Key Concepts: Operating Requirements

42 key concepts from Title 22, Division 6, Chapter 8, Article 4: Operating Requirements, for the RCFE Administrator exam. For the searchable, bookmarkable version, use the interactive Study Guide.

Fire Clearance Required for Nonambulatory or Bedridden Residents
87202 p. 50
Every facility has to maintain a fire clearance approved by the applicable fire authority (city/county/district fire department, or the State Fire Marshal). Before accepting or keeping certain higher-risk residents, the facility specifically has to notify the licensing agency and get an appropriate fire clearance covering:
  • Nonambulatory persons, and
  • Bedridden persons.
Show Title 22 source text
(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: (1) Nonambulatory persons. (2) Bedridden personsPart 1, Page 50
General Fire Safety Compliance
87203 p. 50.1
Beyond fire clearance for specific higher-risk residents, every facility overall has to be maintained in conformity with the State Fire Marshal's regulations for protecting life and property against fire and panic.
Show Title 22 source text
All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic.Part 1, Page 50.1
Capacity & Ambulatory-Status Limits Aren't Optional
87204 p. 50.1
A licensee can't operate beyond what the license actually says, including the maximum number of residents allowed at any one time. The only exception is a catastrophic emergency, where the licensing agency can grant a temporary exception to the approved capacity.

Separately, rooms that are only approved for 24-hour care of ambulatory residents can't be used for nonambulatory residents. And if a resident's condition changes so they become nonambulatory, they can't just stay in a room that's restricted to ambulatory residents; they need to be moved.
Show Title 22 source text
(a) A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including specification of the maximum number of persons who may receive services at any one time. An exception may be made in the case of catastrophic emergency when the licensing agency may make temporary exceptions to the approved capacity.Part 1, Page 50.1
(b) Resident rooms approved for 24-hour care of ambulatory residents only shall not accommodate nonambulatory residents. Residents whose condition becomes nonambulatory shall not remain in rooms restricted to ambulatory residents.Part 1, Page 50.1
The Licensee's Governing Responsibility
87205 p. 51
The licensee (whether that's an individual or some other entity) has to actively supervise the facility's affairs and set operating policies that both comply with these regulations and serve residents' welfare.

If the licensee is a corporation or association, this means the governing body (board) actually has to function and be engaged, not just exist on paper, so there's real accountability.
Show Title 22 source text
(a) The licensee, whether an individual or other entity, shall exercise general supervision over the affairs of the licensed facility and establish policies concerning its operation in conformance with these regulations and the welfare of the individuals it serves.Part 1, Page 51
(b) If the licensee is a corporation or an association, the governing body shall be active, and functioning in order to assure accountability.Part 1, Page 51
License Number Must Appear in Advertisements
87206 / H&S 1569.681(a) p. 51
Every facility has to include its license number in all public advertisements (including online) and in any correspondence intended to attract clients or residents.
Show Title 22 source text
(a) In accordance with Health and Safety Code sections 1569.68 and 1569.681, licensees shall reveal each facility license number in all public advertisements, including Internet, or correspondence.Part 1, Page 51
(a) Each residential care facility for the elderly licensed under this chapter shall reveal its license number in all advertisements, publications, or announcements made with the intent to attract clients or residents.Part 1, Page 51
No False or Misleading Claims
87207 p. 52
No licensee, officer, or employee of a licensee is allowed to make or spread any false or misleading statement about the facility or the services it provides, whether in advertising, conversations with prospective residents, or anywhere else.
Show Title 22 source text
No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility.Part 1, Page 52
What the Plan of Operation Must Cover: Program & Staffing Basics
87208 p. 53
Every licensee has to maintain a current, written "plan of operation" and actually run the facility according to what it says, or risk being cited under Health and Safety Code 1569.49. It has to be kept on file at the facility, submitted with the license application, and updated (with licensing agency approval) whenever there's a significant change affecting resident services.

Among the required contents:
  • The facility's stated purpose and program goals.
  • A copy of the Admission Agreement, showing basic and optional services.
  • The facility's admission policies and procedures.
  • The administrative organization structure.
  • The staffing plan, including qualifications and duties.
  • The staff training plan required under 87411 and 87705 (and Health and Safety Code 1569.625, 1569.626, 1569.69).
