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The document outlines required compliance documents for a healthcare facility, including notarized agreements, training certificates, and water analysis results. Specific items needed include approved floor plans, pest control policies, and calibration certificates. Additionally, it requests notarized employment contracts and training certificates for various staff members involved in hemodialysis services.

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mmkrenalhealthcareinc
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6 views1 page

1

The document outlines required compliance documents for a healthcare facility, including notarized agreements, training certificates, and water analysis results. Specific items needed include approved floor plans, pest control policies, and calibration certificates. Additionally, it requests notarized employment contracts and training certificates for various staff members involved in hemodialysis services.

Uploaded by

mmkrenalhealthcareinc
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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1.

Notarized MOA with the hospital


2. Filled out customer satisfaction form, Quality Assurance Program reports and
meetings with noted corrective actions taken
3. REDCOP/PRDR Certificates
4. Folder for previous DOH inspections and monitoring
5. Records of HD machine hours

Upon evaluation of the submitted documents for the physical facilities part, the following
are still for compliance:

1. Copy of the approved floor plan with the stamp of DOH-HFSRB.


2. Submit video of actual testing of TDS with raw water and product water as sampling
points.
3. Submit proof of implementation of policies and procedures for pest control,
housekeeping and building maintenance.
4. Submit Updated Calibration Certificates for the digital weighing scale, defibrillator and
ECG machine.
5. Submit copies of Microbiological Water Analysis Results for the whole year of 2025.
6. Submit copies of Chemical water analysis results for the whole year of 2024.

Hi MMK,

Please submit the following:


1. Notarized list of hemodialysis centers handled by Dr. Katherine Zapanta and the
corresponding work schedule.
2. Notarized contract of employment, certificate of employment from previous employer,
and ACLS training certificate of Dr. Marion Regalado.
3. ACLS Training certificate of Dr. Catherine Calma
4. Proposed schedule of the PODs
5. Hemodialysis training certificate of Esnira Barcena, Mark Tuballa, and Patricia
Bagood.
6. BLS training certificate of Mark Paraton and Patricia Bagood
7. Proposed schedule of nurses based on the applied 12 stations.
8. Certificate of training as a Dialysis Technician of Ariel Ticong, Carlo Abregana, and
Joed Aguilar

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