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Order of the Health Officer No. c19-1d: Long-term Care Facilities (Revised)
Date Order Issued: July 14, 2020

Health Officer Updates Health Orders

Please read this Order carefully. Violation of or failure to comply with this Order constitutes a misdemeanor punishable by fine, imprisonment, or both. California Health and Safety Code § 120295, et seq.; Cal. Penal Code §§ 69, 148(a)(1).

UNDER THE AUTHORITY OF CALIFORNIA HEALTH AND SAFETY CODE SECTIONS 101040, 101085, 120175, AND 17 CCR SECTION 2501, THE HEALTH OFFICER OF THE COUNTY OF SAN MATEO (THE “HEALTH OFFICER”) ORDERS:

  1. Administrative Staff of each Facility as defined below in Section 6 shall continue to exclude from entry or access to its premises any Unauthorized Visitors and Non-Essential Personnel including, but not limited to, visitors of residents at the Facility, except as expressly permitted under the Limited Outdoor Visitation exception pursuant to Section 8 below, and as permitted under the Limited Exception for CCRCs pursuant to Section 6 below. Necessary Indoor Visitation (called Necessary Visitation or Contact under the Prior Order), shall expressly include Compassionate Care Visits, as defined in Section 6 below. By operation of this Order, Unauthorized Visitors and Non-Essential Personnel, including but not limited to family members of residents, are ordered not to visit any Facility except as expressly permitted by this Order. Facilities are required to implement and maintain a plan (“COVID-19 Plan”) to comply with applicable guidance from the United States Centers for Disease Control and Prevention (“CDC”) as described in Section 6 below. Finally, as set forth in Section 12, Facilities shall be subject to San Mateo County Department of Public Health (“County Public Health”) mandatory testing, containment measures, and reporting requirements for COVID-19 positive and presumed COVID-19 positive residents and Facility Staff.
  2. The Order supersedes the previous June 15, 2020 Order of the Health Officer restricting Unauthorized Visitors and Non-Essential Personnel from long-term care facilities in San Mateo County (hereinafter “Prior Order”). This Order extends the provisions of the Prior Order to continue to slow the spread of Novel Coronavirus Disease 2019 (“COVID-19”) and mitigate the impact on delivery of critical healthcare services, and to protect vulnerable populations residing in Facilities—who are at increased risk from COVID-19—and Staff who provide vital care within Facilities. Additionally, this Order now allows under specified conditions Limited Outdoor Visitation, provides for a limited exception applicable to CCRCs, and further defines Necessary Visitation and Contact (renamed “Necessary Indoor Visitation”) as expressly including Compassionate Care Visits, also defined herein. This Order also clarifies that Staff and resident screening under the COVID-19 Plan shall include temperature checks. As of the effective date and time of this Order, all individuals, businesses, and government agencies in the County of San Mateo (“County”) are required to follow the provisions of this Order.
  3. This Order is issued based on evidence of continued significant community transmission of COVID-19 within the County and throughout the Bay Area, including asymptomatic transmission; continued uncertainty regarding the degree of undetected asymptomatic transmission; scientific evidence and best practices regarding the most effective approaches to slow the transmission of communicable diseases generally and COVID-19 specifically; evidence that the age, condition, and health of a significant portion of the population of the County, places it at risk for serious health complications, including death, from COVID-19, and the majority of individuals residing in Facilities subject to this Order are in that higher-risk category; and further evidence that others, including younger and otherwise healthy people, are also at risk for serious outcomes. Due to the outbreak of the COVID-19 disease in the general public, there is a public health emergency throughout the County. Making the problem worse, some individuals who contract the virus causing the COVID-19 disease have no symptoms or mild symptoms, which means they may not be aware they carry the virus and can transmit it to others. Further, evidence shows that the virus can survive for hours to days on surfaces and be indirectly transmitted between individuals. Because even people without symptoms can transmit the infection, and because evidence shows the infection is easily spread, interpersonal interactions can result in preventable transmission of the virus. The scientific evidence further shows that at this stage of the emergency, it remains essential to continue to slow virus transmission as much as possible to protect the most vulnerable, to prevent the health care system from being overwhelmed, and to prevent deaths. Extension of the Prior Order is necessary to mitigate and reduce the spread of the COVID-19 disease, preserving critical and limited healthcare capacity in the County.
