Proposed Text
CHAPTER 51
STANDARDS FOR INTERIM REGULATION OF CHILDREN'S RESIDENTIAL FACILITIES (REPEALED)
6VAC35-51-10. Definitions. (Repealed.)
The following words and terms when used in this chapter
shall have the following meanings unless the context clearly indicates
otherwise:
"Allegation" means an accusation that a facility
is operating without a license or receiving public funds for services it is not
certified to provide.
"Annual" means within 13 months of the previous
event or occurrence.
"Applicable state regulation" means any
regulation that the promulgating state agency determines applies to the
facility. The term includes, but is not necessarily limited to, modules,
standards, and other regulations promulgated by the Departments of Education;
Health; Housing and Community Development; Juvenile Justice; Mental Health, Mental
Retardation and Substance Abuse Services; Social Services; or other state
agencies.
"Applicant" means the person, corporation,
partnership, association, or public agency that has applied for a license or
certificate.
"Aversive stimuli" means physical forces (e.g.,
sound, electricity, heat, cold, light, water, or noise) or substances (e.g.,
hot pepper, pepper sauce, or pepper spray) measurable in duration and intensity
that when applied to a resident are noxious or painful to the individual, but
in no case shall the term "aversive stimuli" include striking or
hitting the individual with any part of the body or with an implement or
pinching, pulling, or shaking the resident.
"Behavior support" means those principles and
methods employed by a provider to help a child achieve positive behavior and to
address and correct a child's inappropriate behavior in a constructive and safe
manner in accordance with written policies and procedures governing program
expectations, treatment goals, child and staff safety and security, and the
child's service plan.
"Behavior support assessment" means
identification of a resident's behavior triggers, successful intervention
strategies, anger and anxiety management options for calming, techniques for
self-management, and specific goals that address the targeted behaviors that
lead to emergency safety interventions.
"Body cavity search" means any examination of a
resident's rectal or vaginal cavities, except the performance of medical
procedures by medical personnel.
"Case record" or "record" means
up-to-date written or automated information relating to one resident. This
information includes social data, agreements, all correspondence relating to
care of the resident, service plans with periodic revisions, aftercare plans
and discharge summary, and any other data related to the resident.
"Child" means any person legally defined as a
child under state law. The term includes residents and other children coming in
contact with the resident or facility (e.g., visitors). When the term is used,
the requirement applies to every child at the facility regardless of whether
the child has been admitted to the facility for care (e.g., staff/child ratios
apply to all children present even though some may not be residents).
"Child-placing agency" means any person licensed
to place children in foster homes or adoptive homes or a local board of social
services authorized to place children in foster homes or adoptive homes.
"Children's residential facility" or
"facility" means a publicly or privately operated facility, other
than a private family home, where 24-hour per day care is provided to children
separated from their legal guardians and is required to be licensed or
certified by the Board of Juvenile Justice by the Code of Virginia.
"Complaint" means an accusation against a
licensed or certified facility regarding an alleged violation of standards or
law.
"Confined in postdispositional detention" means
that a court has sentenced the juvenile to a detention home for a period
exceeding 30 days as found in § 16.1-284.1 B of the Code of Virginia.
"Contraband" means any item prohibited by law or
by the rules and regulations of the agency, or any item that conflicts with the
program or safety and security of the facility or individual residents.
"Corporal punishment" means punishment
administered through the intentional inflicting of pain or discomfort to the
body through actions such as, but not limited to (i) striking or hitting with
any part of the body or with an implement; (ii) pinching, pulling, or shaking;
or (iii) any similar action that normally inflicts pain or discomfort.
"Corrective action plan" means violations
documented by the regulatory authority and the facility's submitted pledged
corrective action to the documented violations cited by the regulatory
authority.
"Day" means calendar day unless the context
clearly indicates otherwise.
"Detention home" or "secure detention"
means a local, regional, or state, publicly or privately operated secure
custody facility that houses juveniles who are ordered detained pursuant to the
Code of Virginia. The term does not include juvenile correctional centers.
"DJJ" means the Department of Juvenile Justice.
"DMHMRSAS" means the Department of Mental Health,
Mental Retardation and Substance Abuse Services.
"DOE" means the Department of Education.
"DSS" means the Department of Social Services.
"Emergency" means a sudden, generally unexpected
occurrence or set of circumstances demanding immediate action. Emergency does
not include regularly scheduled time off for permanent staff or other
situations that should reasonably be anticipated.
"Emergency admission" means the sudden,
unplanned, unexpected admittance of a child who needs immediate care except
self-admittance to a temporary care facility or a court-ordered placement.
"Goal" means expected results or conditions that
usually involve a long period of time and that are written in behavioral terms
in a statement of relatively broad scope. Goals provide guidance in
establishing specific short-term objectives directed toward the attainment of
the goal.
"Good character and reputation" means findings
have been established, and knowledgeable and objective people agree that the
individual maintains business or professional, family, and community
relationships that are characterized by honesty, fairness, truthfulness, and
dependability and has a history or pattern of behavior that demonstrates that
the individual is suitable and able to care for, supervise, and protect
children. Relatives by blood or marriage, and persons who are not knowledgeable
of the individual, such as recent acquaintances, shall not be considered
objective references.
"Group home" means a children's residential
facility that is a community-based, home-like single dwelling, or its
acceptable equivalent, other than the private home of the operator, and serves
up to 12 residents.
"Health record" means the file maintained by a
provider that contains personal health information.
"Human research" means any systematic
investigation including research development, testing, and evaluation,
utilizing human subjects, that is designed to develop or contribute to
generalized knowledge. Human research shall not include research exempt from
federal research regulations pursuant to 45 CFR 46.101(b).
"Immediately" means directly without delay.
"Independent living program" means a
competency-based program that is specifically approved by the regulatory
authority to provide the opportunity for the residents to develop the skills
necessary to live successfully on their own following completion of the
program.
"Individualized service plan" means a written
plan of action developed, and modified at intervals, to meet the needs of a
specific resident. It specifies measurable short- and long-term goals,
objectives, strategies, time frames for reaching the goals, and the individuals
responsible for carrying out the plan.
"Juvenile correctional center" means a secure
custody facility operated by, or under contract with, DJJ to house and treat
persons committed to the department.
"Legal guardian" means the natural or adoptive
parents or other person, agency, or institution that has legal custody of a
child.
"License or certificate" means a document
verifying approval to operate a children's residential facility and that
indicates the status of the facility regarding compliance with applicable state
regulations.
"Live-in staff" means staff who are required to
be on duty for a period of 24 consecutive hours or more during each work week.
"Living unit" means the space in which a
particular group of children in care of a residential facility reside. A living
unit contains sleeping areas, bath and toilet facilities, and a living room or
its equivalent for use by the residents of the unit. Depending upon its design,
a building may contain one living unit or several separate living units.
"Mechanical restraint" means the use of an
approved mechanical device that involuntarily restricts the freedom of movement
or voluntary functioning of a limb or portion of a person's body as a means to
control his physical activities when the individual receiving services does not
have the ability to remove the device.
"Medication error" means an error made in
administering a medication to a resident including the following: (i) the wrong
medication is given to a resident; (ii) the wrong resident is given the
medication; (iii) the wrong dosage is given to a resident; (iv) medication is
given to a resident at the wrong time or not at all; and (v) the proper method
is not used to give the medication to a resident. A medication error does not
include a resident's refusal of offered medication.
"Objective" means expected short-term results or
conditions that must be met in order to attain a goal. Objectives are stated in
measurable, behavioral terms and have a specified time for achievement.
"On duty" means that period of time during which
a staff person is responsible for the supervision of one or more children.
"Parent" means a natural or adoptive parent or a
surrogate parent appointed pursuant to DOE's regulations governing special
education programs for students with disabilities. "Parent" means
either parent unless the facility has been provided documentation that there is
a legally binding instrument, a state law, or a court order governing such
matters as divorce, separation, or custody, that provides to the contrary.
"Pat down" means a thorough external body search
of a clothed resident.
