Licensing and certification Program

All Facilities Letters - 2020

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*All Facilities Letters are listed in ascending order by release date, with updated AFLs listed directly after their original version

Bulletin Number	Facility Type Affected	Subject	Release Date
AFL 20-01 (PDF)	Skilled Nursing Facilities	Reminder of Mandatory use of “Census and Direct Care Service Hours Per Patient Day (DHPPD)” (CDPH Form 612) and “Nursing Staffing Assignment and Sign-in Sheet (DHPPD Salaried/Dual Role/Nurse Assistant)” (CDPH Form 530)	01/06/2020
AFL 20-02 (PDF)	All Facilities	Changes to the Application Review Process	01/06/2020
AFL 20-03 (PDF)	Skilled Nursing Facilities	Announcement: Online Application Period for Patient Needs Waiver (PNW) and Workforce Shortage Waiver (WSW)	01/06/2020
AFL 20-04 (PDF)	General Acute Care Hospitals	Notice of New Penalties for Violating Nurse to Patient Staffing Ratios	01/16/2020
AFL 20-05 (PDF)	General Acute Care Hospitals	Medical Evidentiary Examinations and Reporting	01/17/2020
AFL 20-06 (PDF)	General Acute Care Hospitals , Acute Psychiatric Hospitals, Special Hospitals, Hospice Facilities	Senate Bill (SB) 322: Health Facilities: Inspections: Employee Reporting	01/17/2020
AFL 20-07 (PDF)	General Acute Care Hospitals, Alternative Birth Centers, Primary Care Clinics	California Dignity in Pregnancy and Childbirth Act	01/17/2020
AFL 20-08 (PDF)	General Acute Care Hospitals	Notice of Stakeholder Meeting for GACH Administration, Licensure, Medical Services, and Records and Reporting Regulations (GACH Administration)	01/17/2020
AFL 20-09 (PDF)	All Facilities	Health Update and Interim Guidance – 2019 Novel Coronavirus (nCoV)	01/23/2020
AFL 20-10 (PDF)	All Facilities	Healthcare Facility Resources for the 2019 Novel Coronavirus (2019-nCoV)	01/27/2020
AFL 20-11 (PDF)	All Facilities	Updated 2019 Novel Coronavirus Information (2019-nCoV), Including Patient Under Investigation (PUI) Guidance from the Centers for Disease Control and Prevention (CDC)	01/31/2020
AFL 20-12 (PDF)	All Facilities	Change of Ownership Procedural Requirements	02/03/2020
AFL 20-13 (PDF)	All Facilities	2019 Novel Coronavirus Interim Guidance for Risk Assessment and Health Management of Healthcare Personnel with Potential Exposure	02/10/2020
AFL 20-14 (PDF)	All Facilities	Environmental Infection Control for the Coronavirus Disease 2019 (COVID-19)	02/19/2020
AFL 20-15.1 (Supersedes AFL 20-15)	All Facilities	Infection Control Recommendations for Facilities with Suspect Coronavirus (COVID-19) Patients	02/28/2020
AFL 20-16.1 (Supersedes AFL 20-16)	All Facilities	Notice of Stakeholder Meeting for GACH Cardiac Catheterization Laboratory Service Regulations	03/25/2020
AFL 20-17 (PDF)	All Facilities	Guidance for Healthcare Facilities on Preparing for Coronavirus Disease 2019 (COVID-19)	03/03/2020
AFL 20-18 (PDF)	Hospitals	Hospital Resources Survey to Assess Surge Capacity Regarding Coronavirus Disease 2019 (COVID-19)	03/08/2020
AFL 20-20	All Facilities	2020 Census Workers: Group Quarters Enumeration	03/11/2020
AFL 20-21	Hospitals and Critical Access Hospitals with Psychiatric or Rehabilitative Distinct Part Units	New Electronic Process for Hospitals to Report a Death Associated with Restraint or Seclusion	03/11/2020
AFL 20-22.9 (Superseded - see AFL 22-07)	Skilled Nursing Facilities	Guidance for Limiting the Transmission of COVID-19 in Skilled Nursing Facilities	08/12/2021
AFL 20-23	All Facilities	California Coronavirus Disease 2019 (COVID-19) Health Care System Mitigation Playbook	03/20/2020
