Frequently Asked Questions

Title 22 (§ 87405 & 87406)

All facilities must have a certified administrator.  The RCFE administrator is the individual designated by the Licensee to oversee the management of the facility.  The administrator must have sufficient freedom from other responsibilities (i.e. caregiving) and be on the premises a sufficient number of hours to permit adequate attention to the management of the facility. 

Title 22 states "that CCLD can require the administrator to devote additional hours  to their responsibilities in the facility if substantiated by written documentation" and CCLD "reserves the right to revoke the license of the facility for an administrator's failure to comply with regulations."

If you are concerned with the performance of an administrator, it is appropriate to document your concerns and to contact CCLD.

According to Title 22, administrators must possess the following qualifications: (1) Knowledge of providing appropriate care and supervision, (2) Knowledge of and ability to conform to applicable laws and regulations, (3) Ability to maintain financial and other records, (4) Ability to direct the work of others, (5) Good character and a reputation for personal integrity, (6) Be at least 21 years old, (7) Have a high school diploma or GED for 1-6 bed facilities; 15 college credits and one year's experience for 16-49 bed facilities; two years of college and three years experience for 50+bed facilities.

To become certified as an administrator, individuals must receive 40-hours of  training from an accredited vendor, pass a test administered by CCLD, receive a criminal record clearance from the Department of Justice and pay a $100 processing fee.

Administrator certificates must be renewed every two years.  To maintain the certification, administrators must receive at least 20 hours of continuing education annually and pay $100 processing fee upon request for renewal.  Title 22 also requires that appropriate documentation be maintained demonstrating an administrator's certificate is valid and current (Title 22 §87412).

Proof of an administrator's qualifications and training is not available in the public file, however the consumer can verify whether an Administrator's Certificate is current by viewing the "List of Active Certificates"  on CCLD's website.   With limited available resources to independently evaluate the qualifications of those responsible for facility operations, it would be useful to interview the Administrator during the facility tour. 

The admissions process is the critical point at which you, the consumer, can identify if the facility you have chosen will be able to meet all of the resident's needs and expectations.  Prior to accepting a resident, the regulations stipulate that a facility must evaluate the appropriateness of the resident for the facility.  This evaluation typically consists of an interview, a pre-admissions appraisal, a medical assessment, and presentation of the Admissions Agreement (Title 22 § 87456).  Presented here is what you can expect from each of these events.

If at any point a facility conveys a sense of urgency, for example "Act now or your spot may be taken", it is important for consumers to be aware that in many cases facilities are operating below capacity and this sentiment could simply be a part of their marketing strategy.

Consumers can view the entire admissions process as YOUR chance to evaluate the appropriateness of the facility for the resident. 

You can expect the following from the facility:

(1) An interview with the Licensee/Administrator (§87457)

According to Title 22, during this interview, sufficient information must be provided regarding the facility and its services such that all persons involved in the placement can make an informed decision regarding admission.  Topics for discussion include the prospective resident's desires, expectations, their personal and medical background, and any specific resident needs.  Topics should be discussed in detail and in reference to how the facility anticipates achieving the care requested and required by this resident.

(2) A pre-admission appraisal (§ 87457)

The LIC 603 created by CCL and is used by facilities to document the appraisal.  This form can be used as a tool to assist you in your interview of the facility.  By reviewing these questions ahead of time, you will be prepared to ask the facility more specifically how it plans to address the resident's needs. 

Furthermore, Title 22 requires that if the initial appraisal (or any reappraisal) identifies a service need which is not being met by the general program of the facility, the facility must then obtain advice from a physician, social worker or other appropriate consultant to determine if the needs can be met by the facility, and then they must create a plan outlining the specifics of how those needs will be accommodated should the individual become/remain a resident.  The plan is required to include time frames, objectives, responsible parties, and methods for evaluating progress.  It is imperative that this plan be documented and signed by both parties and a copy maintained in and outside the resident's file to avoid confusion when/if concerns arise. 

