I Want To Departments & Agencies
News Events Employment

Department of Health Services

COVID-19 Information
County Of Sonoma › Health and Human Services › Health Services › Divisions › Public Health › Disease Control › COVID-19 Data and Resources › Orders from the Health Officer › Order of the Health Officer of the County of Sonoma No. RVP25-01
COVID-19 Information

Order of the Health Officer of the County of Sonoma No. RVP25-01

DATE OF ORDER: October 06, 2025

Please read this Order carefully.  Violation of or failure to comply with this Order is a misdemeanor and may be punishable by fine, imprisonment, or both.  (California Health and Safety Code § 120275, et seq.)

UNDER THE AUTHORITY OF CALIFORNIA HEALTH AND SAFETY CODE SECTIONS 1288.7, 101040, 101085, AND 120175, AND 8 CAL. CODE REGS SECTION 5199, THE HEALTH OFFICER OF THE COUNTY OF SONOMA (“HEALTH OFFICER”) ORDERS:

  1. Summary. This Order of the Health Officer requires Health Care Delivery Facility personnel and other non-patients to wear a Face Mask in Patient Care Areas of specified health care delivery facilities, subject to medical and other specified exemptions, annually during respiratory virus season as listed below.
  2. Duration of this Order: This Order takes effect at 12:01 a.m. on November 1, 2025 and shall remain in effect until March 31, 2026. Thereafter, this order will be effective during the respiratory virus season, defined as November 1 to March 31 of the following year, and will apply annually unless rescinded. The Health Officer may adjust these dates based on respiratory virus surveillance data. If the Health Officer changes the dates of this Order, the Health Officer will notify Health Care Delivery Facilities through a Health Advisory and a notice posted on the County Department of Health Services website.
  3. Basis for Order.Historical data demonstrates that higher rates of influenza, COVID-19, and other respiratory viruses that can cause severe respiratory infections occur annually between late fall and spring. Influenza and other seasonal respiratory viruses infect tens of millions in the United States each year and can result in serious medical outcomes, including hospitalizations and death. Patients and residents in our health care and congregate care facilities, especially young children, pregnant women, the elderly, and those with chronic health conditions, are at greater risk for respiratory virus-related hospitalizations and death. Workers in direct care, health care, and congregate facilities are at risk for respiratory illness and can transmit the viruses to their clients, patients, and coworkers.  Moreover, respiratory virus-related illness in health care workers can cause absenteeism, placing further strain on our limited health care resources. The Health Officer makes this Order in light of ongoing transmission of SARS-CoV-2 (also referred to as “COVID-19”) and recurrence of seasonal influenza and other respiratory infections. The co-occurrence of influenza season with a probability of another late fall/winter surge of COVID-19 may increase the risk of our health systems being overwhelmed with patients with critical respiratory illness. The widespread availability of COVID-19 testing and treatment, the high level of community vaccination in the County, and the lower death rate seen in the most recent surges of COVID-19, have diminished the necessity for year-round mandatory orders related to masking in multiple high-risk settings. However, the risk to vulnerable patients of COVID-19, influenza, and other respiratory viruses in Health Care Settings, including skilled nursing facilities, remains significant, and so it continues to be important for Face Masks to be used in Patient Care Areas of these settings when seasonal risk of exposure to one or multiple viruses is at its highest.
    Since at least 2017, Sonoma County required that all Health Care Facilities establish an influenza vaccination program requiring that all health care workers providing direct patient care receive an annual influenza vaccine or wear a mask.(https://sonomacounty.gov/Public%20Health/Documents/vaccination-of-healthcare-workers-for-influenza-masking-order.pdf.) The order applied to every influenza season thereafter.
    In 2020, Sonoma County Public Health expanded the order to require that all health care and specified congregate care facilities establish an influenza vaccination program requiring all staff to receive an annual influenza vaccination, subject to medical exemptions and religious accommodation. (https://sonomacounty.ca.gov/Mandatory-Flu-Vaccines-for-Healthcare-Staff/.)
    In 2021, Sonoma County Public Health expanded the order to include certain specified health care and congregate care facilities. (https://socoemergency.org/order-of-the-health-officer-of-the-county-of-sonoma-mandatory-influenza-vaccination-of-workers-at-health-care-facilities/.)
    In recognition that the risk posed by co-circulation of multiple respiratory viruses is not fully mitigated by influenza vaccination, this Order continues the requirement for Face Masks in specified Health Care Delivery Facilities that serve the highest risk patients as set forth in Section 4 below. In addition, the Health Officer STRONGLY RECOMMENDSthat ALL Healthcare Facilities, even those not subject to this order, encourage use of face masks by all personnel not vaccinated for influenza and COVID-19.