AFL 20-24	All Facilities	Guidance for Procedures and Transfer of Deceased Persons with Confirmed or Suspected Coronavirus Disease 2019 (COVID-19)	03/16/2020
AFL 20-25.2 (Supersedes AFL 20-25.1)	Skilled Nursing Facilities	Preparing for Coronavirus Disease 2019 (COVID-19) in California Skilled Nursing Facilities	04/15/2020
AFL 20-26.13 (Supersedes AFL 20-26.12)	General Acute Care Hospitals	Suspension of Regulatory Enforcement of Hospital Requirements	06/30/2022
AFL 20-27.1 (Supersedes AFL 20-27)	Adult Day Health Centers	Guidance for Limiting the Transmission of Coronavirus Disease 2019 (COVID-19) in Adult Day Health Centers	03/23/2020
AFL 20-28	Skilled Nursing Facilities	Announcement: Extension of the Deadline to Apply for Patient Needs and Workforce Shortage Waivers	03/23/2020
AFL 20-29	Adult Day Health Centers (ADHC) Home Health Agencies (HHA) Intermediate Care Facilities (ICF) ICF/Developmentally Disabled (ICF/DD) Referral Agencies	Regulatory Update for Social Worker Definition and Services	03/26/2020
AFL 20-30.9 (Supersedes AFL 20-30.8)	Primary Care Clinics (PCCs) Mobile Health Care Units (MHCUs)	Suspension of Regulatory Enforcement of Specified PCC and MHCU Requirements	06/30/2022
AFL 20-31.4 (Supersedes AFL 20-31.3)	General Acute Care Hospitals (GACHs)	GACH Coronavirus Disease (COVID-19) Daily Reporting	11/23/2021
AFL 20-32.3 (Superseded - see AFL 21-36)	Skilled Nursing Facilities	Suspension of Regulatory Enforcement of Specified Skilled Nursing Facility Requirements	06/02/2021
AFL 20-33.2 (Supersedes AFL 20-33.1)	Skilled Nursing Facilities	Interim Guidance for Transfer of Residents with Suspected or Confirmed Coronavirus Disease (COVID-19)	05/15/2020
AFL 20-34.7 (Supersedes AFL 20-34.6)	Adult Day Health Care Centers (ADHCs)	Suspension of Regulatory Enforcement of Specified ADHC Requirements	06/30/2022
AFL 20-35.8 (Supersedes AFL 20-35.7)	All Facilities	Suspension of Professional Certification Requirements for Certified Nurse Assistants (CNAs)	07/05/2022
AFL 20-36.3 (Supersedes AFL 20-36.2)	General Acute Care Hospitals Skilled Nursing Facilities	Guidance for Decontamination and Reuse of N95 Filtering Facepiece Respirators	06/16/2020
AFL 20-37	Ambulatory Surgery Centers (ASCs)	ASC Ventilator Inventory Survey	04/08/2020
AFL 20-38.7 (Supersedes AFL 20-38.6)	All Facilities	Visitor Limitations Guidance	06/16/2021
AFL 20-39	All Facilities	Coronavirus Disease 2019 (COVID-19) Optimizing the Use of Personal Protective Equipment (PPE)	04/13/2020
AFL 20-40.5 (Supersedes AFL 20-40.4)	All Facilities Nurse Assistant Training Programs	Suspension of Specified Regulatory Requirements for Nurse Assistant Training Programs (NATPs)	06/30/2022
AFL 20-41	All Facilities	Prohibition on charging for federally supplied assets or pharmaceuticals from the Strategic National Stockpile (SNS)	04/16/2020
AFL 20-42	Acute Psychiatric Hospitals (APHs)	Coronavirus Disease (COVID-19) APH Reporting	04/17/2020
AFL 20-43.3 (Supersedes AFL 20-46.2)	Skilled Nursing Facilities (SNFs)	SNF Coronavirus Disease 2019 (COVID-19) Daily Reporting	06/19/2020
AFL 20-44.1 (Supersedes AFL 20-44)	All Facilities	Expanding Access to Testing: Updated Interim Guidance on Prioritization for Coronavirus Disease 2019 (COVID-19) Laboratory Testing	05/02/2020
AFL 20-45	All Facilities	Hotels for Healthcare Workers	04/20/2020
AFL 20-46 .3 (Supersedes AFL 20-46.2)	All Facilities	Requests for Urgent Staffing Resources for COVID-19	09/07/2021
AFL 20-47.2 (Supersedes AFL 20-47.1)	Hospice Providers	Suspension of Regulatory Enforcement of Hospice Requirements	07/16/2021