"Personal health information" means the
information that encompasses the universe of oral, written, or otherwise
recorded information that is created or received by an entity relating to
either an individual's physical or mental health or the provision of or payment
for health care to an individual.
"Pharmacological restraint" means the use of a
medication that is administered involuntarily for the emergency control of an
individual's behavior when the individual's behavior places him or others at
imminent risk and the administered medication is not a standard treatment for
the individual's medical or psychiatric condition.
"Physical restraint" (also referred to as a
"manual hold") means use of a physical intervention or
"hands-on" hold to prevent an individual from moving his body when
that individual's behavior places him or others at imminent risk.
"Placement" means an activity by any person that
provides assistance to a parent or legal guardian in locating and effecting the
movement of a child to a foster home, adoptive home, or children's residential
facility.
"Premises" means the tracts of land on which any
part of a residential facility for children is located and any buildings on
such tracts of land.
"Provider," "licensee," or
"sponsor" means the person, corporation, partnership, association, or
public agency to whom a license or certificate is issued and who is legally
responsible for compliance with the regulatory and statutory requirements
relating to the facility.
"Regulatory authority or agency" means the
department or state board that is responsible under the Code of Virginia for
the licensure or certification of a children's residential facility. For
facilities governed by these Standards for Interim Regulation of Children's
Residential Facilities (interim standards), the regulatory authority is the
Board of Juvenile Justice.
"Resident" means a person admitted to a
children's residential facility for supervision, care, training, or treatment
on a 24-hour per day basis.
"Respite care facility" means a facility that is
specifically approved to provide short-term, periodic residential care to children
accepted into its program in order to give the parents or legal guardians
temporary relief from responsibility for their direct care.
"Rest day" means a period of not less than 24
consecutive hours during which a staff person has no responsibility to perform
duties related to the facility.
"Routine admission" means the admittance of a
child following evaluation of an application for admission and execution of a
written placement agreement.
"Rules of conduct" means a listing of a
facility's rules or regulations that is maintained to inform residents and
others about behaviors that are not permitted and the consequences applied when
the behaviors occur.
"Sanitizing agent" means any substance approved
by the Environmental Protection Agency to destroy bacteria.
"Seclusion" means the involuntary placement of an
individual alone in an area secured by a door that is locked or held shut by a
staff person by physically blocking the door or by any other physical or verbal
means so that the individual cannot leave it.
"Secure custody facility" means a detention home
or a juvenile correctional center with physical barriers that regulate
movement.
"Self-admission" means the admittance of a child
who seeks admission to a temporary care facility as permitted by Virginia
statutory law without completing the requirements for "routine
admission."
"Severe weather" means extreme environment or
climate conditions that pose a threat to the health, safety, or welfare of
residents.
"Standard" means a statement that describes in
measurable terms a required minimum performance level. The term
"standard" and the term "regulation" may be used
interchangeably.
"Strategies" means a series of steps and methods
used to meet goals and objectives.
"Strip search" means a visual inspection of the
body of a resident when that resident's outer clothing or total clothing is
removed and an inspection of the removed clothing. Strip searches are conducted
for the detection of contraband.
"Structured program of care" means a
comprehensive planned daily routine including appropriate supervision that
meets the needs of each resident both individually and as a group.
"Student/intern" means an individual who
simultaneously is affiliated with an educational institution and a residential
facility. Every student/intern who is not an employee is either a volunteer or
contractual service provider depending upon the relationship among the
student/intern, educational institution, and facility.
"Substantial compliance" means that while there
may be noncompliance with one or more standards that represents minimal risk,
compliance clearly and obviously exists with most of the standards as a whole.
"Systemic deficiency" means violations documented
by the regulatory authority that demonstrate defects in the overall operation
of the facility or one or more of its components.
"Target population" means individuals with a
similar, specified characteristic or disability.
"Temporary care facility" means a facility or an
emergency shelter specifically approved to provide a range of services, as
needed, on an individual basis not to exceed 90 days, except that this term
does not include secure detention facilities.
"Temporary contract worker" means an individual
who is not a direct salaried employee of the provider but is employed by a
third party and is not a consistently scheduled staff member.
"Therapy" means provision of direct diagnostic,
preventive, and treatment services where functioning is threatened or affected
by social and psychological stress or health impairment.
"Time out" means the involuntary removal of a
resident by a staff person from a source of reinforcement to a different open
location for a specified period of time or until the problem behavior has
subsided to discontinue or reduce the frequency of problematic behavior.
"Treatment" means individually planned, sound,
and therapeutic interventions that are intended to improve or maintain
functioning of an individual receiving services in those areas that show
impairment as the result of mental disability, substance addiction, or physical
impairment. In order to be considered sound and therapeutic, the treatment must
conform to current acceptable professional practice.
"Variance" means temporary or permanent waiver of
compliance with a standard or portion of a standard, or permission to meet the
intent of the standard by a method other than that specified in the standard,
when the regulatory authority, in its sole discretion, determines: (i)
enforcement will create an undue hardship, and (ii) resident care will not be
adversely affected.
"Volunteers" means any individual or group who of
their own free will, and without any financial gain, provides goods and
services to the program without compensation.
"Wilderness program" means a facility
specifically approved to provide a primitive camping program with a nonpunitive
environment and an experience curriculum for residents nine years of age and
older who cannot presently function in home, school, or community. In lieu of
or in addition to dormitories, cabins, or barracks for housing residents,
primitive campsites are used to integrate learning, mentoring, and group
process with real living needs and problems for which the resident can develop
a sense of social responsibility and self-worth.
6VAC35-51-20. Interdepartmental cooperation. (Repealed.)
This chapter replaces the Standards for Interdepartmental
Regulation of Children's Residential Facilities (22VAC42-11) for all children's
residential facilities regulated by the Board of Juvenile Justice. The
Standards for Interdepartmental Regulation of Children's Residential Facilities
remain in effect, pursuant to the third enactment clause of Chapter 873 of the
2008 Acts of the General Assembly, for children's residential facilities
regulated by the regulatory authority or agency for the Departments of
Education, Mental Health, Mental Retardation and Substance Abuse Services, and
Social Services until such time as each board adopts new regulations related
thereto.
6VAC35-51-30. Applications. (Repealed.)
A. Initial applications.
1. A completed application includes, but is not limited to,
an initial application form; proposed working budget for the year showing
projected revenue and expenses for the first year of operation and a balance
sheet showing assets and liabilities; evidence of financial resources or a line
of credit sufficient to cover estimated operating expenses for 90 days unless
the facility is operated by a state or local government agency, board, or
commission; a description of the program; a proposed staffing/supervision plan
including the staff information sheet; copies of all job descriptions; evidence
of the applicant's authority to conduct business in Virginia; a copy of the
floor plan with dimensions of rooms; a certificate of occupancy; current health
inspection; evidence of consultation with state or local fire prevention
authorities; a list of board members, if applicable; three references for the applicant;
and, if required by the regulatory authority, references for three officers of
the board if applicable. This information shall be submitted to and approved by
the regulatory authority in order for the application to be considered
complete.
2. All initial applications that are not complete within 12
months shall be closed.
3. Facilities operated by state or local government
agencies, boards, and commissions shall submit evidence of sufficient funds to
operate including a working budget showing appropriated revenue and projected
expenses for the coming year.
4. Currently licensed providers shall demonstrate that they
are operating in substantial compliance with applicable regulations before new
facilities operated by the same provider will be licensed.
B. Renewal applications. A completed application for
renewal of a facility's license or certificate shall be submitted within 30
days after being notified to submit a renewal application.
6VAC35-51-40. Investigation. (Repealed.)
The regulatory authority will arrange and conduct an
on-site inspection of the facility and a thorough review of the services and an
investigation of the character, reputation, status, and responsibility of the
applicant.
6VAC35-51-50. Review of facilities. (Repealed.)
A. Representatives of the regulatory authority shall make
announced and unannounced reviews during the effective dates of the
license/certificate. The purpose of these reviews is to monitor compliance with
applicable standards.
