Article 2: License
Selling or Transferring the Facility
87109
p. 30-30.1
If a licensee is selling the facility, they must give written notice to the Department and to every resident (or their representative) at least 30 days before the transfer happens, or at the time a bona fide offer is made, whichever gives more notice.
The buyer then has only 5 days after accepting the offer to submit their own license application. No sale can close until 30 days after that notice was given. The Department must decide on the buyer's application within 60 days of receiving a complete one.
Show Title 22 source text
"The licensee shall notify the licensing agency and all residents receiving services, or their representatives, in writing as soon as possible and in all cases at least thirty (30) days prior to the transfer of the property or business, or at the time that a bona fide offer is made, whichever period is longer, as specified in Health and Safety Code Section 1569.191."Part 1, Page 30
"(2) The prospective buyer shall submit an application for a license ... within five days of the acceptance of the offer by the seller." / "(c) No sale of the facility shall be permitted until 30 days have elapsed from the date upon which notice has been provided..." / "(d) ...The department shall make a decision within 60 days after a complete application is submitted..."Part 1, Page 30.1
Other Ownership, License Type, or Location Changes
87109
p. 30.1
Beyond a sale, any change in licensee, license type, or facility location requires the same 30-day advance written notice to the licensing agency and to residents (or their representatives).
Show Title 22 source text
"In all other instances, including a change in licensee, type of license, or location of the facility, the licensee shall notify the licensing agency and all residents receiving services, or their responsible persons, in writing as soon as possible and in all cases at least thirty (30) days prior to the effective date of that change."Part 1, Page 30.1
If the Licensee Dies
87111
p. 31-32
The person the licensee designated in advance to take over must notify the Department by the next working day after the death.
If that designee decides not to apply for their own license, they must tell the Department within 5 working days.
If they do want to keep operating, they must file a license application, along with proof of death (death certificate, obituary, etc.), within 20 calendar days of the death. The Department then has 60 days to decide on that application.
Show Title 22 source text
"(1) notify the Department by the next working day of the licensee's death; (2) inform the Department within 5 working days if the designee decides not to apply for licensure."Part 1, Page 31
"The designee files an application for licensure, and provides a copy of the licensee's death certificate, obituary notice, certification of death from the decedent's mortuary, or a letter from the attending physician or coroner's office verifying the death of the licensee, within 20 calendar days of the licensee's death."Part 1, Page 31
"The Department shall determine, within 60 days, after receipt of the completed application, whether a license will be issued."Part 1, Page 32
Declaring a Facility "Abandoned"
87112
p. 34-35
Before the licensing agency can conclude a licensee has abandoned the facility (which causes automatic license forfeiture), it must first try to reach them:
- Call once per day for 5 consecutive workdays with no response, and
- Send a certified letter that goes unanswered for 7 calendar days.
Show Title 22 source text
"2. The licensing agency has made at least one (1) phone call per day, to the licensee's last telephone number of record, for five (5) consecutive workdays with no response; and 3. The licensing agency has sent a certified letter, requesting the licensee to contact the licensing agency, to the licensee's last mailing address of record with no response within seven (7) calendar days."Part 1, Page 34-35
Reporting an Address Change
87114
p. 35
Any applicant or licensee must notify the licensing agency in writing within 10 calendar days whenever their mailing address changes.
Show Title 22 source text
"The applicant or licensee shall file his/her mailing address, in writing, with the licensing agency and shall notify the agency, in writing, of any change within 10 calendar days."Part 1, Page 35
Article 3: Application Procedures
Licensing Fee Schedule
87156
p. 40
Application and annual fees scale with a facility's licensed capacity:
| Capacity | Initial Application | Annual Fee |
|---|
| 1-3 | $495.60 | $495.60 |
| 4-6 | $990.00 | $495.60 |
| 7-15 | $1,486.80 | $742.80 |
| 16-30 | $1,980.00 | $990.00 |
| 31-49 | $2,476.80 | $1,238.40 |
| 50-74 | $2,972.40 | $1,448.00 |
| 75-100 | $3,469.20 | $1,734.00 |
| 101-150 | $3,964.80 | $1,982.40 |
| 151-200 | $4,622.40 | $2,311.20 |
| 201-250 | $5,280.00 | $2,640.00 |
| 251-300 | $5,940.00 | $2,970.00 |
| 301-350 | $6,600.00 | $3,300.00 |
| 351-400 | $7,260.00 | $3,630.00 |
| 401-500 | $8,580.00 | $4,290.00 |
| 501-600 | $9,900.00 | $4,950.00 |
| 601-700 | $11,220.00 | $5,610.00 |
| 701+ | $13,200.00 | $6,600.00 |
Show Title 22 source text
Health and Safety Code section 1569.185: "An application fee adjusted by facility and capacity shall be charged by the department for the issuance of a license to operate a residential care facility for the elderly. After initial licensure, a fee shall be charged by the department annually on each anniversary of the effective date of the license." (Full fee table reproduced in 87156, Page 40.)Part 1, Page 40
Reporting a Corporate Reorganization
87161
p. 46
If there's a corporate structure change, sale/transfer of the majority of stock, a spin-off from a parent company, or a merger, the licensee must notify the licensing agency within 48 hours.
Show Title 22 source text
"A corporate organizational change, including, but not limited to, change in structure, sale or transfer of the majority of stock, separating from a parent company, or merger with another company. The licensee shall notify the licensing agency of such organizational change within forty-eight (48) hours."Part 1, Page 46
How Long a Provisional License Lasts
87162
p. 46-47
A provisional license is a temporary license issued while a new facility works toward full compliance.
- Up to 6 months if the agency believes full compliance is achievable in that time.
- Up to 12 months if the agency determines more time is genuinely needed, due to circumstances beyond the applicant's control.
Show Title 22 source text
"(1) A provisional license may be issued for a maximum of six (6) months when the licensing agency determines that full compliance with licensing regulations will be achieved within that time period. (2) A provisional license may be issued for a maximum of twelve (12) months when the licensing agency determines, at the time of application, that more than six (6) months is required to achieve full compliance with licensing regulations due to circumstances beyond the control of the applicant."Part 1, Page 46-47
Appealing a License Denial
87163
p. 49
If your initial license application is denied, you have 15 days from the postmark date on the denial notice to file a written appeal.
