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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 “Census and Direct Care Service Hours Per Patient Day (DHPPD)” (CDPH Form 612) and “Nursing Staffing Assignment and Sign-in Sheet (DHPPD Salaried/Dual Role/Nurse Assistant)” (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
AFL 20-04 (PDF)General Acute Care Hospitals​Notice of New Penalties for Violating Nurse to Patient Staffing Ratios​01/16/2020​
​AFL 20-05 (PDF)​General Acute Care Hospitals​Medical Evidentiary Examinations and Reporting ​01/17/2020
AFL 20-06 (PDF)​General Acute Care Hospitals ,
Acute Psychiatric Hospitals,
Special Hospitals,
Hospice Facilities
​Senate Bill (SB) 322: Health Facilities: Inspections: Employee Reporting​01/17/2020
AFL 20-07 (PDF)​General Acute Care Hospitals,
Alternative Birth Centers,
Primary Care Clinics
California Dignity in Pregnancy and Childbirth Act​​01/17/2020
​AFL 20-08 (PDF)
​General Acute Care Hospitals​Notice of Stakeholder Meeting for GACH Administration, Licensure, Medical Services, and Records and Reporting Regulations (GACH Administration) ​01/17/2020
AFL 20-09 (PDF)
​All Facilities
​Health Update and Interim Guidance – 2019 Novel Coronavirus (nCoV)​01/23/2020
AFL 20-10 (PDF)
​All Facilities
​Healthcare Facility Resources for the 2019 Novel Coronavirus (2019-nCoV)​01/27/2020
AFL 20-11 (PDF)​All Facilities​Updated 2019 Novel Coronavirus Information (2019-nCoV), Including Patient Under Investigation (PUI) Guidance from the Centers for Disease Control and Prevention (CDC)​01/31/2020
AFL 20-12 (PDF)​All Facilities​Change of Ownership Procedural Requirements ​02/03/2020
AFL 20-13 (PDF)​All Facilities​2019 Novel Coronavirus Interim Guidance for Risk Assessment and Health Management of Healthcare Personnel with Potential Exposure​02/10/2020
​AFL 20-14 (PDF)​All Facilities​Environmental Infection Control for the Coronavirus Disease 2019 (COVID-19)​02/19/2020
AFL 20-15.1
(Supersedes AFL 20-15)
All Facilities​Infection Control Recommendations for Facilities with Suspect Coronavirus (COVID-19) Patients​02/28/2020​
AFL 20-16.1 (Supersedes AFL 20-16)​All FacilitiesNotice of Stakeholder Meeting for GACH Cardiac Catheterization Laboratory Service Regulations ​03/25/2020
​AFL 20-17 (PDF)​All Facilities​Guidance for Healthcare Facilities on Preparing for Coronavirus Disease 2019 (COVID-19) ​03/03/2020
​AFL 20-18 (PDF)Hospitals​​Hospital Resources Survey to Assess Surge Capacity Regarding Coronavirus Disease 2019 (COVID-19)03/08/2020​
AFL 20-20 ​All Facilities​ 2020 Census Workers: Group Quarters Enumeration​03/11/2020
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 Seclusion​03/11/2020
AFL 20-22.5
AFL 20-22.4)
Long-Term Care Facilities​Guidance for Limiting the Transmission of COVID-19 in Long-Term Care Facilities​10/23/2020
​AFL 20-23​All FacilitiesCalifornia Coronavirus Disease 2019 (COVID-19) Health Care System Mitigation Playbook ​03/20/2020
​AFL 20-24​All Facilities​Guidance for Procedures and Transfer of Deceased Persons with Confirmed or Suspected Coronavirus Disease 2019 (COVID-19)0​3/16/2020
AFL 20-25.2 (Supersedes AFL 20-25.1)​Skilled Nursing Facilities​Preparing for Coronavirus Disease 2019 (COVID-19) in California Skilled Nursing Facilities​04/15/2020
AFL 20-26.3
(Supersedes AFL 20-26.2)
​General Acute Care Hospitals​Suspension of Regulatory Enforcement of Hospital Requirements​07/03/2020
AFL 20-27.1 (Supersedes AFL 20-27)​Adult Day Health Centers​Guidance for Limiting the Transmission of Coronavirus Disease 2019 (COVID-19) in Adult Day Health Centers


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

​Regulatory Update for Social Worker Definition and Services

AFL 20-30.1 
(Supersedes AFL 20-30)
​Primary Care Clinics (PCCs)

Mobile Health Care Units (MHCUs)