Show Title 22 source text
(a) The licensee shall have and maintain a current, written definitive plan of operation for the facility. The licensee shall operate the facility in accordance with the terms specified in the plan of operation and may be cited for not doing so pursuant to Health and Safety Code section 1569.49. The plan and related materials shall be on file in the facility and shall be submitted to the licensing agency with the license application. Any significant changes in the plan of operation which would affect the services to residents shall be submitted to the licensing agency for approval. The plan and related materials shall contain the following:Part 1, Page 53
(1) Statement of purposes and program goals.Part 1, Page 53
(2) A copy of the Admission Agreement, containing basic and optional services.Part 1, Page 53
(3) Statement of admission policies and procedures regarding acceptance of persons for services.Part 1, Page 53
(4) Administrative organization.Part 1, Page 53
(5) Staffing plan, qualifications and duties.Part 1, Page 53
(6) Plan for training staff, as required by Health and Safety Code sections 1569.625, 1569.626, and 1569.69 and as specified in Section 87411, Personnel Requirements–General and Section 87705, Care of Persons with Dementia.Part 1, Page 53
What the Plan of Operation Must Cover: Physical Space, Transportation & Family Communication
87208 p. 53-54
More required contents of the plan of operation:
  • Dimensioned sketches of the buildings (including a floor plan identifying which rooms are designated for nonambulatory or bedridden residents) and the grounds (driveways, fences, storage, pools, gardens, recreation areas).
  • Transportation arrangements for residents who don't have their own.
  • Whether the facility will handle residents' money or valuables, and if so, how it will safeguard them (tying into the Commingling of Money, Bonding, and Safeguards for Resident Cash requirements).
  • The facility's policy on family visits and communication, which has to be designed to actively encourage regular family involvement and give families real opportunities to participate in facility activities.
Show Title 22 source text
(7) Sketches, showing dimensions, of the following: (A) Building(s) to be occupied, including a floor plan that describes the capacities of the buildings for the uses intended and a designation of the rooms to be used for nonambulatory residents and for bedridden residents, other than for a temporary illness or recovery from surgery as specified in Section 87606(d) and (e). (B) The grounds showing buildings, driveways, fences, storage areas, pools, gardens, recreation area and other space used by the residents.Part 1, Page 53
(8) Transportation arrangements for persons served who do not have independent arrangements.Part 1, Page 53
(9) A statement whether or not the applicant will handle residents' money or valuables. If money or valuables will be handled, the method for safeguarding pursuant to Sections 87215, Commingling of Money, 87216, Bonding and 87217, Safeguards for Resident Cash, Personal Property, and Valuables.Part 1, Page 53
(10) A statement of the licensee's policy concerning family visits and other communication with residents, as specified in Health and Safety Code section 1569.313.Part 1, Page 53
Health and Safety Code section 1569.313 provides in part: "The facility's policy concerning family visits and communication shall be designed to encourage regular family involvement with the resident client and shall provide ample opportunities for family participation in activities at the facility."Part 1, Page 54
What the Plan of Operation Must Cover: Behavioral Expression, Infection Control & Special Populations
87208 p. 54
The remaining required contents:
  • A description of how the licensee will address "behavioral expression" (as defined in 87101): covering resident assessments, care practices, and safety measures.
  • The facility's Infection Control Plan under 87470.
Two situational add-ons: a licensee that advertises or provides dementia special care programming has to include additional plan-of-operation details under 87706, and a licensee that accepts or keeps bedridden residents has to include additional details under 87606.
Show Title 22 source text
(11) A description of the ways in which the licensee will address resident behavioral expression as defined in Section 87101, Definitions, including resident assessments, care practices, and safety measures.Part 1, Page 54
(12) The Infection Control Plan pursuant to Section 87470.Part 1, Page 54
(b) A licensee who advertises or promotes dementia special care, programming or environments shall include additional information in the plan of operation as specified in Section 87706, Advertising Dementia Special Care, Programming, and Environments.Part 1, Page 54
(c) A licensee who accepts or retains bedridden persons shall include additional information in the plan of operation as specified in Section 87606, Care of Bedridden Residents.Part 1, Page 54
Program Flexibility: Requesting a Waiver or Exception
87209 p. 54
The regulations don't have to be a strict, one-size-fits-all template; a facility can propose alternative concepts, programs, services, procedures, techniques, equipment, space, staffing ratios, or even experimental/demonstration projects. But conditions apply before any of that is allowed:
  • The alternative still has to include provisions for safe and adequate services, and
  • The facility has to submit a written request for a waiver or exception (with supporting evidence) to the licensing agency in advance.
Show Title 22 source text
(a) The use of alternate concepts, programs, services, procedures, techniques, equipment, space, personnel qualifications or staffing ratios, or the conduct of experimental or demonstration projects shall not be prohibited by these regulations provided that:Part 1, Page 54
(1) Such alternatives shall be carried out with provisions for safe and adequate services.Part 1, Page 54
(2) A written request for a waiver or exception and substantiating evidence supporting the request shall be submitted in advance to the licensing agency by the applicant or licensee.Part 1, Page 54
What Must Be Reported Within 7 Days
87211 p. 55
Facilities have to report certain events to the licensing agency (and the resident's responsible person) in writing within 7 days, including the resident's name, age, sex, admission date, the date and nature of the event, the attending physician's findings/treatment, and how the case was resolved. The events that trigger this:
  • A resident's death, from any cause, regardless of where it happened (including a day program, a hospital, en route to/from a hospital, or while away from the facility).
