87560 GOVERNING BODY
(a) The licensee, whether an individual or other entity, shall exercise general supervision over the affairs of the licensed facility and establish policies concerning its operation in conformance with these regulations and the welfare of the individuals it serves.
(b) If the licensee is a corporation or an association, the governing body shall be active, and functioning in order to assure accountability.
(c) Any change in the chief corporate officer of an organization, corporation or association shall be reported to the Department or licensing agency in writing within fifteen (15) working days following such change. Such notification shall include the name, address and the fingerprint card of the new chief executive officer as required by Section 87219.
87561 REPORTING REQUIREMENTS
(a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following:
(1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident’s name, age, sex and date of admission; date and nature of event; attending physician’s name, findings, and treatment, if any; and disposition of the case.
(A) Death of any resident from any cause regardless of where the death occurred, including but not limited to a day program, a hospital, an route to or from a hospital, or visiting away from the facility.
(B) Any serious injury as determined by the attending physician and occurring while the resident is under facility supervision.
(C) The use of an Automated External Defibrillator.
(D) Any incident which threatens the welfare, safety or health of any resident, such as physical or psychological abuse of a resident by staff or other residents, or unexplained absence of any resident
(2) Occurrences, such as epidemic outbreaks, poisonings, catastrophes or major accidents which threaten the welfare, safety or health of residents, personnel or visitors, shall be reported within 24 hours either by telephone or facsimile to the licensing agency and to the local health officer when appropriate.
(3) Fires or explosions which occur in or on the premises shall be reported immediately to the local fire authority; in areas not having organized fire services, within 24 hours to the State Fire Marshal; and no later than the next working day to the licensing agency.
(b) The licensee shall notify the Department, in writing, within thirty (30) days of the hiring of a new administrator. The notification shall include the following:
(1) Name and residence and mailing addresses of the new administrator.
(2) Date he/she assumed his/her position.
(3) Description of his/her background and qualifications, including documentation of required education and administrator certification.
87562 FINANCES
The licensee shall have a financial plan which conforms to the requirements of Section 87218, and which assures sufficient resources to meet operating costs for care of residents; shall maintain adequate financial records; and shall submit such financial reports as may be required upon the written request of the Department of licensing agency. Such request shall explain the need for disclosure. The Department or licensing agency reserves the right to reject any financial report and to request additional information or examination including interim financial statements.
87564 ADMINISTRATOR – QUALIFICATIONS AND DUTIES
(a) All facilities shall have a certified administrator. The licensee and the administrator may be one and the same person. The administrator shall have sufficient freedom from other responsibilities and shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility as specified in this section. When the administrator is not in the facility, there shall be coverage by a designated substitute who shall have qualifications adequate to be responsible and accountable for management and administration of the facility as specified in this section. The Department may require that the administrator devote additional hours in the facility to
his/her responsibilities when the need for such additional hours is substantiated by written documentation.
(b) The administrator of a facility or facilities shall have the responsibility and authority to carry out the policies of the licensee.
(c) Failure to comply with all licensing requirements pertaining to certified administrators may constitute cause for revocation of the license of the facility.
(d) The administrator shall have the qualifications specified in Sections 87564(d)(1) through (7). If the licensee is also the administrator, all requirements for an administrator shall apply.
(1) Knowledge of the requirements for providing care and supervision appropriate to the residents.
(2) Knowledge of and ability to conform to the applicable laws, rules and regulations.
(3) Ability to maintain or supervise the maintenance of financial and other records.
(4) When applicable, the ability to direct the work of others.
(5) Good character and a continuing reputation of personal integrity.
(6) Have a high school diploma or equivalent, such as a General Education Development (GED) certificate.
(7) Be at least 21 years of age.
(e) The administrator of a facility licensed for sixteen (16) to forty-nine (49) residents shall have completed, with a passing grade, at least fifteen (15) college or continuing education semester or equivalent quarter units; and shall have at least one year’s experience providing residential care to the elderly; or equivalent education and experience as approved by the Department.
(f) The administrator in facilities licensed for fifty (50) or more shall have two years of college; at least three years experience providing residential care to the elderly; or equivalent education and experience as approved by the licensing agency.
(g) All administrators shall be required to complete at least 20 clock hours of continuing education per year in areas related to aging and/or administration.
(h) Administrators employed/licensed prior to July 1, 1982, shall not be required to comply with the college and continuing education requirements in Section 87564(e) or the college requirements in Section 87564(f) provided that they have no break in employment as an RCFE administrator exceeding three (3) consecutive years.
(i) The administrator shall have the responsibility to:
(1) Administer the facility in accordance with these regulations and established policy, program and budget.
(2) Where applicable, report to the licensee on the operation of the facility, and provide the licensee with necessary interpretations of recognized standards of care and supervision.
(3) Develop an administrative plan and procedures to ensure clear definition of lines of responsibility, equitable workloads, and adequate supervision.
(4) Recruit, employ and train qualified staff, and terminate employment of staff who perform in an unsatisfactory manner.
