Beginning July 29, 2020, CDPH requests that facilities report COVID-19 data to CDPH and to notify clients, clients' representatives, and families of clients when there are COVID-19 positive clients or healthcare workers in the facility. The report must include, but is not limited to, the following: suspected and confirmed COVID-19 infections among clients and staff, supply of personal protective equipment (PPE) and hand hygiene supplies in the facility, staff shortages, and other information specified by CDPH.

Accessing the CDPH COVID-19 ICF Survey

To access the survey, follow the instructions below. For full details on how to login to the COVID-19 ICF Survey Hub, refer to the login instructions (PDF).

If you are completing this survey from a web browser:

1. Go to the COVID-19 ICF Survey Hub (Google Chrome is recommended; it does not work in Internet Explorer).
2. Login with your username and password.
1. Username: Facility ID_ICF (e.g. 000000000_ICF)
2. Temporary Password: xIcf#123 (you will then be prompted to create a new password)
3. Select "Submit a Survey for this Facility" to launch the survey.

If you do not know your Facility ID, use the CDPH Health Care Facility ID Lookup Tool.

Note: Some questions are conditional and will appear based on your answers, so please try to answer accurately.

If you are completing this survey from the Survey123 app on a mobile device:

1. Ensure that you have downloaded Survey123 from your mobile device's App Store
2. Ensure you have already used the COVID-19 ICF Survey to create a password.
3. Log into the survey hub and scan the QR code from the survey hub page with the mobile device.
4. On the landing page, select "Open in the Survey123 field app"
5. If you have not signed in yet, select "Sign in to download" and login with your username and password.
6. This will launch the Survey123 App and automatically download the survey to your App.

Note: If you would like to fill this survey out from your mobile device, you can do so without the use of the mobile application. Please scan the QR code and select "Open in browser."

ICF COVID-19 Reporting

CDPH requests that facilities report via the COVID-19 ICF Survey by no later than 12:00 P.M. Pacific Time daily. The first report will be for cumulative data from January 1, 2020, to July 29, 2020. Subsequent daily reporting will be for new incidents from the last reporting date. To ensure consistent reporting across the state, CDPH is including a data dictionary (PDF). Facilities are encouraged to review the data dictionary in its entirety before inputting data into the COVID-19 Survey.

Online submissions using the COVID-19 ICF Survey will take the place of daily reporting to CDPH district offices related to the information specified above. All other reporting requirements to CDPH district offices will continue using the standard reporting process. Please note that even if you are already receiving assistance from the CDPH Healthcare Acquired Infection (HAI) Infection Control strike teams, you should still fill out this survey daily.

Information from this survey will be shared with the local public health office emergency teams so we can work collaboratively with facilities to quickly find solutions; however, facilities should still notify their local Medical Health Operational Area Coordinator (MHOAC) for PPE resource requests.

Notification to Clients, Clients' Representatives, and Families of Clients

It is vitally important for facilities to notify clients, client representatives, and family members when there are COVID-19 positive clients or healthcare workers in the facility to keep them informed of the conditions at the facility. Pursuant to Title 42 CFR section 483.420, facilities should inform clients, their representatives, and families of those residing in facilities of serious diseases, such as COVID-19. Facilities should give this notification when there is:

• A single confirmed infection of COVID-19, or
• Three or more clients or staff with new-onset of respiratory symptoms occurring within 72 hours of each other.

This information:

• Must not include personally identifiable information.
• Should include information on mitigating actions implemented to prevent or reduce the risk of transmission, including if normal operations of the facility will be altered.

This notification will provide an opportunity to inform families of the safety measures your facility is taking to protect their loved ones. Constant communication and transparent information are useful tools for all facilities to use with their healthcare worker staff, clients, and community.

For the purposes of this AFL the following definitions apply:

• "COVID suspect" means, persons with symptoms of COVID-19 or persons who are asymptomatic that have been exposed to a lab-confirmed case of COVID-19.
• "COVID laboratory positive" means, an individual who has at least one respiratory specimen that tested positive for the virus that causes COVID-19 by a CDC laboratory, state or local public health laboratory, or commercial laboratory using Food and Drug Administration (FDA)-validated COVID-19 nucleic acid amplification (NAA) test.

If you have any questions about this AFL, please contact COVID-19SNFSURVEY@cdph.ca.gov.

Sincerely,

Original signed by Heidi W. Steinecker

Heidi W. Steinecker
Deputy Director

Resources:

• COVID-19 ICF Survey Hub
• ICF Daily Reporting Data Dictionary (PDF)
• How to Login to the COVID-19 ICF Survey (PDF)