  • Any serious injury (as determined by the attending physician) that happens while the resident is under facility supervision.
  • Use of an Automated External Defibrillator (AED) on a resident.
  • Any incident threatening a resident's welfare, safety, or health, like psychological abuse by staff or other residents, or an unexplained absence.
Show Title 22 source text
(1) 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. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case.Part 1, Page 55
(A) Death of any resident from any cause regardless of where the death occurred, including but not limited to a day program, a hospital, en route to or from a hospital, or visiting away from the facility.Part 1, Page 55
(B) Any serious injury as determined by the attending physician and occurring while the resident is under facility supervision.Part 1, Page 55
(C) The use of an Automated External Defibrillator.Part 1, Page 55
(D) Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident.Part 1, Page 55
Faster-Turnaround Reports: Epidemics & Fires
87211 p. 55
Some events need faster reporting than the standard 7-day window:
  • Epidemics, poisonings, catastrophes, or major accidents threatening residents/staff/visitors: report within 24 hours, by phone or fax, to the licensing agency (and the local health officer, when appropriate).
  • Fires or explosions on the premises: report immediately to the local fire authority (or, in areas without organized fire service, to the State Fire Marshal within 24 hours), and no later than the next working day to the licensing agency.
Show Title 22 source text
(2) 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 1, Page 55
(3) 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 1, Page 55
Reporting Suspected Abuse With Serious Injury
87211 p. 56
If suspected physical abuse of an elder or dependent adult results in serious bodily injury, it has to be reported to the local ombudsman, the licensing agency, and local law enforcement within 2 hours, as required by Welfare and Institutions Code 15630(b)(1).
Show Title 22 source text
(b) 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 1, Page 56
Reporting Suspected Abuse Without Serious Injury
87211 p. 56.1
If suspected physical abuse does not result in serious bodily injury, the same three parties (local ombudsman, licensing agency, local law enforcement) still have to be notified, just with a longer window: 24 hours instead of 2.
Show Title 22 source text
(c) 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 1, Page 56.1
Reporting Financial Distress Events (Foreclosure & Eviction Actions)
87211 p. 56.1
If the licensee's own financial situation starts to deteriorate in specific ways, they have to notify the Department, the State Long-Term Care Ombudsman, all residents, and (where applicable) residents' representatives, in writing, within 2 business days of the event or of learning about it. Two of the triggering events:
  • A notice of default, notice of trustee's sale, or any other sign of foreclosure being issued on the property.
  • An unlawful detainer (eviction) action being initiated against the licensee.
Show Title 22 source text
(d) 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 1, Page 56.1
(1) A notice of default, notice of trustee's sale, or any other indication of foreclosure is issued on the property.Part 1, Page 56.1
(2) An unlawful detainer action is initiated against the licensee.Part 1, Page 56.1
More Financial Distress Triggers: Bankruptcy, Rent Default, Utility Shutoff
87211 p. 56.2
Rounding out the financial-distress reporting list, the licensee also has to notify the Department/Ombudsman/residents within 2 business days if:
  • They file for bankruptcy.
  • They receive a written notice of default on rent payment (under Code of Civil Procedure 1161).
  • A utility company sends notice of intent to shut off electricity, gas, or water, and that notice has to give at least 15 days before service is actually cut.
Show Title 22 source text
(3) The licensee files for bankruptcy.Part 1, Page 56.2
(4) The licensee receives a written notice of default of payment of rent described in Section 1161 of the Code of Civil Procedure.Part 1, Page 56.2
(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 1, Page 56.2
Reporting a New Administrator
87211 p. 56.2
When a facility hires a new administrator, the licensee has to notify the Department in writing within 30 days, including the new administrator's name and addresses, the date they started, and documentation of their background/qualifications/certification (a photocopy is acceptable).
Show Title 22 source text
(g) The licensee shall notify the Department, in writing, within thirty (30) days of the hiring of a new administrator. The notification shall include the following: (1) Name and residence and mailing addresses of the new administrator. (2) Date he/she assumed his/her position. (3) Description of his/her background and qualifications, including documentation of required education and administrator certification.Part 1, Page 56.2
Reporting a Change in Chief Corporate Officer
87211 p. 56.3
If an organization/corporation/association's chief corporate officer changes, that has to be reported to the licensing agency in writing within 15 working days, including the new officer's name, address, and fingerprint card (per the criminal record clearance requirement in 87355).
Show Title 22 source text
(h) 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. Such notification shall include the name, address and the fingerprint card of the new chief executive officer, as required by Section 87355, Criminal Record Clearance.Part 1, Page 56.3
Every Facility Needs a Written Disaster Plan
87212 p. 56.3
Every facility has to have a disaster and mass casualty plan of action, and it has to be in writing and readily available (not something that only exists in someone's head, or buried somewhere hard to find in an emergency).
