Frequently Asked Questions – Basic Respiratory Tasks (CCR § 1399.365)

This page provides answers to common questions about California Code of Regulations (CCR), title 16, section 1399.365.

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Understanding CCR § 1399.365

• Does this regulation change the scope of practice for Respiratory Care Practitioners (RCPs)?

  No. This regulation does not expand, limit, or otherwise change the scope of practice for licensed Respiratory Care Practitioners (RCPs). Instead, it clarifies the distinction between basic respiratory tasks identified in subdivision (b) of CCR section 1399.365 and respiratory care services that require a respiratory assessment, clinical judgment, or specialized respiratory training, which must be performed by an RCP or another provider authorized by law, such as a registered nurse (RN).

• What specific tasks have been classified as “basic” under the regulation?

  Subdivision (b) of CCR section 1399.365 lists basic respiratory tasks and services that do not require a respiratory assessment. Examples include application and monitoring of pulse oximetry, patient data collection, medication administration by aerosol that does not require ventilator manipulation, and certain hygiene care related to respiratory devices. A full list is available in CCR section 1399.365(b).

• Who can perform basic respiratory tasks identified in subdivision (b)?

  The regulation identifies which tasks are considered “basic” (CCR section 1399.365(b)) because they do not require a respiratory assessment. Basic tasks may be performed by health care personnel who are otherwise authorized by law, consistent with applicable laws and facility policies.

  The regulation does not assign tasks to specific license types. Employers and care settings must ensure tasks are performed only by personnel acting within their lawful authority, training, and competency requirements.

• Who must perform respiratory tasks listed in subdivision (c)?

  Respiratory tasks listed in subdivision (c) of CCR section 1399.365 must be performed by a licensed Respiratory Care Practitioner (RCP) or another provider authorized by law, such as a registered nurse (RN). These tasks require a respiratory assessment, advanced clinical judgment, or specialized respiratory training.

  Subdivision (c) lists tasks that are not basic respiratory tasks. The list of excluded tasks in subdivision (c) is not exhaustive. Any respiratory care task or service that requires assessment, evaluation, or clinical judgment must be performed by an RCP or another provider authorized by law, such as a RN to ensure patient safety.

• How do I know whether a respiratory task requires a respiratory assessment?

  CCR section 1399.365 defines “assessment” as making an analysis or judgment and making recommendations concerning the management, diagnosis, treatment, or care of a patient, or as a means to perform any task related to the care of a patient.

  Assessment goes beyond documenting observations and gathering and reporting data. If a task requires analysis, evaluation, decision-making, or clinical judgment, it is not a basic task and must be performed by a licensed RCP or another provider authorized by law, such as a registered nurse (RN).

Common Task Classification Questions

Note: CCR section 1399.365 identifies which respiratory tasks are considered “basic” and which are not. Basic respiratory tasks identified in the regulation may be performed by health care personnel when consistent with their lawful scope of practice.

Licensed Vocational Nurses (LVNs) may perform basic respiratory tasks identified in CCR section 1399.365(b). LVNs are not authorized to perform respiratory tasks requiring respiratory assessment, including those that are expressly excluded from basic tasks in under CCR section 1399.365(c).

Non-Invasive Ventilation (CPAP/BiPAP)

• Is applying CPAP or BiPAP masks or operating non-invasive ventilators a basic respiratory task?

  No. The initiation, operation, or manipulation of non-invasive ventilators, including the placement, adjustment, or removal of CPAP or BiPAP interfaces, is excluded from basic respiratory tasks under CCR section 1399.365(c). These functions require a respiratory assessment and must be performed by a licensed Respiratory Care Practitioner (RCP) or another provider authorized by law, such as a registered nurse (RN).

  Supportive, non-clinical assistance for patients already using CPAP or BiPAP, such as assisting with hygiene, skin inspection, comfort measures, or routine observation and documentation, does not constitute ventilator manipulation. However, any adjustment to mask fit, pressures, alarms, or device settings involves respiratory assessment and clinical judgment and must be performed by an RCP or another provider authorized by law, such as an RN.