B. The regulatory authority shall notify relevant local
governments and placing and funding agencies, including the Office of
Comprehensive Services, of multiple health and safety or human rights
violations in children's residential facilities when such violations result in
the lowering of the license or certificate to provisional status.
6VAC35-51-60. Posting of information. (Repealed.)
A. Information concerning the application for initial
licensure of children's residential facilities shall be posted to the DJJ
website by locality.
B. An accurate listing of all licensed or certified
facilities including information on renewal, denial, or provisional licensure,
services and identification of the regulatory authority shall be posted on the
DJJ website by locality.
6VAC35-51-70. General requirements. (Repealed.)
A. The provider shall demonstrate substantial compliance
with these standards to demonstrate that its program and physical plant provide
reasonably safe and adequate care while approved plans of action to correct
findings of noncompliance are being implemented and there are no noncompliances
that pose an immediate and direct danger to residents.
B. Corporations sponsoring residential facilities for
children shall maintain their corporate status in accordance with Virginia law.
C. The provider shall comply with the terms of its license
or certificate.
D. A license or certificate is not transferable and
automatically expires when there is a change of ownership or sponsorship.
E. The current license or certificate shall be posted at
all times in a place conspicuous to the public.
F. A license or certificate shall not be issued to a
facility when noncompliance poses an immediate danger to the resident's life,
health, or safety.
G. Intermediate sanctions authorized by statute may be
imposed at the discretion of the regulatory authorities.
H. Each provider shall self-report within 10 days, to the
regulatory authority, lawsuits against or settlements with residential facility
operators relating to the health and safety or human rights of residents and
any criminal charges against staff that may have been made relating to the
health and safety or human rights of residents.
I. The provider shall comply with all other applicable
federal, state, or local laws and regulations.
J. The provider's current policy and procedure manual shall
be readily accessible to all staff.
K. The provider shall comply with its own policies and
procedures.
6VAC35-51-80. Written corrective action plans. (Repealed.)
A. Facilities regulated by DJJ shall comply with the Board
of Juvenile Justice's certification regulations governing corrective action
plans.
B. If there is noncompliance with applicable standards during
an initial or ongoing review or investigation, the regulatory authority shall
issue a licensing report describing the noncompliance and requesting the
provider to submit a corrective action plan.
C. The provider shall submit to the regulatory authority
and implement a written corrective action plan for each standard for which the
provider is found to be in noncompliance.
D. The corrective action plan shall include a:
1. Description of each corrective action to be taken and
person responsible for implementation;
2. Date of completion for each action; and
3. Signature of the person responsible for oversight of the
implementation of the pledged corrective action.
E. The provider shall submit the corrective action plan to
the regulatory authority within 15 business days of the issuance of the
licensing report. Extensions may be granted by the regulatory authority when
requested prior to the due date, but extensions shall not exceed an additional
10 business days. An immediate corrective action shall be required if the
regulatory authority determines that the violations pose a threat to the
health, safety, or welfare of residents.
F. A corrective action plan shall be approved by the
regulatory authority. The provider shall have an additional 10 business days to
submit a revised corrective action plan after receiving a notice that the plan
submitted has not been approved.
6VAC35-51-90. Licenses/certificates. (Repealed.)
A. The Board of Juvenile Justice shall issue a certificate
to each facility regulated by the board indicating the facility's certification
status when the facility is in compliance with these interim standards, other
applicable regulations issued by the board, and applicable statutes. The
certificate shall be effective for the period specified by the board unless it
is revoked or surrendered sooner.
B. The term of a facility's license or certificate may be
modified at any time during the licensure or certification period based on a
change in the facility's compliance with these standards and other applicable
statutes and regulations.
6VAC35-51-100. Application fees. (Repealed.)
A. There shall be a $500 nonrefundable initial application
fee. If the application is closed, denied, or withdrawn, all subsequent initial
applications shall require another $500 fee.
B. There shall be a $100 nonrefundable renewal application
fee.
C. A renewal fee shall not be charged to providers directly
following the issuance of a conditional license.
D. The application fee shall not apply to state or locally
owned, operated, or contracted facilities.
E. Application fees shall be used for the development and
delivery of training for providers and staff of children's residential
facilities and regulators of these facilities.
6VAC35-51-110. Modification. (Repealed.)
A. The conditions of a license or certificate may be
modified during the term of the license or certificate with respect to the
capacity, residents' age range, facility location, gender, or changes in the
services. Limited modifications may be approved during the conditional
licensure or certification period.
B. The provider shall submit a written report of any
contemplated changes in operation that would affect the terms of the license or
certificate or the continuing eligibility for licensure or certification to the
regulatory authority.
C. A change shall not be implemented prior to approval by
the regulatory authority. The provider will be notified in writing within 60
days following receipt of the request as to whether the modification is
approved or a new license or certificate is required.
6VAC35-51-120. Denial. (Repealed.)
A. An application for licensure or certification may be
denied when the applicant:
1. Violates any provision of applicable laws or regulations
made pursuant to such laws;
2. Has a founded disposition of child abuse or neglect after
the appeal process has been completed;
3. Has been convicted of a crime listed in § 37.2-416 or
63.2-1726 of the Code of Virginia;
4. Has made false statements on the application or
misrepresentation of facts in the application process;
5. Has not demonstrated good character and reputation as
determined through references, background investigations, driving records, and
other application materials; or
6. Has a history of adverse licensing actions or sanctions.
B. If denial of a license or certificate is recommended,
the facility shall be notified in writing of the deficiencies, the proposed
action, the right to appeal, and the appeal process.
6VAC35-51-130. Revocation. (Repealed.)
A. A license or certificate may be revoked when the
provider:
1. Violates any provision of applicable laws or regulations;
2. Engages in conduct or practices that are in violation of
statutes related to abuse or neglect of children;
3. Deviates significantly from the program or services for
which a license or certificate was issued without obtaining prior written
approval from the regulatory authority or fails to correct such deviations
within the specified time; or
4. Engages in a willful action or gross negligence that
jeopardizes the care or protection of residents.
B. If revocation of a license or certificate is
recommended, the facility shall be notified in writing of the deficiencies, the
proposed action, the right to appeal, and the appeal process.
6VAC35-51-140. Summary suspension. (Repealed.)
A. In conjunction with any proceeding for revocation,
denial, or other action, when conditions or practices exist that pose an immediate
and substantial threat to the health, safety, and welfare of the residents, the
director of DJJ may issue an order of summary suspension of the license or
certificate to operate a children's residential facility when he believes the
operation of the facility should be suspended during the pendency of such
proceeding.
B. Prior to the issuance of an order of summary suspension,
the regulatory authority shall contact the Executive Secretary of the Supreme
Court of Virginia to obtain the name of a hearing officer. The regulatory
authority shall schedule the time, date, and location of the administrative
hearing with the hearing officer.
C. The order of summary suspension shall take effect upon
its issuance. It shall be delivered by personal service and certified mail,
return receipt requested, to the address of record of the facility as soon as
practicable. The order shall set forth:
1. The time, date, and location of the hearing;
2. The procedures for the hearing;
3. The hearing and appeal rights; and
4. Facts and evidence that formed the basis for the order of
summary suspension.
D. The hearing shall take place within three business days
of the issuance of the order of summary suspension.
E. The regulatory authority shall have the burden of
proving in any summary suspension hearing that it had reasonable grounds to
require the facility to cease operations during the pendency of the concurrent
revocation, denial, or other proceeding.
F. The administrative hearing officer shall provide written
findings and conclusions, together with a recommendation as to whether the
license or certificate should be summarily suspended, to the director of DJJ
within five business days of the hearing.
G. The director of DJJ shall issue a final order of summary
suspension or make a determination that the summary suspension is not warranted
based on the facts presented and the recommendation of the hearing officer
within seven business days of receiving the recommendation of the hearing
officer.