Show Title 22 source text
(a) Each facility shall have a disaster and mass casualty plan of action. The plan shall be in writing and shall be readily available.Part 1, Page 56.3
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.
Financial Plan & Reporting Requirements
87213 p. 57
Every licensee needs a financial plan (tied to the plan submitted under 87155) showing they have enough resources to cover operating costs for resident care. They also have to maintain adequate financial records and submit financial reports whenever the licensing agency makes a written request explaining why it's needed. The agency can reject a financial report and ask for more information or a deeper examination, including interim financial statements.
Show Title 22 source text
The licensee shall have a financial plan that conforms to the requirements of Section 87155, Application for License, and that assures sufficient resources to meet operating costs for care of residents; shall maintain adequate financial records; and shall submit such financial reports as may be required upon the written request of the licensing agency. Such request shall explain the need for disclosure. The licensing agency reserves the right to reject any financial report and to request additional information or examination, including interim financial statements.Part 1, Page 57
No Commingling Money Across Different Licenses
87215 p. 57
If a licensee operates more than one facility, each under its own separate license number, they can't mix resident money/valuables between those different licenses, even if the facilities are jointly owned. Each license's resident funds have to stay separate from the others.
Show Title 22 source text
Money and valuables of residents entrusted to the licensee of one community care facility licensed under a particular license number shall not be commingled with those of another residential care facility for the elderly of a different license number, regardless of joint ownership.Part 1, Page 57
Bonding: Filing, Adjusting, and Disclosing
87216 p. 58
Any licensee (other than a county) entrusted with safeguarding resident cash has to have a surety bond on file with the licensing agency, issued to the State of California. (The dollar-amount schedule for how big that bond has to be is covered in the Numbers & Deadlines "Bonding Requirements" card.)

A few related rules:
  • If the licensing agency decides the bond amount isn't enough to protect residents' money, or the bond gets reduced because of a claim against it, the agency can require the licensee to file an additional bond.
  • Every license application or renewal has to include a sworn affidavit stating whether the applicant/licensee handles resident cash, and the maximum amount they'll handle for all residents combined in any given month.
  • A licensee can't handle money beyond what that affidavit states, or handle money at all, if the affidavit said they wouldn't, without first notifying the agency and filing a new or updated bond.
Show Title 22 source text
(a) Each licensee, other than a county, who is entrusted to safeguard resident cash resources, shall file or have on file with the licensing agency a copy of a bond issued by a surety company to the State of California as principal.Part 1, Page 58
(b) Whenever the licensing agency determines that the amount of the bond is insufficient to adequately protect the money of residents, or whenever the amount of any bond is impaired by any recovery against the bond, the licensing agency may require the licensee to file an additional bond in such amount as the licensing agency determines to be necessary to adequately protect the residents' money.Part 1, Page 58
(c) Each application for a license or renewal of license shall be accompanied by an affidavit on a form provided by the licensing agency. The affidavit shall state whether the applicant/licensee will be entrusted/is entrusted to safeguard or control cash resources of persons and the maximum amount of money to be handled for all persons in any month.Part 1, Page 58
(d) No licensee shall either handle money of a resident or handle amounts greater than those stated in the affidavit submitted by him or for which his bond is on file without first notifying the licensing agency and filing a new or revised bond as required by the licensing agency.Part 1, Page 58
Handling Resident Cash Is Only Required When Necessary
87217 p. 59
A licensee doesn't have to handle residents' cash at all. But if a resident is accepted for care who's been documented (in their initial or later appraisal) as incapable of handling their own cash, that resident's cash has to be safeguarded according to this section's requirements.
Show Title 22 source text
(a) A licensee shall not be required to handle residents' cash resources. However, if a resident incapable of handling his own cash resources, as documented by the initial or subsequent appraisal, is accepted for care, his cash resource shall be safeguarded in accordance with the regulations in this section.Part 1, Page 59
What a Licensee Can Never Do With a Resident's Finances
87217 p. 59
Except in approved continuing care agreements, a licensee or facility employee is never allowed to:
  • Accept appointment as a guardian or conservator of a resident's person or estate.
  • Accept a general or special power of attorney for a resident.
  • Become a substitute payee for a resident's payments, though this doesn't apply if the licensee is appointed by the Social Security Administration as the resident's official representative payee.
  • Become a joint tenant with a resident on a financial account.
Show Title 22 source text
(d) Except as provided in approved continuing care agreements, no licensee or employee of a facility shall:Part 1, Page 59
(1) accept appointment as a guardian or conservator of the person and/or estate of any resident;Part 1, Page 59
(2) accept any general or special power of attorney for any such person;Part 1, Page 59
(3) become substitute payee for any payments made to any persons; (A) This requirement does not apply to a licensee who is appointed by the Social Security Administration as representative payee for the resident.Part 1, Page 59
(4) become the joint tenant on any account specified in Section 87217(h) with a resident.Part 1, Page 59
Keep Resident Funds Separate (and Never Use Them for Basic Services)
87217 p. 59
Any cash or valuables the licensee holds for safekeeping can't be mixed with the facility's own funds or petty cash; they have to stay separate and intact, protected from any liability the licensee runs into using their own money. (The licensee can still give residents advances or loans from facility money, though.)