• Is adjusting a CPAP or BiPAP mask fit or straps a basic respiratory task?

  Assistance with comfort measures or routine observation for a patient already using CPAP or BiPAP may be a basic respiratory task when it does not involve ventilator manipulation or require respiratory assessment or clinical judgment. However, adjusting mask fit in a way that changes the seal or affects delivered pressures, alarms, or device settings is considered manipulation of a non-invasive ventilator and is not a basic respiratory task.

Oxygen-Related Tasks

• Is initiating oxygen therapy a basic respiratory task?

  No. Initiating oxygen therapy is not a basic respiratory task. Initial setup or initiation of oxygen therapy requires respiratory assessment and clinical judgment and is excluded from basic tasks.

• Is adjusting or titrating oxygen flow or concentration a basic respiratory task?

  No. Adjusting oxygen liter flow or oxygen concentration is not a basic respiratory task. These activities require respiratory assessment and clinical judgment and are expressly excluded under CCR section 1399.365(c)(6).

• Is replacing an oxygen tank a basic respiratory task?

  Yes. Replacing an oxygen tank after oxygen therapy has already been initiated and ordered is considered a basic respiratory task, provided the prescribed oxygen flow rate or concentration is not changed and no respiratory assessment or clinical judgment is required.

• Is replacing oxygen tubing or humidifier bottles a basic respiratory task?

  Yes. Routine replacement of oxygen tubing or humidifier bottles is considered a basic respiratory task when oxygen therapy is already established and ordered, and no changes are made to oxygen flow or concentration.

• Is setting up oxygen equipment a basic respiratory task?

  No. Initial setup of oxygen equipment for the purpose of starting oxygen therapy is not a basic respiratory task. Initial setup requires respiratory assessment and clinical judgment and is excluded under CCR section 1399.365(c)(6).

• Is increasing oxygen in response to low oxygen saturation a basic respiratory task?

  No. Increasing oxygen flow or concentration in response to a patient’s condition is not a basic respiratory task. This action requires respiratory assessment and clinical judgment and is excluded under CCR section 1399.365(c)(6).

Suctioning-Related Tasks

• Is oral suctioning a respiratory task? – Added January 2026

  Oral suctioning that is limited to the oral cavity only is not a respiratory task because it does not involve the airway and does not require a respiratory assessment or clinical judgment.

  Oral suctioning becomes a respiratory task if it extends beyond the oral cavity and enters the airway. Once oral suctioning involves the airway, it requires a respiratory assessment and is therefore not a basic respiratory task.

  Professional Qualifications Committee – Guidance on Suctioning Activities (PDF)

• Is nasal suctioning a respiratory task? – Added January 2026

  Suctioning limited to the nasal cavity only is not a respiratory task because it does not involve the airway and does not require a respiratory assessment or clinical judgment.

  Nasal suctioning becomes a respiratory task if it extends beyond the nasal cavity and enters the airway, including the nasopharynx or beyond. Once nasal suctioning involves the airway, it requires a respiratory assessment and is therefore not a basic respiratory task and is expressly excluded under CCR section 1399.365(c)(5).

  Professional Qualifications Committee – Guidance on Suctioning Activities (PDF)

• Is tracheostomy tube suctioning a respiratory task? – Added January 2026

  Suctioning that is limited to the tracheostomy tube only is not a respiratory task because it does not require a respiratory assessment or clinical judgment.

  Suctioning becomes a respiratory task if it extends past the tracheostomy tube. Once suctioning extends beyond the tracheostomy tube, it requires a respiratory assessment and is therefore not a basic respiratory task and is expressly excluded under CCR section 1399.365(c)(5).

  Professional Qualifications Committee – Guidance on Suctioning Activities (PDF)

• Is endotracheal suctioning a basic respiratory task?

  No. Endotracheal suctioning requires respiratory assessment and clinical judgment. Endotracheal suctioning is expressly excluded from basic respiratory tasks under CCR section 1399.365(c)(5).

• Is tracheal suctioning a basic respiratory task?