Show Title 22 source text
"...an applicant may appeal the denial of the application by sending a written notice of appeal to the licensing agency within 15 days of the postmark date of the denial notice."Part 2, Page 49
Article 4: Operating Requirements
Reporting a Death, Serious Injury, or AED Use
87211
p. 55
If a resident dies (regardless of cause or location), suffers a serious injury while under facility supervision, or an AED is used on them, or any incident occurs that threatens a resident's welfare, safety, or health, the facility must submit a written report within 7 days to the licensing agency and the resident's responsible person.
Show Title 22 source text
"A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below."Part 2, Page 55
Reporting an Epidemic, Poisoning, or Major Accident
87211
p. 55
Occurrences that threaten the welfare, safety, or health of residents, staff, or visitors (like an epidemic outbreak, poisoning, or major accident) must be reported within 24 hours, by phone or fax, to the licensing agency (and the local health officer when appropriate).
Show Title 22 source text
"Occurrences, such as epidemic outbreaks, poisonings, catastrophes or major accidents which threaten the welfare, safety or health of residents, personnel or visitors, shall be reported within 24 hours either by telephone or facsimile to the licensing agency and to the local health officer when appropriate."Part 2, Page 55
Reporting a Fire or Explosion
87211
p. 55
A fire or explosion on the premises must be reported immediately to the local fire authority. If there's no organized local fire service, report to the State Fire Marshal within 24 hours. Either way, the licensing agency must be notified no later than the next working day.
Show Title 22 source text
"Fires or explosions which occur in or on the premises shall be reported immediately to the local fire authority; in areas not having organized fire services, within 24 hours to the State Fire Marshal; and no later than the next working day to the licensing agency."Part 2, Page 55
Reporting Suspected Abuse: With Serious Bodily Injury
87211
p. 56
If suspected physical abuse of a resident results in serious bodily injury, the mandated reporter must phone local law enforcement within 2 hours, and also submit a written report to the local ombudsman, the licensing agency, and law enforcement within that same 2-hour window.
Show Title 22 source text
"Any suspected physical abuse that results in serious bodily injury of an elder or dependent adult shall be reported to the local ombudsman, the corresponding licensing agency, and the local law enforcement agency within two (2) hours as required by Welfare and Institutions Code Section 15630(b)(1)."Part 2, Page 56
Reporting Suspected Abuse: Without Serious Bodily Injury
87211
p. 56.1
If suspected physical abuse does not result in serious bodily injury, the same reports (to law enforcement, the ombudsman, and the licensing agency) are still required; the window is just 24 hours instead of 2.
Show Title 22 source text
"Any suspected physical abuse that does not result in serious bodily injury of an elder or dependent adult shall be reported to the local ombudsman, the corresponding licensing agency, and the local law enforcement agency within twenty-four (24) hours as required by Welfare and Institutions Code Section 15630(b)(1)."Part 2, Page 56.1
Reporting Financial Distress Events
87211
p. 56.1-56.2
If the licensee experiences a foreclosure notice, an eviction (unlawful detainer) action against them, a bankruptcy filing, a notice of default on rent, or a utility shut-off notice, they must notify the Department, the Ombudsman, and all residents/representatives in writing within 2 business days of learning about it.
Note: a utility shut-off notice itself must give the facility at least 15 days before service is actually cut, which is what triggers this reporting duty.
Show Title 22 source text
"The licensee shall notify the Department, the State Long-Term Care Ombudsman, all residents, and, if applicable, their representatives, in writing within two business days of any of the following specified events, or knowledge thereof..."Part 2, Page 56.1
"(5) A utility company has sent a notice of intent to terminate electricity, gas, or water service on the property within not more than 15 days of the notice."Part 2, Page 56.2
Reporting a New Administrator
87211
p. 56.2
When a facility hires a new administrator, the licensee must notify the Department in writing within 30 days, including the new administrator's background/qualifications documentation.
Show Title 22 source text
"The licensee shall notify the Department, in writing, within thirty (30) days of the hiring of a new administrator."Part 2, Page 56.2
Reporting a Change in Chief Corporate Officer
87211
p. 56.3
Any change in the chief corporate officer of a licensee organization (corporation or association) must be reported to the licensing agency in writing within 15 working days, including the new officer's fingerprint card.
Show Title 22 source text
"Any change in the chief corporate officer of an organization, corporation or association shall be reported to the licensing agency in writing within fifteen (15) working days following such change."Part 2, Page 56.3
Bonding Requirements (When Facility Handles Resident Cash)
87216
p. 58
If a facility handles residents' cash, it must carry a surety bond sized to how much money it safeguards per month:
| Total Safeguarded Per Month | Bond Required |
|---|
| $750 or less | $1,000 |
| $751 - $1,500 | $2,000 |
| $1,501 - $2,500 | $3,000 |
Every additional $1,000 (or fraction) handled requires
another $1,000 of bond coverage.
Show Title 22 source text
"$750 or less...$1,000 / $751 to $1,500...$2,000 / $1,501 to $2,500...$3,000 / Every further increment of $1,000 or fraction thereof shall require an additional $1,000 on the bond."Part 2, Page 58
Recording Gifts to the Licensee
87217
p. 61
Any monetary gift, or any gift worth more than $100, given to the licensee by or on behalf of a resident must be recorded and attached to that resident's account records.
Show Title 22 source text
"All monetary gifts, and any gift exceeding an estimated value of $100, which are given to a licensee by or on behalf of a resident shall be recorded. The record shall be attached to the account specified in (f) above."Part 2, Page 61
Documenting and Reporting Theft or Loss
87218
p. 62-64
If a resident's property valued at $25 or more goes missing or is stolen, the facility must document it within 72 hours of discovering the loss.
If the value is $100 or more, the facility must also report it to local law enforcement within 36 hours.
The facility must review its overall theft-and-loss prevention efforts at least semiannually (twice a year).