Facilities are not required to accept every resident.  It is their responsibility to accept and retain only those residents whose needs can be met.

(3) The request for a recent medical assessment (Title 22 § 87458)

The form LIC 602A, is known as the Physician's Report.  This assessment must be completed and signed by a physician.  It is important to reiterate that RCFEs are non-medical facilities.  The staff employed by RCFEs are not required to have any medical experience aside from general training requirements (Title 22 § 87411).  If you feel the resident may need medical support, even intermittently, you will want to investigate the following:

  • the medical experience of the caregivers employed by the facility
  • the medical experience and critical thinking skills of the administrator/licensee
  • the availability of an RN or LVN (either one employed by the facility or available for consult)
  • and/or you might want to verify whether a higher level of care might not be more appropriate, in that it may provide more experience, more oversight, and more attention to certain conditions and changes in status.
(4) Presentation of the Admissions Agreement

Community Care Licensing offers LIC 604A for facilities to use as their Admissions Agreement.  Based on CARR's review of the files, many smaller facilities use this standard form.  Larger, corporate-owned facilities tend to use their own Admissions Agreement crafted by an attorney. 

Admission Agreement Summary (Title 22 § 87507)

1) Facility and Licensee Contact Information

2) Resident Information

  • Providing your Social Security Number is voluntary

  • Providing information pertaining to financial status, property ownership and (life) insurance information are not required per regulation

3) Basic Services

  • A detailed list and description of what constitutes the basic services provided by the facility must be in the admissions agreement (To see what is required to be provided at a minimum see Title 22 § 87464)

  • The monthly private pay rate for basic services must be stated in the admissions agreement

  • The monthly SSI/SSP rate for basic services must be stated in the admissions agreement and cannot be in excess of the SSI/SSP rate.  Per CCLD's Evaluator Manual (§ 87464): It is a violation of law for a licensee to purposely obtain an SSI/SSP beneficiary's personal and incidental needs allowance to pay for basic services.  CARR is unsure about what is acceptable with regard to requiring family members to pay additional expenses for SSI/SSP residents.  Title 22 § 87464 states that voluntary payments are allowed.  Should this issue arise, CARR recommends contacting Community Care Licensing for guidance.

4) Optional Items and Services

  • Those services not included under basic services, but are available to residents should they choose to receive them must be listed in the admissions agreement alongside the costs associated with each optional item or service.  The resident must agree to purchases these services at an extra charge in the admission agreement.

  • Typical optional items/services include incontinence products, cosmetology services, special food services or products (such as kosher food), etc.

  • Verify the facility's policy on notifying resident's and/or their responsible party should these services become necessary and the policy on arranging payment.

  • Verify the facility's policy on implementing these services should they be desired and the policy on arranging payment

  • Facility's are allowed to post these services in an accessible location if they are not included in the admissions agreement; therefore verifying policies regarding implementation of services and fees is helpful

5) Policies on Rate Changes

  • Facilities must provide 60 days written notice to resident of any basic rate change
  • For SSI/SSP rate changes, residents must be notified as soon as facility is notified.

6) Refund Conditions

7) Eviction Procedures (Title 22 § 87224)

As with any contract, read it entirely and be mindful of:

  • Hidden fees (levels of care or itemized services when additional assistance becomes necessary)
  • Pre-admission fees (non-refundable)
  • Terms of agreement tucked inside residential Handbooks that must be signed and dated.

If you have questions concerning the provisions, contact Community Care Licensing or have your attorney review the document for you.  

A licensee must give 30 days written notice delivered in person or via mail to the resident and/or resident's responsible party.  Three (3) day evictions (aka expedited evictions) are possible with approval from the Department.  Approval for an expedited eviction will only be granted if the Department finds good cause.  Good cause exists if the facility can prove the resident is engaging in behaviors threatening to the well-being of other residents.

