Amended in Assembly April 1, 2014

California Legislature—2013–14 Regular Session

Assembly BillNo. 2044


Introduced by Assembly Member Rodriguez

February 20, 2014


An act to amendbegin delete Sections 1569.33, 1569.35, 1569.618, and 1569.625ofend deletebegin insert Section 1569.618 of, and to add Section 1569.629 to,end insert the Health and Safety Code, relating to care facilities.

LEGISLATIVE COUNSEL’S DIGEST

AB 2044, as amended, Rodriguez. Residential care facilities for the elderly.

Existing law provides for the licensure and regulation of residential care facilities for the elderly by the State Department of Social Services. A violation of these provisions is a misdemeanor.begin delete Existing law requires, unless otherwise specified, licensed residential care facilities for the elderly to be subject to unannounced visits by the department as often as necessary to ensure the quality of care provided, but no less often than once every 5 years.end delete

begin delete

This bill would, instead, require every licensed residential care facility to be subject to an annual unannounced visit by the department, as prescribed, and would require the department to conduct more frequent unannounced visits under specified circumstances.

end delete
begin delete

Existing law authorizes a person to request an inspection of a residential care facility for the elderly for an alleged violation of law or regulations, and requires, with some exceptions, the department to make an onsite inspection within 10 days after receiving the complaint. Existing law requires the department to promptly inform the complainant of the department’s proposed course of action.

end delete
begin delete

This bill would, instead, require the department to make an onsite inspection within 3 days after receiving the complaint if the complaint involves alleged abuse or serious neglect, or within 10 days after receiving the complaint for all other complaints. The bill would require the department to complete the investigation within 30 days and to promptly inform the complainant in writing of the department’s findings and proposed course of action. The bill would provide a complainant who is dissatisfied with the department’s findings or proposed action regarding a matter that would pose a threat to the health, safety, security, welfare, or rights of a resident with the right to request an informal conference and subsequent appeal, as prescribed.

end delete

Existing law requires the administrator designated by the licensee to be present at the facility during normal working hours and requires a facility manager, as defined, to be responsible for the operation of the facility when the administrator is temporarily absent from the facility.

This bill would require that at least one administrator, facility manager, or other person designated by the administrator who is at least 21 years of age be on the premises of the facility 24 hours per day and would require a minimum of one staff member who assists residents with personal activities of daily living per 16 residents be on the premises 24 hours per day. The bill would also require the facility to employ, and the administrator to schedule, a sufficient number of staff members, as prescribed.

Existing law requires the department to adopt regulations to require staff members who assist residents with personal activities of daily living to receive appropriate training, which consists of 10 hours of training within the first 4 weeks and 4 hours annually thereafter.

begin delete

This bill would, instead, require the staff members to receive, at a minimum, 10 hours of training within certain timeframes, and 6 hours annually of continuing education, as prescribed.

end delete
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This bill would require that this training also include specified topics, including, among others, building and fire safety and the appropriate response to emergencies, abuse, neglect, and financial exploitation prevention, and reporting requirements.

end insert

By expanding the scope of a crime, this bill would impose a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes.

The people of the State of California do enact as follows:

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P3    1

SECTION 1.  

Section 1569.33 of the Health and Safety Code
2 is amended to read:

3

1569.33.  

(a) Every licensed residential care facility for the
4elderly shall be subject to an annual unannounced visit by the
5department. The department shall visit these facilities as often as
6necessary to ensure the quality of care provided.

7(b) The department shall conduct more frequent unannounced
8visits of a facility under any of the following circumstances:

9(1) When a license is on probation.

10(2) When the terms of agreement in a facility compliance plan
11require more frequent unannounced visits.

12(3) When an accusation against a licensee is pending.

13(4) When a facility requires more frequent unannounced visits
14as a condition of receiving federal financial participation.

15(5) When the facility has a record of frequent complaints
16indicating a pattern of inadequate care.

17(6) In order to verify that a person who has been ordered out of
18the facility for the elderly by the department is no longer at the
19facility.

20(c) The department shall notify the residential care facility for
21the elderly in writing of all deficiencies in its compliance with the
22provisions of this chapter and the rules and regulations adopted
23pursuant to this chapter, and shall set a reasonable length of time
24for compliance by the facility.

25(d) Reports on the results of each inspection, evaluation, or
26consultation shall be kept on file in the department, and all
27inspection reports, consultation reports, lists of deficiencies, and
28plans of correction shall be open to public inspection.

