Court Opinion

ID: 9905936
Source: CourtListenerOpinion
Date Created: 2023-11-30 17:02:43.266689+00
Date Added: 2024-06-11T09:24:00.528033
License: Public Domain

Filed 11/29/23
                 CERTIFIED FOR PUBLICATION

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA

                  FIRST APPELLATE DISTRICT

                         DIVISION FOUR

 SAVANNAH PHILLIPS,
        Plaintiff and Appellant,
                                      A165289
 v.
 STEVE GORDON,                        (San Mateo County
 DIRECTOR OF                          Super. Ct. No. 21-CIV-
 DEPARTMENT OF MOTOR                  04140)
 VEHICLES,
      Defendant and
 Respondent.

       Savannah Phillips appeals from the trial court’s denial of
her petition for review of an order of the Department of Motor
Vehicles (DMV or Department) suspending her driver’s license
for driving with a blood-alcohol concentration (BAC) of 0.08
percent or more. Phillips argues the trial court erred because the
DMV failed to provide sufficient foundational evidence of the
reliability of the way in which her blood was collected for the
BAC test. She contends she rebutted the presumption that the
certified phlebotomy technician (CPT) drew her blood in a proper
manner by showing that the CPT was not supervised and the
procedure she followed was not properly approved as required by
applicable regulations and statutes. We agree that Phillips
rebutted the presumption of reliability but will affirm the trial
court’s order because evidence introduced at the hearing
nonetheless established the reliability of the manner of collection
of Phillips’ blood.
                           BACKGROUND
        One night in September 2020, around 11:23 p.m., a
California Highway Patrol officer pulled Phillips over and
arrested her for driving under the influence in violation of
Vehicle Code section 23152, subdivision (a). The officer’s partner
took Phillips to a facility in Burlingame and requested a
phlebotomist.
        A phlebotomist named Yasmin Ramos, employed by Bay
Area Phlebotomy and Laboratory Services, arrived. At 1:07 a.m.,
Ramos took a needle out of a sealed package supplied by the San
Mateo County Forensic Lab, cleaned Phillips’ arm with a non-
alcoholic antiseptic wipe, and drew two vials of blood from a vein
in Phillips’ right arm. The officer gave Phillips a notice informing
her that the DMV would suspend or revoke her privilege to drive
a car within 30 days because of her arrest for driving under the
influence.
        The county lab measured Phillips’ BAC at 0.110 percent, +/-
0.004 percent. The lab report states, “Based on the information
provided, the collected sample appears to be compliant with Title
17.”1

        1 This is an apparent reference to title 17, sections 1215 to

1222.1 of the California Code of Regulations, which governs the
operation of forensic alcohol laboratories and collection of
evidence. (Davenport v. Department of Motor Vehicles (1992)
      At an administrative hearing in June 2021 concerning the
suspension of Phillips’ license, the DMV hearing officer offered
into evidence the lab test report and the arresting officer’s
investigation report. Phillips objected to the lab report on the
grounds of, among other things, lack of foundation. Phillips
asserted her own evidence would rebut the presumption under
Evidence Code section 664 that the blood was properly collected
and argued the certification on the lab report was therefore
insufficient on its own to establish the test’s foundational
scientific reliability. The hearing officer overruled the objection
and admitted the documents into evidence.
      Phillips called one witness, Salustiano Ribeiro, the
president and chief executive officer of Bay Area Phlebotomy and
Laboratory Services (the company). Ribeiro testified that Ramos
had been hired in February 2020. Ramos was only a CPT, not a
licensed physician and surgeon, registered nurse, licensed
vocational nurse, licensed clinical laboratory scientist, licensed
clinical laboratory bioanalyst, certified paramedic, or licensed
physician assistant.2 Before Ramos was allowed to draw blood
for the company, she had to pass a written competency exam for

6 Cal.App.4th 133, 142 (Davenport).) Subsequent citations to
title 17 are to the California Code of Regulations.
      2 Phillips elicited this testimony because, as explained post,

regulations governing the collection of blood for purposes of BAC
tests require certain actions to be performed by a “physician and
surgeon, physician assistant, clinical laboratory bioanalyst,
registered nurse, or clinical laboratory scientist.” (Veh. Code,
§ 23158, subd. (g); see also id., subd. (e); title 17, § 1219.1,
subd. (a).) In the interests of brevity, we will refer to anyone
meeting one of these criteria as a “qualified” person or supervisor.
the company and a supervisor named Josh Hammack, who was
also a CPT, observed her draw blood.
      Phillips also used Ribeiro’s testimony to establish several
violations of governing regulations.3 First, a licensed physician
and surgeon had not approved the company’s policies and
procedures that Ramos followed to draw blood. (Tit. 17, § 1219.1,
subd. (a) [requiring compliance with Veh. Code, § 23158];
Veh. Code, § 23158, subd. (e).) Second, a qualified person had not
reviewed and verified Ramos’ competency to draw blood for
alcohol testing purposes before she was first allowed to draw
blood for those purposes without direct supervision. (Veh. Code,
§ 23158, subds. (e) & (g).) Third, a qualified person had not
reviewed and verified Ramos’ work at least once a month to
ensure compliance with policies, procedures, and regulations.
(Ibid.) Finally, no qualified individual was accessible for
consultation within 30 minutes when Ramos drew Phillips’ blood.
(Ibid.) We will refer to the first violation as the “approval of
procedures violation” and the other violations as the “supervisory
violations.”4