Title 22 87224: A facility may evict a resident for 1 or more of the following reasons:

1)      Non-payment of the rate for basic services within 10 days of due date.  Basic services at a minimum are defined in Title 22, §87464 (LINK) and services considered basic by the facility are to be specified in the signed admissions agreement.  If a resident becomes a recipient of SSI/SSP during their stay, the facility cannot evict the resident for a change in the resident's income status and must continue to provide basic services as stated in the admissions agreement to the resident at the SSI/SSP basic rate.  (For Fee Schedule SEE SSI (LINK) (family not make up difference FAQ:)

2)      Failure of a resident to comply with state or local law after a written notice of the alleged violation has been issued from the appropriate authorities. The violation must be deemed as one that affects the well-being of other residents.  For example, a driving violation would not be grounds for eviction unless the resident was responsible for driving other residents.

3)      Failure of a resident to comply with the written policies of the facility.  These policies must be contained in the signed admissions agreement.  Said policies must be in place for the purpose of making communal living possible.

4)      If a resident is deemed through a reappraisal to be no longer appropriate for the facility. While the licensee can conduct the reappraisal (§87463), they must bring any significant changes in a resident's condition to the attention of the resident's physician, family and responsible party and must arrange a meeting to include all parties. It has been noted that some facilities attempt to misuse this section as an opportunity to dump a difficult or high-needs resident.  If the facility should have reasonably predicted the resident's current condition during the admissions process and admitted them in spite of, than the facility remains responsible for providing the necessary care.  For example, if the resident is admitted with a diagnosis of dementia and begins to wander, it is the facility's responsibility to properly address this behavior.  They cannot seek the remedy of eviction since this is not a change in condition but rather a behavior that should have been anticipated by the licensee given the resident's diagnosis of dementia. 

Should a reappraisal determine that the resident has a developed a prohibited health condition (link) then the facility may request a waiver to retain the resident or the resident will need to be moved to a higher level of care. 

Note to consumer:  LPAs are not medical professionals and are, therefore, limited in their ability to determine whether or not a facility is truly qualified for a waiver that expands the scope of care of a facility.  CARR recommends families discuss with a trusted physician or nurse, the specific requirements and attention necessary to ensure the health of a medically-compromised resident living in a non-medical environment.  Additionally, families’ continued vigilance is paramount in all circumstances surrounding changes in conditions.

5)      A change in the use of the facility.

Eviction notices must include:

  • Reasons for the eviction, specific facts, dates, places, witnesses and circumstances
  •  Information about resources to assist in locating alternative housing and care options (i.e. public & private placement agencies & care managers)
  •  Information about a resident's rights to file a complaint with the Department regarding the eviction alongside contact information for State & Local Long-term Care Ombudsman offices (LINK)

Contesting an Eviction

  • Residents have the right to file a complaint regarding evictions.  Residents and/or their families can contact the local Community Care Licensing Office.  The Department is mandated to investigate a complaint within 10 days.  Click here for a list of Program Offices  and contact information.  
  • Should a resident remain after the effective date of the eviction, then the facility must file an unlawful detainer action with the superior court and get a written judgment signed by a judge to have the resident evicted.  Only a sheriff or sheriff's deputy is authorized to physically evict a resident.  A licensee is not authorized to take any physical action to remove the resident and/or their belongings from the facility or deny them access.
  • During the 30 days and after (should the resident remain) it is still the facility's responsibility to provide uninterrupted care and services to the resident.

More information on enforcement of these polices can be found in CANHR's archive

Notes in italics represent the views and/or experience of CARR regarding this topic and/or regulation. 

(Title 22, §87202)

  • Prior to accepting any residents, the licensee must notify CCLD and obtain an appropriate fire clearance for the clients the RCFE plans to serve.
  • All facilities must maintain an appropriate fire clearance approved by the fire department having jurisdiction over the area the facility is located in.   

