Report 2012-107 Recommendation 16 Responses

Report 2012-107: Developmental Centers: Poor-Quality Investigations, Outdated Policies, Leadership and Staffing Problems, and Untimely Licensing Reviews Put Residents at Risk (Release Date: July 2013)

Recommendation #16 To: Public Health, Department of

To ensure that the facilities Public Health monitors take timely corrective action on deficiencies, Public Health should comply with CMS's 45-day revisit requirement. If the 45-day revisit time frame is not possible due to the extent of the corrections required at particular facilities, Public Health should seek exemptions from CMS as appropriate. For facilities whose deficiencies are not severe enough to require an on-site revisit, Public Health should direct its staff to complete desk reviews within 60 days.

60-Day Agency Response

L&C has created and implemented a tracking log to monitor this performance metric. L&C maintains the log in a common electronic repository known as a "collaboration site," to allow headquarters staff to view current field operation activities seamlessly. In addition, L&C provided directions and training during staff meetings to all District Office staff to ensure compliance with the tracking log. Each District Office is responsible for updating the tracking log on a daily basis. Each week, CDPH Headquarters evaluates the tracking log and provide findings to the District Office managers. Exhibit A is a copy of the tracking log.

If L&C is unable to complete a revisit within CMS' 45-day requirement, L&C will notify CMS by e-mail and request an exemption or extension to the revisit requirement.

  • Completion Date: August 2013
  • Response Date: August 2013

California State Auditor's Assessment of 60-Day Status: Fully Implemented

L&C is the Department of Public Health's Licensing and Certification unit.


All Recommendations in 2012-107

Agency responses received are posted verbatim.


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