubesinavarietyofsizesmustbereadilyavailableonthepremisesandmustbeproperlymaintained.


f Endotrachealtubesarekeptcleanandstoredinasanitarymanner.

CCR § 2032.4(b)(5)Seebelow.

28. Resuscitation BagsObjective(s)

□ Resuscitationorrebreathingbags(bothofvarioussizes)mustbecleanandregularlymaintained.


f Functional,clean,re-breathingbagsarereadilyavailableinappropriatesizes.


CCR § 2032.4(b)(5)(b) Whenadministeringgeneralanesthesia,aveterinarianshallcomplywith

thefollowingstandards:

(5) When administering general anesthesia in a hospital setting, aveterinarianshallhaveresuscitationorrebreathingbagsofappropriatevolumes for theanimalpatientandanassortmentofendotrachealtubesreadilyavailable.

29. Anesthetic EquipmentObjective(s)

□ Anestheticequipmentisfunctionalandavailableatalltimes.


f Maintainanestheticequipmentaccordingtomanufacturer’sspecifications/recommendations:• Inspect,cleanandmaintainhoses• Calibratevaporizer• CO2absorbentdatedandchangedasappropriate• Monitorandchangescavengingcanistersasappropriate• Methodofwasteanestheticgasscavenging


(10)Anestheticequipmentinaccordancewiththeproceduresperformedshall be maintained in proper working condition and available at alltimes.

30. Anesthetic MonitoringObjective(s)

□ Provideforamethodofrespiratorymonitoringduringgeneralanesthesiaofanimal.

□ Provideforamethodofcardiacmonitoringduringgeneralanesthesiaofanimal.



f Respiratorymonitoringcouldincludearebreathingbagorrespirometer.

f Cardiacmonitoringcouldincludeastethoscopeorelectrocardiographicmonitor.

CCR § 2032.4(b)(3) & (4)(b) Whenadministeringgeneralanesthesia,aveterinarianshallcomplywith


(3) Providerespiratorymonitoringincluding,butnotlimitedto,observationoftheanimal’schestmovements,observationoftherebreathingbag,orrespirometer.

(4) Providecardiacmonitoringincluding,butnotlimitedto,theuseofastethoscope,pulseoximeterorelectrocardiographicmonitor.

31. Surgical Packs and Sterile IndicatorsObjective(s)

□ Useseparatesterilesurgicalpack,foreachanimal.

□ Useofindicatortoassuresurgicalpackissterile.


f In-packmonitorstoverifypropersterilization(intheinteriorofthepack).

f Surgicalpacksaredatedandhandledinawaytomaintainsterility.

CCR § 2030(g)(9) & (10)(g) A veterinary premises which provides aseptic surgical services shall


(9) Inanysterileprocedure,aseparatesterilepackshallbeusedforeachanimal.

(10)Allinstruments,packsandequipmentthathavebeensterilizedshallhaveanindicatorthatreactstoandverifiessterilization.


32. Sterilization of EquipmentObjective(s)

□ Practiceinstrumentskeptcleanandsanitary.

□ Practiceinstrumentssterilizedinamannerappropriateforthetypeofsurgerybeingperformed.


f Effectivesterilizationisappropriateforitemsbeingsterilized.

f Equipmentisstoredandhandledinawaytomaintainsterility.

f Surgicalpacksindicatesterilizationdate.

f Appropriatebarriermaterialusedinsurgicalpacks.

CCR § 2030(f)(8) and (g)(8)(B)(f) Theveterinarypremisesshallmeetthefollowingstandards:

(8) Veterinarymedicalequipmentused toperformasepticproceduresshallbesterilizedandmaintainedinasterilecondition.

(g) A veterinary premises which provides aseptic surgical services shallcomplywiththefollowing:

(8) Surgicalinstrumentsandequipmentshallbe:

(B) Sterilizedas requiredby thesurgicalprocedureperformedandinstrumentsused.

33. Sanitary AttireObjective(s)

□ Propersurgicalattireforthesurgeon,assistant,andancillarypersonnelisrequired.

□ Propersurgicalattireforthesurgicalteamhandlinginstrumentsshallconsistofsanitarycap,sanitarymask,sterilizedsurgicalgownwithlongsleeves,andsterilizedglovescompletelycoveringhair,mouth,nose,andanyfacialhairexceptforeyebrowsandeyelashes.