(5) Provide or ensure the provision of services to the residents with appropriate regard for the residents’ physical and mental well-being and needs, including those services identified in the residents’ pre-admission appraisal, specified in Section 87583.
(6) Make special provisions for the safety and guidance of residents with visual or auditory deficiencies.
(7) Make provision for the resident with unmet needs to attend available community programs,
including but not limited to, arranging for transportation.
(8) Have the personal characteristics, physical energy and competence to provide care and supervision and, where applicable, to work effectively with social agencies.
(j) In those cases where the individual is both the licensee and the administrator of a residential care facility for the elderly, the individual shall comply with all of the licensee and certified administrator requirements.
(a) All individuals shall be certificate holders prior to being employed as an administrator, or shall have submitted to the Department the documentation required to obtain a certificate pursuant to Section 87564.2(b).
(1) Administrators who possess a valid Nursing Home Administrator license, issued by the California Board of Nursing Home Administrators, shall be exempt from completing an approved Initial Certification Training Program and taking a written test, provided the individual completes twelve (12) hours of classroom instruction in the following uniform Core of Knowledge areas:
(A) Laws, regulations, policies, and procedural standards that impact the operations of residential care facilities for the elderly.
(B) The use, misuse, and interaction of medication commonly used by the elderly in a residential setting.
(C) Resident admission, retention, and assessment procedures.
(2) Individuals who were both the licensee and administrator on or before July 1, 1991, shall complete an Initial Certification Training Program but shall not be required to take the written test. Individuals exempted from the written test shall be issued a conditional certification valid only for the administrator of the facility for which the exemption was granted.
87564.2 ADMINISTRATOR CERTIFICATION REQUIREMENTS
(A) As a condition to becoming a certified administrator of another facility, a holder of a conditional certificate issued pursuant to Section 87564(a)(2) shall be required to pass the written test.
(B) As a condition to applying for a new facility license, the holder of a conditional certificate issued pursuant to Section 87564(a)(2) shall be required to pass the written test.
(3) An applicant for licensure shall be subject to the same application process for Initial Certification of Administrators as set forth in Section 87564.2(b).
(b) To receive his/her certificate an applicant shall:
(1) Unless exempted by Section 87564.2(a)(1), successfully complete a Department-approved Initial Certification Training Program.
(2) Unless exempted by Section 87564.2(a)(1) or (a)(2), pass a written test administered by the Department within sixty (60) days of completion of an Initial Certification Training Program.
(3) Submit an application to the Department’s certification section within thirty (30) days of being notified of having passed the test, or if the applicant is exempt from taking the written test, within 30 days of completing the certification training. The application shall contain the following:
(A) Proof that the applicant has successfully completed a Department-approved Initial Certification Training Program or, in the case of a Nursing Home Administrator, proof of completion of 12 hours of classroom instruction as specified in Section 87564.2(a)(1).
(B) Documentation of passing the written test or qualifying for an exemption pursuant to Section 87564.2(a)(1) or (a)(2).
(C) A statement certifying that the applicant is at least twenty-one (21) years of age.
(D) Fingerprint cards, or evidence that the applicant has submitted fingerprints to the Department of Justice at a live scan facility, or a statement that the applicant has a current criminal record clearance on file with the Department.
(E) A one hundred dollar ($100) processing fee.
(F) A copy of the front and back of his/her current nursing home wallet license, or
equivalent, if the applicant is a current Nursing Home Administrator.
87564.3 ADMINISTRATOR RECERTIFICATION REQUIREMENTS
(a) Administrators shall complete at least forty (40) classroom hours of continuing education during each two (2)-year certification period.
(1) Administrators who renew their administrator certification on or after January 1, 2003, shall submit proof of having completed at least eight (8) hours of the 40 hour continuing education requirement in subjects related to serving residents with Alzheimer’s Disease and other dementias, including, but not limited to, instruction related to direct care, physical environment, and admissions procedures and assessment.
(2) Courses provided by vendors approved by the Department, or
(3) Accredited educational institutions offering courses that are consistent with the requirements of this section, or
(4) Courses offered by vendors approved by other California State agencies provided that:
(A) The approval and enforcement procedures of the state agency are comparable to the approval and enforcement procedures of the Department, and
(B) The course relates to the Core of Knowledge as specified in Sections 87730(h)(1)(A) through (I).
(C) Prior to taking a course from one of the entities specified in Sections 87564.3(a)(2) or
(3), the certificate holder should study the course description carefully to ensure that it fits within the Core of Knowledge as specified in Sections 87730(h)(1)(A) through (I). If the course does not fit within the Core of Knowledge, it may not be credited toward the recertification requirement.
(D) Examples of other California State agencies that meet the requirements specified in Section 84064.3(a)(3) are the Department of Developmental Services, Department of Rehabilitation, Board of Behavioral Science Examiners and Board of Psychology.
87564.4 DENIAL OR REVOCATION OF A CERTIFICATE
(a) The Department may deny or revoke any administrator certificate for violation of licensing regulations or for any of the following grounds:
(1) The certificate holder procured a certificate by fraud or misrepresentation.
(2) The certificate holder knowingly made or gave a false statement or information in conjunction with the application for a certificate.
