reglab/statecodes huggingface dataset:
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 2 - License › Section 73240 - Conviction of Crime: Standards for Evaluating Rehabilitation

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
When considering the denial, suspension or revocation of a
					 license based on the conviction of a crime in accordance with Section
					 1265.1
					 or
					 1294
					 of the Health and Safety Code, the following criteria shall be considered in
					 evaluating rehabilitation:
(1) The
				  nature and the seriousness of the crime(s) under consideration.
(2) Evidence of conduct subsequent to the
				  crime which suggests responsible or irresponsible character.
(3) The time which has elapsed since
				  commission of the crime(s) or conduct referred to in subdivision (1) or
				  (2).
(4) The extent to which the
				  applicant has complied with any terms of parole, probation, restitution, or any
				  other sanction lawfully imposed against the applicant.
(5) Any rehabilitation evidence submitted by
				  the applicant.
1. New
					 section filed 9-13-84; effective thirtieth day thereafter (Register 84, No.
					 37).
Note: Authority cited: Sections
						208(a),
						1265.2
						and
						1275,
						Health and Safety Code. Reference: Sections
						1265.1,
						1265.2
						and
						1294,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 2 - License › Section 73241 - Bonds

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Each licensee
				  shall file or have on file with the Department a bond issued by a surety
				  company authorized to do business in California if the licensee is handling or
				  will handle money in the amount of $25 or more per patient or $500 or more for
				  all patients in any month. The amount of the bond shall be according to the
				  following schedule:
(1)
Amount Handled
Bond Required
$750 or less..
$1,000
$751 to $1,500..
$2,000
$1,501 to $2,500.
$3,000
(2)
				  Every further increments of $1,000 or fraction thereof shall require an
				  additional $1,000 on the bond.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73301 - Required Services

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  Intermediate care facilities shall provide as a minimum, but shall not be
				  limited to, the following required services: Physician, intermittent nursing,
				  dietary, pharmaceutical and an activity program.
(b) Intermediate care facilities caring for
				  patients who are mentally disordered, developmentally disabled or substance
				  abusers and who have identified program needs as described in Section
				  73391 shall meet also the
				  requirements for a special disability service.
(c) Intermediate care facilities caring for
				  day care patients shall meet all the requirements for inpatients and shall not
				  exceed their licensed bed capacity.
(d) Written arrangements shall be made for
				  obtaining all necessary diagnostic and therapeutic services prescribed by the
				  attending physician, podiatrist, dentist or clinical psychologist subject to
				  the scope of licensure and the policies of the facility. If the service cannot
				  be brought into the facility, the facility shall assist the patient, if
				  necessary, in arranging for transportation to and from the service
				  location.
(e) Provision shall be
				  made for dental examinations and dental treatments by a dentist as indicated by
				  the needs of the patient.
(f)
				  Arrangements shall be made for one or more licensed healthcare practitioners
				  acting within the scope of their professional licensure to be called in an
				  emergency.
1. Amendment
					 of subsection (f) and new NOTE filed 3-3-2010; operative 4-2-2010 (Register
					 2010, No. 10).
Note: Authority cited: Sections
						1275,
						100275
						and
						131200,
						Health and Safety Code. Reference: Sections
						1276,
						1316.5,
						131050,
						131051
						and
						131052,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73303 - Physician Services-General

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Physician services are services provided
				  by physicians responsible for the care of individual patients in the facility.
				  Physician services shall include but are not limited to:
(1) Patient examinations.
(2) Patient diagnosis.
(3) Advice, treatment and treatment plan, and
				  determination of appropriate level of patient care needed for each
				  patient.
(4) Written and signed
				  orders for care, diagnostic tests and treatment of patients by others. Orders
				  for restraints must specify the duration and circumstances under which the
				  restraints are to be used and must comply with the following:
(A) Orders must be specific to individual
				  patients.
(B) In accordance with
				  Section 73355 there shall be no standing
				  orders.
(C) There shall be no
				  P.R.N. orders for physical restraints.
(5) Health record progress notes and other
				  appropriate entries in the patient's health records.
(6) Periodic reevaluation of the patient's
				  condition and the review and updating of treatment orders and care program at
				  least every 60 days unless otherwise approved by the Department.
(7) Provision of emergency medical services
				  in the facility when indicated.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73305 - Physician Services-Policies and Procedures

