Form Lic 613c-2 - Personal Rights In Privately Operated Residential Care Facilities For The Elderly Page 5

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
(18) To written notice of any room changes at least 30 days in advance unless the
request for a change is agreed to by the resident, required to fill a vacant bed, or
necessary due to an emergency.
(19) To share a room with the resident’s spouse, domestic partner, or a person of
resident’s choice when both spouses, partners, or residents live in the same
facility and consent to the arrangement.
(20) To select their own physicians, pharmacies, privately paid personal assistants,
hospice agency, and health care providers, in a manner that is consistent
with the resident’s contract of admission or other rules of the facility, and in
accordance with this act.
(21) To have prompt access to review all of their records and to purchase
photocopies. Photocopied records shall be promptly provided, not to exceed two
business days, at a cost not to exceed the community standard for photocopies.
(22) To be protected from involuntary transfers, discharges, and evictions in violation
of state laws and regulations. Facilities shall not involuntarily transfer or evict
residents for grounds other than those specifically enumerated under state law or
regulations, and shall comply with enumerated eviction and relocation protections
for residents. For purposes of this paragraph, “involuntary” means a transfer,
discharge, or eviction that is initiated by the licensee, not by the resident.
(23) To move from a facility.
(24) To consent to have relatives and other individuals of the resident’s choosing visit
during reasonable hours, privately and without prior notice.
(25) To receive written information on the right to establish an advanced health care
directive and, pursuant to Section 1569.156, the licensee’s written policies on
honoring those directives.
(26) To be encouraged to maintain and develop their fullest potential for independent
living through participation in activities that are designed and implemented for
this purpose, in accordance with Section 87219 of Title 22 of the California Code
of Regulations.
LIC 613C-2 (7/17) (CONFIDENTIAL)
PAGE 5 OF 8

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