2005 California Health and Safety Code Sections 1265-1271.15 Article 2. Administration

1265.  Any person, political subdivision of the state, or
governmental agency desiring a license for a health facility,
approval for a special service under this chapter, or approval to
manage a health facility currently licensed as a health facility, as
defined in subdivision (a), (b), (c), (d), or (f) of Section 1250,
that has not filed an application for a license to operate that
facility shall file with the department a verified application on
forms prescribed and furnished by the department, containing all of
the following:
   (a)  The name of the applicant and, if an individual, whether the
applicant has attained the age of 18 years.
   (b)  The type of facility or health facility.
   (c)  The location thereof.
   (d)  The name of the person in charge thereof.
   (e)  Evidence satisfactory to the department that the applicant is
of reputable and responsible character. If the applicant is a firm,
association, organization, partnership, business trust, corporation,
or company, like evidence shall be submitted as to the members or
shareholders thereof, and the person in charge of the health facility
for which application for license is made. If the applicant is a
political subdivision of the state or other governmental agency, like
evidence shall be submitted as to the person in charge of the health
facility for which application for license is made.
   (f)  Evidence satisfactory to the department of the ability of the
applicant to comply with this chapter and of rules and regulations
promulgated under this chapter by the department.
   (g)  Evidence satisfactory to the department that the applicant to
operate a skilled nursing facility or intermediate care facility
possesses financial resources sufficient to operate the facility for
a period of at least 45 days. A management company shall not be
required to submit this information.
   (h)  Each applicant for a license to operate a skilled nursing
facility or intermediate care facility shall disclose to the
department evidence of the right to possession of the facility at the
time the application will be granted, which may be satisfied by the
submission of a copy of applicable portions of a lease agreement or
deed of trust. The names and addresses of any persons or
organizations listed as owner of record in the real estate, including
the buildings and the grounds appurtenant to the buildings, shall be
disclosed to the department.
   (i)  Any other information as may be required by the department
for the proper administration and enforcement of this chapter.
   (j)  Upon submission of an application to the department by an
intermediate care facility/developmentally disabled habilitative or
an intermediate care facility/developmentally disabled-nursing, the
application shall include a statement of need signed by the
chairperson of the area board pursuant to Chapter 4 (commencing with
Section 4570) of Division 4.5 of the Welfare and Institutions Code.
In the event the area board has not provided the statement of need
within 30 days of receipt of the request from the applicant, the
department may process the application for license without the
statement.
   (k)  The information required pursuant to this section, other than
individuals' social security numbers, shall be made available to the
public upon request, and shall be included in the department's
public file regarding the facility.
   (l) With respect to a facility licensed as a health facility, as
defined in subdivision (a), (b), or (f) of Section 1250, for purposes
of this section, "manage" means to assume operational control of the
facility.
1265.1.  (a) An application for licensure under this chapter may be
denied by the state department if the applicant for a license has
been convicted of a crime, as defined in Section 1265.2, or on the
ground of knowingly making a false statement of fact required to be
revealed in an application for such licensure.
   (b) If the applicant is a firm, partnership, association, or
corporation, the conviction of any officer, director, shareholder
with a beneficial ownership interest in the applicant exceeding 10
percent, or the person in charge of the health facility may serve as
the basis for denial of the license by the state department.  If the
applicant is a political subdivision of the state or other
governmental agency, the conviction of such a crime by the person in
charge of the health facility may serve as the basis for denial of
the license by the state department.
   (c) The record of conviction or a certified copy thereof certified
by the clerk of the court or by the judge in whose court the
conviction is had, shall be conclusive evidence thereof.
1265.2.  A "crime," within the meaning of this chapter, means a
violation of a law or regulation which is substantially related to
the qualifications or duties of the applicant or licensee or which is
substantially related to the functions of the business for which the
license was, or is to be, issued.
   A "conviction," within the meaning of this chapter, means a plea
or verdict of guilty or a conviction following a plea of nolo
contendere.  Any action which the state department is permitted to
take following the establishment of a conviction may be taken when
the time for appeal has elapsed, or the judgment of conviction has
been affirmed on appeal or when an order granting probation is made
suspending the imposition of sentence, notwithstanding a subsequent
order pursuant to the provisions of Section 1203.4 of the Penal Code
permitting such person to withdraw his plea of guilty and to enter a
plea of not guilty, or setting aside the verdict of guilty, or
dismissing the accusation, information, or indictment.
   Evidence of conviction of a misdemeanor following a plea of nolo
contendere pursuant to the provisions of Section 1290 shall not be
admissible in any hearing conducted under Section 1269 or 1295.
   No application for licensure shall be denied nor shall a license
be suspended or revoked solely on the basis of the conviction of a
crime if the director determines that the person has been
rehabilitated in accordance with standards for rehabilitation
developed by the director.  The director shall take into account all
competent evidence of rehabilitation furnished by the applicant or
licensee.
1265.3.  (a) For any individual or entity that seeks approval to
operate or manage a health facility licensed pursuant to subdivision
(a), (b), or (f) of Section 1250 and is subject to Section 1265, the
department shall consider the following:
   (1) To determine whether the applicant is of reputable and
responsible character, the department shall consider any available
information that the applicant has demonstrated a pattern and
practice of violations of state or federal laws and regulations. The
department shall give particular consideration to those violations
that affect the applicant's ability to deliver safe patient care.
   (2) To determine whether the applicant has the ability to comply
with this chapter and the rules and regulations adopted under this
chapter, the department shall consider evidence that shall include
all of the following:
   (A) If any, prior history of operating in this state any other
facility licensed pursuant to Section 1250, and the applicant's
history of substantial compliance with the requirements imposed under
that license, applicable federal laws and regulations, and
requirements governing the operators of those facilities.
   (B) If any, prior history of operating in any other state any
facility authorized to receive Medicare Program reimbursement or
Medicaid Program reimbursement, and the applicant's history of
substantial compliance with that state's requirements, and applicable
federal laws, regulations, and requirements.
   (C) If any, prior history of providing health services as a
licensed health professional or an individual or entity contracting
with a health care service plan or insurer, and the applicant's
history of substantial compliance with state requirements, and
applicable federal law, regulations, and requirements.
   (b) The department may also require the entity described in
subdivision (a) to furnish other information or documents for the
proper administration and enforcement of the licensing laws.
1265.5.  (a) Prior to the initial licensure or renewal of a license
of any person or persons to operate or manage an intermediate care
facility/developmentally disabled habilitative, an intermediate care
facility/developmentally disabled nursing, or an intermediate care
facility/developmentally disabled, other than an intermediate care
facility/developmentally disabled operated by the state that secures
criminal record clearances for its employees through a method other
than as specified in this section or upon the hiring of direct care
staff by any of these facilities, the state department shall secure
from an appropriate law enforcement agency a criminal record to
determine whether the applicant, facility administrator or manager,
any direct care staff, or any other adult living in the same
location, has ever been convicted of a crime other than a minor
traffic violation.
