Community Care Facilities - Where People Reside Overnight AND Receive Care (excluding: Jails, Settings Associated with People Experiencing Homelessness, Housing Facilities Not Providing Care, Acute Care Facilities, and Skilled Nursing Facilities)
Under Title 17, Section 2500, California Code of Regulations all suspected outbreaks are reportable.
High-Risk Community Care Facility (See below for facility definition)
Ten or more lab confirmed (antigen or PCR) cases
(symptomatic or asymptomatic) of COVID-19 have been
identified in residents within a 14-day period.
NOTE: If newly admitted residents (e.g. within 7 days of admission) are admitted to the quarantine area of the facility test positive for COVID-19, this is not considered an outbreak as it could have been acquired outside the facility.
NOTE: If a facility has cases in residents but does not meet the above thresholds, the outbreak should NOT be opened.
Low Risk Community Care Facility (See below for facility definition)
Ten or more lab confirmed (antigen or PCR) cases (symptomatic or asymptomatic) of COVID-19 have been identified in residents within a 14-day period.
NOTE: If newly admitted residents (e.g. within 7 days of admission) are admitted to the quarantine area of the facility test positive for COVID-19, this is not considered an outbreak as it could have been acquired outside the facility.
NOTE: If a facility has cases in residents but does not meet one above thresholds, the outbreak should NOT be opened.
DCFS-affiliated congregate care facilities (see below for definition)
Ten or more lab confirmed (antigen or PCR) cases
of symptomatic or asymptomatic COVID-19 (including residents and/or staff who have face to face contact with residents), within a 14-day period.
NOTE: If newly admitted residents (e.g. within 7 days of admission) are admitted to the quarantine area of the facility test positive for COVID-19, this is not considered an outbreak as it
could have been acquired outside the facility.
Emergency shelters for isolation/quarantine of DCFS-affiliated youth diagnosed or suspected of COVID-19 or contacts of confirmed COVID-19 cases
Ten or more lab confirmed cases (antigen or PCR) of symptomatic or asymptomatic COVID-19 in staff within a 14-day period. NOTE: Residents are not included in the outbreak definition because they are there specifically for isolation or quarantine due to COVID-19.
Congregate Living Health Facilities (CLHFs) and Intermediate Care Facilities (ICFs): Two or more lab confirmed (antigen or PCR) cases (symptomatic or asymptomatic) of COVID-19 have been identified in residents, epidemiologically linked to the facility, within a 14 day period.
NOTE: If newly admitted residents (e.g., within 7 days of admission) are admitted to the quarantine area of the facility test positive for COVID-19, this is not considered an outbreak as it could have been acquired outside the facility.
NOTE: If a facility has cases in residents but does not meet the above threshold, the outbreak should NOT be opened.
Office of Diversion and Re-entry (ODR) Facilities: Ten or more lab confirmed (antigen or PCR) cases (symptomatic or asymptomatic) of COVID-19 have been identified in residents within a 14-day period.
NOTE: If newly admitted residents (e.g., within 7 days of admission) are admitted to the quarantine area of the facility test positive for COVID-19, this is not considered an outbreak as it could have been acquired outside the facility.
NOTE: If a facility has cases in residents but does not meet the above threshold, the outbreak should NOT be opened.
Adult Day Programs (ADPs) licensed by CCLD and Community Based Adult Services (CBAS) Centers Ten or more lab confirmed (antigen or PCR) cases (symptomatic or asymptomatic) of COVID-19 have been identified in participants within a 14-day period.
Investigation can be conducted over the phone. The frequency of follow-up with the facility for outbreak updates will be at least bi-weekly, but more frequently as needed and determined by Outbreak Management Branch (OMB) MD.
Inform the facility that they will be included on a public outbreak notification list posted on the LAC Public Health website until the facility demonstrates that there are no new cases at the facility for at least 14 days and outbreak is resolved.
Note: All staff in CCLD licensed adult and senior care facilities who are fully vaccinated and eligible for bivalent booster doses should receive their recommended booster doses. The bivalent booster dose is not mandatory; however it is the best defense against the currently circulating strains of COVID-19. If a fully vaccinated staff member has been subsequently infected with COVID-19, they may defer receiving the booster dose up to 90 days after clinical diagnosis or first positive test. Staff in DCFS facilities are not required to be fully vaccinated or boosted, but they are highly recommended to do so.
Additional Guidance and Resources:
See detailed instructions below for case management of residents, as well as cases in facility staff.
A close contact is a person with exposure to a confirmed or suspected case of COVID-19 during the period from 2 days before symptom onset until the case meets criteria for discontinuing isolation (see detailed instructions below for staff and residents). For asymptomatic cases, the date of collection of the specimen positive for SARS-CoV-2 can be used in place of onset date to determine period of isolation.
Exposures are defined as follows:
Note: CDC does not recommend testing, symptom monitoring or special management for people exposed to asymptomatic people with potential exposures to SARS-CoV-2 (i.e., “contacts of contacts;” these people are not considered exposed to SARS-CoV-2).
Low-Risk Community Care Facilities:
These are short- or long-term residential facilities that meet any one of the following descriptors:
High-Risk Community Care Facilities:
Facilities that provide caregiving services primarily to residents with at least two or more of the following:
DCFS-affiliated congregate care facilities
Emergency shelters for isolation for DCFS-affiliated youth diagnosed or suspected of COVID-19 and for quarantine of youth contacts of confirmed COVID-19 cases
Note: The rationale for mask and eye protection is to try to prevent caregiver exposure. Medical grade or surgical masks can be worn for an extended period but should be discarded after they become saturated with moisture.
Note: The actual isolation area will depend on each building but define the area by your local workflow (e.g. the unit the resident is located would be a logical decision).
For more details, refer to CDC Discontinuation of Transmission-Based Precautions and Disposition of Patients with COVID-19 in Healthcare Settings.
Refer to Interfacility Transfer Rules During COVID-19 Pandemic.
Interfacility transfers should be limited as much as possible, while still maintaining appropriate levels of care for all patients.
Patients/residents should not be sent to the Emergency Department (ED) to obtain SARS CoV-2 testing.
LAC DPH does not recommend transferring residents to hospitals unless they require higher level of care and does not recommend transfers between community care facilities unless the facility is unable to isolate the resident adequately. Refer to Interfacility Transfer Rules During COVID-19 Pandemic. If the facility is a dedicated COVID receiving facility, they may accept transfers of COVID+ residents from other facilities.
Outbreak can be closed once closure criteria is met:
At least 14 days have passed since the last confirmed COVID-19 case in a resident.