□ Duringasepticsurgicalprocedures,surgicalassistantsorpersonnelinproximityoftheproceduremustwearacapandmask.


CCR § 2030(g)(11) and (h)(g) A veterinary premises which provides aseptic surgical services shall


(11) Thefollowingattireshallberequiredforasepticsurgery:

(A) Eachmemberof thesurgical teamshallputonanappropriatesanitary cap and sanitary mask which covers his or her hairand mouth, nose and any facial hair, except for eyebrows oreyelashes.Allmembersofthesurgicalteamwhowillbehandlingtheinstrumentsortouchingthesurgicalsiteshallwearsterilizedsurgicalgownswithlongsleevesandsterilizedgloves.

(B) Ancillarypersonnelinthesurgeryroomshallwearcleanclothing,footwear,sanitarycapandmask.

(h) When performing clean surgery, the instruments used to performsuchsurgeryshallhavebeensterilizedandthesurgeon(s)andancillarypersonnelshallwearcleanclothingandfootwearwhenappropriate.

Forpurposesofthissection,“cleansurgery”shallmeantheperformanceof a surgical operation for the treatment of a condition and undercircumstanceswhich,consistentwiththestandardsofgoodveterinarymedicine,donotwarranttheuseofasepticsurgicalprocedures.



danGerousdruGs/ControlledsubstanCes

34. Expired DrugsObjective(s)

□ Expireddrugsarenottobepurchased,sold,ortradedandaredisposedofthroughappropriatemethods.

□ Expiredcontrolleddrugsarenotallowedtobetransferredotherthanthroughreversedistributionforcontrolleddrugs.


f Regularinspectionsanddisposalofexpireddrugsarerequired.Specialattentionshouldbepaidtocrashcartsandemergencykits.


(6) All drugs and biologicals shall be maintained, administered,dispensed,andprescribedincompliancewithstateandfederallaws.

BPC § 4169(a)(4)(a) Apersonorentityshallnotdoanyofthefollowing:

(4) Purchase, trade, sell, or transfer dangerous drugs or dangerousdevicesafterthebeyondusedateonthelabel.

BPC § 4342(a) The board may institute any action or actions as may be provided by

law and that, in its discretion, are necessary, to prevent the sale, ofpharmaceutical preparations and drugs that do not conform to thestandard and tests as to quality and strength, provided in the latesteditionoftheUnitedStatesPharmacopoeiaortheNationalFormulary,orthatviolateanyprovisionoftheShermanFood,DrugandCosmeticLaw(Part5(commencingwithsection109875)ofDivision104oftheHealthandSafetyCode).

(b) Any knowing or willful violation of any regulation adopted pursuant toSection4006shallbesubjecttopunishmentinthesamemannerasisprovidedinSections4321and4336.

AndrefertoHealthandSafetyCode§§111330–111510.


35. Drug Security ControlsObjective(s)

□ Thefacilityprovideseffectivecontrolsandprocedurestoguardagainsttheftanddiversionofcontrolledsubstances.

□ Thefacilitystoresallcontrolledsubstancesinasecurelylocked,substantiallyconstructedcabinet.

Code of Federal Regulations (CFR) § 1301.75(a) Controlledsubstances listed inScheduleIshallbestored inasecurely

locked,substantiallyconstructedcabinet.

(b) ControlledsubstanceslistedinScheduleII,III,IV,andVshallbestoredinasecurelylocked,substantiallyconstructedcabinet.However,pharmaciesandinstitutionalpractitionersmaydispersesuchsubstancesthroughoutthestockofnoncontrolledsubstances insuchamannerastoobstructthetheftordiversionofthecontrolledsubstances.

(c) This section shall also apply to nonpractioners authorized to conductresearchorchemicalanalysisunderanotherregistration.

(d) CarfentaniletorphinehydrochlorideanddiprenorphineshallbestoredinasafeorsteelcabinetequivalenttoaU.S.GovernmentClassVsecuritycontainer.

36. Drug LogsObjective(s)

□ Thefacility/DrugEnforcementAdministration(DEA)licenseholdermaintainspurchasingandreceivingrecordsconsistentwithrequirementsinlaw.

