Suspension of Professional Certification Requirements for Certified Nurse Assistants (CNAs)

AFL 20-35.3 From the California Department of Public Health July 8, 2021 TO: All Facilities SUBJECT: Suspension of Professional Certification Requirements for Certified Nurse Assistants (CNAs) (This AFL supersedes AFL 20-35.2) ​AUTHORITY:      Proclamation of a State of Emergency (PDF), Executive OrderN-39-20 (PDF), and Executive Order N-08-21 (PDF)  All Facilities Letter (AFL) Summary This AFL notifies all facilities of a temporary waiver of specified statutory and regulatory requirements for CNAs due to the state of emergency related to the COVID-19 outbreak.This AFL allows a CNA who remains in an “employable during state of emergency” status to complete in-service or continuing education units and count them towards certificate renewal.This revision:Adds specific instructions for applicants submitting reciprocity applications.Notifies facilities who hired CNAs under the “Reciprocity” section of this AFL that they must retain a copy of the applicant’s verification form for a period of four years.This AFL notifies all facilities that the temporary waiver of specified regulatory requirements contained in this AFL will expire September 30, 2021.

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Suspension of Regulatory Enforcement of Hospital Requirements

AFL 20-26.7 From the California Department of Public Health April 28, 2021 TO: General Acute Care Hospitals SUBJECT: Suspension of Regulatory Enforcement of Hospital Requirements(This AFL supersedes AFL 20-26.6) ​AUTHORITY:     Proclamation of Emergency (PDF), Executive Order N-27-20 and Executive Order N-39-20 All Facilities Letter (AFL) Summary This AFL notifies hospitals of a temporary waiver of specified regulatory requirements due to the state of emergency related to the Coronavirus Disease 2019 (COVID-19) outbreak.This AFL clarifies approval is needed if a hospital is seeking a waiver of minimum nurse-to-patient ratios.

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STATEWIDE WAIVER RELATED TO CORONAVIRUS DISEASE 2019 (COVID-19) AND VISITATION; COMMUNAL DINING; GROUP ACTIVITIES; NON-ESSENTIAL SERVICES; OUTINGS; NEW ADMISSIONS; AND ENTERTAINMENT

California Department of Social Services PIN 21-17.1-ASC  April 23, 2021 TO: ALL ADULT AND SENIOR CARE PROGRAM RESIDENTIAL LICENSEES Original signed by Kevin Gaines FROM: KEVIN GAINESDeputy DirectorCommunity Care Licensing Division SUBJECT: STATEWIDE WAIVER RELATED TO CORONAVIRUS DISEASE 2019 (COVID-19) AND VISITATION; COMMUNAL DINING; GROUP ACTIVITIES; NON-ESSENTIAL SERVICES; OUTINGS; NEW ADMISSIONS; AND ENTERTAINMENT Provider Information Notice (PIN) Summary PIN 21-17.1-ASC supersedes PIN 21-17-ASC dated March 19, 2021, continues the statewide waiver related to visitation, and provides specific updates related to communal dining, group activities, residents returning from outings, new admissions, and entertainment.

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Guidance for Limiting the Transmission of COVID-19 in Long-Term Care Facilities

AFL 21-22.7 From the California Department of Public Health April 16, 2021 TO: Long-Term Care Facilities SUBJECT: Guidance for Limiting the Transmission of COVID-19 in Long-Term Care Facilities (This AFL supersedes guidance provided in AFL 20-22.6) All Facilities Letter (AFL) Summary This AFL notifies long-term care (LTC) facilities of the Centers for Medicare and Medicaid Services (CMS) and Centers for Disease Control and Prevention (CDC) guidance for improving their infection control and prevention practices to prevent the transmission of COVID-19, including guidance for visitation.This AFL authorizes LTC facilities to temporarily modify their facility’s visitation policies in accordance with CMS and CDC COVID-19 guidance when necessary to protect the health and safety of residents, staff, and the public.This AFL provides the California Department of Public Health’s (CDPH’s) visitation guidance for expanded opportunities for indoor in-room visitation and physical touch and infection control measures for fully vaccinated residents and visitors.This revision includes additional visitation guidelines for pediatric residents.  Background On March 11, 2020, CDPH issued AFL 20-22, authorizing LTC facilities to temporarily modify their visitation policies in accordance with CMS and CDC COVID-19 guidance when necessary to protect the health and safety of residents, staff, and the public.

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Guidance on Quarantine for Health Care Personnel (HCP) Exposed to SARS-CoV-2

AFL 21-08.2 From the California Department of Public Health March 23, 2021 TO: General Acute Care Hospitals (GACHs) Acute Psychiatric Hospitals (APHs) Skilled Nursing Facilities (SNFs) SUBJECT: Guidance on Quarantine for Health Care Personnel (HCP) Exposed to SARS-CoV-2 (This AFL supersedes AFL 21-08.1) All Facilities Letter (AFL) Summary The purpose of this AFL is to provide health care facilities with updated guidance on exposure risk assessment and the duration of quarantine for SARS-CoV-2 exposed HCP working in hospitals and SNFs and SNF residents.This revision includes updated risk assessment and quarantine guidance from the Centers for Disease Control and Prevention (CDC) for HCP working in hospitals and SNFs and SNF residents who have been fully vaccinated against SARS-CoV-2.

