I hereby certify under penalty of perjury that I am not precluded from certification or accreditation for those reasons defined in section 1798.200 of the Health and Safety Code, which are as follows:
c. Any of the following actions shall be considered evidence of a threat to the public health and safety and may result in the denial, suspension or revocation of a certificate or license issued under this division; or in the placement on probation of a certificate holder or licenseholder under this division:
1. Fraud in the procurement of any certificate or license under this division.
2. Gross negligence.
3. Repeated negligent acts.
5. The commission of any fraudulent, dishonest or corrupt act that is substantially related to the qualifications, functions and duties of prehostpital personnel.
6. Conviction of any crime which is substantially related to the qualifications, function and duties of prehospital personnel. The record of conviction or a certified copy of the record shall be conclusive evidence of the conviction.
7. Violating or attempting to violate directly or indirectly or assisting in abetting the violation of, or conspring to violate any provision of this division or the regulations adopted by the authority pertaining to the prehospital personnel.
8. Violating or attempting to violate any federal or state statute or regulation that regulates narcotics, dangerous drugs or controlled substances.
9. Addiction to, the excessive use of, or the misuse of alcoholic beverages, narcotics, dangerous drugs or controlled substances.
10. Functioning outside the supervision of medical control in the field care system operating at the local level, except as authorized by any other license or certification.
11. Demonstration of irrational behavior or occurence of a physical disability to the extent that a resonable and prudent person would have reasonable cause to believe that the ability to perform the duties normally expected may be impaired.
12. Unprofessional behavior exhibited in any of the following:
A. The mistreatment or physical abuse of any patient resulting from force in excess of what a reasonable and prudent person trained and acting in a similar capacity while engaged in the performance of his or her duties would use if confronted with a similar circumstance.
B. The failure to maintain confidentiality of patient medical information, except as disclosure is otherwise permitted or required by law in Part 2.6 (commencing with Sections 56) of Division 1 of the Civil Code. [Amended by SB 1330 (Ch. 328) Statutes of 2010.]
C. The commission of any sexually related offense specified under Section 290 of the Penal Code.