The request (STD 850) for Fire Marshal Clearance (FMC) is forwarded to the local Fire Marshal Office, or Fire Protection Jurisdiction.  The agency then schedules a tour of the facility, and notes any approvals or special conditions on the body of the STD 850.  The completed document is signed by the agency and returned to CCLD for its action.  Fire clearances are required for non-ambulatory, hospice and bedridden resident acceptance and retention. 
 

Whether to carry liability insurance is no longer left to the discretion of the licensee.  Effective 7/1/2015 there is a law requiring every RCFE in the state to carry liability insurance compliant with the statute, Health and Safety Code 1569.618 (c).  

Because this is a new requirement, CARR recommends that consumers ask the licensee to produce proof of insurance to be assured the facility has the coverage required under the new law:  $1,000,000 per occurrence, and $3,000,000 in aggregate.  

Notes in italics represent the views and/or experience of CARR regarding this topic and/or regulation..

Use:    Third party caregivers or skilled medical professionals hired through Home Healthcare (HHC) agencies can be used in an RCFE.  These individuals can be hired either a) by the RCFE to provide the skilled medical professional services necessary to meet the resident’s incidental medical needs, or b) by the resident’s family or responsible party to augment care and services being provided by the facility. 

Medicare Certification:  Home health care (HHC) agencies offer a variety of skilled medical services, and most are not required by the state to be licensed.  However if use of HHC individuals is expected to be paid by Medicare, it is important to select a Medicare-certified HHC agency, as services rendered by a non-Medicare certified agency will not be reimbursed.  

Facility-Provided Home Health Services:    Typically, the resident’s care plan prepared by the Licensee will stipulate the requirement for use of a home health aide to provide injections, wound care, or other specialized care that the Licensee is unable by regulation to provide. 

Resident-Provided Home Health Services:  There are times when family members (or responsible parties) of the resident elect to have additional care, assistance and supervision provided for their residents.  The resident may receive Home Healthcare services directly, and apart from any care and supervision provided by the facility. 

In these instances, the family or other responsible party would independently arrange for the service, interview the caregiver, arrange for payment, and would be responsible for coordinating with the Licensee, this 3rd party’s presence in the facility, including Criminal Background Checks (see below).

Criminal Background Checks:   Title 22, Section 87411 exempts “licensed or certified medical professionals from criminal background check requirements.  Thus a privately paid personal assistant who is also a licensed medical professional is exempt.  In addition, a privately paid personal assistant who has a current certification as a Certified Nursing Assistant and/or a Certified Home Health Aide is exempt.”  The operative word here is “certified.”    

What You Should Know: 

 

Consumers should ask to see evidence of a home health aide’s certification if the agency or the individual represents they are “certified.”  The licensee must keep a copy of the  person’s current license or certification on file in the facility.

Some RCFEs may have Home Health Agencies that they regularly use.  The Licensee or Administrator may tell you that you have to use ‘their’ home health agency.  That is not true.  You and your resident have the choice of which home health agency you use. 

Notes in italics represent the views and/or experience of CARR regarding this topic and/or regulation.. 

To retain a terminally ill resident, and permit her to receive care from a hospice agency, an RCFE must obtain a hospice waiver from Community Care Licensing (CCLD).

A hospice waiver, according to Title 22 (§87632), allows for variance with regard to a specific regulation based on a facility-wide need or circumstance which is not typically tied to a specific resident and which would otherwise not be allowed in an RCFE setting. 

When a facility requests a hospice waiver it is requesting permission to accept any resident at any time in the future who may require hospice services.  And since many services provided under hospice care go beyond the scope of practice for unlicensed professionals, the facility will require the assistance of a state and Medicare-certified hospice agency to provide this higher level of care.

Requests for hospice waivers are made to CCLD, in advance, by the facility.  The facility must submit a written request that includes, but is not limited to, the following:

(1) Specification of the maximum number of terminally ill residents the facility wants to have at any one time.

(2) A statement by the Licensee that he has read the section in Title 22 pertaining to hospice care.