29(e) As a part of the department’s evaluation process, the
30department shall review the plan of operation, training logs, and
31marketing materials of any residential care facility for the elderly
32that advertises or promotes special care, special programming, or
P4    1a special environment for persons with dementia to monitor
2compliance with Sections 1569.626 and 1569.627.

3

SEC. 2.  

Section 1569.35 of the Health and Safety Code is
4amended to read:

5

1569.35.  

(a) Any person may request an inspection of any
6residential care facility for the elderly in accordance with this
7chapter by transmitting to the department notice of an alleged
8violation of applicable requirements prescribed by statutes or
9regulations of this state, including, but not limited to, a denial of
10access of any person authorized to enter the facility pursuant to
11Section 9722 of the Welfare and Institutions Code. A complaint
12may be made either orally or in writing.

13(b) The substance of the complaint shall be provided to the
14licensee no earlier than at the time of the inspection. Unless the
15complainant specifically requests otherwise, neither the substance
16of the complaint provided the licensee nor any copy of the
17 complaint or any record published, released, or otherwise made
18available to the licensee shall disclose the name of any person
19mentioned in the complaint except the name of any duly authorized
20officer, employee, or agent of the department conducting the
21investigation or inspection pursuant to this chapter.

22(c) Upon receipt of a complaint, other than a complaint alleging
23denial of a statutory right of access to a residential care facility for
24the elderly, the department shall make a preliminary review and,
25unless the department determines that the complaint is willfully
26intended to harass a licensee or is without any reasonable basis, it
27shall make an onsite inspection within 3 days after receiving the
28complaint if the complaint involves alleged abuse or serious
29neglect, or within 10 days after receiving the complaint for all
30other complaints, except when the visit would adversely affect the
31licensing investigation or the investigation of other agencies,
32including, but not limited to, law enforcement agencies. The
33department shall complete the investigation within 30 days and
34shall promptly inform the complainant in writing of the
35department’s findings and proposed course of action.

36(d) Upon receipt of a complaint alleging denial of a statutory
37right of access to a residential facility for the elderly, the
38department shall review the complaint. The complainant shall be
39notified promptly of the department’s proposed course of action.

P5    1(e) (1) Upon being notified of the department’s findings or
2proposed course of action as a result of the investigation conducted
3pursuant to subdivision (c), a complainant who is dissatisfied with
4the department’s determination, regarding a matter that would pose
5a threat to the health, safety, security, welfare, or rights of a
6resident, shall be notified by the department of the right to an
7informal conference, as set forth in this subdivision. The
8complainant may, within five business days after receipt of the
9notice, notify the director in writing of his or her request for an
10informal conference. The informal conference shall be held with
11 the designee of the director for the county in which the residential
12care facility for the elderly that is the subject of the complaint is
13located. The residential care facility for the elderly may participate
14as a party in this informal conference. The director’s designee shall
15notify the complainant and licensee of his or her determination
16within 10 working days after the informal conference and shall
17apprise the complainant and licensee in writing of the appeal rights
18provided in paragraph (2).

19(2) If the complainant is dissatisfied with the determination of
20the director’s designee for the county in which the facility is
21located, the complainant may, within 15 days after receipt of this
22determination, notify in writing the Deputy Director of the
23Community Care Licensing Division of the department, who shall
24assign the request to a representative for review of the facts that
25led to both determinations. As a part of this independent
26 investigation, and at the request of the complainant, the
27representative shall interview the complainant in the senior care
28program office where the complaint was initially referred. Based
29upon this review, the Deputy Director of the Community Care
30Licensing Division of the department shall make his or her own
31determination and notify the complainant and the facility within
3230 days.

33(3) The department shall notify the facility of any action against
34the facility resulting from the conference or review provided for
35in paragraph (1) or (2) within three working days of the final
36determination, unless the licensee agrees in writing to an extension
37of this time. Notice may be effected either personally or by
38registered or certified mail. A copy of the notice shall also be sent
39to the complainant by registered or certified mail.

end delete
P6    1

begin deleteSEC. 3.end delete
2begin insertSECTION 1.end insert  

Section 1569.618 of the Health and Safety Code
3 is amended to read:

4

1569.618.  

(a) The administrator designated by the licensee
5pursuant to subdivision (k) of Section 1569.15 shall be present at
6the facility during normal working hours. A facility manager
7designated by the licensee with notice to the department, shall be
8responsible for the operation of the facility when the administrator
9is temporarily absent from the facility.

10(b) (1) At least one administrator, facility manager, or other
11person designated by the administrator who is at least 21 years of
12age shall be on the premises 24 hours per day.

13(2) A minimum of one staff member who assists residents with
14personal activities of daily living per 16 residents shall be on the
15premises 24 hours per day.

