Elder Care Residential Services

RESOURCES ON THE COMMUNITY CARE LICENSING DIVISION WEBSITE

Often times, it is difficult to know where to find information – below is a compilation of
various questions and answers that may help accessing Community Care Licensing
Division (CCLD) information about facility operations, fingerprint requirements and so
much more! This is not an exhaustive list – take some time and find out more about
free tools and information to help you help those in care.
Where can I find the regulations?
See http://www.dss.cahwnet.gov/ord/PG240.htm
Where can I find out if there is a policy associated with a regulation?
See http://www.ccld.ca.gov/PG546.htm and go to the facility category of interest.
What regulation packages are in the Office of Regulation Development?
See http://www.dss.cahwnet.gov/ord/PG321.htm
Where can I find current or past issues of the Adult and Senior Care Quarterly
Updates?
See http://www.ccld.ca.gov/PG432.htm
Where can I find information on fingerprint clearances?
See http://www.ccld.ca.gov/PG399.htm
Someone mentioned that there are Information Releases – where can I find these?
See http://www.ccld.ca.gov/PG493.htm]\

cLICK HERE TO READ THE ARTICLE FROM CCLD

SOURCE: http://www.ccld.ca.gov

PROPOSED EVICTION REGULATIONS

The CCLD held a public hearing on February 15, 2012, regarding the Eviction
Procedures Package for Residential Care Facilities for the Elderly (RCFEs). This
regulation was developed as a result of Senate Bill (SB) 781 (Leno). SB 781, Statutes
of 2009, requires licensees to include in the eviction notice the effective date of the
eviction, resources to assist in identifying alternative housing, and information about the
resident’s right to file a complaint with the California Department of Social Services
(CDSS). In addition, licensees are to include contact information for the nearest CCLD
office and the State Long-Term Care Ombudsman office. Furthermore, a statement to
require licensees to file an unlawful detainer action in superior court in order to evict
residents who remain in the facility after the effective date of the eviction. Under these
circumstances, the resident must be served with a summons and complaint, and the
resident has a right to contest the eviction in writing and through a hearing. The CCLD
responded to the comments received. This regulation package is anticipated to be
submitted to the Office of Administrative Law for final review on June 21, 2012. The
anticipated effective date of the regulations is September 4, 2012.

TWITTER AND FOOD SAFETY ALERTS

The United States Department of Agriculture’s (USDA) Food Safety and Inspection
Service (FSIS) has launched a series of Twitter feeds that will provide state-specific,
food safety alerts to consumers. Followers of these Twitter accounts will receive alerts
about recalls of meat, poultry and processed egg products in their state, as well as
information on how to protect the safety of their food during severe weather events.
The USDA under Secretary for Food Safety Dr. Elisabeth Hagen states, “The
immediacy of information-sharing through social media is unparalleled, and we believe
these timely, targeted updates will better protect public health.”
For more information on creating a Twitter account and accessing these state feeds, go
to twitter.com. A list of all FSIS state food safety alert Twitter feeds is available at

http://www.fsis.usda.gov/Fsis_Recalls/Open_Federal_Cases/index.asp#Twitter.

PRIVATELY PAID PERSONAL ASSISTANTS

An RCFE licensee cannot require a resident to hire a 24-hour caregiver.
Under Health & Safety Code section 1569.312, a RCFE must provide basic services,
which by definition include assistance with activities of daily living. Regulation sections
87464(f) – Basic Services and 87608(a) – Personal Assistance and Care describe these
services that required to be provided by the licensee to meet the needs of residents
such as safe and healthful living accommodations; personal assistance and care;
observation and supervision; planned activities; food service; and arrangements for
obtaining incidental medical and dental care. The licensee cannot delegate these
services.
The services of privately paid personal assistants do not relieve the licensee of the
responsibility to meet all licensing statutory and regulatory requirements. The licensee
must ensure that there is always sufficient staff to meet the resident’s needs, and that
staff are aware of the resident’s current overall health and safety needs.Privately paid personal assistants may only provide services other than those the
licensee is required to provide. The assistants can provide companionship, or
additional baths beyond what the licensee is required to provide. They cannot assist
the resident with care relating to any incidental medical services described under
regulation sections 87605 through 87631. Some of those services include postural
supports, oxygen administration, colostomy/illeostomy care, catheter care and
injections.
The RCFE statutes and regulations do not prohibit RCFE residents from hiring private
paid personal assistants and do not require a private paid personal assistant to be an
employee of a RCFE. In addition, licensees are not prohibited from requiring in their
admission agreement that residents hire only employees of the licensee. Private paid
personal assistants must, however, have a criminal record clearance or exemption, and
can only provide specified services to the resident.