  4. The collective efforts taken to date regarding this public health emergency have slowed the trajectory of the virus, but the emergency and the attendant risk to public health remain significant. As of July 13, 2020, there are 4168 confirmed cases of COVID-19 in the County and 114 deaths, 78 of which were associated with senior congregate living facilities. The cumulative number of confirmed cases has continued to increase in the weeks leading up to this Order. Evidence suggests that the restrictions imposed by the Prior Order (and the orders that preceded it) have helped to contain and/or mitigate the rate of increase in transmission within congregate care settings by limiting exposures among Facility residents and Staff, consistent with scientific evidence of the efficacy of similar measures in other parts of the country and world.
  5. This Order is issued in accordance with, and incorporates by reference, the March 4, 2020 Proclamation of a State of Emergency issued by Governor Gavin Newsom, the March 3, 2020 Proclamation by the Director of Emergency Services Declaring the Existence of a Local Emergency in the County, the March 3, 2020 Declaration of Local Health Emergency Regarding Novel Coronavirus 2019 (COVID19) issued by the Health Officer, the March 10, 2020 Resolution of the Board of Supervisors of the County of San Mateo Ratifying and Extending the Declaration of a Local Health Emergency, the April 7, 2020, Board of Supervisors’ Resolution Further Extending the Proclamation of Local Health Emergency Until the County Takes Action to Terminate the Local Emergency, the March 24, 2020 Order of the Health Officer No. c19-4 directing all laboratories conducting COVID-19 diagnostic tests to report COVID-19 test information, the May 11, 2020 Order of the Health Officer No. c19-9, allowing for certain highly regulated vehicle-based gatherings, the May 13, 2020 Order of the Health Officer No. c19-10 directing clinical laboratories to accept assignments for diagnostic tests from Optum Serve and Logistics Health Inc., the May 14, 2020 Orders of the Health Officer Nos. c19-6b and c19-7b revising the requirements concerning isolation for COVID-19 positive individuals and quarantine of Close Contacts of COVID-19 positive individuals, and the June 17, 2020 Health Officer Order c19-11 limiting gatherings, allowing social bubbles, mandating social distancing and face coverings and requiring businesses to implement social distancing protocols and health and safety plans (“Social Distancing Order”).
  6. Definitions and Exemptions:​
    1. For the purposes of this Order a Facility means any licensed facility located within the geographic boundaries of the County providing residential care in a congregate setting, including Skilled Nursing Facilities; Intermediate Care Facilities of all license types; Hospice Facilities; Congregate Living Health Facilities; Chronic Dialysis Centers; Social Rehabilitation Facilities; Group Homes; Residential Care Facilities for the Elderly; Adult Residential Facilities; Mental Health Rehabilitation Centers; and Residential Treatment Facilities.
    2. For the purposes of this Order Unauthorized Visitors and Non-Essential Personnel are employees, contractors, or members of the public who do not regularly perform treatment, maintenance, support, or administrative tasks deemed essential to the healthcare mission of the Facility. Except as defined by “Necessary Visitation or Contact” or permitted under the Limited Outdoor Visitation and Indoor Compassionate Care provisions below, Unauthorized Visitors and Non-Essential Personnel includes individuals with legal authority to make decisions on behalf of Facility residents and friends and families of residents. Nothing in this Order shall prevent household members of Facility operators whose Facility is operated within a structure that also includes private residential space from continuing to live in the same building in which a Facility is operated, however they must comply with the requirements of this Order to the maximum extent possible with regard to the portion or portions of the building that comprise the Facility. The Ombudsperson is an authorized visitor and is not included in this term, but the Ombudsperson must still follow Facility protocols regarding minimizing risk and should also try to avoid visits onsite that are not required.
    3. For the purpose of this Order, Facility Staff are all owners, operators, employees, contractors, volunteers and other personnel who regularly perform treatment, maintenance, support, or administrative tasks deemed essential to the healthcare mission of the Facility.
    4. While this Order remains in effect, and consistent with the requirements of the Prior Order, each Facility must have in place and continue to implement a COVID-19 Plan to comply with applicable guidance from the CDC for nursing homes and other long-term care settings (“CDC Guidance”) (available online at https://www.cdc.gov/coronavirus/2019-ncov/hcp/long-termcare.html) and the guidance issued by California Department of Public Health (“CDPH”) (available online at https://www.cdph.ca.gov/) regarding the screening of residents, staff, and visitors for signs of COVID-19, and other applicable COVID-19-related guidance. Nothing in this Order prohibits a Facility from taking steps more protective than the guidance provided by the CDC or CDPH in its plan, however the decision to implement such heightened protections should take into consideration the social wellbeing and emotional and mental health needs of Facility residents. Each Facility must update its COVID-19 Plan when new COVID-19 recommendations or requirements for nursing homes and other long-term care settings are issued by the CDC, CDPH, or Health Officer, or as otherwise required by law. At a minimum each plan must include:
      1. Daily screening of residents for COVID-19 symptoms, including temperature checks.
      2. Daily screening of Staff and providers for COVID-19 symptoms including temperature checks before they enter the Facility.
