California Adult Residential Facility (ARF)
Administrator Exam Prep: Master ARF
Regulations & Title 22 Compliance Practice
Questions
SUBTOPIC: California Title 22 Regulations, Resident Rights, and ARF
Operational Compliance
Question 1: An ARF administrator receives a request from a resident's family member to access
the resident’s personal records. According to Title 22, under what condition can the
administrator release this information?
A) The family member is an immediate relative and pays the facility fees.
B) The resident has provided written authorization, or the family member holds legal Power of
Attorney (POA) for healthcare decisions.
C) The administrator can release records to any immediate family member to ensure
transparency.
D) The administrator must wait for the licensing agency to approve the request before releasing
any documentation.
Correct Answer: B) The resident has provided written authorization, or the family member
holds legal Power of Attorney (POA) for healthcare decisions.
Explanation: Resident confidentiality is strictly protected. Records cannot be released to family
members—even immediate relatives—without explicit written consent from the resident (if they
have capacity) or legal authority demonstrated via documentation like a Durable Power of
Attorney for Healthcare. Option A and C are incorrect because familial relationship alone does
not grant a right to private medical or personal records.
Question 2: During an annual facility inspection, a surveyor discovers that the facility’s
emergency disaster plan does not include specific procedures for the evacuation of non-
ambulatory residents. How should the administrator address this deficiency to maintain
compliance?
A) The administrator should wait until the next state inspection to revise the plan.
B) The administrator must update the written disaster plan immediately to include specific
evacuation procedures for all residents based on their mobility needs and train staff accordingly.
,C) The administrator should simply verbally inform staff of the evacuation procedures during the
next staff meeting.
D) The facility is exempt if they have a contract with a local ambulance company.
Correct Answer: B) The administrator must update the written disaster plan immediately to
include specific evacuation procedures for all residents based on their mobility needs and
train staff accordingly.
Explanation: Title 22 requires every facility to maintain a comprehensive, written disaster and
mass casualty plan. This plan must be specific to the population served, including the needs of
non-ambulatory residents. Verbally informing staff (Option C) is insufficient as the regulation
mandates written documentation and evidence of staff training.
Question 3: What is the maximum timeframe permitted for an administrator to report a "Special
Incident" (e.g., physical abuse, theft, or serious injury) to the Licensing Agency?
A) Within 72 hours of the occurrence.
B) Within 10 calendar days.
C) Within 24 hours of the occurrence.
D) Immediately upon the next quarterly report.
Correct Answer: C) Within 24 hours of the occurrence.
Explanation: The regulation regarding Special Incident Reporting (SIR) is strict. Administrators
are required to notify the Department of Social Services (DSS) licensing office via phone or
fax/email within one working day (24 hours) of the occurrence of a special incident to ensure
immediate state oversight of resident safety.
Question 4: A resident’s physician orders a "PRN" medication. Under Title 22 regulations,
which of the following is mandatory before a staff member can administer this medication to the
resident?
A) The physician’s order must be signed by the facility administrator.
B) The medication must be clearly labeled with the resident’s name and specific instructions
regarding the symptoms that necessitate its use.
C) The staff member must obtain verbal approval from the resident's emergency contact.
D) The medication must be administered by a licensed nurse, as unlicensed staff cannot
administer PRN medication.
,Correct Answer: B) The medication must be clearly labeled with the resident’s name and
specific instructions regarding the symptoms that necessitate its use.
Explanation: Title 22 requires that all medications, especially PRN (as needed) medications,
must be prescribed by a physician and clearly labeled. PRN medications specifically require
clear documentation from the physician describing the exact conditions (symptoms) that indicate
the need for administration to ensure unlicensed staff (who are trained to assist with self-
administration) do not make clinical diagnostic decisions.
Question 5: An ARF is planning a renovation to add a new bedroom. Before construction
begins, what is the administrator's primary responsibility regarding the Licensing Agency?
A) No notification is required if the renovations are strictly cosmetic.
B) The administrator must notify the licensing agency in writing and receive approval for any
changes to the facility’s physical plan or capacity.
C) The administrator only needs to inform the local building department.
D) The administrator can proceed with the construction as long as they notify the agency upon
completion.
Correct Answer: B) The administrator must notify the licensing agency in writing and
receive approval for any changes to the facility’s physical plan or capacity.
Explanation: Any change that affects the licensed capacity or the physical footprint of the facility
(floor plan) requires prior notification and approval from the Community Care Licensing
Division. This ensures the facility remains in compliance with fire safety and square footage
requirements per resident.