      3 Because the DMV does not dispute that Phillips

established these violations, we need not describe in detail the
evidence showing the violations.
      4 Phillips argues that she also established that a qualified

supervisor did not review Ramos’ competency on an annual basis.
However, Ramos drew Phillips’ blood within the first year of her
employment, so no annual review was necessary at that time.
Any failure to review Ramos’ competency after she drew Phillips’
blood is irrelevant.
      In closing argument, Phillips argued these four violations
rebutted the presumption under Evidence Code section 664 that
the collection of her blood was properly performed, making the
blood test result inadmissible without some foundational
evidence of scientific reliability. The hearing officer rejected
Phillips’ argument because Ramos was a certified phlebotomist
and found a preponderance of the evidence supported all of the
required elements for suspending Phillips’ license. The hearing
officer therefore ordered the suspension of Phillips’ driving
privilege.
      Phillips filed in the trial court a petition for review of the
DMV’s order, renewing her argument about the lack of
foundational evidence of the reliability of her blood collection.
The trial court denied the petition, concluding that even
assuming Phillips had established the violations she alleged,
Gerwig v. Gordon (2021) 61 Cal.App.5th 59 (Gerwig) had already
concluded that such violations did not rebut the presumption that
the blood test was properly performed.
                           DISCUSSION
I.   Legal background and standard of review
      Administrative DMV hearings are informal, are governed
by the Administrative Procedure Act, and do not “require the full
panoply of the Evidence Code provisions used in criminal and
civil trials.” (Petricka v. Department of Motor Vehicles (2001)
89 Cal.App.4th 1341, 1348 (Petricka).) The only issues to be
decided at such a hearing are “whether the arresting officer had
reasonable cause to believe [the accused] was driving, whether
she was arrested for an enumerated offense, and whether she
was driving with 0.08 percent BAC or higher.” (Coffey v.
Shiomoto (2015) 60 Cal.4th 1198, 1207–1208.)5 “If the DMV
hearing officer finds these three statutory prerequisites proved by
a preponderance of the evidence, the accused’s driver’s license
will be suspended for four months if the driver has had a clean
driving record [citation].” (Id. at p. 1208.) When a driver submits
to a blood test, as Phillips did, at the administrative hearing the
DMV typically satisfies its burden of proving the driver had a
BAC of 0.08 percent or higher with “two documents: the sworn
statement of the arresting officer and a forensic lab report
documenting the results of a chemical test of the driver’s blood.”
(Petricka, at p. 1348.)
      Usually, to establish the necessary foundational
requirement of reliability for the admission of test results like a
BAC lab report, a party would have to show either compliance
with title 17 or provide evidence of the foundational elements of
(1) properly functioning equipment, (2) a properly administered
test or collection procedures, and (3) a competent and qualified
operator. (People v. Williams (2002) 28 Cal.4th 408, 417
(Williams); Davenport, supra, 6 Cal.App.4th at pp. 140, 142;
Petricka, supra, 89 Cal.App.4th at p. 1349 [foundation
requirement applies to evidence collection].) But because DMV

      5 “Somewhat different rules apply to those under 21 years

of age [citation], those driving commercial vehicles [citation], and
those on probation for prior drunk driving convictions [citation].”
(Coffey v. Shiomoto, supra, 60 Cal.4th at p. 1208, fn. 9.) None of
these other rules is relevant here.
administrative hearings are not criminal trials and the
foundational fact of compliance with title 17 is not a part of the
DMV’s prima facie case, the DMV need not submit evidence of
such compliance and may instead rely on the presumption in
Evidence Code section 664. (Petricka, at pp. 1348, 1350;
Davenport, at p. 144.)
      Evidence Code section 664 states in pertinent part, “It is
presumed that official duty has been regularly performed.”
Under this statute, at an administrative hearing, the forensic
laboratory or technician collecting evidence for testing is
presumed to have complied with the governing regulations. (See
Imachi v. Department of Motor Vehicles (1992) 2 Cal.App.4th 809,
816–817 & fn. 5 [presumption applies to forensic laboratory as an
agent of a public entity].) “If the licensee shows, through cross-
examination of the officer or by the introduction of affirmative
evidence, that official standards were in any respect not
observed, the burden shifts to the Department to prove that the
test was reliable despite the violation,” through evidence of the
three foundational elements. (Davenport, supra, 6 Cal.App.4th at
p. 144.)
      “[T]he hearing officer’s decision is subject to judicial review.
[Citations.] The trial court exercises its independent judgment to
determine whether the administrative decision was supported by
the weight of the evidence. [Citation.] On appeal, we determine
whether substantial evidence supports the trial court’s findings.
[Citations.] To the extent the question is one of statutory or
regulatory interpretation, we exercise our independent
judgment.” (Delgado v. Department of Motor Vehicles (2020)
50 Cal.App.5th 572, 577.)
II.   Analysis
      As in the DMV hearing and the trial court, Phillips
contends that she rebutted the Evidence Code section 664
presumption that Ramos’ collection of her blood complied with
title 17 by establishing the above-described approval of
procedures and supervisory violations.6 Although the violations
are undisputed, to evaluate their significance it is helpful to
briefly review the language of the regulation and statute Phillips
showed were violated.
      Title 17, section 1219.1, subdivision (a) governs the
collection of blood samples and requires them to be “processed in
compliance with Vehicle Code Section 23158.” As relevant here,
Vehicle Code section 23158, subdivision (a) establishes that only
certain individuals, including qualified individuals and CPTs,
“acting at the request of a peace officer may withdraw blood for
the purpose of determining the alcoholic content therein.”
      Subdivision (e) states, “Notwithstanding any other
provision of law, a person who has been issued a ‘certified
phlebotomy technician’ certificate pursuant to Section 1246 of the
Business and Professions Code and who is authorized by this
section to draw blood at the request and in the presence of a
peace officer for purposes of determining its alcoholic content,