□ Thefacility/DEAlicenseholdermaintainsdispensingandadministrationrecordswithrequiredinformationforeachcontrolledsubstance.


f Maintainphysicalorelectroniclogswithrequiredinformation:• seeControlledDrugDispensationLogSampleat

www.vmb.ca.gov/laws_regs/drug_log.pdf• seeBiennialControlledDrugInventorySampleat

www.vmb.ca.gov/laws_regs/drug_inv.pdf


CFR § 1304.22 (a)(2), (c)Eachpersonregisteredorauthorized(by§1301.13(e)or§§1307.11-1307.13ofthischapter)tomanufacture,distribute,dispense,import,exportreversedistribute,destroy,conduct researchwithcontrolledsubstances,orcollectcontrolledsubstances fromultimateusers, shallmaintain recordswith theinformationlistedinparagraphs(a)through(f)ofthissection.

(a)(2)Foreachcontrolledsubstanceinfinishedform,

(i) Thenameofthesubstance;

(ii) Each finished form (e.g., 10-milligram tablet or 10-milligramconcentration per fluid ounce or millimeter) and the number ofunits or volume of finished form in each commercial container(e.g.,100-tabletbottleor3-milimetervial);

(iv) The number of units of finished forms and/or commercialcontainersacquiredfromotherpersons,includingthedateofandnumberofunitsand/orcommercialcontainersineachacquisitiontoinventoryandthename,address,andregistrationnumberofthepersonfromwhomtheunitswereacquired;

(vii)Thenumberofcommercialcontainersdistributedtootherpersons,includingthedateofandnumberofcontainersineachreductionfrominventory,andthename,address,andregistrationnumberofthepersontowhomthecontainersweredistributed;

(ix) The number of units of finished forms and/or commercialcontainers distributed or disposed of in any other manner bythe registrant (e.g.,bydistributionof complimentarysamplesorbydestruction), including thedateandmannerofdistributionordisposal,thename,address,andregistrationnumberofthepersontowhomdistributed,andthequantityinfinishedformdistributedordisposed.

(c) Records for dispensers and researchers. Each person registered orauthorizedtodispenseorconductresearchwithcontrolledsubstancesshallmaintainrecordswiththesameinformationrequiredofmanufacturerspursuanttoparagraph(a)(2)(i),(ii),(iv),(vii),and(ix)ofthissection.Inaddition,recordsshallbemaintainedofthenumberofunitsorvolumeofsuchfinishedformdispensed,includingthenameandaddressofthepersontowhomitwasdispensed,thedateofdispensing,thenumberofunitsorvolumedispensed,and thewrittenor typewrittennameorinitialsoftheindividualwhodispensedoradministeredthesubstanceonbehalfofthedispenser.Inadditiontotherequirementsofthisparagraph,practitionersdispensinggamma-hydroxybutyricacidunderaprescriptionmustalsocomplywithsection1304.26.


37. Veterinary Assistant Controlled Substance PermitObjective(s)

□ VeterinaryassistantswhohaveaccesstocontrolledsubstancesmustholdaVeterinaryAssistantControlledSubstancePermit(VACSP).

□ Restrictaccesstocontrolledsubstancesfromanypersonwhohasadrugoralcoholrelatedfelonyconviction.

□ Complywithlicenseemanagerrequirementsrelatingtosupervisionofpermitholder.


f Originalpermitisprominentlydisplayedinreception/lobbyarea.

Or

f VACSPpermitholderwearsabadgedisplayingrequiredinformation.

f SubmittotheBoardanapplicationandsignedacknowledgmentthatlicenseemanagerhasreadandagreestocomplywiththelawsregardingsupervisionofpermitholder.

BPC § 4836.1(b)(1) & (2)(b) Aveterinaryassistantmayobtainoradministeracontrolledsubstance

pursuant to the order, control, and full professional responsibility ofa licensed veterinarian, only if he or she meets both of the followingconditions:

(1) Is designated by a licensed veterinarian to obtain or administercontrolledsubstances.

(2) HoldsavalidveterinaryassistantcontrolledsubstancepermitissuedpursuanttoSection4836.2.

CCR § 2087.1 (a) & (b)(a) Once a permit holder is authorized to obtain or administer controlled

substances in an animal hospital setting, the licensee manager shallsubmitonanapplicationprovidedbytheboard.

