The Legislature hereby finds and declares:
(a) The Legislature has taken steps in recent years to develop a
continuum of long-term social and health support services for older
persons in the community that provide a range of options for
long-term care and residential care facilities for the elderly are
central in that continuum.
(b) These efforts require a reevaluation of residential care for
the elderly outside the constraints of the Community Care Facilities
(c) The Community Care Facilities Act was enacted in 1973 with the
primary purpose of ensuring that residents of state hospitals would
have access to safe, alternative community-based housing.
(d) Since that time, due to shortages in affordable housing and a
greater demand for residences for the elderly providing some care and
supervision, a growing number of elderly persons with health and
social care needs now reside in community care facilities that may or
may not be designed to meet their needs.
(e) Progress in the field of gerontology has provided new insights
and information as to the types of services required to allow older
persons to remain as independent as possible while residing in a
residential care facility for the elderly.
(f) The fluctuating health and social status of older persons
demands a system of residential care that can respond to these needs
by making available multilevels of service within the facility, thus
reducing the need for residents with fluctuating conditions to move
between medical and nonmedical facilities.
(g) Residential care facilities for the elderly which are not
primarily medically oriented represent a humane approach to meeting
the housing, social and service needs of older persons, and can
provide a homelike environment for older persons with a variety of
(h) It is, therefore, the intent of the Legislature to require
that residential care facilities for the elderly be licensed as a
separate category within the existing licensing structure of the
State Department of Social Services.
As used in this chapter:
(a) "Administrator" means the individual designated by the
licensee to act on behalf of the licensee in the overall management
of the facility. The licensee, if an individual, and the
administrator may be one and the same person.
(b) "Beneficial ownership interest" means an ownership interest
through the possession of stock, equity in capital or any interest in
the profits of the applicant or licensee or through the possession
of such an interest in other entities that directly or indirectly
hold an interest in the applicant or licensee. The percentage of
beneficial ownership in the applicant or licensee that is held by any
other entity is determined by multiplying the other entities'
percentage of ownership interest at each level.
(c) "Care and supervision" means the facility assumes
responsibility for, or provides or promises to provide in the future,
ongoing assistance with activities of daily living without which the
resident's physical health, mental health, safety, or welfare would
be endangered. Assistance includes assistance with taking
medications, money management, or personal care.
(d) "Chain" means a group of two or more licensees that are
controlled, as defined in this section, by the same persons or
(e) "Control" means the ability to direct the operation or
management of the applicant or licensee and includes the ability to
exercise control through intermediary or subsidiary entities.
(f) "Department" means the State Department of Social Services.
(g) "Director" means the Director of Social Services.
(h) "Health-related services" mean services that shall be directly
provided by an appropriate skilled professional, including a
registered nurse, licensed vocational nurse, physical therapist, or
(i) "Instrumental activities of daily living" means any of the
following: housework, meals, laundry, taking of medication, money
management, appropriate transportation, correspondence, telephoning,
and related tasks.
(j) "License" means a basic permit to operate a residential care
facility for the elderly.
(k) "Parent organization" means an organization in control of
another organization either directly or through one or more
(l) "Personal activities of daily living" means any of the
following: dressing, feeding, toileting, bathing, grooming, and
mobility and associated tasks.
(m) "Personal care" means assistance with personal activities of
daily living, to help provide for and maintain physical and
(n) "Protective supervision" means observing and assisting
confused residents, including persons with dementia, to safeguard
them against injury.
(o) (1) "Residential care facility for the elderly" means a
housing arrangement chosen voluntarily by persons 60 years of age or
over, or their authorized representative, where varying levels and
intensities of care and supervision, protective supervision, or
personal care are provided, based upon their varying needs, as
determined in order to be admitted and to remain in the facility.
Persons under 60 years of age with compatible needs may be allowed to
be admitted or retained in a residential care facility for the
elderly as specified in Section 1569.316.
(2) This subdivision shall be operative only until the enactment
of legislation implementing the three levels of care in residential
care facilities for the elderly pursuant to Section 1569.70.
(p) "Residential care facility for the elderly" means a housing
arrangement chosen voluntarily by persons 60 years of age or over, or
their authorized representative, where varying levels and
intensities of care and supervision, protective supervision, personal
care, or health-related services are provided, based upon their
varying needs, as determined in order to be admitted and to remain in
the facility. Persons under 60 years of age with compatible needs
may be allowed to be admitted or retained in a residential care
facility for the elderly as specified in Section 1569.316.
This subdivision shall become operative upon the enactment of
legislation implementing the three levels of care in residential care
facilities for the elderly pursuant to Section 1569.70.
(q) "Sundowning" means a condition in which persons with cognitive
impairment experience recurring confusion, disorientation, and
increasing levels of agitation that coincide with the onset of late
afternoon and early evening.
(r) "Supportive services" means resources available to the
resident in the community that help to maintain their functional
ability and meet their needs as identified in the individual resident
assessment. Supportive services may include any of the following:
medical, dental, and other health care services; transportation;
recreational and leisure activities; social services; and counseling
(a) The director shall adopt regulations authorizing
residential care facilities for the elderly, as defined in Section
1569.2, to fill unused capacity on a short-term, time-limited basis
to provide temporary respite care for persons who are frail and
elderly, adults who have functional impairments, or persons with
mental health disorders who need 24-hour supervision and who are
being cared for by a caretaker or caretakers. The regulations shall
address provisions for liability coverage and the level of facility
responsibility for routine medical care and medication management,
and may require screening of persons to determine the level of care
required, a physical history completed by the person's personal
physician, and other alternative admission criteria to protect the
health and safety of persons applying for respite care. The
regulations shall permit these facilities to charge a fee for the
services provided, which shall include, but not be limited to,
supervision, room, leisure activities, and meals.
(b) No facility shall accept persons in need of care beyond the
level of care for which that facility is licensed.