      6 Phillips does not challenge the presumption that her blood

was properly tested, merely the presumption that it was properly
collected.
may do so in a jail, law enforcement facility, or medical facility,
with general supervision. The ‘certified phlebotomy technician’
shall draw blood following the policies and procedures approved
by a [licensed] physician and surgeon . . . appropriate to the
location where the blood is being drawn and in accordance with
state regulations.” (Veh. Code, § 23158, subd. (e).)
      Subdivision (f) requires CPTs (and no one else) to carry a
valid identification card with their name, certificate type, and
effective dates when performing blood withdrawals. (Veh. Code,
§ 23158, subd. (f).)
      Subdivision (g) defines “general supervision.” It states, “As
used in this section, ‘general supervision’ means that the
supervisor of the technician is licensed under the Business and
Professions Code as a [qualified individual] and reviews the
competency of the technician before the technician may perform
blood withdrawals without direct supervision, and on an annual
basis thereafter. The supervisor is also required to review the
work of the technician at least once a month to ensure compliance
with venipuncture policies, procedures, and regulations. The
supervisor, or another [qualified] person . . . shall be accessible to
the location where the technician is working to provide onsite,
telephone, or electronic consultation, within 30 minutes when
needed.” (Veh. Code, § 23158, subd. (g).)
      Finally, Vehicle Code section 23158, subdivision (h) states,
“Nothing in this section shall be construed as requiring the
certified phlebotomy technician who is authorized to withdraw
blood by this section at the request and in the presence of a peace
officer for purposes of determining alcoholic content to be
associated with a clinical laboratory or to be directly supervised
after competency has been established.”
        Phillips argues that because the testimony established
violations of Vehicle Code section 23158, subdivisions (e) and (g),
she rebutted the Evidence Code section 664 presumption that
Ramos’ blood collection complied with title 17, and thus for her
blood test results to be admissible, the DMV had to submit
evidence that (1) the blood collection equipment was properly
functioning, (2) the blood was properly collected, and (3) Ramos
was competent and qualified. She asserts the DMV failed to do
this and concludes that the test result was inadmissible and the
remaining evidence does not show she was driving with a BAC
above 0.08 percent.
   A.    Rebuttal of the presumption of compliance
          Gerwig
        As the trial court recognized, Gerwig considered and
rejected a virtually identical argument. At the DMV hearing in
that case, the hearing officer found the driver had established
supervisory violations like those Phillips established here.
(Gerwig, supra, 61 Cal.App.5th at pp. 63–64.) The hearing officer
relied on the lab report anyway because there was no evidence
that the phlebotomist was unqualified or that there was a
problem with the driver’s specific test. (Id. at p. 64.) The trial
court denied the driver’s petition for review on the same
rationale. (Ibid.)
      The Court of Appeal affirmed. (Gerwig, supra,
61 Cal.App.5th at p. 62.) It recognized that Davenport had stated
that evidence “ ‘that official standards were in any respect not
observed’ ” would rebut the Evidence Code section 664
presumption that a test was properly performed. (Gerwig, at
p. 67, italics added.) But the court believed the “ ‘in any respect’ ”
phrase was dicta that was inconsistent with Davenport’s
reasoning and the cases on which Davenport relied. (Id. at
pp. 67–68.) Gerwig viewed those cases, as well as others
concerning title 17 violations at DMV hearings, as focusing on
whether a driver proved violations that would cast doubt on the
reliability of the relevant tests. (Id. at pp. 68–71 & fns. 6–7.)
Gerwig therefore held that only proof of violations of title 17 that
give rise to a reasonable inference that a rest result is unreliable
will rebut the presumption that tests were properly conducted.
(Id. at pp. 62, 72.)
      Gerwig further concluded that the supervisory violations
the driver had established in that case did not meet its standard.
The driver first claimed broadly that there was “a nexus between
approved procedures, appropriate supervision, and the proper
conduct of a blood draw.” (Gerwig, supra, 61 Cal.App.5th at
p. 68.) The court found this true on an indirect level, “just as one
could say that good nutrition and adequate rest are important to
a phlebotomist’s job performance,” but found such factors on their
own “too tenuous to cast doubt on the reliability of the blood test
results.” (Id. at pp. 68–69.) The court noted that title 17 includes
some requirements, such as the requirements that a phlebotomist
always carry an identification card or that an administrator of a
breath test receive a certificate with certain information, which
are patently not connected to the reliability of tests. (Id. at p. 68,
fn. 5.)
          Gerwig also rejected the driver’s attempt to compare an
unsupervised phlebotomist to a piece of lab equipment that is
