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State of California—Health and Human Services Agency
California Department of Public Health

AFL 15-13
July 1, 2015

All Health Care Facilities

Level II Heat Alert Advisory

All Facilities Letter (AFL) Summary

  • This AFL notifies health care facilities that the National Weather Service has issued an Excessive Heat Watches and Warnings alert from 1400 hours Wednesday, July 1, through 0800 hours Friday, July 3, 2015, for portions of Northern California. California is now in Phase II of the State Contingency Plan for Excessive Heat Emergencies.
  • Facilities must implement recommended precautionary measures to keep individuals safe and comfortable during extremely hot weather and must have contingency plans in place to deal with the loss of air conditioning, or in the case when no air conditioning is available, take measures to ensure patients and residents are free of adverse conditions that may cause heat-related health complications.

There will be excessive heat in Northern and Central Sacramento Valley and adjacent foothills resulting from high pressure over Northern California. The hottest temperatures are expected through Thursday, July 2, with many locations experiencing temperatures of 110-115 degrees north of interstate 80. There will be little relief from the heat overnight, as lows stay warm in the upper 70s to around 80 degrees. Daytime heat with warm overnight lows will make it challenging to get relief, especially for residents who do not have access to air conditioning.

Long-term health care facilities are reminded that the elderly and other health-compromised individuals are more susceptible to extremes in temperature and dehydration. It is important that facility administrators monitor weather predictions for fluctuations in extreme temperatures and take extra precautions to be sure appropriate air conditioning equipment is well maintained and operating effectively.

Facilities must have contingency plans in place to deal with either the loss of air conditioning or, in the case when no air conditioning is available, to take measures to ensure patients and residents are free of adverse conditions that may cause heat-related health complications. Portable fans and other temporary cooling devices should be used when indicated.

CDPH recommends that the following measures be implemented to keep residents and clients comfortable during extremely hot weather:

  • Dress in lightweight, loose-fitting clothing.
  • Keep well hydrated with particular attention to dependent residents.
  • Minimize physical activities during the hottest parts of the day.
  • Stay indoors and out of the sun during the hottest parts of the day.
  • Use fans as indicated in the attached "Fast Facts" sheet on preventing summer heat injuries.
  • Open windows where feasible if screens are intact, to allow fresh air to circulate.
  • Use cool compresses, misting, showers, and baths to promote cooling.
  • Avoid hot foods and heavy meals.
  • Encourage frozen treats such as "popsicles" between meals.
  • Keep a hydration station readily available to residents, family, and staff.
  • Be alert to adverse changes in patient and resident conditions that may be heat related. Develop and implement a system to monitor hydration status and be prepared to take appropriate interventions.
  • Pay special attention to patients and residents with medications that make the patient susceptible to high temperatures, e.g., psychotropic medications.

Licensing regulations require that all emergency/disaster-related occurrences that threaten the welfare, safety, or health of patients, must be reported to the Department of Public Health (CDPH), Licensing and Certification (L&C) Program. If your facility is impacted by extreme heat conditions that compromise patient health and safety, and/or require an evacuation, transfer, or discharge of patients, you must contact your CDPH L&C District Office.

Please follow these guidelines for reporting process:

During normal business hours (8:00 a.m. – 5:00 p.m.), contact the local CDPH L&C District Office you customarily work with for your geographic location.

For after-hour reporting, or if the local CDPH L&C District Office is non-operational due to an emergency/disaster, follow the process below:

For facilities outside Los Angeles County, notify the:

State Office of Emergency Services Warning Center at (916) 845-8911
Ask that they notify the CDPH Duty Officer.

For facilities in Los Angeles County notify the:

Los Angeles County Operator at (213) 974-1234
Ask that they notify the on-call Health Facilities Inspection Division Supervisor.

Links to the excessive heat warnings and advisories are available at: 



Original signed by Jean Iacino

Jean Iacino
Deputy Director


Attachment: "Fast Facts: Preventing Summer Heat Injuries"

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