State citations AA, A and B, explained

ICF/DD-H, DD-N, DD and DD-CN facilities are "long-term health care facilities" under Health and Safety Code §1418, so the citation system in §1424 applies to them. A citation is a separate state action from a federal deficiency, though both can come from the same survey; when they do, the citation lists the survey's event ID.

Class AA

A Class A violation that was a substantial factor in a resident's death.

Class A

A violation presenting imminent danger, or a substantial probability, of death or serious physical harm.

Class B

A violation with a direct or immediate relationship to residents' health, safety or security, other than AA or A.

CDPH's data also records other penalty kinds alongside citations; this site shows those with the class CDPH recorded, or as "Other penalty".

Under §1424, the civil penalty ranges for the ICF/DD types are:

• Class AA: $5,000 to $25,000 per citation.
• Class A: $1,000 to $10,000 per citation.
• Class B: $100 to $1,000 per citation.
• Willful material falsification or omission in a health record: up to $10,000.

The higher ranges in §1424.5 are written for skilled nursing facilities and plain intermediate care facilities. Statutes change, so check the current text before relying on a figure.

In setting a penalty, CDPH considers the probability and severity of the risk, the resident's condition, the facility's good-faith efforts and its compliance history. For a Class AA citation that becomes final, CDPH must consider suspending or revoking the license.

Under §1423, CDPH must issue a notice of violation within 24 hours (not counting weekends and holidays) of determining that a violation occurred, and serve any citation within 30 days of completing the investigation. A violation the facility itself reported as an unusual occurrence isn't cited if it caused no harm, was promptly corrected and the facility's report was CDPH's first notice.

A facility can contest a citation. On a facility page, each penalty shows its status as CDPH records it (open or closed) and, when CDPH's data says so, that it was appealed and when the appeal was received. The final class and amount can differ from what was first issued; when they do, both are shown.

• History runs back to 1998. A long-licensed facility has had more time to be cited.
• Read the category and the code sections. A citation for patient rights or staffing says more than its dollar amount does.
• Look at the dates. Recent citations say more about a home today than ones from decades ago.
• Read the document. Recent citations link to CDPH's citation document on CalHealthFind, which describes what happened.

You can narrow Facility Search to ICFs with a Class A or AA citation, or to those with no state penalties on record.