  1. Mandatory Requirement to Wear a Face Mask in Patient Care Areas of Health Care Delivery Facilities.Regardless of vaccination status, personnel and other non-patients must wear a Face Mask whenever in Patient Care Areas of specified Health Care Facilities. All businesses and governmental entities with Health Care Delivery Facilities covered by this order must enforce this Face Mask Requirement for all personnel and other non-patients entering Patient Care Areas within the Health Care Delivery Facility, regardless of vaccination status, except as otherwise provided in this order. All such businesses and governmental entities must post clearly visible and easy-to-read signage at all entry points to Patient Care Areas to communicate the Face Mask Requirements to all personnel and other non-patients entering the Patient Care Areas of the Health Care Delivery Facility. In addition, those responsible for Health Care Delivery Facilities are required to provide Face Masks to personnel who will be in an area where Face Masks are required.
  2. Exceptions and Accommodations.The following personnel and other non-patients may be exempt from wearing masks:
    1. Persons with a diagnosed medical condition, mental health condition, or disability that prevents the individual from wearing a face mask. This includes persons with a medical condition for whom wearing a mask could obstruct breathing or who are unconscious, incapacitated, or otherwise unable to remove a mask without assistance.
    2. Persons who are hearing impaired, or communicating with a person who is hearing impaired, where the ability to see the mouth is essential for communication.
    3. Persons for whom wearing a mask would create a risk to the person related to their work, as determined by local, state, or federal regulators or workplace safety guidelines.
  3. Definitions. For purposes of this Order, the following terms have the meanings given below.
    1. “Business” includes any for-profit, non-profit, or educational entity, whether a corporate entity, organization, partnership, or sole proprietorship, and regardless of the nature of the service, the function it performs, or its corporate or entity structure.
    2. “Face Mask” means a surgical mask, KN95, KF94, or N95 respirator. A scarf, ski mask, balaclava, bandana, turtleneck, collar, cloth mask, or any mask that has an unfiltered, one-way exhaust valve does not qualify as a Face Mask under this order.
    3. “Facilities Subject to the Order” includes skilled nursing facilities, portions of long-term care facilities where nursing care is provided, acute and non-acute rehabilitation facilities, infusion centers, and dialysis centers. The Health Officer may expand this Order to additional health care facilities as needed based on respiratory virus surveillance data. If the Health Officer expands the health care facilities subject to this Order, the Health Officer will notify Health Care Delivery Facilities through a Health Advisory and a notice posted on the County Department of Health Services website.
    4. “Patient Care Area” means any area where health care personnel routinely interact directly with patients within a Health Care Delivery Facility or routinely enter rooms occupied by patients, i.e., meal delivery, custodial activities, etc. Patient Care Areas include registration desks in lobbies and waiting rooms, examination rooms, and other rooms in which patients and health care providers interact, including therapy rooms. Patient Care Areas do not include areas such as cafeterias or gift shops that are not used for the provision of health care or access to areas where health care services are provided.
    5. “Personnel” shall mean, except where otherwise specified below in Facilities Subject to the Order, all workers, paid or volunteer, who have direct patient contact or work in patient care areas. This includes but is not limited to clerical staff, dietary workers, janitorial staff, medical assistants, nurses, physician assistants, physicians, allied health workers and EMS personnel entering the facility. “Other Non-Patients” shall mean, except where otherwise exempted by this Order, visitors and other members of the public accompanying or visiting patients in patient care areas.
  4. Facilities subject to this Order may refer any interpretation questions to Sonoma County Public Health, Disease Control Unit, at PHNurse@sonomacounty.gov or (707) 565-4567.
  5. More Restrictive Order.Where a conflict exists between this Order and any state or federal public health orders, then the most restrictive provision (i.e., the more protective of public health) controls.
  6. Public Distribution.Copies of this Order shall promptly be: (1) made available at the County Administration Center at 575 Administration Drive, Santa Rosa CA 95403;    (2) posted on the County Public Health division website (https://sonomacounty.gov/health-and-human-services/health-services/divisions/public-health/disease-control/covid-19-data-and-resources/orders-from-the-health-officer); and (3) provided to any member of the public requesting a copy of this.
  7. Severability. If any provision of this Order to the application thereof to any person or circumstance is held to be invalid, the remainder of the Order, including the application of such part or provision to other persons or circumstances, shall not be affected and shall continue in full force and effect. To this end, the provisions of this Order are severable.

The Health Officer may, at any time, subject additional Health Care Facilities to this order based on respiratory virus surveillance data. If the Health Officer changes the Facilities Subject to this Order, the Health Officer will notify Health Care Delivery Facilities through a Health Advisory and a notice posted on the County Department of Health Services website.

IT IS SO ORDERED:
Karen L. Smith, MD, MPH, Interim Health Officer of the County of Sonoma
October 06, 2025