OIG reviewed allegations of improper reusable medical equipment practices at the VA Northern California Healthcare System (system), Sacramento, CA. We found that the system generally complied with the manufacturer’s instructions (MI) regarding sterilization parameters for selected Olympus and Padgett Dermatome devices. However, sterilization processes for the Phaco Alcon and Midwest dental handpieces were inconsistent with the MI. We concluded that the system’s standard operating procedures and sterilization logs were generally inconsistent with the MI. We substantiated the allegations related to bioburden testing, delayed reprocessing, endoscope reprocessing documentation, and staff competencies. We identified improvement opportunities regarding proper use and care of suction canisters and other accessories. We recommended that the System Director review all findings in this report and take steps to correct the identified deficiencies. The Veterans Integrated Service Network and System Directors agreed with the findings and recommendation and provided acceptable action plans.