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.
Cal/OSHA publishes a statewide top-ten list of frequently cited standards 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 →
The top ten, 2020–2025
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 | Aerosol Transmissible Diseases | 840 | $3,494 | $135 – $40,500 |
| 2 | §3203 | Injury and Illness Prevention Program | 305 | $1,148 | $60 – $19,125 |
| 3 | §342 | Reporting Work-Connected Fatalities and Serious Injuries | 192 | $3,954 | $1,000 – $20,000 |
| 4 | §3342 | Violence Prevention in Health Care | 148 | $4,193 | $90 – $79,000 |
| 5 | §5162 | Emergency Eyewash and Shower Equipment | 136 | $2,086 | $75 – $18,000 |
| 6 | §5193 | Bloodborne Pathogens | 132 | $742 | $75 – $10,800 |
| 7 | §5144 | Respiratory Protective Equipment | 84 | $1,397 | $150 – $12,375 |
| 8 | §6151 | Portable Fire Extinguishers | 76 | $228 | $75 – $700 |
| 9 | §5194 | Hazard Communication | 71 | $408 | $100 – $6,750 |
| 10 | §3395 | 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
§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 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 covers the general-industry side of that line.
The rest is general industry, health-care flavored. Bloodborne pathogens (§5193), respiratory protection (§5144), eyewash (§5162) — exposure-control programs with written-plan and training components. And §3203, 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 covers it.
Most Cited Cal/OSHA Violations by Industry
- Most Cited Cal/OSHA Violations in Construction
- Most Cited Cal/OSHA Violations in Manufacturing
- Most Cited Cal/OSHA Violations in Restaurants
- Most Cited Cal/OSHA Violations in Landscaping
- Most Cited Cal/OSHA Violations in Agriculture
- Most Cited Cal/OSHA Violations in Auto Repair
- Most Cited Cal/OSHA Violations in Trucking and Warehousing
Methodology
Computed from the U.S. Department of Labor enforcement dataset (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.
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.