California is as prepared as any state can be for an earthquake and it is constantly looking for better ways to be prepared.
https://www.latimes.com/local/lanow/la-me-ln-earthquake-legi...
In the event of a larger quake, you might survive the initial shock but a high percentage of your city, including new buildings will need to be torn down.
This represents a huge loss to a city in economic terms. Imagine if downtown LA lost 50% of its office buildings and apartment buildings. Compare this to Japan where buildings survive and are required to be usable. Japanese engineers are shocked at what they consider to be American substandard building codes.
The US govt has even concluded that better and stiffer building codes would save billions a year: https://cdn.ymaws.com/www.nibs.org/resource/resmgr/docs/MS_C...
"Buildings Can Be Designed to Withstand Earthquakes. Why Doesn’t the U.S. Build More of Them?"
https://www.nytimes.com/interactive/2019/06/03/us/earthquake...
We didn't have much damage, but walking through the neighborhood afterward I counted about 20 houses that slid off their foundations.
When I lived in that general area, there was a 7.1 or 7.2 and I think there was one death. IIRC, it was due to a heart attack and locals joked it was in reaction to the amount of liquor bottles broken in some liquor store because photos of the broken bottles got splashed all over the papers as one of the bigger points of damage.
A train was derailed in that quake and I think someone broke their arm but no one died because it was going unusually slow for a passenger train, having been scheduled behind a slow-moving freight train.
We had aftershocks for weeks that interfered with my sleep. Some of the aftershocks were above a 5.0.