16(c) The facility shall employ, and the administrator shall
17schedule, a sufficient number of staff members to do all of the
18following:

19(1) Provide the care required in each resident’s negotiated
20service agreement during all hours of the day.

21(2) Ensure the health, safety, comfort, and supervision of the
22residents.

23(3) Ensure that at least one staff member who has
24cardiopulmonary resuscitation (CPR) training and first aid training
25is on duty and on the premises at all times.

26(4) Ensure that the interior and exterior of the facility is
27maintained in a safe and clean manner.

28(d) “Facility manager” means a person on the premises with the
29authority and responsibility necessary to manage and control the
30day-to-day operation of a residential care facility for the elderly
31and supervise the clients. The facility manager, licensee, and
32administrator, or any combination thereof, may be the same person
33provided he or she meets all applicable requirements. If the
34administrator is also the facility manager for the same facility, he
35or she shall be limited to the administration and management of
36only one facility.

begin delete
37

SEC. 4.  

Section 1569.625 of the Health and Safety Code is
38amended to read:

39

1569.625.  

(a) The Legislature finds that the quality of services
40provided to residents of residential care facilities for the elderly is
P7    1dependent upon the training and skills of staff. It is the intent of
2the Legislature in enacting this section to ensure that direct-care
3staff have the knowledge and proficiency to carry out the tasks of
4their jobs.

5(b) The department shall adopt regulations to require staff
6members of residential care facilities for the elderly who assist
7residents with personal activities of daily living to receive
8appropriate training as provided in this section.

9(c) Staff members of residential care facilities for the elderly
10who assist residents with personal activities of daily living shall
11receive, at a minimum, 10 total hours of training as follows:

12(1) Within seven calendar days of the date of hire, training on
13all of the following:

14(A) Physical limitations and needs of the elderly.

15(B) Importance and techniques for personal care services.

16(C) Residents’ rights.

17(D) Policies and procedures regarding medications.

18(E) Psychosocial needs of the elderly.

19 (F) Building and fire safety and the appropriate response to
20emergencies.

21(G) Abuse, neglect, and financial exploitation prevention as
22prescribed by the Department of Justice.

23(H) Reporting requirements.

24(I) Sanitation and food safety.

25(J) Resident health and related problems.

26(K) An overview of the staff members’ specific job
27requirements.

28(L) The philosophy and principles of independent living in an
29assisted living residence.

30(2) Within 30 calendar days from the date of hire, additional
31training on medication assistance and monitoring, communicable
32diseases, and dementia and cognitive impairment.

33(3) Within 180 calendar days from the date of hire, additional
34training on communication skills, the aging process, and disability
35sensitivity.

36(d) In addition to the training specified in subdivision (c), staff
37members of residential care facilities for the elderly who assist
38residents with personal activities of daily living shall also complete
396 hours annually of continuing education that includes, but is not
40limited to, training on the promotion of resident dignity,
P8    1independence, self-determination, privacy, and choice, and review
2of all the subjects described in subdivision (c).

3(e) The training described in this section shall be administered
4on the job, or in a classroom setting, or any combination of the
5two.

6(f) The department shall establish, in consultation with the
7provider organization, the subject matter for the training described
8in this section.

end delete
9begin insert

begin insertSEC. 2.end insert  

end insert

begin insertSection 1569.629 is added to the end insertbegin insertHealth and Safety
10Code
end insert
begin insert, end insertimmediately following Section 1569.628begin insert, to read:end insert

begin insert
11

begin insert1569.629.end insert  

The training required under Section 1569.625 shall
12also include all of the following topics:

13(a) Building and fire safety and the appropriate response to
14emergencies.

15(b) Abuse, neglect, and financial exploitation prevention as
16prescribed by the Department of Justice.

17(c) Reporting requirements.

18(d) Sanitation and food safety.

19(e) Resident health and related problems.

20(f) An overview of the staff members’ specific job requirements.

21(g) The philosophy and principles of independent living in an
22assisted living residence.

23(h) The promotion of resident dignity, independence,
24self-determination, privacy, and choice.

end insert
25

begin deleteSEC. 5.end delete
26begin insertSEC. 3.end insert  

No reimbursement is required by this act pursuant to
27Section 6 of Article XIII B of the California Constitution because
28the only costs that may be incurred by a local agency or school
29district will be incurred because this act creates a new crime or
30infraction, eliminates a crime or infraction, or changes the penalty
31for a crime or infraction, within the meaning of Section 17556 of
32the Government Code, or changes the definition of a crime within
33the meaning of Section 6 of Article XIII B of the California
34Constitution.



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