(b) Thelicenseemanagershallsubmitasignedacknowledgmentthatheorshehasreadandagreestocomplywiththeprovisionsofthelawsandregulationsrelatingtothesupervisionofthepermitholder,asdefinedin


section2035,onaformprovidedbytheboard.ThepermitholdershallnotobtainoradministercontrolledsubstancesuntilsuchtimethePermitHolder / Licensee Manager Agreement form has been submitted andapprovedbytheboard.

CCR § 2087.3(a) & (b)(a) EveryCaliforniapermitholdershallwearanametaginatleast18point

type.Thename tagshall include thename that thepermitholderhasfiled with the board and the term “VACSP Number,” followed by theVACSPnumberissuedtothepermitholderbytheboard.

(b) PermitholdersneednotwearanametagiftheirVACSPisprominentlydisplayedinanareaoftheanimalhospitalsettingthatiseasilyaccessibletoallmembersofthepublicatall timesthepremise isopen.VACSPsshallnotbealteredinanymannernorshallanyinformationcontainedontheVACSPbeobscuredorobliterated.

38. Controlled Substance Utilization and Review System (CURES) Reporting Objective(s)

□ AllcontrolledsubstancesthataredispensedarereportedtotheDepartmentofJusticethroughControlledSubstanceUtilizationReviewandEvaluationSystem.


f Aveterinarianwhoprescribes,dispenses,oradministersanycontrolledsubstancemustregisterwithCURESandmustreportweeklyifdispensingcontrolledsubstances.

Health and Safety Code § 11165(a) & (d) (a) Toassisthealthcarepractitioners intheireffortstoensureappropriate

prescribing, ordering, administering, furnishing, and dispensing ofcontrolled substances, law enforcement and regulatory agencies intheireffortstocontrolthediversionandresultantabuseofScheduleII,Schedule III,andSchedule IVcontrolledsubstances,and forstatisticalanalysis, education, and research, the Department of Justice shall,contingentupontheavailabilityofadequatefunds intheCURESFund,


maintain the Controlled Substance Utilization Review and EvaluationSystem (CURES) for the electronic monitoring of, and Internet accesstoinformationregarding,theprescribinganddispensingofScheduleII,ScheduleIII,andScheduleIVcontrolledsubstancesbyallpractitionersauthorized to prescribe, order, administer, furnish, or dispense thesecontrolledsubstances.

(d) For each prescription for a Schedule II, Schedule III, or Schedule IVcontrolledsubstance,asdefinedinthecontrolledsubstancesschedulesinfederallawandregulations,specificallySections1308.12,1308.13,and1308.14,respectively,ofTitle21oftheCodeofFederalRegulations,thedispensingpharmacy,clinic,orotherdispensershallreportthefollowinginformationtotheDepartmentofJusticeassoonasreasonablypossible,butnotmore thansevendaysafter thedateacontrolledsubstance isdispensed,inaformatspecifiedbytheDepartmentofJustice:

(1) Fullname,address,and,ifavailable,telephonenumberoftheultimateuserorresearchsubject,orcontactinformationasdeterminedbytheSecretary of the United States Department of Health and HumanServices,andthegender,anddateofbirthoftheultimateuser.

(2) The prescriber’s category of licensure, license number, nationalprovideridentifier(NPI)number,ifapplicable,andfederalcontrolledsubstanceregistrationnumber,andthestatemedicallicensenumberofanyprescriberusingthefederalcontrolledsubstanceregistrationnumberofagovernment-exemptfacility.

(3) Pharmacy prescription number, license number, NPI number, andfederalcontrolledsubstanceregistrationnumber.

(4) National Drug Code (NDC) number of the controlled substancedispensed.

(5) Quantityofthecontrolledsubstancedispensed.

(6) InternationalStatisticalClassificationofDiseases,9threvision(ICD-9)or10threvision(ICD-10)Code,ifavailable.

(7) Numberofrefillsordered.

(8) Whetherthedrugwasdispensedasarefillofaprescriptionorasafirst-timerequest.

(9) Dateoforiginoftheprescription.

(10)Dateofdispensingtheprescription.


39. Current DEAObjective(s)

□ VeterinariancompliancewiththefederalControlledSubstancesActthroughDEAregistration.


f Aveterinarianwhoprescribes,dispenses,oradministersanycontrolledsubstancemustobtainDEAregistration.

