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90 <br />OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT <br />jrIhV ifI FACILITIES DEVELOPMENT DIVISION <br />14 <br />SPECIAL INSPECTORS (Continued) <br />Provide Following Information for Each Special Inspector Employed by the Agency (Attach <br />additional sheets if needed) <br />*To update expiration date a renewal application for OPAA and proof of renewal for certification/license shall be required <br />Inspector's Name <br />Certification/ <br />License Type <br />Certification/ <br />Licensing Agency <br />Certification/ <br />License Number <br />Expiration Date* <br />Comments <br />S ecial Ins ectors with expired license shall not be permifted to perform Special Inspections. <br />"Access to S.M. Qu.Fty Healthcare Eavironmenls that Meet Galifomia's Diverse and Ovnamic Needs" <br />OSHPD <br />STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY <br />OSH-FD-OPAA-100 (6/24,2016) <br />3/28/2017 OPAA-0010-16 <br />Page 17 of 19 <br />