Question 6: Regarding the "Personal Rights" of a resident in an ARF, which of the following is
a violation of these rights?
A) Requiring a resident to participate in a daily scheduled exercise program.
B) Prohibiting a resident from sending or receiving unopened mail.
C) Setting a curfew for all residents for safety reasons.
D) Limiting a resident's access to their own clothing.
Correct Answer: B) Prohibiting a resident from sending or receiving unopened mail.
Explanation: Residents have a fundamental right to send and receive unopened, private
correspondence. Interference with this mail or opening a resident's mail without their consent is
a direct violation of Personal Rights under Title 22.
, Question 7: A resident has a history of wandering. The facility wants to install a locked fence
around the perimeter. What must the administrator ensure?
A) The fence is high enough to be aesthetically pleasing.
B) The facility has obtained approval from the Licensing Agency for the use of restricted egress
or perimeter controls, ensuring it does not violate resident rights to freedom of movement.
C) The fence is constructed of wood rather than metal.
D) The facility only needs to notify the local fire department.
Correct Answer: B) The facility has obtained approval from the Licensing Agency for the
use of restricted egress or perimeter controls, ensuring it does not violate resident rights to
freedom of movement.
Explanation: Facilities cannot arbitrarily restrict a resident's movement. If a facility wishes to
use locked doors or perimeter fencing that restricts egress, it must be approved as a specialized
safety measure, usually requiring justification based on resident needs (e.g., dementia-related
wandering) and adherence to strict fire safety codes.
Question 8: An administrator has hired a new staff member. What is the mandatory timeline for
the staff member to receive an orientation to the facility's policies and procedures?
A) Within 30 days of the hire date.
B) During the first week of employment.
C) Prior to or at the time of initial presence in the facility.
D) Immediately after the first performance review.
Correct Answer: C) Prior to or at the time of initial presence in the facility.
Explanation: To ensure the safety of residents, all staff must be familiar with the facility's
emergency procedures, resident rights, and job responsibilities before they begin working with
residents. This orientation must occur at the time of their first presence in the facility.
Question 9: A resident requests to keep a pet in their room. What is the administrator’s
regulatory obligation?
A) The administrator must allow the pet if it is a service animal, but can restrict other pets based
on facility policy.
B) The administrator must allow all pets regardless of the type.
Administrator Exam Prep: Master ARF
Regulations & Title 22 Compliance Practice
Questions
SUBTOPIC: California Title 22 Regulations, Resident Rights, and ARF
Operational Compliance
Question 1: An ARF administrator receives a request from a resident's family member to access
the resident’s personal records. According to Title 22, under what condition can the
administrator release this information?
A) The family member is an immediate relative and pays the facility fees.
B) The resident has provided written authorization, or the family member holds legal Power of
Attorney (POA) for healthcare decisions.
C) The administrator can release records to any immediate family member to ensure
transparency.
D) The administrator must wait for the licensing agency to approve the request before releasing
any documentation.
Correct Answer: B) The resident has provided written authorization, or the family member
holds legal Power of Attorney (POA) for healthcare decisions.
Explanation: Resident confidentiality is strictly protected. Records cannot be released to family
members—even immediate relatives—without explicit written consent from the resident (if they
have capacity) or legal authority demonstrated via documentation like a Durable Power of
Attorney for Healthcare. Option A and C are incorrect because familial relationship alone does
not grant a right to private medical or personal records.
Question 2: During an annual facility inspection, a surveyor discovers that the facility’s
emergency disaster plan does not include specific procedures for the evacuation of non-
ambulatory residents. How should the administrator address this deficiency to maintain
compliance?
A) The administrator should wait until the next state inspection to revise the plan.
B) The administrator must update the written disaster plan immediately to include specific
evacuation procedures for all residents based on their mobility needs and train staff accordingly.
,C) The administrator should simply verbally inform staff of the evacuation procedures during the
next staff meeting.
D) The facility is exempt if they have a contract with a local ambulance company.
Correct Answer: B) The administrator must update the written disaster plan immediately to
include specific evacuation procedures for all residents based on their mobility needs and
train staff accordingly.
Explanation: Title 22 requires every facility to maintain a comprehensive, written disaster and
mass casualty plan. This plan must be specific to the population served, including the needs of
non-ambulatory residents. Verbally informing staff (Option C) is insufficient as the regulation
mandates written documentation and evidence of staff training.
Question 3: What is the maximum timeframe permitted for an administrator to report a "Special
Incident" (e.g., physical abuse, theft, or serious injury) to the Licensing Agency?
