Welcome to Consumer Advocates For RCFE Reform

CARR's October 2019 Newsletter is out! In this issue, we cover citations in the world of assisted living. Here's an excerpt.

"One indicator that consumers can use to evaluate a facility's regulatory compliance is the citation. In this issue, we do a deeper dive into citations--contextualizing them from a policy and consumer point of view. We also give you data about citation counts by facility size."

More trending news …

Did you catch Reveal from The Center for Investigative Reporting & Jennifer Gollan's latest article on assisted living? We certainly did. We've followed some leads in the article to uncover more about the facilities and how CCLD handled them.

By Rebecca Ruiz

San Diego's Superior Court's Judge Maino delivered justice for two vulnerable women who were raped by an 18-year old dishwasher-cum-caregiver - Bradley Thomas.  CARR attended the sentencing hearing in Dept 1302 on 29 August 2019 and was privileged to sit among victims' family members and law enforcement personnel as the sentence was delivered:  8 years in prison. This is a triumph for elder justice advocates and for the District Attorney's Office - specifically Scott Pirrello.  It may go on to serve as an example for DA's around the state to aggressively pursue criminal actions against individuals who commit crimes inside California's assisted living facilities (also called residential care facilities for the elderly - RCFEs). 


You've probably seen the Reveal articles on RCFE worker exploitation:  "Elder care homes rake in profits as legions of workers earn a pittance for long hours of care.  

The investigative reporter, Jen Gollan, contacted CARR over the last few months for background and details to make sure she was getting the content right.   After reading her expose, CARR recognized there was much unsaid.  This commentary is intended to level the playing field for consumers and policymakers, to give recognition to the broader issues at play and the assisted living facilities who are playing by the rules.

CARR, with Golden Gate Law (GGL) School’s Associate Professor of Law and Director of the Women’s Employment Rights Clinic, Hina Shah, has been pressing for legislation that would improve caregiver rights. Read on...

CARR turned 10 this year!  And, to celebrate we want to honor one of the communities we serve.

CARR Gives Back seeks to spotlight the San Ysidro Senior Center as the vibrant, community space it truly is.  Read on to learn more about CARR's Give Back Project and how YOU can be a part.

FREQUENTLY ASKED QUESTIONS (Click here for all the FAQs)

Hospice Waiver: Authorization for


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. 

This FAQ is in category: Understanding California's Oversight & Regulation

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License and Licensee



Title 22, §87101 (l)(1) and H&SC §1569.2(g) defines  "license" to ". . . mean a basic permit to operate a residential care facility for the elderly."

The license should be posted prominently in every facility, demonstrating Community Care Licensing's (CCLD's) care parameters approved by the state. 


This FAQ is in category: TERMS

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Deficiencies: Serious - Type A Violations


Title 22, §87758

A Type A violation is considered the most serious type of deficiency.  It is described as a deficiency that "poses an immediate or substantial threat to the health, safety and/or rights of the residents if not corrected".  Examples cited in Title 22  "include, but are not limited to", the following issues:

This FAQ is in category: Understanding Inspection and Enforcement

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Postural Supports


Title 22 §87608.

The following regulations pertain to postural supports:

(1) Supports shall be limited to devices used to achieve proper body position and balance, to improve a resident's mobility and independent functioning, or to position rather than restrict movement including, but not limited to, preventing a resident from falling out of a bed, a chair, etc.  Included here are physician-prescribed orthopedic devices (braces or casts) used for support of a weakened body part or correction of body parts.

(2) Supports shall be fastened or tied in a manner that permits quick release by the resident.

This FAQ is in category: Understanding Medications Within RCFEs

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Evaluations and Deficiencies: Facilities


Title 22 §87756

Reasons for Evaluations

This FAQ is in category: Understanding California's Oversight & Regulation

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See these sections inside …


Keep in touch with what’s happening in California about assisted living and RCFE legislation and related items.

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