      3. Provision of hygiene supplies, including:
        1. Hand sanitizer containing 60–95% alcohol in every resident room (ideally both inside and outside of the room) and other resident care and common areas (e.g., outside dining hall, in therapy rooms) unless the administrator determines that allowing unsupervised access to hand sanitizer poses a risk to the resident(s).
        2. Make sure that sinks are well-stocked with soap and paper towels for handwashing
        3. Make tissues and facemasks available for coughing people.
      4. Provision of necessary Personal Protective Equipment (“PPE”) for use in accordance with CDC Guidance, accessible in areas where resident care is provided. Put a trash can near the exit inside the resident room to make it easy for Staff to discard PPE prior to exiting the room, or before providing care for another resident in the same room. Facilities should take all reasonable steps to obtain adequate supplies of PPE to protect residents in accordance with CDC Guidance, including, to the extent appropriate for the care provided, supplies of:
        1. Facemasks;
        2. Respirators (if available and the Facility has a respiratory protection program with trained, medically cleared, and fit-tested providers);
        3. Gowns;
        4. Gloves; and
        5. Eye protection (i.e., face shield or goggles).
      5. Provision of training on how to properly use PPE and perform proper hygiene practices.
      6. Prohibition of all in-person group activities and communal dining.
      7. Maintaining and making available supplies of EPA-registered, hospital-grade disinfectants in sufficient quantity to allow for frequent cleaning of high-touch surfaces and shared resident care equipment.
      8. Notification to the destination Facility or acute care hospital and to Emergency Medical Services (“EMS”) and any other transferring personnel of the confirmed or suspected COVID-19 positive status of any resident being transferred to another Facility or acute care hospital.
    5. Necessary Indoor Visitation means an in-person visit or contact inside the Facility that is necessitated by urgent health, legal, or other issues that cannot wait until this Order is no longer in effect, and which cannot feasibly take place outside under the Limited Outdoor Visitation provisions set for in Section 8, below. Necessary Indoor Visitation shall include, but not be limited to: visits mandated by law, visits by legal decision-makers such as conservators and agents under valid Health Care powers of attorney currently in effect, and Compassionate Care Visits, meaning visits inside the Facility with a resident at the end of life when it would not be safe or feasible for the visit to take place in an outdoor setting. Necessary Indoor Visitation including Compassionate Care Visits shall be:
      1. Scheduled in advance with the Facility, although a Facility may waive advance scheduling in emergent circumstances and as deemed appropriate;
      2. In a resident’s room or in another area of a Facility appropriate for such visits, such as a solarium or other area. The location for the visit must be of sufficient size to allow visitors to maintain six feet of distance from Staff and resident. Facility must ensure that Necessary Indoor Visitation visitors do not pass through any space designated as a COVID-19 care space or any space where residents suspected or confirmed to be infected with COVID-19 are present, except to the extent necessary when visiting a COVID-19 positive or presumed positive resident;
      3. For Necessary Indoor Visitation including Compassionate Care Visits with residents who are not positive or presumed positive for COVID-19, including residents who have recovered from such infections, Facility must provide Staff and residents with surgical masks at all times during the visit, and visitors must wear Face Coverings in accordance with State law and the Social Distancing Order, at all times they are inside the Facility and continuously throughout the visit.
      4. For Necessary Indoor Visitation including Compassionate Care Visits with COVID-19 positive and presumed positive residents pursuant to Section 10 below, Facility must provide residents with surgical masks and face shields, and all Staff supervising visits and all visitors with appropriate personal protective equipment, including surgical face masks, surgical gowns and gloves, which they must wear at all times throughout the duration of the visit, and shall provide hand sanitizer and supervise the appropriate use of hand hygiene, at the beginning and end of each visit, for all participants.