​Suspension of Regulatory Enforcement of Specified PCC and MHCU Requirements​06/26/2020
AFL 20-31.2
(Supersedes AFL 20-31.1)
General Acute Care Hospitals (GACHs)​GACH Coronavirus Disease (COVID-19) Daily Reporting​07/17/2020​

AFL 20-32.1
(Supersedes AFL 20-32)

​Skilled Nursing Facilities​Suspension of Regulatory Enforcement of Specified Skilled Nursing Facility Requirements​06/26/2020
AFL 20-33.2
(Supersedes AFL 20-33.1)
​Skilled Nursing Facilities
​Interim Guidance for Transfer of Residents with Suspected or Confirmed Coronavirus Disease (COVID-19)

​AFL 20-34.2 
(Supersedes AFL 20-34.1)
​Adult Day Health Care Centers (ADHCs) Suspension of Regulatory Enforcement of Specified ADHC Requirements​07/10/2020
​AFL 20-35.2
(Supersedes AFL 10-35.1)
​All Facilities​Suspension of Professional Certification Requirements for Certified Nurse Assistants (CNAs) ​10/15/2020
AFL 20-36.3
(Supersedes AFL 20-36.2)

​General Acute Care Hospitals
Skilled Nursing Facilities

​Guidance for Decontamination and Reuse of N95 Filtering Facepiece Respirators​06/16/2020
​AFL 20-37Ambulatory Surgery Centers (ASCs)​ASC Ventilator Inventory Survey ​04/08/2020

​AFL 20-38.5

(Supersedes AFL 20-38.4)

​All FacilitiesVisitor Limitations Guidance10/23/2020​
AFL 20-39​All Facilities​Coronavirus Disease 2019 (COVID-19) Optimizing the Use of Personal Protective Equipment (PPE)            ​04/13/2020
AFL 20-40​ All Facilities
Nurse Assistant Training Programs
​Suspension of Specified Regulatory Requirements for Nurse Assistant Training Programs (NATPs)​04/14/2020
AFL 20-41​All Facilities​Prohibition on charging for federally supplied assets or pharmaceuticals from the Strategic National Stockpile (SNS)​04/16/2020
​AFL 20-42​Acute Psychiatric Hospitals (APHs)​Coronavirus Disease (COVID-19) APH Reporting​04/17/2020
AFL 20-43.3​Skilled Nursing Facilities (SNFs)​SNF Coronavirus Disease 2019 (COVID-19) Daily Reporting ​06/19/2020

​AFL 20-44.1
(Supersedes AFL 20-44)

​All Facilities​Expanding Access to Testing: Updated Interim Guidance on Prioritization for Coronavirus Disease 2019 (COVID-19) Laboratory Testing​05/02/2020
​AFL 20-45​All FacilitiesHotels for Healthcare Workers ​04/20/2020
AFL 20-46.2
(Supersedes AFL 20-46)
​All FacilitiesRequests for Urgent Staffing Resources for COVID-19​08/31/2020​
AFL 20-47​Hospice ProvidersSuspension of Regulatory Enforcement of Hospice Requirements​04/23/2020
AFL 20-48.1
(Supersedes AFL 20-48)
​All Facilities​Transfers to Low Acuity Alternate Care Sites During Coronavirus Disease 2019 (COVID-19) Pandemic ​05/05/2020
​AFL 20-49.1
(Supersedes AFL 20-49)
​All Facilities​Suspension of Professional Certification Requirements for Home Health Aides (HHAs) ​07/10/2020
​AFL 20-50.1 
(Supersedes AFL 20-50) 
​Skilled Nursing FacilitiesSkilled Nursing Facility Infection Prevention Meetings​06/22/2020
​AFL 20-51​All Facilities​Updated Coronavirus Disease 2019 (COVID-19) Symptoms​05/09/2020
​AFL 20-52
​Skilled Nursing Facilities ​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)​05/11/2020

AFL 20-53.3(Supersedes AFL 20-53.2)