H. The director of DJJ shall issue and serve on the
children's residential facility or its designee by personal service or by
certified mail, return receipt requested, either:
1. A final order of summary suspension including (i) the
basis for accepting or rejecting the hearing officer's recommendations and (ii)
notice that the children's residential facility may appeal the director of
DJJ's decision to the appropriate circuit court no later than 10 days following
issuance of the order; or
2. Notification that the summary suspension is not warranted
by the facts and circumstances presented and that the order of summary
suspension is rescinded.
I. The facility may appeal the director of DJJ's decision
on the summary suspension to the appropriate circuit court no more than 10 days
after issuance of the final order.
J. The outcome of concurrent revocation, denial, and other
proceedings shall not be affected by the outcome of any hearing pertaining to
the appropriateness of the order of summary suspension.
K. At the time of the issuance of the order of summary
suspension, the regulatory authority shall contact the appropriate agencies to
inform them of the action and the need to develop relocation plans for
residents, and ensure that parents and guardians are informed of the pending
action.
6VAC35-51-150. Variances. (Repealed.)
A. Any request for a variance shall be submitted in writing
to the regulatory authority and shall include a:
1. Justification why enforcement of the standard would
create an undue hardship;
2. How the facility can comply with the intent of the
standard; and
3. Justification why resident care would not be adversely
affected if the variance was granted.
B. A variance shall not be implemented prior to approval of
the regulatory authority.
6VAC35-51-160. Investigation of complaints and allegations.
(Repealed.)
The Departments of Education; Juvenile Justice; Mental
Health, Mental Retardation and Substance Abuse Services; and Social Services
are responsible for complete and prompt investigation of all complaints and
allegations made against providers for which they have regulatory authority,
and for notification of the appropriate persons or agencies when removal of
residents may be necessary. Suspected criminal violations shall be reported to
the appropriate law-enforcement authority.
6VAC35-51-170. Governing body. (Repealed.)
A. The provider shall clearly identify the corporation,
association, partnership, individual, or public agency that is the licensee.
B. The provider shall clearly identify any governing board,
body, entity, or person to whom it delegates the legal responsibilities and
duties of the provider.
6VAC35-51-180. Responsibilities of the provider. (Repealed.)
A. The provider shall appoint a qualified chief
administrative officer to whom it delegates, in writing, the authority and
responsibility for administrative direction of the facility.
B. The provider shall develop and implement a written
decision-making plan that shall provide for a staff person with the
qualifications of the chief administrative officer or program director to be
designated to assume the temporary responsibility for the operation of the
facility. Each plan shall include an organizational chart.
C. The provider shall develop a written statement of the
objectives of the facility including a description of the target population and
the programs to be offered.
D. The provider shall develop and implement written
policies and procedures to monitor and evaluate service quality and
effectiveness on a systematic and on-going basis. The provider shall implement
improvements when indicated.
6VAC35-51-190. Fiscal accountability. (Repealed.)
A. Facilities operated by corporations, unincorporated
organizations or associations, individuals, or partnerships shall prepare at
the end of each fiscal year:
1. An operating statement showing revenue and expenses for
the fiscal year just ended;
2. A working budget showing projected revenue and expenses
for the next fiscal year that gives evidence that there are sufficient funds to
operate; and
3. A balance sheet showing assets and liabilities for the
fiscal year just ended.
B. There shall be a system of financial recordkeeping that
shows a separation of the facility's accounts from all other records.
C. The provider shall develop and implement written
policies and procedures that address the day-to-day handling of facility funds
to include:
1. Handling of deposits;
2. Writing of checks; and
3. Handling of petty cash.
6VAC35-51-200. Insurance. (Repealed.)
A. The provider shall maintain liability insurance covering
the premises and the facility's operations.
B. The provider shall provide documentation that all
vehicles used to transport residents are insured, including vehicles owned by
staff.
C. The members of the governing body and staff who have
been authorized to handle the facility's or residents' funds shall be bonded or
otherwise indemnified against employee dishonesty.
6VAC35-51-210. Fundraising. (Repealed.)
The provider shall not use residents in its fundraising
activities without written permission of the legal guardian and the permission
of residents 14 years or older.
6VAC35-51-220. Weapons. (Repealed.)
The provider shall develop and implement written policies
and procedures governing the possession and use of firearms, pellet guns, air
guns, and other weapons on the facility's premises and during facility-related activities.
The policy shall provide that no firearms, pellet guns, air guns, or other
weapons shall be permitted on the premises or at facility-sponsored activities
unless the weapons are:
1. In the possession of licensed security personnel or
law-enforcement officers;
2. Kept securely under lock and key; or
3. Used by a resident with the legal guardian's permission
under the supervision of a responsible adult in accord with policies and
procedures developed by the facility for the weapons' lawful and safe use.
6VAC35-51-230. Relationship to regulatory authority. (Repealed.)
A. The provider shall submit or make available to the
regulatory authority such reports and information as the regulatory authority may
require to establish compliance with these interim standards and other
applicable regulations and statutes.
B. The governing body or its official representative shall
notify the regulatory authority within five working days of any change in
administrative structure or newly hired chief administrative officer or program
director.
6VAC35-51-240. Facilities serving persons over the age of 17
years. (Repealed.)
Facilities that are approved to serve persons over the age
of 17 years shall comply with these interim standards for all occupants regardless
of age, except when it is determined by the regulatory authority that housing,
programs, services, and supervision for such persons are provided separately
from those for the other residents.
6VAC35-51-250. Health information. (Repealed.)
A. Health information required by this section shall be
maintained for each staff member and for each individual who resides in a
building occupied by residents, including each person who is not a staff member
or resident of the facility. Health information is to be handled, maintained,
and stored in a fashion that maintains confidentiality of the information at
all times.
B. Tuberculosis evaluation.
1. At the time of hire or residency at the facility, each
individual shall submit the results of a screening assessment documenting the
absence of tuberculosis in a communicable form as evidenced by the completion
of a form containing, at a minimum, the elements of a current screening form
published by the Virginia Department of Health. The screening assessment shall
be no older than 30 days.
2. Each individual shall annually submit the results of a
screening assessment, documenting that the individual is free of tuberculosis
in a communicable form as evidenced by the completion of a form containing, at
a minimum, the elements of a current screening form published by the Virginia
Department of Health.
C. Subsequent evaluations for tuberculosis.
1. An individual who comes in contact with a known case of
infectious tuberculosis shall be screened as determined appropriate based on
consultation with the local health department.
2. An individual who develops chronic respiratory symptoms
of three weeks' duration shall be evaluated immediately for the presence of
infectious tuberculosis.
D. An individual suspected of having infectious
tuberculosis shall not be permitted to return to work or have contact with
staff or residents until a physician has determined that the individual is free
of infectious tuberculosis.
E. The provider shall report any active case of
tuberculosis developed by a staff member or a resident to the local health
department.
6VAC35-51-260. Physical or mental health of personnel. (Repealed.)
A. The provider or the regulatory authority may require a
report of examination by a licensed physician or mental health professional
when there are indications that an individual's physical, mental, or emotional
health may jeopardize the care of residents.
B. An individual who is determined by a licensed physician
or mental health professional to show an indication of a physical or mental condition
that may jeopardize the safety of residents or that would prevent the
performance of duties shall be removed immediately from contact with residents
and food served to residents until the condition is cleared as evidenced by a
signed statement from the physician or mental health professional.
6VAC35-51-270. Qualifications. (Repealed.)
A. Standards establishing minimum position qualifications
shall be applicable to all providers. In lieu of the minimum position
qualifications contained in this chapter, providers subject to (i) the rules
and regulations of the Virginia Department of Human Resource Management, or
(ii) the rules and regulations of a local government personnel office may
develop written minimum entry-level qualifications in accord with the rules and
regulations of the supervising personnel authority.
B. A person who assumes or is designated to assume the
responsibilities of a position or any combination of positions described in
these interim standards after December 28, 2007, shall:
1. Meet the qualifications of the position or positions;
2. Fully comply with all applicable standards for each
function; and
3. Demonstrate a working knowledge of the policies and
procedures that are applicable to his specific position or positions.