   (b) (1) The application for licensure or renewal shall be denied
if the criminal record indicates that the person seeking initial
licensure or renewal of a license referred to in subdivision (a) has
been convicted of a violation or attempted violation of any one or
more of the following Penal Code provisions:  Section 187,
subdivision (a) of Section 192, Section 203, 205, 206, 207, 209, 210,
210.5, 211, 220, 222, 243.4, 245, 261, 262, or 264.1, Sections 265
to 267, inclusive, Section 273a, 273d, 273.5, or 285, subdivisions
(c), (d), (f), and (g) of Section 286, Section 288, subdivisions (c),
(d), (f), and (g) of Section 288a, Section 288.5, 289, 289.5, 368,
451, 459, 470, 475, 484, or 484b, Sections 484d to 484j, inclusive,
or Section 487, 488, 496, 503, 518, or 666, unless any of the
following applies:
   (A) The person was convicted of a felony and has obtained a
certificate of rehabilitation under Chapter 3.5 (commencing with
Section 4852.01) of Title 6 of Part 3 of the Penal Code and the
information or accusation against the person has been dismissed
pursuant to Section 1203.4 of the Penal Code with regard to that
felony.
   (B) The person was convicted of a misdemeanor and the information
or accusation against the person has been dismissed pursuant to
Section 1203.4 or 1203.4a of the Penal Code.
   (C) The person was convicted of a felony or a misdemeanor, but has
previously disclosed the fact of each conviction to the department
and the department has made a determination in accordance with law
that the conviction does not disqualify the person.
   (D) The person was convicted of a misdemeanor violation of Section
488 or 496 and has had no subsequent conviction of either offense in
the last five years.  This paragraph shall become inoperative on
August 1, 2001.
   (2) The application for licensure or renewal shall be denied if
the criminal record of the person includes a conviction in another
state for an offense that, if committed or attempted in this state,
would have been punishable as one or more of the offenses set forth
in paragraph (1), unless evidence of rehabilitation comparable to the
dismissal of a misdemeanor or a certificate of rehabilitation as set
forth in subparagraph (A) or (B) of paragraph (1) is provided to the
department.
   (c) If the criminal record of a person described in subdivision
(a) indicates any conviction other than a minor traffic violation or
other than a conviction listed in subdivision (b), the department may
deny the application for licensure or renewal.  In determining
whether or not to deny the application for licensure or renewal
pursuant to this subdivision, the department shall take into
consideration the following factors as evidence of good character and
rehabilitation:
   (1) The nature and seriousness of the offense under consideration
and its relationship to their employment duties and responsibilities.
   (2) Activities since conviction, including employment or
participation in therapy or education, that would indicate changed
behavior.
   (3) The time that has elapsed since the commission of  the conduct
or offense referred to in paragraph (1) or (2) and the number of
offenses.
   (4) The extent to which the person has complied with any terms of
parole, probation, restitution, or any other sanction lawfully
imposed against the person.
   (5) Any rehabilitation evidence, including character references,
submitted by the person.
   (6) Employment history and current employer recommendations.
   (7) Circumstances surrounding the commission of the offense that
would demonstrate the unlikelihood of repetition.
   (8) The granting by the Governor of a full and unconditional
pardon.
   (9) A certificate of rehabilitation from a superior court.
   (d) Nothing in this section shall be construed to require a
criminal record check of a person receiving services in an
intermediate care facility/developmentally disabled habilitative,
intermediate care facility/developmentally disabled-nursing, or
intermediate care facility/developmentally disabled.
   (e) For purposes of this section, "direct care staff" means all
facility staff who are trained and experienced in the care of persons
with developmental disabilities and who directly provide program and
nursing services to clients.  Administrative and licensed personnel
shall be considered direct care staff when directly providing program
and nursing services to clients.  Persons employed as consultants
and acting as direct care staff shall be subject to the same
requirements for a criminal record clearance as other direct care
staff.  However, the employing facility shall not be required to pay
any costs associated with that criminal record clearance.
   (f) Upon the employment of any person specified in subdivision
(a), and prior to any contact with clients or residents, the facility
shall submit fingerprint cards to the department for the purpose of
obtaining a criminal record check.
   (g) The department shall develop procedures to ensure that any
licensee, direct care staff, or certificate holder for whom a
criminal record has been obtained pursuant to this section or Section
1338.5 or 1736 shall not be required to obtain multiple criminal
record clearances.
1265.7.  (a) (1) The state department shall adopt regulations for
the licensure of congregate living health facilities.  The
regulations shall include minimum standards of adequacy, safety, and
sanitation of the physical plant and equipment, minimum standards for
staffing with duly qualified personnel, and training of the staff,
and minimum standards for providing the services offered.
   (2) Regulations for facilities approved to provide services for
persons who may be ventilator dependent shall ensure that residents
of these facilities are assured appropriate supportive health
services in the most normal, least restrictive physical and
rehabilitative environment appropriate to individual resident needs.
   (3) Regulations for facilities approved to provide services for
persons who are terminally ill, who have a diagnosis of a
life-threatening illness, who are catastrophically and severely
disabled, or any combination of those persons, shall ensure that
residents of these facilities receive supportive health services,
based on individual resident acuity levels in the most normal, least
restrictive physical environment for individual resident needs.
   (b) Pending adoption of the regulations pursuant to paragraphs (2)
and (3) of subdivision (a), an entity shall be licensed as a
congregate living health facility serving persons who are terminally
ill, persons who are catastrophically and severely disabled, persons
who are mentally alert but physically disabled, or any combination of
these persons, by the state department beginning July 1, 1988, if it
meets the requirements identified in subdivision (i) of Section 1250
and in Section 1267.13.
1265.8.  In addition to the requirements of this chapter, any
person, political subdivision of the state, or governmental agency
desiring a license for a health facility shall file with the state
department a verified statement that it has complied with the
requirements of Chapter 1 (commencing with Section 15000) of Division
12.5, and it has received approval pursuant to that chapter.  The
state department shall not issue any license until such requirement
has been met.
1266.  (a) Each new and renewal application for a license for the
health facilities listed below shall be accompanied by an annual fee
as set forth below.
   (1) The annual fee for a general acute care hospital, acute
psychiatric hospital, special hospital, and chemical dependency
recovery  hospital, based on the number of licensed beds, is as
follows:
               1-49 beds                   $460 plus $8 per bed
              50-99 beds                   $850 plus $8 per bed
             100 or more beds            $1,175 plus $8 per bed
   (2) The annual fee for a skilled nursing facility, intermediate
care facility, and intermediate care facility/developmentally
disabled, based on the number of licensed beds, is as follows:
               1-59 beds               $2,068 plus $26 per bed
              60-99 beds               $2,543 plus $26 per bed
             100 or more beds          $3,183 plus $26 per bed
   (3) The fees provided in this subdivision shall be adjusted,
commencing July 1, 1983, as proposed in the state department's
1983-84 fiscal year Health Facility License Fee Report to the
Legislature.  Commencing July 1, 1984, fees provided in this
subdivision shall be adjusted annually, as directed by the
Legislature in the annual Budget Act.
   (b) (1) By March 17 of each year, the State Department of Health
Services shall make available to interested parties, upon request,
information regarding the methodology and calculations used to
determine the fee amounts specified in this section, the staffing and
systems analysis required under subdivision (e), program costs
associated with the licensing provisions of this division, and the
actual numerical fee charges to be implemented on July 1 of that
year.  This information shall specifically identify federal funds
received, but not previously budgeted for, the licensing provisions
of this division that are used to offset the amount of General Fund
money to be recovered through license fees.  The information shall
also identify the purpose of federal funds received for any
additional activities under the licensing provisions of this division
that are not used to offset the amount of General Fund money.
