What Do You Know About California Assisted Living Regulations?
The National Center for Assisted Living indicates that the United States has more than 28,000 assisted living facilities. Common long-term care centers include facility-based care homes, assisted living facilities, and nursing homes.
National regulators include the U.S. Department of Health & Human Services in addition to others. Funding involves the Social Security Administration, Medicaid, Supplemental Security Income (SSI), and others associated with seniors or long-term care.
Within the California Department of Social Services, is the Residential Care Facilities for the Elderly (RCFE). This entity regulates Continuing Care Retirement Communities (CCRCs), Memory Care homes or units, any assisted living community, and others.
The California Department of Health manages state programs including the California Health and Safety Code. (see PDF) Some of the topics involve types of care homes, compliance, protections, care needs, personal needs, and more.
What is an Assisted Living Community?
An assisted living facility is defined under Title 22, Division 6 of the Manual of Policies and Procedures for RCFE. Any provider of assisted living is a licensee with “authority or responsibility” for a state-licensed facility.
A licensee might include a firm, partnership, corporation, county, and others. An RCFE is a housing structure that a resident or someone acting on their behalf voluntarily enters.
At least 75% of the residents (persons) of an RCFE are older adults, defined as those at least 60 years of age. Residents may be in a distinct category based on their level of care i.e., persons with memory care needs.
For example, those with memory care needs might suffer from Alzheimer’s disease or dementia, or other medical conditions. Some arrangements are exempt from licensing procedures and requirements, some as those where a family member exclusively provides care.
For example, a family member provides basic services such as personal care assistance or help with daily living activities. This might occur in private apartments or a private room within a home.
State of California: Regional Offices
The State of California Department of Social Services has established the Community Care Licensing Division (CCLD) with 14 office locations. County office locations include San Francisco, San Bernardino, Los Angeles, San Joaquin, Contra Costa, and San Diego.
As a large state, California has more regional locations than most nearby states for managing day-to-day operations. The division adheres to a robust body of laws, as with Medi-Cal and most any other state program.
Persons Who Work or Visit an Assisted Living Facility
A person you might encounter during day-to-day operations includes residents, caregivers, family members, or those performing inspections.
A staff member might be a medical care provider who transitions between medical facilities, residential care communities, or personal care centers.
Laws and regulations require workers who work in a residential care home, health care center, and other locations to meet certain criteria. Examples might include a criminal background check, a high school diploma, and no history of complaints.
Key Responsibilities of Facilities
Capacity
California licenses specify the maximum capacity of a care facility, which refers to residents—not those entering for family visits. Capacity is based on many factors including physical survey results such as for smaller or larger facilities.
Capacity is based on information deemed reasonable for maintaining resident independence or the medical conditions of the residents.
Recordkeeping
Critical information is gathered in reports according to policy to the greatest extent possible in an electronic format (i.e., PDF file). Records might be required according to intervals such as weeks or months.
Some of the documentation necessary includes the amount of public access, such as family visits, and any vital financial data such as median monthly cost or average cost. There is always documentation of any records about violations, complaints, or other similar issues.
Basics of the Assisted Living Waiver Program
Medi-Cal, the California Medicaid Program, provides help with long-term care for those lacking the necessary resources. Nursing homes and other institutions represent some of the most expensive places or options for individuals needing this level of care.
The Medicaid Waiver program was introduced as a potentially more affordable option using Home and Community-Based Services (HCBS) Waivers. The California Department of Health Care Services (DHCS) uses fact sheets, informational brochures, and other ads that outline the details for enrollment.
Three primary goals of the program include:
- Providing reasonably-priced housing with access to personal care and health care services for seniors and those with disabilities
- To ensure seniors maintain dignity and promote resident independence and quality of life
- To offer community-based alternative living arrangements for those in need of assisted living or other long-term care
Infection Control Requirements in CA Assisted Living Facilities
Questions regarding proper cleaning and disinfection of residential care facilities are partially addressed in Title 22 §85095.5 for Infection Control. Some of the critical practices include:
- All facilities must create and maintain an Infection Control Plan as well as a related training plan
- Clean and dry hands following exposure involving direct contact with residents, liquids, and food.
- Always adhere to the manufacturer’s instructions when using cleaning agents or disinfection products
- Remember to discard gloves when changing to another task
- Regularly clean and disinfect handles, knobs, elevator touch panels, and other shared or “high-touch” objects
Centers for Disease Control and Prevention (CDC): Nursing Homes and Assisted Living Recommendations
CDC estimates suggest that one to three million severe infections occur in long-term care facilities annually. They stress the importance of precleaning surfaces before using a disinfectant to control the influenza virus effectively.
Controlling Waterborne Organisms
The CDC encourages practicing excellent hand hygiene, such as wearing gloves, for limiting the transfer of waterborne germs. Sinks and basins for washing should remain cleaned and disinfected.
Procedures for Mops, Cloths, and Similar Cleaning Tools
Prepare fresh cleaning solution and change mop heads each day. Immediately change mop heads following exposure to any bodily fluids or similar substances.
Before reusing cloths or mops, properly clean them and allow them to dry. Consider using disposable (single-use) products if possible.
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