Show Title 22 source text
Health and Safety Code section 1569.153(c): "Documentation of lost and stolen resident property with a value of twenty-five dollars ($25) or more within 72 hours of the discovery of the loss or theft..."Part 2, Page 62
"(i) Reports to the local law enforcement agency within 36 hours when the administrator of the facility has reason to believe resident property with a then current value of one hundred dollars ($100) or more has been stolen."Part 2, Page 64
"(g) Documentation, at least semiannually, of the facility's efforts to control theft and loss, including the review of theft and loss documentation and investigative procedures and results of the investigation by the administrator..."Part 2, Page 63
Activity Program Staffing, by Facility Size
87219
p. 66
- 7 or more residents: activity notices must be posted, and copies kept on file for at least 6 months.
- 16-49 residents: needs a designated activities staff member with at least 6 months of relevant experience (or currently enrolled in training).
- 50+ residents: needs a full-time activities coordinator with at least 1 year of relevant experience.
Show Title 22 source text
"In facilities licensed for seven (7) or more persons, notices of planned activities shall be posted in a central location... Copies shall be retained for at least six (6) months."Part 2, Page 66
"In facilities licensed for sixteen (16) to forty-nine (49) persons, one staff member, designated by the administrator, shall have primary responsibility for the organization, conduct and evaluation of planned activities. This person shall have had at least six (6) months experience in providing planned activities..."Part 2, Page 66
"In facilities licensed for fifty (50) persons or more, one staff member shall have full-time responsibility to organize, conduct and evaluate planned activities... The responsible employee shall have had at least one year of experience in conducting group activities..."Part 2, Page 66
Timelines for Accepting APS Emergency Placements
87222
p. 68-70
- The Department must approve or deny a facility's request to accept APS emergency placements within 15 working days.
- Once an APS resident is placed, the facility has 7 calendar days to gather standard resident record information, and the resident must get a TB test by day 7.
- The resident's medications must be verified with their physician by the next working day, and no later than 72 hours after placement; if that can't happen, the facility must ask APS to relocate the resident.
- A resident under 60 admitted this way generally cannot be kept longer than 30 calendar days.
- Any change to the facility's agreement with the APS agency must be reported to the Department within 7 calendar days.
Show Title 22 source text
"The Department shall provide written approval or denial of a licensee's request to provide emergency shelter services within 15 working days of its receipt."Part 2, Page 68
"Within seven calendar days of an APS emergency placement, the licensee shall obtain other resident information... The resident must have a tuberculosis test... by the seventh day of placement..."Part 2, Page 69
"The licensee shall contact the resident's attending physician... to identify all of the resident's prescribed medications and usage instructions... by the next working day, but no later than 72 hours from the initial APS emergency placement."Part 2, Page 69
"A licensee cannot retain a resident under age 60 beyond 30 calendar days from initial placement by the APS agency, unless the acceptance and retention requirement provided in Section 87455(b)(6) is met."Part 2, Page 70
"Within seven calendar days of the licensee making any changes to an agreement with an APS agency, the licensee shall notify the Department in writing of these changes..."Part 2, Page 70
Eviction Notice Periods
87224
p. 71-72
How much notice a resident must be given depends on the reason for eviction:
- Standard eviction (rule violations, non-compliance with policies, unmet needs, etc.): 30 days' written notice.
- Nonpayment of fees: the resident must be at least 10 days past the due date before this ground applies.
- Facility "change of use" (e.g., converting to a different type of facility): at least 60 days' written notice.
- "Good cause" emergency eviction (resident poses a safety threat): only 3 days' notice, and only with prior written approval from the licensing agency.
Whichever type of eviction, the facility must send a written eviction report to the licensing agency
within 5 days.
Show Title 22 source text
"The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required except as otherwise specified in paragraph (5). (1) Nonpayment of the rate for basic services within ten days of the due date."Part 2, Page 71
"(5)(A) The licensee may, upon no less than sixty (60) days written notice, evict a resident due to change of use of the facility."Part 2, Page 71
"(b) The licensee may, upon obtaining prior written approval from the licensing agency, evict the resident upon three (3) days written notice to quit. The licensing agency may grant approval for the eviction upon a finding of good cause."Part 2, Page 71.1
"A written report of any eviction shall be sent to the licensing agency within five (5) days."Part 2, Page 72
Disaster Drill Frequency
Instructor guidance (not in Title 22 text)
- Regular RCFEs run disaster drills every 6 months.
- Dementia-care RCFEs run disaster drills every 3 months.
- All facilities keep documentation of these drills on file for 1 year.
Article 5: Physical Environment
Room Temperature Standards
87303
p. 73
Facilities must be able to heat occupied rooms to at least 68°F, and cool them to a comfortable 78-85°F (or at least 30°F below the outside temperature during extreme heat).
Show Title 22 source text
"The facility shall heat rooms that residents occupy to a minimum of 68 degree F, (20 degrees C). The facility shall cool rooms to a comfortable range, between 78 degrees F (26 degrees C) and 85 degrees F (30 degrees C), or in areas of extreme heat to 30 degrees F less than the outside temperature."Part 2, Page 73
Private Well Water Testing Schedule
87303
p. 74
How often private well water must be tested for safety, based on licensed capacity:
| Licensed Capacity | Testing Schedule |
|---|
| Under 6 | Initial test, then only if there's reason to suspect a problem |
| 7-15 | Initial test, then annually |
| 16-24 | Initial test, then every 6 months |
| 25+ | Follow county health department rules (Safe Drinking Water Act) |
Show Title 22 source text
"Under 6 -- Initial Licensing -- Upon evidence of need / 7 through 15 -- Initial Licensing -- Annually / 16 through 24 -- Initial Licensing -- Every six months / 25 or more -- Refer to the county health department for compliance with the California Safe Drinking Water Act..."Part 2, Page 74
Hot Water Temperature
87303
p. 74
Water at fixtures residents use for personal care must stay between 105°F and 120°F. Any tap that can reach 125°F or hotter must have a warning sign posted.
Show Title 22 source text
"Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C). Taps delivering water at 125 degree F (52 degree C) or above shall be prominently identified by warning signs."Part 2, Page 74
Bedroom and Bathroom Ratios
87307
p. 77-78
- No more than 2 residents may share a bedroom.
- Each resident needs at least 8 cubic feet of drawer/closet space.
- At least 1 toilet/washbasin per 6 people (residents + staff + family).
- At least 1 bathtub/shower per 10 people.
