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Licensing and certification Program

All Facilities Letters - 2020

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*All Facilities Letters are listed in ascending order by release date, with updated AFLs listed directly after their original version

Bulletin NumberFacility Type Affected Subject Release Date
AFL 20-01 (PDF)Skilled Nursing FacilitiesReminder of Mandatory use of ā€œCensus and Direct Care Service Hours Per Patient Day (DHPPD)ā€ (CDPH Form 612) and ā€œNursing Staffing Assignment and Sign-in Sheet (DHPPD Salaried/Dual Role/Nurse Assistant)ā€ (CDPH Form 530) 01/06/2020
AFL 20-02 (PDF) All FacilitiesChanges to the Application Review Process01/06/2020
AFL 20-03 (PDF) Skilled Nursing FacilitiesAnnouncement: Online Application Period for Patient Needs Waiver (PNW) and Workforce Shortage Waiver (WSW)01/06/2020
ā€‹AFL 20-04 
(Superseded - see AFL 23-27ā€‹)
General Acute Care Hospitalsā€‹Notice of New Penalties for Violating Nurse to Patient Staffing Ratiosā€‹01/16/2020ā€‹
ā€‹AFL 20-05 (PDF)ā€‹General Acute Care Hospitalsā€‹Medical Evidentiary Examinations and Reporting ā€‹01/17/2020
ā€‹AFL 20-06 (PDF)ā€‹General Acute Care Hospitals ,
Acute Psychiatric Hospitals,
Special Hospitals,
Hospice Facilities
ā€‹Senate Bill (SB) 322: Health Facilities: Inspections: Employee Reportingā€‹01/17/2020
ā€‹AFL 20-07 (PDF)ā€‹General Acute Care Hospitals,
Alternative Birth Centers,
Primary Care Clinics
California Dignity in Pregnancy and Childbirth Actā€‹ā€‹01/17/2020
ā€‹AFL 20-08 (PDF)
ā€‹General Acute Care Hospitalsā€‹Notice of Stakeholder Meeting for GACH Administration, Licensure, Medical Services, and Records and Reporting Regulations (GACH Administration) ā€‹01/17/2020
ā€‹AFL 20-09ā€‹
(Obsolete)
ā€‹All Facilities
ā€‹Health Update and Interim Guidance ā€“ 2019 Novel Coronavirus (nCoV)ā€‹01/23/2020
ā€‹AFL 20-10
(Obsolete)
ā€‹All Facilities
ā€‹Healthcare Facility Resources for the 2019 Novel Coronavirus (2019-nCoV)ā€‹01/27/2020
ā€‹AFL 20-11
(Obsolete)
ā€‹All Facilitiesā€‹Updated 2019 Novel Coronavirus Information (2019-nCoV), Including Patient Under Investigation (PUI) Guidance from the Centers for Disease Control and Prevention (CDC)ā€‹01/31/2020
ā€‹AFL 20-12 (PDF)ā€‹All Facilitiesā€‹Change of Ownership Procedural Requirements ā€‹02/03/2020
ā€‹AFL 20-13
(Obsolete)
ā€‹All Facilitiesā€‹2019 Novel Coronavirus Interim Guidance for Risk Assessment and Health Management of Healthcare Personnel with Potential Exposureā€‹02/10/2020
ā€‹AFL 20-14
(Obsolete)
ā€‹All Facilitiesā€‹Environmental Infection Control for the Coronavirus Disease 2019 (COVID-19)ā€‹02/19/2020
ā€‹AFL 20-15.1
(Obsolete)
All Facilitiesā€‹Infection Control Recommendations for Facilities with Suspect Coronavirus (COVID-19) Patientsā€‹02/28/2020ā€‹
ā€‹AFL 20-16.1
(Supersedes AFL 20-16)
ā€‹All FacilitiesNotice of Stakeholder Meeting for GACH Cardiac Catheterization Laboratory Service Regulations ā€‹03/25/2020
ā€‹AFL 20-17
(Obsolete)
ā€‹All Facilitiesā€‹Guidance for Healthcare Facilities on Preparing for Coronavirus Disease 2019 (COVID-19) ā€‹03/03/2020
ā€‹AFL 20-18
(Obsolete)
Hospitalsā€‹ā€‹Hospital Resources Survey to Assess Surge Capacity Regarding Coronavirus Disease 2019 (COVID-19)03/08/2020ā€‹
ā€‹AFL 20-20 ā€‹All Facilitiesā€‹ 2020 Census Workers: Group Quarters Enumerationā€‹03/11/2020
ā€‹AFL 20-21Hospitals and Critical Access Hospitals with Psychiatric or Rehabilitative Distinct Part UnitsNew Electronic Process for Hospitals to Report a Death Associated with Restraint or Seclusionā€‹03/11/2020
ā€‹AFL 20-22.9 
(Superseded - see
AFL 22-07)
Skilled Nursing Facilities
ā€‹Guidance for Limiting the Transmission of COVID-19 in Skilled Nursing Facilities
08/12/2021
ā€‹AFL 20-23
(Obsolete)
ā€‹All FacilitiesCalifornia Coronavirus Disease 2019 (COVID-19) Health Care System Mitigation Playbook ā€‹03/20/2020
ā€‹AFL 20-24
(Obsolete)
ā€‹All Facilitiesā€‹Guidance for Procedures and Transfer of Deceased Persons with Confirmed or Suspected Coronavirus Disease 2019 (COVID-19)0ā€‹3/16/2020
ā€‹AFL 20-25.2
(Obsolete)
ā€‹Skilled Nursing Facilities
ā€‹Preparing for Coronavirus Disease 2019 (COVID-19) in California Skilled Nursing Facilitiesā€‹04/15/2020
ā€‹AFL 20-26.13 
(Rescinded)
ā€‹General Acute Care Hospitalsā€‹Suspension of Regulatory Enforcement of Hospital Requirements
06/30/2022
ā€‹AFL 20-27.1
(Obsolete)
ā€‹Adult Day Health Centers
ā€‹Guidance for Limiting the Transmission of Coronavirus Disease 2019 (COVID-19) in Adult Day Health Centers