And a licensee or employee can never spend a resident's cash to cover a basic service, whether that's a basic service required by this chapter, or one spelled out in the resident's admission agreement. (The Social Security representative-payee exception applies here too.)
Show Title 22 source text
(e) Cash resources and valuables of residents which are handled by the licensee for safekeeping shall not be commingled with or used as the facility funds or petty cash, and shall be separate, intact and free from any liability the licensee incurs in the use of his own or the facility's funds and valuables. This does not prohibit the licensee from providing advances or loans to residents from facility money.Part 1, Page 59
(f) No licensee or employee of a facility shall make expenditures from residents' cash resources for any basic service specified in this Chapter, or for any basic services identified in a contract/admission agreement between the resident and facility. (1) This requirement does not apply to a licensee who is appointed by the Social Security Administration as representative payee for the resident.Part 1, Page 59
Recordkeeping for a Resident's Drawing Account
87217 p. 60
For any resident cash kept as a running "drawing account," the licensee has to maintain accurate, current records: a ledger showing income, disbursements, and balance for each resident, with supporting receipts filed in chronological order.

When cash is handed to a resident from their account, the receipt has to be signed (by the resident or their responsible party) and include a statement acknowledging the amount and date received, something like: "(resident's signature) accepts (dollar amount), this date (date), from (payor)."
Show Title 22 source text
(g) Each licensee shall maintain adequate safeguards and accurate records of cash resources and valuables entrusted to his care, including, but not limited to the following:Part 1, Page 60
(1) Records of residents' cash resources maintained as a drawing account shall include a ledger accounting (columns for income, disbursements and balance) for each resident, and supporting receipts filed in chronological order. Each accounting shall be kept current.Part 1, Page 60
(A) An acceptable receipt where cash is provided to residents from their respective accounts, includes: the resident's signature or mark, or responsible party's full signature, and a statement acknowledging receipt of the amount and date received. An acceptable form of receipt would include: "(full signature of resident) accepts (dollar amount) (amount written in cursive), this date (date), from (payor)".Part 1, Page 60
Returning a Resident's Property at Discharge
87217 p. 61
When a resident is discharged, the licensee has to hand over all of that resident's cash, personal property, and valuables that were entrusted to them, given to the resident or their responsible person, with a signed receipt obtained to document the handoff.
Show Title 22 source text
(i) Upon discharge of a resident, all cash resources, personal property and valuables of that resident which have been entrusted to the licensee shall be surrendered to the resident, or his responsible person. A signed receipt shall be obtained.Part 1, Page 61
Recording Gifts to the Licensee
87217 p. 61
Any monetary gift, and any gift worth more than $100, given to the licensee by or on behalf of a resident has to be recorded and attached to the resident's cash-resource account. (This doesn't cover gifts given by friends or family of a resident who has since died.) (Same $100 threshold as the Numbers & Deadlines card of the same name.)
Show Title 22 source text
(m) 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. This shall not include monetary gifts or valuables given by the friends or relatives of a deceased resident.Part 1, Page 61
The Theft & Loss Program: Basic Licensee Duties
87218 p. 62
The licensee has to run an adequate theft and loss program per Health and Safety Code 1569.153. Two baseline duties:
  • Complete an initial personal property inventory together with the resident (or their representative) at admission.
  • If the licensee didn't make reasonable efforts to safeguard a resident's property, they have to reimburse or replace stolen or lost property at its current value. (The licensee is presumed to have made reasonable efforts if there's clear and convincing evidence they met each of the program requirements in 1569.153.)
Show Title 22 source text
(a) The licensee shall ensure an adequate theft and loss program as specified in Health and Safety Code section 1569.153.Part 1, Page 62
(1) The initial personal property inventory shall be completed by the licensee, and the resident, or the resident's representative.Part 1, Page 62
(2) A licensee who fails to make reasonable efforts to safeguard resident property, shall reimburse a resident for or replace stolen or lost resident property at its current value. The licensee shall be presumed to have made reasonable efforts to safeguard resident property if there is clear and convincing evidence of efforts to meet each requirement specified in section 1569.153.Part 1, Page 62
What the Theft & Loss Program Must Include
H&S 1569.153 p. 62-63
Health and Safety Code 1569.153 (the statute 87218 points to) spells out exactly what a facility's theft and loss program has to cover:
  • Documenting lost/stolen property worth $25 or more within 72 hours of discovering it (with 12 months of records available on request to the Department, law enforcement, or the Ombudsman).
