The City of Los Angeles is not making it easy for employers operating within city limits.  First, they rushed through an ordinance implementing new paid sick leave requirements on an urgency basis that became effective July 1st.  And now, they have issued rules and regulations explaining the statute that quite frankly, are partially nonsensical, and leave employers in quite a bind to figure out how to comply.
One troubling issue is that although the ordinance allows employers to either accrue sick leave or front load it, the main benefit of the front load method is diminished.  Under current California law, when an employee front loads 24 hours of sick leave, they don’t have to carry over any days from year to year.  That significantly eases the administrative burden.  One would assume the same applied for Los Angeles sick leave, and that 48 hours could simply be front loaded, and not carried over.  In fact, the language of the ordinance only references carry over as to accrued sick leave.  “Accrued unused paid sick leave shall carry over to the following year of employment and may be capped at 72 hours.”  Yet, the regulations contradict that language, and provide that the 72 hour cap applies whether you front load or accrue.  According to the regulations, even if you front load 48 hours, and only allow 48 hours of use per year, there will still be more time on the books that is not available for use (and would need to be reinstated if the employee leaves and comes back within a year).  Plus, good luck trying to explain to an employee why the paystub says 72 hours, but they can only use 48 (even if your policy is clear on that point).
Another problematic issue is the potential for abuse given the inability to discipline for use of 48 hours of sick time.  The Los Angeles regulations state that an employer can’t deny the request to use sick leave if the “Employee communicates the request more than one (1) hour before the beginning of the Employee’s shift in a manner consistent with the Employers’ normal method of communication.” 
But what if the Employer’s policy requires a 2-hour call in?  Apparently that can’t be enforced.  And what about the California law requirement that foreseeable needs for sick leave (like a planned medical appointment) need to be communicated ahead of time with “reasonable advance notification”?  Can that still be enforced in Los Angeles?  Maybe not.  And while you can ask for a doctor’s note, you can only do so after three consecutive days of sick leave.  Oh yes, and you can’t ask in a way that “deters” an employee from taking “a legitimate sick day.”
Finally, good luck with figuring out how much sick time accrues if your employees travel in and out of city boundaries.  There are three pages of regulations on that issue alone.  Suffice it to say, you have to have a method to track how much time someone works in the city, even if it is just driving through the city on the freeway!  No joke.  It’s in the regulations.
Pass the antacids.  If you do business in Los Angeles, you are going to need them (and a good lawyer or HR consultant to help you navigate these requirements).