(3) The Department has issued an exclusion order against the certificate holder pursuant to Health and Safety Code Sections 1558, 1568.092, 1569.58 or 1596.8897 after the Department issued the certificate, and;
(A) The certificate holder did not appeal the exclusion order, or
(B) After the appeal, the Department issued a decision and order that upheld the exclusion order.
(4) The certificate holder does not have a current criminal record clearance.
(5) The certificate holder fails to comply with certificate renewal requirements.
(A) The Department may reinstate a certificate that has been revoked for failure to comply
with certificate renewal requirements provided all conditions for recertification have
been satisfied, including payment of all appropriate renewal and delinquency fees.
(6) The certificate holder engaged in conduct which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility or the people of the State of California.
(b) Any denial or revocation of an administrator certificate may be appealed as provided by Health and
Safety Code Section 1569.51.
(c) Unless otherwise ordered by the Department, any application for an administrator certificate submitted
after a denial or revocation action shall be processed in accordance with the provisions of Health and
Safety Code Section 1569.16.
87564.5 FORFEITURE OF A CERTIFICATE
(a) Unless otherwise ordered by the Department, the certificate shall be considered forfeited under any of
the following conditions:
(1) The Department has revoked any license held by the certificate holder after the Department issued the certificate.
(2) The Department has issued an exclusion order against the certificate holder pursuant to Health and Safety Code Sections 1558, 1568.092, 1569.58, or 1596.8897 after the Department issued the certificate, and;
(A) The certificate holder did not appeal the exclusion order or,
(B) After the appeal, the Department issued a decision and order that upheld the exclusion order.
(b) Unless otherwise ordered by the Department, any application for an administrator certificate submitted
after a certificate has been forfeited shall be processed in accordance with the provisions of Health and
Safety Code Sections 1569.16 and/or 1569.58(h).
87565 PERSONNEL REQUIREMENTS
(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services
necessary to meet resident needs. In facilities licensed for sixteen or more, sufficient support staff shall
be employed to ensure provision of personal assistance and care as required in Section 87578.
Additional staff shall be employed as necessary to perform office work, cooking, house cleaning,
laundering, and maintenance of buildings, equipment and grounds. The licensing agency may require
any facility to provide additional staff whenever it determines through documentation that the needs of
the particular residents, the extent of services provided, or the physical arrangements of the facility
require such additional staff for the provision of adequate services.
(b) All persons who supervise employees or who supervise or care for residents shall be at least eighteen
(18) years of age.
(c) All RCFE staff who assist residents with personal activities of daily living shall receive at least ten hours of initial training within the first four weeks of employment and at least four hours annually hereafter.
(1) This training shall be administered on the job, in a classroom setting, or any combination of the two.
(2) The training shall include, but not be limited to, the following:
(A) The aging process and physical limitations and special needs of the elderly. At least two
(2) of the required ten (10) hours shall cover this subject.
(B) Importance and techniques of personal care services, including but not limited to, bathing, grooming, dressing, feeding, toileting, and universal precautions. At least three
(3) of the required ten (10) hours shall cover this subject.
(C) Residents’ rights, as specified in Section 87572.
(D) Policies and procedures regarding medications, including the knowledge in Section
87565(d)(4). At least two (2) of the required ten (10) hours shall cover this subject. Any on-the-job training provided for the requirements in Section 87565(d)(4) may also count towards the requirement in this subsection.
(E) Psychosocial needs of the elderly, such as recreation, companionship, independence, etc.
(F) Recognizing signs and symptoms of dementia in individuals.
87566 PERSONNEL RECORDS
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each
employee. Each personnel record shall contain the following information:
(1) Employee’s full name.
(2) Social Security number.
(3) Date of employment.
(4) Written verification that the employee is at least 18 years of age, including, but not necessarily limited to, a copy of his/her birth certificate or driver’s license.
(5) Home address and telephone number.
(6) Educational background.
(A) For administrators this shall include verification that he/she meets the educational requirements in Sections 87564(b) and (c).
(7) Past experience, including types of employment and former employers.
(8) Type of position for which employed.
(9) Termination date if no longer employed by the facility.
(10) Reasons for leaving.
(11) A health screening as specified in Section 87565.
(12) Hazardous health conditions documents as specified in Section 87565.
(13) For employees that are required to be fingerprinted pursuant to Section 80019:
(A) A signed statement regarding their criminal record history as required by Section 87219(d).
(B) Documentation of either a criminal record clearance or a criminal record exemption as required by Section 87219(e).
1. For Certified Administrators, a copy of their current and valid Administrative Certification meets this requirement.
87567 GENERAL
(a) Prior to accepting a resident for care and in order to evaluate his/her suitability, the facility shall, as
specified in this article:
(1) Conduct an interview with the applicant and his responsible person.
(2) Perform a pre-admission appraisal.
(3) Obtain and evaluate a recent medical assessment.
(4) Execute the admissions agreement.
(a) The licensee shall complete an individual written admission agreement with each resident and that
resident’s responsible person or conservator, if any.
