REGULATION INTERPRETATIONS AND …

1 REGULATION INTERPRETATIONS AND PROCEDURES FOR residential care facilities FOR THE ELDERLY EVALUATOR MANUAL residential care facilities FOR THE ELDERLY residential care facilities FOR THE ELDERLY TABLE OF CONTENTS ARTICLE 1. DEFINITIONS AND FORMS General ..87100 ARTICLE 2. LICENSE Operation Without a License ..87106 Exemption from Licensure ..87107 Integral facilities ..87108 Transferability of License ..87109 Continuation of License under Emergency Conditions/Sale of Property ..87111 Conditions for Forfeiture of a License ..87112 ARTICLE 3. APPLICATION PROCEDURES Application for Licensing Fees ..87156 Application Review ..87157 Withdrawal of Application ..87159 Resubmission of Application ..87161 Provisional License ..87162 Denial of License Application.

2 87163 ARTICLE 4. OPERATING REQUIREMENTS Fire Clearance ..87202 Fire Safety ..87203 Limitations Capacity and Ambulatory Status ..87204 Accountability of Licensee/Governing Body ..87205 Plan of Operation ..87208 Program Flexibility ..87209 Reporting Requirements ..87211 Emergency Disaster Plan ..87212 Bonding ..87216 Safeguards for Resident Cash, Personal Property, and Valuables ..87217 Planned Activities ..87219 Resident Councils ..87221 Eviction Procedures ..87224 ARTICLE 5. PHYSICAL ENVIRONMENTS AND ACCOMMODATIONS Maintenance and Operation ..87303 Alterations to Existing Buildings or New facilities ..87305 Personal Accommodations and Services ..87307 Storage Space ..87309 Motor Vehicles Used in Transporting Residents ..87312 11 RCFE-01 August 2011 i EVALUATOR MANUAL residential care facilities FOR THE ELDERLY residential care facilities FOR THE ELDERLY TABLE OF CONTENTS (Continued) ARTICLE 6.

3 BACKGROUND CHECK Criminal Record Exemption ..87356 ARTICLE 7. PERSONNEL Administrator Qualifications and Duties ..87405 Personnel Requirements - Personnel Records ..87412 Personnel Operations ..87413 Night Supervision ..87415 ARTICLE 8. RESIDENT ASSESSMENTS, FUNDAMENTAL SERVICES AND RIGHTS Acceptance and Retention Limitations ..87455 Evaluation of Suitability for Admission ..87456 Pre-Admission Appraisal ..87457 Medical Functional Capabilities ..87459 Mental Condition ..87461 Social Factors ..87462 Reappraisals ..87463 Basic Services ..87464 Incidental Medical and Dental care Services ..87465 Personal Rights ..87468 Advanced Health care Directives, Requests to Forego Resuscitative Measures, ..87469 And Do-Not Resuscitate Forms ARTICLE 9. RESIDENT RECORDS Resident Records ..87506 Admission Agreements.

4 87507 Register of Residents ..87508 ARTICLE 10. FOOD SERVICE General Food Service Requirements ..87555 ARTICLE 11. HEALTH-RELATED SERVICES AND CONDITIONS Postural Supports ..87608 Allowable Health Conditions and the Use of Home Health Agencies ..87609 Prohibited Health Conditions ..87615 Departmental Review of Health Conditions ..87617 Oxygen Administration Gas and Liquid ..87618 Intermittent Positive Pressure Breathing (IPPB) Machine ..87619 Injections ..87629 Hospice care Waiver ..87632 Hospice care for Terminally Ill Residents ..87633 Resident Request for Review of Health Condition Relocation Order ..87638 Transfer Dependency (Repealed by Manual Letter No. CCL-92-10, 7/21/92 ..87640 10 RCFE-04 November 2011 ii EVALUATOR MANUAL residential care facilities FOR THE ELDERLY residential care facilities FOR THE ELDERLY TABLE OF CONTENTS (Continued) ARTICLE 12.)

