Suspension of Professional Certification Requirements for Certified Nurse Assistants (CNAs)

AFL 20-35.1 From the California Department of Public Health July 10, 2020 TO: All Facilities SUBJECT:Suspension of Professional Certification Requirements for Certified Nurse Assistants (CNAs) (This AFL supersedes AFL 20-35) ​AUTHORITY:      Proclamation of a State of Emergency (PDF) and Executive Orders N-27-20 (PDF) and N-39-20 (PDF) All Facilities Letter (AFL) Summary This AFL notifies all facilities of a temporary waiver of specified statutory and regulatory requirements for CNAs due to the state of emergency related to the COVID-19 outbreak.This AFL has been updated to provide a deadline for CNAs to complete Live Scan submission requirements following the resumption of Live Scan services.

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Suspension of Regulatory Enforcement of Hospital Requirements

AFL 20-26.3 From the California Department of Public Health July 3, 2020 TO: General Acute Care Hospitals SUBJECT: Suspension of Regulatory Enforcement of Hospital Requirements (This AFL supersedes AFL 20-26.2) ​AUTHORITY:     Proclamation of Emergency and Executive Order N-27-20 All Facilities Letter (AFL) Summary This AFL notifies hospitals of a temporary waiver of specified regulatory requirements due to the state of emergency related to the Coronavirus Disease 2019 (COVID-19) outbreak.This AFL has been updated to extend the waiver until March 1, 2021.This AFL provides clarifying changes for downgrading, changing, or eliminating services and conditions for which facilities may request a staffing waiver.  Pursuant to the Governor’s declaration of a state of emergency related to COVID-19, the Director of the California Department of Public Health (CDPH) may waive any of the licensing requirements of Chapter 2 of Division 2 of the Health and Safety Code (HSC) and accompanying regulations with respect to any hospital or health facility identified in HSC section 1250.

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Suspension of Regulatory Enforcement of Specified ADHC Requirements

AFL 20-34.1 From the California Department of Public Health June 26, 2020 TO:Adult Day Health Care Centers (ADHCs) SUBJECT: Suspension of Regulatory Enforcement of Specified ADHC Requirements (This AFL supersedes AFL 20-34) ​AUTHORITY:     Executive Order N-35-20 (PDF) ​All Facilities Letter (AFL) Summary This AFL notifies ADHCs of a temporary waiver of specified regulatory requirements due to the state of emergency related to the Coronavirus Disease 2019 (COVID-19) outbreak.This AFL has been updated to extend the waiver until March 1, 2021.

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Guidance for Limiting the Transmission of COVID-19 in Long-Term Care Facilities

AFL 20-22.3 From the California Department of Public Health June 26, 2020 TO: Long-Term Care Facilities SUBJECT: Guidance for Limiting the Transmission of COVID-19 in Long-Term Care Facilities (This AFL supersedes guidance provided in AFL 20-22.2) All Facilities Letter (AFL) Summary This AFL notifies long-term care (LTC) facilities of Centers for Medicare and Medicaid Services (CMS) and Centers for Disease Control and Prevention (CDC) guidance for improving their infection control and prevention practices to prevent the transmission of Coronavirus Disease 2019 (COVID-19), including revised guidance for visitation.This AFL authorizes LTC facilities to temporarily modify their facility’s visitation policies in accordance with CMS and CDC COVID-19 guidance when necessary to protect the health and safety of residents, staff, and the public.This AFL updates visitation guidance in accordance with revised CMS guidance in order to safely reopen SNFs to visitors.

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Suspension of Regulatory Enforcement of Hospital Requirements

AFL 20-26.1 From the California Department of Public Health June 26, 2020 TO: General Acute Care Hospitals SUBJECT: Suspension of Regulatory Enforcement of Hospital Requirements (This AFL supersedes AFL 20-26) ​AUTHORITY:     Executive Order N-27-20 All Facilities Letter (AFL) Summary This AFL notifies hospitals of a temporary waiver of specified regulatory requirements due to the state of emergency related to the Coronavirus Disease 2019 (COVID-19) outbreak.This AFL has been updated to extend the waiver until March 1, 2021.

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Visitor Limitations Guidance

AFL 20-38.2 From the California Department of Public Health June 16, 2020 TO: All Facilities SUBJECT: Visitor Limitations Guidance (This AFL supersedes AFL 20-38.1) All Facilities Letter (AFL) Summary This AFL notifies all facilities of updated visitor guidelines for pediatric patients, patients in labor and delivery, and patients at end-of-life and patients with physical, intellectual, and/or developmental disabilities and patients with cognitive impairments.This AFL clarifies that health facilities may permit a support person to accompany a patient for whom a support person has been determined to be essential to the care of the patient (medically necessary), including patients with physical, intellectual, and/or developmental disabilities and patients with cognitive impairments.This AFL has been updated to include updated guidance for neonatal intensive care unit (NICU) and pediatric intensive care unit patients (PICU).

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Guidance for Limiting the Transmission of COVID-19 in Long-Term Care Facilities

AFL 20-22.2 From the California Department of Public Health June 1, 2020 TO: All Long-Term Care Facilities SUBJECT: Guidance for Limiting the Transmission of COVID-19 in Long-Term Care Facilities (This AFL supersedes guidance provided in AFL 20-22.1) All Facilities Letter (AFL) Summary This AFL notifies long-term care facilities of Centers for Medicare and Medicaid Services (CMS) and Centers for Disease Control and Prevention (CDC) guidance for improving their infection control and prevention practices to prevent the transmission of COVID-19, including revised guidance for visitation.

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Coronavirus Disease 2019 (COVID-19) Mitigation Plan Recommendations for Testing of Health Care Personnel (HCP) and Residents at Skilled Nursing Facilities (SNF)

AFL 20-53 From the California Department of Public Health May 22, 2020 TO: Skilled Nursing Facilities SUBJECT: Coronavirus Disease 2019 (COVID-19) Mitigation Plan Recommendations for Testing of Health Care Personnel (HCP) and Residents at Skilled Nursing Facilities (SNF) All Facilities Letter (AFL) Summary This AFL provides recommendations from the California Department of Public Health (CDPH) for SNFs developing COVID-19 Mitigation Plans.

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SNF Coronavirus Disease 2019 (COVID-19) Daily Reporting

AFL 20-43.2 From the California Department of Public Health May 13, 2020 TO: Skilled Nursing Facilities (SNFs) SUBJECT: SNF Coronavirus Disease 2019 (COVID-19) Daily Reporting(This AFL supersedes AFL 20-43.1) ​AUTHORITY:      Title 42 Code of Federal Regulations (CFR) section 483.80                                 Proclamation of Emergency (PDF) All Facilities Letter (AFL) Summary This AFL requires all SNFs to report daily COVID-19 facility data to the California Department of Public Health (CDPH) via an online survey.

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Guidance for Decontamination and Reuse of N95 Filtering Facepiece Respirators

AFL 20-36.2 From the California Department of Public Health May 7, 2020 TO: General Acute Care Hospitals Skilled Nursing Facilities SUBJECT: Guidance for Decontamination and Reuse of N95 Filtering Facepiece Respirators(This AFL supersedes AFL 20-36.1) All Facilities Letter (AFL) Summary This AFL provides guidance for the handling of used N95 FFRs so they can be decontaminated and reused as respirator supplies are depleted during the Coronavirus Disease 2019 (COVID-19) pandemic.This AFL updates instructions on how to sign-up for the Battelle CCDS Critical Care Decontamination SystemTM and how to collect, properly package, and ship the used N95 FFRs to Battelle for decontamination.

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