Skilled Nursing Facilities​​COVID-19 Mitigation Plan Recommendations for Testing of HCP and Residents at SNF ​09/12/2020
AFL 20-54​All Facilities​Hot Summer Weather Advisory​05/27/2020
AFL 20-55​Skilled Nursing Facilities​SNF Coronavirus Disease 2019 (COVID-19) Baseline Testing Reporting​06/02/2020
AFL 20-56​All Facilities​Request for Interest in Serving as a Temporary Manager ​06/12/2020
AFL 20-57​All Facilities​Suspension of Professional Certification Requirements for Home Health Aide Training Programs (HHA Training Programs)​06/19/2020
AFL 20-58​All Facilities​Fiscal Year (FY) 2020-21 Health Care Facility License Fee Schedule​07/07/2020
AFL 20-59​All Facilities​Public Safety Power Shutoff Power Outage Reporting​07/13/2020
​AFL 20-60​Skilled Nursing Facilities​SNF Weekly Reporting of Coronavirus Disease 2019 (COVID-19) Surveillance/Response-Driven Testing​07/17/2020
​AFL 20-61​Skilled Nursing Facilities​Dialysis Transportation for Coronavirus Disease 2019 (COVID-19) Positive Residents​07/21/2020
AFL 20-62​Intermediate Care Facilities (ICF), Intermediate Care Facilities/Developmentally Disabled (ICF/DD), Intermediate Care Facilities/Developmentally Disabled – Habilitative (ICF/DD-H), Intermediate Care Facilities/Developmentally Disabled – Nursing (ICF/DD-N), Intermediate Care Facilities/Developmentally Disabled – Continuous Nursing (ICF/DD-CN)​ICF Coronavirus Disease 2019 (COVID-19) Daily Reporting​07/25/2020
AFL 20-63.1​​Skilled Nursing Facilities​Deployment of Online Survey Application for Coronavirus Disease 2019 (COVID-19) SNF Mitigation Surveys​08/07/2020
AFL 20-64​Skilled Nursing Facilities​Staffing Data Submission through the Payroll-Based Journal (PBJ) System​08/13/2020
AFL 20-65​All Facilities​Level II Extreme Heat Alert08/13/2020​
​AFL 20-66Skilled Nursing Facilities,
Distinct Part Skilled Nursing Facilities,
End Stage Renal Disease Dialysis Facilities,
Chronic Dialysis Clinics​
Updated Guidance for Provision of Home Dialysis Services in a Skilled Nursing Facility​08/17/2020​
AFL 20-67​Skilled Nursing FacilitiesEmergency Resident Transfers during the Coronavirus Disease 2019 (COVID-19) Pandemic​08/20/2020
​AFL 20-68​Nursing Homes​Health Services Advisory Group (HSAG) Centers for Medicare and Medicaid Services (CMS) Initiatives to Support Nursing Home Quality Improvement ​09/03/2020
AFL 20-69​All Facilities​Survey Priorities during the Coronavirus Disease 2019 (COVID-19) Pandemic​09/11/2020
AFL 20-70​Skilled Nursing Facilities​Non-Emergency Transportation during the Coronavirus Disease 2019 (COVID-19) Pandemic​09/14/2020
AFL 20-71​All Facilities​Recall Notice of Advoque Safeguard N95 Particulate Filtering Respirator​09/14/2020
AFL 20-72​Home Health Agencies​Suspension of Regulatory Enforcement of Home Health Agency Requirements​09/17/2020
AFL 20-73​​Skilled Nursing Facilities​Advance Care Planning, Physician’s Order for Life Sustaining Treatment (POLST) and Coronavirus Disease 2019 (COVID-19) ​09/22/2020
​AFL 20-74​​Skilled Nursing Facilities​Coronavirus Disease 2019 (COVID-19) Recommendations for Personal Protective Equipment (PPE), Resident Placement/Movement, and Staffing in Skilled Nursing Facilities ​​09/22/2020
AFL 20-75​All Facilities​Coronavirus Disease 2019 (COVID-19) Outbreak Investigation and Reporting Thresholds​​09/22/2020
​AFL 20-76​Skilled Nursing Facilities (SNF)
Nursing Facilities (NF)
Intermediate Care Facilities
Swing Bed Hospitals
​Changes on the Minimum Data Set (MDS) 3.0 v1.17.2​09/29/2020
​AFL 20-77​Skilled Nursing Facilities
Nursing Facilities
​Notice of Grant Opportunity to Benefit Nursing Facility Residents to Support In-Person Visitation​10/02/2020
AFL 20-78​Skilled Nursing Facilities​November 3, 2020 Election: Voting During the COVID-19 Pandemic​10/05/2020
AFL 20-79​General Acute Care Hospitals​Access to Salesforce for Resource Requests​10/09/2020
​AFL 20-80
​​Skilled Nursing Facilities
​Recommendations for the Prevention and Control of Influenza during the Coronavirus Disease 2019 (COVID-19) Pandemic
​AFL 20-81
​General Acute Care Hospitals
GACH Coronavirus Disease 2019 (COVID-19) Vaccination Survey
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