ADVERTISEMENT AND FACILITY LICENSE NUMBERS

Licensees are reminded that regulations require that the facility license number be
disclosed in all public advertisements or correspondence. Public advertisements
include but are not limited to the internet, newspaper or magazine, consumer report,
announcement of intent to commence business, yellow pages, professional or service
directory, and radio and television. For more information, see
http://www.dss.cahwnet.gov/ord/PG295.htm in General Licensing Requirements for
Adult Residential Facilities under section 80011 and in RCFE under section 87206.

WAIVERS AND EXCEPTIONS

Licensees are required to maintain compliance with regulations at all times. In certain
instances, licensees may wish to use alternative methods which, while not in strict
compliance with regulatory requirements, meet the intent of the regulations and allow
for a more effective operation of the facility and for more resident-centered care. These
alternate methods however, must not compromise the health and safety of other
residents in care. In these cases, waivers and exceptions may be requested by the
licensee. For more information, see http://www.dss.cahwnet.gov/ord/PG295.htm and
scroll down to your facility category regulations, then search using the terms “Program
Flexibility.”
Waivers are requests to waive a particular regulation on a facility-wide basis. They are
not for a specific individual and may remain in effect regardless of changes in residents
and individual staff. All waiver requests are evaluated on a case-by-case basis because
the variables that must be considered, such as physical plant, staffing, plan of
operation, etc., will be different each time.
Exceptions are a request to make an exception to a particular regulation for a specific
resident or staff based upon the unique needs or circumstances of that individual. The
regulation in question will still apply to all other residents and staff in the facility.
Exceptions cannot be transferred to other residents or staff Waivers and exceptions must be approved by the local licensing office before the facility
implements the practice described in the request. In order to retain residents already in
care, the licensee shall submit the request. The facility may retain the residents,
following receipt of the approval of the waiver/exception. A facility that operates in
violation of any regulation without an approved waiver or exception is subject to a
citation(s). The CCLD reserves the right to rescind waivers and exceptions if the terms
and conditions of the approved waiver or exception are not met by the licensee.
At times, the local licensing office has received requests from licensees that already
have an existing Hospice exception and now wish to change the exception to a Hospice
waiver. The waiver must be approved by the local licensing office which may take time
and in the interim the licensee has a resident who is waiting to be admitted upon
approval of the waiver. To help eliminate the wait time, the licensee may want to initially
request a Hospice waiver rather than an exception. Also, if a licensee anticipates that a
resident may be discharged from an acute care facility, the licensee must conduct a
reappraisal of the resident to determine if they can meet their needs. The licensee may
need to request an exception for that resident.

REORGANIZATION

The Branch and Division continue to work vigorously on the reorganization that was
announced in the Winter 2012 Adult and Senior Care Update. Implementation is
planned for mid-2012. Please check periodically at our website for updates, and to see
the Regional Boundary Lines that will be established upon implementation. You can
also see Biographies for the Regional Managers, and contact information for the
Regional Offices. For more information, see http://www.ccld.ca.gov/PG2860.htm.