   (2) The methodology and calculations used to determine the fee
amounts shall result in fee levels in an amount sufficient to provide
revenues equal to the sum of the following:
   (A) The General Fund expenditures for the fiscal year beginning on
July 1 of that year, as specified in the Governor's proposed budget,
less license fees estimated to be collected in that fiscal year by
the licensing provisions of this division, excluding licensing fees
collected pursuant to this section.
   (B) The amount of federal funds budgeted for the fiscal year
ending June 30 of that year for the licensing provisions of the
division, less federal funds received or credited, or anticipated to
be received or credited, during that fiscal year for that purpose.
   The methodology for calculating the fee levels shall include an
adjustment that takes into consideration the actual amount of license
fee revenue collected pursuant to this section for that prior fiscal
year.
   (3) If the Budget Act provides for expenditures that differ by 5
percent from the Governor's proposed budget, the Department of
Finance shall adjust the fees to reflect that difference and shall
instruct the State Department of Health Services to publish those
fees in accordance with subdivision (d).
   (c) The annual fees determined pursuant to this section shall be
waived for any health facility conducted, maintained, or operated by
this state or any state department, authority, bureau, commission, or
officer, or by the Regents of the University of California, or by a
local hospital district, city, county, or city  and county.
   (d) The department shall, within 30 calendar days of the enactment
of the Budget Act, publish a list of actual numerical fee charges as
adjusted pursuant to this section.  This adjustment of fees, any
adjustment by the Department of Finance, and the publication of the
fee list shall not be subject to the rulemaking requirements of
Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3
of Title 2 of the Government Code.  If the published list of fees is
higher than that made available to interested parties pursuant to
subdivision (b), the affected health facilities may choose to pay the
fee in the amount presented at the public hearing and to defer
payment of the additional increment until 60 days after publication
of the list of fees pursuant to this subdivision.
   (e) Prior to the establishment of the annual fee, the department
shall prepare a staffing and systems analysis to ensure efficient and
effective utilization of fees collected, proper allocation of
departmental resources to licensing and certification activities,
survey schedules, complaint investigations, enforcement and appeal
activities, data collection and dissemination, surveyor training, and
policy development.
   The analysis under this subdivision shall be included in the
information made available pursuant to subdivision (b), and shall
include all of the following:
   (1) The number of surveyors and administrative support personnel
devoted to the licensing and certification of health care facilities.
   (2) The percentage of time devoted to licensing and certification
activities for the various types of health facilities.
   (3) The number of facilities receiving full surveys and the
frequency and number of followup visits.
   (4) The number and timeliness of complaint investigations.
   (5) Data on deficiencies and citations issued, and numbers of
citation review conferences and arbitration hearings.
   (6) Training courses provided for surveyors.
   (7) Other applicable activities of the licensing and certification
division.
   The analysis shall also include recommendations for administrative
changes to streamline and prioritize the survey process, complaint
investigations, management information systems, word processing
capabilities and effectiveness, consumer information system, and
surveyor training.
   The annual staffing and systems analysis shall be presented to the
Health Care Advisory Committee and the Legislature prior to the
establishment and adoption of the annual fee.
   (f) The annual fee for a congregate living health facility shall
initially, and until adjusted by the Legislature in a Budget Act, be
based on the number of licensed beds as follows:
               1-3 beds               $  800
               4-6 beds               $1,000
               7-10 beds              $1,200
              11-15 beds              $1,500
              16 or more beds         $1,700
Commencing July 1, 1991, fees provided in this subdivision shall be
adjusted annually, as directed by the Legislature in the annual
budget.
   (g) The annual fee for a pediatric day health and respite care
facility, as defined in Section 1760.2, shall initially, and until
adjusted by the Legislature in a Budget Act, be based on the number
of licensed beds as follows:
           1-3 beds or clients                $  800
           4-6 beds or clients                $1,000
           7-10 beds or clients               $1,200
          11-15 beds or clients               $1,500
          16 or more beds or clients          $1,700 plus $50 for
each
                                              additional bed or
client
                                              over 16 beds or clients
Commencing July 1, 1993, fees provided in this subdivision shall be
adjusted annually, as directed by the Legislature in the annual
Budget Act.
   (h) The department shall, in consultation with affected provider
representatives, develop a specific proposal by July 1, 1995, to do
all of the following:
   (1) Revise the health facility licensure fee methodologies in a
manner that addresses the fee methodology and subsidy issues
described in the State Auditor Report Number 93020, Issues 2 and 3.
   (2) Ensure the validity and reliability of the data systems used
to calculate the license fee.
   (3) Address the subsidy of licensing and certification activities
regarding health facilities for which the annual license fee is
waived.
   (4) Develop a licensing and certification special fund into which
all fees collected by the state department, for health facility
licensing, certification, regulation, and inspection duties,
functions, and responsibilities, shall be deposited.
1266.1.  (a) Each new or renewal application for a license for a
psychiatric health facility shall be accompanied by a fee equal in
amount to the fee for an acute psychiatric hospital as specified in
subdivision (a) of Section 1266 or, as modified by subdivision (e).
   (b) New or renewal licensure application fees for psychiatric
health facilities shall be collected by the State Department of
Mental Health.
   (c) The State Department of Mental Health shall make available to
the Legislature and other interested parties, on or before January 17
of each year, information describing program costs within the State
Department of Mental Health for licensure, regulation, and monitoring
of psychiatric health facilities.
   (d) The annual fees shall be waived for any psychiatric health
facility conducted, maintained, or operated by this state or any
state department, authority, bureau, commission, or officer, or by
the Regents of the University of California, or by a local hospital
district, city, county, or city and county.
   (e) If additional private psychiatric health facilities seek new
licensure on  or after January 1, 1991, the State Department of
Mental Health may increase the fees for all private psychiatric
health facilities with more than nine beds sufficient to accommodate
the increased level of workload and costs.
   (f) (1) Any licensee desiring to obtain a special permit to offer
and provide  structured outpatient services shall file an application
with the State Department of Mental Health.
   (2) The application for a special permit, if any, shall be
submitted with each new or renewal application for a license for a
psychiatric health facility, and shall be accompanied by a reasonable
fee, as determined by the State Department of Mental Health, not to
exceed the actual costs of administration related to the special
permit.  An application for a special permit submitted by a
psychiatric health facility operated by a public entity shall be
exempt from the fee required pursuant to this section for the
issuance of the special permit.
   (3) The State Department of Mental Health shall not issue a
special permit unless the applicant furnishes all of the following:
   (A) Its annual licensing fee required pursuant to subdivision (a).
   (B) A completed application submitted on forms furnished by the
department.
   (C) A written agreement ensuring that the facility will have
additional staffing for the services to be provided under the special
permit, that the additional staffing will meet the same professional
standards as required by regulation for inpatient services, and that
a coordinator of these services will be appointed.
   (D) Any other information or documentation as may be required by
the department for its proper and efficient administration and
enforcement of special permit services.
   (4) The provision of structured outpatient services pursuant to a
special permit may be as an alternative to admission to inpatient
services, as aftercare services following discharge from inpatient
care, or as both.
1267.  (a) (1) Each license issued pursuant to this chapter shall
expire 12 months from the date of its issuance and each special
permit shall expire on the expiration date of the license.
Application for renewal of a license or special permit accompanied by
the necessary fee shall be filed with the state department not less
than 30 days prior to the expiration date. Failure to make a timely
renewal shall result in expiration of the license or special permit.