(b) The licensee shall complete and maintain in the resident’s file a Telecommunications Device
Notification form (LIC 9158, 5/97) for each resident whose pre-admission appraisal or medical
assessment indicates he/she is deaf, hearing-impaired, or otherwise disabled.
(c) Agreements shall specify the following:
(1) Basic services to be made available.
(2) Optional services which are available.
(3) Payment provisions, including the following:
(A) Basic services rate, including any exempt-income-allowance, if the resident agrees to such charge.
(B) Optional services costs.
(C) Payor.
(D) Due date.
(E) Funding source, provided that the resident may refuse to disclose such source.
87569 MEDICAL ASSESSMENT
(a) Prior to a person’s acceptance as a resident, the licensee shall obtain and keep on file, documentation of
a medical assessment, signed by a physician, made within the last year. The licensee shall be permitted
to use the form LIC 602 (Rev. 9/89), Physician’s Report, to obtain the medical assessment.
(b) The medical assessment shall include, but not be limited to:
(1) A physical examination of the resident indicating the physician’s primary diagnosis and
secondary diagnosis, if any and results of an examination for communicable tuberculosis, other
contagious/infectious diseases or other medical conditions which would preclude care of the
person by the facility.
(2) Documentation of prior medical services and history and current medical status including, but not
limited to height, weight, and blood pressure.
(3) A record of current prescribed medications, and an indication of whether the medication should
be centrally stored, pursuant to Section87575(h)(1).
(4) Identification of physical limitations of the person to determine his/her capability to participate in
the programs provided by the licensee, including any medically necessary diet limitations.
(5) The determination whether the person is ambulatory or non ambulatory as defined in Section
87101(a) or (n), or bedridden as defined in Section 87582(d). The assessment shall indicate
whether non ambulatory status is based upon the resident’s physical condition, mental condition
or both.
(6) Information applicable to the pre-admission appraisal specified in Section 87583.
(c) The licensee shall obtain an updated medical assessment when required by the Department.
87570 RESIDENT RECORDS
(a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in
the facility or in a central administrative location readily available to facility staff and to licensing
agency staff.
(b) Each record shall contain at least the following information:
(1) Resident’s name and Social Security number.
(2) Dates of admission and discharge.
(3) Last known address.
(4) Birthdate.
(5) Religious preference, if any, and name and address of clergyman or religious advisor, if any.
(6) Names, addresses, and telephone numbers of responsible persons, as defined in Section 87101(r),
to be notified in case of accident, death, or other emergency.
(7) Name, address and telephone number of physician and dentist to be called in an emergency.
(8) Reports of the medical assessment specified in Section 87569, and of any special problems or precautions.
(9) The documentation required by Section 87702.1(a) for residents with an allowable health condition.
(10) Ambulatory status.
(11) Continuing record of any illness, injury, or medical or dental care, when it impacts the resident’s
ability to function or the services he needs.
(12) Current centrally stored medications as specified in Section 87575.
(13) The admission agreement and pre-admission appraisal, specified in Sections 87568 and 87583.
(14) Records of resident’s cash resources as specified in Section 87227.
(15) Documents and information required by the following:
(A) Section 87583, Pre-Admission Appraisal – General;
(B) Section 87584, Functional Capabilities;
(C) Section 87585, Mental Condition;
87571 REGISTER OF RESIDENTS
(a) The licensee shall ensure that a current register of all residents in the facility is maintained and contains
the following updated information:
(1) The resident’s name and ambulatory status as specified in Sections 87570(b)(1) and (b)(10).
(2) Information on the resident’s attending physician as specified in Section 87570(b)(7).
(3) Information on the resident’s responsible person as specified in Section 87570(b)(6).
(b) Registers of residents shall be available to the licensing agency to inspect, audit, and copy upon
demand during normal business hours. Registers may be removed if necessary for copying. Removal
of registers shall be subject to the following requirements:
(1) Licensing representatives shall not remove current registers unless the same information is
otherwise readily available in another document or format.
(2) Prior to removing any registers, a licensing representative shall prepare a list of the registers to be
removed, sign and date the list upon removal of the records, and leave a copy of the list with the
administrator or designee.
(3) Licensing representatives shall return the registers undamaged and in good order within three
business days following the date the records were removed.
(c) The register of current residents shall be kept in a central location at the facility.
(1) The register shall be treated as confidential information pursuant to Section 87570(c).
87572 PERSONAL RIGHTS
(a) Each resident shall have personal rights which include, but are not limited to, the following:
(1) To be accorded dignity in his/her personal relationships with staff, residents, and other persons.
(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment.
(3) To be free from corporal or unusual punishment, humiliation, intimidation, mental abuse, or
other actions of a punitive nature, such as withholding of monetary allowances or interfering with
daily living functions such as eating or sleeping patterns or elimination.
(4) To be informed by the licensee of the provisions of law regarding complaints and of procedures
to confidentially register complaints, including, but not limited to, the address and telephone
number of the complaint receiving unit of the licensing agency.
(5) To have the freedom of attending religious services or activities of his/her choice and to have
visits from the spiritual advisor of his/her choice. Attendance at religious services, either in or
outside the facility, shall be on a completely voluntary basis.