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
There shall be available to attending physicians a list of
					 the services provided in or available through the facility and a listing of the
					 types of patients who may be admitted for care. Information pertinent to the
					 orientation of new physicians to the facility or changes in services or policy
					 shall be made available by the facility. Patient care policies, manuals or
					 other patient care instruction or reference materials shall be available for
					 review or reference by individual physicians when requested or
					 indicated.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73307 - Physician Services-Equipment and Supplies

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Equipment for physical examinations and emergency treatment
					 of patients shall be available in the facility and shall include at
					 least:
stethoscope
scales for weighing patients
sphygmomanometer
vaginal speculum
flashlight
rectal speculum
gloves (sterile and unsterile)
appropriate record forms
tongue depressors
sterile dressing
examination spotlight
suture tray
suction apparatus
suture removal equipment
emergency oxygen supply and equipment for
								administration
airway
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73309 - Nursing Service-Defined

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Nursing service" means a service organized, staffed and
					 equipped to provide nursing care to patients.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73311 - Nursing Service-General

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Nursing service shall include, but not be limited to, the
					 following:
(a) Identification of
				  problems and development of an individual plan of care for each patient based
				  upon initial and continuing assessment of the patient's needs by the nursing
				  staff and other health care professionals. The plan shall be reviewed and
				  revised as needed but not less often than quarterly.
(b) Notification of the attending licensed
				  healthcare practitioner acting within the scope of his or her professional
				  licensure immediately of any patient exhibiting unusual signs or
				  behavior.
(c) Ensuring that
				  patients are served the diets as ordered by the attending licensed healthcare
				  practitioner acting within the scope of his or her professional licensure, and
				  that patients are provided with the necessary and acceptable equipment for
				  eating and that prompt assistance in eating is given when needed.
(d) Any marked or sudden change in weight
				  shall be reported promptly to the attending licensed healthcare practitioner
				  acting within the scope of his or her professional licensure.
1. Amendment
					 of subsections (b)-(d) and new NOTE filed 3-3-2010; operative 4-2-2010
					 (Register 2010, No. 10).
Note: Authority cited: Sections
						1275,
						100275
						and
						131200,
						Health and Safety Code. Reference: Sections
						1276,
						1316.5,
						131050,
						131051
						and
						131052,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73313 - Nursing Service-Drug Administration

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Nursing service shall include but not be limited to the
					 following, with respect to the administration of drugs:
(a) Medications and treatments shall be
				  administered as prescribed and shall be recorded in patient's health
				  records.
(b) Preparation of doses
				  for more than one scheduled administration time shall not be
				  permitted.
(c) Medications shall
				  only be administered by personnel who have completed a state-approved training
				  program in medication administration.
(d) Medications shall be administered as soon
				  as possible after doses are prepared and shall be administered by the same
				  person who prepared the doses for administration. Doses shall be administered
				  within one hour of the prescribed time unless otherwise indicated by the
				  prescriber.
(e) Patients shall be
				  identified prior to administration of a drug.
(f) The time and dose of drug administered to
				  the patient shall be properly recorded in each patient's medication record by
				  the person who administered the drug.
(g) No medication or treatment shall be given
				  except on the order of a person lawfully authorized to give such
				  order.
(h) Telephone orders shall
				  be received only by a licensed nurse or pharmacist and shall be recorded
				  immediately in the patient's health record and shall be signed by the
				  prescriber within 48 hours.
(i)
				  Medications brought by or with the patient to the facility shall not be used
				  unless all of the conditions specified in Section
				  73363 are met.
(j) A registered nurse or a pharmacist shall
				  review each patient's medications monthly and if appropriate, request a review
				  from the patient's attending licensed healthcare practitioner acting within the
				  scope of his or her professional licensure.
1. Amendment
					 of subsection (j) and new NOTE filed 3-3-2010; operative 4-2-2010 (Register
					 2010, No. 10).
Note: Authority cited: Sections
						1275,
						100275
						and
						131200,
						Health and Safety Code. Reference: Sections
						1276,
						1316.5,
						131050,
						131051
						and
						131052,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73315 - Nursing Service-Patient Care