Click here to read the pdf of this article from CCLD

SOURCE: http://www.ccld.ca.gov

What are the Medication Training Requirements for Assisted Living Staff?
The same medication training requirements apply for “Board and Care” homes also.
It is the responsibility of each licensee to ensure that the training in H&S Code
section 1569.69 is provided to staff as specified.
AB 2609 General Reminders
• The medication training material and exam for all RCFEs must be developed by, or
in consultation with, a licensed nurse, pharmacist or physician.
• The medication training components include the hands-on shadowing training,
training or instruction in the nine topics specified in statute, and passing an
examination that tests the employee’s comprehension of, and competency in, the
subjects specified in H&S Code section 1569.69(a)(4).
• The hands-on shadowing component of the training must be provided at the facility
by a licensed nurse, pharmacist or physician or by a trainer who meets the
education and experience requirements in H&S Code section 1569.69(e) and must
be completed prior to staff assisting residents with the self-administration of
medication.
• The training on the nine topics, including passing an examination on these topics,
must be completed within the first two weeks of employment if the employee’s duties
include assistance with the self-administration of medication.
• If an employee goes to work for another licensee in an RCFE and will be assisting
residents with the self-administration of medication, then the medication training
must be completed again. Certain exceptions may apply.
• Employee medication training requirements must be repeated if an employee of an
RCFE has a break of service of more than 180 consecutive calendar days and then
returns to work for the same licensee and will be assisting residents with the self administration
of medication.
SOURCE: ccld.ca.gov
CLICK HERE TO READ THE PDF

AB 2609 (Evans), CHAPTER 615, STATUTES OF 2006
Affects: Residential Care Facilities for the Elderly (RCFEs)
Subject: RCFEs: Medication Training for Direct Care Staff
Summary: This new law, which is effective January 1, 2008, adds Section 1569.69 to
the Health and Safety Code. It requires direct care staff in RCFEs, excluding licensed
medical professionals, to meet specified training requirements, including passing an
examination, in order to be able to assist residents with the self-administration of
medications. It does not authorize unlicensed personnel to directly administer
medications.
This law requires 16 hours of initial training on specified topics relating to medications
(including eight hours of hands-on shadowing and eight hours of other training or
instruction) for staff who assist residents with the self-administration of medications in
facilities licensed with a capacity of 16 or more residents, and six hours (including two
hours of hands-on shadowing and four hours of other training or instruction) for staff in
facilities with a licensed capacity of 15 or fewer residents. The training material and
exam for all RCFEs must be developed by, or in consultation with, a licensed nurse,
pharmacist or physician. Each employee who received the initial training and passed
the required exam, and who continues to assist with the self-administration of
medications, must also complete four hours of in-service training on medication-related
issues in each succeeding 12-month period.
RCFEs licensed to provide care for 16 or more residents must maintain documentation
that demonstrates that a consultant pharmacist or nurse has reviewed the facility’s
medication management program and procedures at least twice a year.
Licensees must encourage pharmacists and licensed medical professionals to use
“plain English” (no abbreviations, symbols, or Latin medical terms in instructions) when
preparing labels on medications supplied to residents.

SOURCE: ccld.ca.gov

CLICK HERE TO READ THE PDF

Regulations RESIDENTIAL CARE FACILITIES FOR THE ELDERLY 87621
87621 COLOSTOMY/ILEOSTOMY 87621
(a) Except as specified in Section 87611(a), the licensee shall be permitted to accept or retain a resident who has a colostomy or ileostomy under the following circumstances:
(1) If the resident is mentally and physically capable of providing all routine care for his/her ostomy, and the physician has documented that the ostomy is completely healed.
OR
(2) If assistance in the care of the ostomy is provided by an appropriately skilled professional.
(b) In addition to Section 87611(b), the licensees shall be responsible for the following:
(1) Ensuring that ostomy care is provided by an appropriately skilled professional.
(A) The ostomy bag and adhesive may be changed by facility staff who have been instructed by the professional.
(B) There shall be written documentation by an appropriately skilled professional outlining the instruction of the procedures delegated and the names of the facility staff who have been instructed.
(C) The professional shall review the procedures and techniques no less than twice a month.
(2) Ensuring that used bags are discarded as specified in Section 87303(f)(1).
(3) Privacy shall be afforded when ostomy care is provided.
NOTE: Authority cited: Section 1569.30, Health and Safety Code. Reference: Sections 1569.2 and 1569.312, Health and Safety Code.
CALIFORNIA-DSS-

Click here to see the section 87621 of the California Health and Safety Code

Earlier this week, CCL announced it was suspending licensing application processing, citation appeal reviews, and orientations, among other functions (click here for the original alert).

CALA has just received unofficial word that this policy is being reversed and CCL will continue functioning as usual.  The delays in application processing and appeal reviews that providers have been experiencing will continue, but the doors will remain open.

We expect to see an official written release from the department posted on their website (www.ccld.ca.gov) early next week. CALA will get the details out to you as soon as they’re available. Thank you to everyone who wrote letters – your voices were heard!

SOURCE:  CALA