A) Within 72 hours of the occurrence.
B) Within 10 calendar days.
C) Within 24 hours of the occurrence.
D) Immediately upon the next quarterly report.
Correct Answer: C) Within 24 hours of the occurrence.
Explanation: The regulation regarding Special Incident Reporting (SIR) is strict. Administrators
are required to notify the Department of Social Services (DSS) licensing office via phone or
fax/email within one working day (24 hours) of the occurrence of a special incident to ensure
immediate state oversight of resident safety.
Question 4: A resident’s physician orders a "PRN" medication. Under Title 22 regulations,
which of the following is mandatory before a staff member can administer this medication to the
resident?
A) The physician’s order must be signed by the facility administrator.
B) The medication must be clearly labeled with the resident’s name and specific instructions
regarding the symptoms that necessitate its use.
C) The staff member must obtain verbal approval from the resident's emergency contact.
D) The medication must be administered by a licensed nurse, as unlicensed staff cannot
administer PRN medication.
,Correct Answer: B) The medication must be clearly labeled with the resident’s name and
specific instructions regarding the symptoms that necessitate its use.
Explanation: Title 22 requires that all medications, especially PRN (as needed) medications,
must be prescribed by a physician and clearly labeled. PRN medications specifically require
clear documentation from the physician describing the exact conditions (symptoms) that indicate
the need for administration to ensure unlicensed staff (who are trained to assist with self-
administration) do not make clinical diagnostic decisions.
Question 5: An ARF is planning a renovation to add a new bedroom. Before construction
begins, what is the administrator's primary responsibility regarding the Licensing Agency?
A) No notification is required if the renovations are strictly cosmetic.
B) The administrator must notify the licensing agency in writing and receive approval for any
changes to the facility’s physical plan or capacity.
C) The administrator only needs to inform the local building department.
D) The administrator can proceed with the construction as long as they notify the agency upon
completion.
Correct Answer: B) The administrator must notify the licensing agency in writing and
receive approval for any changes to the facility’s physical plan or capacity.
Explanation: Any change that affects the licensed capacity or the physical footprint of the facility
(floor plan) requires prior notification and approval from the Community Care Licensing
Division. This ensures the facility remains in compliance with fire safety and square footage
requirements per resident.
Question 6: Regarding the "Personal Rights" of a resident in an ARF, which of the following is
a violation of these rights?
A) Requiring a resident to participate in a daily scheduled exercise program.
B) Prohibiting a resident from sending or receiving unopened mail.
C) Setting a curfew for all residents for safety reasons.
D) Limiting a resident's access to their own clothing.
Correct Answer: B) Prohibiting a resident from sending or receiving unopened mail.
Explanation: Residents have a fundamental right to send and receive unopened, private
correspondence. Interference with this mail or opening a resident's mail without their consent is
a direct violation of Personal Rights under Title 22.
, Question 7: A resident has a history of wandering. The facility wants to install a locked fence
around the perimeter. What must the administrator ensure?
A) The fence is high enough to be aesthetically pleasing.
B) The facility has obtained approval from the Licensing Agency for the use of restricted egress
or perimeter controls, ensuring it does not violate resident rights to freedom of movement.
C) The fence is constructed of wood rather than metal.
D) The facility only needs to notify the local fire department.
Correct Answer: B) The facility has obtained approval from the Licensing Agency for the
use of restricted egress or perimeter controls, ensuring it does not violate resident rights to
freedom of movement.
Explanation: Facilities cannot arbitrarily restrict a resident's movement. If a facility wishes to
use locked doors or perimeter fencing that restricts egress, it must be approved as a specialized
safety measure, usually requiring justification based on resident needs (e.g., dementia-related
wandering) and adherence to strict fire safety codes.
Question 8: An administrator has hired a new staff member. What is the mandatory timeline for
the staff member to receive an orientation to the facility's policies and procedures?
A) Within 30 days of the hire date.
B) During the first week of employment.
C) Prior to or at the time of initial presence in the facility.
D) Immediately after the first performance review.
Correct Answer: C) Prior to or at the time of initial presence in the facility.
Explanation: To ensure the safety of residents, all staff must be familiar with the facility's
emergency procedures, resident rights, and job responsibilities before they begin working with
residents. This orientation must occur at the time of their first presence in the facility.
Question 9: A resident requests to keep a pet in their room. What is the administrator’s
regulatory obligation?
A) The administrator must allow the pet if it is a service animal, but can restrict other pets based
on facility policy.
B) The administrator must allow all pets regardless of the type.
