The department is responsible for creating and updating rules for different types of medical clinics in California. The rules for primary care and specialty clinics must be distinct from each other. Regulations for licensed clinics in place as of December 31, 1977, will remain until changed by the department director.

Specific requirements are in place for chronic dialysis, surgical, and rehabilitation clinics. These clinics must comply with federal standards effective before January 1, 2018, as listed in the Code of Federal Regulations. Chronic dialysis clinics must follow standards for end-stage renal disease, surgical clinics must adhere to ambulatory surgical standards, and rehabilitation clinics must comply with comprehensive outpatient rehabilitation standards.

This section outlines the standards for clinics in California regarding the types of services they can offer, the required physical conditions, staffing, and construction requirements. Clinics must meet minimum standards to ensure safety, adequacy, and patient needs, following the California Building Standards Code.

There are detailed construction standards for clinics, including specific criteria for community and rural health clinics to comply with federal Medicare and Medicaid safety guidelines.

Cities or counties oversee plan review and building inspection to confirm adherence to these standards and can certify in writing the compliance within 30 days after construction. If local authorities do not provide certification, clinics must obtain it from the Department of Health Care Access and Information, which may charge a fee.

The State Fire Marshal dictates fire and safety regulations for surgical clinics. Additionally, clinical laboratory standards do not apply to clinics already licensed under the Business and Professions Code.

Primary care clinics in California have specific health and safety requirements for their employees. First, any employee who will have direct contact with patients must have a health check-up within six months before starting work or within 15 days of starting. This exam includes a medical history and physical assessment, and a written report must confirm the employee can safely perform their job duties.

Employees must be tested for tuberculosis at the time of hiring, using a skin test or another CDC-recommended method. If the test is positive, further evaluation may require a chest X-ray. Follow-up health exams are needed only if medically necessary.

Clinics are responsible for maintaining these health records for at least three years after an employee leaves. Employees showing signs of a contagious disease cannot work until cleared by a doctor's certification. Also, any stricter regulations made before 2004 are not applicable anymore.

This section describes the formation of the Community Clinics Advisory Committee, which meets as needed and includes at least 15 people who are full-time employees or contractors for a community clinic. These members can represent either their clinic directly or through a clinic association. Appointment of committee members is done by the three main primary care clinic associations in California that represent the most community or free clinic sites.

A primary care clinic can prove it meets building safety and adequacy standards by providing a written certification from a licensed architect or a statement from a local building department. This certification shows that any construction or modifications comply with state standards. The form of this certification doesn't have to be specific; any document that meets local building department standards or is certified by an architect will work. The local building department is solely responsible for enforcing compliance with the California Building Standards Code.

This law aims to create earthquake safety standards for certain surgical facilities, like clinics and Medicare-certified ambulatory surgical centers, that use general anesthesia. These facilities don't have to stay open during emergencies after an earthquake.

If such facilities install heavy equipment after January 1, 1991, they must hire a licensed architect, structural engineer, or civil engineer to ensure the equipment is securely anchored as per specific regulations.

The facilities must keep a certification from the architect or engineer, proving compliance, accessible for five years for possible inspections.

This law allows authorized state officers or agents to enter and inspect buildings or premises at any time, with or without prior notice, to ensure that rules in this section or related regulations are being followed, or to stop any violations.

This law requires that most clinics in California, which have a license or special permit, must be inspected regularly to ensure they provide quality care. Inspections should occur at least once every three years, and more frequently if needed. During inspections, department representatives can give advice and can work with local health departments when necessary.

Local health departments might help with these inspections, and the state will cover their costs. However, certain clinics like rural health clinics, accredited primary care clinics, ambulatory surgical centers, end stage renal disease facilities, and Medicare or Medicaid certified comprehensive outpatient rehabilitation facilities are exempt from these inspections.

Even though some primary care clinics are exempt, the department can still inspect them if needed to ensure quality care.

This law requires the state department to notify clinics about any compliance issues found during inspections. The clinic must then agree on a correction plan with the department, with a specified period to fix these issues. The list of issues and the correction plan must be displayed publicly in the clinic. If the clinic fails to correct the issues in time, it can incur a fine of up to $50 per day until compliance is achieved, and it may also face license suspension or revocation. Clinics unable to correct issues beyond their control can voluntarily give up their license to avoid penalties or further actions.

This law states that a primary care clinic or someone working for it cannot be penalized, fined, or have their license affected for breaking a state agency rule unless that rule was officially adopted following specific government procedures.

This law section states that after an inspection of a clinic, the resulting report, including any corrections planned and comments from the clinic, must be filed with the state department. These documents, including any deficiencies and how the clinic plans to correct them, are public records that anyone can access. The report might also suggest that another inspection be conducted in the future.

This law states that clinics must follow licensing rules but can use different methods or run pilot projects if they get prior written approval from the department. Clinics need to submit a detailed request with evidence to justify their request, and the department has 60 days to approve or deny it. If approved, the department will specify the conditions for the exception. If denied, the department will explain why.

Clinics can show a lack of certain health professionals as proof for needing an exception, particularly if they're in a medically underserved area or serving a population with limited access to healthcare.

If a clinic is found violating the terms of its waiver, the department will revoke that waiver immediately.

This law allows the department to grant exemptions to PACE programs from certain regulations, as long as they follow specific guidelines. However, this provision will no longer be effective once a particular condition concerning another section becomes active, and it will be repealed the next January 1 following that change.

This section states that clinics performing sterilization for birth control can't impose special nonmedical requirements like age or marital status on patients that aren't required for other types of surgeries. It permits medical requirements based on the individual's health and allows doctors to advise on sterilization suitability. It doesn't change laws for minors.

This law allows a surgical clinic to limit its facility access to its own medical staff and any other doctors that the staff approves to practice there.

This law requires licensed clinic boards and their medical directors to create and implement policies to screen for spousal or partner abuse by June 30, 1995. These policies must include procedures for identifying signs of abuse as part of medical screening, documenting related injuries or illnesses in medical records, and providing patients who show signs of abuse with referral lists for community support services like hotlines and shelters.

Additionally, clinics must assign licensed clinical staff to ensure these guidelines are followed. The law encourages clinics to use the American Medical Association's guidelines on domestic violence as a reference model when developing their policies.

This law states that smoking tobacco is not allowed in patient areas of a clinic, unless those areas are specifically designated for smokers. Signs must be posted in clinics to show where smoking is banned or permitted. If there are areas where smoking is allowed, signs must also be posted at all major entrances indicating smoking is restricted to these areas.

This rule does not apply to skilled nursing facilities or intermediate care facilities. The definitions of 'smoking' and 'tobacco product' align with specific sections of the Business and Professions Code.