Cal. Code Regs. Tit. 22, § 85095.5 - Infection Control Requirements
(a) A licensee shall ensure that infection
control practices are maintained as follows:
(1) All staff and volunteers shall perform
hand hygiene.
(A) When conducting hand
washing, the method shall include the following: Wet hands with clean water and
apply soap. Lather hands by rubbing them together with soap. Lather the backs
of the hands, between the fingers, and under the nails. Scrub hands for at
least 20 seconds. Rinse hands well under clean, running water. Dry hands using
a clean towel (disposable or non-disposable) or air dry.
(B) Hand hygiene shall be conducted as
follows:
1. Immediately before and after
client care.
2. Before and after
handling, preparing or eating foods.
3. Before and after assisting with
medications.
4. After contact with
blood, body fluids, or contaminated surfaces.
5. Immediately before putting gloves on and
immediately after removing gloves.
6. When hands are visibly soiled.
(2) Environmental
cleaning and disinfection activities shall be performed following the
manufacturers' instructions for proper use of the cleaning and disinfecting
products. These activities shall be completed, at a minimum, as follows:
(A) Surfaces such as floors, chairs, toilets,
sinks, counters and tabletops shall be cleaned and disinfected on a regular
basis to ensure they are safe and sanitary. These surfaces shall also be
disinfected when these surfaces are contaminated or visibly soiled.
(B) Walls and window coverings in resident
care areas shall be dusted or cleaned on a regular schedule to ensure they are
safe and sanitary or when they are visibly contaminated or soiled.
(C) Spills of blood and other potentially
infectious materials and surfaces shall be promptly cleaned and
disinfected.
(D) Facility items
that cannot be decontaminated (ex: blood) shall be discarded immediately in an
appropriate waste receptacle with a tight-fitting cover immediately or
otherwise made inaccessible to human contact or transmission.
(E) For a resident's personal item(s) that
cannot be decontaminated, the licensee shall develop a plan with the resident
to mitigate human contact or transmission.
(3) All direct care staff who assist
residents with the self-administration of injectable medication shall observe
the following procedures:
(A) Medications
administered by injection shall be drawn up in a clean area.
(B) The same syringe and needle shall only be
used to assist one resident and then properly disposed of after each use in a
puncture-resistant waste receptable with a tight-fitting cover. A medication
vial shall not be entered with a used syringe or needle.
(C) The top of a medication vial shall always
be cleaned with an alcohol swab before needle entry.
(4) All facility staff and volunteers shall
use gloves as a protective barrier to prevent the spread of potential infection
as specified below.
(A) Gloves shall always be
worn when:
1. Coming into contact with blood
or body fluids such as saliva, stool, vomit or urine.
2. There is a cut or open wound on the hands
of the staff or volunteer.
3.
Assisting with direct resident care and coming into direct contact with
residents, such as bathing, dressing, or assisting with incontinence.
4. Administering first aid.
(B) A pair of gloves may not be
used on multiple residents and shall be properly discarded in between tasks or
after being used as described in subsection (a)(4) above.
(C) Gloves shall be removed and discarded in
the nearest appropriate waste receptacle with a tight-fitting cover immediately
upon completing a task.
(5) All staff and volunteers, regardless of
having direct contact with clients, shall practice and maintain respiratory
etiquette as specified below to minimize exposure to potential illness.
(A) The mouth and nose shall be covered with
a tissue or one's upper sleeve or elbow rather than one's hand(s), when
coughing or sneezing.
(B) A tissue
shall be disposed of in the nearest waste receptacle with a tight-fitting cover
immediately after use.
(6) All direct care staff and volunteers
assigned to assist residents with the self-administration of medication or
assigned to the care of a client shall clean and disinfect reusable medical
equipment as follows:
(A) Reusable medical
equipment, such as blood pressure cuffs, shall be disinfected using an EPA
(Environmental Protection Agency) approved disinfectant prior to use for the
care of another resident.
1. Physical
separation between clean and soiled equipment shall be maintained to prevent
cross contamination.
(b) In addition to subsection (a), when one
or more residents in the facility are diagnosed with a communicable disease,
the following shall apply:
(1) In addition to
the requirements of subsection (a)(2), assigned staff and volunteers,
regardless of having direct contact with clients, shall be required to perform
enhanced environmental cleaning and disinfection to maintain a safe and
sanitary environment and to prevent, contain, and mitigate the transmission of
the communicable disease. Enhanced environmental cleaning and disinfection
shall be of:
(A) all frequently touched
surfaces such as doorknobs, handles, and shared items, as well as,
(B) when one or more client(s) has a
communicable disease, in any impacted areas and immediately after contact with
a client who has a communicable disease.
