× The federal government has shut down due to the failures of the President and Congress to continue government funding. Millions of Californians receiving benefits from state programs may be impacted. For now, California’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) will continue to provide services and enroll eligible families as long as funding is available. No new federal funding to California WIC will be provided until the President and Congress take action. Families should continue to use their WIC benefits and attend their WIC appointments. This information is subject to change, so please monitor the California WIC website for updates.

Please be wary of potential highly partisan political messaging while visiting federal government websites for information related to the federal government shutdown.

Skip Navigation LinksLNCAFL23

LICENSING AND CERTIFICATION

All Facilities Letters - 2023

It is recommended to use Google Chrome, Microsoft Edge, or Firefox as your web browser when opening the AFL. Internet Explorer may not work correctly. 

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

Bulletin NumberFacility Type AffectedSubjectRelease Date
AFL 23-01 
Skilled Nursing Facilities (SNF)
Intermediate Care Facilities (ICF)
Assembly Bill (AB) 895: Notice to Prospective Residents
01/18/2023
AFL 23-02 
General Acute Care Hospitals (GACH)
Assembly Bill (AB) 1394 – Suicide Screening Requirement
01/18/2023
AFL 23-03 
Hospice Facilities (HOFA)
Skilled Nursing Facilities (SNF)
Intermediate Care Facilities (ICF)
Assembly Bill (AB) 1852 – Automated Drug Dispensing Systems
01/18/2023
AFL 23-04 
Skilled Nursing Facilities (SNFs)
Assembly Bill (AB) 1907 – Frequency of Inspections
01/18/2023
AFL 23-05 
​General Acute Care Hospitals (GACH)
Acute Psychiatric Hospitals (APH)
Chemical Dependency Recovery Hospitals (CDRH)
​Assembly Bill (AB) 2096 – Revision and Expansion of Permitted Licensure of Chemical Dependency Recovery (CDR) Services

​01/18/2023
​AFL 23-06 
​Skilled Nursing Facilities (SNFs)
​Assembly Bill (AB) 2511 – Skilled Nursing Facilities: Backup Power Source
​01/18/2023
AFL 23-07 
​General Acute Care Hospitals (GACH)
Special Hospitals (SH)
Skilled Nursing Facilities (SNF)
Congregate Living Health Facilities (CLHF)
Hospice Facilities (HOFA)
​Senate Bill (SB) 988 – Compassionate Access to Medical Cannabis Act
​01/18/2023
AFL 23-08 
(Supersedes AFL 19-18)

General Acute Care Hospitals (GACH) Skilled Nursing Facilities (SNF)

​Requirements to Report Outbreaks and Unusual Infectious Disease Occurrences 

​01/18/2023
​AFL 23-09 
(Obsolete)

​All Facilities

​Coronavirus Disease 2019 (COVID-19) Outbreak Investigation and Reporting Thresholds

​01/18/2023
​AFL 23-10 
​Skilled Nursing Facilities (SNF)
​Recommendations for the Prevention and Control of Influenza in California Skilled Nursing Facilities (SNFs) for the 2022-2023 Season during the Coronavirus Disease 2019 (COVID-19) Pandemic
​01/18/2023
AFL 23-11 
​All Facilities

​Availability of Waivers to Continue Operations During the Series of Atmospheric River Systems
​01/19/2023
​AFL 23-12 
(Supersedes AFL 20-74.1)

​Skilled Nursing Facilities (SNFs)
​Coronavirus Disease 2019 (COVID-19) Recommendations for Personal Protective Equipment (PPE), Resident Placement/Movement, and Staffing in Skilled Nursing Facilities
​01/24/2023
​​AFL 23-13 

​All Facilities 
​Notice of Expiration of Temporary Waivers Related to the Coronavirus Disease 2019 (COVID-19) Pandemic   
​02/07/2023
​​AFL 23-14​ 

​Hospice Agencies

Hospice Facilities

​Notice of Stakeholder Meeting for Hospice Regulations​
​02/13/2023
AFL 23-15​ 

​Skilled Nursing Facilities (SNFs)

​Notice of Stakeholder Meeting for Modifying SNF Application Fees
​03/10/2023
​​AFL 23-16​ 

​Skilled Nursing Facilities (SNFs)​
​Clarification on Family Council Requirements
​04/12/2023
AFL 23-17​ 