C. When services or consultations are obtained on a contractual
basis, they shall be provided by professionally qualified personnel.
6VAC35-51-280. Job descriptions. (Repealed.)
A. There shall be a written job description for each
position that, at a minimum, includes the:
1. Job title;
2. Duties and responsibilities of the incumbent;
3. Job title of the immediate supervisor; and
4. Minimum education, experience, knowledge, skills, and
abilities required for entry-level performance of the job.
B. A copy of the job description shall be given to each
person assigned to a position at the time of employment or assignment.
6VAC35-51-290. Written personnel policies and procedures.
(Repealed.)
A. The provider shall have and implement provider-approved
written personnel policies and make its written personnel policies readily
accessible to each staff member.
B. The provider shall develop and implement written
policies and procedures to assure that persons employed in or designated to
assume the responsibilities of each position possess the education, experience,
knowledge, skills, and abilities specified in the job description for the
position.
6VAC35-51-300. Personnel records. (Repealed.)
A. Separate, up-to-date written or automated personnel
records shall be maintained for each employee, student/intern, volunteer, and contractual
service provider for whom background investigations are required by Virginia
statute. Content of personnel records of volunteers, students/interns, and
contractual service providers may be limited to documentation of compliance
with requirements of Virginia laws regarding child protective services and
criminal history background investigations.
B. The records of each employee shall include:
1. A completed employment application form or other written
material providing the individual's name, address, phone number, and social
security number or other unique identifier;
2. Educational background and employment history;
3. Written references or notations of oral references;
4. Reports of required health examinations;
5. Annual performance evaluations;
6. Date of employment for each position held and separation;
7. Documentation of compliance with requirements of Virginia
laws regarding child protective services and criminal history background
investigations;
8. Documentation of educational degrees and of professional
certification or licensure;
9. Documentation of all training required by these standards
and any other training received by individual staff; and
10. A current job description.
C. Personnel records, including separate health records,
shall be retained in their entirety for at least three years after separation
from employment, contractual service, student/intern, or volunteer service.
6VAC35-51-310. Staff development. (Repealed.)
A. Required initial training:
1. Within seven days following the begin date, each staff
member responsible for supervision of children shall receive basic orientation to
the facility's behavior intervention policies, procedures, and techniques
regarding less restrictive interventions, timeout, and physical restraint.
2. Within 14 days following an individual's begin date, or
before an individual is alone supervising children, the provider shall conduct
emergency preparedness and response training that shall include:
a. Alerting emergency personnel and sounding alarms;
b. Implementing evacuation procedures, including evacuation
of residents with special needs (i.e., deaf, blind, nonambulatory);
c. Using, maintaining, and operating emergency equipment;
d. Accessing emergency information for residents including
medical information; and
e. Utilizing community support services.
3. Within 14 days following the begin date, new employees,
employees transferring from other facilities operated by the same provider,
relief staff, volunteers, and students/interns shall be given orientation and
training regarding:
a. The objectives of the facility;
b. Practices of confidentiality;
c. The decision-making plan;
d. These interim standards including the prohibited actions
as outlined in this regulation; and
e. Other policies and procedures that are applicable to
their positions, duties, and responsibilities.
4. Within 30 days following the begin date, all staff
working with residents shall be enrolled in a standard first-aid class and in a
cardiopulmonary resuscitation class facilitated by the American Red Cross or
other recognized authority, unless the individual is currently certified in
first aid and cardiopulmonary resuscitation.
5. Within 30 days following the begin date, all staff
working with residents shall be trained in child abuse and neglect, mandatory
reporting, maintaining appropriate professional relationships and interaction
among staff and residents, and suicide prevention.
6. Within 30 days following the begin date, all staff shall
be trained on the facility's policies and procedures regarding standard
precautions.
7. Within 30 days following the begin date, all staff shall
be trained on appropriate siting of children's residential facilities and good
neighbor policies and community relations.
8. Before they can administer medication, all staff
responsible for medication administration shall have successfully completed a
medication training program approved by the Board of Nursing or be licensed by
the Commonwealth of Virginia to administer medications.
9. All staff shall be trained in any area of quality
improvement as identified from the results of the quality improvement plan.
B. Required annual retraining:
1. All employees, contractors, students/interns, and
volunteers shall complete an annual refresher emergency preparedness and
response training that shall include:
a. Alerting emergency personnel and sounding alarms;
b. Implementing evacuation procedures, including evacuation
of residents with special needs (i.e., deaf, blind, nonambulatory);
c. Using, maintaining, and operating emergency equipment;
d. Accessing emergency information for residents including
medical information; and
e. Utilizing community support services.
2. All staff who administer medication shall complete annual
refresher medication training.
3. All child care staff shall receive annual retraining on the
provider's behavior intervention and timeout policies and procedures.
4. All staff working with residents shall receive annual
retraining in child abuse and neglect, mandatory reporting, maintaining
appropriate professional relationships and interaction among staff and
residents, and suicide prevention.
5. All staff shall receive annual retraining on the
provider's policies and procedures regarding standard precautions.
C. Each full-time staff person who works with residents
shall complete an additional 15 hours of annual training applicable to their
job duties.
D. Providers shall develop and implement written policies
and procedures to ensure that part-time staff receive training applicable to
their positions.
E. Training provided shall be comprehensive and based on
the needs of the population served to ensure that staff have the competencies
to perform their jobs.
6VAC35-51-320. Staff supervision. (Repealed.)
The provider shall develop and implement written policies
and procedures regarding the supervision of staff, volunteers, contractors, and
students/interns. These policies and procedures shall include:
1. Type of supervision;
2. Frequency of supervision; and
3. How the supervision will be documented.
6VAC35-51-330. Applicant. (Repealed.)
A. Each applicant shall provide documentation that he has
been trained on appropriate siting of children's residential facilities and
good neighbor policies and community relations.
B. The applicant shall be interviewed in person by the
regulatory authority to determine the qualifications of the owner or operator
as set out in these standards.
C. Should the applicant not be qualified to perform the
duties of the chief administrative officer, the applicant shall hire an
individual with the qualifications, as set out in these standards, to perform
the duties of the chief administrative officer.
6VAC35-51-340. Chief administrative officer. (Repealed.)
A. The chief administrative officer shall have the
following responsibilities:
1. Responsibility for compliance with these interim
standards and other applicable standards;
2. Responsibility for all personnel;
3. Responsibility for overseeing the facility operation in
its entirety, including the approval of the design of the structured program of
care and its implementation; and
4. Responsibility for the facility's financial integrity.
B. A chief administrative officer appointed after December
28, 2007, shall have at least:
1. A master's degree in social work, psychology, counseling,
nursing, or administration and a combination of two years' professional
experience working with children and in administration and supervision;
2. A baccalaureate degree in social work, psychology,
counseling, nursing, or administration and three years of combined professional
experience with children and in administration and supervisory experience;
3. A baccalaureate degree and a combination of four years'
professional experience in a children's residential facility and in
administration and supervision; or
4. For a program whose lead regulatory agency is the
Department of Education, a master's degree in education and a combination of
two years of professional experience working with children and in
administration and supervision or a baccalaureate degree in education and a
combination of three years professional experience with children and in administration
and supervision may be accepted.
C. Any applicant for the chief administrative officer
position shall submit the following to demonstrate compliance with the
qualifications required by this regulation for the chief administrative
officer:
1. Official transcripts from the accredited college or
university of attendance within 30 days of hire; and
2. Documentation of prior relevant experience.
6VAC35-51-350. Program director. (Repealed.)
A. The facility's program shall be directed by one or more
qualified persons.
B. Persons directing programs shall be responsible for the
development and implementation of the programs and services offered by the
facility, including overseeing assessments, service planning, staff scheduling,
and supervision.
C. Persons directing programs of a facility licensed or
certified to care for 13 or more residents shall be full-time, qualified staff
members.