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) No patient shall be admitted or accepted
				  for care by an intermediate care facility except upon the order of a licensed
				  healthcare practitioner acting within the scope of his or her professional
				  licensure.
(b) Each patient shall
				  be treated as an individual with dignity and respect and shall not be subjected
				  to verbal or physical abuse of any kind.
(c) Each patient, upon admission, shall be
				  given proper orientation to the intermediate care facility and the facility's
				  services and staff.
(d) Each
				  patient shall show evidence of good personal hygiene, including care of the
				  skin, shampooing and grooming of hair, oral hygiene, shaving or beard trimming,
				  cleaning and cutting of fingernails and toenails and shall be free of offensive
				  odors.
(e) Each patient shall be
				  encouraged and/or assisted to achieve and maintain his highest level of
				  self-care and independence. Every effort shall be made to keep patients active
				  except when contraindicated by orders provided by a licensed health care
				  practitioner acting within the scope of his or her professional
				  licensure.
(f) Such supportive and
				  restorative nursing and personal care needed to maintain maximum functioning of
				  the patient shall be provided.
(g)
				  Treatment for minor illness or routine treatments for minor disorders when
				  ordered by the licensed health care practitioner acting within the scope of his
				  or her professional licensure shall be administered by nursing
				  personnel.
(h) Bedside nursing care
				  may be provided on a temporary basis when the attending licensed health care
				  practitioner acting within the scope of his or her professional licensure
				  determines the illness to be temporary and minor.
(i) When a patient requires services which
				  are not considered to be intermediate care services, the licensed health care
				  practitioner acting within the scope of his or her professional licensure shall
				  be notified and arrangements made to transfer the patient from the intermediate
				  care facility.
1. Amendment
					 of subsections (a), (e) and (g)-(i) and new NOTE filed 3-3-2010; operative
					 4-2-2010 (Register 2010, No. 10).
Note: Authority cited: Sections
						1275,
						100275
						and
						131200,
						Health and Safety Code. Reference: Sections
						1276,
						1316.5,
						131050,
						131051
						and
						131052,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73317 - Nursing Service-Policies and Procedures

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Written policies and procedures developed
				  by the supervisor of health services and approved by the Patient Care Policy
				  Committee shall be available to all nursing personnel. Such policies and
				  procedures shall include:
(1) An organization
				  chart of the nursing service showing staff positions, lines of authority and
				  communication.
(2) Specific
				  instruction on the preparation, review and updating of individual patient care
				  plans.
(3) Orientation procedures
				  and programs for new employees.
(4)
				  An ongoing education program planned and conducted for the development and
				  improvement of skills of all facility's personnel including training related to
				  problems and needs of the aged, ill and disabled.
(5) A current nursing procedure
				  manual.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73318 - Nursing Service-Nurse Assistant Training and Certification. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. Repealer
					 and new section filed 1-12-79 as an emergency; effective upon filing (Register
					 79, No. 2). For prior history, see Register 77, No. 52.
2.
					 Certificate of Compliance filed 4-16-79 (Register 79, No. 15).
3.
					 Repealer filed 7-16-91 as an emergency; operative 7-16-91 (Register 91, No.
					 46). A Certificate of Compliance must be transmitted to OAL by 11-13-91 or
					 emergency repeal will be reinstated by operation of law on the following
					 day.
4. Repealer refiled 11-14-91 as an emergency; operative
					 11-14-91 (Register 92, No. 8). A Certificate of Compliance must be transmitted
					 to OAL 3-13-92 or emergency language will be repealed by operation of law on
					 the following day.
5. Editorial correction of HISTORY 4. and
					 repealer refiled 5-6-92 as an emergency; operative 5-6-92 (Register 92, No.
					 20). A Certificate of Compliance must be transmitted to OAL 9-3-92 or emergency
					 language will be repealed by operation of law on the following
					 day.
6. Certificate of Compliance as to 5-6-92 order transmitted to
					 OAL 8-27-92 and filed 10-9-92 (Register 92, No.
					 41).
Note: Authority cited: Section
						1137.7,
						Health and Safety Code. Reference: Chapter 351/1978 (AB
						2567).
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73319 - Nursing Service - Staff