Show Title 22 source text
"(D) Not more than two residents shall sleep in a bedroom."Part 2, Page 77
"(E) Portable or permanent closets and drawer space in the bedrooms for clothing and personal belongings. A minimum of eight (8) cubic feet (.743 cubic meters) of drawer space per resident shall be provided."Part 2, Page 78
"(1) At least one toilet and washbasin for each six (6) persons, which include residents, family and personnel. (2) At least one bathtub or shower for each ten (10) persons, which includes residents, family and live-in personnel."Part 2, Page 78
Administrative Office Requirement
87308
p. 79
Facilities licensed for 16 or more residents must maintain a dedicated administrative office area with space for business, admissions, and a reception/restroom area.
Show Title 22 source text
"Administrative offices or area shall be maintained in facilities having a capacity of sixteen (16) persons or more, which includes space for business, administration and admission activities, a reception area and restroom facilities which may be used by visitors."Part 2, Page 79
Phone Directory Listing
87311
p. 80.1
Facilities with a capacity of 16 or more must be listed in the telephone directory under the facility's name.
Show Title 22 source text
"All facilities shall have telephone service on the premises. Facilities with a capacity of sixteen (16) or more persons shall be listed in the telephone directory under the name of the facility."Part 2, Page 80.1
Article 6: Background Check
How Long Criminal Clearance Records Are Kept
87355
p. 87
The Department holds an individual's criminal record clearance in its active files for at least 2 years after they stop working at a licensed facility. This is what allows the clearance to be transferred to a new employer without redoing the background check.
Show Title 22 source text
Health and Safety Code Section 1569.17(g): "The California Department of Social Services shall hold criminal records clearances in its active files for a minimum of two years after an employee is no longer employed at a licensed facility in order for the criminal records clearances to be transferred."Part 2, Page 87
Reporting an Address Change (Clearance/Exemption Holders)
87355
p. 87
Anyone who holds a criminal record clearance or exemption has to keep a current, valid mailing address on file with the Department, and notify the Department within 10 days of any change. (This is a separate 10-day rule from the 87114 address-change requirement, which applies to applicants/licensees specifically.)
Show Title 22 source text
(A) An individual who holds a criminal record clearance or exemption shall maintain a current and valid mailing address with the Department and shall notify the Department within ten (10) days of any change in mailing address.Part 2, Page 87
Article 7: Personnel
Administrator Minimum Age and Grandfathering
87405
p. 104-105
An administrator must be at least 21 years old.
Administrators who were already licensed or working as of July 1, 1982 don't have to meet the newer college/continuing-education requirements, as long as they haven't had a gap in RCFE administrator employment longer than 3 consecutive years.
Show Title 22 source text
"(7) Be at least 21 years of age."Part 3, Page 104
"Administrators employed/licensed prior to July 1, 1982, shall not be required to comply with the college and continuing education requirements... provided that they have no break in employment as a Residential Care Facility for the Elderly administrator exceeding three (3) consecutive years."Part 3, Page 105
Nursing Home Administrator Exemption
87406
p. 106
Someone who already holds a valid Nursing Home Administrator license is exempt from the full 80-hour Initial Certification Training Program and the written exam, but must still complete 12 hours of specific classroom instruction covering laws/regulations, medication management, and resident admission procedures.
Show Title 22 source text
"Applicants who possess a valid Nursing Home Administrator license, issued by the California Department of Public Health, shall be exempt from completing an approved Initial Certification Training Program and taking a written exam, provided the individual completes twelve (12) hours of classroom instruction in the following Core of Knowledge areas..."Part 3, Page 106
Passing the Certification Exam
87406
p. 106
After completing the Initial Certification Training Program, a candidate must pass the Department's written exam within 60 days, with up to 3 attempts allowed.
Show Title 22 source text
"Unless exempted by Section 87406(a)(1) or (a)(2), pass a written exam developed and administered by the Department within sixty (60) days of completion of an Initial Certification Training Program and within three (3) attempts."Part 3, Page 106
Submitting Your Certification Application
87406
p. 107
Once you pass the exam, you must submit your certification application (Form LIC 9214) within 30 days of being notified you passed, or within 30 days of finishing training, if you're exempt from the exam.
Show Title 22 source text
"Submit a completed Application for Administrator Certification form LIC 9214 to the Department's Administrator Certification section within thirty (30) days of being notified of having passed the exam, or if the applicant is exempt from taking the written exam, within 30 days of completing the Initial Certification Training Program."Part 3, Page 107
Certification Fee
87406
p. 107
Submitting a certification application requires a $100 non-refundable processing fee.
Show Title 22 source text
"(H) A non-refundable one hundred dollar ($100) processing fee."Part 3, Page 107
Certificate Validity Period
87406
p. 108
Once issued, an administrator certificate is valid for 2 years before it needs to be renewed.
Show Title 22 source text
"Certificates shall be valid for a period of two (2) years and expire on either the anniversary date of initial issuance or on the individual's birthday during the second calendar year following certification."Part 3, Page 108
Extending Certification Deadlines
87406
p. 108
The 60-day exam deadline and 30-day application deadline can be extended for good cause (e.g., a death in the immediate family, military service), but only up to 60 days total, and the request must be made in writing within 60 days of finishing training.
Show Title 22 source text
"Time deadlines specified in Sections 87406(b)(2) and (3) may be extended up to sixty (60) days in total for good cause as determined by the Department. Any request for an extension of time shall be made in writing to the Administrator Certification Section Manager within sixty (60) days of completing the Initial Certification Training Program..."Part 3, Page 108
Continuing Education Hour Requirements
87407
p. 109
Every 2-year certification period, an administrator must complete
40 classroom hours of continuing education, including:
- At least 8 hours on Alzheimer's/dementia care
- At least 4 hours on laws and regulations
- At least 1 hour on LGBT cultural competency
Up to half of the 40 hours (
20 hours) can be completed through approved interactive online courses. No more than
10 hours can count toward the total in a single day, regardless of format.
Show Title 22 source text
"Administrators shall complete at least forty (40) classroom hours of continuing education during each two (2)-year certification period, including... at least eight (8) hours in subjects related to serving residents with Alzheimer's Disease and other dementias... At least four (4) hours of instruction in laws, regulations, policies, and procedural standards... at least one (1) hour of instruction in cultural competency and sensitivity in issues relating to the underserved aging lesbian, gay, bisexual, and transgender community."Part 3, Page 109
"...up to one-half of the required forty (40) hours of continuing education necessary to renew the certificate may be satisfied through interactive online courses... The Department will not count toward the continuing education requirements more than ten (10) hours of instruction, in-class and/or online, completed in a single day."Part 3, Page 109
Renewal Timing and Fee
87407
p. 110
Renewal applications must be submitted on, or up to 90 days before, your certificate's expiration date, along with a $100 fee.