    6. Limited Exception for CCRCs means the exception expressly identified in this subsection and pursuant to guidance issued by the California Department of Social Services for residents in a Continuing Care Retirement Communities (“CCRC”) who live independently (“Independent CCRC Residents”). CCRC Facilities that meet the Required Preconditions set forth in Section 8 below, may, if actively managed and monitored for compliance by the Facility, allow the business activity of hair salons and barbershops as described in the State of California guidance on Hair Salons and Barbershops (“State Guidance”) to occur in strict compliance with that guidance on premises under the following conditions: (1) all such activity must occur outdoors in a suitable and safe location, scheduled in advance, with no more than one Independent CCRC Resident receiving services and one CCRC Resident waiting for an appointment (maintaining a distance of at least six feet from others) at any time; (2) CCRC must select a single professional (“Professional”) to perform all service, and Professional must wear a Face Covering or mask pursuant to State law and the Social Distancing Order while on CCRC premises, must additionally wear a face shield at all times while providing services, and must provide hand sanitizer for all participants to use proper hand hygiene before and after services; (3) Independent CCRC Residents must wear a Face Covering or mask pursuant to State law and the Social Distancing Order at all times while accessing services under this subsection; (4) in addition to State Guidance, CCRC shall ensure compliance with all requirements of Section 7(a), (d) and (e) below; and (5) CCRC must prohibit residents who utilize the service from interacting with other residents who are not Independent CCRC Residents for at least 14 days after receiving service. For clarity, this exception is not available to Assisted Living, skilled nursing, or Memory/ Dementia Care CCRC residents. For additional clarity, the CCRC may select a new single Professional to provide service as long as 14 days have passed since the previous Professional’s visit.
  7. Requirements for All Visitation Permitted Under This Order.
    1. ​Visitor Screening. Subject to the limited exception for First Responders in Section 16, at the time of the visit, prior to any visitor entering the Facility and prior to transporting a resident to the designated outdoor visitation space, Facility must screen all visitors, including for Limited Outdoor Visitation and Necessary Indoor Visitation and Compassionate Care Visits, for symptoms associated with COVID-19 and take their temperatures. Any person with signs and symptoms suggestive of COVID-19, including fever equal to or greater than 100.4 F, chills, cough, shortness of breath or difficulty breathing, sore throat, myalgia, malaise or fatigue, abdominal pain, nausea, vomiting, diarrhea, headache, new onset of loss of taste or smell, conjunctivitis or pink eye, rash, painful purple or red lesions on the feet or swelling of the toes, and in accordance with guidance from the CDC (available online at www.cdc.gov) and the CDPH (available online at www.cdph.ca.gov) shall not be allowed to visit. Persons in isolation for COVID-19 or in quarantine for a potential exposure to COVID-19 are prohibited from visiting any Facility during the isolation or quarantine period. Persons who have recovered from COVID-19 and/or have been released from isolation or quarantine may visit, and Facilities shall not require evidence of a negative test result prior to allowing such a visit.
    2. Social Distancing. All visitors must remain at least six feet from the resident and attending staff member(s) at all times during the visit, i.e., no touching, hugging, sharing of food, drink or utensils is permitted. Any exchange of documents or signatures necessitated by legal mandate should be done using appropriate infection control measures, e.g., electronic transmission and/or signature, maintaining six feet of distance. Notwithstanding the foregoing, nothing in this Order shall be interpreted to impede or prevent the delivery of medically necessary care that requires direct contact with residents or proximity closer than six feet.
    3. Notice to Visitors. When scheduling visits and again at the time of the visit, Facility shall inform visitors that they must cancel or postpone their visit if they are feeling unwell, and that any visitor who develops symptoms consistent with COVID-19 and/or is diagnosed with COVID-19 within two days of a visit must immediately alert the Facility and Facility shall immediately notify the Communicable Disease Unit of San Mateo County Health.
    4. Supervision of Visits. Facility must ensure that each visit is supervised by Facility Staff, ideally an individual trained in patient safety/infection control, at all times throughout the duration of the visit. Notwithstanding the foregoing, during visits permitted under this Order that involve matters requiring confidentiality, such as with legal counsel, Facility Staff shall make best efforts to safely facilitate such confidentiality.
    5. Visitor Log. Facilities must keep a log of all visitors under this Order until instructed to destroy it. The Visitor Log should be maintained in a secure location when not in use, and maintained as confidential. The Visitor Log must contain the following information:
      1. Date and time of visit
      2. Name/location of person being visited
      3. Name, address and phone number of visitor
  8. Limited Outdoor Visitation. Subject to strict compliance with this Order, including the specified Required Preconditions set forth below, and the requirements of Section 7, above, Facilities may permit Limited Outdoor Visitation as set forth herein. However, County Public Health may suspend Limited Outdoor Visitation at any individual Facility or at all Facilities subject to this Order at any time as necessary for the protection of public health.