D. A person appointed after December 28, 2007, to direct
programs shall have at least:
1. A master's degree in social work, psychology, counseling,
or nursing and a combination of two years' professional experience with
children in a children's residential facility and in administration or
supervision;
2. A baccalaureate degree in social work, psychology,
counseling, or nursing and a combination of three years' professional
experience with children in a children's residential facility and in
administration or supervision;
3. A baccalaureate degree and a combination of four years of
professional experience with children in a children's residential facility and
in administration or supervision;
4. A license or certificate issued by the Commonwealth of
Virginia as a drug or alcoholism counselor/worker if the facility's purpose is
to treat drug abuse or alcoholism; or
5. For a program whose lead regulatory agency is DOE, a
master's degree in education and a combination of two years of professional
experience with children in a children's residential facility and in
administration or supervision, or a baccalaureate degree in education with an
endorsement in at least one area of disability served by the program, and a
combination of three years' professional experience working with children in a
children's residential facility and in administration or supervision.
E. Any applicant for the program director position shall
submit the following to demonstrate compliance with the qualifications required
by this regulation for the program director:
1. Official transcripts from the accredited college or
university of attendance within 30 days of hire; and
2. Documentation of prior relevant experience.
6VAC35-51-360. Case manager. (Repealed.)
A. Case managers shall have the responsibility for:
1. Coordination of all services offered to each resident;
and
2. Provision of case management services as required in
6VAC35-51-760 A.
B. Case managers shall have:
1. A master's degree in social work, psychology, or
counseling;
2. A baccalaureate degree in social work or psychology with
documented field work experience and must be supervised by the program director
or other staff employed by the provider with the same qualifications as
required by 6VAC35-51-350 D; or
3. A baccalaureate degree and three years of professional
experience working with children.
6VAC35-51-370. Child care supervisor. (Repealed.)
A. Child care supervisors shall have responsibility for
the:
1. Development of the daily living program within each child
care unit; and
2. Orientation, training, and supervision of direct care
workers.
B. Child care supervisors shall have:
1. A baccalaureate degree in social work or psychology and
two years of professional experience working with children, one year of which
must have been in a residential facility for children;
2. A high school diploma or a General Education Development
Certificate (G.E.D.) and a minimum of five years' professional experience
working with children with at least two years in a residential facility for
children; or
3. A combination of education and experience working with children
as approved by the regulatory authority.
6VAC35-51-380. Child care staff. (Repealed.)
A. The child care worker shall have responsibility for
guidance and supervision of the children to whom he is assigned including:
1. Overseeing physical care;
2. Development of acceptable habits and attitudes;
3. Management of resident behavior; and
4. Helping to meet the goals and objectives of any required
service plan.
B. A child care worker and a relief child care worker
shall:
1. Have a baccalaureate degree in human services;
2. Have an associate's degree and three months' experience
working with children; or
3. Be a high school graduate or have a General Education
Development Certificate (G.E.D.) and have six months of experience working with
children.
C. Child care staff with a high school diploma or G.E.D.
with no experience working with children may not work alone, but may be
employed as long as they are working directly with the chief administrative
officer, program director, case manager, child care supervisor, or a child care
worker with one or more years' professional experience working with children.
This section does not apply to the juvenile correctional facilities where staff
are trained in a comprehensive basic skills curriculum before beginning their
child care duties.
D. An individual hired, promoted, demoted, or transferred
to a child care worker's position after the effective date of these standards
shall be at least 21 years old, except as provided in 6VAC35-51-270 A.
E. The provider shall not be dependent on temporary
contract workers to provide resident care.
6VAC35-51-390. Relief staff. (Repealed.)
Qualified relief staff shall be employed as necessary to
meet the needs of the programs and services offered and to maintain a
structured program of care in accordance with 6VAC35-51-780.
6VAC35-51-400. Volunteers and students/interns. (Repealed.)
A. A facility that uses volunteers or students/interns
shall develop and implement written policies and procedures governing their
selection and use.
B. The facility shall not be dependent upon volunteers or
students/interns to provide basic services.
C. Responsibilities of volunteers and students/interns
shall be clearly defined in writing.
D. Volunteers and students/interns shall have
qualifications appropriate to the services they render.
6VAC35-51-410. Support functions. (Repealed.)
A. Child care workers and other staff responsible for child
care may assume the duties of nonchild care personnel only when these duties do
not interfere with their child care responsibilities.
B. Residents shall not be solely responsible for support
functions, including but not necessarily limited to, food service, maintenance
of building and grounds, and housekeeping.
6VAC35-51-420. Buildings, inspections, and building plans.
(Repealed.)
A. All buildings and building related-equipment shall be
inspected and approved by the local building official. Approval shall be
documented by a certificate of occupancy.
B. The facility shall document at the time of its original
application evidence of consultation with state or local fire prevention
authorities.
C. The facility shall document annually after the initial
application that buildings and equipment are maintained in accordance with the
Virginia Statewide Fire Prevention Code (13VAC5-51).
D. At the time of the original application and at least
annually thereafter the buildings shall be inspected and approved by state or
local health authorities, whose inspection and approval shall include:
1. General sanitation;
2. The sewage disposal system;
3. The water supply; and
4. Food service operations.
E. The buildings and physical environment shall provide
adequate space and shall be of a design that is suitable to house the programs
and services provided and meet specialized needs of the residents.
F. Building plans and specifications for new construction,
change in use of existing buildings, and any structural modifications or
additions to existing buildings shall be submitted to and approved by the
regulatory authority and by other appropriate regulatory authorities.
G. Swimming pools shall be inspected annually by the state
or local health authorities or by a swimming pool business.
6VAC35-51-430. Heating systems, ventilation, and cooling
systems. (Repealed.)
A. Heat shall be evenly distributed in all rooms occupied
by the residents such that a temperature no less than 68°F is maintained, unless
otherwise mandated by state or federal authorities.
B. Natural or mechanical ventilation to the outside shall
be provided in all rooms used by residents.
C. Air conditioning or mechanical ventilating systems, such
as electric fans, shall be provided in all rooms occupied by residents when the
temperature in those rooms exceeds 80°F.
6VAC35-51-440. Lighting. (Repealed.)
A. Artificial lighting shall be by electricity.
B. All areas within buildings shall be lighted for safety,
and the lighting shall be sufficient for the activities being performed.
C. Lighting in halls shall be adequate and shall be
continuous at night.
D. Operable flashlights or battery-powered lanterns shall
be available for each staff member on the premises between dusk and dawn to use
in emergencies.
E. Outside entrances and parking areas shall be lighted for
protection against injuries and intruders.
6VAC35-51-450. Plumbing. (Repealed.)
A. Plumbing shall be maintained in good operational
condition.
B. An adequate supply of hot and cold running water shall
be available at all times.
C. Precautions shall be taken to prevent scalding from running
water. Water temperatures should be maintained at 100°F - 120°F.
6VAC35-51-460. Toilet facilities. (Repealed.)
A. There shall be at least one toilet, one hand basin, and
one shower or bathtub in each living unit.
B. There shall be at least one bathroom equipped with a
bathtub in each facility.
C. There shall be at least one toilet, one hand basin, and
one shower or tub for every eight residents for facilities licensed before July
1, 1981.
D. There shall be one toilet, one hand basin, and one
shower or tub for every four residents in any building constructed or
structurally modified after July 1, 1981, except secure custody facilities.
Facilities licensed after December 28, 2007, shall comply with the one-to-four
ratio.
E. The maximum number of staff members on duty in the
living unit shall be counted in determining the required number of toilets and
hand basins when a separate bathroom is not provided for staff.
F. There shall be at least one mirror securely fastened to
the wall at a height appropriate for use in each room where hand basins are located
except in security rooms in hospitals and secure custody facilities.
6VAC35-51-470. Personal necessities. (Repealed.)
A. An adequate supply of personal necessities shall be
available to the residents at all times for purposes of personal hygiene and
grooming.
B. Clean, individual washcloths and towels shall be in good
repair and available once each week and more often if needed.
C. When residents are incontinent or not toilet trained:
1. Provision shall be made for sponging, diapering, or other
similar care on a nonabsorbent changing surface that shall be cleaned with warm
soapy water after each use.