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  Nursing service personnel shall be employed in the number and with the
				  qualifications determined by the Department to provide the necessary services
				  for those patients admitted for care. The Department may require a facility to
				  provide additional staff whenever the Department determines through a written
				  evaluation of patients and patient care in the facility that such additional
				  staff are needed to provide adequate nursing care and treatment or to provide
				  for the safety of the patients.
(b)
				  Facilities shall employ a registered nurse or licensed vocational nurse eight
				  hours per day on the day shift, seven days per week. In case of facilities
				  where a licensed vocational nurse serves as supervisor of health services,
				  consultation shall be provided by a registered nurse, through formal contract,
				  at regular intervals, but not less than four hours weekly.
(c) Facilities with 100 or more beds shall
				  employ a registered nurse eight hours per day, on the day shift, seven days per
				  week. In addition, a registered nurse or licensed vocational nurse shall be
				  employed four hours per day, seven days per week, during the day for each 50
				  beds or portion thereof in excess of 100.
(d) Nursing stations shall be staffed by
				  nursing personnel day and night when patients are housed in the nursing
				  unit.
(e) Each facility shall
				  employ sufficient staff to provide a minimum average of 1.1 nursing hour per
				  patient day.
(1) Facilities which provide care
				  for mentally disordered or developmentally disabled patients and in which
				  psychiatric technicians provide patient care shall meet the following
				  standards:
(A) If patients are not certified
				  for special treatment programs, facilities shall employ sufficient staff to
				  provide a minimum average of 1.1 nursing hour per patient day.
(B) For patients certified for special
				  treatment programs, facilities shall employ sufficient staff to provide a
				  minimum average of 0.7 nursing hour per patient day for each patient certified
				  to the special treatment program, exclusive of additional staff required to
				  meet the staffing standards of the special treatment
				  program.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73321 - Nursing Service-Equipment and Supplies

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Equipment and supplies of the quality and
				  in the quantity necessary for care to patients, as ordered or indicated, shall
				  be provided and shall include but not be limited to:
(1) Water pitchers, emesis basins, denture
				  cups, ice caps, urinals, bedpans, thermometers, stethoscope, sphygmomanometer,
				  ear syringe, hypodermic syringes and needles and scales for weighing
				  patients.
(2) A sufficient supply
				  of wheelchairs and walkers to meet the intermittent needs of patients and
				  maintained in clean and operable condition.
(3) Supplies necessary to perform urine sugar
				  and acetone testing.
(4) Current
				  and authoritative nursing reference material.
(5) First aid equipment and supplies, as
				  determined by the patient care policy committee, readily available at all
				  times.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73323 - Dietetic Service-Defined

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Dietetic service" means a service organized, staffed and
					 equipped to assure that food served to patients is safe, appetizing and
					 provides for their nutritional needs.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73325 - Dietetic Service-Food Service

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The dietetic service shall provide food
				  of the quality and quantity to meet the patient's needs in accordance with
				  orders of a licensed healthcare practitioner acting within the scope of his or
				  her professional licensure and, to the extent medically possible, to meet the
				  "Dietary Reference Intakes: The Essential Guide to Nutrient Requirements"
				  (2006) by the National Research Council of the National Academy of Sciences,
				  Institute of Medicine, hereby incorporated by reference, and the following:
(1) Not less than three meals shall be served
				  daily.
(2) Not more than 14 hours
				  shall elapse between the evening meal and breakfast of the following
				  day.
(3) Nourishment or between
				  meal feedings shall be provided as required by the diet prescription. Bedtime
				  nourishments shall be offered to all patients unless contraindicated.
(4) Patient food preferences shall be adhered
				  to as much as possible and substitutes for all food refused shall be from
				  appropriate food groups.
(5) Table
				  service shall be provided for all who can and wish to eat at a table. Tables of
				  appropriate height shall be provided for wheelchairs.
(6) When food is provided by an outside
				  commercial food service, all applicable requirements shall be met. The facility
				  shall maintain adequate space, equipment and food supplies to provide patients'
				  food service in emergencies.
(7)
				  Food shall be prepared by methods that conserve nutritive value, flavor and
				  appearance. Food shall be served attractively at appropriate temperatures and
				  in a form to meet individual needs.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73327 - Dietetic Service-Policies and Procedures

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Manuals of dietetic services policies and of procedures to
					 implement the policies shall be available to all personnel concerned with
					 dietetic services. Manuals shall be developed and kept current with the
					 assistance of the dietitian in cooperation with appropriate staff from other
					 services where overlapping functions occur.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73329 - Dietetic Service-Diet Manual

