Posted: February 6, 2020

New Statewide Inspection Tool for RCFEs

Article 4: New Statewide Inspection Tool for RCFEs


Back in August 2019, the State of California Department of Social Services (CDSS) sent a provider information notice regarding the Fall launch of Community Care Licensing Division’s (CCLD) new inspection tool for RCFEs.  The new tool aims to promote health, safety, and quality of life for people living in licensed settings. Specifically, CCLD plans to enhance the inspection process’ consistency, effectiveness, and quality by refocusing on the three priority areas of: 1) prevention, 2) compliance, and 3) enforcement.  


The new tool has been officially rolled out, and the CCLD encourages RCFEs to be familiar with the tool and process.  The CCLD Inspection Process Project website includes details about the new tool for the Adult and Senior Care portion.  Below is a summary of the inspection tool development methodology and the tool’s senior care domains.


Inspection Tool Development and Methodology

The goals for the new tool and inspection process include:

  • Ensuring inspections are performed consistently and systematically through the use of standardized tools.

  • Collecting actionable information by gathering data on facility compliance and noncompliance.  Previous data collected only focused on noncompliance.

  • Identifying areas of promising practices and areas of concern.


CCLD employed three key elements, which include: 1) considerations for statistical validity, 2) risk assessment and review by subject matter experts, and 3) considerations for process implementation and practicality.  These elements combine to create a practical tool that gives a holistic view of a facility. 


Senior Care Domains

Inspection tools used for RCFEs contain requirements in the 11 licensing domains below:

  • Operational Requirements: plan of operation, required insurances, fire clearance, etc.

  • Physical Plant/Environmental Safety: facility maintenance, living accommodations, storage space, etc.

  • Staffing: administrator presence, sufficient staffing, night supervision, etc.

  • Personnel Records/Staff Training: criminal record clearance/exemption, training, etc.

  • Resident Rights/Information: resident councils, family councils, resident rights, etc.

  • Resident Records/Incident Reports: admission agreements, register of residents, etc.

  • Food Services: meal requirements, food supply menus, food preparation, etc.

  • Planned Activities: resident participation, community-centered activities, etc.

  • Incidental Medical and Dental: plan for incidental medical and dental care, medications, etc.

  • Residents with Special Health Needs: hospice care, residents with dementia, postural supports, etc.

  • Disaster Preparedness: emergency plan/disaster and mass casualty plan, etc.

These 11 Senior Care Domains are very similar to Choose Well’s 11 Quality Measures.  Specifically, there are 8 out of the 11 CCLD licensing domains that have an equivalent Choose Well Quality Measure used for rating Member facilities.  See table below for comparison.  


CCLD Senior Care Domain

Equivalent Choose Well Quality Measure

Physical Plant/Environmental Safety

Facility Maintenance and Safety 



Resident Rights/Information

Resident Rights

Food Services

Food and Nutrition 

Planned Activities

Activities and Socialization 

Incidental Medical and Dental

Medical Needs and Responsiveness

Residents with Special Health Needs

Specialty Care

Disaster Preparedness

Emergency Disaster Planning 


CCLD plans to continue updating their Inspection Process Project website with information on new tools and documents.  Be sure to stay informed and keep your RCFE up-to-date by periodically visiting the website.