Show Title 22 source text
"To apply for recertification prior to the expiration date of the certificate, the certificate holder shall submit to the Department's Administrator Certification Section, post-marked on, or up to ninety (90) days before, the certificate expiration date... Payment of a non-refundable one hundred dollar ($100) processing fee."Part 3, Page 110
Late Renewal
87407
p. 110-111
If your certificate lapses, you can still renew within 4 years of the expiration date, but you'll owe a $300 late fee (3x the normal $100 fee), and you'll need to make up CE hours based on how long you were lapsed.
Show Title 22 source text
"To apply for recertification after the expiration date of the certificate, but within four (4) years of the certificate expiration date... Payment of a non-refundable delinquency fee equal to three times the one hundred dollar ($100) renewal fee, or three hundred dollars ($300)."Part 3, Page 110
"Certificates not renewed within four (4) years of their expiration date shall not be renewed, restored, reissued or reinstated."Part 3, Page 110-111
Nursing Home Administrator CE Reduction
87407
p. 111
Certificate holders who also hold a valid Nursing Home Administrator license only need to complete 20 of the 40 CE hours (but must still include the topic-specific hours: dementia, laws, LGBT competency).
Show Title 22 source text
"Certificate holders who possess a valid Nursing Home Administrator license shall be required to complete only twenty (20) of the required forty (40) hours of continuing education, but including the requirements of Section 87407(a)(1)-(3)."Part 3, Page 111
Lost Certificate and Address Changes
87407
p. 111
Replacing a lost certificate costs $25. Certificate holders must report a mailing address change within 30 days, and notify the Department within 30 days any time they start or stop working as an administrator at a facility.
Show Title 22 source text
"A non-refundable processing fee of twenty-five dollars ($25) shall be paid for the replacement of a lost certificate. A certificate holder shall report any change of mailing address within thirty (30) days of the change to the Department's Administrator Certification Section."Part 3, Page 111
"Whenever a certified administrator assumes or relinquishes responsibility for administering a residential care facility for the elderly, he or she shall provide written notice, within thirty (30) days..."Part 3, Page 111
Minimum Staff Age
87411
p. 115
Anyone who supervises employees, or supervises/cares for residents, must be at least 18 years old.
Show Title 22 source text
"All persons who supervise employees or who supervise or care for residents shall be at least eighteen (18) years of age."Part 3, Page 115
New Staff Training Requirements
87411
p. 116, 120
Staff who assist residents with personal activities of daily living need at least 10 hours of initial training within their first 4 weeks on the job, and at least 4 more hours every year after that.
Show Title 22 source text
"(A) For staff who assist with personal activities of daily living, there shall be documentation of at least ten hours of initial training within the first four weeks of employment, and at least four hours of training annually thereafter in one or more of the content areas as specified in Section 87411(c)(2)."Part 3, Page 120
Direct-Care Staff Training Hours
Instructor guidance (not in Title 22 text)
This isn't in the Title 22 regulation text; it came from your instructor rather than the statute (the regulation's own figures are 10 hours initial / 4 hours annual, in the card above). Worth knowing for the exam anyway:
- Within 4 weeks of employment, staff must receive 40 hours of training.
- Before working alone with a resident, staff need 20 hours of training.
- After that, 20 hours of training is needed every year.
Staff Health Screening Timing
87411
p. 117
Every staff member (including the licensee and administrator) needs a health screening by a physician, done sometime between 6 months before starting and 7 days after starting.
Show Title 22 source text
"Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure."Part 3, Page 117
Personnel Records Retention
87412
p. 121
Personnel files must be kept for at least 3 years after an employee leaves. If a licensing inspector removes records to make copies, they must return them within 3 business days.
Show Title 22 source text
"All personnel records shall be retained for at least three (3) years following termination of employment."Part 3, Page 121
"Licensing representatives shall return the records undamaged and in good order within three business days following the date the records were removed."Part 3, Page 121
Posted Staff Schedule
87413
p. 122
Facilities licensed for 16 or more residents must post a dated, weekly employee work schedule where staff can conveniently see it.
Show Title 22 source text
"If the facility is licensed for sixteen (16) persons or more, there shall be a dated weekly employee time schedule displayed conveniently for employee reference. The schedule shall contain employee's name, job title, hours of work, and days off."Part 3, Page 122
Night Supervision Staffing, by Facility Size
87415
p. 122
Overnight (10:00 p.m. to 6:00 a.m.) supervision requirements:
| Facility Size | Requirement |
|---|
| Under 16 residents | 1 qualified person on call |
| 16-100 residents | 1 employee awake and on duty, plus 1 more on call (able to respond within 10 minutes) |
| 101-200 residents | 1 on call on premises, plus 1 awake and on duty, plus 1 more on call (within 10 minutes) |
| Each additional 100 residents | +1 more awake staff person on duty |
Show Title 22 source text
"(1) In facilities caring for less than sixteen (16) residents, there shall be a qualified person on call on the premises. (2) In facilities caring for sixteen (16) to one hundred (100) residents at least one employee shall be on duty on the premises, and awake. Another employee shall be on call, and capable of responding within ten minutes."Part 3, Page 122
"(3) In facilities caring for one hundred one (101) to two hundred (200) residents, one employee shall be on call, on the premises; one employee shall be on duty on the premises and awake; and one employee shall be on call and capable of responding within ten minutes. (4) Every additional 100 residents, or fraction thereof, shall require an additional one (1) staff person on duty, on the premises and awake."Part 3, Page 122
Article 8: Resident Assessments & Rights
Medical Assessment Currency
87458
p. 127
Before a person can be admitted, the facility must have documentation of a medical assessment signed by a licensed medical professional, and that assessment can't be more than one year old.