CCR 2030(f)(6)(f) Theveterinarypremisesshallmeetthefollowingstandards:

(6) Alldrugsandbiologicalsshallbemaintained,administered,dispensed,andprescribedincompliancewithstateandfederallaws.

Title 21 USC 822(a)(a) Periodofregistration

(1) Every person who manufactures or distributes any controlledsubstance or list I chemical, or who proposes to engage in themanufacture or distribution of any controlled substance or list Ichemical,shallobtainannuallyaregistrationissuedbytheAttorneyGeneralinaccordancewiththerulesandregulationspromulgatedbyhim.

(2) Every person who dispenses, or who proposes to dispense, anycontrolled substance, shall obtain from the Attorney General aregistration issued in accordance with the rules and regulationspromulgated by him. The Attorney General shall, by regulation,determine the period of such registrations. In no event, however,shallsuchregistrationsbeissuedforlessthanoneyearnorformorethanthreeyears.



PraCtICeManaGeMent

40. Managing LicenseeObjective(s)

□ Ensurethatthepremisescomplieswithallapplicablelawsandregulationsgoverningthephysicalandoperationalcomponentsofapremises.

□ Ensurethatnounlicensedactivityisoccurringwithinthepremisesorinanylocationwhereanyfunctionofveterinarymedicine,veterinarysurgery,orveterinarydentistryisbeingconductedoffthepremisesundertheauspicesofthepremises.


f Maintainappropriatephysicalpresencewithinthefacilitytoensurecompliancewiththepremisesrequirements.

CCR § 2030.05 (a) ALicenseeManageristheCalifornialicensedveterinariannamedasthe

LicenseeManageronafacility’spremisespermit.

(b) TheLicenseeManagerisresponsibleforensuringthatthepremisesforwhich he/she is manager complies with the requirements in sections4853, 4854, 4855 and 4856 of the Business and Professions Code,Division2,Chapter11,Article3.TheLicenseeManager is responsibleforensuringthatthephysicalandoperationalcomponentsofapremisesmeettheminimumstandardsofpracticeassetforth insections2030through2032.5oftheCaliforniaCodeofRegulations,Title16,Division20,Article4.

(c) The Licensee Manager is responsible for ensuring that no unlicensedactivity is occurring within the premises or in any location where anyfunctionofveterinarymedicine,veterinarysurgeryorveterinarydentistryisbeingconductedoffthepremisesundertheauspicesofthispremiseslicense.

(d) The Licensee Manager shall maintain whatever physical presence isreasonablewithinthefacilitytoensurethattherequirementsin(a)–(c)aremet.

(e) Each licensed veterinarian shall be responsible for their individualviolations of the Veterinary Medicine Practice Act or any regulationadoptedthereunder.


41. Veterinary Reference LibraryObjective(s)

□ Selectionofcurrenttextbooks,referencematerials,andjournalsareaccessibleonpremises.


f Accesstosubscriptionjournals,onlinereferencematerials,textbooks,electronicreferencematerials,etc.


(9) Current veterinary reference materials shall be readily available onthepremises.

42. Record KeepingObjective(s)

□ Theresultofthephysicalexaminationandtreatmentshallbenotedintheanimalpatient’smedicalrecord.

□ Recordsaremaintainedforaminimumofthree(3)yearsaftertheanimal’slastvisit.

BPC § 4855A veterinarian subject to the provisions of this chapter shall, as requiredby regulation of the board, keep a written record of all animals receivingveterinaryservices,andprovideasummaryof that recordto theownerofanimalsreceivingveterinaryservices,whenrequested.Theminimumamountof information which shall be included in written records and summariesshallbeestablishedbytheboard.Theminimumdurationoftimeforwhichalicensedpremiseshallretainthewrittenrecordoracompletecopyofthewrittenrecordshallbedeterminedbytheboard.

CCR § 2032.3(a) Every veterinarian performing any act requiring a license pursuant to

theprovisionsofChapter11,Division2,ofthecode,uponanyanimalor


groupofanimalsshallpreparealegible,writtenorcomputergeneratedrecordconcerningtheanimaloranimalswhichshallcontainthefollowinginformation:

(1) Nameorinitialsofthepersonresponsibleforentries.

(2) Name,addressandphonenumberoftheclient.

(3) Nameoridentityoftheanimal,herdorflock.