   (2) Notwithstanding paragraph (1), the license of a facility
operated by a receiver appointed pursuant to Article 8 (commencing
with Section 1325) shall not expire during the period of the
receivership, and for 30 days thereafter.
   (b) A renewal license or special permit may be issued for a period
not to exceed two years if the holder of the license or special
permit has been found in substantial compliance with any statutory
requirements, regulations, or standards during the preceding license
period.  However, for a health facility specified in subdivision (a)
or (b) of Section 1250, a renewal license or special permit may be
issued for a period not to exceed three years, if the holder of the
license or special permit has been found in substantial compliance
with statutory requirements, regulations, or standards during the
preceding license period.
   (c) Notwithstanding the length of the period for which a renewal
license is issued, a license fee shall be due and payable annually.
1267.5.  (a) (1) Each applicant for a license to operate a skilled
nursing facility or intermediate care facility shall disclose to the
state department the name and business address of each general
partner if the applicant is a partnership, or each director and
officer if the applicant is a corporation, and each person having a
beneficial ownership interest of 5 percent or more in the applicant
corporation or partnership.
   (2) If any person described in paragraph (1) has served or
currently serves as an administrator, general partner, trustee or
trust applicant, sole proprietor of any applicant or licensee who is
a sole proprietorship, executor, or corporate officer or director of,
or has held a beneficial ownership interest of 5 percent or more in,
any other skilled nursing facility or intermediate care facility or
in any community care facility licensed pursuant to Chapter 3
(commencing with Section 1500) of this division, the applicant shall
disclose the relationship to the state department, including the name
and current or last address of the health facility or community care
facility and the date the relationship commenced and, if applicable,
the date it was terminated.
   (3) (A) If the facility is operated by, or proposed to be operated
in whole or part under, a management contract, the names and
addresses of any person or organization, or both, having an ownership
or control interest of 5 percent or more in the management company
shall be disclosed to the state department.  This provision shall not
apply if the management company has submitted an application for
licensure with the state department and has complied with paragraph
(1).
   (B) If the management company is a subsidiary of one or more other
organizations, the information shall include the names and addresses
of the parent organizations of the management company and the names
and addresses of any officer or director of the parent organizations.
  The failure to comply with this subparagraph may result in action
to revoke or deny a license.  However, once the information that is
required under this subparagraph is provided, the action to revoke
the license shall terminate.
   (4) If the applicant or licensee is a subsidiary of one or more
other organizations, the information shall include the names and
addresses of the parent organizations of the subsidiary and the names
and addresses of any officer or director of the parent
organizations.
   (5) The information required by this subdivision shall be provided
to the state department upon initial application for licensure, and
any change in the information shall be provided to the state
department within 30 calendar days of that change.
   (6) Except as provided in subparagraph (B) of paragraph (3), the
failure to comply with this section may result in action to revoke or
deny a license.
   (7) The information required by this section shall be made
available to the public upon request, shall be included in the public
file of the facility, and by July 1, 2002, shall be included in the
department's automated certification licensing administration
information management system.
   (b) On and after January 1, 1990, no person may acquire a
beneficial interest of 5 percent or more in any corporation or
partnership licensed to operate a skilled nursing facility or
intermediate care facility, or in any management company under
contract with a licensee of a skilled nursing facility or
intermediate care facility, nor may any person become an officer or
director of, or general partner in, a corporation, partnership, or
management company of this type without the prior written approval of
the state department.  Each application for departmental approval
pursuant to this subdivision shall include the information specified
in subdivision (a) as regards the person for whom the application is
made.
   The state department shall approve or disapprove the application
within 30 days after receipt thereof, unless the state department,
with just cause, extends the application review period beyond 30
days.
   (c) The state department may deny approval of a license
application or of an application for approval under subdivision (b)
if a person named in the application, as required by this section,
was an officer, director, general partner, or owner of a 5-percent or
greater beneficial interest in a licensee of, or in a management
company under contract with a licensee of, a skilled nursing
facility, intermediate care facility, community care facility, or
residential care facility for the elderly at a time when one or more
violations of law were committed therein that resulted in suspension
or revocation of its license, or at a time when a court-ordered
receiver was appointed pursuant to Section 1327, or at a time when a
final Medi-Cal decertification action was taken under federal law.
However, the prior suspension, revocation, or court-ordered
receivership of a license shall not be grounds for denial of the
application if the applicant shows to the satisfaction of the state
department (1) that the person in question took every reasonably
available action to prevent the violation or violations that resulted
in the disciplinary action and (2) that he or she took every
reasonably available action to correct the violation or violations
once he or she knew, or with the exercise of reasonable diligence
should have known of, the violation or violations.
   (d) No application shall be denied pursuant to this section until
the state department first (1) provides the applicant with notice in
writing of grounds for the proposed denial of application, and (2)
affords the applicant an opportunity to submit additional documentary
evidence in opposition to the proposed denial.
   (e) Nothing in this section shall cause any individual to be
personally liable for any civil penalty assessed pursuant to Chapter
2.4 (commencing with Section 1417) or create any new criminal or
civil liability contrary to general laws limiting that liability.
   (f) This section shall not apply to a bank, trust company,
financial institution, title insurer, controlled escrow company, or
underwritten title company to which a license is issued in a
fiduciary capacity.
   (g) As used in this section, "person" has the same meaning as
specified in Section 19.
   (h) This section shall not apply to the directors of a nonprofit
corporation exempt from taxation under Section 23701d of the Revenue
and Taxation Code that operates a skilled nursing facility or
intermediate care facility in conjunction with a licensed residential
facility, where the directors serve without financial compensation
and are not compensated by the nonprofit corporation in any other
capacity.
1267.7.  The State Department of Health Services and the State
Department of Developmental Services shall jointly develop and
implement licensing and Medi-Cal regulations appropriate to
intermediate care facility/developmentally disabled-habilitative
facilities.  These regulations shall ensure that residents of these
facilities are assured appropriate developmental and supportive
health services in the most normal, least restrictive physical and
programmatic environments appropriate to individual resident needs.
Regulations adopted pursuant to this section shall include provision
for maximum utilization of generic community resources in the
provision of services to residents and participation of the residents
in community activities.
1267.8.  (a) An intermediate care facility/developmentally disabled
habilitative or an intermediate care facility/developmentally
disabled --nursing or a congregate living health facility shall meet
the same fire safety standards adopted by the State Fire Marshal
pursuant to Sections 13113, 13113.5, 13143, and 13143.6 that apply to
community care facilities, as defined in Section 1502, of similar
size and with residents of similar age and ambulatory status.  No
other state or local regulations relating  to fire safety shall apply
to these facilities and the requirements specified in this section
shall be uniformly enforced by state and local fire authorities.
   (b) An intermediate care facility/developmentally disabled
habilitative or an intermediate care facility/developmentally
disabled--nursing or a congregate living health facility shall meet
the same seismic safety requirements applied to community care
facilities of similar size with residents of similar age and
ambulatory status.  No additional requirements relating to seismic
safety shall apply to such facilities.
   (c) Whether or not unrelated persons are living together, an
intermediate care facility/developmentally disabled habilitative
which serves six or fewer persons or an intermediate care
facility/developmentally disabled--nursing which serves six or fewer
persons or a congregate living health facility shall be considered a
residential use of property for the purposes of this article. In
addition, the residents and operators of the facility shall be
considered a family for the purposes of any law or zoning ordinance
which is related to the residential use of property pursuant to this
article.