(2) All staff and volunteers providing direct
care to a resident who has a communicable disease shall wear appropriate
Personal Protective Equipment (PPE) to prevent exposure to infectious agents or
chemicals through the respiratory system, skin, or mucous membranes of the
eyes, nose, or mouth. PPE may include gloves, gowns, masks, respirators, shoe
coverings and eye protection.
(A) The licensee
shall consult with a local health official or a licensed medical professional
to determine the type of PPE to be used based on the communicable disease
present in the facility.
(B) PPE
shall be removed and discarded in the nearest appropriate waste receptacle with
a tight-fitting cover immediately upon completing a task.
(C) The licensee shall ensure all staff and
volunteers are trained in the proper use of all required PPE prior to being
around residents and annually thereafter.
(D) PPE shall be used when assisting with
direct resident care, such as bathing, or assisting with
incontinence.
(3) There
shall be separation and care of residents whose illness requires separation,
including quarantine or isolation, from others.
(c) An Infection Control Plan shall be
developed by the licensee and shall be included in the Plan of Operation
required by Section
85022.
(1) The Infection Control Plan shall include
all of the following:
(A) Identification of a
staff position to perform the duties of an Infection Preventionist for the
facility.
1. Contact information for the
designated Infection Preventionist shall be made available to the department
upon request.
2. A description
shall be included of how the Infection Preventionist shall be trained by a
medical professional, local health official, health department, or other
research-based medical authority that provides infection control training that
will include enforcement of the Infection Control Plan.
(B) A description of how the licensee shall
meet the specific infection control practice requirements of subsections (a),
(b) and (d).
(C) An Infection
Control Training Plan.
1. Initial training
requirements for new facility staff shall be addressed in the plan, with
training to be provided by the Infection Preventionist within 10 calendar days
of employment.
2. Ongoing training
requirements for all facility staff shall be addressed by the plan, with
training to be provided by the Infection Preventionist.
3. The description of initial and ongoing
training shall address the requirements of subsections (a), (b) and
(d).
(D) The licensee
shall review the use of infection control procedures in the facility at least
annually, if local government public health determines an epidemic outbreak has
occurred, or if the review is requested by the local licensing
agency.
(E) The licensee shall
ensure that staff encourage clients to follow infection control practices as
necessary.
(F) Staff shall
demonstrate knowledge of and skill in infection control, as appropriate to the
job assigned and as evidenced by safe and effective job performance.
(d) When an emergency,
as defined in Government Code section
8558,
or federal emergency for a communicable disease is proclaimed or declared, the
licensee shall develop an Emergency Infection Control Plan that includes
infection control measures that are not already addressed in the Infection
Control Plan as specified in subsection (c), to prevent, contain, and mitigate
the associated communicable disease.
(1) The
Emergency Infection Control Plan shall include the applicable infection control
measures required by the federal, state, and local government public health
authorities for the communicable disease, and shall be completed and sent to
the Department within 15 calendar days from the date the state or federal
emergency is proclaimed or declared. In the event there are differing standards
between the government public health authorities, the licensee shall follow the
strictest requirement.
(2) If there
are no additional infection control measures to be taken to prevent, contain,
and mitigate the associated communicable disease that are not already addressed
in the Infection Control Plan, then the licensee shall notify the Department of
this determination within 15 days from the date on which the state or federal
emergency is proclaimed or declared.
(A) The
licensee shall complete and send to the Department within 15 calendar days an
Emergency Infection Control Plan should additional infection control measures
to prevent, contain, and mitigate the associated communicable disease be
recommended by federal, state, and local government public health authorities
or the Department that are not already addressed in the Infection Control
Plan.
(3) The Emergency
Infection Control Plan shall be submitted to the Department and used until the
proclaimed or declared state of emergency is no longer in effect.
(4) The Emergency Infection Control Plan
shall be distributed to residents, facility staff and, if applicable, each
residents' authorized representative.
(5) All staff shall be trained on the
Emergency Infection Control Plan immediately but no later than 10 calendar days
after submission to the Department.
(6) The Emergency Infection Control Plan
shall be reviewed and updated as necessary every 30 calendar days, or whenever
new infection control measures are recommended by the federal, state, and local
government public health authorities, or as determined by the Department, until
the proclaimed or declared state of emergency is no longer in effect. Any
updates to the plan shall be shared with staff, residents and if applicable,
each resident's authorized representative, and submitted to the
Department.