(4) Exceptforherdsorflocks,age,sex,breed,species,andcoloroftheanimal.

(5) Dates(beginningandending)ofcustodyoftheanimal,ifapplicable.

(6) Ahistoryorpertinentinformationasitpertainstoeachanimal,herd,orflock’smedicalstatus.

(7) Data, includingthatobtainedbyinstrumentation,fromthephysicalexamination.

(8) Treatment and intended treatment plan, including medications,dosages,routeofadministration,andfrequencyofuse.

(9) Records for surgical procedures shall include a description of theprocedure,thenameofthesurgeon,thetypeofsedative/anestheticagents used, their route of administration, and their strength ifavailableinmorethanonestrength.

(10)Diagnosis or assessment prior to performing a treatment orprocedure.

(11) Ifrelevant,aprognosisoftheanimal’scondition.

(12)All medications and treatments prescribed and dispensed, includingstrength,dosage,routeofadministration,quantity,andfrequencyofuse.

(13)Dailyprogress,ifrelevant,anddispositionofthecase.

(b) Recordsshallbemaintainedforaminimumofthree(3)yearsaftertheanimal’s last visit.A summaryof an animal’smedical records shall bemadeavailabletotheclientwithinfive(5)daysorsooner,dependingiftheanimalisincriticalcondition,uponhisorherrequest.Thesummaryshallinclude:

(1) Nameandaddressofclientandanimal.

(2) Age,sex,breed,species,andcoloroftheanimal.

(3) A history or pertinent information as it pertains to each animal’smedicalstatus.

(4) Data, includingthatobtainedbyinstrumentation,fromthephysicalexamination.


(5) Treatmentandintendedtreatmentplan,includingmedications,theirdosageandfrequencyofuse.

(6) Allmedicationsandtreatmentsprescribedanddispensed,includingstrength,dosage,routeofadministration,quantity,andfrequencyofuse.

(7) Dailyprogress,ifrelevant,anddispositionofthecase.

(c) (1) Radiographs and digital images are the property of the veterinaryfacilitythatoriginallyorderedthemtobeprepared.Radiographsordigital images shall be released to another veterinarian upon therequest of another veterinarian who has the authorization of theclient.Radiographsshallbereturnedtotheveterinaryfacilitywhichoriginally ordered them to be prepared within a reasonable timeupon request. Radiographs originating at an emergency hospitalshall become thepropertyof thenext attendingveterinary facilityuponreceiptofsaidradiograph(s).Transferofradiographsshallbedocumentedinthemedicalrecord.

(2) Radiographanddigitalimages,exceptforintraoralradiographs,shallhaveapermanentidentificationlegiblyexposedintheradiographorattachedtothedigitalfile,whichshallincludethefollowing:

(A) Thehospitalorclinicnameand/ortheveterinarian’sname,

(B) Clientidentification,

(C) Patientidentification,and

(D) Thedatetheradiographwastaken.

(3) Non-digital intraoral radiographs shall be inserted into sleevecontainersandincludeinformationinsubdivision(c)(2)(A)- (D).Digitalimagesshallhaveidentificationcriterialistedinsubdivision(c)(2)(A)-(D)attachedtothedigitalfile.

(d) Laboratorydataisthepropertyoftheveterinaryfacilitywhichoriginallyorderedittobeprepared,andacopyshallbereleasedupontherequestoftheclient.


(e) The client shall be provided with a legible copy of the medical recordwhen the patient is released following emergency clinic service. Theminimuminformationincludedinthemedicalrecordshallconsistofthefollowing:

(1) Physicalexaminationfindings.

(2) Dosagesandtimeofadministrationofmedications.

(3) Copiesofdiagnosticdataorprocedures.

(4) Allradiographsanddigitalimages,forwhichthefacilityshallobtainasignedreleasewhentransferred.

(5) Surgicalsummary.

(6) Tentativediagnosisandprognosis,ifknown.

(7) Anyfollow-upinstructions.

CCR 2032.4(b)(1), (6)(a) Whenadministeringgeneralanesthesia,aveterinarianshallcomplywith


(1) Within twelve (12) hours prior to the administration of a generalanesthetic,theanimalpatientshallbegivenaphysicalexaminationbyalicensedveterinarianappropriatefortheprocedure.Theresultofthephysicalexaminationshallbedocumentedintheanimalpatient’smedicalrecords.