2. A covered diaper pail, or its equivalent, with leak-proof
disposable liners shall be used to dispose of diapers. If both cloth and
disposable diapers are used, there shall be a diaper pail for each.
3. Adapter seats and toilet chairs shall be cleaned
immediately after each use with appropriate cleaning materials.
4. Staff shall thoroughly wash their hands with warm, soapy
water immediately after assisting a child or themselves with toileting.
5. Appropriate privacy, confidentiality, and dignity shall
be maintained for residents during toileting and diapering.
6VAC35-51-480. Sleeping areas. (Repealed.)
A. When residents are four years of age or older, boys and
girls shall have separate sleeping areas.
B. No more than four children shall share a bedroom or sleeping
area except as provided by other applicable state regulations governing
juvenile correctional centers.
C. Children who use wheelchairs, crutches, canes, or other
mechanical devices for assistance in walking shall be provided with a planned,
personalized means of effective egress for use in emergencies.
D. Beds shall be at least three feet apart at the head,
foot, and sides; and double-decker beds shall be at least five feet apart at
the head, foot, and sides.
E. Sleeping quarters in facilities licensed by DSS prior to
July 1, 1981, and facilities established, constructed or structurally modified
after July 1, 1981, except for primitive campsites, shall have:
1. At least 80 square feet of floor area in a bedroom
accommodating one person;
2. At least 60 square feet of floor area per person in rooms
accommodating two or more persons; and
3. Ceilings with a primary height at least 7-1/2 feet in
height exclusive of protrusions, duct work, or dormers.
F. Each child shall have a separate, clean, comfortable bed
equipped with a clean mattress, clean pillow, clean blankets, clean bed linens,
and, if needed, a clean waterproof mattress cover.
G. Bed linens shall be changed at least every seven days
and more often if needed.
H. Mattresses shall be fire retardant as evidenced by
documentation from the manufacturer except in buildings equipped with an
automated sprinkler system as required by the Virginia Uniform Statewide
Building Code (13VAC5-63).
I. Cribs shall be provided for residents under two years of
age.
J. Each resident shall be assigned drawer space and closet
space, or the equivalent, which is accessible to the sleeping area for storage
of clothing and personal belongings except in secure custody facilities.
K. The environment of sleeping areas shall be conducive to
sleep and rest.
6VAC35-51-490. Smoking prohibition. (Repealed.)
Smoking shall be prohibited in living areas and in areas
where residents participate in programs.
6VAC35-51-500. Residents' privacy. (Repealed.)
A. When bathrooms are not designated for individual use,
except in secure custody facilities:
1. Each toilet shall be enclosed for privacy, and
2. Bathtubs and showers shall provide visual privacy for bathing
by use of enclosures, curtains, or other appropriate means.
B. Windows in bathrooms, sleeping areas, and dressing areas
shall provide for privacy.
C. Every sleeping area shall have a door that may be closed
for privacy or quiet, and this door shall be readily opened in case of fire or
other emergency. In secure custody facilities, the door may be equipped with an
observation window.
D. Residents shall be provided privacy from routine sight
supervision by staff members of the opposite gender while bathing, dressing, or
conducting toileting activities. This section does not apply to medical
personnel performing medical procedures, to staff providing assistance to
infants, or to staff providing assistance to residents whose physical or mental
disabilities dictate the need for assistance with these activities as justified
in the resident's record.
E. Video and audio monitoring shall be permitted only with
the approval of the regulatory agency and for facilities licensed by DMHMRSAS,
the approval of the Office of Human Rights.
6VAC35-51-510. Living rooms and indoor recreation space. (Repealed.)
A. Each living unit, except for secure custody, shall have
a living room, or other area for informal use, for relaxation and entertainment.
The furnishings shall provide a comfortable, home-like environment that is
appropriate to the ages of the residents.
B. All facilities shall have indoor recreation space that
contains indoor recreation materials appropriate to the ages and interests of
the residents.
C. Facilities licensed or certified to care for 13 or more
residents shall have indoor recreation space distinct from the living room.
Recreation space is not required in every living unit.
6VAC35-51-520. Study space. (Repealed.)
A. Facilities serving a school-age population shall provide
study space. Study space may be assigned in areas used interchangeably for
other purposes.
B. Study space shall be well-lighted, quiet, and equipped
with tables or desks and chairs.
6VAC35-51-530. Kitchen and dining areas. (Repealed.)
A. Meals shall be served in areas equipped with sturdy
tables and benches or chairs that are size and age appropriate for the
residents.
B. Adequate kitchen facilities and equipment shall be provided
for preparation and serving of meals.
C. Walk-in refrigerators, freezers, and other enclosures
shall be equipped to permit emergency exits.
6VAC35-51-540. Laundry areas. (Repealed.)
Appropriate space and equipment in good repair shall be
provided if laundry is done at the facility.
6VAC35-51-550. Storage. (Repealed.)
Space shall be provided for safe storage of items such as
first-aid equipment, household supplies, recreational equipment, luggage,
out-of-season clothing, and other materials.
6VAC35-51-560. Staff quarters. (Repealed.)
A. A separate, private bedroom shall be provided for staff
and their families when a staff member is on duty for 24 consecutive hours or
more.
B. A separate, private bathroom shall be provided for staff
and their families when there are more than four persons in the living unit and
the staff person is on duty for 24 consecutive hours or more.
C. Staff and members of their families shall not share
bedrooms with residents.
6VAC35-51-570. Office space. (Repealed.)
Space shall be provided for administrative activities
including, as appropriate to the program, confidential conversations and
provision for storage of records and materials.
6VAC35-51-580. Buildings and grounds. (Repealed.)
A. The facility's grounds shall be safe, properly
maintained, and free of clutter and rubbish. The grounds include, but are not limited
to, all areas where residents, staff, and visitors may reasonably be expected
to have access, including roads, pavements, parking lots, open areas,
stairways, railings, and potentially hazardous or dangerous areas.
B. The interior and exterior of all buildings shall be
safe, properly maintained, clean, and in good working order. This includes, but
is not limited to, required locks, mechanical devices, indoor and outdoor
equipment, and furnishings.
C. Outdoor recreation space shall be available and appropriately
equipped for the residents' use.
6VAC35-51-590. Equipment and furnishings. (Repealed.)
A. All furnishings and equipment shall be safe, clean, and
suitable to the ages and number of residents.
B. There shall be at least one continuously operable, nonpay
telephone accessible to staff in each building in which children sleep or
participate in programs.
6VAC35-51-600. Housekeeping and maintenance. (Repealed.)
A. All buildings shall be well-ventilated and free of
stale, musty, or foul odors.
B. Adequate provision shall be made for the collection and
legal disposal of garbage and waste materials.
C. Buildings shall be kept free of flies, roaches, rats,
and other vermin.
D. A sanitizing agent shall be used in the laundering of
bed, bath, table, and kitchen linens.
6VAC35-51-610. Farm and domestic animals. (Repealed.)
A. Horses and other animals maintained on the premises
shall be quartered at a reasonable distance from sleeping, living, eating, and food
preparation areas, as well as a safe distance from water supplies.
B. Animals maintained on the premises shall be tested,
inoculated, and licensed as required by law.
C. The premises shall be kept free of stray domestic
animals.
D. Pets shall be provided with clean quarters and adequate
food and water.
6VAC35-51-620. Acceptance of children. (Repealed.)
Children shall be accepted only by court order or by
written placement agreement with legal guardians. This requirement does not
apply to temporary care facilities when self-admission is made according to Virginia
law.
6VAC35-51-630. Admission procedures. (Repealed.)
A. The facility shall have written criteria for admission
that shall include:
1. A description of the population to be served;
2. A description of the types of services offered;
3. Intake and admission procedures;
4. Exclusion criteria to define those behaviors or problems
that the facility does not have the staff with experience or training to
manage; and
5. Description of how educational services will be provided
to the population being served.