ā€‹03/23/2020

ā€‹AFL 20-28ā€‹Skilled Nursing FacilitiesAnnouncement: Extension of the Deadline to Apply for Patient Needs and Workforce Shortage Waiversā€‹03/23/2020
ā€‹AFL 20-29ā€‹Adult Day Health Centers (ADHC)
Home Health Agencies (HHA)
Intermediate Care Facilities (ICF)
ICF/Developmentally Disabled (ICF/DD)
Referral Agencies

ā€‹Regulatory Update for Social Worker Definition and Services

ā€‹03/26/2020
ā€‹AFL 20-30.9 
(Rescinded)
ā€‹Primary Care Clinics (PCCs)

Mobile Health Care Units (MHCUs)

ā€‹Suspension of Regulatory Enforcement of Specified PCC and MHCU Requirements06/30/2022
ā€‹AFL 20-31.6ā€‹
(Rescinded)
General Acute Care Hospitals (GACHs)ā€‹GACH Coronavirus Disease (COVID-19) Daily Reportingā€‹
05/12/2023

ā€‹AFL 20-32.3
(Superseded - see AFL 21-36)

ā€‹Skilled Nursing Facilitiesā€‹Suspension of Regulatory Enforcement of Specified Skilled Nursing Facility Requirements06/02/2021
ā€‹AFL 20-33.2
(Obsolete)
ā€‹Skilled Nursing Facilities
ā€‹Interim Guidance for Transfer of Residents with Suspected or Confirmed Coronavirus Disease (COVID-19)

05/15/2020
ā€‹AFL 20-34.7 
(Rescinded)
ā€‹Adult Day Health Care Centers (ADHCs) Suspension of Regulatory Enforcement of Specified ADHC Requirements
06/30/2022
ā€‹AFL 20-35.8 
(Rescinded)
ā€‹All Facilitiesā€‹Suspension of Professional Certification Requirements for Certified Nurse Assistants (CNAs) ā€‹07/05/2022
ā€‹AFL 20-36.3
(Obsolete)

