California workplace safety officials issued a serious citation against a Kaiser Permanente psychiatric facility in Santa Clara, accusing the center of failing to provide workers with N95 masks and other protection against COVID-19. But the problems facing the health care giant may run much deeper.

The citation, issued last week by the state’s Division of Occupational Safety and Health with a proposed fine of $11,200, is the first in an expected wave of citations against Kaiser Permanente facilities statewide for failing to acknowledge that COVID-19 can be transmitted via aerosol particles, according to a source inside Cal/OSHA, who asked not to be identified. Kaiser told CalMatters on Thursday that it plans to appeal.

The agency found that Kaiser systematically failed to comply with California health and safety standards for aerosol transmissible diseases, the source said, even after early studies showed that the virus could survive in the air. California instructed employers in May to assume that was the case, and most California hospitals complied. After a series of evolving statements, the Centers for Disease Control and Prevention updated its guidelines last week to say that COVID-19 transmission can be, in fact, airborne.

Cal/OSHA’s citation thrusts the health care giant into the heart of a national battle over how hospitals and other health care employers should keep workers safe not only from virus particles that can hurl through the air in droplets from a sneeze or cough but also hover in the air after being exhaled by those infected.

Until this week, Cal/OSHA had closed 80 complaints about COVID-19 hazards in Kaiser Permanente hospitals and medical centers without issuing any citations. Many alleged that health care workers were never provided with N95 masks and other personal protective equipment.

CalMatters obtained and reviewed the citation against the Santa Clara facility, which identified five violations of the state’s rules on aerosol transmissible diseases, including failing to provide an adequate supply of N95 masks, allowing symptomatic and asymptomatic employees to work alongside other employees and failing to quickly notify employees of exposure.

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