   For the purposes of all local ordinances, an intermediate care
facility/developmentally disabled habilitative which serves six or
fewer persons or an intermediate care facility/developmentally
disabled--nursing which serves six or fewer persons or a congregate
living health facility shall not be included within the definition of
a boarding house, rooming house, institution or home for the care of
minors, the aged, or the mentally infirm, foster care home, guest
home, rest home, sanitarium, mental hygiene home, or other similar
term which implies that the intermediate care
facility/developmentally disabled habilitative or intermediate care
facility/developmentally disabled--nursing or a congregate living
health facility is a business run for profit or differs in any other
way from a single-family residence.
   This section does not forbid any city, county, or other local
public entity from placing restrictions on building heights, setback,
lot dimensions, or placement of signs of an intermediate care
facility/developmentally disabled habilitative which serves six or
fewer persons or an intermediate care facility/developmentally
disabled--nursing which serves six or fewer persons or a congregate
living health facility as long as such restrictions are identical to
those applied to other single-family residences.
   This section does not forbid the application to an intermediate
care facility/developmentally disabled habilitative or an
intermediate care facility/developmentally disabled--nursing or a
congregate living health facility of any local ordinance which deals
with health and safety, building standards, environmental impact
standards, or any other matter within the jurisdiction of a local
public entity, as long as that ordinance does not distinguish
intermediate care facility/developmentally disabled habilitative
which serves six or fewer persons or an intermediate care
facility/developmenta lly disabled--nursing or a congregate living
health facility from other single-family dwellings and that the
ordinance does not distinguish residents of the intermediate care
facility/developmentally disabled habilitative or intermediate care
facility/developmentally disabled--nursing which serves six or fewer
persons or a congregate living health facility from persons who
reside in other single-family dwellings.
   No conditional use permit, zoning variance, or other zoning
clearance shall be required of an intermediate care
facility/developmentally disabled habilitative which serves six or
fewer persons or an intermediate care facility/developmentally
disabled--nursing which serves six or fewer persons or a congregate
living health facility which is not required of a single-family
residence in the same zone.
   Use of a single-family dwelling for purposes of an intermediate
care facility/developmentally disabled habilitative serving six or
fewer persons or an intermediate care facility/developmentally
disabled--nursing which serves six or fewer persons or a congregate
living health facility shall not constitute a change of occupancy for
purposes of Part 1.5 (commencing with Section 17910) of Division 13
or local building codes.  However, nothing in this section supersedes
Section 13143 to the extent these provisions are applicable to
intermediate care facility/developmentally disabled habilitative
providing care for six or fewer residents or an intermediate care
facility/developmentally disabled--nursing serving six or fewer
persons or a congregate living health facility.
1267.9.  (a) The Legislature hereby declares it to be the policy of
the state to prevent overconcentrations of intermediate care
facilities/development ally disabled habilitative, intermediate care
facilities/developmentally disabled-nursing, congregate living health
facilities, or pediatric day health and respite care facilities, as
defined in Section 1760.2, which impair the integrity of residential
neighborhoods.  Therefore, the director shall deny an application for
a new intermediate care facility/developmentally disabled
habilitative license, a new intermediate care
facility/developmentally disabled-nursing license, a congregate
living health facility, or a pediatric day health and respite care
facility license if the director determines that the location is in
such proximity to an existing intermediate care
facility/developmentally disabled habilitative, an intermediate care
facility/developmentally disabled-nursing, a congregate living health
facility, or a pediatric day health and respite care facility as
would result in overconcentration.
   (b) As used in this section, "overconcentration" means that if a
new license is issued, either of the following will occur:
   (1) There will be intermediate care facilities/developmentally
disabled habilitative, intermediate care facilities/developmentally
disabled-nursing, residential care facilities, as defined in Section
1502, or pediatric day health and respite care facilities which are
separated by a distance of less than 300 feet, as measured from any
point upon the outside walls of the structures housing the
facilities.
   (2) There will be congregate living health facilities serving
persons who are terminally ill, diagnosed with a life-threatening
illness, or catastrophically and severely disabled, as defined in
Section 1250, which are separated by a distance of less than 1,000
feet, as measured from any point upon the outside walls of the
structures housing the facilities.
   Based on special local needs and  conditions, the director may
approve a separation distance of less than 300 feet or 1,000 feet,
whichever is applicable, with the approval of the city or county in
which the proposed facility will be located.
   (c) At least 45 days prior to approving any application for a new
intermediate care facility/developmentally disabled habilitative, a
new intermediate care facility/developmentally disabled-nursing, a
congregate living health facility, or a pediatric day health and
respite care facility, the director shall notify, in writing, the
city or county planning authority in which the facility will be
located, of the proposed location of the facility.
   (d) Any city or county may request denial of the license applied
for on the basis of overconcentration of intermediate care
facilities/developmentally disabled habilitative, intermediate care
facilities/developmentally disabled-nursing, a congregate living
health facility, or a pediatric day health and respite care facility.
   (e) Nothing in this section authorizes the director, on the basis
of overconcentration, to refuse to renew an intermediate care
facility/development ally disabled habilitative license, an
intermediate care facility/developmental ly disabled-nursing license,
a congregate living health facility license, or a pediatric day
health and respite care facility license, or to refuse to grant a
license upon a change of ownership of an existing intermediate care
facility/developmentally disabled habilitative, intermediate care
facility/developmentally disabled-nursing, a congregate living health
facility, or a pediatric day health and respite care facility where
there is  no change in the location of the facility.
   (f) Foster family homes and residential care facilities for the
elderly shall  not be considered in determining overconcentration of
intermediate care facilities/developmentally disabled-habilitative,
intermediate care facilities/developmentally disabled-nursing,
residential care facilities, as defined in Section 1502, congregate
living health facilities, or pediatric day health and respite care
facilities.
1267.11.  Each intermediate care facility/developmentally
disabled-habilitative shall designate direct care staff persons to
supervise the direct care services to clients for at least 56 hours
per week.  The hours of these supervisory staff persons shall be
applied against the total number of direct care hours required in
regulations developed by the department pursuant to Section 1267.7.
These supervisory staff persons shall, at a minimum, meet one of the
following criteria:
   (a) Possession of a valid vocational nurse or psychiatric
technician license issued by the Board of Vocational Nurse and
Psychiatric Technician Examiners.
   (b) Completion of at least 30 college or university units in
education, social services, behavioral sciences, health sciences, or
related fields, and six months experience providing direct services
to developmentally disabled persons.
   (c) Eighteen months experience providing direct services to
developmentally disabled persons while under the supervision of a
person who meets the requirements of a mental retardation
professional as defined in regulations promulgated pursuant to
Section 1267.7.
1267.12.  No person shall be admitted, or accepted for care, or
discharged, by a congregate living health facility except upon the
order of a physician and surgeon.  Admission criteria shall be
subject to review and approval by the state department.  All persons
admitted or accepted for care by the congregate living health
facility shall remain under the care of a physician and surgeon who
shall see the resident at least every 30 calendar days or more
frequently if required by the resident's medical condition.
1267.13.  Pursuant to paragraph (3) of subdivision (a) and
subdivision (b) of Section 1265.7, this section shall be effective
until the adoption of permanent regulations.  Notwithstanding, the
state department has authority to make reasonable accommodation for
exceptions to the standards in this section, providing the health,
safety, and quality of patient care is not compromised.  No
exceptions shall be made for building standards.  Prior written
approval communicating the terms and conditions under which the
exception is granted shall be required.  Applicants shall request the
exception in writing accompanied by detailed, supporting
documentation.
