Article 4. Standards And Inspection of California Health And Safety Code >> Division 2. >> Chapter 3.3. >> Article 4.
The state department shall adopt and may from time to time
amend or repeal, in accordance with Chapter 3.5 (commencing with
Section 11340) of Part 1 of Division 3 of Title 2 of the Government
Code, the reasonable rules and regulations as may be necessary or
proper to carry out the purposes and intent of this chapter and to
enable the state department to exercise the powers and perform the
duties conferred upon it by this chapter, not inconsistent with any
statute of this state. The regulations shall prescribe standards of
safety and sanitation for the physical plant of adult day health
centers and standards for the quality of adult day health care
services, including, but not limited to, staffing with duly qualified
personnel and average daily staffing requirements. For the purposes
of computing average daily attendance staffing requirements,
maintenance programs for elderly persons shall, as of January 1,
1992, be included in the calculation for monthly total hours of
services provided. In adopting the regulations, the state department
shall take into account the physical and mental capabilities and
needs of the persons to be served, and consideration shall be given
to flexible application of safety and sanitation standards, if
necessary, to be consistent with the legislative intent of
establishing adult day health care programs in locations easily
accessible to economically disadvantaged older persons. Program
standards contained in regulations adopted pursuant to this section
shall be those specified in Chapter 8.7 (commencing with Section
14520) of Part 3 of Division 9 of the Welfare and Institutions Code.
The State Department of Health Care Services, and as
applicable, the State Department of Public Health and the California
Department of Aging, may grant to entities contracting with the State
Department of Health Care Services under the PACE program, as
defined in Chapter 8.75 (commencing with Section 14591) of Part 3 of
Division 9 of the Welfare and Institutions Code, exemptions from the
provisions contained in this chapter in accordance with the
requirements of Section 100315.
On or before December 1, 1978, the director shall by
regulation adopt an equitable and uniform method of evaluating the
quality of care and services provided by adult day health centers
based upon the following:
(a) Compliance with regulations adopted pursuant to this chapter.
(b) Continued demonstrated community need.
(c) Conformity of the program to individual participants' assessed
and reassessed needs and interests with particular attention to
visual, auditory, and equipment needs.
(d) Suitability of program changes to the community and
(e) Compliance with requirements of law pertaining to fire and
life and safety.
The evaluation method adopted by the state department shall be
published and distributed to all licensed adult day health centers
and all other interested persons.
(a) Every adult day health care center shall be
periodically inspected and evaluated for quality of care by a
representative or representatives designated by the director.
Inspections shall be conducted prior to the expiration of
certification or at least every two years and as often as necessary
to ensure the quality of care being provided, whether initiated by
the state department or pursuant to Section 1580.9. As resources
permit, an inspection may be conducted prior to, as well as within
the first 90 days of, adult day health care center operation.
(b) After each inspection, the state department shall notify the
adult day health care center in writing of any deficiencies in its
compliance with 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. Upon a finding of noncompliance, the
state department may also assess a civil penalty not to exceed fifty
dollars ($50) per day for each violation continuing beyond the date
fixed in the notice for correction. If the violation is not corrected
within that time, the civil penalty shall accrue from the date of
receipt of the notice by the licensee. If the violation continues
beyond the date fixed for correction, the state department may also
initiate action against the licensee in accordance with Article 7
(commencing with Section 1595).
(c) When a civil penalty is to be assessed pursuant to this
section, the notice shall specify the amount thereof and shall be
served upon the licensee in a manner prescribed by subdivision (c) of
Section 11505 of the Government Code. Any judicial action required
to collect a civil penalty assessed pursuant to this section shall be
brought by the Attorney General acting on behalf of the state
department in the superior court of the county in which the adult day
health care center is located.
Any person may request an inspection of any adult day
health center in accordance with the provisions of this article by
transmitting to the state department notice of an alleged violation
of applicable requirements prescribed by statute or regulation. Any
such notice shall be in writing, specifying to a reasonable extent
the details of the alleged violation, and shall be signed by the
complainant. 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 or the public shall disclose the name of
any person mentioned in the complaint, unless the complainant is a
duly authorized officer, employee, or agent of the state department
conducting the investigation or inspection pursuant to this article.
Upon receipt of a complaint pursuant to Section 1580.9, the
state department shall make a preliminary review. Unless the state
department determines that the complaint is willfully intended to
harass a licensee or is without any reasonable basis, it shall make
an onsite inspection within 10 days after receiving the complaint. In
either event, the complainant shall be promptly informed of the
state department's proposed course of action.