(6) Recordsforproceduresinvolvinggeneralanesthesiashallincludeadescriptionoftheprocedure,thenameofthesurgeon,thetypeofsedativeand/oranestheticagentsused,theirrouteofadministration,andtheirstrengthifavailableinmorethanonestrength.


sMallanIMalMobIleClInIC

43. Hot and Cold Water

44. 110-Volt Power

45. Collection Tank for Waste

46. Floors, Tabletops and Counter TopsObjective(s)

□ Maintainhotandcoldwater.

□ Maintain110-voltpowersourcefordiagnosticequipment.

□ Maintaincollectiontankforwastematerial.

□ Maintainfloors,tabletopsandcountertopscleananddisinfected.

CCR § 2030.2(a)(1) – (3) and (5) For purposes of these regulations, a “small animal mobile clinic” shallmean a trailer or mobile facility established to function as a veterinarypremiseswhichconcentratesinprovidingveterinaryservicestocommondomestichouseholdpetsandisrequiredbysection4853ofthecodetoberegisteredwiththeboard.(a) Asmallanimalmobileclinicshallhave:

(1) Hotandcoldwater.

(2) A110-voltpowersourcefordiagnosticequipment.

(3) Acollectiontankfordisposalofwastematerial.

(5) Floors,tabletops,andcountertopsshallbeofanon-porousmaterialsuitableforregulardisinfecting,andcleaning,andshallbecleanedanddisinfectedregularly.


NOTE:Inadditiontotheaboveminimumstandards,smallanimalmobileclinicsshallcomplywiththeminimumstandardssetforthinCCR§§2030(f)(6)and2030.2,includingthefollowingitemsasapplicable:

1. AfterHoursReferral

2. License/PermitDisplayed

3. CorrectAddress

5. GeneralSanitaryConditions

6. TemperatureandVentilation

7. Lighting

9. ExamRooms

10. FoodandBeverage

11. FirePrecautions

12. OxygenEquipment

13. EmergencyDrugsandEquipment

14. LaboratoryServices

15–17. X-RayStandards

18. WasteDisposal

19. DisposalofAnimals

20. Freezer/CarcassStorage

21. Compartments

24–33. SurgeryStandards

34–39.DrugStandards

40–42.PracticeManagementStandards


sMallanIMalVaCCInatIonClInIC

47. Veterinarian on Site

48. Adequate Equipment

49. Fresh Clean Water

50. List of Emergency ServicesObjective(s)

□ Licensedveterinarianisonsite.

□ Maintainadequateequipment.

□ Maintaincleanwater.

□ Providecontactinformationoflocalemergencyservices.

CCR § 2030.3(a), (b), (g), (h) and (j)(a) Theterm“smallanimalvaccinationclinic”shallmeanaprivatelyorpublicly

supportedvaccinationclinicwhereaveterinarianperformsvaccinationsand/or immunizations against disease on multiple animals, and wheretheveterinarianmayalsoperformpreventativeproceduresforparasiticcontrol.

(b) Aveterinarianmustremainonsitethroughoutthedurationofavaccinationclinic and must maintain responsibility for all medical decisions made.The veterinarian is responsible for proper immunization and parasiticprocedures and the completeness of recommendations made to thepublic by theparaprofessional staff that the veterinarian supervisesoremploys.Theveterinarianisresponsibleforconsultationandreferralofclientswhendiseaseisdetectedorsuspected.

(g) Equipmentshallbeofthetypeandqualitytoprovideforthedeliveryofvaccines and parasiticides in the best interest of the patient and withsafetytothepublic.


(h) Fresh,cleanwatershallbeavailableforsanitizingandfirstaid.Disposabletowelsandsoapshallbereadilyavailable.

(j) Thevaccinationclinicshallprovidealegiblelistofthename,address,andhours of operation of all facilities that provide or advertise emergencyservicesand,whenapplicable,the locationofotherclinicsprovidedbythesameentityonthatday,thatarelocatedwithina30-minuteor30-mileradius.