ā€‹General Acute Care Hospitals
Skilled Nursing Facilities

ā€‹Guidance for Decontamination and Reuse of N95 Filtering Facepiece Respiratorsā€‹06/16/2020
ā€‹AFL 20ā€‹-37
(Obsolete)
Ambulatory Surgery Centers (ASCs)ā€‹ASC Ventilator Inventory Survey ā€‹04/08/2020
ā€‹AFL 20-38.7
(Obsolete)
ā€‹All Facilities
ā€‹Visitor Limitations Guidance
ā€‹06/16/2021
ā€‹AFL 20-39
(Obsolete)
ā€‹All Facilitiesā€‹Coronavirus Disease 2019 (COVID-19) Optimizing the Use of Personal Protective Equipment (PPE)            ā€‹04/13/2020
ā€‹AFL 20-40.5 
(Rescinded)
ā€‹ All Facilities
Nurse Assistant Training Programs
ā€‹Suspension of Specified Regulatory Requirements for Nurse Assistant Training Programs (NATPs)06/30/2022
ā€‹AFL 20-41ā€‹All Facilitiesā€‹Prohibition on charging for federally supplied assets or pharmaceuticals from the Strategic National Stockpile (SNS)ā€‹04/16/2020
ā€‹AFL 20-42
(Rescinded)
ā€‹Acute Psychiatric Hospitals (APHs)ā€‹Coronavirus Disease (COVID-19) APH Reportingā€‹04/17/2020
ā€‹AFL 20-43.4ā€‹
(Supersedes AFL 20-43.3)
ā€‹Skilled Nursing Facilities (SNFs)ā€‹SNF Coronavirus Disease 2019 (COVID-19) Daily Reporting ā€‹05/11/2023

ā€‹AFL 20-44.1
(Obsolete)

ā€‹All Facilitiesā€‹Expanding Access to Testing: Updated Interim Guidance on Prioritization for Coronavirus Disease 2019 (COVID-19) Laboratory Testingā€‹05/02/2020
ā€‹AFL 20-45
(Obsolete)
ā€‹All FacilitiesHotels for Healthcare Workers ā€‹04/20/2020
ā€‹AFL 20-46.3
(Rescinded)
ā€‹All FacilitiesRequests for Urgent Staffing Resources for COVID-19ā€‹09/07/2021ā€‹
ā€‹AFL 20-47.2  
(Rescinded)
ā€‹Hospice ProvidersSuspension of Regulatory Enforcement of Hospice Requirements07/16/2021
ā€‹AFL 20-48.3
(Obsolete)
ā€‹All Facilitiesā€‹Transfers to Low Acuity Alternate Care Sites During Coronavirus Disease 2019 (COVID-19) Pandemic ā€‹12/16/2020
ā€‹AFL 20-49.6
(Rescinded)
ā€‹All Facilitiesā€‹Suspension of Professional Certification Requirements for Home Health Aides (HHAs) 06/30/2022
ā€‹AFL 20-50.1 
(Supersedes AFL 20-50) 
ā€‹Skilled Nursing FacilitiesSkilled Nursing Facility Infection Prevention Meetingsā€‹06/22/2020
ā€‹AFL 20-51
(Obsolete)
ā€‹All Facilitiesā€‹Updated Coronavirus Disease 2019 (COVID-19) Symptomsā€‹05/09/2020
ā€‹AFL 20-52
(Obsolete)
ā€‹Skilled Nursing Facilities ā€‹Coronavirus Disease 2019 (COVID-19) Mitigation Plan Implementation and Submission Requirements for Skilled Nursing Facilities (SNF) and Infection Control Guidance for Health Care Personnel (HCP)ā€‹05/11/2020

ā€‹AFL 20-53.6 
(Superseded - see AFL 22-13)

