(

a) Every health facility for which a license or special permit has been issued shall be periodically inspected by the department, or by another governmental entity under contract with the department. The frequency of inspections shall vary, depending upon the type and complexity of the health facility or special service to be inspected, unless otherwise specified by state or federal law or regulation. The inspection shall include participation by the California Medical Association consistent with the manner in which it participated in inspections, as provided in

Section prior to September 15, 1992. (

b) Except as provided in subdivision (

c) and

Section 1422, inspections shall be conducted no less than once every two years and as often as necessary to ensure the quality of care being provided. (

c) For a health facility specified in subdivision (a), (b), or (

f) of

Section 1250, inspections shall be conducted no less than once every three years, and as often as necessary to ensure the quality of care being provided. (

d) During the inspection, the representative or representatives shall offer such advice and assistance to the health facility as they deem appropriate. (

e) For acute care hospitals of beds or more, the inspection team shall include at least a physician, registered nurse, and persons experienced in hospital administration and sanitary inspections. During the inspection, the team shall offer advice and assistance to the hospital as it deems appropriate. (

f) The department shall ensure that a periodic inspection conducted pursuant to this

section is not announced in advance of the date of inspection. An inspection may be conducted jointly with inspections by entities specified in

Section 1282. However, if the department conducts an inspection jointly with an entity specified in

Section that provides notice in advance of the periodic inspection, the department shall conduct an additional periodic inspection that is not announced or noticed to the health facility. The department shall conduct a periodic inspection to inspect compliance with this

section and regulations adopted pursuant to

Section 1276.4 that is not announced in advance of the date of inspection. (

g) Notwithstanding any other law, the department shall inspect the facility for compliance with provisions of state law and regulations during a state periodic inspection or at the same time as a federal periodic inspection, including, but not limited to, an inspection required under this section. If the department inspects for compliance with state law and regulations at the same time as a federal periodic inspection, the inspection shall be done consistent with the guidance of the federal Centers for Medicare and Medicaid Services for the federal portion of the inspection. (

h) The department shall emphasize consistency across the state and its district offices when conducting licensing and certification surveys and complaint investigations, including the selection of state or federal enforcement remedies in accordance with

Section 1423. The department may issue federal deficiencies and recommend federal enforcement actions in those circumstances where they provide more rigorous enforcement action.