  No. Tracheal suctioning that extends beyond an endotracheal or tracheostomy tube is a respiratory task that requires respiratory assessment and clinical judgment. Tracheal suctioning is expressly excluded from basic respiratory tasks under CCR section 1399.365(c)(5).

Aerosol Medication Tasks

• Is medication administration by aerosol a basic respiratory task?

  Yes, in limited circumstances. Medication administration by aerosol is a basic respiratory task under CCR section 1399.365(b)(3) only when it does not require manipulation of an invasive or non-invasive mechanical ventilator.

• Is administering an aerosol treatment through a ventilator a basic respiratory task?

  No. Aerosol medication administration is not a basic task when it requires manipulation of an invasive or non-invasive mechanical ventilator. CCR section 1399.365(b)(3) limits aerosol medication administration to situations that do not require ventilator manipulation.

Ventilators and Breathing Circuits

• Is replacing or changing a ventilator breathing circuit a basic respiratory task?

  No. Initial setup, change-out, or replacement of a breathing circuit is excluded from basic respiratory tasks under CCR section 1399.365(c)(6). These functions require respiratory assessment and clinical judgment.

• Is turning a ventilator on or off a basic respiratory task?

  No. Turning an invasive or non-invasive ventilator (including CPAP or BiPAP) on or off is considered manipulation and is excluded from basic tasks under CCR section 1399.365(c). This function must be performed by a licensed RCP or another provider authorized by law, such as a registered nurse (RN).

Monitoring, Data Collection, and Assessment

• Is performing chest auscultation, palpation, or percussion a basic respiratory task?

  Yes. Performing chest auscultation, palpation, and percussion for the purpose of observing and gathering data is identified as a basic respiratory task under CCR section 1399.365(b)(8).

  However, assessment, interpretation, or evaluation of the findings from chest auscultation, palpation, or percussion requires respiratory assessment and clinical judgment and is excluded from basic respiratory tasks under CCR section 1399.365(c)(2).

• Is interpreting pulse oximetry or auscultation findings to change respiratory care a basic respiratory task?

  No. Interpreting or evaluating collected data to make treatment decisions requires respiratory assessment and clinical judgment and is not a basic respiratory task. CCR section 1399.365 defines assessment as analysis or judgment, which is beyond gathering and reporting observations and data.

Responsibilities and Reporting (Licensees and Staff)

• How does this regulation affect responsibility for patient assessments?

  Licensed Respiratory Care Practitioners (RCPs) and other providers authorized by law, such as registered nurses (RNs), remain responsible for respiratory assessments, clinical judgment, and advanced respiratory care services that require assessment or evaluation. CCR section 1399.365 clarifies which tasks are basic and which are not, but it does not change existing responsibilities related to assessment-based respiratory care.

• What should I do if I observe a basic task performed improperly?

  Report the issue to your supervisor or facility compliance officer. If the concern involves potential violations of respiratory care law or regulations, it may also need to be reported to the RCB. Patient safety should always be the top priority.

• How do I report a violation of respiratory care laws or regulations?

  If you believe a violation of the Respiratory Care Practice Act or related regulations has occurred, you may file a complaint with the RCB. Complaints can be submitted online, by mail, fax, or phone. For more information and to access the complaint form, visit rcb.ca.gov/licensees/lic_file_a_complaint.shtml , email rcbinfo@dca.ca.gov, or call (916) 999-2190.

Patients and the Public

• How can I be sure the respiratory care I receive is safe and being done by the appropriate person?

  The RCB protects the public by regulating Respiratory Care Practitioners and enforcing respiratory care laws and regulations. Health care facilities are responsible for ensuring personnel are properly trained and supervised and that tasks are assigned only when permitted under applicable law. If you have concerns, you may ask who is providing your care and what qualifications they have, and you may report concerns through the facility or to the RCB.

• How does this regulation improve patient safety?

  This regulation improves patient safety by clearly identifying which respiratory tasks are considered basic and which require the advanced education and clinical judgment of a licensed Respiratory Care Practitioner (RCP) or another provider authorized by law, such as a registered nurse (RN). By distinguishing basic tasks from respiratory care services that require assessment or clinical judgment, the regulation supports safe task assignment, clearer role boundaries, and appropriate use of specialized respiratory expertise.