Skilled Nursing Facilitiesā€‹
ā€‹COVID-19 Mitigation Plan Recommendations for Testing of HCP and Residents at SNF 12/27/2021
ā€‹AFL 20-54ā€‹All Facilitiesā€‹Hot Summer Weather Advisoryā€‹05/27/2020
ā€‹AFL 20-55
(Obsolete)
ā€‹Skilled Nursing Facilitiesā€‹SNF Coronavirus Disease 2019 (COVID-19) Baseline Testing Reportingā€‹06/02/2020
ā€‹AFL 20-56ā€‹All Facilitiesā€‹Request for Interest in Serving as a Temporary Manager ā€‹06/12/2020
ā€‹AFL 20-57.5
(Rescinded)
ā€‹All Facilities
ā€‹Suspension of Professional Certification Requirements for Home Health Aide Training Programs (HHA Training Programs)06/30/2022
ā€‹AFL 20-58ā€‹All Facilitiesā€‹Fiscal Year (FY) 2020-21 Health Care Facility License Fee Scheduleā€‹07/07/2020
ā€‹AFL 20-59ā€‹All Facilitiesā€‹Public Safety Power Shutoff Power Outage Reportingā€‹07/13/2020
ā€‹AFL 20-60
(Rescinded)
ā€‹Skilled Nursing Facilitiesā€‹SNF Weekly Reporting of Coronavirus Disease 2019 (COVID-19) Surveillance/Response-Driven Testingā€‹07/17/2020
ā€‹AFL 20-61
(Obsolete)
ā€‹Skilled Nursing Facilitiesā€‹Dialysis Transportation for Coronavirus Disease 2019 (COVID-19) Positive Residentsā€‹07/21/2020
ā€‹AFL 20-62
(Rescinded)
ā€‹Intermediate Care Facilities (ICF), Intermediate Care Facilities/Developmentally Disabled (ICF/DD), Intermediate Care Facilities/Developmentally Disabled ā€“ Habilitative (ICF/DD-H), Intermediate Care Facilities/Developmentally Disabled ā€“ Nursing (ICF/DD-N), Intermediate Care Facilities/Developmentally Disabled ā€“ Continuous Nursing (ICF/DD-CN)ā€‹ICF Coronavirus Disease 2019 (COVID-19) Daily Reportingā€‹07/25/2020
ā€‹AFL 20-63.1
(Supersedes AFL 20-63)
ā€‹ā€‹Skilled Nursing Facilitiesā€‹Deployment of Online Survey Application for Coronavirus Disease 2019 (COVID-19) SNF Mitigation Surveysā€‹08/07/2020
ā€‹AFL 20-64ā€‹Skilled Nursing Facilitiesā€‹Staffing Data Submission through the Payroll-Based Journal (PBJ) Systemā€‹08/13/2020
ā€‹AFL 20-65ā€‹All Facilitiesā€‹Level II Extreme Heat Alert08/13/2020ā€‹
ā€‹AFL 20-66.1 
(Supersedes AFL 20-66)
Skilled Nursing Facilities,
Distinct Part Skilled Nursing Facilities,
End Stage Renal Disease Dialysis Facilities,
Chronic Dialysis Clinicsā€‹
Updated Guidance for Provision of Home Dialysis Services in a Skilled Nursing Facilityā€‹03/08/2021
ā€‹AFL 20-67
(Rescinded)
ā€‹Skilled Nursing FacilitiesEmergency Resident Transfers during the Coronavirus Disease 2019 (COVID-19) Pandemicā€‹08/20/2020
ā€‹AFL 20-68ā€‹Nursing Homesā€‹Health Services Advisory Group (HSAG) Centers for Medicare and Medicaid Services (CMS) Initiatives to Support Nursing Home Quality Improvement ā€‹09/03/2020
ā€‹AFL 20-69.1
(Obsolete)
ā€‹All Facilitiesā€‹Survey Priorities during the Coronavirus Disease 2019 (COVID-19) Pandemic03/01/2021
ā€‹AFL 20-70
(Obsolete)
ā€‹Skilled Nursing Facilitiesā€‹Non-Emergency Transportation during the Coronavirus Disease 2019 (COVID-19) Pandemicā€‹09/14/2020
ā€‹AFL 20-71ā€‹All Facilitiesā€‹Recall Notice of Advoque Safeguard N95 Particulate Filtering Respiratorā€‹09/14/2020
ā€‹AFL 20-72.1 
(Rescinded)
ā€‹Home Health Agenciesā€‹Suspension of Regulatory Enforcement of Home Health Agency Requirements
(See Frequently Asked Questions for additional guidance)
ā€‹07/16/2021
ā€‹AFL 20-73
ā€‹ā€‹Skilled Nursing Facilitiesā€‹Advance Care Planning, Physicianā€™s Order for Life Sustaining Treatment (POLST) and Coronavirus Disease 2019 (COVID-19) ā€‹09/22/2020
ā€‹AFL 20-74.1 
(Superseded - See AFL 23-12)
ā€‹ā€‹Skilled Nursing Facilitiesā€‹Coronavirus Disease 2019 (COVID-19) Recommendations for Personal Protective Equipment (PPE), Resident Placement/Movement, and Staffing in Skilled Nursing Facilities ā€‹ā€‹07/22/2021
ā€‹AFL 20-75.1 
(Superseded - See AFL 23-09)
ā€‹All Facilitiesā€‹Coronavirus Disease 2019 (COVID-19) Outbreak Investigation and Reporting Thresholdsā€‹ā€‹07/22/2021
ā€‹AFL 20-76
(Superseded - See AFL 23-32ā€‹)
ā€‹Skilled Nursing Facilities (SNF)
Nursing Facilities (NF)
Intermediate Care Facilities
Swing Bed Hospitals
ā€‹Changes on the Minimum Data Set (MDS) 3.0 v1.17.2ā€‹09/29/2020
ā€‹AFL 20-77ā€‹Skilled Nursing Facilities
Nursing Facilities
ā€‹Notice of Grant Opportunity to Benefit Nursing Facility Residents to Support In-Person Visitationā€‹10/02/2020
ā€‹AFL 20-78
(Obsolete)
ā€‹Skilled Nursing Facilitiesā€‹November 3, 2020 Election: Voting During the COVID-19 Pandemicā€‹10/05/2020
ā€‹AFL 20-79ā€‹General Acute Care Hospitalsā€‹Access to Salesforce for Resource Requestsā€‹10/09/2020
ā€‹AFL 20-80
(Superseded - See AFL 21-44ā€‹)
ā€‹ā€‹Skilled Nursing Facilities
ā€‹Recommendations for the Prevention and Control of Influenza during the Coronavirus Disease 2019 (COVID-19) Pandemicā€‹10/12/2020
ā€‹AFL 20-81
ā€‹General Acute Care Hospitals
GACH Coronavirus Disease 2019 (COVID-19) Vaccination Surveyā€‹10/12/2020
ā€‹AFL 20-82
(Obsolete)
ā€‹All Facilitiesā€‹California Department of Public Health (CDPH) Influenza Vaccination and Masking Policy ā€‹10/30/2020
ā€‹AFL 20-83.2 
(Supersedes AFL 20-83.1)
ā€‹Skilled Nursing Facilities
Intermediate Care Facilities