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
A current therapeutic diet manual, if appropriate, is
					 approved by the dietitian and readily available to dietetic service personnel
					 and licensed healthcare practitioners acting within the scope of their
					 professional licensure or certification.
1. Amendment
					 of section and new NOTE filed 3-3-2010; operative 4-2-2010 (Register 2010, No.
					 10).
Note: Authority cited: Sections
						1275,
						100275
						and
						131200,
						Health and Safety Code. Reference: Sections
						1276,
						1316.5,
						131050,
						131051
						and
						131052,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73331 - Dietetic Service-Therapeutic Diets

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Therapeutic diets shall be provided as prescribed by the
					 attending physician and shall be planned, prepared and served with supervision
					 and/or consultation from the dietitian. Persons responsible for therapeutic
					 diets shall have sufficient knowledge of food values to make appropriate
					 substitutions when necessary.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73333 - Dietetic Service-Menus

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Menus for regular and modified diets
				  shall be written at least one week in advance, dated and posted in the kitchen
				  at least three days in advance.
(b)
				  If any meal served varies from the planned menu, the change shall be noted in
				  writing on the posted menu in the kitchen.
(c) Menus shall provide a variety of foods in
				  adequate amounts at each meal. Menus shall be different for the same day of
				  consecutive weeks. If a cycle menu is used, the cycle shall be of no less than
				  three weeks' duration and shall be revised quarterly.
(d) Menus shall be adjusted to include
				  seasonal commodities.
(e) Menus
				  shall be planned with consideration for cultural background and food habits of
				  patients.
(f) A copy of the menu as
				  served shall be kept on file for at least 30 days.
(g) Records of food purchased shall be kept
				  for one year and available for review by the Department.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73335 - Dietetic Service-in-Service Training

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
In-service training shall be provided for all dietetic
					 service personnel and a record of subject areas covered, date and duration of
					 each session and attendance lists shall be maintained.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73337 - Dietetic Service-Food Storage

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Food storage areas shall be clean at all
				  times.
(b) Dry or staple food items
				  shall be stored at least 30 centimeters (12 inches) above the floor, in a
				  ventilated room, not subject to sewage or waste water backflow, or
				  contamination by condensation, leakage, rodents or vermin.
(c) All readily perishable foods or beverages
				  capable of supporting rapid and progressive growth of microorganisms which can
				  cause food infections or food intoxication shall be maintained at temperatures
				  of 7°C (45°F) or below, or at 60°C (140°F) or above, at all
				  times, except during necessary periods of preparation and service. Frozen foods
				  shall be stored at minus 18°C (0°F) or below at all times. There shall
				  be a reliable thermometer in each refrigerator freezer and in storerooms used
				  for perishable food.
(d)
				  Pesticides, other toxic substances and drugs shall not be stored in the kitchen
				  area or in storerooms for food and/or food preparation equipment and
				  utensils.
(e) Soaps, detergents,
				  cleaning compounds or similar substances shall be stored in separate defined
				  storage areas.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73339 - Dietetic Service-Sanitation

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) All kitchens and kitchen areas shall be
				  kept clean, free from litter and rubbish and protected from rodents, roaches,
				  flies and other insects.
(b) All
				  utensils, counters, shelves and equipment shall be kept clean, maintained in
				  good repair and shall be free from breaks, corrosions, open seams, cracks and
				  chipped areas.
(c) Plastic ware,
				  china and glassware that is unsightly, insanitary or hazardous because of
				  chips, cracks or loss of glaze shall be discarded.
(d) Ice which is used in connection with food
				  or drink shall be from a sanitary source and shall be handled and dispensed in
				  a sanitary manner.
(e) Kitchen
				  wastes that are not disposed of by mechanical means shall be kept in leakproof,
				  nonabsorbent, tightly closed containers and shall be disposed of as frequently
				  as necessary to prevent a nuisance or unsightliness.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73341 - Dietetic Service-Cleaning and Disinfection of Utensils

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) All utensils used for eating, drinking
				  and in the preparation and serving of food and drink shall be cleaned and
				  disinfected or discarded after each usage.
(b) Gross food particles shall be removed by
				  careful scraping and prerinsing in running water.
(c) The utensils shall be thoroughly washed
				  in hot water (minimum temperature of 43°C (110°F)), using soap or
				  detergent, rinsed in hot water to remove soap or detergent, and disinfected by
				  one of the following methods or the equivalent, as approved by the Department:
(1) Immersion for at least two minutes in
				  clean water at 77°C (170°F).
(2) Immersion for at least 30 seconds in
				  clean water at 83°C (180°F).
(3) Immersion in water containing
				  bactericidal chemical as approved by the Department.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73343 - Dietetic Service-Staff