Show Title 22 source text
"Prior to a person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment, signed by a licensed medical professional acting within the scope of their practice and made within the last year, to be kept in the resident's record."Part 3, Page 127
Reappraisal Cycle
87463
p. 130-131
A resident's care needs must be reassessed in writing any time there's a significant change in their condition, or at least once every 12 months, whichever comes first. Residents should also get an annual visit with a licensed medical professional at least once every 12 months.
Show Title 22 source text
"The pre-admission appraisal... shall be updated in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition, as defined in Section 87101, Definitions, and to keep the appraisal accurate."Part 3, Page 130
"The licensee shall request that all residents receive an annual routine visit with a licensed medical professional once every twelve months, either in person or by video appointment."Part 3, Page 130.1
Private Room Upcharge Cap
87464
p. 132
If a resident receiving SSI/SSP wants a private room even though a shared room is available, the facility can charge extra, but that extra charge cannot exceed 10% of the Board & Room portion of their SSI/SSP grant.
Show Title 22 source text
"An extra charge to the resident shall be allowed for a private room if a double room is made available but the resident prefers a private room, provided the arrangement is documented in the admissions agreement and the charge is limited to 10% of the Board and Room portion of the SSI/SSP grant."Part 3, Page 132
Medication and Destruction Records
87465
p. 136-137
Records of any medication the facility centrally stores for a resident must be kept for at least 1 year. If medications are later destroyed (because they're no longer needed and can't be returned), that destruction record must be kept for at least 3 years.
Show Title 22 source text
"The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained for at least one year and includes..."Part 3, Page 136
"...shall be destroyed in the facility by the facility administrator and one other adult who is not a resident. Both shall sign a record, to be retained for at least three years..."Part 3, Page 137
Designated First Aid Staff
87465
p. 137
Facilities licensed for 16 or more residents must designate a specific staff member (or members) responsible for making sure residents get needed first aid and emergency medical services.
Show Title 22 source text
"In all facilities licensed for sixteen (16) persons or more, one or more employees shall be designated as having primary responsibility for assuring that each resident receives needed first aid and needed emergency medical services and for assisting residents as needed with self-administration of medications."Part 3, Page 137
Care-Planning Meeting Timing
87467
p. 138
Within 2 weeks of a new resident moving in, the facility must hold a meeting with the resident (and their representative, if any) to write down the care the resident will receive. This plan must be revisited whenever there's a significant change in condition, or at least once every 12 months.
Show Title 22 source text
"Prior to, or within two weeks of the resident's admission, the licensee shall arrange a meeting with the resident, the resident's representative, if any, appropriate facility staff... to prepare a written record of the care the resident will receive in the facility..."Part 3, Page 138
"The licensee shall arrange a meeting with the resident and appropriate individuals... to review and revise the written record as specified, when there is a significant change in the residents condition, or once every 12 months, whichever occurs first."Part 3, Page 138
Translating Resident Rights Notices
87468
p. 139.1
If 5% or more of a facility's residents can only read a language other than English, the facility's rights postings and notices must also be provided in that language.
Show Title 22 source text
"Licensees shall post the personal rights, nondiscrimination notice, and complaint information specified above in English, and, in any other language in which at least five (5) percent of the residents can only read that other language."Part 3, Page 139.1
Rate Increase Notice
87468.2
p. 139.8, 148.1
Any regular rate or fee-structure increase requires at least 60 days' written notice to residents (or their representatives).
Show Title 22 source text
Health and Safety Code section 1569.655(a): "...the licensee shall provide no less than 60 days' prior written notice to the residents or the residents' representatives setting forth the amount of the increase, the reason for the increase, and a general description of the additional costs..."Part 3, Page 139.8
Rate Increase Due to a Change in Level of Care
87468.2 / 87507
p. 139.8, 148.2
If a rate goes up specifically because a resident's level of care changed (not a general rate hike), the facility only needs to give notice within 2 business days after it starts providing the new, higher level of service, rather than the usual 60-day notice.
Show Title 22 source text
Health and Safety Code section 1569.657(a): "For any rate increase due to a change in the level of care of the resident, the licensee shall provide the resident and the resident's representative, if any, written notice of the rate increase within two business days after initially providing services at the new level of care."Part 3, Page 148.1
Providing Copies of Records
87468.2
p. 139.10
If a resident (or their representative) asks for photocopies of their records, the facility must provide them within 2 business days.
Show Title 22 source text
"To have prompt access to review all of their records and to purchase photocopies of their records. Photocopied records shall be provided within two (2) business days and at a cost that does not exceed the community standard for photocopies."Part 3, Page 139.10
Room Change Notice
87468.2
p. 139.10
If a resident is being moved to a different room, they need at least 30 days' written notice, unless the resident agrees to the move, it's needed to fill a vacant bed, or it's an emergency.
Show Title 22 source text
"To written notice of any room changes at least 30 days in advance unless a room change is agreed to by the resident, required to fill a vacant bed, or necessary due to an emergency."Part 3, Page 139.10
Responding to Resident or Family Council Concerns
87468.2
p. 139.12, 139.18
If a resident council or family council submits written concerns or recommendations, the facility must respond in writing within 14 calendar days.
Show Title 22 source text
Health and Safety Code section 1569.157(c): "If a resident council submits written concerns or recommendations, the facility shall respond in writing regarding any action or inaction taken in response to those concerns or recommendations within 14 calendar days."Part 3, Page 139.12
Health and Safety Code section 1569.158(f): "If a family council submits written concerns or recommendations, the facility shall respond in writing regarding any action or inaction taken in response to the concerns or recommendations within 14 calendar days."Part 3, Page 139.18
Article 9: Resident Records
Resident Records Retention Period
87506
p. 144-145
Resident records must be kept for at least 3 years after a resident leaves the facility. If a licensing inspector removes records for copying, they must return them within 3 business days.
Show Title 22 source text
"Original records or photographic reproductions shall be retained for a minimum of three (3) years following termination of service to the resident."Part 3, Page 145
"Licensing representatives shall return the records undamaged and in good order within three business days following the date the records were removed."Part 3, Page 144
Signing the Admission Agreement
87507
p. 146
The admission agreement must be signed and dated by both the resident (or representative) and the licensee no later than 7 days after the resident is admitted.