​Skilled Nursing Facilities (SNFs)
Intermediate Care Facilities (ICFs)
​Assembly Bill (AB) 1502 – Change of Ownership and Change of Management Requirements 
​06/12/2023
AFL 23-18 

​Skilled Nursing Facilities (SNFs)
Intermediate Care Facilities (ICFs)

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

​06/14/2023
​AFL 23-19​ 

​Skilled Nursing Facilities (SNFs)
​Appeal Procedures for Direct Care Service Hours Per Patient Day Penalties
​06/15/2023
AFL 23-20​ 

​All Facilities
​Hot Summer Weather Advisory
​06/28/2023
AFL 23-21 

​General Acute Care Hospitals
​General Acute Care Hospital (GACH) Water Rationing Plan and Storage Requirements
​06/30/2023
AFL 23-22​ 

​All Health Facilities
​Fiscal Year (FY) 2023-24 Health Care Facility License Fee Schedule
​06/30/2023
AFL 23-23 


​General Acute Care Hospitals (GACHs)
Acute Psychiatric Hospitals (APHs)
Skilled Nursing Facilities (SNFs)
​California Health and Human Services (CalHHS) Data Exchange Framework (DxF)

​06/30/2023
​​AFL 23-24 

​All Facilities
Revised Licensure and Certification Application (HS 200) and Applicant Individual Information (HS 215A)
​06/30/2023
​AFL 23-25​​​​​

​All Facilities

​Weather Advisory Hurricane Hilary

​08/18/2023

​AFL 23-26​ 
​All Facilities
​​New Legal Requirement to Submit Immunization Data
​​08/25/2023​
​AFL 23-27​ 


​General Acute Care Hospitals (GACHs)

​Nurse-to-Patient Ratios Penalties and Clarification on Unpredictable Situations Affecting Staffing Levels​

​09/11/2023
​​AFL 23-28​ 


​Skilled Nursing Facilities (SNFs)
​Select Skilled Nursing Facility Recertification Surveys to be Conducted by CertiSurv
​09/14/2023
​​AFL 23-29​ 
(Supersedes AFL 22-20)​

​Skilled Nursing Facilities​

​Coronavirus Disease 2019 (COVID-19) Treatment Resources for Skilled Nursing Facilities (SNFs) ​
​09/26/2023
​AFL 23-30​ 
(Supersedes AFL 22-23.2)​

​All Hospitals
​Guidance for Response to Anticipated Adult and Pediatric Surges in Respiratory Virus Transmission 
​10/10/2023
​​AFL 23-31​ 

​Hospice Agencies
Hospice Facilities​

​Notice of Stakeholder Meeting for Hospice Regulations​
​10/13/2023
​AFL 23-32.1​ 
(Supersedes AFL 23-32)

​Skilled Nursing Facilities (SNF) 
Nursing Facilities (NF) and 
Swing Beds Non-Critical Access Hospital (SB Non-CAH)

​Centers for Medicare and Medicaid Service’s (CMS) Minimum Data Set (MDS) Resident Assessment Instrument (RAI) 3.0 Manual v1.18.11 went into effect October 1, 2023
​11/03/2023
AFL 23-33 
(Supersedes AFL 21-20.2)
General Acute Care Hospitals (GACHs)
Acute Psychiatric Hospitals (APHs)
​​Coronavirus Disease 2019 (COVID-19) Vaccine Recommendations for Eligible Individuals Prior to Discharge

​11/13/2023
AFL 23-34​ 

(Supersedes AFL ​22-09.1)​


​​All Facilities
​Coronavirus Disease 2019 (COVID-19) Vaccine Recommendations for Clinically Eligible Individuals​

​11/13/2023
​​AFL 23-35​ 

​All Facilities
​Xylazine in the Illicit Drug Supply and Patient Best Practices
​11/28/2023
​​AFL 23-36​ 

​Skilled Nursing Facilities (SNFs)
​Recommendations for Prevention and Control of COVID-19, Influenza, and Other Respiratory Viral Infections in California Skilled Nursing Facilities – 2023-24
​12/05/2023
AFL 23-37​ - NEW

​Skilled Nursing Facilities
​Skilled Nursing Facility Admission, Transfer and Discharge Requirements 
​12/22/2023


​​

Page Last Updated :