misused. (Gerwig, supra, 61 Cal.App.5th at p. 71.) Gerwig
reasoned that the phlebotomist who drew the driver’s blood was
“a person who presumably conducts blood draws, which he is
trained to do, in the same way regardless of the general
supervision he receives. While an unsupervised phlebotomist
could make a mistake, so too could a properly supervised one.”
(Id. at p. 71.) The court found no reason to believe the
phlebotomist made a mistake or that “the particular
circumstance of [the driver’s] blood draw presented a problem the
lackluster supervision structure” at the phlebotomist’s employer
left the phlebotomist “ill equipped to address.” (Ibid.) The court
speculated that it might have reached a different result if, for
example, the phlebotomist had tried unsuccessfully to reach a
supervisor during the collection of blood to ask a question, since
that would have implicated the requirement that a supervisor be
accessible for consultation within 30 minutes during a
phlebotomist’s work. (Id. at p. 71, fn. 8.)
          Phillips contends Gerwig was wrongly decided. She
disputes Gerwig’s broader holding that only a violation of title 17
that relates to the reliability of a test will suffice to rebut the
presumption that the test was performed in compliance with
regulatory and statutory standards. Phillips urges us to follow
instead Davenport’s statement that evidence “that official
standards were in any respect not observed” will rebut the
presumption. (Davenport, supra, 6 Cal.App.4th at p. 144, italics
added.) She also disagrees with Gerwig’s narrower holding
concerning supervisory violations and reliability, maintaining
that the court there took an unduly narrow view of what
constitutes the reliability of a test. She faults Gerwig for focusing
on accuracy, which refers to how close a measured value is to a
standard or known true value, and ignoring precision, meaning
how close multiple measurements are to each other. (See, e.g.,
Gerwig, supra, 61 Cal.App.5th at p. 62 [“It is not enough to show
a violation of governing regulations that has only a tenuous
connection to the accuracy of the results,” italics added].) She
contends both are required by title 17 and both are necessary for
a test to be reliable, since a test must be not just accurate but
dependably so, to exclude the possibility that a test merely
described the correct amount of alcohol in a sample of blood by
random chance. (Cf. tit. 17, § 1220.1, subd. (a)(1) [Methods for
forensic alcohol analysis “shall be capable of the analysis of a
reference sample of known alcohol concentration within accuracy
and precision limits of plus or minus 5 percent of the
value . . . . ”].)
       We begin by agreeing with Gerwig that a violation must
relate to reliability to rebut the Evidence Code section 664
presumption and force the DMV to submit evidence of reliability.
The precise nature of the presumption dictates this conclusion.
As explained in Davenport, “what is directly presumed is not the
actual reliability of the test.” (Davenport, supra, 6 Cal.App.4th at
p. 144.) Rather, “what is actually presumed under Evidence Code
[section] 664 is compliance with statutory and regulatory
standards, which in turn gives rise to an inference of reliability.”
(Ibid., italics omitted.) Proof that a test was completed in
violation of a regulatory or statutory standard unrelated to
reliability is therefore irrelevant because it would not
meaningfully disrupt the inference that a test was reliable.
      To use an example that Gerwig, supra, 61 Cal.App.5th at
page 68, footnote 5, highlighted, if a driver proved that a
phlebotomist failed to carry an identification card as required by
Vehicle Code section 23158, subdivision (f), it would not
meaningfully call into question whether the phlebotomist could
be counted on to properly draw blood. This is because the
identification card requirement on its face does not relate to
reliability and appears to exist for other reasons, such as
demonstrating to a driver or law enforcement officer that the
phlebotomist is properly certified. On some level, one might infer
from a phlebotomist’s failure to comply with the identification
card requirement that the phlebotomist might also fail to comply
with substantive regulations for drawing blood. But this
inference is weak because, as Gerwig pointed out, a conscientious
and competent CPT could simply leave an identification card at
home. (Gerwig, at p. 68.) Accordingly, Gerwig’s holding that
proof of a violation must relate to reliability to rebut the
presumption that a test was properly performed is sound.
      We part company with Gerwig, however, on the question of
whether the supervisory violations at issue there, as well as the
initial competency verification and approval of procedures
violation Phillips proved here, relate to reliability. Gerwig
reasoned that a phlebotomist “presumably” draws blood in
accordance with training regardless of the level of supervision
and that a properly supervised phlebotomist can make a mistake
just like an unsupervised one. (Gerwig, supra, 61 Cal.App.5th at
p. 71.) The DMV takes a similar tack in emphasizing repeatedly
that Ramos was a CPT, trained and certified by the Department
of Public Health to draw blood samples.
      A phlebotomist may be more likely to draw blood correctly
