In California, rest homes are classified as skilled nursing facilities, intermediate care facilities, or community care facilities. Criminal sanctions are provided for the willful or repeated violations of regulations for the care of residents in some facilities. The most severe problems in rest homes are the neglect and substandard care provided in some facilities. In Los Angeles, a small group of health facility inspectors has been assigned the task of making repeated visits to the worst facilities throughout the year. This has provided an increased volume of evidence of serious and repeated regulatory violations. To provide an effective deterrent to patient neglect, the Long-term Care, Safety, and Security Act of 1973 established a civil citation system which imposes quick and effective economic sanctions for patient-care violations. Statutory and regulatory changes which would impose broader reporting requirements for the ownership and operation of each facility have also been proposed. Steps have also been taken to curtail rest home trust fund abuses and other financial abuses. Close working relationships between local prosecutors, the Department of Health, and other concerned and involved public agencies have been valuable to an effective enforcement program with respect to the rest homes.