Interdisciplinary Team (IDT) Authorized Medical Interventions for Residents Unable to Provide Informed Consent and Without a Health Care Decision Maker

ā€‹08/31/2022
ā€‹AFL 20-84ā€‹Skilled Nursing Facilitiesā€‹Infection Prevention Recommendations and Incorporation into the Quality and Accountability Supplemental Payment (QASP) Programā€‹11/04/2020
ā€‹AFL 20-85ā€‹ā€‹Skilled Nursing Facilities
ā€‹Assembly Bill (AB) 2644 ā€“ Skilled Nursing Facilities: Infection Preventionists and Communicable Disease Reportingā€‹11/09/2020
ā€‹AFL 20-86.1
(Obsolete)
ā€‹Long-Term Care Facilitiesā€‹Coronavirus Disease 2019 (COVID-19) Infection Control Recommendations during Holiday Celebrations
ā€‹11/20/2020
ā€‹AFL 20-87.1 
(Superseded - see AFL 22-31)
ā€‹Skilled Nursing Facilities
General Acute Care Hospitals
ā€‹Movement of Patients/Residents in the Healthcare Continuum During Seasonal Surges and the Coronavirus Disease 2019 (COVID-19) Pandemicā€‹11/15/2021
ā€‹AFL 20-88.4 
(Obsolete)
ā€‹General Acute Care Hospitals

Coronavirus Disease 2019 (COVID-19) Testing Recommendations for Patients and Health Care Personnel (HCP) at General Acute Care Hospitals (GACHs)

01/23/2023
ā€‹AFL 20-89.1
(Supersedes AFL 20-89)
ā€‹Skilled Nursing Facilities
Intermediate Care Facilities
Educational Institutions
Requirements for Application Submission for Online or Distance Learning Nurse Assistant Training Programs (NATPs)06/07/2021
ā€‹AFL 20-90
(Rescinded)
ā€‹General Acute Care Hospitalsā€‹Program Flexibility Requirement for General Acute Care Hospitals (GACH) Before Providing Acute Hospital Care at Home Services ā€‹12/23/2020
ā€‹AFL 20-91
(Rescinded)
ā€‹ā€‹General Acute Care Hospitalsā€‹California Crisis Care Continuum Guidelines: Implementing During the Surge of Coronavirus Disease 2019 (COVID-19) Casesā€‹12/28/2020
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