Supersedes PINs 23-02-ASC, 22-28.1-ASC, 22-23-ASC and 22-05.2-ASC. Applies to all RCFEs, CCRCs and all Adult and Senior Care Licensees: Adult Day Program; Adult Residential Facilities; Adult Residential Facilities for Persons with Special Health Needs; Community Crisis Homes; Enhanced Behavioral Supports Homes • Residential Care Facilities for the Chronically Ill • Social Rehabilitation Facilities.

Provides information on the end of the vaccination and booster requirement for all employees and the end of the masking requirement in RCFEs, following the end of the COVID-19 SOE and termination of CA PHOs.

Provides the latest guidance on screening, testing, isolation, quarantine, visitation and other infection control requirements.

If there are differing requirements between CDC, CDPH, CDSS, Cal/OSHA and LHD guidance or health orders, follow the strictest requirements.

Termination of the Worker COVID-19 Vaccination Requirement

Effective 4/3, the CA PHO worker vaccine requirement was terminated. There is no longer a COVID-19 Vaccination and Booster requirement for workers who provide services or work in RCFEs. Licensees no longer are required to maintain records of vaccination or exemption status.

CCLD continues to encourage all staff to stay up to date with COVID-19 vaccinations and boosters as this remains the most important strategy to prevent serious illness and death from COVID-19.

Respirators and Masking Effective 4/3. The CDPH masking requirements ended, replaced with CDPH Guidance for the Use of Face Masks recommendations based on CDC COVID-19 Community Levels

There may be masking requirements for staff that are more strict than the CDPH guidance – either from the local health department or the COVID-19 Prevention Plan required of all employers Cal/OSHA COVID-19 Prevention Non-Emergency-Regulations

Screening of Residents and Staff

Resident Symptom Screening – Regulatory requirements to observe for changes in condition mean an RCFE must continue to observe residents for symptoms of COVID-19. If observed, ask the resident if they are experiencing symptoms and take appropriate action as required.

Staff Symptom Screening – Screen staff for COVID-19 symptoms and exposure daily, which may be conducted through passive screening measures – staff self-screen and self-report potential COVID-19 illness or exposure to the virus:

· Educate staff on how to self-screen prior to entering the community

· Post signs for staff at entrances reminding them to self-screen and not to enter if experiencing symptoms of COVID-19 or are not feeling well

· Communicate through staff meetings, memos, emails, website and other means

Take action as required when staff report they have tested positive for COVID-19

Passive screening measures apply to visitors, volunteers and others who enter the community.

Testing, Isolation, and Quarantine

Continue Infection Prevention and Control Interventions to protect the vulnerable RCFE population:

· monitoring all staff and residents for signs and symptoms of COVID19

· masking by staff and residents when recommended to reduce the spread of large respiratory droplets to others

· use of PPE by staff when required, to help reduce the likelihood of breathing in infectious respiratory particles and

· environmental cleaning and disinfection

Testing, Isolation, and Quarantine Recommendations for Residents CDPH Guidance on Isolation and Quarantine of the General Public applies to residents. Residents who are close contacts and asymptomatic do not need to be quarantined, restricted to their room or cared for by staff using PPE required for care of a resident with COVID-19

Providing Care to Residents in Isolation – Ensure residents identified with confirmed COVID-19 are promptly isolated. Isolation areas ideally include measures to improve ventilation and avoid shared spaces to reduce the risk of transmission to other residents. Follow the community’s current infection control plan that addresses Isolation Protocols.

If care includes the need for oxygen,, adhere to RCFE statues and regulations related to oxygen administration

Testing, Isolation, and Quarantine Recommendations for Staff CDPH Guidance on Isolation and Quarantine of the General Public and Cal/OSHA COVID-19 Prevention Non-Emergency-Regulations guide testing close contacts, outbreak/response testing, work exclusion and return-to-work criteria.

Licensees always have the option to implement more protective procedures and follow prior guidance for a longer isolation period and require additional negative tests for infected staff or quarantine for exposed staff.

Develop a contingency plan for staffing shortages.

Visitation

Screening Protocols – screening for COVID-19 signs, symptoms and exposure is recommend, which may be conducted through passive screening measures

· Posting signs at entrances reminding visitors to self-screen for COVID-19. Signage should also remind visitors not to visit if they are experiencing symptoms/not feeling well or have been exposed to COVID-19.

· Educating visitors on how to self-screen prior to entry. Send information to resident representatives and visitors with COVID-19 self-screening information, including the symptoms for COVID-19.

Licensees should exclude any visitors showing COVID-19 symptoms.

Updated Masking Effective 4/3, visitors should mask in accordance with CDPH Guidance for the Use of Face Masks recommendations based on CDC COVID-19 Community Levels Surgical masks or higher-level respirators with a good fit are recommended Face-Coverings Q&A

Visiting a Resident in Isolation and Personal Protective Equipment (PPE)

Provide the visitor with the same type of PPE used by staff. They do not need a fit tested N95 respirator, but should be instructed on how to perform a seal check.

RCFE Infection Control Requirements

Continue to follow regulations as announced in PIN 22-13-ASC – have an Infection Control Plan, including a training plan, guidelines related to environmental cleaning and disinfection, use of PPE and hygiene and cough etiquette (submitted to your regional office 6/30/2022)

An Emergency Infection Control Plan is still required when a state or federal emergency for a communicable disease is proclaimed or declared.

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