87451 SERIOUS DEFICIENCIES

(a) Regulations including but not limited to the following may result in serious deficiencies when a failure to comply presents an immediate or substantial threat to the physical health, mental health, or safety of the residents:
(1) Section 87219 relating to criminal record clearance.
(2) Section 87220 relating to fire clearance.
(3) Section 87110 relating to limitations on the number or types of facility residents.
(4) Section 87573 relating to telephone service.
(5) Sections 87582(c)(1) or (2), or (4), or Section 87701 relating to persons with communicable diseases, persons requiring inpatient health care, persons who are bedridden, or persons with a prohibited health condition.
(6) Section 87110(b) relating to non ambulatory residents.
(7) Section 87572(a)(3) relating to resident rights.
(8) Section 87578(a) relating to restraints.
(9) Sections 87577(d)(3) through (7) or (e) relating to safety of resident accommodations.
(10) Sections 87576(b)(24), (25), or (27) relating to storage, preparation and service of food.
(11) Section 87575(b)(3) relating to medical and dental care of residents.
(12) Section 87575(c) relating to storing and dispensing medications.
(13) Section 87691(e)(2) relating to hot water temperature.
(14) Sections 87691 (e)(4), (5), or (6) relating to toilet, handwashing and bathing accommodations.
(15) Sections 87691 (f)(1) or (2) relating to storage and disposal of solid wastes, syringes and needles.
(16) Section 87581 relating to night supervision.
(17) Section 87701.5 relating to licensees forwarding to the Department a resident’s request for review by an interdisciplinary team of a health condition relocation order.

87452 DEFICIENCIES IN COMPLIANCE 

(a) When a routine visit, evaluation or investigation of a complaint is conducted and the evaluator determines that a deficiency exists, the evaluator shall issue a notice of deficiency, unless the deficiency is minor and corrected during the visit.
(b) Prior to completion of a visit, evaluation or investigation, the evaluator shall meet with the licensee, administrator, operator, or other person in charge of the facility to discuss any deficiencies noted. At the meeting, a plan for correcting each deficiency shall be developed and included in the notice of deficiency. Prior to completion of the visit the evaluator shall serve the notice of deficiency on the licensee by either:
(1) Personal delivery to the licensee, or
(2) If the licensee is not at the facility site, leaving the notice with the person in charge of the facility and also mailing a copy to the licensee.
(3) If the licensee or the person in charge of the facility refuses to accept the notice, a notation of the
refusal shall be written on the notice and a copy left at the facility.
(A) Under such circumstances, a copy of the notice shall also be mailed to the licensee.
(c) The notice of deficiency shall be in writing and shall include:
(1) A reference to the statute or regulation upon which the deficiency is premised.
(2) A factual description of the nature of the deficiency fully stating the manner in which the licensee failed to comply with specified statute or regulation, and the particular place or area of the facility in which it occurred.
(3) The plan developed, as specified in (b) above, for correcting each deficiency.
(4) A date by which each deficiency shall be corrected.
(A) In prescribing the date for correcting a deficiency, the evaluator shall consider the following factors:

87452 DEFICIENCIES IN COMPLIANCE

1. The seriousness of the deficiency.
2. The number of residents affected.
3. The availability of equipment or personnel necessary to correct the deficiency.
4. The estimated time necessary for delivery and any installation of necessary equipment.
(B) The evaluator shall require correction of the deficiency within 24 hours and shall specify on the notice the date by which the correction must be made whenever penalties are assessed pursuant to Sections 87454(c), (d) and (e).
(C) The date for correcting a deficiency shall not be more than 30 calendar days following service of the notice of deficiency, unless the evaluator determines that the deficiency cannot be completely corrected in 30 calendar days. If the date for correcting the deficiency is more than 30 days following service of the notice of deficiency the notice shall specify action which must be taken within 30 calendar days to begin correction.
(5) The amount of penalty which shall be assessed and the date the penalty shall begin if the deficiency is not corrected by the specific due date.
(6) The address and telephone number of the licensing office

87453 FOLLOW-UP VISITS TO DETERMINE COMPLIANCE

(a) A follow-up visit shall be conducted within 10 working days following the latest date of correction specified in the notice of deficiency, unless the licensee has demonstrated that the deficiency was corrected as required in the notice of deficiency. No penalty shall be assessed unless a follow-up visit is conducted.
(b) If a follow-up visit indicates that a deficiency was not corrected on or before the date specified in the notice of deficiency, the evaluator shall issue a notice of penalty.
(c) A notice of penalty shall be in writing and shall include:
(1) The amount of penalty assessed, and the date the payment is due.
(2) The name and address of the agency responsible for collection of the penalty.
(d) When an immediate penalty has been assessed pursuant to Sections 87454(c), (d), (e) and (f) and
correction is made when the evaluator is present, a follow-up visit is not required.