AFL 20-48.3 (Supersedes AFL 20-48.1)	All Facilities	Transfers to Low Acuity Alternate Care Sites During Coronavirus Disease 2019 (COVID-19) Pandemic	12/16/2020
AFL 20-49.6 (Supersedes AFL 20-49.5)	All Facilities	Suspension of Professional Certification Requirements for Home Health Aides (HHAs)	06/30/2022
AFL 20-50.1 (Supersedes AFL 20-50)	Skilled Nursing Facilities	Skilled Nursing Facility Infection Prevention Meetings	06/22/2020
AFL 20-51	All Facilities	Updated Coronavirus Disease 2019 (COVID-19) Symptoms	05/09/2020
AFL 20-52	Skilled Nursing Facilities	Coronavirus Disease 2019 (COVID-19) Mitigation Plan Implementation and Submission Requirements for Skilled Nursing Facilities (SNF) and Infection Control Guidance for Health Care Personnel (HCP)	05/11/2020
AFL 20-53.6 (Superseded - see AFL 22-13)	Skilled Nursing Facilities	COVID-19 Mitigation Plan Recommendations for Testing of HCP and Residents at SNF	12/27/2021
AFL 20-54	All Facilities	Hot Summer Weather Advisory	05/27/2020
AFL 20-55	Skilled Nursing Facilities	SNF Coronavirus Disease 2019 (COVID-19) Baseline Testing Reporting	06/02/2020
AFL 20-56	All Facilities	Request for Interest in Serving as a Temporary Manager	06/12/2020
AFL 20-57.5 (Supersedes AFL 20-57.4)	All Facilities	Suspension of Professional Certification Requirements for Home Health Aide Training Programs (HHA Training Programs)	06/30/2022
AFL 20-58	All Facilities	Fiscal Year (FY) 2020-21 Health Care Facility License Fee Schedule	07/07/2020
AFL 20-59	All Facilities	Public Safety Power Shutoff Power Outage Reporting	07/13/2020
AFL 20-60	Skilled Nursing Facilities	SNF Weekly Reporting of Coronavirus Disease 2019 (COVID-19) Surveillance/Response-Driven Testing	07/17/2020
AFL 20-61	Skilled Nursing Facilities	Dialysis Transportation for Coronavirus Disease 2019 (COVID-19) Positive Residents	07/21/2020
AFL 20-62	Intermediate Care Facilities (ICF), Intermediate Care Facilities/Developmentally Disabled (ICF/DD), Intermediate Care Facilities/Developmentally Disabled – Habilitative (ICF/DD-H), Intermediate Care Facilities/Developmentally Disabled – Nursing (ICF/DD-N), Intermediate Care Facilities/Developmentally Disabled – Continuous Nursing (ICF/DD-CN)	ICF Coronavirus Disease 2019 (COVID-19) Daily Reporting	07/25/2020
AFL 20-63.1 (Supersedes AFL 20-63)	Skilled Nursing Facilities	Deployment of Online Survey Application for Coronavirus Disease 2019 (COVID-19) SNF Mitigation Surveys	08/07/2020
AFL 20-64	Skilled Nursing Facilities	Staffing Data Submission through the Payroll-Based Journal (PBJ) System	08/13/2020
AFL 20-65	All Facilities	Level II Extreme Heat Alert	08/13/2020
AFL 20-66.1 (Supersedes AFL 20-66)	Skilled Nursing Facilities, Distinct Part Skilled Nursing Facilities, End Stage Renal Disease Dialysis Facilities, Chronic Dialysis Clinics	Updated Guidance for Provision of Home Dialysis Services in a Skilled Nursing Facility	03/08/2021
AFL 20-67	Skilled Nursing Facilities	Emergency Resident Transfers during the Coronavirus Disease 2019 (COVID-19) Pandemic	08/20/2020
AFL 20-68	Nursing Homes	Health Services Advisory Group (HSAG) Centers for Medicare and Medicaid Services (CMS) Initiatives to Support Nursing Home Quality Improvement	09/03/2020
AFL 20-69.1 (Supersedes AFL 20-69)	All Facilities	Survey Priorities during the Coronavirus Disease 2019 (COVID-19) Pandemic	03/01/2021
AFL 20-70	Skilled Nursing Facilities	Non-Emergency Transportation during the Coronavirus Disease 2019 (COVID-19) Pandemic	09/14/2020
