# Most Cited Cal/OSHA Violations in Health Care

Cal/OSHA issued 2,816 citations across 955 California health care inspections from 2020 through 2025. §5199, Aerosol Transmissible Diseases, leads — heavily concentrated in the pandemic years — with the IIPP and health-care violence prevention behind it.

Source: https://compliantca.com/guides/most-cited-cal-osha-violations-healthcare/
Published: 2026-08-21
Updated: 2026-08-21
Publisher: CompliantCA — not a law firm; this is not legal advice.

Cal/OSHA publishes a statewide [top-ten list of frequently cited standards](https://www.dir.ca.gov/dosh/statistics/Frequently-cited-standards.html) but no per-industry breakdown. This page is the health care cut, computed from the federal enforcement data that Cal/OSHA inspections flow into. The period is January 2020 through December 2025: **2,816 citations across 955 California health care inspections** (NAICS 621–623 — ambulatory care, hospitals, and nursing and residential care).

**Free IIPP template.** A fill-in Injury and Illness Prevention Program with plain-language prompts for each element §3203 names. PDF, no account.
[Request the template →](/request/iipp-template/?from=most-cited-cal-osha-violations-healthcare)
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## The top ten, 2020–2025 {#top-ten}

Citations counted per violation line item. Average penalty is the mean current penalty across the row's citations, including those reduced to $0; the range minimum is the smallest non-zero current penalty. Current penalties are as retrieved 2026-08-21 and change as cases settle.

| # | Standard | What it covers | Citations | Avg penalty | Penalty range |
|---|---|---|---|---|---|
| 1 | [§5199](https://www.dir.ca.gov/title8/5199.html) | Aerosol Transmissible Diseases | 840 | $3,494 | $135 – $40,500 |
| 2 | [§3203](https://www.dir.ca.gov/title8/3203.html) | Injury and Illness Prevention Program | 305 | $1,148 | $60 – $19,125 |
| 3 | [§342](https://www.dir.ca.gov/title8/342.html) | Reporting Work-Connected Fatalities and Serious Injuries | 192 | $3,954 | $1,000 – $20,000 |
| 4 | [§3342](https://www.dir.ca.gov/title8/3342.html) | Violence Prevention in Health Care | 148 | $4,193 | $90 – $79,000 |
| 5 | [§5162](https://www.dir.ca.gov/title8/5162.html) | Emergency Eyewash and Shower Equipment | 136 | $2,086 | $75 – $18,000 |
| 6 | [§5193](https://www.dir.ca.gov/title8/5193.html) | Bloodborne Pathogens | 132 | $742 | $75 – $10,800 |
| 7 | [§5144](https://www.dir.ca.gov/title8/5144.html) | Respiratory Protective Equipment | 84 | $1,397 | $150 – $12,375 |
| 8 | [§6151](https://www.dir.ca.gov/title8/6151.html) | Portable Fire Extinguishers | 76 | $228 | $75 – $700 |
| 9 | [§5194](https://www.dir.ca.gov/title8/5194.html) | Hazard Communication | 71 | $408 | $100 – $6,750 |
| 10 | [§3395](https://www.dir.ca.gov/title8/3395.html) | Heat Illness Prevention in Outdoor Places of Employment | 64 | $1,810 | $110 – $20,250 |
| 11 | All other standards | 139 distinct sections outside the top ten | 768 | $1,218 | $75 – $25,000 |
| | **Total** | **All standards cited** | **2,816** | **$2,223** | **$60 – $79,000** |

## Reading the table {#reading-the-table}

**§5199 leads, but read it with its dates.** Of its 840 citations, 721 — 86% — were issued in 2020 and 2021. The aerosol transmissible diseases standard was the vehicle for pandemic-era enforcement in health care; its citation counts since have fallen to single and double digits per year in this data (24 in 2023, 8 in 2024, 9 in 2025).

**§3342 is the row with the SB 553 connection.** [Violence Prevention in Health Care](https://www.dir.ca.gov/title8/3342.html) predates SB 553, and Labor Code §6401.9 exempts health care facilities covered by it — meaning this sector runs on its own violence-prevention standard while every other California employer follows SB 553. Its citations carry the table's highest maximum, $79,000, and a $4,193 average. Our [SB 553 guide](/guides/what-is-sb-553/) covers the general-industry side of that line.

**The rest is general industry, health-care flavored.** Bloodborne pathogens ([§5193](https://www.dir.ca.gov/title8/5193.html)), respiratory protection ([§5144](https://www.dir.ca.gov/title8/5144.html)), eyewash ([§5162](https://www.dir.ca.gov/title8/5162.html)) — exposure-control programs with written-plan and training components. And [§3203](https://www.dir.ca.gov/title8/3203.html), the IIPP, is #2 — a medical or dental office with no other row on this list still has that one. Our [Cal/OSHA IIPP guide](/guides/cal-osha-iipp/) covers it.

## Most Cited Cal/OSHA Violations by Industry {#other-industries}

- [Most Cited Cal/OSHA Violations in Construction](/guides/most-cited-cal-osha-violations-construction/)
- [Most Cited Cal/OSHA Violations in Manufacturing](/guides/most-cited-cal-osha-violations-manufacturing/)
- [Most Cited Cal/OSHA Violations in Restaurants](/guides/most-cited-cal-osha-violations-restaurants/)
- [Most Cited Cal/OSHA Violations in Landscaping](/guides/most-cited-cal-osha-violations-landscaping/)
- [Most Cited Cal/OSHA Violations in Agriculture](/guides/most-cited-cal-osha-violations-agriculture/)
- [Most Cited Cal/OSHA Violations in Auto Repair](/guides/most-cited-cal-osha-violations-auto-repair/)
- [Most Cited Cal/OSHA Violations in Trucking and Warehousing](/guides/most-cited-cal-osha-violations-trucking-warehousing/)

## Methodology {#methodology}

Computed from the [U.S. Department of Labor enforcement dataset](https://dataportal.dol.gov/) (the OSHA Information System), which includes Cal/OSHA because California operates an OSHA-approved State Plan. Scope: citation line items on California inspections with NAICS codes beginning 621, 622, or 623, issuance dates January 2020 through December 2025, excluding citation records deleted in the source data; social assistance (NAICS 624) is excluded. Data as retrieved 2026-08-21; counts change as cases settle and records are amended. Cal/OSHA's own statewide summaries are at [DIR's citation statistics pages](https://www.dir.ca.gov/dosh/Citation-statistics.html).

A citation count says what inspectors cited, not what any employer must do — the standards themselves say that. Each section above links to its full text.

## Frequently asked questions

### What is the most cited Cal/OSHA standard in health care?

8 CCR §5199, Aerosol Transmissible Diseases — 840 citations on California health care inspections from 2020 through 2025 in the federal enforcement data. Of those, 721 (86%) were issued in 2020 and 2021, the pandemic years. §3203, the IIPP, is second at 305.

### Does SB 553 apply to health care facilities?

Labor Code §6401.9 exempts health care facilities already covered by 8 CCR §3342, Violence Prevention in Health Care — the health-care-specific standard that predates SB 553. §3342 is #4 on this list with 148 citations, averaging $4,193.

### Which part of health care draws the most citations?

In this data, nursing and residential care facilities (NAICS 623) account for 1,517 of the 2,816 citations — more than hospitals (827) and ambulatory care such as medical and dental offices (472) combined.