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Food Service Supervisor.
A full-time person qualified by training and experience
					 shall be employed to be responsible for the operation of the food
					 service.
(b) Professional
				  Dietitian. If the facility accepts or retains patients in need of medically
				  prescribed special diets, the menus for such diets shall be planned by a
				  dietitian.
(c) Sufficient staff
				  shall be employed, oriented, trained and their working hours scheduled to
				  provide for the nutritional needs of the patients and to maintain the dietetic
				  service areas. If dietetic service employees are assigned duties in other
				  services, those duties shall not interfere with the sanitation, safety or time
				  required for dietetic work assignments.
(d) Current work schedules by job titles and
				  weekly duty schedules shall be posted.
(e) Dietetic services personnel shall be
				  trained in basic food sanitation techniques, wear clean clothing, including a
				  cap or a hair net and shall be excluded from duty when affected by skin
				  infection or communicable diseases. Beards and mustaches which are not closely
				  cropped and neatly trimmed shall be covered.
(1) Employees street clothing stored in the
				  kitchen area shall be in a closed area.
(2) Kitchen sinks shall not be used for
				  handwashing. Separate handwashing facilities with soap, running water and
				  individual towels shall be provided.
(3) Persons other than dietetic services
				  personnel shall not be allowed in the kitchen areas unless required to do so in
				  the performance of their duties.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73345 - Dietetic Service-Equipment and Supplies

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Equipment of the type and in the amount
				  necessary for the proper preparation, serving and storing of food and for
				  proper dishwashing shall be provided and maintained in good working order.
(1) The dietetic service area shall be
				  ventilated in a manner that will maintain comfortable working conditions,
				  remove objectionable odors, fumes and prevent excessive condensation.
(2) Fixed and mobile equipment in the
				  dietetic service shall be located to assure sanitation and safety and shall be
				  of sufficient size to handle the needs of the facility.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73347 - Pharmaceutical Service-General

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Arrangements shall be made to assure that
				  pharmaceutical services are available to provide patients with prescribed drugs
				  and biologicals.
(b) If a pharmacy
				  is located on the premises, the pharmacy shall be licensed by the California
				  State Board of Pharmacy and approved by the Department. The pharmacy shall not
				  serve the general public unless a separate public entrance or a separate public
				  serving window is utilized. Pharmacies located on the licensed premises of
				  intermediate care facilities shall be opened for inspection upon the request of
				  an authorized Department representative.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73349 - Pharmaceutical Service Requirements

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Pharmaceutical service shall include, but
				  not be limited to, the following:
(1)
				  Obtaining necessary drugs on a prompt and timely basis, including the
				  availability of 24-hour emergency prescription service.
(2) Preparation for administration of drugs
				  and biologicals.
(3) Monitoring the
				  drug distribution system which includes ordering, dispensing and administration
				  of medications.
(4) Provision of
				  consultative and other services furnished by pharmacists which assist in the
				  development, coordination, supervision and review of the pharmaceutical
				  services within the facility.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73351 - Pharmaceutical Service-Policies and Procedures

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
There shall be written policies and procedures for safe and
					 effective distribution, control, use and disposition of drugs developed by the
					 patient care policy committee. The committee shall monitor implementation of
					 the policies and procedures and make recommendations for
					 improvement.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73353 - Pharmaceutical Service-Orders for Drugs

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
No drugs shall be administered except upon the order of a
					 person lawfully authorized to prescribe for and treat human illness. All such
					 orders shall be in writing and signed by the person giving the order. The name,
					 quantity or duration of therapy, dosage and time of administration of the drug,
					 the route of administration if other than oral and the site of injection when
					 indicated shall be specified. Telephone orders may be given only to a licensed
					 pharmacist or licensed nurse and shall be immediately recorded in the patient's
					 health record and shall be signed by the prescriber within 48 hours. The
					 signing of orders shall be by signature or a personal computer
					 key.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73355 - Pharmaceutical Service-Standing Orders

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
No facility shall use any standing order for medications or
					 treatments.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73357 - Pharmaceutical Service-Stop Orders

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Written policies shall be established limiting the duration
					 of drug therapy, in the absence of a prescriber's specific indication of
					 duration of therapy. The prescriber shall be contacted for new orders prior to
					 the termination time established by the policy.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73359 - Pharmaceutical Service-Drug Order Processing