Show Title 22 source text
"Admission agreements shall be signed and dated, acknowledging the contents of the document, by the resident or the resident's representative, if any, and the licensee or the licensee's designated representative no later than seven days following admission."Part 3, Page 146
Refunding Fees After a Resident's Death
87507
p. 148.3
When a resident dies, any fees the facility already collected that cover time after the resident's personal belongings have been removed from their living unit must be refunded.
The refund goes to whoever was contractually responsible for paying the fees (or, if the resident themselves paid, to the resident's estate), and it must be issued within 15 days of the personal property being removed.
Show Title 22 source text
Health and Safety Code section 1569.652(c): "A refund of any fees paid in advance covering the time after the resident's personal property has been removed from the facility shall be issued to the individual, individuals, or entity contractually responsible for the fees or, if the deceased resident paid the fees, to the resident's estate, within 15 days after the personal property is removed."Part 3, Page 148.3
Article 10: Food Services
Meal Timing Requirements
87555
p. 150
Residents must be offered at least 3 meals a day, and no more than 15 hours can pass between the last meal of the day and the first meal the next day.
Show Title 22 source text
"Where all food is provided by the facility arrangements shall be made so that each resident has available at least three meals per day. Exceptions may be allowed on weekends and holidays providing the total daily food needs are met. Not more than fifteen (15) hours shall elapse between the third and first meal."Part 4, Page 150
Food Storage Temperatures
87555
p. 152
Freezers must stay at 0°F; refrigerators must stay no warmer than 40°F.
Show Title 22 source text
"Freezers of adequate size shall be maintained at a temperature of 0 degrees F (-17.7 degrees C), and refrigerators of adequate size shall maintain a maximum temperature of 40 degrees F (4 degrees C)."Part 4, Page 152
Minimum Food Supply on Hand
87555
p. 152
Facilities must keep at least a 1 week's supply of nonperishable food and at least 2 days' supply of perishable food on the premises at all times.
Show Title 22 source text
"Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises."Part 4, Page 152
Article 11: Health-Related Services
Notifying the Fire Authority About a Bedridden Resident
87606
p. 154-154.1
If a facility accepts or retains a resident who is (or becomes) bedridden, the local fire authority must be notified within 48 hours.
Show Title 22 source text
"A licensee shall notify the fire authority having jurisdiction within 48 hours of accepting or retaining any person who is bedridden, as specified in Health and Safety Code section 1569.72."Part 4, Page 154
What Counts as "Temporary" Illness
87606
p. 154.1
A "temporary illness" (which doesn't trigger the need for a special fire clearance) is defined as an illness lasting 14 days or less. If bedridden status is expected to last longer, the facility needs Department approval plus a physician's statement to keep the resident there.
Show Title 22 source text
Health and Safety Code Section 1569.72(d)(1): "For purposes of this section, 'temporary illness' means any illness which persists for 14 days or less."Part 4, Page 154.1
Oversight of Ostomy Care by Facility Staff
87621
p. 165
When trained facility staff assist with colostomy/ileostomy bag changes, the appropriately skilled professional who trained them must review the procedure and technique at least twice a month.
Show Title 22 source text
"(C) The professional shall review the procedures and techniques no less than twice a month."Part 4, Page 165
Oversight of Catheter and Contracture Care
87623 / 87626
p. 167, 169
For catheter care or range-of-motion/contracture exercises performed by trained facility staff, the supervising professional must review staff performance at least annually.
Show Title 22 source text
"(C) The licensee shall ensure that the professional reviews staff performance as often as necessary, but at least annually." (Indwelling Urinary Catheter)Part 4, Page 167
"(3) Ensuring that the professional reviews staff performance as often as necessary, but at least annually." (Contractures)Part 4, Page 169
Hospice Waiver Approval and Notification Timelines
87632
p. 171-172
Once a facility submits an acceptable request to accept hospice residents, the Department has 30 days to respond.
Once approved, if the facility actually starts hospice services for a resident, it must notify the Department in writing within 5 working days.
Show Title 22 source text
"Within 30 days of receipt of an acceptable request for a hospice care waiver, the Department shall notify the applicant or licensee, in writing of one of the following: (1) The request has been approved or denied..."Part 4, Page 171.1
"The licensee shall notify the Department in writing within five working days of the initiation of hospice care services for any terminally ill resident in the facility or within five working days of admitting a resident already receiving hospice care services."Part 4, Page 172
Health Condition Relocation Plan Deadline
87637
p. 177
If the Department orders a resident relocated because of a health condition the facility can't legally handle, the facility's written relocation plan generally cannot take longer than 30 days to complete.
Show Title 22 source text
"(A) A specific date for beginning and a specific date for completion of the process of safely relocating the resident. The time frame for relocation may provide for immediate relocation but shall not exceed 30 days."Part 4, Page 177
Appealing a Health Condition Relocation Order
87638
p. 179-180
If a resident disagrees with a health-condition relocation order, they (or their representative) have 3 working days from receiving the order to request a review.
The facility must then compile the required supporting documentation (current medical assessment, appraisal, etc.) within 10 working days.
The Department must tell the resident its final decision within 30 days of when the resident was first notified they needed to relocate.
Show Title 22 source text
"The resident, or the resident's responsible person, if any, shall have three (3) working days, from receipt of the relocation order, to submit to the licensee a written, signed and dated request for a review and determination by the interdisciplinary team."Part 4, Page 179
"Within ten (10) working days from the date of the resident's review request, the licensee shall submit to the Department the documentation specified in Section 87638(g) to complete the resident's review request."Part 4, Page 179
"The Department shall inform the resident and/or the resident's responsible person, if any, in writing, of the interdisciplinary team's determination and the reason for that determination not more than 30 days after the resident or his/her responsible person, if any, is notified of the need to relocate."Part 4, Page 180
Article 12: Dementia
Dementia-Specific Staff Training Hours
87705
p. 183
All direct care staff need 12 hours of dementia care training total: 6 hours must happen before they start working independently with residents, and the remaining 6 hours within their first 4 weeks of employment.
After that, everyone needs 8 hours of dementia-related in-service training every year.
Show Title 22 source text
Health and Safety Code section 1569.626(a): "(1) Twelve hours of dementia care training, six of which shall be completed before a staff member begins working independently with residents, and the remaining six hours of which shall be completed within the first four weeks of employment. All 12 hours shall be devoted to the care of persons with dementia. (2) Eight hours of in-service training per year on the subject of serving residents with dementia."Part 4, Page 183
Reporting an Elopement
87705
p. 184
If a resident at risk for elopement leaves the facility unsupervised, the facility must notify the resident's representative immediately, and notify the licensing agency's Officer of the Day no later than the next working day.