NOTE:In addition to the above minimum standards, small animal vaccinationclinics shall comply with the minimum standards set forth in CCR§§2030(f)(6)and2030.3,includingthefollowingitemsasapplicable:

2. License/PermitDisplayed

3. CorrectAddress

5. GeneralSanitaryConditions

7. Lighting

10. FoodandBeverage

11. FirePrecautions

13. EmergencyDrugsandEquipment

18. WasteDisposal

26. Floors,TabletopsandCountertops

34. ExpiredDrugs

42. RecordKeeping


aPPendIx

BPC §4809.5 states, in part, “The Board may at any time inspect the premises in which veterinarymedicine,veterinarydentistry,orveterinarysurgeryisbeingpracticed.”

TheBoardisrequiredtoinspect,andtheveterinarianisrequiredtoallowanunannounced inspection,pursuant toBPC§4809.7,whichprovidesthat “The board shall establish a regular inspection program that willprovideforrandom,unannounced inspections.”An inspector isallowedto perform an unannounced inspection whether or not the managinglicenseeispresent.

TheveterinarianisalsorequiredtoallowanunannouncedinspectionbytheBoardpursuanttoBPC§4856asfollows:“(a)Allrecordsrequiredbylawtobekeptbyaveterinariansubjecttothischapter,including,butnotlimitedto,recordspertainingtodiagnosisandtreatmentofanimalsandrecordspertainingtodrugsordevicesforuseonanimals,shallbeopento inspection by the board, or its authorized representatives, during aninspectionaspartofaregularinspectionprogrambytheboard,orduringan investigation initiated in response toacomplaint thata licenseehasviolatedanylaworregulationthatconstitutesgroundsfordisciplinaryactionbytheboard.Acopyofallthoserecordsshallbeprovidedtotheboardimmediatelyuponrequest.(b)Equipmentanddrugsonthepremises,oranyotherplace,whereveterinarymedicine,veterinarydentistry,veterinarysurgery,orthevariousbranchesthereofisbeingpracticed,orotherwiseinthepossessionofaveterinarianforpurposesofthatpractice,shallbeopentoinspectionbytheboard,oritsauthorizedrepresentatives,duringan inspection as part of a regular inspection program by the board, orduringaninvestigationinitiatedinresponsetoacomplaintthatalicenseehasviolatedanylaworregulationthatconstitutesgroundsfordisciplinaryactionbytheboard.”

SpecificareasrequiringinspectionbytheBoardareoutlinedinCCR§2030:“Allfixedpremiseswhereveterinarymedicineand itsvariousbranchesarebeingpracticed,andall instruments, apparatusandapparelused inconnection with those practices, shall be kept clean and sanitary at alltimesandshallconformtoorpossessthefollowingminimumstandards.”


16_24611/16(Rev07/17)

Responsibilities of Veterinarians and Registered Veterinary TechniciansAll licensed veterinarians and registered veterinary technicians areresponsibleforknowingthelawsgoverningtheirrespectiveprofessions.ThisincludesalllawsintheCaliforniaVeterinaryMedicinePracticeActandallrelatedlawsregulatingdrugs,radiologicinstallations,safetyissues(Cal/OSHA),etc.Thefacility’sManagingLicensee(premisespermitholder)isultimatelyresponsibleforoverseeingandensuringthatalltheselawsarebeingmet.This responsibility isoutlined inBPC§4853, registrationofplaceofpractice.

AllaspectsofmedicalcareforpatientsareunderthecontrolofaveterinarianlicensedbythestateofCalifornia.TheveterinarianmaydelegatesomeanimalhealthcaretaskstolicensedregisteredveterinarytechniciansasspecifiedbyCalifornia law.Theveterinarianmayalsodelegate tasks tounlicensedassistants,butunlicensedassistantsmaynotperformtasksrestrictedtolicensedregisteredveterinarytechnicians.

TheprimarylawsregulatinganimalhealthcaretaskscanbefoundinCCR§2034–AnimalHealthCareTasksDefinitions,CCR§2035–DutiesofSupervisingVeterinarian,CCR§2036–AnimalHealthCareTasksforR.V.T.,CCR§2036.5–AnimalHospitalHealthCareTasks forPermitHoldersand Veterinary Assistants, BPC § 4836.1 – Administration of Drugs byregisteredveterinarytechnicianorassistants,BPC§4840–Authorizedservices by technicians and assistants, BPC § 4840.2 – Unauthorizedpractices, and BPC § 4840.7 – Operation of radiographic equipment;Trainingrecords.

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Documents

Hospital Standards Self-Evaluation Checklist