despite a lack of supervision than a misused piece of laboratory
equipment is to correctly report a test result, as Gerwig stated.
(Gerwig, supra, 61 Cal.App.5th at p. 71.) But Gerwig’s reasoning
calls into question why the supervision and competency
evaluation requirements exist at all. Unlike the identification
card requirement, there is no purpose for the supervision
requirement other than to ensure that a CPT follows applicable
rules and regulations. The supervision requirement indicates
that a supervised phlebotomist is more likely to have drawn blood
correctly than an unsupervised one. If the Legislature viewed a
CPT’s training and certification as a sufficient basis for
confidence that the phlebotomist would draw blood the same way
every time, or if unsupervised phlebotomists made errors at the
same rate as supervised ones, it would not have required CPTs to
be supervised. Accordingly, while the DMV can show that an
unsupervised phlebotomist drew blood correctly on a given
occasion (as we conclude, post, it has in this case), only a
phlebotomist supervised in accordance with the statutory and
regulatory requirements can be presumed under Evidence Code
section 664 to have done so.
      Gerwig’s comparison between the supervision requirements
and good nutrition and adequate rest actually serves to
demonstrate the point. (Gerwig, supra, 61 Cal.App.5th at pp. 68–
69.) Good nutrition and rest can be fairly said to have a tenuous
connection to reliability of a blood test. But the Legislature did
not mandate nutrition or rest requirements in Vehicle Code
section 23158. It did, however, include supervision requirements
in the statute. It must have had a good reason to do so. Courts
should therefore treat a lack of supervision differently than a
lack of rest or proper nutrition.
         Legislative history
      To the extent that the statute is ambiguous on this point,
the history of the CPT certification and the general supervision
requirement confirm that the supervision requirements relate to
the reliability of CPTs’ work. The Legislature created the CPT
certification in 1999. (Stats. 1999, ch. 695, § 3, pp. 5055–5056.)
Under existing law at that time, unlicensed personnel employed
by a licensed clinical laboratory could draw blood so long as (1)
the person worked under the supervision of a certain type of
qualified individual and the supervisor was physically available
to be summoned during a blood withdrawal within five minutes,
and (2) a certain kind of qualified individual had trained the
unlicensed person for at least ten hours. (Bus. & Prof. Code,
former § 1246, subds. (a)–(b), as amended by Stats. 1978, ch. 429,
§ 9, pp. 1332–1333; tit. 17, former § 1034, subds. (a)–(b), Register
1975, No. 50 (Dec. 13, 1975); see also Assem. Com. on Health,
Analysis of Assem. Bill No. 1557 (1999–2000 Reg. Sess.) as
introduced, pp. 1–2 (Assembly Committee on Health Analysis).)
      In part because of an incident in which a phlebotomist
admitted to reusing needles, the Legislature became concerned
that inadequate training of phlebotomists could lead to
“inaccurate or invalid diagnosis of patients’ medical conditions,
inaccurate treatment as a result of inaccurate diagnosis, physical
injuries to patients ranging from bruising to paralysis, and
exposing workers and patients to blood-borne diseases and
viruses such as hepatitis B, hepatitis C, or HIV.” (Assem. Com.
on Health Analysis, supra, at pp. 2–3.) The Legislature therefore
directed what is now the Department of Public Health to adopt
regulations for CPT certification of employees drawing blood in a
clinical laboratory, which were to include that a CPT had to
obtain a certification from a national accreditation agency,
complete at least 40 hours each of didactic and practical training,
be found competent by certain qualified individuals, and work
under the supervision of certain qualified individuals or their
designee. (Bus. & Prof. Code, former § 1246, subd. (b)(1),
(b)(2)(A)–(B), (4)–(5), as amended by Stats. 1999, ch. 695, § 3,
p. 5056; Bus. & Prof. Code, § 1202.) The supervision requirement
for CPTs did not mention any need for the supervisor to be
available within a certain amount of time. (Bus. & Prof. Code,
former § 1246, subd. (b)(5), as amended by Stats. 1999, ch. 695,
§ 3, p. 5056.)
      The implementing regulation, which is still in effect, allows
CPTs to draw blood only if they maintain a valid state CPT
certification, work under the supervision of a qualified individual
or designee, have shown competency to draw blood without direct
and constant supervision, and have such competency documented
annually. (Tit. 17, § 1030, subd. (b)(2)(A)–(C).)7 A CPT’s
supervisor must review the CPT’s work monthly and be
accessible to the CPT’s worksite to provide on-site, telephone, or
electronic consultation as needed. (Tit. 17, § 1030,
subd. (b)(2)(B).)
      In 2004, the Legislature enacted Assembly Bill No. 371
(2003–2004 Reg. Sess.) (Assembly Bill 371) to amend Vehicle
Code section 23158 so that CPTs could draw blood in the field for
alcohol testing for law enforcement.8 (Stats. 2004, ch. 14, § 2;
Assem. Com. on Public Safety, Analysis of Assem. Bill 371 (2003–
2004 Reg. Sess.) as amended Mar. 26, 2003, at pp. 2, 4–5