No licensee shall discriminate or retaliate in any manner against
any person receiving the services of such licensee's adult day health
center, or against any employee of such licensee's facility, on the
basis or for the reason that such person or employee or any other
person has initiated or participated in an inspection pursuant to
Section 1580.9 or 1581.
Any duly authorized officer, employee, or agent of the
department or the California Department of Aging may, upon
presentation of proper identification, enter and inspect any place
providing adult day health care at any time, with or without advance
notice, to secure compliance with, or to prevent a violation of, any
provision of this chapter or any regulation adopted hereunder.
The state department may provide consulting services upon
request to any adult day health center to assist in the
identification or correction of deficiencies and in the upgrading of
the quality of care provided by such adult day health center.
Reports on the results of each inspection, evaluation, or
consultation performed pursuant to this article shall be kept on file
in the state department, and all inspection reports, consultation
reports, lists of deficiencies, and plans of correction shall be open
to public inspection.
The director shall publish and make available to interested
persons a list of all licensed adult day health centers, the services
which each such facility provides, and the relative evaluation
rating of each adult day health center as determined pursuant to
(a) An adult day health care center that provides care for
adults with Alzheimer's disease and other dementias may install for
the safety and security of those persons secured perimeter fences or
egress control devices of the time-delay type on exit doors.
(b) As used in this section, "egress control device" means a
device that precludes the use of exits for a predetermined period of
time. These devices shall not delay any participant's departure from
the center for longer than 30 seconds. Center staff may attempt to
redirect a participant who attempts to leave the center.
(c) Adult day health care centers installing security devices
pursuant to this section shall meet all of the following
(1) The center shall be subject to all fire and building codes,
regulations, and standards applicable to adult day health care
centers using egress control devices or secured perimeter fences and
shall receive a fire clearance from the fire authority having
jurisdiction for the egress control devices or secured perimeter
(2) The center shall maintain documentation of diagnosis by a
physician of a participant's Alzheimer's disease or other dementia.
(3) The center shall provide staff training regarding the use and
operation of the egress control devices utilized by the center, the
protection of participants' personal rights, wandering behavior and
acceptable methods of redirection, and emergency evacuation
procedures for persons with dementia.
(4) All admissions to the center shall continue to be voluntary on
the part of the participant or with consent of the participant's
conservator, an agent of the participant under a power of attorney
for health care, or other person who has the authority to act on
behalf of the participant. Persons who have the authority to act on
behalf of the participant include the participant's spouse or closest
(5) The center shall inform all participants, conservators,
agents, and persons who have the authority to act on behalf of
participants of the use of security devices. The center shall
maintain a signed participation agreement indicating the use of the
devices and the consent of the participant, conservator, agent, or
person who has the authority to act on behalf of the participant. The
center shall retain the original statement in the participant's
files at the center.
(6) The use of egress control devices or secured perimeter fences
shall not substitute for adequate staff. Staffing ratios shall at all
times meet the requirements of applicable regulations.
(7) Emergency fire and earthquake drills shall be conducted at
least once every three months, or more frequently as required by a
county or city fire department or local fire prevention district. The
drills shall include all center staff and volunteers providing
participant care and supervision. This requirement does not preclude
drills with participants as required by regulations.
(8) The center shall develop a plan of operation approved by the
department that includes a description of how the center is to be
equipped with egress control devices or secured perimeter fences that
are consistent with regulations adopted by the State Fire Marshal
pursuant to Section 13143. The plan shall include, but not be limited
to, the following:
(A) A description of how the center will provide training for
staff regarding the use and operation of the egress control device
utilized by the center.
(B) A description of how the center will ensure the protection of
the participant's personal rights consistent with applicable
(C) A description of the center's emergency evacuation procedures
for persons with Alzheimer's disease and other dementias.
(d) This section does not require an adult day health care center
to use security devices in providing care for persons with Alzheimer'
s disease and other dementias.
Every adult day health care center shall, for the purpose
of addressing issues that arise when an adult day health care
participant is missing from the facility, develop and comply with an
absentee notification plan, as part of the individual plan of care,
as defined in Section 1570.7. The plan shall include and be limited
to the following: a requirement that an administrator of the
facility, or his or her designee, inform the participant's authorized
representative when that participant is missing from the facility
and the circumstances in which an administrator of the facility, or
his or her designee, shall notify local law enforcement when a
participant is missing from the facility.