As of 2026 and ongoing, San Diego Regional Center (SDRC) will conduct an annual review of all settings where HCBS-funded services are provided. For each review, SDRC will use any two or more, of the methods listed below, in any combination, to collect evidence of compliance.  

SDRC staff and or consultants will review the HCBS service settings to conduct these activities throughout 2026 and annually thereafter. Any documents that are used to review the HCBS service settings will be posted to this site (see section below titled "Resources"). 

Evidence of compliance may be collected through two or more of the following methods: 

• Interviews with individuals served, addressing all HCBS settings requirements

• Individual satisfaction surveys linked to specific HCBS requirements 

• Interviews with service providers and direct support professionals addressing all HCBS settings requirements

• Review of the HCBS service provider records, including but not limited to: 

• Program design 

• Policies and procedures 

• Staff training documentation 

• Signed admission agreements 

• Meeting notes with individuals served 

• Activity calendars with documentation showing activities chosen by the individual 

• Other applicable documentation 

• Review of Standardized Individual Program Plans (S-IPPs) 

• On-site review and observation 

All collected information must be reported to DDS to meet Centers for Medicare & Medicaid Services (CMS) and Quality Incentive Program (QIP) requirements. 

🌟 If HCBS compliance is determined, a letter will be emailed to the service provider. This letter is to be kept in the service provider records and will satisfy HCBS Ongoing Compliance Monitoring for 2026. 

🚨 NOTE: If after receiving a compliance letter, and the service provider is found out of compliance, the service provider will need to work with SDRC to remediate the issues identified.

Technical Assistance Plan. TAP is used when deficiencies are seen but can be corrected quickly. This may be used for missing documents, minor infractions, and incidental situations. Consider this document as a warning and a written request for initial collaboration for minor situations. This action is not shared with the Department of Developmental Services (DDS) or Community Care Licensing (CCL). 

If areas of noncompliance are identified, SDRC will work collaboratively with the service provider to develop a Technical Assistance Plan (TAP). Examples of remediation activities may include: 

• Seeking input from individuals receiving services on how noncompliance can be corrected 

• Completing required training and/or training staff on HCBS requirements and person-centered planning 

• Updating documentation, policies, or practices to support full implementation of HCBS requirements. 

If the service provider successfully addresses the areas of concern and compliance has been determined, SDRC will report the correction to DDS, and remove the TAP.  

Corrective  Action Plan. CAP is used when there are deficiencies that are seen and need more aid to come into compliance. This could be when a provider must complete training or change a procedures. A CAP is issued after 10 working days of the found and verified substantial inadequacy (Title 17 Section 56056). This document is shared with Department of Developmental Services (DDS) and/or Community Care Licensing (CCL). 

If noncompliance persists after TAP remediation efforts, SDRC will work with the service provider to issue a written Corrective Action Plan (CAP) within ten (10) working days of the finding. CAPs will align with existing processes outlined in California Code of Regulations, Title 17, Section 56056, including appeal rights. 

The CAP will include: 

1. The specific federal HCBS requirement(s) found to be noncompliant, potential sanctions for failure to comply, and the provider’s right to appeal 

2. Required remediation actions, including those identified during technical assistance 

3. A remediation timeline not to exceed 30 days from the CAP issuance date, unless additional time is mutually agreed upon 

The service provider must return the signed and dated CAP within seven (7) days of receipt, noting any areas of disagreement in writing. SDRC will provide copies of the signed CAP to the service provider, any other involved regional centers, and DDS through existing reporting processes. 

Sanction is substantial inadequacy is not corrected within the period of the issued CAP or there are 2 findings of substantial inadequacy in the same home within 12-month period. This document is shared with Department of Developmental Services (DDS) or Community Care Licensing (CCL).

If a service provider does not complete CAP requirements within the specified timeframe, SDRC may progressively impose sanctions, including: 

1. An immediate moratorium on new referrals and authorizations for the affected service 

2. Meetings with individuals receiving services (or their authorized representatives) to discuss the situation and offer alternative service options 

• Meetings may occur via remote technology, if preferred 

Service providers will receive written notification of any imposed sanction, including the effective date. Continued noncompliance may result in termination of vendorization, in accordance with California Code of Regulations, Title 17, Section 54370. 

Moratorium: A temporary prohibition of an activity. The service provider may not accept referrals. May be issued to the agency during the appeal process or until such violation has been corrected. (Title 17 54370)

Situations that present less immediate risk to health, safety, or personal care (Title 17 56054).

Examples of Such: Insufficient staffing (CS), Inappropriate clothing, Failure to provide agreed services, Inadequate, improper nutrition, Improper accounting of Resident funds, Violation of Resident rights, Improper supervision of medications, Insufficient training hours (CS), DSP certification

Please note that this is a representative list and does not encompass all possible situations. 

Existence of an impending threat to health and safety (Title 17 56053)

Examples of: No Direct Supervision, Inadequate Food/Clothing, Presence of a Dangerous Person, Suspicion of Abuse, Structural Hazard, Failure to follow the Medical Diet, Resident Rights Violation

Please note that this is a representative list and does not encompass all possible situations. 

Service providers may appeal any sanction imposed due to continued HCBS noncompliance by submitting a written appeal to the Director of SDRC within 30 days of receiving the notice. Appeals will follow procedures outlined in California Code of Regulations, Title 17, Section 54380.  

Compliance with HCBS requirements is a required element for eligibility in the Quality Incentive Program (QIP), which may provide up to 10 percent of a provider’s full rate model established through rate reform. Additional details are outlined in the October 2025 DDS Directive D-2025-Quality Incentive Program-015.  

Title 17: most commonly Title 17 of the California Code of Regulations (CCR), which governs Public Health, including Developmental Services (Individuals’ Rights, Licensed Residential Home Standards) 

Title 22: most commonly refers to the California Code of Regulations (CCR) Title 22, which governs health and social services in California for residential and adult day programs.  

Title 42: refers to Medicaid programs authorized under Title 42 of the Code of Federal Regulations, specifically Sections 1915(c) & (i), allowing states to offer support services in the community as an alternative to nursing homes for eligible individuals, featuring services like personal care, case management, and respite care, governed by CMS and defined in federal regulations like 42 CFR Part 440.180 and Part 441 Subpart G.   

Compliant (C): There is actual evidence of the requirement occurring in the home   

Partially Compliant (PC): There is some evidence, but something may be missing or not documented   

Not Compliant (NC): There is no evidence of the requirement, there are no procedures, and/or no documentation