  • A written personal property inventory established at admission, in ink, witnessed and dated, with a copy given to the resident; kept current as items are added or removed, at the resident's/family's written request.
  • Inventorying and surrendering the resident's belongings at discharge (against a signed receipt) or after death (to the authorized representative, against a signed receipt, with immediate written notice to the county public administrator if no one claims the property).
  • Documenting the facility's theft-and-loss prevention efforts at least semiannually, including a review by the administrator (and the resident council, when feasible).
  • Marking personal property for identification when feasible, including engraving dentures and tagging other prosthetic devices.
Show Title 22 source text
(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 and, upon request, the documented theft and loss record for the past 12 months shall be made available to the State Department of Social Services, law enforcement agencies and to the office of the State Long-Term Care Ombudsman in response to a specific complaint.Part 1, Page 62
(d) A written resident personal property inventory is established upon admission and retained during the resident's stay in the residential care facility for the elderly. Inventories shall be written in ink, witnessed by the facility and the resident or resident's representative, and dated. A copy of the written inventory shall be provided to the resident or the person acting on the resident's behalf.Part 1, Page 63
(e) Inventory and surrender of the resident's personal effects and valuables upon discharge to the resident or authorized representative in exchange for a signed receipt.Part 1, Page 63
(f) Inventory and surrender of personal effects and valuables following the death of a resident to the authorized representative in exchange for a signed receipt. Immediate written notice to the public administrator of the county upon the death of a resident whose heirs are unable or unwilling to claim the property as specified in Chapter 20 (commencing with Section 1140) of Division 3 of the Probate Code.Part 1, Page 63
(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 and, when feasible, the resident council.Part 1, Page 63
(h) Establishment of a method of marking, to the extent feasible, personal property items for identification purposes upon admission and, as added to the property inventory list, including engraving of dentures and tagging of other prosthetic devices.Part 1, Page 63
Reporting Bigger Thefts to Law Enforcement
H&S 1569.153 p. 64
If the facility administrator has reason to believe a resident's stolen property was worth $100 or more at the time, that has to be reported to local law enforcement within 36 hours. Copies of those reports (for the past 12 months) have to be available to the Department and law enforcement on request.
Show Title 22 source text
(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. Copies of those reports for the preceding 12 months shall be made available to the State Department of Social Services and law enforcement agencies.Part 1, Page 64
Planned Activities Must Include Socialization Opportunities
87219 p. 65
Residents have to be encouraged to maintain and develop their quality of life through a variety of planned activities. The first required category is socialization: activities that promote or enhance personal relationships, such as:
  • Group discussion and conversation.
  • Reminiscence activities (looking at photos, letters, greeting cards).
  • Cultural and/or religious activities (holiday celebrations, cultural traditions).
  • Other social activities: arts, crafts, games, gardening, pet care, and similar activities that promote social interaction.
Show Title 22 source text
(a) Residents shall be encouraged to maintain and develop their quality of life through participation in a variety of planned activities. The activities made available shall include:Part 1, Page 65
(1) Socialization to promote or enhance personal relationships. Activities may include, but are not limited, to: (A) Group discussion and conversation. (B) Reminiscence activities, such as looking at photos, letters, or greeting cards. (C) Cultural and/or religious activities, such as holiday celebrations and cultural traditions. (D) Other social activities such as arts, crafts, games, gardening, pet care, and other recreational activities promoting social interaction.Part 1, Page 65
The Rest of the Required Activity Categories
87219 p. 65
Beyond socialization, the full required activity mix also has to include:
  • Daily living skills/activities that foster and maintain independent functioning.
  • Cognitive and mental stimulation (reading, writing, movies, crossword puzzles, board/card games, computer use).
  • Sensory stimulation (music therapy, aromatherapy) or tactile activities (pet therapy).
  • Leisure time activities that cultivate personal interests, including with other residents.
  • Physical activities (games, sports, exercises) that promote balance, strength, coordination, flexibility, and range of motion.
  • Education, through special classes or activities.
  • Free time, so residents can pursue activities of their own choosing.
Show Title 22 source text
(2) Daily living skills/activities which foster and maintain independent functioning.Part 1, Page 65
(3) Cognitive and mental stimulation activities such as reading, writing, movies, crossword puzzles, board and card games, and using the computer.Part 1, Page 65
(4) Sensory stimulation, such as music therapy and aromatherapy, or tactile activities, such as pet therapy.Part 1, Page 65
(5) Leisure time activities cultivating personal interests and pursuits, and encouraging leisure-time activities with other residents.Part 1, Page 65
(6) Physical activities that maintain physical health including games, sports, exercises, and other similar activities that promote balance, strength, coordination, flexibility, and range of motion.Part 1, Page 65
(7) Education, achieved through special classes or activities.Part 1, Page 65
(8) Provision for free time so residents may engage in activities of their own choosing.Part 1, Page 65
Activity Staffing Requirements, by Facility Size
87219 p. 66
Activity program staffing scales with facility size:
  • 7+ residents: activity notices posted centrally, retained for at least 6 months.