(3) A statement by the facility that the terms and conditions of all hospice care plans which are designated as the responsibility of the facility, or under the control of the facility, shall be adhered to by the facility.  This is basically a promise by the facility to follow all the rules.  For a narrative on "all the rules" : Providing Hospice Care.

Per Title 22, CCLD can deny a waiver request if the facility is not in substantial compliance.  Waiver requests will not be approved unless the facility demonstrates the ability to meet the care and supervision needs of terminally ill residents and states a willingness to provide additional staff if required by the hospice plan. 

CCLD is required to respond to a hospice waiver request within 30 days of receipt, either to notify the facility the request has been received, that the request is deficient, and/or that the request has been approved or denied.

When hospice services are required by a resident, C  onsumers should be aware that:

(1) A Licensee is only required to read the Title 22, § 87633, pertaining to hospice care.  They are not required to have any other mastery of the requirements.  When granting a hospice waiver, CCLD does take into consideration the facility's history of compliance.  It is imperative that consumers review a facility's evaluations and complaints (LIC 809s & LIC 9099s) to evaluate for themselves the ability of a facility to continue to provide quality care when a resident is receiving hospice care.

(2) Title 22 (for RCFEs) contains no staffing requirements or resident-to-staff ratios for RCFEs.  The regulations require only "sufficient staff" as determined by the facility and, at times, CCLD

(3) When interviewing potential facilities, inquire about the facility's ability to care for hospice residents (experience, staffing levels, etc).  While the resident may not require such services upon admission, he may need them in the future:  moving at a later date, to a better-equipped facility, may not be a viable option. 

 

Assisted living services in California are almost entirely private pay.  Though, there is some governmental assistance available for seniors meeting certain eligibility criteria.  Below you will find brief descriptions regarding payment options & links to additional information.

Personal Resource Options Include:
  • Personal Income/Savings/Assets
  • Reverse Mortgages:  Reverse Mortgages are a special type of home loan that lets homeowners (62 and older) convert the equity in their home into cash. 

Free information is available from the U.S Department of Housing & Urban Development at or by calling The National Council on Aging at (800) 510-0301.  Here the phone is answered by individuals offering counseling on reverse mortgages, providing answers to the following questions:

  • The pros & cons of reverse mortgages
  • The cost associated
  • Other options that may be available

This document contains a thorough overview of long-term care insurance and answers the most pertinent questions you need to get your research started:

  • What is LTC & who can benefit from it?

  • How to choose a qualified agent?

  • Questions to ask before purchase.

  • Rules that apply to agents, benefits & policies, etc.

  • In California only 3 categories of LTC insurance are sold, here they are listed and described.

  • Additional resources - Including HICAP, the Health Insurance Counseling & Advocacy Program  This organization provides free counseling on LTC insurance & Medicare & Medicare Supplement Policies.  Consumers should call 1(800) 434-0222 to find the local HICAP project operating in their community.

Government Assistance Options Include:

  • Veterans Benefits:  For free information, call The Department of Veteran Affairs at 1-800-827-1000] California Regional Offices.    Another good resource appears to be VeteranAid.  
  • Supplemental Security Income (SSI):   Supplemental Security Income, also known as SSI, is a benefit paid to qualifying blind, disabled, or 65+ year old individuals having fewer than $2,000 in assets.  As of 2011, the monthly rate for RCFEs from SSI funds is $982/month.  The maximum SSI a qualifying elder can receive is $1,100. (SEE ALSO SSI FAQ)

Not all RCFEs accept SSI clients.  However, after admission, a facility cannot evict a resident for non-payment should the resident's wealth diminish and they be approved for SSI.  The resident must be retained and cared for at the lower SSI rate making the original rate contained in the Admissions Agreement void.  