(6) To leave or depart the facility at any time and to not be locked into any room, building, or on
facility premises by day or night. This does not prohibit the establishment of house rules, such as
the locking of doors at night, for the protection of residents; nor does it prohibit, with permission
of the licensing agency, the barring of windows against intruders.
(7) To visit the facility prior to residence along with his/her family and responsible persons.
(8) To have his/her family or responsible persons regularly informed by the facility of activities
related to his care or services including ongoing evaluations, as appropriate to the resident’s
needs.
(9) To have communications to the facility from his/her family and responsible persons answered
promptly and appropriately.
87573 TELEPHONES
All facilities shall have telephone service on the premises. Facilities with a capacity of sixteen (16) or more
persons shall be listed in the telephone directory under the name of the facility.
87574 MOTOR VEHICLES USED IN TRANSPORTING RESIDENTS
Only drivers licensed for the type of vehicle operated shall be permitted to transport residents. The rated
seating capacity of the vehicles shall not be exceeded. Any vehicle used by the facility to transport residents
shall be maintained in a safe operating condition.
87575 INCIDENTAL MEDICAL AND DENTAL CARE
(a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall
encourage routine medical and dental care and provide for assistance in obtaining such care, by
compliance with the following:
(1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the
conditions and needs of residents.
(2) The licensee shall provide assistance in meeting necessary medical and dental needs. This
includes transportation which may be limited to the nearest available medical or dental facility
which will meet the resident’s need. In providing transportation the licensee shall do so directly
or make arrangements for this service.
(3) There shall be arrangements for separation and care of residents whose illness requires separation from others.
(4) When residents require prosthetic devices, vision and hearing aids, the staff shall be familiar with
the use of these devices, and shall assist such persons with their utilization as needed.
(5) The licensee shall assist residents with self-administered medications as needed.
(6) Facility staff, except those authorized by law, shall not administer injections, but staff designated
by the licensee may assist persons with self-administration as needed. Assistance with self administered medications shall be limited to the following:
(A) Medications usually prescribed for self-administration which have been authorized by the person’s physician.
(B) Medications during an illness determined by a physician to be temporary and minor.
(C) Assistance required because of tremor, failing eyesight and similar conditions.
(D) Assistance with self-administration does not include forcing a resident to take
medication, hiding or camouflaging medications in other substances without the
resident’s knowledge and consent, or otherwise infringing upon a resident’s right to
refuse to take a medication.
(7) When requested by the prescribing physician or the Department, a record of dosages of
medications which are centrally stored shall be maintained by the facility
87576 FOOD SERVICE
(a) The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the
residents and shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the
National Research Council. All food shall be selected, stored, prepared and served in a safe and
healthful manner.
(b) The following food service requirements shall apply:
(1) Where all food is provided by the facility arrangements shall be made so that each resident has
available at least three meals per day. Exceptions may be allowed on weekends and holidays
providing the total daily food needs are met. Not more than fifteen (15) hours shall elapse
between the third and first meal.
(2) Where meal service within a facility is elective, arrangements shall be made to assure availability
of an adequate daily food intake for all residents who, in their admission agreement, elected meal
service. If a resident’s condition changes so that he is no longer able to cook or purchase his own
meals, the admission agreement shall be modified and the resident provided full meal service.
(3) Between-meal nourishment or snacks shall be made available for all residents unless limited by
dietary restrictions prescribed by a physician.
(4) Meals on the premises shall be served in a designated dining area suitable for the purpose and
residents encouraged to have meals with other residents. Tray service shall be provided in case
of temporary need.
(5) Meals shall consist of an appropriate variety of foods and shall be planned with consideration for
cultural and religious background and food habits of residents.
(6) In facilities for sixteen (16) persons or more, menus shall be written at least one week in advance
and copies of the menus as served shall be dated and kept on file for at least 30 days. Facilities
licensed for less than sixteen (16) residents shall maintain a sample menu in their file. Menus
shall be made available for review by the residents or their designated representatives and the
licensing agency upon request.
(7) Modified diets prescribed by a resident’s physician as a medical necessity shall be provided.
87577 PERSONAL ACCOMMODATIONS AND SERVICES
(a) Living accommodations and grounds shall be related to the facility’s function. The facility shall be
large enough to provide comfortable living accommodations and privacy for the residents, staff, and
others who may reside in the facility. The following provisions shall apply:
(1) There shall be common rooms such as living rooms, dining rooms, dens or other
recreation/activity rooms. They shall be of sufficient space and/or separation to promote and
facilitate the program of activities and to prevent such activities from interfering with other
functions.
(2) Resident bedrooms shall be provided which meet, at a minimum, the following requirements:
(A) Bedrooms shall be large enough to allow for easy passage between and comfortable
usage of beds and other required items of furniture specified below, and any resident
assistant devices such as wheelchairs or walkers.
(B) No room commonly used for other purposes shall be used as a sleeping room for any
resident. This includes any hall, stairway, unfinished attic, garage storage area, shed or
similar detached building.