  • 16-49 residents: a designated staff member with at least 6 months' relevant experience (or in/completed appropriate training) takes primary responsibility for activities.
  • 50+ residents: one staff member has full-time responsibility for activities, with at least 1 year of group-activity experience, knowledgeable in evaluating resident needs, supervising staff, and training volunteers.
The 50+ full-time requirement isn't absolute, though; the licensing agency can grant an exception if the facility submits a satisfactory alternative plan in writing.
Show Title 22 source text
(d) In facilities licensed for seven (7) or more persons, notices of planned activities shall be posted in a central location readily accessible to residents, relatives, and representatives of placement and referral agencies. Copies shall be retained for at least six (6) months.Part 1, Page 66
(e) 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 or have completed or be enrolled in an appropriate education or training program.Part 1, Page 66
(f) In facilities licensed for fifty (50) persons or more, one staff member shall have full-time responsibility to organize, conduct and evaluate planned activities, and shall be given such staff assistance as necessary in order for all residents to participate in accordance with their interests and abilities. The program of activities shall be written, planned in advance, kept up-to-date, and made available to all residents. The responsible employee shall have had at least one year of experience in conducting group activities and be knowledgeable in evaluating resident needs, supervising other employees, and in training volunteers.Part 1, Page 66
(1) An exception to this requirement may be made by the licensing agency upon the facility's presentation in writing of a satisfactory alternative plan.Part 1, Page 66
Resident Councils
87221 p. 66.1
A facility has to allow interested residents to form a resident council, providing meeting space, posting meeting notices, and helping residents attend if they ask. Part of each meeting has to happen without any facility staff present, so residents can speak freely. Attendance is encouraged but never required.

The council's purpose: work with facility administration to improve residents' quality of life (including enriching the activity program), discuss the services the facility offers, and make recommendations about problems residents identify.
Show Title 22 source text
The facility shall permit the formation of a resident council by interested residents, provide space and post notice for meetings, and provide assistance in attending meetings for those residents who request it. In order to permit a free exchange of ideas, at least part of each meeting shall be allowed to be conducted without the presence of any facility personnel. Residents shall be encouraged, but shall not be compelled to attend. The purpose of such an organization shall be to work with the administration in improving the quality of life for all residents by enriching the activity program and to discuss the services offered by the facility and make recommendations regarding identified problems.Part 1, Page 66.1
Getting Approved to Accept APS Emergency Placements
87222 p. 67
A facility can accept emergency placements from an Adult Protective Services (APS) agency, but only if the Department has already approved the facility to provide emergency shelter services. Getting that approval requires a written request to the Department that includes:
  • A letter of interest from the county APS agency confirming that, if approved, the APS agency may enter into an agreement with the licensee for these services. (Once signed, a copy of that agreement has to go to the Department within 7 calendar days.)
  • A written addendum to the facility's Plan of Operation covering how it will handle an APS emergency intake (on-call/additional staff, training, etc.). That addendum has to include provisions for a private room: the facility must provide one until the resident's pre-admission appraisal is complete, unless the Department approves an alternative (like awake or additional staff) that doesn't displace other staff or residents.
Show Title 22 source text
(a) The licensee shall be permitted to accept emergency placements by an adult protective services (APS) agency, if the licensee has received approval from the Department to provide emergency shelter services.Part 1, Page 67
(1) To obtain approval, the licensee shall submit a written request to the Department. The request shall include, but not be limited to, the following:Part 1, Page 67
(A) A letter of interest from the county APS agency stating that if the request to provide emergency shelter services is approved, the APS agency may enter into an agreement with the licensee to provide such services. 1. A copy of the written agreement between the APS agency and the licensee, listing the responsibilities of each party, shall be sent to the Department within seven calendar days of signing.Part 1, Page 67
(B) A written addendum to the Plan of Operation, specified in Section 87208, Plan of Operation that includes procedures for the intake of an APS emergency placement. The addendum shall specify how the licensee will meet the needs of a resident placed on an emergency basis, such as on-call staff, additional staff and training. 1. The procedures shall include, but not be limited to, provisions for a private room. a. The licensee shall provide a private room for the resident until a pre-admission appraisal of the resident's individual service needs has been completed, specified in Section 87457, Pre-admission Appraisal. b. The Department may approve an alternative to a private room, such as awake or additional staff, but an alternative shall not be approved if it displaces staff or other residents of the facility.Part 1, Page 67
Cooperating With a Department-Ordered Relocation
87223 p. 70
When the Department orders a resident relocated, whether for a health-condition reason under 87612 or a temporary suspension order under 87775(c), the licensee can't obstruct the process and has to cooperate. That cooperation includes:
  • Identifying and preparing to remove the resident's medications, insurance documents (Medi-Cal/Medicare/other), clothing, safeguarded cash and valuables, and other belongings.