   Congregate living health facilities serving persons who are
terminally ill, persons who are catastrophically and severely
disabled, persons who are mentally alert but physically disabled, or
any combination of these persons, shall conform to the following:
   (a) Facilities shall obtain and maintain a valid fire clearance
from the appropriate authority having jurisdiction over the facility,
based on compliance with state regulations concerning fire and life
safety, as adopted by the State Fire Marshal.
   (b) The State Fire Marshal, with the advice of the State Board of
Fire Services, shall adopt regulations on or before January 1, 1991,
following a public hearing, establishing minimum requirements for the
protection of life and property for congregate living health
facilities serving terminally ill persons, catastrophically and
severely disabled persons, persons who are mentally alert but
physically disabled, or any combination of these persons.  These
minimum requirements shall recognize the residential and
noninstitutional setting of congregate living health facilities
serving terminally ill persons, catastrophically and severely
disabled persons, persons who are mentally alert but physically
disabled, or any combination of these persons.
   (c) Facilities shall be in a homelike residential setting.  Living
accommodations and grounds shall be related to the facility's
function and clientele.  Facilities shall provide sufficient space
for comfortable living accommodations and privacy for residents,
staff, and others who may reside in the facility.
   (d) Common rooms, including, but not limited to, living rooms,
dining rooms, and dens or other recreation or activity rooms, shall
be provided and shall have sufficient space, separation, or both to
promote and facilitate the program of activities and to prevent these
activities from interfering with other functions.  Accommodations
shall ensure adequate space for residents to have visitors and for
privacy during visits, if desired.
   (e) Resident bedrooms shall have adequate space to allow easy
passage throughout; permit comfortable usage of furnishings; promote
ease of nursing care; and accommodate use of assistive devices,
including, but not limited to, wheelchairs, walkers, and patient
lifts, when needed.
   (f) No room commonly used for other purposes, including, but not
limited to, a hall, stairway, attic, garage, storage area, shed, or
similar detached building, shall be used as a sleeping room for any
resident.
   (g) No resident bedroom shall be used as a passageway to another
room, bath, or toilet.
   (h) Not more than two residents shall share a bedroom.
   (i) Equipment and supplies necessary for personal care and
maintenance of adequate hygiene shall be readily available to all
residents.
   (j) Toilets and bathrooms shall be conveniently located.  At least
one toilet and washbasin shall be provided per six residents.  At
least one bathtub or shower shall be provided per 10 residents.
Individual privacy shall be provided in all toilet, bath and shower
areas.  Separate toilet, washbasin, and bathtub or shower
accommodations shall be provided for staff.
   (k) Sufficient room shall be available throughout the facility to
accommodate and serve all persons in comfort and safety.  The
premises shall be maintained in good repair and shall provide a safe,
clean, and healthful environment.
   (l) Facilities shall have equipment and supplies appropriate to
meet the routine and specialized needs of all residents.
   (m) All persons shall be protected from hazards throughout the
premises:
   (1) Stairways, inclines, ramps, open porches, and other areas of
potential hazard to residents with poor balance or eyesight shall be
made inaccessible unless well lighted and equipped with sturdy hand
railings.
   (2) Night lights shall be maintained in hallways and passages to
nonprivate bathrooms.
   (3) All indoor and outdoor passageways and stairways shall be kept
free of obstructions.
   (4) Fireplaces, woodstoves, and open-faced heaters shall be
adequately screened.
   (5) Facilities shall assure the inaccessibility of fishponds,
wading pools, hot tubs, swimming pools, or similar bodies of water or
other areas of potential hazard when not in active use.
   (n) Facilities serving persons who are terminally ill,
catastrophically and severely disabled, mentally alert but physically
disabled, or any combination of these persons, shall, in addition to
the requirements of this chapter and until specific regulations
governing their operation are filed, conform to regulations contained
in  Chapter 3 of Division 5  of Title 22 of the California Code of
Regulations of April 1, 1988, with the exception of the following
sections or portions of sections:  72007, 72053, 72073, subdivision
(a) of Section 72077, 72097, 72099, 72103, 72203, subdivision (a) of
Section 72205, 72301, 72305, subdivision (a) of Section 72325, 72327,
72329, 72331, 72337, subdivisions (b), (g), and (h) of Section
72351, 72353, subdivision (a) of Section 72367, 72373, subdivision
(b) of Section 72375, 72401, 72403, 72405, 72407, 72409, 72411,
72413, 72415, 72417, 72419, 72421, 72423, 72425, 72427, 72429, 72431,
72433, 72435, 72437, 72439, 72441, 72443, 72445, 72447, 72449,
72451, 72453, 72455, 72457, 72459, 72461, 72463, 72465, 72467, 72469,
72471, 72473, 72475, 72503, paragraph (2) of subdivision (a) of
Section 72513, 72520, 72535, 72555, 72557, subdivisions (a) and (b)
of Section 72601, subdivision (d) of Section  72607, subdivisions (a)
and (d) of Section 72609, 72611, 72615, 72617, 72629, 72631, 72633,
72635, subdivisions (b), (c), and (d) of Section 72639, 72641, and
72665.
   (o) (1) Facilities serving persons who are terminally ill,
catastrophically and severely disabled, mentally alert but physically
disabled, or any combination of these persons, shall have an
administrator who is responsible for the day-to-day operation of the
facility.  The administrator may be either a licensed registered
nurse, a nursing home administrator, or the licensee.  The
administrator shall be present at the facility a sufficient number of
hours to ensure the smooth operation of the facility.  If the
administrator is also the registered nurse fulfilling the duties
specified in paragraph (2), the administrator shall not be
responsible for more than one facility.  In all other circumstances,
the administrator shall not be responsible for more than three
facilities with an aggregate total of 75 beds and these facilities
shall be within one hour's surface travel time of each other.
   (2) (A) For each congregate living health facility of more than
six beds serving persons who are terminally ill, catastrophically and
severely disabled, mentally alert but physically disabled, or any
combination of these persons, there shall be, at a minimum, a
registered nurse or licensed vocational nurse awake and on duty at
all times.  A registered nurse shall be awake and on duty eight hours
a day, five days a week.
   (B) For each congregate living health facility of six or fewer
beds serving persons who are terminally ill, catastrophically and
severely disabled, mentally alert but physically disabled, or any
combination of these persons, a registered nurse shall visit each
patient at least twice a week for approximately two hours, or more as
patient care requires.
   (C) For all congregate living health facilities serving persons
who are terminally ill, catastrophically and severely disabled,
mentally alert but physically disabled, or any combination of these
persons, a registered nurse shall be available for consultation and
able to come into the facility within 30 minutes, if necessary, when
no registered nurse is on duty.  In addition, certified nurse
assistants, or persons with similar training and experience as
determined by the department, shall be awake and on duty in the
facility in at least the following ratios:  facilities with six beds
or less, one per shift; facilities with 7 to 12 beds, two per shift;
facilities with 13 to 25 beds, three per day and evening shifts and
two per nocturnal shift.  No nursing services personnel shall be
assigned housekeeping or dietary duties.
   (3) Notwithstanding the provisions of this subdivision, the
facility shall provide appropriately qualified staff in sufficient
numbers to meet patient care needs.
