California Legislature—2013–14 Regular Session

Assembly Bill No. 2044

Introduced by Assembly Member Rodriguez

February 20, 2014

An act to amend Sections 1569.33, 1569.35, 1569.618, and 1569.625 of the Health and Safety Code, relating to care facilities.

LEGISLATIVE COUNSEL’S DIGEST

AB 2044, as introduced, 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. 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.

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.

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.

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.

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.

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.

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:

SECTION 1.  

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

1569.33.  

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

(b) The department shall conduct begin delete an annual unannounced visit end delete
begin insert more frequent unannounced visits end insert of a facility under any of the
following circumstances:

(1) When a license is on probation.

(2) When the terms of agreement in a facility compliance plan
require begin delete an annual evaluation. end delete begin insert more frequent unannounced visits. end insert

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

(4) When a facility requires begin delete an annual visit end delete begin insert more frequent
unannounced visits end insert as a condition of receiving federal financial
participation.

begin insert

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

end insert begin delete

(5)

end delete

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

begin delete

(c) (1) The department shall conduct annual unannounced visits
to no less than 20 percent of facilities not subject to an evaluation
under subdivision (b). These unannounced visits shall be conducted
based on a random sampling methodology developed by the
department.

end delete begin delete

(2) If the total citations issued by the department exceed the
previous year’s total by 10 percent, the following year the
department shall increase the random sample by 10 percent of the
facilities not subject to an evaluation under subdivision (b). The
department may request additional resources to increase the random
sample by 10 percent.

end delete begin delete

(d) Under no circumstance shall the department visit a residential
care facility for the elderly less often than once every five years.

end delete begin delete

(e)

end delete

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

begin delete

(f)

end delete

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

begin delete

(g)

end delete

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

SEC. 2.  

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

1569.35.  

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

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

(c) Upon receipt of a complaint, other than a complaint alleging
denial of a statutory right of access to a residential care facility for
the elderly, the department shall make a preliminary review and,
unless the department determines that the complaint is willfully
intended to harass a licensee or is without any reasonable basis, it
shall make an onsite inspection begin insert within 3 days after receiving the
complaint if the complaint involves alleged abuse or serious
neglect, or end insert within 10 days after receiving the complaint begin insert for all
other complaints, end insert except begin delete where end delete begin insert when end insert the visit would adversely
affect the licensing investigation or the investigation of other
agencies, including, but not limited to, law enforcement agencies.
begin delete In either event, the complainant shall be promptly informed of the
department’s proposed course of action. end delete begin insert The department shall
complete the investigation within 30 days and shall promptly
inform the complainant in writing of the department’s findings
and proposed course of action. end insert

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

begin insert

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

end insert begin insert

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

end insert begin insert

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

end insert

SEC. 3.  

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

1569.618.  

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

begin insert

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

end insert begin insert

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

end insert begin insert

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

end insert begin insert

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

end insert begin insert

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

end insert begin insert

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

end insert begin insert

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

end insert begin delete

(b)

end delete

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

SEC. 4.  

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

1569.625.  

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

(b) The department shall adopt regulations to require staff
members of residential care facilities for the elderly who assist
residents with personal activities of daily living to receive
appropriate training begin delete . This training shall consist of 10 hours of
training within the first four weeks of employment and four hours
annually thereafter. This training shall be administered on the job,
or in a classroom setting, or any combination of the two. The
department shall establish, in consultation with provider
organizations, the subject matter required for this training. end delete begin insert as
provided in this section. end insert

begin delete

(c)  The training shall include, but not be limited to, the
following:

end delete begin insert

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

end insert begin insert

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

end insert

begin insert (A) end insert  Physical limitations and needs of the elderly.

begin delete

(2)

end delete

begin insert (B) end insert  Importance and techniques for personal care services.

begin delete

(3)

end delete

begin insert (C) end insert  Residents’ rights.

begin delete

(4)

end delete

begin insert (D) end insert  Policies and procedures regarding medications.

begin delete

(5)

end delete

begin insert (E) end insert  Psychosocial needs of the elderly.

begin insert

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

end insert begin insert

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

end insert begin insert

(H) Reporting requirements.

end insert begin insert

(I) Sanitation and food safety.

end insert begin insert

(J) Resident health and related problems.

end insert begin insert

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

end insert begin insert

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

end insert begin insert

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

end insert begin insert

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

end insert begin insert

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

end insert begin insert

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

end insert begin insert

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

end insert

SEC. 5.  

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