  • The Assisted Living Waiver Pilot Program (ALW):  Under the ALW program, Medicaid pays for services in assisted living for eligible seniors at a tiered reimbursement rate.  While SSI is used to cover the cost of room & board.  The program is currently only available in the following counties- Sacramento, San Joaquin, Los Angeles, Sonoma, Fresno, San Bernardino and Riverside Counties.  The number of waiver slots available in each county is limited.  Individuals applying must be deemed nursing home eligible.  For here more on this program,  or contact the state office directly at (916) 552-9105.

  • Medicare:  Medicare does not cover services in assisted living facilities.

Notes in italics represent the views and/or experience of CARR regarding this topic.

Title 22, §87217(d)(1)-(4)

"No Licensee or employee shall*:

(1) accept appointment as a guardian or conservator of the person and/or estate of any resident,

(2) accept any general or special power of attorney for any resident,

(3) become substitute payee for any payments made to any resident [unless involving Social Security monies & licensee is representative payee], or

(4) become the joint tenant on any account specified in §87217(h) with a resident. 

*except as provided in approved continuing care agreements.

Title 22 (§ 87507) only mandates refunds in two (2) situations:

1)      The Department orders the relocation of a resident.  In this case, the resident is relieved of any advance notice requirements contained in the admissions agreement.

2)      Upon the death of a resident, the agreement between the facility and the resident is terminated and relatives are not liable for any payment beyond that due at the date of death, unless agreed to in writing or ordered by a court.

Title 22 includes no other provisions for refunds or advanced notice requirements for residents or families.  Refund policies (outside of the above) are at the discretion of the facility and will be stated in the admissions agreement.  Therefore, it is imperative you familiarize yourself with a facility's policy regarding events that may prompt a resident's departure from the facility:

  •  Personal decision to move
  •  Sickness/Injury/Higher level of care
  •  Depleted Resources

If the terms set forth in the admissions agreement are not agreeable to you, search for a facility that has more reasonable policies or see if there is room for negotiation (and get all agreements in writing, no verbal assurances).  For example, is the required notification for moving 30 days or 60 days?  Is there the option for a reduced payment or per diem rate should the resident need to relocate temporarily?  How soon must you remove the resident's personal effects after death to avoid being charged?

While consumers always have the right to ask for a refund and to file a complaint against a facility they believe is taking advantage, the policy that is contained in the signed admissions agreement is binding.

Notes in italics represent the views and/or experience of CARR regarding this topic and/or regulation. 

Title 22, §87217(a) et.al.

Licensees are not ". . .required to handle residents' cash resources.  [However, if it is deemed and documented through an appraisal, that] a resident is incapable of handling his own cash resources, his cash resource must be safeguarded in accordance with the regulations. . .".    If the Licensee elects to safeguard a resident's cash resources, the Licensee does so pursuant to the stipulations of Title 22, §87217, paraphrased and summarized below:

  • Accurate records shall be kept and adequate safeguards maintained  (§87217(c)
  • Receipts for articles or cash must be given.  (§87217(b)
  • There is to be no commingling with facility funds. [This does not prohibit the Licensee from providing advances or loans to residents from facility money.]  (§87217(e)
  • No facility shall make expenditures from these resources for basic services. [There is an exception with regard to Social Security monies if Licensee is representative payee].  (§87217(f)
  • "No Licensee or employee shall (a) accept appointment as a guardian or conservator of the person and/or estate of any resident, (b) accept any general or special power of attorney for any resident, (c) become substitute payee for any payments made to any resident [unless involving Social Security monies & licensee is representative payee], or (d) become the joint tenant on any account with a resident.*" (§87217(d). 
  • Cash resources entrusted to the Licensee and  kept on the facility premises shall be locked and secured. (§87217(h)
  • Cash resources not kept at the facility must be immediately upon admission be deposited into a bank account separate from the personal and business accounts of the licensee provided that the account title clearly notes that it is residents' money and the resident has access to the money upon demand to the licensee.  (§87217(h)
  • All monetary gifts and any gift exceeding an estimated value of $100, which are given to the licensee by or on behalf of a resident shall be recorded (this does not include friends or relatives of deceased residents).  (§87217(k)
  • Any Licensee who is entrusted to safeguard resident cash resources shall file or have on file with the licensing agency a copy of a surety bond issued by a company to the State of California as principal. (§87216(a)

If a resident needs assistance from a facility with her finances, verify that the RCFE under consideration is bonded and that the amount is sufficient to adequately safeguard the money of the resident.  CCLD verifies that the bond held is sufficient , however there is no substitute for performing your own due diligence. 