5 DEMENTIA care of Persons with ARTICLE 13. ENFORCEMENT Inspection Authority of the Licensing Agency ..87755 Evaluation Visit ..87756 Serious Deficiencies Examples ..87758 Follow-up Visits to Determine Compliance ..87759 Penalties ..87761 Appeal Process ..87763 ARTICLE 14. ADMINISTRATIVE ACTIONS GENERAL ARTICLE 15. ADMINISTRATOR CERTIFICATION TRAINING PROGRAMS- VENDOR INFORMATION 11 RCFE-01 August 2011 iii EVALUATOR MANUAL residential care facilities FOR THE ELDERLY ARTICLE 1. DEFINITIONS AND FORMS 87100 GENERAL 87100 POLICY Existing general requirements for all community care facility categories do not apply to residential care facilities for the elderly.

6 Chapter 8 is a complete set of regulations that includes both general and basic requirements for residential care facilities for the elderly. 87101 DEFINITIONS 87101 (a)(6) Ambulatory Person PROCEDURE Refer to REGULATION INTERPRETATIONS Section 87204. (b)(1) Basic Rate POLICY Refer to REGULATION INTERPRETATIONS Section 87507(c) for clarification on charging for basic services for both private pay and Supplementary Security Income/State Supplementary Payment residents. (b)(2) Basic Services POLICY Refer to REGULATION INTERPRETATIONS and Procedures Section 87507(c) for clarification on charging for basic services for both private pay and Supplementary Security Income/State Supplementary Payment residents. (e)(6) Exception POLICY This term is used in REGULATION Section 87209, Program Flexibility, which allows facilities to use alternative methods to meet the intent of a REGULATION with approval from the licensing agency.

7 Also see REGULATION Section 87101(w)(1), Waiver. The term should not be confused with exemption, which applies only to criminal record clearances. See REGULATION Section 87356, Criminal Record Exemption. PROCEDURE Refer to REGULATION Sections 87209 and 87101(w)(1) and Reference Material Section 2-5000 for exception and waiver information. (g)(1) Guardian POLICY A guardian is exempt from licensure. (i)(1) Immediate Need PROCEDURE Refer to REGULATION Section 87162, Provisional License. 11 RCFE-01 AUGUST 2011 1 EVALUATOR MANUAL residential care facilities FOR THE ELDERLY 87101 DEFINITIONS (Continued) 87101 (l)(1) - License PROCEDURE Refer to Health and Safety Code Section (g) in the Evaluator Manual Appendix.

8 (l)(4) - Licensing Agency PROCEDURE Refer to the Health and Safety Code Section in the Evaluator Manual Appendix. (n)(2) - Nonambulatory Person POLICY Nonambulatory Person means a person who is unable to leave a building unassisted under emergency conditions. It includes any person who is unable, or is likely to be unable, to physically and mentally respond to a sensory signal approved by the State Fire Marshal--or to an oral instruction relating to fire danger. It includes persons who depend upon mechanical aids such as crutches, walkers and wheelchairs. The determination of the ambulatory or nonambulatory status of persons with developmental disabilities will be made by the Director of the Department of Social Services or his or her designee, in consultation with the Director of Developmental Services or his or her designee.

9 The determination of the ambulatory or nonambulatory status of all other persons with disabilities placed after January 1, 1984 who are not developmentally disabled will be made by the Director of Department of Social Services or his or her designee. Persons who are deaf or blind are not necessarily considered nonambulatory. Other factors should be evaluated to determine if a deaf or blind person is physically and mentally capable of leaving a building without assistance from another person or a mechanical aid. For example, a deaf person who can respond to a visual signal may be considered ambulatory. However, when coupled with another factor(s) such as dependence upon a mechanical aid, the same deaf person would be considered nonambulatory.

10 See REGULATION Section 87204, Limitations - Capacity and Ambulatory Status. (r)(5) - residential care Facility for the Elderly PROCEDURE See Health and Safety Code Section (l) in the Evaluator Manual Appendix. (w)(1) - Waiver PROCEDURE Refer to REGULATION Sections 87101(e)(6) and 87209 and Reference Material Section 2- 5000 for waiver and exception information. 09 RCFE-01 April 2009 2 EVALUATOR MANUAL residential care facilities FOR THE ELDERLY ARTICLE 2. LICENSE 87106 OPERATION WITHOUT A LICENSE 87106 (b) PROCEDURE If information is received regarding the operation of an unlicensed facility, it should be treated as, and given priority as, a complaint.