  • Contacting the resident's responsible person to help arrange transportation, if needed.
  • Contacting other suitable facilities for placement, if needed.
  • Giving the Department access to the resident's files when required.
Show Title 22 source text
(a) When a resident must be relocated by Department order whether individual health-condition relocations pursuant to Section 87612, Restricted Health Conditions, or temporary suspension orders pursuant to Section 87775(c), the licensee shall not obstruct the relocation process and shall cooperate with the Department in the relocation process. Such cooperation shall include, but not be limited to, the following activities: (1) Identifying and preparing for removal of the medications, Medi-Cal or Medicare or other medical insurance documents, clothing, safeguarded cash resources, valuables and other belongings of the resident. (2) Contacting the person responsible for the resident to assist in transporting him or her, if necessary. (3) Contacting other suitable facilities for placement, if necessary. (4) Providing access to resident's files when required by the Department.Part 1, Page 70
Grounds for Eviction & the Standard Notice Period
87224 p. 71
A licensee can evict a resident only for one of five specified reasons, and unless a reason says otherwise, that requires 30 days' written notice:
  • Nonpayment for basic services, once the resident is more than 10 days past the due date.
  • Failing to comply with state or local law, after getting written notice of the alleged violation.
  • Failing to comply with the facility's general policies (which have to be written, aimed at helping residents live together, and included in the admission agreement).
  • A newly identified need (found through a reappraisal under 87463) that the licensee and the person who did the reappraisal agree the facility isn't equipped to meet.
  • A change of use of the facility, which instead requires at least 60 days' written notice, and (per Health and Safety Code 1569.682) has to meet a longer list of specific notice content requirements beyond the standard eviction notice.
Show Title 22 source text
(a) 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).Part 1, Page 71
(1) Nonpayment of the rate for basic services within ten days of the due date.Part 1, Page 71
(2) Failure of the resident to comply with state or local law after receiving written notice of the alleged violation.Part 1, Page 71
(3) Failure of the resident to comply with general policies of the facility. Said general policies must be in writing, must be for the purpose of making it possible for residents to live together and must be made part of the admission agreement.Part 1, Page 71
(4) If, after admission, it is determined that the resident has a need not previously identified and a reappraisal has been conducted pursuant to Section 87463, and the licensee and the person who performs the reappraisal believe that the facility is not appropriate for the resident.Part 1, Page 71
(5) Change of use of the facility. (A) The licensee may, upon no less than sixty (60) days written notice, evict a resident due to change of use of the facility. 1. In addition to written notice to quit requirements specified in Section 87224(d), written notice to evict due to change of use of the facility shall be made to the resident or the resident's responsible person and shall include all requirements specified in Section 1569.682(a)(2)(A) through (F) of the Health and Safety Code.Part 1, Page 71
Emergency 3-Day Eviction & Notifying the Responsible Person
87224 p. 71.1
In urgent situations, a licensee can evict on just 3 days' written notice, but only with prior written approval from the licensing agency, granted for "good cause." Good cause exists specifically when the resident's behavior threatens the mental or physical health/safety of themselves or others in the facility.

Whichever notice period applies (30 days, 60 days, or the 3-day emergency process) the licensee also has to notify (or mail a copy of the notice to) the resident's responsible person.
Show Title 22 source text
(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. Good cause exists if the resident is engaging in behavior which is a threat to the mental and/or physical health or safety of himself or to the mental and/or physical health or safety of others in the facility.Part 1, Page 71.1
(c) The licensee shall, in addition to either serving the required thirty (30) days notice, sixty (60) days notice, or seeking approval from the Department and service three (3) days notice on the resident, notify or mail a copy of the notice to quit to the resident's responsible person.Part 1, Page 71.1
What the Eviction Notice Itself Must Say
87224 p. 71.2
The written notice to quit itself has to include:
  • The effective date of the eviction.
  • Resources to help the resident find alternative housing and care, including referral services and case management organizations that can help manage their ongoing care and service needs.
Show Title 22 source text
(1) The notice to quit shall include the following information:Part 1, Page 71.2
(A) The effective date of the eviction.Part 1, Page 71.2
(B) Resources available to assist in identifying alternative housing and care options which include, but are not limited to, the following: 1. Referral services that will aid in finding alternative housing. 2. Case management organizations which help manage individual care and service needs.Part 1, Page 71.2
Eviction Reports to the Licensing Agency
87224 p. 72
Whichever type of eviction happens, the licensee has to send a written report of it to the licensing agency within 5 days.
Show Title 22 source text
(f) A written report of any eviction shall be sent to the licensing agency within five (5) days.Part 1, Page 72

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