Notes
Note: Authority cited: Section 1530, Health and Safety Code. Reference: Sections 1501 and 1531, Health and Safety Code.
2. new section refiled 8-8-2022 as an emergency; operative
3. New section refiled 11-7-2022 as an emergency; operative
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
(a) A licensee shall ensure that infection control practices are maintained as follows:
(1) All staff and volunteers shall perform hand hygiene.
(A) When conducting hand washing, the method shall include the following: Wet hands with clean water and apply soap. Lather hands by rubbing them together with soap. Lather the backs of the hands, between the fingers, and under the nails. Scrub hands for at least 20 seconds. Rinse hands well under clean, running water. Dry hands using a clean towel (disposable or non-disposable) or air dry.
(B) Hand hygiene shall be conducted as follows:
1. Immediately before and after client care.
2. Before and after handling, preparing or eating foods.
3. Before and after assisting with medications.
4. After contact with blood, body fluids, or contaminated surfaces.
5. Immediately before putting gloves on and immediately after removing gloves.
6. When hands are visibly soiled.
(2) Environmental cleaning and disinfection activities shall be performed following the manufacturers' instructions for proper use of the cleaning and disinfecting products. These activities shall be completed, at a minimum, as follows:
(A) Surfaces such as floors, chairs, toilets, sinks, counters and tabletops shall be cleaned and disinfected on a regular basis to ensure they are safe and sanitary. These surfaces shall also be disinfected when these surfaces are contaminated or visibly soiled.
(B) Walls and window coverings in resident care areas shall be dusted or cleaned on a regular schedule to ensure they are safe and sanitary or when they are visibly contaminated or soiled.
(C) Spills of blood and other potentially infectious materials and surfaces shall be promptly cleaned and disinfected.
(D) Facility items that cannot be decontaminated (ex: blood) shall be discarded immediately in an appropriate waste receptacle with a tight-fitting cover immediately or otherwise made inaccessible to human contact or transmission.
(E) For a resident's personal item(s) that cannot be decontaminated, the licensee shall develop a plan with the resident to mitigate human contact or transmission.
(3) All direct care staff who assist residents with the self-administration of injectable medication shall observe the following procedures:
(A) Medications administered by injection shall be drawn up in a clean area.
(B) The same syringe and needle shall only be used to assist one resident and then properly disposed of after each use in a puncture-resistant waste receptable with a tight-fitting cover. A medication vial shall not be entered with a used syringe or needle.
(C) The top of a medication vial shall always be cleaned with an alcohol swab before needle entry.
(4) All facility staff and volunteers shall use gloves as a protective barrier to prevent the spread of potential infection as specified below.
(A) Gloves shall always be worn when:
1. Coming into contact with blood or body fluids such as saliva, stool, vomit or urine.
2. There is a cut or open wound on the hands of the staff or volunteer.
3. Assisting with direct resident care and coming into direct contact with residents, such as bathing, dressing, or assisting with incontinence.
4. Administering first aid.
(B) A pair of gloves may not be used on multiple residents and shall be properly discarded in between tasks or after being used as described in subsection (a)(4) above.
(C) Gloves shall be removed and discarded in the nearest appropriate waste receptacle with a tight-fitting cover immediately upon completing a task.
(5) All staff and volunteers, regardless of having direct contact with clients, shall practice and maintain respiratory etiquette as specified below to minimize exposure to potential illness.
(A) The mouth and nose shall be covered with a tissue or one's upper sleeve or elbow rather than one's hand(s), when coughing or sneezing.
(B) A tissue shall be disposed of in the nearest waste receptacle with a tight-fitting cover immediately after use.
(6) All direct care staff and volunteers assigned to assist residents with the self-administration of medication or assigned to the care of a client shall clean and disinfect reusable medical equipment as follows:
(A) Reusable medical equipment, such as blood pressure cuffs, shall be disinfected using an EPA (Environmental Protection Agency) approved disinfectant prior to use for the care of another resident.
1. Physical separation between clean and soiled equipment shall be maintained to prevent cross contamination.
(b) In addition to subsection (a), when one or more residents in the facility are diagnosed with a communicable disease, the following shall apply:
(1) In addition to the requirements of subsection (a)(2), assigned staff and volunteers, regardless of having direct contact with clients, shall be required to perform enhanced environmental cleaning and disinfection to maintain a safe and sanitary environment and to prevent, contain, and mitigate the transmission of the communicable disease. Enhanced environmental cleaning and disinfection shall be of:
(A) all frequently touched surfaces such as doorknobs, handles, and shared items, as well as,
(B) when one or more client(s) has a communicable disease, in any impacted areas and immediately after contact with a client who has a communicable disease.
