Involuntary residential facilities: health and safety inspections.

The bill's official name was changed from 'Involuntary Residential Facilities Health and Safety Act of 2026, Masuma Khan Justice Act' to simply 'Masuma Khan Justice Act,' removing the descriptive subtitle.

The regulations section was restructured: previously both inspecting agencies could promulgate regulations AND CDPH adopted rules; now only CDPH adopts rules and regulations necessary to implement the part, with standards at least as stringent as those for licensed residential health care facilities.

Three new Assembly members (Bennett, Kalra, and Lee) were added as coauthors of the bill.

Three new violation classification definitions were added: Class AA (substantial factor in causing a death), Class A (imminent risk of death or serious harm), and Class B (direct relationship to health or safety but not class A or AA).

The definitions for 'city or county permit or approval' and 'state-issued permit or certification' were removed from the bill.

Unnoticed (no-prior-notice) inspection authority was narrowed: previously any inspecting agency could enter without notice upon reasonable cause of imminent threat or a reported hazard; now only the State Department of Public Health may conduct inspections without prior notice, and only for its limited sanitary/hygienic/safe conditions purpose.

The authority for an inspecting agency to suspend or revoke state-issued permits or certifications was removed, as was the provision allowing agencies to inform operators about city or county permits needed.

A new referral mechanism was added: if CDPH identifies conditions within another agency's jurisdiction during an inspection, it must refer them to that agency. The referral does not expand CDPH's authority beyond the scope of this part.

Penalties were restructured from a flat civil penalty of up to $25,000 per violation per day into tiered administrative penalties: $25,000 for class AA, $10,000 for class A, and $1,000 for class B. Each uncorrected day 'may constitute' (rather than definitively 'constitutes') a separate violation.

Clarification added that a safety warning is an administrative notice subordinate to the citation framework under Division 2 and does not itself constitute a separate violation, though it may be considered in determining compliance status.

The requirement for operators to submit annual reports (starting January 1, 2027) documenting fire safety compliance, environmental compliance, worker injury and illness logs, and infectious disease prevention protocols was removed entirely.

Operator record-keeping obligations were narrowed from covering 'health, safety, environmental, and labor standards' to 'health and safety standards, including the standards adopted pursuant to Section 19998.9.'

Inspection reports are now transmitted to 'the Legislature' rather than specifically to the Assembly Committee on Health and the Senate Committee on Health.

Added Section 2 declaring the bill an urgency statute under Article IV of the California Constitution, making it take effect immediately rather than on January 1. The stated justification is the need for prompt inspection to identify and correct conditions posing imminent risk to health and safety, including loss of life.

The legislative vote requirement changed from a simple majority to a two-thirds supermajority in both houses, which is the constitutional threshold required for urgency statutes. This makes passage more difficult but allows immediate effect.

Assembly Member Zbur was added as a coauthor of the bill.

Section numbers were renumbered throughout to eliminate duplicate or placeholder section headings that existed in the Senate version. Cross-references within the text were updated accordingly (e.g., Section 19998.5(a) now references Section 19998.4 instead of 19998.3, and Section 19998.8(b) now references both Sections 19998.9 and 19998.10).

CDPH is now specifically authorized to inspect involuntary residential facilities for sanitary, hygienic, and safe conditions using standards consistent with licensed residential health facilities under Division 2 of the Health and Safety Code, without requiring those facilities to be licensed under that division.

The bill is renamed the 'Masuma Khan Justice Act' as a subtitle to the Involuntary Residential Facilities Health and Safety Act of 2026.

The flat civil penalty of up to $25,000 per violation was replaced with a tiered administrative penalty system: up to $25,000 for class AA violations, up to $10,000 for class A, and up to $1,000 for class B. Penalties now require appropriate notice and an opportunity for a hearing before imposition.

New safety warning mechanism: if an operator fails to correct a violation within the time specified in a citation, CDPH may issue a safety warning identifying the uncorrected condition and requiring prompt corrective action. Safety warnings are subordinate to the Division 2 citation framework.

CDPH may now refer violations to the Attorney General, who may bring a civil action for declaratory or injunctive relief to compel abatement of a hazard.

CDPH must use the inspection and citation protocols from Section 1279 and Chapter 2.4 of Division 2 (including class AA, A, and B citations) when exercising its authority under this part.

CDPH must adopt rules and regulations establishing measurable standards at least as stringent as those applied to licensed residential health care facilities, covering: personal hygiene and cleaning frequency, vector and pest control, indoor air quality and temperature control, potable water access and dietary requirements (including medically necessary and religious diets), communicable disease protocols, and physical harm prevention (safe restraints, medical evaluation after force incidents, de-escalation training, workplace violence prevention).

CDPH must consult with stakeholders including civil rights advocates, public health experts, and organizations representing the interests of persons held in involuntary residential facilities when developing standards.

New provision prohibits operators from using internal security protocols to deny inspectors access to areas where residents are housed, fed, or receive medical care, while requiring inspectors to comply with reasonable security procedures for safety.

Inspectors may now review deidentified or aggregate health, safety, and incident records including injury rates, use of force or restraint incidents, infectious disease data, hospitalizations, and mortality, provided resident privacy is protected.

New definition of 'unreasonably interfere' added: conduct that materially disrupts or impedes facility operations or security functions beyond what is necessary to carry out an inspection.

Assembly Members Gipson, Connolly, and Ortega were added as coauthors. Report submission now must comply with Section 9795 of the Government Code. CDPH may conduct unannounced inspections for its specific sanitary/safety purposes without prior notice.

Removed the multi-agency inspection framework. The Office of the State Fire Marshal, State Water Resources Control Board, and Department of Industrial Relations (Cal/OSHA) no longer have independent authority to inspect involuntary residential facilities. All inspection authority is now vested solely in the State Department of Public Health.

Added a new exemption: juvenile facilities operated by local government are excluded from the definition of 'involuntary residential facility,' except for secure youth treatment facilities operated under Welfare and Institutions Code Section 875 (including those located within or in conjunction with a juvenile facility).

Removed the detailed list of specific systems that inspections may examine (heating, ventilation, water, wastewater, fire suppression, hazardous materials storage, structural, electrical). The new version does not enumerate specific inspection targets.

Added a new section (19998.3) requiring the department to implement inspections in a manner that avoids unnecessary duplication of existing state or local health and safety oversight, and permitting consideration of prior inspections, certifications, and compliance findings when setting inspection priorities.

Removed the requirement that adopted standards be 'at least as stringent as those applied to residential health care facilities licensed under Division 2.' The new language only requires 'measurable standards for sanitary, hygienic, and safe conditions' without a comparative stringency floor.

Removed reference to Section 1279 from the citation protocol provision. The department now relies only on Chapter 2.4 (commencing with Section 1417) of Division 2 for its inspection and citation framework, including class AA, A, and B citations.

Removed the separate provision authorizing 'inspecting agencies' to conduct periodic inspections evaluating compliance with building, environmental, and labor standards. This broad multi-domain inspection authority no longer exists in the bill.