      7 This regulation was originally enacted at title 17, section

1034, Register 2003, No. 2 (Jan. 10, 2003). In 2022, the
regulation was renumbered as section 1030, without substantive
change. (Tit. 17, § 1030, Register 2022, No. 40 (Oct. 4, 2022).)
We cite to the current numbering of the regulation regardless of
the time period at issue.
      8 Assembly Bill 371 also added similar language to

Business and Professions Code section 1246, the statute that
created the CPT certification. (Stats. 2004, ch. 14, §§ 1, 3.) For
simplicity, we focus on the amendment to Vehicle Code section
23158, but the changes to Business and Professions Code section
1246 evolved in the same way.
(Assembly Committee on Public Safety Analysis).) The author of
Assembly Bill 371 stated that law enforcement was experiencing
difficulty getting routine blood withdrawals in the field in DUI
cases. (Assem. Com. on Public Safety Analysis, supra, at p. 2.)
Phlebotomists could not draw blood in the field unsupervised and
the individuals who could, such as physicians and nurses, were
difficult and costly to recruit and retain. (Ibid.) The bill aimed to
make it cheaper for law enforcement to get blood tests by
allowing CPTs to draw blood in the field. (Ibid.)
      An early version of Assembly Bill 371 would have done this
by allowing CPTs to draw blood at the request and in the
presence of a peace officer “in any location and without
supervision,” thereby essentially transferring the requirement of
supervision by a qualified individual to supervision by a peace
officer. (Assem. Amend to Assem. Bill 371, Mar. 26, 2003, § 2;
Assem. Com. on Public Safety Analysis, supra, at p. 5.) A
committee analysis of this version of the bill noted, however, that
peace officers are not usually medically trained. (Assem. Com. on
Public Safety Analysis, supra, at p. 5.)
      Ensuing amendments to the bill considerably restricted the
scope of CPTs’ authority in the early draft and gave the statute
its current form. One Assembly amendment changed the bill to
allow CPTs to draw blood at the request of a peace officer only in
a jail, law enforcement facility, or medical facility and only with
“general supervision,” meaning oversight by a licensed medical
professional. (Assem. Amend to Assem. Bill 371, Apr. 29, 2003,
§ 2; Assem. Com. on Public Safety, Analysis of Assem. Bill 371
(2003–2004 Reg. Sess.) as amended Mar. 26, 2003, at p. 4.) The
Assembly amendment defined “general supervision” to mean:
(1) the CPT’s supervisor is a qualified individual; (2) the qualified
supervisor reviews the CPT’s competency before the CPT can
perform blood withdrawals without direct supervision and
annually thereafter; (3) the qualified supervisor reviews the
CPT’s work monthly to ensure compliance with policies,
procedures, and regulations; and (4) the qualified supervisor or
another qualified individual is accessible to the CPT’s worksite to
provide onsite, telephone, or electronic consultation if needed.
(Assem. Amend. to Assem. Bill 371, Apr. 29, 2003, § 2.) However,
this amendment also added the language currently found in
Vehicle Code section 23158, subdivision (h) making clear that
CPTs did not need “to be associated with a clinical laboratory or
to be directly supervised after competency has been established.”
(Ibid.) The Senate amended the new definition of general
supervision to require a qualified individual to be accessible to a
CPT for consultation within 30 minutes. (Assem. Amend to
Assem. Bill 371, May 21, 2003, § 2.) Another Senate amendment
added the language in Vehicle Code section 23158, subdivision (e)
requiring a CPT drawing blood for alcohol testing to follow a
procedure approved by a physician or surgeon for the location
where the blood was being drawn. (Sen. Amend. to Assem. Bill
371, Sept. 8, 2003, § 2.) The current statute reflects the language
of these amendments. (Veh. Code, § 23158, subds. (e), (g), & (h).)
      This legislative history confirms that Gerwig should have
treated the supervision requirements as related to the reliability
of the collection of blood. The Legislature created the CPT
certification because of concerns about the reliability of
phlebotomists’ work, and it did not treat CPTs’ training and
certification as sufficient guarantees of reliability. It instead
allowed CPTs to draw blood so long as they complied with the
requirements of qualified supervision, annual demonstrations of
competence, and monthly review of work. A CPT who draws
blood in violation of these requirements therefore acts beyond the
scope of the authority the Legislature conferred.
      When the Legislature later created an exception to these
requirements to allow CPTs to draw blood for alcohol testing
without direct supervision outside of laboratories, it considered
and rejected a proposal that would have freed CPTs from medical
supervision entirely and allowed them to work anywhere. It
instead circumscribed the locations where CPTs could operate,
maintained the requirement that CPTs continue to be supervised
by qualified individuals, restored a requirement that a CPT’s
supervisor in such circumstances must be available in a certain
amount of time, and added an additional requirement that CPTs
drawing blood for alcohol testing must follow a procedure
approved by a physician or surgeon. It did this precisely so that
CPTs would operate under oversight by medical professionals.
The approval of procedures and supervision requirements in
Vehicle Code section 23158, subdivisions (e) and (g) are integrally
related to the reliability of CPTs’ work, not extraneous to it.
      Our conclusion that these requirements relate to reliability
is consistent with Coombs v. Pierce (1991) 1 Cal.App.4th 568.
The DMV there did not submit foundational evidence of the
reliability of the breath testing machine used to determine the
driver’s BAC and instead relied on the fact that the machine was