   (4) Nursing service personnel shall be employed and on duty in at
least the number and with the qualifications determined by the
department to provide the necessary nursing services for patients
admitted for care.  The department may require a facility to provide
additional professional, administrative, or supportive personnel
whenever the state department determines through a written
evaluation, that additional personnel are needed to provide for the
health and safety of patients.
   (5) All staff members shall receive orientation regarding care
appropriate for the patients' diagnoses and individual resident
needs.  Orientation shall include a minimum of 16 hours during the
first 40 hours of employment.
   (6) Nothing in this chapter shall prevent the use of volunteers;
however, volunteers shall not be used as substitutes for the
personnel required in the above  sections.  Volunteers providing
patient care services shall:
   (A) Be provided clearly defined roles and written job
descriptions.
   (B) Receive orientation and training equivalent to that provided
paid staff.
   (C) Possess education and experience equal to that required of
paid staff performing similar functions.
   (D) Conform to the facility's policies and procedures.
   (E) Receive periodic performance evaluations.
   (p) The interim standards prescribed by this section shall become
inoperative upon the filing of the regulations with the Secretary of
State.
1267.15.  Congregate living health facilities shall be freestanding,
but this does not preclude their location on the premises of a
hospital.  Congregate living health facilities shall be separately
licensed.
1267.16.  (a) A congregate living health facility which serves six
or fewer persons shall be considered a residential use of property
for purposes of any zoning ordinance or law related to the
residential use of property.  This article does not forbid any city,
county, or local public entity from placing restrictions on building
heights, setback, lot dimensions, or placement of signs of a
congregate living health facility as long as these restrictions are
identical to those applied to single-family residences.
   (b) This article does not forbid the application to a congregate
living health facility of any local ordinance which deals with health
and safety, building standards, environmental impact standards, or
any other matter within the jurisdiction of a local public entity,
except as provided in subdivisions (a) and (b) of Section 1267.9 and
this section.
   (c) Any congregate living health facility of more than six beds
for persons who are terminally ill and any congregate living health
facility of more than six beds for persons who are catastrophically
and severely disabled shall be subject to the conditional use permit
requirements of the city or county in which it is located unless
those requirements are waived by the city or county.  However, any
facility that, on the effective date of this section, is performing
the functions of a congregate living health facility for persons who
are terminally ill and that is subsequently licensed as a congregate
living health facility within 18 months of the effective date of this
section shall not be subject to the conditional use permit
requirements of the city or county in which it is located, unless the
number of beds is increased.
1267.17.  Each congregate living health facility shall conspicuously
post the license, or a true copy thereof in a location accessible to
public view.
1267.19.  Congregate living health facilities shall not be subject
to architectural plan review by the Office of Statewide Health
Planning and Development.   As part of the application for licensure,
the prospective licensee shall submit evidence of compliance with
local building code requirements.  In addition, the physical
environment shall be adequate to provide the level of care and
service required by the residents of the facility as detemined by the
department.
1268.  (a) Upon the filing of the application for licensure or for a
special permit for special services and full compliance with this
chapter and the rules and regulations of the state department, the
state department shall issue to the applicant the license or special
permit applied for.  A license shall not be issued or renewed for
beds permanently converted to other than patient use and that do not
meet construction and operational requirements.  However, if the
director finds that the applicant is not in compliance with the laws
or regulations of this part, the director shall deny the applicant a
license or a special permit for special services.  Additionally, the
director shall not issue a license covering a project within the
meaning of Section 127170 for which there is no valid, subsisting,
and unexpired certificate of need issued pursuant to Chapter 1
(commencing with Section 127125) of Part 2 of Division 107.
   (b) As a condition of licensure, the director shall require
evidence that the applicant have a written policy relating to the
dissemination of the following information to patients:
   (1) A summary of current state laws requiring child passenger
restraint systems to be used when transporting children in motor
vehicles.
   (2) A listing of child passenger restraint system programs located
within the county, as required by Section 27360 or 27362 of the
Vehicle Code.
   (3) Information describing the risks of death or serious injury
associated with the failure to utilize a child passenger restraint
system.
   A hospital may satisfy the requirements of this paragraph by
reproducing for distribution materials specified in Section 27366 of
the Vehicle Code, describing the risks of injury or death as a result
of the failure to utilize passenger restraints for infants and
children, as provided, without charge, by the Department of the
California Highway Patrol.  A hospital that does not have these
materials, but demonstrates that it has made a written request to the
Department of the California Highway Patrol for the materials, is in
compliance with this paragraph.
   (c) The conversion of a general acute care hospital or special
hospital to a general acute care hospital that exclusively provides
acute medical rehabilitation center services shall not require a
certificate of need, as required by Section 127170, if the health
facility is rendering the services specified in subdivision (f) of
Section 1250 on January 1, 1979.
1268.5.  (a) Notwithstanding the provisions of Section 1268
requiring full compliance with this chapter and the rules and
regulations of the state department as a condition to the issuance of
a license or special permit, the state department may issue a
provisional license to a health facility except for a health facility
defined in subdivisions (a) and (b) of Section 1250, if:
   (1) The facility and the applicant for licensure substantially
meet the standards specified by this chapter and regulations adopted
pursuant to this chapter.
   (2) No violation of this chapter or regulations adopted pursuant
to this chapter exists in the facility which jeopardizes the health
or safety of patients.
   (3) The applicant has adopted a plan for correction of any
existing violations which is satisfactory to the state department.
   (b) A provisional license issued under this section shall expire
not later than six months after the date of issuance, or at an
earlier time as determined by the state department at the time of
issuance, and may not be renewed.  At the end of the provisional
license period under this section or Section 1437 the state
department shall assess the facility's full compliance with licensure
requirements.  The state department may  extend a provisional
license for a period of no longer than six months from the time of
the extension for one of the following purposes:
   (1) Requiring the facility's full compliance with a plan of
correction, which includes time frames, as specified by the state
department.
   (2) Allowing the provisional licensee to comply with Section
1336.2.
   (3) Providing for a change of ownership.
   (4) Instituting a receivership of the facility.
   The length of the extension period shall be determined by the
state department at the time of the issuance of the extension.
   (c) The department shall not apply less stringent criteria when
issuing a provisional license pursuant to this section than it
applies when issuing a license pursuant to Section 1268.
   It is the intent of the Legislature in enacting this section to
additionally provide for continuity of reimbursement under the
Medi-Cal Act, Chapter 7 (commencing with Section 14000) of Part 3 of
Division 9 of the Welfare and Institutions Code, whenever ownership
of a skilled nursing facility or intermediate care facility is
transferred.
1268.6.  Commencing July 1, 1997, it shall be a requirement of
initial licensure of an intermediate care facility/developmentally
disabled-habilitative or an intermediate care
facility/developmentally disabled-nursing that the applicant or
designee of the applicant attend an eight-hour orientation program
approved by the State Department of Developmental Services.
   (a) The eight-hour orientation program shall outline the role,
requirements, and regulations of each of the following:
   (1) The scope of responsibility for operation including regulatory
requirements and statutes governing the facility type.
   (2) Cost reporting.
   (3) Local planning.
   (4) Regional center and other community support services.
   (5) All federal and state agencies responsible for licensing and
certification, and data collection.
   (6) Government and private agencies responsible for ensuring the
rights of the developmentally disabled.