Show Title 22 source text
"(A) The resident's representative, if applicable, immediately upon becoming aware of the incident... (B) The licensing agency Officer of the Day, by telephone, e-mail, fax, or hand-delivery no later than the next working day following the incident."Part 4, Page 184
Article 13: Enforcement
How Often Facilities Get Inspected
87755
p. 190, 195
A brand-new facility gets its first compliance inspection within 90 days of accepting its first resident (and the licensee must tell the Department within 5 business days once they've accepted that first resident).
If someone files a complaint, the agency generally inspects within 10 days.
Every facility gets visited at least once every 5 years, and each year the Department does unannounced visits to at least 20% of facilities that aren't already flagged for other reasons (probation, pending accusation, etc.).
Show Title 22 source text
Health and Safety Code section 1569.24: "Within 90 days ...after a facility accepts its first resident for placement following its initial licensure, the department shall inspect the facility... The licensee shall notify the department, within five business days after accepting its first resident for placement, that the facility has commenced operating."Part 4, Page 190
Health and Safety Code section 1569.35(c): "...it shall make an onsite inspection within 10 days after receiving the complaint..." / section 1569.33(c)-(d): "The department shall conduct annual unannounced visits to no less than 20 percent of facilities not subject to an evaluation under subdivision (b)... Under no circumstance shall the department visit a residential care facility for the elderly less often than once every five years."Part 4, Page 195
Deadlines for Fixing a Cited Deficiency
87756
p. 198
Depending on how serious the issue is, the evaluator sets a correction deadline. Urgent/serious issues may require correction within 24 hours; otherwise the standard deadline is generally no more than 30 calendar days from the date of the notice.
Show Title 22 source text
"(B) The evaluator shall require correction of the deficiency within 24 hours and shall specify on the notice the date by which the correction must be made whenever penalties are assessed... (C) The date for correcting a deficiency shall not be more than 30 calendar days following service of the notice of deficiency, unless the evaluator determines that the deficiency cannot be completely corrected in 30 calendar days."Part 4, Page 198
Follow-Up Inspection Timing
87759
p. 200
After a correction deadline passes, the licensing agency conducts a follow-up visit within 10 working days to confirm the fix was actually made.
Show Title 22 source text
"A follow-up visit shall be conducted within 10 working days following the latest date of correction specified in the notice of deficiency, unless the licensee has demonstrated that the deficiency was corrected as required in the notice of deficiency."Part 4, Page 200
Standard Penalty Amounts
87761
p. 200-201
If a deficiency isn't fixed by its deadline, the facility is fined $50/day per violation, up to a maximum of $150/day.
If the deficiency actually caused a resident's sickness, injury, or death, the fine jumps immediately to $150/day.
Show Title 22 source text
"A penalty of $50 per day, per cited violation, shall be assessed for all serious deficiencies that are not corrected by the date specified in the notice of deficiency, up to a maximum of $150 per day."Part 4, Page 200
"Notwithstanding Section 87761(a) above, an immediate penalty of $150 per day shall be assessed for any of the following: (1) Sickness, injury of death of a client has occurred as a result of the deficiency."Part 4, Page 201
Appealing a Citation
87763
p. 202
A licensee who wants to challenge a deficiency notice, penalty notice, or health-condition relocation order can request a review, but must submit that request in writing within 10 working days of receiving it.
Show Title 22 source text
"A licensee or his/her representative may request in writing a review of a notice of deficiency, notice of penalty and/or health condition relocation order within 10 working days of receipt of the notice or order."Part 4, Page 202
Suspension of New Admissions: Timelines
87764 / 87765
p. 202.2-202.3
If the Department suspends a facility's ability to admit new residents (due to an uncorrected serious deficiency or unpaid penalties), the facility can appeal within 10 business days.
The reviewing Deputy Director must decide within 3 business days of receiving that appeal, and the Department must notify the facility of the outcome within 2 business days after that.
If the suspension was due to a deficiency, the Department does a follow-up compliance visit within 10 business days of the correction deadline before lifting the suspension.
Show Title 22 source text
"(1) In the case of a suspension pursuant to subsection (a)(1), ... If the facility does not demonstrate to the Department the correction of all deficiencies identified in the notice, the Department shall conduct a follow-up visit to determine compliance within ten (10) business days following the latest date of correction specified in the notice."Part 4, Page 202.2
"A licensee or their representative may appeal the decision of the Department to suspend new admissions by requesting, in writing, a review of the order of suspension of new admissions within ten (10) business days of receipt of the order... The Deputy Director or their designee shall conduct the review and render a final decision within three (3) business days of receipt of the written appeal."Part 4, Page 202.3
Operating Without a License
87768
p. 203-204
If a facility is caught operating unlicensed, it has 15 calendar days from the violation notice to submit a complete license application. If it doesn't, the facility is fined $100 per resident per day, which jumps to $200 per resident per day starting on the 16th calendar day.
If the application is later denied, the facility must shut down within 10 calendar days of that denial.
Show Title 22 source text
"A penalty of $100 per day per resident shall be assessed for the operation of an unlicensed facility under either of the following conditions: (1) The operator has not submitted a completed application for licensure within 15 calendar days of issuance of the Notice of Operation in Violation of Law..."Part 4, Page 203
"A $200 per day per resident penalty shall be assessed for the continued operation of an unlicensed facility as follows: (1) On the 16th calendar day after the operator has been issued the Notice of Operation in Violation of Law, and has not submitted a completed application as required."Part 4, Page 204
"(2)(A) Notwithstanding any appeal action, facility operation must cease within 10 calendar days of the mailing of the notice of denial or upon receipt of the denial notice by the operator, whichever occurs first."Part 4, Page 204
Appealing an Unlicensed-Facility Penalty
87769
p. 205
The operator of an unlicensed facility can appeal a penalty assessment, but must do so within 10 working days of being served the penalty notice.
Show Title 22 source text
"An unlicensed operator or his/her representative shall have the right to appeal the penalty assessment within 10 working days after service of the penalty assessment."Part 4, Page 205