(2) All staff and volunteers providing direct care to a resident who has a communicable disease shall wear appropriate Personal Protective Equipment (PPE) to prevent exposure to infectious agents or chemicals through the respiratory system, skin, or mucous membranes of the eyes, nose, or mouth. PPE may include gloves, gowns, masks, respirators, shoe coverings and eye protection.
(A) The licensee shall consult with a local health official or a licensed medical professional to determine the type of PPE to be used based on the communicable disease present in the facility.
(B) PPE shall be removed and discarded in the nearest appropriate waste receptacle with a tight-fitting cover immediately upon completing a task.
(C) The licensee shall ensure all staff and volunteers are trained in the proper use of all required PPE prior to being around residents and annually thereafter.
(D) PPE shall be used when assisting with direct resident care, such as bathing, or assisting with incontinence.
(3) There shall be separation and care of residents whose illness requires separation, including quarantine or isolation, from others.
(c) An Infection Control Plan shall be developed by the licensee and shall be included in the Plan of Operation required by Section 85022.
(1) The Infection Control Plan shall include all of the following:
(A) Identification of a staff position to perform the duties of an Infection Preventionist for the facility.
1. Contact information for the designated Infection Preventionist shall be made available to the department upon request.
2. A description shall be included of how the Infection Preventionist shall be trained by a medical professional, local health official, health department, or other research-based medical authority that provides infection control training that will include enforcement of the Infection Control Plan.
(B) A description of how the licensee shall meet the specific infection control practice requirements of subsections (a), (b) and (d).
(C) An Infection Control Training Plan.
1. Initial training requirements for new facility staff shall be addressed in the plan, with training to be provided by the Infection Preventionist within 10 calendar days of employment.
2. Ongoing training requirements for all facility staff shall be addressed by the plan, with training to be provided by the Infection Preventionist.
3. The description of initial and ongoing training shall address the requirements of subsections (a), (b) and (d).
(D) The licensee shall review the use of infection control procedures in the facility at least annually, if local government public health determines an epidemic outbreak has occurred, or if the review is requested by the local licensing agency.
(E) The licensee shall ensure that staff encourage clients to follow infection control practices as necessary.
(F) Staff shall demonstrate knowledge of and skill in infection control, as appropriate to the job assigned and as evidenced by safe and effective job performance.
(d) When an emergency, as defined in Government Code section 8558, or federal emergency for a communicable disease is proclaimed or declared, the licensee shall develop an Emergency Infection Control Plan that includes infection control measures that are not already addressed in the Infection Control Plan as specified in subsection (c), to prevent, contain, and mitigate the associated communicable disease.
(1) The Emergency Infection Control Plan shall include the applicable infection control measures required by the federal, state, and local government public health authorities for the communicable disease, and shall be completed and sent to the Department within 15 calendar days from the date the state or federal emergency is proclaimed or declared. In the event there are differing standards between the government public health authorities, the licensee shall follow the strictest requirement.
(2) If there are no additional infection control measures to be taken to prevent, contain, and mitigate the associated communicable disease that are not already addressed in the Infection Control Plan, then the licensee shall notify the Department of this determination within 15 days from the date on which the state or federal emergency is proclaimed or declared.
(A) The licensee shall complete and send to the Department within 15 calendar days an Emergency Infection Control Plan should additional infection control measures to prevent, contain, and mitigate the associated communicable disease be recommended by federal, state, and local government public health authorities or the Department that are not already addressed in the Infection Control Plan.
(3) The Emergency Infection Control Plan shall be submitted to the Department and used until the proclaimed or declared state of emergency is no longer in effect.
(4) The Emergency Infection Control Plan shall be distributed to residents, facility staff and, if applicable, each residents' authorized representative.
(5) All staff shall be trained on the Emergency Infection Control Plan immediately but no later than 10 calendar days after submission to the Department.
(6) The Emergency Infection Control Plan shall be reviewed and updated as necessary every 30 calendar days, or whenever new infection control measures are recommended by the federal, state, and local government public health authorities, or as determined by the Department, until the proclaimed or declared state of emergency is no longer in effect. Any updates to the plan shall be shared with staff, residents and if applicable, each resident's authorized representative, and submitted to the Department.
Notes
Note: Authority cited: Section 1530, Health and Safety Code. Reference: Sections 1501 and 1531, Health and Safety Code.
2. new section refiled 8-8-2022 as an emergency; operative