included on a list of devices that a regulation permitted to be
used. (Id. at pp. 576–578, 580.) Coombs determined the
machine’s inclusion on the list was not evidence of reliability and
did not shift the burden to the driver to overcome the test’s
presumed reliability because the driver submitted evidence that
the county laboratory that used the device was not licensed to do
so. (Id. at pp. 579–581.) The court therefore held that there was
not substantial evidence to uphold the suspension of the driver’s
license. (Id. at p. 581.)
      The situation here is analogous to Coombs in that Ramos
was acting beyond the scope of her authority under Vehicle Code
section 23158, like the laboratory that operated a device without
a license, because she was not properly supervised or operating
pursuant to a properly approved procedure. When withdrawing
Phillips’ blood, Ramos cannot be presumed to have followed
regulations when it was demonstrated that she had acted beyond
the authority conferred by those regulations.
      Shea v. Department of Motor Vehicles (1998) 62 Cal.App.4th
1057 also supports our conclusion. Shea held that the Evidence
Code section 664 presumption did not apply to a BAC test report
prepared by trainees who signed a statement that they followed
title 17. (Id. at p. 1060–1061.) The court noted that trainees
could only perform forensic analysis when supervised, there was
no evidence the trainees were supervised, and a trainee has no
official duty to report test results. (Id. at pp. 1059–1061.) It
therefore concluded that the trainees’ compliance with that duty
could not be presumed. (Id. at p. 1061; see also Manning v.
Department of Motor Vehicles (1998) 61 Cal.App.4th 273, 275–276
& fn. 3 [same].) Here, Ramos’ authority and duty under Vehicle
Code section 25158, subdivisions (e) and (g) was to draw blood
only under general supervision and pursuant to a properly
approved procedure document. She drew Phillips’ blood without
the proper supervision or procedure, so she was acting beyond the
scope of her duty. The DMV therefore cannot rely on a
presumption that she properly performed her official duty.
   B.      Foundational evidence of reliability
        Because we agree with Phillips that the violations she
established relate to reliability, her proof of those violations
rebutted the presumption that her blood sample was collected in
accordance with title 17. This shifted the burden back to the
DMV to provide evidence of the foundational elements of
(1) proper equipment, (2) proper collection procedures, and (3) a
competent and qualified collector. (Davenport, supra,
6 Cal.App.4th at pp. 140, 144; Williams, supra, 28 Cal.4th at
p. 417.)
        Phillips asserts that reversal is required because the DMV
failed to provide the necessary evidence. To establish the first
two elements, Phillips argues the DMV needed to show the blood
collection complied with the requirements in title 17, section
1219.1. On the third element, Phillips argues that the approval
of procedures and supervisory violations make it impossible for
the DMV to establish that Ramos was competent and qualified.
She contends the lack of properly approved procedures and
qualified supervision, especially the pre-collection competence
review required by Vehicle Code section 23158, subdivision (g),
made Ramos not qualified as a matter of law.
      The premise of Phillips’ arguments is the notion that full
compliance with title 17 is required to establish the three
foundational elements of reliability. This is incorrect, as
Williams held. The Supreme Court there adopted the holding of
People v. Adams (1976) 59 Cal.App.3d 559. (Williams, supra,
28 Cal.4th at p. 417.) As summarized by the Supreme Court,
“Rather than equate the regulatory standards with the minimum
showing of reliability, Adams expressly held that title 17
compliance and the tripartite foundational requirements were
distinct and independent means to support the admission of test
results.” (Ibid., italics added.) “[A]lthough the regulations are a
standard of competency, they are not the only standard. Even
absent compliance with the regulations, the People could obtain
admission of the evidence through the general foundational
requirements . . . . ” (Id. at p. 416, italics omitted.) This is
because “[c]ompliance with regulations is sufficient to support
admission, but not necessary.” (Id. at p. 414.) The Supreme
Court therefore concluded that the foundational requirements for
reliability of a test “are not coextensive with the title 17
regulations” so that test results—breath test results, in that
case—“are admissible upon a showing of either compliance with
title 17 or the foundational elements of (1) properly functioning
equipment, (2) a properly administered test, and (3) a qualified
operator . . . . ” (Id. at p. 417, italics added.)9
      In light of Williams, full compliance with title 17 is not
required to establish the three foundational elements of
reliability. (Gov. Code, § 11513, subd. (c) [in administrative
hearings, “[a]ny relevant evidence shall be admitted if it is the
sort of evidence on which responsible persons are accustomed to
rely in the conduct of serious affairs, regardless of the existence
of any common law or statutory rule which might make improper
the admission of the evidence over objection in civil actions”];
Lake v. Reed (1997) 16 Cal.4th 448, 467 [applying Gov. Code
§ 11513 to DMV administrative hearing].) Evidence of partial
compliance with title 17 can help establish the foundational
elements, as can any other relevant evidence.
      It is true that the DMV did not supply much foundational
evidence here. However, Phillips herself did so, since she
introduced an exhibit that contained copies of several forms
Ramos completed when she drew Phillips’ blood and certain
records from Ramos’ employer. We agree with the DMV that this