    1. Required Preconditions. In order for a Facility to allow Limited Outdoor Visitation for its residents under this Order, it must first certify in writing to County Public Health that it meets the following Required Preconditions: 
      1. Facility has adequate access to COVID-19 testing and has implemented (for Skilled Nursing Facilities) County Public Health’s “COVID-19 Mass Testing Strategy”: https://www.smchealth.org/sites/main/files/fileattachments/mass_testing_strategy_for_snfs_in_san_mateo_county_5.29.2020_0.pdf?159 2794624 or (for all other licensed facilities subject to this order, County Public Health’s “COVID-19 Recommendations Checklist for LTCFs, RCFs and Congregate Settings” https://www.smchealth.org/sites/main/files/file-attachments/covid19_recommendations_checklist_for_ltcfs_rcfs_and_congregate_settings_6.29.2020.pdf?1 593809707
      2. Facility is not experiencing Staff shortages;
      3. Facility has adequate supplies of PPE and essential cleaning supplies to care for its residents;
      4. Facility has had no new positive COVID-19 cases in Staff or residents identified in at least two sequential rounds of surveillance testing;

        A Facility is prohibited from allowing Limited Outdoor Visitation for any time period of any duration in which it is not in compliance with the applicable Required Preconditions. If a Facility falls out of compliance with the applicable Required Preconditions, it must immediately discontinue any Limited Outdoor Visitation, including visits already scheduled, and notify County Public Health at smccdcontrol@smcgov.org within 24 hours of the reason for noncompliance with the Required Preconditions and the discontinuation of Limited Outdoor Visitation. A Facility that is out of compliance with the applicable Required Preconditions may only initiate or resume Limited Outdoor Visitation upon written certification by the Facility administrator or designee to County Public Health at smccdcontrol@smcgov.org that it is in compliance with the Required Preconditions.
    2. Requirements for Limited Outdoor Visitation. In addition to the requirements set forth in Section 7 above, Limited Outdoor Visitation must comply with the following requirements:
      1. No more than two adults per visit, and one resident per visit, except that cohabitating residents may participate in the same visit together as if one resident. Visitors must be family members and/or designated support persons such as close friends and/or clergy/spiritual advisor (i.e., visits by hired service providers such as hair stylists, barbers, pet therapists, art therapists, etc. are not permitted) or a person whose visit is necessitated by urgent health or legal matters cannot wait until this Order is no longer in effect, including, but not limited to: visits mandated by law, and visits by legal decisionmakers such as conservators and agents under valid Health Care powers of attorney currently in effect.
      2. The visit must be scheduled in advance with the Facility;
      3. The visit must take place in a designated outdoor space on or adjacent to the Facility premises, with sufficient room to allow for compliance with applicable State law and the Social Distancing Order, appropriate protections from weather conditions, and otherwise made safe for Facility residents and their permissible visitors.
      4. The Facility must ensure that any resident being transported to and from outdoor visitation space is not transported through any space designated for COVID-19 care or where residents suspected or confirmed to be infected with COVID-19 are present. Likewise, visitors should not pass through any space designated as a COVID-19 care space or any space where residents suspected or confirmed to be infected with COVID19 are present.
      5. Facilities must provide all Staff supervising visits and all residents being visited surgical face masks, which they must wear at all times throughout the duration of the visit.
      6. Visitors must wear a face covering or mask at all times for the duration of the visit and in accordance with the requirements of State law and the Social Distancing Order. It is recommended, but not required, that Facilities provide a face mask/face shield combination to every person present for a Limited Outdoor Visit to further minimize risk of transmission).
      7. Facility shall provide hand sanitizer and Staff must supervise the appropriate use of hand hygiene, at the beginning and end of each visit, for all participants in Limited Outdoor Visitation.
  9. Facility Discretion. Facilities may create policies establishing the frequency, duration, times, and schedule for Limited Outdoor Visits and shall have discretion to cancel, postpone, reschedule or terminate Limited Outdoor Visitation—whether globally for all such visitation at the Facility, or individually for specific Limited Outdoor Visits—on the basis of insufficient staff, or to protect the health, safety and wellbeing of a resident or residents and/or visitors, including protection from risks caused by weather conditions. Facilities shall have discretion to postpone or reschedule a Necessary Indoor Visit including a Compassionate Care Visit on an individual basis when circumstances such as insufficient staff or other conditions present a specific health risk to residents or visitors that cannot be mitigated.