   (b) The orientation  shall be conducted by relevant community
services and provider organizations.  Organizations conducting the
orientation class shall be responsible for keeping a record of all
attendees and shall provide the department with the information
within 15 working days or upon request.  Instructors of the
orientation must have knowledge or experience in the subject area to
be taught, and shall meet any of the following criteria:
   (1) Possession of a four-year college degree relevant to the
course or courses to be taught.
   (2) Be a health professional with a valid and current license to
practice in California.
   (3) Have at least two years experience in California as an
administrator of a long-term health care facility that provides
services to persons with developmental disabilities within the last
eight years.
   (c) If the licensee can demonstrate to the satisfaction of the
department that the licensee or a representative of the licensee has
taken the orientation program within a two-year period prior to
opening a new facility, the licensee shall not be required to repeat
the program to open the facility.  This subdivision shall become
inoperative on July 1, 2001.
   (d) On or after July 1, 2001, if the licensee can demonstrate to
the satisfaction of the department that the licensee, or a
representative of the licensee, has taken the orientation program any
year prior to opening a new facility, the licensee shall not be
required to repeat the program to open the facility.
1269.  Immediately upon the denial of any application for a license
or for a special permit for special services, the state department
shall notify the applicant in writing.  Within 20 days after the
state department mails the notice, the applicant may present his
written petition for a hearing to the state department.  Upon receipt
by the state department of the petition in proper form, such
petition shall be set for hearing.  The proceedings shall be
conducted in accordance with Chapter 5 (commencing with Section
11500) of Part 1 of Division 3 of Title 2 of the Government Code, and
the state department has all the powers granted therein.
1270.  The provisions of this chapter do not apply to the following
institutions:
   (a) Any facility conducted by and for the adherents of any
well-recognized church or religious denomination for the purpose of
providing facilities for the care or treatment of the sick who depend
upon prayer or spiritual means for healing in the practice of the
religion of that church or denomination.
   (b) Hotels or other similar places that furnish only board and
room, or either, to their guests.
   (c) Any house or institution supplying board and room only, or
room only, or board only; provided, that no resident thereof requires
any element of medical care as determined by the department.
   For the purpose of this subdivision "medical care" means those
services required to be provided by health professionals in
accordance with the provisions of Division 2 (commencing with Section
500) of the Business and Professions Code.  In addition, medical
services means those services provided by health facilities as
defined in Sections 1250, 1250.2, and 1250.3 which includes nursing
care to patients whose primary need is for the availability of
licensed nursing care on an extended, continuous, intermittent, or
part-time basis.
   (d) Any facility as defined in Section 1502.
1271.  (a) The Legislature finds and declares that uniform
orientation and training are fundamental to ensuring a high level of
competency of state personnel charged with enforcing state law
regulating the licensure, certification, and inspection of long-term
health care facilities.
   (b) The state department shall develop, adopt, and implement
comprehensive continuing orientation and in-service training
programs.  The comprehensive programs shall, at a minimum, include,
but not be limited to, both of the following:
   (1) An orientation program consisting of instruction in basic
enforcement, inspection, investigation, and survey skills and
techniques, patients' rights and safety, health facility, clinic, and
agency licensing regulations, and supervised on-the-job training in
long-term health care facilities.
   (2) Ongoing in-service training to maintain continuing competency
in existing and new inspection, investigation, and enforcement
skills, patient care modalities, and to assure statewide uniform
interpretation and application of long-term health care facility
licensing regulations.
   (c) The state department shall establish and maintain a program
review function responsible for inspecting, monitoring, evaluating,
and providing consultative support and assistance to licensing and
certification field offices.  The program review shall ensure that
the licensing and certification field offices implement, enforce, and
interpret applicable state statutes, licensing regulations,
certification standards, and departmental policies and procedures in
an effective and uniform manner statewide.
1271.1.  (a) A health facility may place up to 50 percent of its
licensed bed capacity in voluntary suspension for a period not
exceeding three years, upon submitting written notification to the
state department and to the Office of Statewide Health Planning and
Development.  However, this section does not authorize a health
facility to deactivate all beds utilized for the provision of a basic
service or to deactivate all beds utilized for a special service or
other supplemental service for which the health facility holds a
special permit or licensure approval.  Prior to the expiration of the
voluntary suspension, the health facility may request an extension,
that may be granted by the director if the director finds, after
consultation with the Director of the Office of Statewide Health
Planning and Development, that there is no identified need for
additional beds (of the category suspended) in the service area of
the health facility.  If during a period of voluntary suspension
under this section the statewide Health Facilities and Services Plan
identifies a need for additional beds (of the category suspended) in
the health facility's service area, the Director of the Office of
Statewide Health Planning and Development may require the health
facility to terminate the voluntary suspension and exercise one of
the following options, at the discretion of the health facility:  (1)
place some or all of the suspended beds in operation, in accordance
with the identified need, within one year following his or her order,
or (2) alternatively have the beds deemed permanently converted to
other than patient use within the meaning of Section 1268.
   (b) A health facility may remove all or any portion of its
voluntarily suspended bed capacity from voluntary suspension by
request to the state department, which request shall be granted
unless the areas housing the suspended beds fail to meet currently
applicable operational requirements or fail to meet construction
requirements for the health facility in effect at the time the
request for suspension of the beds was received by the state
department.
   (c) While health facility beds are in suspension pursuant to
subdivision (a), the beds shall not be deemed to be permanently
converted to other than patient use, for purposes of Section 1268.
The requirements of this section shall not apply to any temporary
deactivation of beds necessitated by the work of construction or
other activities required with respect to a project for which a
certificate of need or certificate of exemption has been granted
pursuant to Chapter 1 (commencing with Section 127125) of Part 2 of
Division 107.  Nothing in this section shall in any way limit or
affect the authority of a health facility to use a portion of its
beds in one bed classification in another bed classification as
permitted by subdivision (a) of Section 127170, including the use of
general acute care beds as skilled nursing beds; provided, however,
that when beds in a particular classification are suspended pursuant
to this section, the remainder of the health facility's beds in the
same classification may not be used so as to result in elimination of
all beds utilized for provision of a basic service or utilized for
provision of a special service or other supplemental service for
which the health facility holds a special permit or licensure
approval.
1271.15.  (a) Notwithstanding any provision of law to the contrary,
including, but not limited to, Section 1271.1, a health facility may
do any of the following:
   (1) (A) It may place all or a portion of its licensed bed capacity
in voluntary suspension for the purposes of using the facility to
operate a licensed mental health rehabilitation center pursuant to
Section 5675 of the Welfare and Institutions Code after submitting
written notification to the State Department of Health Services and
to the Office of Statewide Health Planning and Development.  During
the period of voluntary suspense, the facility shall remain under the
jurisdiction of the office.  The office shall enforce both the
mental health rehabilitation center requirements and the health
facility requirements of the California Building Standards Code.
   (B) A mental health rehabilitation center operating under this
paragraph may remove all or any portion of its voluntarily suspended
bed capacity from voluntary suspension by submitting a request to the
State Department of Health Services.
   (C) The department shall grant the request under subparagraph (B)
to remove bed capacity from voluntary suspension and to reinstatement
of the health facility bed capacity, unless the facility fails to
meet currently applicable operational requirements for a health
facility.
   (b) This section authorizes the voluntary suspension of bed
capacity or surrender of a license by a health facility only for the
purpose of converting the facility for use as a licensed mental
health rehabilitation center pursuant to Section 5675 of the Welfare
and Institutions Code.