A new requirement for the California Department of Public Health (CDPH) to conduct unannounced visits to hospitals to inspect for compliance with nurse staffing ratio requirements is now law under Senate Bill 227 recently signed by Governor Gavin Newsom. In 1999 California implemented the nation’s first law mandating nurse-to-patient staffing ratios—those requirements went into effect in 2004. It set the minimum ratio of nurses to patient by unit, including one-to-one in operating rooms and one-to-five in general medical-surgical units as outlined in Title 22 of the California Code of Regulations and are enforced by CDPH. Despite the mandated ratios however, hospitals have repeatedly violated staffing requirements—from 2008 to 2017, there were 634 out-of-ratio deficiencies reported to CDPH. Under the new law CDPH will be empowered to enforce the nurse staffing ratios by fining hospitals that repeatedly create unsafe conditions for patient care. “I appreciate the Governor’s signature of SB 227, which ensures that hospitals prioritize the safety of patients by following the nurse-to-patient staffing ratios already required by law,” said California Senator Connie Leyva who represents District 20. “The state will now have a stronger mechanism to fine hospitals that repeatedly ignore nurse staffing ratios.” SB 227 will give CDPH another tool to hold hospitals accountable for violating nurse staffing ratios to prevent potentially dangerous actions that jeopardize the safety of patients.