(C) No bedroom of a resident shall be used as a passageway to another room, bath or toilet.
(D) Not more than two residents shall sleep in a bedroom.
(3) Equipment and supplies necessary for personal care and maintenance of adequate hygiene
practice shall be readily available to each resident. The resident may provide the following
items; however, if the resident is unable or chooses not to provide them, the licensee shall assure
provision of:
(A) A bed for each resident, except that married couples may be provided with one
appropriate sized bed. Each bed shall be equipped with good springs, a clean and
comfortable mattress, available pillow(s) and lightweight warm bedding. Fillings and
covers for mattresses and pillows shall be flame retardant. Rubber sheeting shall be
provided when necessary.
87578 PERSONAL ASSISTANCE AND CARE
(a) Based on the individual’s preadmission appraisal, and subsequent changes to that appraisal, the facility
shall provide assistance and care for the resident in those activities of daily living which the resident is
unable to do for himself/herself. Postural supports may be used under the following conditions.
(1) Postural supports shall be limited to appliances or devices such as braces, spring release trays, or
soft ties, used to achieve proper body position and balance, to improve a resident’s mobility and
independent functioning, or to position rather than restrict movement including, but not limited
to, preventing a resident from falling out of bed, a chair, etc.
(A) Physician-prescribed orthopedic devices such as braces or casts, used for support of a
weakened body part or correction of body parts, are considered postural supports.
(2) Postural supports shall be fastened or tied in a manner that permits quick release by the resident.
(3) A written order from a physician indicating the need for the postural support shall be maintained
in the resident’s record. The licensing agency shall be authorized to require other additional
documentation if needed to verify the order.
(4) Prior to the use of postural supports that change the ambulatory status of a resident to non ambulatory, the licensee shall ensure that the appropriate fire clearance, as required by Section
87220, Fire Clearance has been secured.
(5) Under no circumstances shall postural supports include tying, depriving, or limiting the use of a
resident’s hands or feet.
(A) A bed rail that extends from the head half the length of the bed and used only for
assistance with mobility shall be allowed.
(B) Bed rails that extend the entire length of the bed are prohibited except for residents who
are currently receiving hospice care and have a hospice care plan that specifies the need
for full bed rails.
87579 PLANNED ACTIVITIES
(a) Residents shall be encouraged to maintain and develop their fullest potential for independent living
through participation in planned activities. The activities made available shall include:
(1) Socialization, achieved through activities such as group discussion and conversation, recreation,
arts, crafts, music and care of pets.
(2) Daily living skills/activities which foster and maintain independent functioning.
(3) Leisure time activities cultivating personal interests and pursuits, and encouraging leisure-time
activities with other residents.
(4) Physical activities such as games, sports and exercise which develop and maintain strength,
coordination and range of motion.
(5) Education, achieved through special classes or activities.
(6) Provision for free time so residents may engage in activities of their own choosing.
(b) Residents served shall be encouraged to contribute to the planning, preparation, conduct, clean-up and
critique of the planned activities.
(c) The licensee shall arrange for utilization of available community resources through contact with
organizations and volunteers to promote resident participation in community-centered activities which
may include:
(1) Attendance at the place of worship of the resident’s choice.
(2) Service activities for the community.
(3) Community events such as concerts, tours and plays.
(4) Participation in community organized grop activities, such as senior citizen groups, sports
leagues and service clubs.
(d) In facilities licensed for seven (7) or more persons, notices of planned activities shall be posted in a
central location readily accessible to residents, relatives, and representatives of placement and referral
agencies. Copies shall be retained for at least six (6) months.
(e) In facilities licensed for sixteen (16) to forty-nine (49) persons, one staff member, designated by the
administrator, shall have primary responsibility for the organization, conduct and evaluation of planned
activities. This person shall have had at least six (6) months experience in providing planned activities
or have completed or be enrolled in an appropriate education or training program.
87580 PERSONNEL – OPERATIONS
(a) In each facility:
(1) When regular staff members are absent, there shall be coverage by personnel with qualifications
adequate to perform the assigned tasks.
(2) Care and supervision of residents shall be provided without physical or verbal abuse, exploitation
or prejudice.
(3) The licensee shall provide for and encourage all personnel to report observations or evidence of
such abuse, exploitation or prejudice.
(b) If the facility is licensed for sixteen (16) persons or more, there shall be a dated weekly employee time
schedule displayed conveniently for employee reference. The schedule shall contain employee’s name,
job title, hours of work, and days off.
87581 NIGHT SUPERVISION
(a) The following persons providing night supervision from l0:00 p.m. to 6:00 a.m. shall be familiar with
the facility’s planned emergency procedures, shall be trained in first aid as required in Section 87575,
and shall be available as indicated below to assist in caring for residents in the event of an emergency.
(1) In facilities caring for less than sixteen (16) residents, there shall be a qualified person on call on the premises.
(2) In facilities caring for sixteen (16) to one hundred (100) residents at least one employee shall be
on duty on the premises, and awake. Another employee shall be on call, and capable of
responding within ten minutes.