• Who can I ask about the qualifications of the person providing my respiratory care?

  You may ask your health care provider or facility staff who is providing your respiratory care and what qualifications they have. You may also ask whether the person performing your respiratory care is a licensed Respiratory Care Practitioner (RCP), a registered nurse (RN), or another trained health care provider.

• What tasks must always be performed by a licensed Respiratory Care Practitioner or another authorized provider?

  Respiratory tasks listed in subdivision (c) of CCR section 1399.365 must be performed by a licensed Respiratory Care Practitioner (RCP) or another provider authorized by law, such as a registered nurse (RN). These tasks require a respiratory assessment, advanced clinical judgment, or specialized respiratory training.

  The list of excluded tasks in subdivision (c) is not exhaustive. Any respiratory care service that requires assessment, evaluation, or clinical judgment must be performed by an Respiratory Care Practitioner (RCP) or another provider authorized by law to ensure patient safety.

• Does this regulation mean patients will see Respiratory Care Practitioners less often?

  No. The regulation does not reduce the need for Respiratory Care Practitioners. RCPs, or other providers authorized by law such as registered nurses (RNs), continue to perform respiratory assessments and advanced respiratory care services that require clinical judgment. Basic tasks performed by trained staff support care delivery, while assessment-based and advanced respiratory care remain the responsibility of authorized licensed providers.

• How do I report concerns about respiratory care I receive?

  You can start by contacting your health care facility’s patient advocate or nursing supervisor. If the issue is not resolved or involves potential violations of respiratory care laws or regulations, you may file a complaint with the RCB at rcb.ca.gov/consumers/cons_file_a_complaint.shtml , email rcbinfo@dca.ca.gov, or call (916) 999-2190.

Employers and Health Care Providers

• Is the Facility Self-Audit Tool required, and what should we do with it?

  The Facility Self-Audit Tool is a recommended resource to help facilities verify alignment with CCR section 1399.365. Use it to confirm that your policies, training, competency validation, and task assignment practices align with the regulation. You do not need to submit it to the RCB.

  Downloads:
  • Facility Self-Audit Tool (PDF)
  • Printable Version of CCR section 1399.365 (PDF)

• How can employers help stay aligned with CCR section 1399.365, and are there tools to help?

  Employers can support compliance by reviewing policies and workflows to ensure that tasks identified as basic in CCR section 1399.365(b) are assigned only when consistent with applicable law, training, and facility policies, and that tasks identified in subdivision (c) are performed only by a licensed RCP or another provider authorized by law, such as a registered nurse (RN).

  The RCB’s Facility Self-Audit Tool may be used as a practical checklist to review training, competency validation, documentation practices, and task assignment: Facility Self-Audit Tool (PDF).

• What is the impact on staffing and task assignment?

  CCR section 1399.365 clarifies which respiratory tasks are basic and which are not. Basic tasks identified in subdivision (b) may be performed by appropriately trained personnel when consistent with applicable law. Tasks listed in subdivision (c) and other respiratory care services requiring assessment or clinical judgment must be performed by a licensed RCP or another provider authorized by law, such as a registered nurse (RN).

Other Health Care Professions

• Does this regulation affect Speech-Language Pathologists (SLPs) and suctioning?

  No. CCR section 1399.365 does not change SLP scope of practice. Under Business and Professions Code section 2530.2(d)(4) , SLPs are authorized to perform suctioning when it is connected to their scope of practice, provided they have completed a medical facility’s training protocols on suctioning procedures.

• Do Licensed Vocational Nurses (LVNs) working in K–12 schools have a school-setting exemption related to suctioning and basic respiratory tasks?

  Yes. SB 389 added BPC § 3765(l), which provides a narrow clarification for LVNs working in K–12 school settings under the supervision of a credentialed school nurse, consistent with applicable Education Code requirements. For details and FAQs, see: SB 389 (Pupil Health) – School-Setting Clarification.

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Need more information? Contact the RCB at (916) 999-2190 or rcbinfo@dca.ca.gov.