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UPDATED STATEWIDE WAIVER RELATED TO CORONAVIRUS DISEASE 2019 (COVID-19) AND VISITATION; COMMUNAL DINING; GROUP ACTIVITIES; NON-ESSENTIAL SERVICES; OUTINGS; AND NEW ADMISSIONS

California Department of Social Services PIN 21-17-ASC March 19, 2021 TO: ALL ADULT AND SENIOR CARE PROGRAM RESIDENTIAL LICENSEES Original signed by Kevin Gaines FROM: KEVIN GAINESDeputy DirectorCommunity Care Licensing Division SUBJECT: UPDATED STATEWIDE WAIVER RELATED TO CORONAVIRUS DISEASE 2019 (COVID-19) AND VISITATION; COMMUNAL DINING; GROUP ACTIVITIES; NON-ESSENTIAL SERVICES; OUTINGS; AND NEW ADMISSIONS Provider Information Notice (PIN) Summary PIN 21-17-ASC informs Adult and Senior Care (ASC) residential licensees of updates to the statewide waiver for visitation, and updates to guidance on communal dining, group activities, non-essential services, residents returning from outings and new admissions.

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Visitor Limitations Guidance

AFL 20-38.6 From the California Department of Public Health TO: All FacilitiesSUBJECT: Visitor Limitations Guidance (This AFL supersedes AFL 20-38.5) All Facilities Letter (AFL) Summary AFL 20-38.6 expands California Department of Public Health’s (CDPH’s) visitation guidance allowing facilities with substantial or lower Coronavirus Disease 2019 (COVID-19) county positivity rates to encourage safely getting more visitors to the bedside and updating prior recommendations for visitation, effective March 23, 2021 (one week from the release of this AFL).This AFL also provides expanded visitation guidelines for certain individuals, regardless of the COVID-19 county positivity rate effective March 23, 2021 (one week from the release of this AFL):Pediatric patientsPatients in labor and deliveryNeonatal intensive care unit (NICU) patientsPediatric intensive care unit (PICU) patientsPatients at end-of-lifePatients with physical, intellectual, and/or developmental disabilities and patients with cognitive impairmentsStudents obtaining clinical experienceSurgery patientsLong-term care (LTC) facilities should refer to AFL 20-22.6 for updated LTC visitation guidance.

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Guidance for Limiting the Transmission of COVID-19 in Long-Term Care Facilities

AFL 20-22.6 From the California Department of Public Health March 8, 2021 TO: Long-Term Care Facilities SUBJECT:Guidance for Limiting the Transmission of COVID-19 in Long-Term Care Facilities (This AFL supersedes guidance provided in AFL 20-22.5) All Facilities Letter (AFL) Summary This AFL notifies long-term care (LTC) facilities of the Centers for Medicare and Medicaid Services (CMS) and Centers for Disease Control and Prevention (CDC) guidance for improving their infection control and prevention practices to prevent the transmission of COVID-19, including guidance for visitation.This AFL authorizes LTC facilities to temporarily modify their facility’s visitation policies in accordance with CMS and CDC COVID-19 guidance when necessary to protect the health and safety of residents, staff, and the public.This revision updates the California Department of Public Health’s (CDPH’s) visitation guidance, including:Expanded opportunities for indoor, in-room visitation and physical touchInfection control measures for fully vaccinated residents and visitors Background On March 11, 2020, CDPH issued AFL 20-22, authorizing LTC facilities to temporarily modify their visitation policies in accordance with CMS and CDC COVID-19 guidance when necessary to protect the health and safety of residents, staff, and the public.

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Guidance on Quarantine for Health Care Personnel (HCP) Exposed to SARS-CoV-2

AFL 21-08.1 From the California Department of Public Health March 5, 2021 TO: General Acute Care Hospitals (GACHs) Acute Psychiatric Hospitals (APHs) Skilled Nursing Facilities (SNFs) SUBJECT: Guidance on Quarantine for Health Care Personnel (HCP) Exposed to SARS-CoV-2 (This AFL supersedes AFL 21-08) All Facilities Letter (AFL) Summary The purpose of this AFL is to provide health care facilities with updated guidance on exposure risk assessment and the duration of quarantine for SARS-CoV-2 exposed HCP working in hospitals and SNFs and SNF residents.This revision includes updated risk assessment and quarantine guidance from the Centers for Disease Control and Prevention (CDC) for HCP working in hospitals and SNFs and SNF residents who have been fully vaccinated against SARS-CoV-2.

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Suspension of Regulatory Enforcement of Specified PCC and MHCU Requirements

AFL 20-30.3 From the California Department of Public Health  March 3, 2021 TO: Primary Care Clinics (PCCs) Mobile Health Care Units (MHCUs) SUBJECT: Suspension of Regulatory Enforcement of Specified PCC and MHCU Requirements (This AFL supersedes AFL 20-30.2) ​AUTHORITY:     Executive Order N-35-20 All Facilities Letter (AFL) Summary This AFL notifies PCCs and MHCUs of a temporary waiver of specified regulatory requirements due to the state of emergency related to the Coronavirus Disease 2019 (COVID-19) outbreak.This revision extends the waiver for all clinics until April 1, 2021.

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