(3) In facilities caring for one hundred one (101) to two hundred (200) residents, one employee shall
be on call, on the premises; one employee shall be on duty on the premises and awake; and one
employee shall be on call and capable of responding within ten minutes.
87582 ACCEPTANCE AND RETENTION LIMITATIONS
(a) Acceptance or retention of residents by a facility shall be in accordance with the criteria specified in
this article and in the Incidental Medical Services, Section 87700, and the following.
(b) The following persons may be accepted or retained in the facility:
(1) Persons capable of administering their own medications.
(2) Persons receiving medical care and treatment outside the facility or who are receiving needed
medical care from a visiting nurse.
(3) Persons who because of forgetfulness or physical limitations need only be reminded or to be
assisted to take medication usually prescribed for self-administration.
(4) Persons with problems including, but not limited to, forgetfulness, wandering, confusion, irritability, and inability to manage money.
(5) Persons with mild temporary emotional disturbance resulting from personal loss or change in living arrangement.
(6) Persons who are under 60 years of age whose needs are compatible with other residents in care, if
they require the same amount of care and supervision as do the other residents in the facility
87583 PRE-ADMISSION APPRAISAL – GENERAL
(a) Prior to admission, the prospective resident and his/her responsible person, if any, shall be interviewed
by the licensee or the employee responsible for facility admissions.
(1) Sufficient information about the facility and its services shall be provided to enable all persons
involved in the placement to make an informed decision regarding admission.
(2) The prospective resident’s desires regarding admission, and his/her background, including any
specific service needs, medical background and functional limitations shall be discussed.
(b) No person shall be admitted without his/her consent and agreement, or that of his/her responsible person, if any.
(c) Prior to admission a determination of the prospective resident’s suitability for admission shall be
completed and shall include an appraisal of his/her individual service needs in comparison with the
admission criteria specified in Section 87582.
(1) The appraisal shall include, at a minimum, an evaluation of the prospective resident’s functional
capabilities, mental condition and an evaluation of social factors as specified in Sections 87584
through 87586.
(A) The licensee shall be permitted to use the form LIC 603 (Rev. 6/87), Preplacement
Appraisal Information, to document the appraisal.
(2) Except as provided in Section 87701.5(g)(3), if an initial appraisal or any reappraisal identifies
an individual resident service need which is not being met by the general program of facility
services, advice shall then be obtained from a physician, social worker, or other appropriate
consultant to determine if the needs can be met by the facility. If so, the licensee and the
consultant shall develop a plan of action which shall include:
(A) Objectives, within a time frame, which relate to the resident’s problems and/or unmet needs.
(B) Plans for meeting the objectives.
(C) Identification of any individuals or agencies responsible for implementing each part of the plan.
(D) Method of evaluating progress.
87584 FUNCTIONAL CAPABILITIES
(a) The facility shall assess the person’s need for personal assistance and care by determining his/her ability
to perform specified activities of daily living. Such activities shall include, but not be limited to:
(1) Bathing, including need for assistance:
(A) In getting in and out of the bath.
(B) In bathing one or more parts of the body.
(C) Through use of grab bars.
(2) Dressing and grooming, including the need for partial or complete assistance.
(3) Toileting, including the need for:
(A) Assistance equipment.
(B) Assistance of another person.
(4) Transferring, including the need for assistance in moving in and out of a bed or chair.
(5) Continence, including:
(A) Bowel and bladder control.
(B) Whether assistive devices such as a catheter are used.
(6) Eating, including the need for:
(A) Adaptive devices.
(B) Assistance from another person.
87585 MENTAL CONDITION
(a) The facility shall determine the amount of supervision necessary by assessing the mental status of the
prospective resident to determine if the individual:
(1) tends to wander;
(2) is confused or forgetful;
(3) is capable of managing his/her own cash resources;
(4) actively participates in social activities or is withdrawn;
(5) has a documented history of behaviors which may result in harm to self or others.
87586 SOCIAL FACTORS
The facility shall obtain sufficient information about each person’s likes and dislikes and interests and
activities, to determine if the living arrangements in the facility will be satisfactory, and to suggest the
program of activities in which the individual may wish to participate.
87587 REAPPRAISALS
(a) The pre-admission appraisal shall be updated, in writing as frequently as necessary to note significant
changes and to keep the appraisal accurate. The reappraisals shall document changes in the resident’s
physical, medical, mental, and social condition. Significant changes shall include but not be limited to:
(1) A physical trauma such as a heart attack or stroke.
(2) A mental/social trauma such as the loss of a loved one.
(3) Any illness, injury, trauma, or change in the health care needs of the resident that results in a
circumstance or condition specified in Sections 87582(c) or 87701.
(b) The licensee shall immediately bring any such changes to the attention of the resident’s physician and
his family or responsible person.
(c) The licensee shall arrange a meeting with the resident, the resident’s representative, if any, appropriate
facility staff, and a representative of the resident’s home health agency, if any, when there is significant
change in the resident’s condition, or once every 12 months, whichever occurs first, as specified in
Section 87583.1.
