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) Hand hygiene shall include hand
washing with soap and water or using an alcohol-based sanitizer or any other
sanitizing method recommended by a medical professional, local health official,
health department , or other research-based medical authority.
(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 other potentially infectious material, 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 and visibly soiled with blood or body fluids or
other potentially infectious material.
(B) Walls and window coverings in client care
areas shall be dusted or cleaned on a regular schedule to ensure they are safe and
sanitary and 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 disinfected shall be discarded immediately in an appropriate waste
receptacle with a tight-fitting cover or otherwise made inaccessible to human
contact or transmission.
(E) For a
client's personal item(s) that cannot be disinfected, the licensee shall work with
the client to mitigate human contact or transmission.
(3) All staff who are assigned to assist clients
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) A syringe and needle shall only be used once
per injection on one resident and then properly disposed of in accordance with the
California Code of Regulations, Title 8, Section 5193.
(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 or other potentially infectious material 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 client care and coming
into direct contact with clients, such as bathing, dressing, or assisting with
incontinence when there is a risk of contact with blood, body fluids or other
potentially infectious material.
4.
Administering first aid.
(B) A
pair of gloves may not be used on multiple clients and shall be properly discarded
in between completing an interaction with one client and prior to an interaction
with another client 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 following the glove use as required by subsection (a)(4)(A) with one
client and prior to an interaction with another client.
(5) All staff and volunteers, regardless of having
direct contact with clients, shall practice and maintain respiratory etiquette, such
as covering the mouth and nose with a tissue or elbow rather than one's hand when
coughing or sneezing, to minimize exposure to potential illness.
(A) A tissue shall be disposed of in the nearest
waste receptacle with a tight-fitting cover immediately after use.
(6) All direct care staff assigned to
assist clients 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 shall be
disinfected using an EPA (Environmental Protection Agency ) approved disinfectant
prior to use for the care of another client.
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 clients in the facility are diagnosed with a contagious 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 contagious disease .
(A) The licensee shall consult with a medical
professional, local health official, health department , or other research-based
medical authority to determine the type of enhanced environmental cleaning based on
the contagious disease in the facility.
(B) The enhanced cleaning and disinfection shall
occur in any impacted areas and immediately after contact with a client who has a
contagious disease .
(2) All
staff and volunteers providing direct care to a client who has a contagious 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 medical professional, local health official,
health department , or other research-based medical authority to determine the type
of PPE to be used based on the contagious disease present in the facility.
(B) PPE shall be removed and discarded in the
nearest appropriate waste receptacle with a tight-fitting cover immediately
following the assisting with direct care for each client.
(C) The licensee shall ensure all staff and
volunteers are trained in the proper use of all required PPE prior to being around
clients and annually thereafter.
(D) PPE
shall be used when assisting with direct client care, such as bathing, or assisting
with incontinence.
(3) There
shall be separation and care of clients 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 Control Lead for the facility.
1. Contact information for the designated
Infection Control Lead shall be made available to the department upon
request.
2. A description shall be
included of how the Infection Control Lead 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 Control Lead 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
Control Lead.
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.
(d) When an emergency, as defined in
Government Code section
8558, or
federal emergency for a contagious 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 contagious
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 contagious 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 contagious
disease that are not already addressed in the Infection Control Plan, then the
licensee shall notify the Department of this determination within 15 calendar 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 any updates to the Emergency Infection Control
Plan should additional infection control measures to prevent, contain, and mitigate
the associated contagious 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 made available to clients, facility
staff and, if applicable, each clients' 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 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 made available to staff, clients and if applicable,
each client's representative, and submitted to the Department .
Notes
2. New section refiled 8-8-2022 as an emergency; operative 8-8-2022 (Register 2022, No. 32). A Certificate of Compliance must be transmitted to OAL by 11-7-2022 or emergency language will be repealed by operation of law on the following
3. New section refiled 11-7-2022 as an emergency; operative 11-7-2022 (Register 2022, No. 45). A Certificate of Compliance must be transmitted to OAL by 2-6-2023 or emergency language will be repealed by operation of law on the following
4. Certificate of Compliance as to 11-7-2022 order, including amendment of section, transmitted to OAL 2-3-2023 and filed 3-20-2023; amendments effective 7-1-2023 (Register 2023, No. 12).
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
4. Certificate of Compliance as to 11-7-2022 order, including amendment of section, transmitted to OAL 2-3-2023 and filed 3/20/2023; amendments effective
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.
No prior version found.