Acute Communicable Disease Control

Infection prevention and control (IPC) is essential to keeping your residents or clients, staff, and visitors safe. IPC is a combination of skills and tools used to both prevent and control the spread of infectious diseases. IPC must be practiced by all staff, residents or clients, and visitors, and facilities must have appropriate policies and procedures in place.  

Understand the infection prevention requirement

The California Department of Social Services (CDSS) requires Adult and Senior Care (ASC) facilities to meet IPC requirements within PIN 22-13-ASC released April, 2022. Facilities should read the PIN thoroughly and verify whether they do or do not fall within the facility type that is required to follow these IPC regulations.¹

PIN 22-13-ASC states that ASC facilities must have the following:

¹The Los Angeles County Department of Public health encourages all CCFs to adopt IPC best practices, even if they are not licensed by CDSS.

Identify an infection preventionist for your facility

After understanding the IPC-related regulations, facilities must designate a staff member as the role of infection preventionist. It is important for facilities to understand that the infection preventionist is not solely responsible for all IPC duties within the facility. The infection preventionist oversees the program, but all staff, residents or clients, and visitors participate in infection prevention and control.

The infection preventionist must be trained in IPC. Facilities should decide what type of trainings the infection preventionist should complete at hire and annually (or other frequency). See below for IPC training resources.

Analyze your current IPC program and consider ways to improve it

Once you understand the IPC regulations and designate an infection preventionist, it can be helpful to analyze your current IPC program. Some facilities may already have an established program and some facilities may be starting from the beginning. In either scenario, facilities can list out the IPC policies and procedures they currently have in place and decide on how to improve their programs.

IPC program improvement strategies should be decided by a group of staff members and can focus on:  

Examples of staff to be included in this discussion include:

• Finding: A facility finds that their IPC policies and procedures are outdated and are not accessible to staff.
• Improvement: The facility sets goals of updating their IPC policies and procedures over the next 3 months and providing electronic and/or paper access to staff with feedback from staff representatives.  

• Finding: A facility finds that their disinfecting products are expired, and some are not labeled.
• Improvement: The facility checks all disinfecting products and disposes of all expired and unlabeled products. The facility purchases new products and thoroughly reviews the instructions for use and storage. The facility trains staff on the new products and staff regularly check the storage closet.  

• Watching housekeepers for correct glove changing
• Watching visitors for proper hand hygiene
• Checking the storage closet for proper product storage  

The overall goal of auditing, or adherence monitoring, is to check that the facility's IPC policies and procedures are implemented correctly and consistently in real-time by all frontline staff. It is helpful to document the number of correct and incorrect IPC practices out of total observations over time and categorized by area of the facility and/or type of staff (e.g., housekeeping, certified nursing assistant, dietary). This will help facilities see where the common challenges are and help to strategize when and where to focus improvement efforts. It is very important to intervene and educate staff, residents or clients, and visitors when they forget or incorrectly perform an IPC procedure.

• Subscribing to CDSS PINs.
• Regularly checking LAC DPH, CDPH and CDSS websites.
• Attending virtual informational calls and listening sessions.
• Continuing education and completing trainings that further your IPC knowledge.  

• Project Firstline (PFL) is a national training and education collaborative created by the Centers for Disease Prevention and Control (CDC) to increase infection control knowledge and understanding among the frontline healthcare workforce.
• Project Firstline’s innovative content is designed so that—regardless of a healthcare worker’s previous training or educational background— they can understand and confidently apply the infection control principles and protocols necessary to protect themselves, their residents, their facility, their family, and their community from infectious disease threats, such as COVID-19.
• For more information, click here to visit the PFL website.  

• An Infection Control Assessment and Response (ICAR) is a gap analysis that helps identify current IPC practices and how to improve them. The LAC DPH Long-term Care Facility Team conducts an on-site visit to the facility. This visit involves observing IPC practices, asking about a facility’s IPC policies and procedures, and touring the facility campus. LAC DPH provides a no-cost, comprehensive assessment, recommendations on how to improve IPC practices, and additional IPC resources.
• To express interest in scheduling an ICAR visit with LAC DPH, click here and complete the interest form.  

• LAC DPH developed a comprehensive collection of transmission-based precaution signs that CCFs and other settings may use to communicate the indicated precautions that can prevent the spread of germs when a resident or client is showing symptoms of or is confirmed to have certain infectious diseases. Click here to access the transmission-based precaution signs. 

• In addition to the transmission-based precaution signs, facilities can access the following handouts to post throughout their facility or use during IPC training: 
  • Hand Hygiene in LTC Settings
  • Notice to Disinfect
  • Who Cleans What Log
  • Outbreak 101
  • Laundry 101
  • Cleaning and Disinfecting