Consistent with its mission to protect the public, the Veterinary Medical Board (“Board”) is tasked with establishing a “regular inspection program that will provide for random, unannounced inspections.”1 Inspections may be routine or complaint-based. The best time to ensure that your practice is in compliance with the minimum standards is before the inspector arrives.
It is the Licensee Manager’s responsibility to ensure that the veterinary premises complies with the requirements of the Business and Professions Code,2 meets the minimum standards of practice3 and that no unlicensed activity is occurring.4 If the premises is found not to be in compliance, it is the Licensee Manager’s responsibility to provide evidence of all corrections made following the inspection. Likewise, the Licensee Manager’s veterinary and premises licenses are subject to discipline for failure to comply with the minimum standards.
Authority to Inspect and Cooperation with Inspection
The Board is authorized to inspect any premises in which veterinary medicine, veterinary dentistry, or veterinary surgery is being practiced.5 This authority includes the inspection of all veterinary medical records, equipment and drugs on the premises.6
It is important to allow the inspector to conduct the inspection and to cooperate with the inspection process.7 It can be helpful to have one staff member guide the inspector, answer questions, and take notes. The inspector will provide information and documents regarding compliance with minimum standards, to include a report documenting compliance and any corrections that need to be made.
Veterinary Medical Board Strategic Plan
As part of its strategic plan for 2020-2024, the Board seeks to streamline the enforcement process to shorten cycle time, expedite consumer protection, and lower costs. This goal has impacted the inspection process in various ways.
The Board is utilizing the inspection unit to handle cases it previously would have assigned to the Division of Investigations. This means that there will be more complaint-based inspections—don’t be surprised if an inspector requests specific medical records or asks questions beyond the scope of a routine investigation.
The Board has also increased the use of citations following inspections, in conjunction with its goal of resolving less egregious violations through non-disciplinary actions (i.e., in lieu of the filing of an Accusation seeking to revoke a license).
The Board has also endeavored to educate its licensees regarding minimum standards and the inspection process by making its Hospital Standards Self-Evaluation Checklist more accessible to licensees. Specifically, the Board reached agreements with the Deans of California veterinary schools to provide the checklist to 4th year students, posted the checklist on its social media accounts, arranged to have it posted on several association chapter websites, and implemented a procedure to provide it to each veterinary premises managing licensee during the renewal process. This emphasizes the Board’s goal of compliance over formal discipline.
Common Compliance Issues
It is well worth your time to carefully review the Board’s Self-Evaluation Checklist, assess your practice, and make any necessary changes now. The checklist provides comprehensive guidance for compliance with all minimum standards. Based on our wealth of experience representing clients whose practices have been inspected, some of the more common and serious compliance issues are addressed here.
Drug Security Controls
It is important to ensure that controlled medications are handled appropriately. All controlled medications must be secured in a lock box, and only accessible by licensed individuals (veterinarian, registered veterinary technician or Veterinary Assistant Controlled Substance Permit holder). If you have controlled medications that require refrigeration, they must be secured in a lock box that has been permanently affixed inside the refrigerator (not in the door). Ensure that any keys to the lock boxes are only accessible by licensed individuals.
Drug Logs
Drug logs must be maintained for all controlled medications administered or dispensed. Ensure that all required information is included in the logs.
Additionally, a biennial controlled drug inventory must be completed every two years. Again, it is important to ensure that all required information is included. Separate inventories must be performed for Schedule II medications and Schedule III/IV/V medications.
Keep all logs together in a binder and easily accessible.
CURES Reporting
CURES reporting is required for all scheduled drugs administered or dispensed. Effective February 9, 2022, CURES reporting will transition from Atlantic Associates to Bamboo Health PMP Clearinghouse and all reporting must be made through the PMP Clearinghouse system. The California Department of Justice website provides detailed instructions regarding CURES registration and compliance.
Expired Drugs
Establish a system to review your inventory of controlled and non-controlled medications on a weekly basis for expired medications. Immediately remove any expired medications from your inventory, place them in a sealed box with a note such as, “DO NOT USE – EXPIRED MEDICATIONS – PENDING DISPOSAL THROUGH REVERSE DISTRIBUTOR.” Expired controlled medications must also be pulled from inventory and boxed with a similar note, but the box must remain locked and secure pending proper disposal through a DEA-registered reverse distributor.
General Sanitary Conditions
Ensure that your facility remains clean and all equipment is in good repair. A clean and organized practice provides an opportunity of a great first impression for the inspector and helps to ensure compliance with minimum standards.
When Your Practice Is Inspected
It is always best to retain legal representation to assist with corrections and documentation of those corrections. We at Simas & Associates, Ltd. have decades of experience helping our clients decipher the reports and other information provided by an inspector, implement the necessary corrections, document the corrections made, and prepare a comprehensive, organized response to the Board. Here we have a common goal with the Board: ensuring compliance with the Veterinary Medicine Practice Act. Our goal is to help you do so before any disciplinary action is initiated. As discussed above, the inspection process is married with the enforcement process, so it is vital to ensure a comprehensive response. Simas & Associates, Ltd. is here for you.
1. Business and Professions Code sections 4800.1 and 4809.7. Note that section 4809.7 requires that the Board inspect at least 20 percent of veterinary premises on an annual basis; however, the Board is currently unable to meet that threshold.
2. Business and Professions Code sections 4853, 4854, 4855 and 4856.
3. California Code of Regulations, title 16, sections 2030 through 2032.5.
4. California Code of Regulations, title 16, section 2030.05.
5. Business and Professions Code section 4809.5.
6. Business and Professions Code section 4856.
7. Conversely, if an investigator from the Division of Investigations shows up at your practice, you have the right to request an attorney be present for any interviews, including interviews of you and your employees.