87588 DOCUMENTATION AND SUPPORT
Each facility shall document in writing the findings of the pre-admission appraisal and any reappraisal or
assessment which was necessary in accordance with Sections 87583 and 87587. If supporting documentation
from a physician is required, this input shall also be obtained and may be the same assessment as required in
Section 87569.
87589 EVICTION PROCEDURES
(a) The licensee may, upon thirty (30) days written notice to the resident, evict the resident for one or more
of the following reasons:
(1) Nonpayment of the rate for basic services within ten days of the due date.
(2) Failure of the resident to comply with state or local law after receiving written notice of the alleged violation.
(3) Failure of the resident to comply with general policies of the facility. Said general policies must
be in writing, must be for the purpose of making it possible for residents to live together and
must be made part of the admission agreement.
(4) If, after admission, it is determined that the resident has a need not previously identified and a
reappraisal has been conducted pursuant to Section 87587, and the licensee and the person who
performs the reappraisal believe that the facility is not appropriate for the resident.
(5) Change of use of the facility.
(b) The licensee may, upon obtaining prior written approval from the licensing agency, evict the resident
upon three (3) days written notice to quit. The licensing agency may grant approval for the eviction
upon a finding of good cause. Good cause exists if the resident is engaging in behavior which is a
threat to the mental and/or physical health or safety of himself or to the mental and/or physical health or
safety of others in the facility.
(c) The licensee shall, in addition to either serving thirty (30) days notice or seeking approval from the
Department and service three (3) days notice on the resident, notify or mail a copy of the notice to quit
to the resident’s responsible person.
(d) The licensee shall set forth in the notice to quit the reasons relied upon for the eviction with specific
facts to permit determination of the date, place, witnesses, and circumstances concerning those reasons.
87590 BASIC SERVICES
(a) The services provided by the facility shall be conducted so as to continue and promote, to the extent
possible, independence and self-direction for all persons accepted for care. Such persons shall be
encouraged to participate as fully as their conditions permit in daily living activities both in the facility
and in the community.
(b) As used in this chapter, basic services are those services required to be provided in order to obtain and
maintain a license.
(c) The admission agreement shall specify which of the basic services are desired and/or needed by, and
will be provided for, each resident.
(d) A facility need not accept a particular resident for care. However, if a facility chooses to accept a
particular resident for care, the facility shall be responsible for meeting the resident’s needs as identified
in the pre-admission appraisal specified in Section 87583 and providing the other basic services
specified below, either directly or through outside resources.
87591 OBSERVATION OF THE RESIDENT
The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and
social functioning and that appropriate assistance is provided when such observation reveals unmet needs.
When changes such as unusual weight gains or losses or deterioration of mental ability or a physical health
condition are observed, the licensee shall ensure that such changes are documented and brought to the
attention of the resident’s physician and the resident’s responsible person, if any.
87592 RESIDENT COUNCILS
The facility shall permit the formation of a resident council by interested residents, provide space and post
notice for meetings, and provide assistance in attending meetings for those residents who request it. In order
to permit a free exchange of ideas, at least part of each meeting shall be allowed to be conducted without the
presence of any facility personnel. Residents shall be encouraged, but shall not be compelled to attend. The
purpose of such an organization shall be to work with the administration in improving the quality of life for
all residents by enriching the activity program and to discuss the services offered by the facility and make
recommendations regarding identified problems.
87593 REQUIREMENTS FOR EMERGENCY ADULT PROTECTIVE SERVICES PLACEMENTS
(a) The licensee shall be permitted to accept emergency placements by an adult protective services (APS)
agency, if the licensee has received approval from the Department to provide emergency shelter
services.
(1) To obtain approval, the licensee shall submit a written request to the Department. The request
shall include, but not be limited to, the following:
(A) A letter of interest from the county APS agency stating that if the request to provide
emergency shelter services is approved, the APS agency may enter into an agreement
with the licensee to provide such services.
1. A copy of the written agreement between the APS agency and the licensee,
listing the responsibilities of each party, shall be sent to the Department within
seven calendar days of signing.
(B) A written addendum to the Plan of Operation, specified in Section 87222, that includes
procedures for the intake of an APS emergency placement. The addendum shall specify
how the licensee will meet the needs of a resident placed on an emergency basis, such as
on-call staff, additional staff and training.
1. The procedures shall include, but not be limited to, provisions for a private room.
a. The licensee shall provide a private room for the resident until a preadmission appraisal of the resident’s individual service needs has been completed, specified in Section 87583.
b. The Department may approve an alternative to a private room, such as awake or additional staff, but an alternative shall not be approved if it displaces staff or other residents of the facility.
(C) A licensee of a residential care facility for the elderly may accept an adult resident, 18
through 59 years of age, for emergency placement under the following conditions:
1. The APS agency has written a statement indicating a local need exists for the licensee to accept emergency placements of adults 18 through 59 years of age.
a. The licensee attaches this APS statement of local need [Section 87593(a)(1)(C)1.] to the written request, specified in Section 87593(a)(1).
b. The licensee must request a statement each year from the APS agency, indicating a local need still exists as specified in Section 87593(a)(1)(C)1., and submit the statement to the Department.