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Written orders for drugs shall be transmitted to the
					 issuing pharmacy as directly as possible, either by written prescription of the
					 prescriber by an order form which produces a direct copy of the order or by an
					 electronically reproduced facsimile.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73361 - Pharmaceutical Service-Drug Order Records

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Facilities shall maintain a record which includes, for each
					 drug ordered by prescription, the drug name, strength and quantity, the name of
					 the patient, the date ordered, the date received and the name of the issuing
					 pharmacy. The records shall be kept at least one year.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73363 - Pharmaceutical Service-Personal Medications

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Medications brought by or with the
				  patient to the facility shall not be used, unless all of the following
				  conditions are met:
(1) The drugs have been
				  ordered by the patient's physician and the order entered in the patient's
				  health record.
(2) The medication
				  containers are clearly and properly labeled.
(3) The contents of the containers have been
				  examined and positively identified after admission by the patient's physician
				  or a pharmacist retained by the facility.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73365 - Pharmaceutical Service-Labeling and Storage of Drugs

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Containers which are cracked, soiled or
				  without secure closures shall not be used. Drug labels shall be
				  legible.
(b) All drugs obtained by
				  prescription shall be labeled in compliance with state and federal laws
				  governing prescription dispensing. No person other than the pharmacist shall
				  alter any prescription label.
(c)
				  Nonlegend drugs shall be labeled in conformance with state and federal food and
				  drug laws.
(d) Test reagents,
				  germicides, disinfectants and other household substances shall be stored
				  separately from drugs.
(e) External
				  use drugs in liquid, tablet, capsule or powder form shall be stored separately
				  from drugs for internal use.
(f)
				  Drugs shall be stored at appropriate temperatures. Drugs required to be stored
				  at room temperature shall be stored at a temperature between 15°C
				  (59°F) and 30°C (86°F). Drugs requiring refrigeration shall be
				  stored in a refrigerator between 2°C (36°F) and 8°C (46°F).
				  When drugs are stored in the same refrigerator with food, the drugs shall be
				  kept in a closed properly labeled container, clearly labeled "drugs."
(g) Drugs shall be stored in an orderly
				  manner in cabinets, drawers or carts of sufficient size to prevent
				  crowding.
(h) Dose preparation and
				  administration areas shall be well lighted. If medication carts are used, a
				  light shall be available on the cart.
(i) Drugs shall be accessible only to
				  licensed nursing personnel.
(j)
				  Bedside storage of medications shall be limited to sublingual or inhalation
				  forms of emergency drugs.
(k) All
				  bedside storage of medications shall be specifically ordered by the
				  physician.
(l) Drugs shall not be
				  kept in stock after the expiration date on the label and no contaminated or
				  deteriorated drugs shall be available for use.
(m) The drugs of each patient shall be kept
				  and stored in their originally received containers. No drug shall be
				  transferred between containers.
(n)
				  Discontinued drug containers shall be marked to indicate that the drug has been
				  discontinued. Discontinued drugs shall be disposed of within 90 days of the
				  date the drug order was discontinued, unless the drug is reordered within that
				  time.
California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 4 - Intermediate Care Facilities › Article 3 - Services › Section 73367 - Pharmaceutical Service-Controlled Drugs

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Drugs listed in Schedules II, III and IV
				  of the Federal Comprehensive Drug Abuse Prevention and Control Act of 1970
				  shall not be accessible to other than licensed nursing, pharmacy and medical
				  personnel designated by the facility. The supervisor of health services shall
				  be designated by the licensee to be responsible for the control of such drugs.
				  Drugs listed in Schedule II of the above Act shall be stored in a locked
				  cabinet or a locked drawer separate from noncontrolled drugs.
(b) Separate records of use shall be
				  maintained on all Schedule II drugs. Such records shall be maintained
				  accurately and shall include the name of the patient and the prescriber, the
				  prescription number, the drug name, strength and dose administered, the date
				  and time of administration and the signature of the person administering the
				  drug. Such records shall be reconciled at least daily and shall be retained at
				  least one year. If such drugs are supplied on a scheduled basis as part of a
				  unit dose medication system, such records need not be separate from patient
				  medication records.
(c) Drug
				  records shall be maintained for drugs listed in Schedules III and IV of the
				  above Act in such a way that the receipt and disposition of any such drug may
				  be readily traced. Such records need not be separate from other medication
				  records.