*Except as provided in approved agreements with continuing care facilities.

Title 22, §87411

According to Title 22, facility personnel at all times must be sufficient in number and competency to provide services necessary to meet residents needs.  Additional staff should be employed as necessary to perform office work, cooking, housekeeping and facility maintenance.  For additional information, see FAQ Staffing in an RCFE.

All personnel who supervise and/or provide care to residents must be at least 18 years old, in good health as verified by a physician, must possess a current First Aid certificate, and must obtain a criminal record clearance from the Department of Justice. 

All staff who provide direct care to residents are required to receive at least 10 hours of initial training within the first 4 weeks of employment and must receive at least 4 hours of additional training annually.  The most popular training tools used in RCFEs are video instruction tapes/CDs and, at times, on-site trainings from persons knowledgeable on the specific subject(s).   

While proof of receiving the appropriate training is available on all employees in their personnel file, how much knowledge employees actually retain from videos/training is unknown.  Therefore, consumers may want to look for the following characteristics to assess the competency of the care staff:      (The following are mentioned in Title 22 as evidence of safe and effective job performance.)

(1) Familiarity with the aging process;

(2) The importance and techniques of personal care services and supervision;

(3) Respectful of Residents Rights;

(4) Knowledge of the psychosocial needs of the elderly (i.e. recreation, companionship);

(5) Knowledge necessary in order to recognize early signs of illness and the need for professional help (includes dementia);

(6) Knowledge of community resources;

(7) Ability to communicate with residents;

(8) Principles of good nutrition and sanitation;

(9) Knowledge of safely assisting with prescribed medications which are self-administered (Medication Management)

If you are concerned with the staffing level, or competency of staff in a particular RCFE, documenting your concerns and sharing the documentation with the LPA assigned to your facility may be helpful.

CCLD "may require a facility to provide additional staff whenever it determines through documentation that additional staff is required to provide adequate services" (Title 22, § 87411). 

Title 22, Division 6, Chapter 8, Section 87468 lists some of the rights residents retain when moving into an assisted living facility.  They are also enumerated in LIC 613C. 

Specifically Title 22 enumerates 18 resident rights including the right to have visitors, including the right to visit privately during reasonable hours, and without prior notice, provided that rights of other residents are not infringed upon.  A facility may not unilaterally restrict a resident’s telephone calls or visitors. 

Having friends, family, business associates and all others requested by the resident to visit is an important aspect of socialization and allowing the resident to remain connected, involved, and feel loved and cared for.  Failures in allowing a resident to have visitors is a violation of the resident’s personal rights, and worse – contributes to an elder’s isolation, depression, and loneliness.

Despite the clarity of Title 22 regarding the resident’s unequivocal right to receive visits by family, friends, ombudsman, advocacy representatives and all others the resident is willing to entertain, issues may arise through actions of a Public Guardian or Conservator.  Generally a Public Guardian or Conservator can restrict visitors to the conserved resident; the legal powers of the Public Guardian or conservator take precedence over Title 22 Section 87468.   

Assert your Rights:   As always, if you feel your resident’s right to have visitors and phone calls is being restricted, document the circumstances, document the facts, and make a prompt complaint to CCL via telephone call to the duty work, or in writing using the LIC802 form, or a letter documenting your allegations and supporting information. 

Notes in italics represent the views and/or experience of CARR regarding this topic and/or regulation.