The CMS regulation indicates that:
V260 - S: PERSONNEL-TRAINING PROGRAM/PERIODIC AUDITS 494.40(a)
A training program that includes quality testing, the risks and hazards of improperly prepared concentrate, and bacterial issues is mandatory. Operators should be trained in the use of the equipment by the manufacturer or should be trained using materials provided by the manufacturer. The training should be specific to the functions performed (i.e., mixing, disinfection, maintenance, and repairs).Periodic audits of the operators' compliance with procedures should be performed .The user should establish an ongoing training program designed to maintain the operator's knowledge and skills. The facility must define the frequency of audits to evaluate the operators' compliance: these should include actual observation of the work: e.g., collecting samples, performing water testing. Audits should be done at least annually and more frequently if problems are identified.