Adult and Senior Care Update for 2007

Adult and Senior Care Update for 2007
This is the third issue of the Adult and Senior Care Update for 2007. We appreciate
your support in sharing these updates with members of your organization and others
interested in adult and senior care issues.
To assist facilities in preparing for an emergency or disaster situation, the Community
Care Licensing Division (CCLD) has an updated Emergency and Disaster
Preparedness Self-Assessment Guide on its website. The Guide is designed to be a
tool for licensees and staff to identify and correct deficiencies in their response to
emergencies and disasters. Disaster preparedness is an important component in the
overall health and safety of facility clients/residents. As winter approaches, licensees
are urged to assess their emergency plans by reviewing the online Guide at


Assembly Bill (AB) 2609, which becomes operative January 1, 2008, added
Section 1569.69 to the Health and Safety (H&S) Code. It requires direct care staff
in RCFEs, excluding licensed medical professionals, to meet specified medication
training requirements in order to assist residents with the self-administration of
The CCLD Senior Care Policy Unit has been receiving numerous questions about the
requirements of AB 2609. An Information Release that addresses these questions is
being developed. In the interim, the following information is intended to address some
of the broader issues that have been raised.
CCLD Administrator Certification Section (ACS) and AB 2609
Currently, some training providers are offering courses on “AB 2609 Medication
Training,” stating that these courses are approved by CCLD’s Administrator Certification
Section (ACS).
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The ACS approval of courses is limited only to approval for purposes of Administrator
Certification requirements. The ACS may only approve vendors that provide initial and
continuing education courses for the purpose of providing classroom hours of training
for individuals seeking to obtain initial certification as administrators or to meet ongoing
continuing education requirements as set forth in H&S Code section 1569.616.
ACS has no authority to approve any courses or components of the AB 2609 training
requirements. ACS may approve courses within the subject area of medication training
for initial or continuing education units, however, the approval criteria is not the same. It
is the responsibility of each licensee to ensure that the training in H&S Code
section 1569.69 is provided to staff as specified.
AB 2609 General Reminders
• The medication training material and exam for all RCFEs must be developed by, or
in consultation with, a licensed nurse, pharmacist or physician.
• The medication training components include the hands-on shadowing training,
training or instruction in the nine topics specified in statute, and passing an
examination that tests the employee’s comprehension of, and competency in, the
subjects specified in H&S Code section 1569.69(a)(4).
• The hands-on shadowing component of the training must be provided at the facility
by a licensed nurse, pharmacist or physician or by a trainer who meets the
education and experience requirements in H&S Code section 1569.69(e) and must
be completed prior to staff assisting residents with the self-administration of
• The training on the nine topics, including passing an examination on these topics,
must be completed within the first two weeks of employment if the employee’s duties
include assistance with the self-administration of medication.
• If an employee goes to work for another licensee in an RCFE and will be assisting
residents with the self-administration of medication, then the medication training
must be completed again. Certain exceptions may apply.
• Employee medication training requirements must be repeated if an employee of an
RCFE has a break of service of more than 180 consecutive calendar days and then
returns to work for the same licensee and will be assisting residents with the self administration
of medication.
As of January 1, 2008, these medication training requirements must be met by all staff
assisting residents with the self-administration of medication. For more information on
AB 2609, please go to

Employers are reminded that the California Department of Industrial Relations (DIR)
requires information related to wages, hours and working conditions to be posted in the
workplace in an area visible to all employees. Additional posting requirements apply to
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some workplaces. For information regarding workplace postings and to obtain copies
visit DIR’s website at or call (415) 703-5070.
California Health and Safety Code sections 1522 and 1569.17 require background
checks of all applicants, licensees, adult residents (other than the clients), volunteers
(under certain conditions), and employees of community care facilities who have contact
with clients. If a background check reveals that an individual has been convicted of a
crime other than a minor traffic violation, the individual may not work or be present in
any community care facility unless he or she receives a criminal record exemption from
the CCLD Caregiver Background Check Bureau. Individuals must obtain a criminal
background clearance or criminal record exemption before working or volunteering at
licensed facilities. For further information on CCLD background check and criminal
record exemption processes, please visit our website at or contact your local CCLD licensing

With the cold and flu season beginning, licensees are encouraged to remind everyone
in their facility to practice respiratory hygiene/cough etiquette at the first sign of a
respiratory illness. In particular, handwashing is considered the single most
effective infection-control measure known to reduce the spread of infection in
any facility. With that in mind, the California Department of Public Health (CDPH),
formerly the California Department of Health Services, recommends that licensees take
the following steps to help stop the spread of illness this fall and winter:
• Post signs. Consider posting signs requesting clients/residents to inform facility
staff if they have symptoms of a respiratory infection.
• Provide plenty of tissues. Provide tissues or masks to clients/residents and facility
visitors who are coughing or sneezing so that they can cover their nose and mouth.
• Provide handwashing supplies. Make handwashing supplies available where
sinks are located, and provide dispensers of alcohol-based hand rubs in other
• Sit three feet away. Provide space for and encourage coughing persons to sit at
least three feet away from others, if tolerated.
• Keep wastebaskets handy. Provide wastebaskets or sealable plastic bags for
tissues or materials soiled with nasal or respiratory secretions.
For more information on respiratory hygiene/cough etiquette, please go to

FLU GUIDELINES/VACCINATIONS – As other reminders, all staff and clients/residents
should be vaccinated against the flu each autumn; contact your physician or local health
department. In addition, CDPH recommendations for the prevention and control of
outbreaks of influenza and viral gastroenteritis (“stomach flu”) in California long-term
care facilities are available on the CCLD web site at: Shortened versions of these
recommendations, adapted for licensed residential community care facilities with
CDPH input, are also available at this web site.


The California Department of Education’s Nutrition Services Division administers the
Child and Adult Care Food Program (CACFP) throughout California. To enhance the
health and well-being of the participants, CACFP provides a supplemental
reimbursement to adult day care programs so they can provide nutritious meals to their
clients. The program is available to all licensed non-residential day care centers that
care for adults age 60 or older and for functionally-impaired persons age 18 or older.
In addition to being licensed or approved, participating centers must also demonstrate
compliance with the following key standards:
• Service to functionally-impaired adults.
• A structured, comprehensive program of health, social, and related support
• Development and maintenance of an individual plan of care for every
functionally-impaired participant.
For additional information, or to request an application, call (800) 952-5609 and ask to
be connected to an Adult Day Care Center Specialist.

In July 2007, Castleberry’s Food Company of Augusta, Georgia, recalled 23 canned
food products suspected of containing Clostridium botulinum, a bacterium that can
cause botulism. The recalled products are marketed under 26 different Castleberry’s
brand names and all “best buy” and code dates are included.
According to the Centers for Disease Control (CDC), food borne botulism is a rare but
serious paralytic illness that occurs when foods containing the botulinum toxin are
consumed. Symptoms of botulism include general weakness, dizziness, double-vision,
and trouble with speaking or swallowing. Difficulty in breathing, weakness of other
muscles, abdominal distension and constipation may also be common symptoms.
Facility licensees and/or staff are urged to check all canned goods on their shelves to
ensure they do not have any of these products.
A complete list of the recalled products, as well as disposal and refund instructions, can
be found at Castleberry’s website at, or contact Castleberry’s
consumer hotline at (800) 203-4412. For more information about botulism, visit the
CDC’s website at, or call
(800) 311-3435.