AFL 20-71	All Facilities	Recall Notice of Advoque Safeguard N95 Particulate Filtering Respirator	09/14/2020
AFL 20-72.1 (Supersedes AFL 20-72)	Home Health Agencies	Suspension of Regulatory Enforcement of Home Health Agency Requirements (See Frequently Asked Questions for additional guidance)	07/16/2021
AFL 20-73	Skilled Nursing Facilities	Advance Care Planning, Physician’s Order for Life Sustaining Treatment (POLST) and Coronavirus Disease 2019 (COVID-19)	09/22/2020
AFL 20-74.1 (Supersedes AFL 20-74)	Skilled Nursing Facilities	Coronavirus Disease 2019 (COVID-19) Recommendations for Personal Protective Equipment (PPE), Resident Placement/Movement, and Staffing in Skilled Nursing Facilities	07/22/2021
AFL 20-75.1 (Supersedes AFL 20-75)	All Facilities	Coronavirus Disease 2019 (COVID-19) Outbreak Investigation and Reporting Thresholds	07/22/2021
AFL 20-76	Skilled Nursing Facilities (SNF) Nursing Facilities (NF) Intermediate Care Facilities Swing Bed Hospitals	Changes on the Minimum Data Set (MDS) 3.0 v1.17.2	09/29/2020
AFL 20-77	Skilled Nursing Facilities Nursing Facilities	Notice of Grant Opportunity to Benefit Nursing Facility Residents to Support In-Person Visitation	10/02/2020
AFL 20-78	Skilled Nursing Facilities	November 3, 2020 Election: Voting During the COVID-19 Pandemic	10/05/2020
AFL 20-79	General Acute Care Hospitals	Access to Salesforce for Resource Requests	10/09/2020
AFL 20-80	Skilled Nursing Facilities	Recommendations for the Prevention and Control of Influenza during the Coronavirus Disease 2019 (COVID-19) Pandemic	10/12/2020
AFL 20-81	General Acute Care Hospitals	GACH Coronavirus Disease 2019 (COVID-19) Vaccination Survey	10/12/2020
AFL 20-82	All Facilities	California Department of Public Health (CDPH) Influenza Vaccination and Masking Policy	10/30/2020
AFL 20-83.2 (Supersedes AFL 20-53)	Skilled Nursing Facilities Intermediate Care Facilities	Interdisciplinary Team (IDT) Authorized Medical Interventions for Residents Unable to Provide Informed Consent and Without a Health Care Decision Maker	08/31/2022
AFL 20-84	Skilled Nursing Facilities	Infection Prevention Recommendations and Incorporation into the Quality and Accountability Supplemental Payment (QASP) Program	11/04/2020
AFL 20-85	Skilled Nursing Facilities	Assembly Bill (AB) 2644 – Skilled Nursing Facilities: Infection Preventionists and Communicable Disease Reporting	11/09/2020
AFL 20-86.1	Long-Term Care Facilities	Coronavirus Disease 2019 (COVID-19) Infection Control Recommendations during Holiday Celebrations	11/20/2020
AFL 20-87.1 (Superseded - see AFL 22-31)	Skilled Nursing Facilities General Acute Care Hospitals	Movement of Patients/Residents in the Healthcare Continuum During Seasonal Surges and the Coronavirus Disease 2019 (COVID-19) Pandemic	11/15/2021
AFL 20-88.3 (Supersedes AFL 20-88.2)	General Acute Care Hospitals	Coronavirus Disease 2019 (COVID-19) Testing Recommendations for Patients and Health Care Personnel (HCP) at General Acute Care Hospitals (GACHs)	10/05/2022
AFL 20-89.1 (Supersedes AFL 20-89)	Skilled Nursing Facilities Intermediate Care Facilities Educational Institutions	Requirements for Application Submission for Online or Distance Learning Nurse Assistant Training Programs (NATPs)	06/07/2021
AFL 20-90	General Acute Care Hospitals	Program Flexibility Requirement for General Acute Care Hospitals (GACH) Before Providing Acute Hospital Care at Home Services	12/23/2020
AFL 20-91	General Acute Care Hospitals	California Crisis Care Continuum Guidelines: Implementing During the Surge of Coronavirus Disease 2019 (COVID-19) Cases	12/28/2020