      9 Williams also rejected the notion that courts should adopt

an exclusionary rule to deter or punish law enforcement’s
indifference to the regulations, holding that the California
Constitution establishes that “excluding evidence is not an
acceptable means of deterring police misconduct” unless required
by the federal Constitution. (Williams, supra, 28 Cal.4th at
pp. 414–415.) The only proper question is whether test results
are reliable and therefore relevant. (Ibid.) Importantly, the
court made clear that “[n]oncompliance [with title 17] goes only to
the weight of the evidence, not its admissibility.” (Id. at p. 414,
italics added.)
evidence met the three foundational requirements under
Williams and Phillips did not impeach the evidence or introduce
any contrary evidence.10
      On the first element, proper equipment, section 1219.1 of
title 17 requires blood samples to be collected “using sterile, dry
hypodermic needles and syringes, or using clean, dry vacuum
type containers with sterile needles” and the blood to “be
deposited into a clean, dry container which is closed with an inert
stopper.” (Tit. 17, § 1219.1, subds. (c)–(d).) The same regulation
further requires that the container not have been cleaned with
alcohol. (Id., subd. (d)(1).)
      A checklist that Ramos and the CHP officer initialed during
the collection of Ramos’ blood describes the equipment Ramos
used. One entry indicates that Ramos began the blood
withdrawal by opening a sealed plastic envelope supplied by the
San Mateo County Forensic Lab containing a vacutainer needle
holder, a sealed sterile needle, and two vacutainer tubes
containing dry white powder. The CHP officer’s report likewise
states that Ramos took a needle out of a sealed package. These
descriptions of the equipment used match the regulatory
requirements. Additionally, the report of the test on Phillips’
blood states that the sample appeared to be in compliance with
title 17.

      10 The trial court denied Phillips’ petition based on Gerwig

and did not consider whether the record contained sufficient
foundational evidence of reliability. However, we must affirm a
trial court ruling if it is correct on any ground. (Donovan v. RRL
Corp. (2001) 26 Cal.4th 261, 278, fn. 5.)
      On the second element, proper collection procedures, title
17, section 1219.1 requires blood to be drawn by venipuncture as
soon as feasible after an offense. (Tit. 17, § 1219.1, subd. (a).) It
further requires that alcohol not be used to clean the skin where
blood is collected and that the collected blood be mixed with an
anticoagulant and a preservative. (Id., subds. (b), (d)(2).) The
checklist shows Ramos followed all of these procedures, since it
indicates that Ramos cleaned the venipuncture site in Phillips’
right arm with the non-alcohol sterile swab supplied by the
county laboratory, drew blood from a vein, and confirmed
afterwards that the blood was venous. The CHP officer’s report
similarly states that Ramos cleaned Phillips’ arm with a non-
alcoholic cleanser. Ramos checked a box on the sample collection
envelope indicating that the disinfectant she used was Povidone-
Iodine, and a photo of a sample collection kit confirms that this
was the type of antiseptic wipe provided. Ramos drew the blood
at 1:07 a.m., which was less than two hours after the officer
pulled Phillips over. Another item on the checklist, which Ramos
and the officer initialed, showed that after drawing the blood
Ramos inverted the tubes to dissolve the preservative and
coagulant. Besides confirming that Ramos mixed the blood as
required, this indicates that the dry white powder contained in
the tubes when Ramos unsealed them was the necessary
coagulant and preservative, not a contaminant.11

      11 The checklist also showed that Ramos followed various

other procedures relating to the labeling of the samples, the chain
of custody, and appropriate care for the venipuncture site on
Phillips’ arm.
      Finally, on the third element, a competent and qualified
collector, Ramos’ CPT certification supplies some evidence of her
competence and qualification, despite her lack of qualified
supervision, since her CPT training and certification made her
more qualified to draw blood than someone without the
certification and training. Other evidence in the record
corroborates Ramos’ qualifications and competence. The evidence
that Ramos followed the procedures cited by Phillips helps
demonstrate Ramos’ competence. In addition, Ramos passed a
test when she was hired, and her supervisor, who was himself a
CPT, observed Ramos draw blood and attested to her competence
before she was allowed to draw blood without direct supervision.
Ramos also had significant experience as a phlebotomist. She
had been a CPT for almost 12 years when she drew Phillips’
blood. She had worked in a laboratory for at least one year or
completed a phlebotomy externship, since her employer required
at least one of those types of experience before hiring her.
      Taken together, this evidence constitutes substantial
evidence that Ramos was qualified and competent to draw
Phillips’ blood, notwithstanding her lack of title 17-compliant
supervision, and did so using the proper equipment and following
the prescribed procedures. Phillips focused solely on rebutting
the presumption of compliance with title 17 and offered no
evidence or impeachment to suggest that Ramos’ collection of
Phillips’ blood was unreliable in any way. The record therefore
demonstrates as a matter of law that the collection and testing of
Phillips’ blood was reliable, and the trial court was correct to
deny Phillips’ petition seeking to direct the DMV to rescind and
set aside the order suspending her driver’s license.
                                DISPOSITION
       The judgment is affirmed.

                                                      BROWN, P. J.

WE CONCUR:

STREETER, J.
GOLDMAN, J.

Phillips v. Gordon, Director of California Department of Motor Vehicles (A165289)
Trial Court:   San Mateo County Superior Court

Trial Judge:   Hon. Danny Y. Chou

Counsel:       Law Office of A. P. Zmurkiewicz, A. P. Zmurkiewicz
               for Plaintiff and Appellant.

               Rob Bonta, Attorney General, Chris Knudsen,
               Assistant Attorney General, Fiel D. Tingo,
               Joshua C. Irwin, Deputy Attorneys General for
               Plaintiff and Respondent.