  10. COVID-19 Positive/Presumed Positive Residents. COVID-19 positive or presumed positive Facility residents shall not be eligible for Limited Outdoor Visitation or the Limited Exception for CCRCs during such time as they are infectious, and until they have recovered, following the protocols issued by County Public Health: COVID-19 Congregate Setting Admission, Readmission and Discontinuation of Transmission-Based Precautions Guidelines, found at: https://www.smchealth.org/sites/main/files/fileattachments/ flow_chart_ covid19_congregate_setting_admission_readmission_and_discontinuation_of_isolation_ guideline_6.15.2020_final_ada_accessible.pdf?1592794761 (“COVID-19 Congregate Setting Guidelines”). COVID-19 positive and presumed positive Facility residents shall be eligible for Necessary Indoor Visitation including Compassionate Care Visits pursuant to this Order, and visits with such residents shall be subject to heightened infection control protocols in accordance with CDC and CDPH infection control guidance, pursuant to Section 6(e)(iv), above.
  11. . In addition to the requirements in Section 6 above, each Facility’s COVID-19 Plan must include a requirement that the Facility comply with COVID-19 Congregate Setting Guidelines linked in Section 8(d), above, concerning any Facility Staff or resident who is sick or does not pass the required screening.
  12. If a Facility learns that any Facility resident, or Facility Staff living or working at the Facility, or who had been recently living or working at the Facility has tested positive for COVID-19 or is informed by a physician that any resident or Staff is presumed positive for COVID-19, the Facility must immediately (within 24 hours) notify the Communicable Disease Unit of San Mateo County Health. Residents and Staff of all Facilities shall also be subject to mandatory COVID-19 testing, and the imposition of such other measures to contain the spread of COVID-19 as deemed necessary for the protection of public health, by the San Mateo County Department of Public Health or its designee.
  13. Each Facility is strongly urged to take all reasonable steps to prevent Facility Staff from working at another Facility or other Facilities within the same 14-day period to avoid increased risk of transmission of COVID-19 from one Facility to another. Such reasonable steps include, but are not limited to, notifying all Facility Staff of the risk of working at more than one Facility and working with Facility Staff and other Facilities to avoid this increased risk to the greatest extent possible.
  14. Nothing in this Order shall relieve Facilities from the requirement to make reasonable efforts to facilitate contact between residents and their friends and families by means other than in-person visits (such as by telephone or videoconference) where such efforts will not otherwise interfere with the Facility’s healthcare mission.
  15. If any Unauthorized Visitor, permitted visitor, or Non-Essential Person refuses to comply with this Order, then the Facility may contact local law enforcement or the San Mateo County Sheriff to request assistance in enforcing this Order. The violation of any provision of this Order constitutes an imminent threat and menace to public health, constitutes a public nuisance, and is punishable by fine, imprisonment, or both.
  16. This Order does not restrict first responder access to Facility during an emergency. Further, this Order does not restrict state or federal regulators, officers, investigators, or medical or law enforcement personnel from carrying out their lawful duties at Facilities. Persons other than first responders accessing a Facility during an emergency must comply with all conditions of visitation imposed by the Facility at the time of entry or access to the Facility to the greatest extent feasible.
  17. This Order shall be effective as of 11:59 p.m. July 15, 2020, and shall remain in effect until rescinded, superseded, or amended by the Health Officer, in writing.
  18. While this Order is in effect, the Facility must provide copies of the Order in all of the following ways: (1) post this Order on the Facility website (if any); (2) post this Order in a visible location at all entrances to the Facility; (3) provide this Order to each Facility resident; (4) provide this Order to any authorized decision maker for each Facility resident if not the resident; (5) provide this Order to the Ombudsman Services of San Mateo County; and (6) provide this Order to anyone who visits the Facility or, upon request, to anyone who contacts the Facility seeking to visit.
  19. Within 12 hours of receipt of this Order each Facility must notify its respective licensing entity (whether the CDPH or otherwise) of the existence of this Order regarding the Facility.
  20. If any provision of this Order or its application to any person or circumstance is held to be invalid, the remainder of the Order, including the application of such part of provision to other persons or circumstance, shall not be affected and shall continue in full force and effect.  To this end, the provisions of this Order are severable.

IT IS SO ORDERED

Scott Morrow MD, MPH
Health Officer
County of San Mateo

Date: July 14, 2020

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