87454 PENALTIES 

(a) A penalty of $50 per day, per cited violation, shall be assessed for all serious deficiencies that are not corrected by the date specified in the notice of deficiency, up to a maximum of $150 per day.
(b) Notwithstanding Section 87454(a) above, an immediate penalty of $100 per cited violation per day for a maximum of five (5) days shall be assessed if any individual required to be fingerprinted under Health and Safety Code Section 1569.17(b) has not obtained a California clearance or a criminal record exemption, requested a transfer of a criminal record clearance or requested and be approved for a transfer of an exemption as specified in Section 87219(e) prior to  working, residing or volunteering in the facility.
(1) Subsequent violations within a twelve (12) month period will result in a civil penalty of one hundred dollars ($100) per violation per day for a maximum of thirty (30) days.
(2) The Department may assess civil penalties for continued violations as permitted by Health and Safety Code Section 1569.49.
(3) Progressive civil penalties specified in Sections 87454(d) and (e) shall not apply.
(c) Notwithstanding Section 87454(a) above, an immediate penalty of $150 per day shall be assessed for any of the following:
(1) Sickness, injury of death of a client has occurred as a result of the deficiency.
(d) When a facility is cited for a deficiency and violates the same regulation subsection within a 12-month period, the facility shall be cited and an immediate penalty of $150 per cited violation shall be assessed for one day only. Thereafter a penalty of $50 per day, per cited violation, shall be assessed until the deficiency is corrected.
(e) When a facility that was cited for a deficiency subject to the immediate penalty assessment specified in Section 87454(d) above violates the same regulation subsection within a 12-month period of the last violation the facility shall be cited and an immediate penalty of $1,000 per cited violation shall be assessed for one day only. Thereafter, a penalty of $100 per day, per cited violation, shall be assessed until the deficiency is corrected.

87455 ADMINISTRATIVE REVIEW

(a) A licensee or his/her representative may request in writing a review of a notice of deficiency, notice of penalty and/or health condition relocation order within 10 working days of receipt of the notice or order. This review shall be conducted by a higher level staff person other than the evaluator who issued the notice of deficiency, notice of penalty, and/or health condition relocation order.
(1) Additional review requirements pertaining to Incidental Medical Services are specified in Section 87720.
(b) If the reviewer determines that a notice of deficiency or notice of penalty was not issued in accordance with applicable statutes and regulations of the Department, he/she shall amend or dismiss the notice. In addition, the reviewer may extend the date specified for correction of a deficiency if warranted by the facts or circumstances presented to support a request for extension.

87457 UNLICENSED FACILITY PENALTIES

(a) A penalty of $100 per day per resident shall be assessed for the operation of an unlicensed facility under either of the following conditions:
(1) The 0perator has not submitted a completed application for licensure within 15 calendar days of issuance of the Notice of Operation in Violation of Law pursuant to Section 87016.
(A) For purposes of this section, an application shall be deemed completed if it includes the information required in Section 87218.
(B) The completed application shall be deemed to be submitted when received by the licensing agency.
(2) Unlicensed operation continued after denial of the initial application.
(A) Notwithstanding any appeal action, facility operation must cease within 10 calendar days of the mailing of the notice of denial or upon receipt of the denial notice by the operator, whichever occurs first.
(b) A $200 per day per resident penalty shall be assessed for the continued operation of an unlicensed facility as follows:
(1) On the 16th calendar day after the operator has been issued the Notice of Operation in Violation of Law, and has not submitted a completed application as required.
(A) The $200 per day per resident penalty shall continue until the operator ceases operation,
or submits a completed application pursuant to Sections 87457(a)(1)(A) and (B).
(2) Within 10 calendar days of the mailing of the notice of denial or upon receipt of the denial notice
by the operator, whichever occurs first.

87458 UNLICENSED FACILITY ADMINISTRATIVE APPEAL

(a) An unlicensed operator or his/her representative shall have the right to appeal the penalty assessment within 10 working days after service of the penalty assessment.
(1) If the unlicensed facility operation has not ceased, the $200 per day penalty shall continue to accrue during the appeal process.
(b) The appeal review shall be conducted by a higher level staff person than the evaluator who issued the penalty.
(c) If the reviewer of the appeal determines that the penalty assessment was not issued in accordance with
applicable statutes and regulations of the Department, he/she shall have the authority to amend or
dismiss the penalty assessment.

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