B. The facility shall accept and serve only those children
whose needs are compatible with the services provided through the facility
unless a child's admission is ordered by a court of competent jurisdiction.
C. Acceptance of a child as eligible for respite care by a
facility approved to provide residential respite care is considered admission
to the facility. Each individual period of respite care is not considered a
separate admission.
D. Each facility shall provide documentation showing proof
of contractual agreements or staff expertise to provide educational services,
counseling services, psychological services, medical services, or any other
services needed to serve the residents in accordance with the facility's
program description as defined by the facility's criteria of admission.
6VAC35-51-640. Maintenance of residents' records. (Repealed.)
A. A separate written or automated case record shall be
maintained for each resident. In addition, all correspondence and documents received
by the facility relating to the care of that resident shall be maintained as
part of the case record. A separate health record may be kept on each resident.
B. Each case record and health record shall be kept up to
date and in a uniform manner.
C. The provider shall develop and implement written
policies and procedures for management of all records, written and automated,
that shall describe confidentiality, accessibility, security, and retention of
records pertaining to residents, including:
1. Access, duplication, dissemination, and acquiring of
information only to persons legally authorized according to federal and state
laws;
2. Facilities using automated records shall address
procedures that include:
a. How records are protected from unauthorized access;
b. How records are protected from unauthorized Internet
access;
c. How records are protected from loss;
d. How records are protected from unauthorized alteration;
and
e. How records are backed up;
3. Security measures to protect records from loss,
unauthorized alteration, inadvertent or unauthorized access, disclosure of
information, and transportation of records between service sites;
4. Designation of person responsible for records management;
and
5. Disposition of records in the event the facility ceases
to operate.
D. The policy shall specify what information is available
to the resident.
E. Active and closed records shall be kept in areas that
are accessible to authorized staff and protected from unauthorized access,
fire, and flood.
1. When not in use written records shall be stored in a
metal file cabinet or other metal compartment.
2. Facility staff shall assure the confidentiality of the
residents' records by placing them in a locked cabinet or drawer or in a locked
room when the staff member is not present.
F. Each resident's written case and health records shall be
stored separately subsequent to the resident's discharge according to
applicable statutes and regulations.
G. Written and automated records shall be retained in their
entirety for a minimum of three years after the date of discharge unless
otherwise specified by state or federal requirements.
H. The face sheet shall be retained permanently unless
otherwise specified by state or federal requirements.
6VAC35-51-650. Interstate Compact on the Placement of
Children. (Repealed.)
A. Documentation of the prior approval of the administrator
of the Virginia Interstate Compact on the Placement of Children, Virginia Department
of Social Services, shall be retained in the record of each resident admitted
from outside Virginia. The requirements of this section shall not apply to a
facility providing documentation that the administrator of the Virginia
Interstate Compact has determined the facility is statutorily exempt from the
Compact's provisions.
B. Documentation that the provider has sent copies of all
serious incident reports regarding any child placed through the Interstate
Compact to the administrator of the Virginia Interstate Compact on the
Placement of Children shall be kept in the resident's record.
C. No later than five days after a resident has been
transferred to another facility operated by the same sponsor, the resident's
record shall contain documentation that the administrator of the Virginia
Interstate Compact on the Placement of Children was notified in writing of the
resident's transfer.
D. No later than 10 days after discharge, the resident's
record shall contain documentation that the administrator of the Virginia
Interstate Compact on the Placement of Children was notified in writing of the
discharge.
E. The provider shall not discharge or send out-of-state
youth in the custody of out-of-state social services agencies and courts to
reside with a parent, relative, or other individual who lives in Virginia
without the approval of the administrator of the Virginia Interstate Compact on
the Placement of Children.
6VAC35-51-660. Participation of residents in human research.
(Repealed.)
The provider shall:
1. Implement a written policy stating that residents will
not be used as subjects of human research; or
2. Document approval, as required by the regulatory authorities,
for each research project using residents as subjects of human research, unless
such research is exempt from review.
6VAC35-51-670. Emergency and self-admissions. (Repealed.)
Providers accepting emergency or self-admissions shall:
1. Develop and implement written policies and procedures
governing such admissions that shall include procedures to make and document
prompt efforts to obtain (i) a written placement agreement signed by the legal
guardian, or (ii) the order of a court of competent jurisdiction;
2. Place in each resident's record the order of a court of
competent jurisdiction, a written request for care, documentation of an oral
request for care, and justification of why the resident is to be admitted on an
emergency basis; and
3. Clearly document in written assessment information
gathered for the emergency admission that the individual meets the facility's
criteria for admission.
6VAC35-51-680. Application for admission. (Repealed.)
A. Admission shall be based on evaluation of an application
for admission. The requirements of this section do not apply to court-ordered placements
or transfer of a resident between residential facilities located in Virginia
and operated by the same sponsor.
B. Providers shall develop, and fully complete prior to
acceptance for care, an application for admission that is designed to compile information
necessary to determine:
1. The educational needs of the prospective resident;
2. The mental health, emotional, and psychological needs of
the prospective resident;
3. The physical health needs, including the immunization
needs, of the prospective resident;
4. The protection needs of the prospective resident;
5. The suitability of the prospective resident's admission;
6. The behavior support needs of the prospective resident;
and
7. Information necessary to develop a service plan and a
behavior support plan.
C. The resident's record shall contain a completed
application for admission at the time of a routine admission or within 30 days
after an emergency admission.
D. Each facility shall develop and implement written
policies and procedures to assess each prospective resident as part of the
application process to ensure that:
1. The needs of the prospective resident can be addressed by
the facility's services;
2. The facility's staff are trained to meet the prospective
resident's needs; and
3. The admission of the prospective resident would not pose
any significant risk to (i) the prospective resident, or (ii) the facility's
residents or staff.
6VAC35-51-690. Written placement agreement. (Repealed.)
A. The facility, except a facility that accepts admission
only upon receipt of the order of a court of competent jurisdiction, shall
develop a written placement agreement that:
1. Authorizes the resident's placement;
2. Addresses acquisition of and consent for any medical
treatment needed by the resident;
3. Addresses the rights and responsibilities of each party
involved;
4. Addresses financial responsibility for the placement;
5. Addresses visitation with the resident; and
6. Addresses the education plan for the resident and the
responsibilities of all parties.
B. Each resident's record shall contain, prior to a routine
admission, a completed placement agreement signed by a facility representative
and the legal guardian or placing agency, except as permitted for temporary
emergency shelters pursuant to § 63.2-1817 of the Code of Virginia.
C. The record of each person admitted based on a court
order shall contain a copy of the court order.
6VAC35-51-700. Face sheet. (Repealed.)
A. At the time of admission, each resident's record shall
include a completed face sheet that contains (i) the resident's full name, last
known residence, birth date, birthplace, gender, race, social security number or
other unique identifier, religious preference, and admission date; and (ii)
names, addresses, and telephone numbers of the resident's legal guardians,
placing agency, emergency contacts and parents, if appropriate.
B. Information shall be updated when changes occur.
C. The face sheet for pregnant teens shall also include the
expected date of delivery and the name of the hospital to provide delivery
services to the resident.
D. The face sheet of residents who are transferred to
facilities operated by the same sponsor shall indicate the address and dates of
placement and transfer at each location.
E. At the time of discharge the following information shall
be added to the face sheet:
1. Date of discharge;
2. Reason for discharge;
3. Names and addresses of persons to whom the resident was
discharged; and
4. Forwarding address of the resident, if known.
6VAC35-51-710. Initial objectives and strategies. (Repealed.)
Within three days following admission, individualized,
measurable objectives and strategies for the first 30 days shall be developed, distributed
to affected staff and the resident, and placed in the resident's record. The
objectives and strategies shall be based on the reasons for admitting the
resident. The requirements of this section do not apply to secure detention
facilities.
6VAC35-51-720. Service plan/quarterly reports. (Repealed.)
A. An individualized service plan shall be developed and
placed in the resident's record within 30 days following admission and
implemented immediately thereafter.
B. Individualized service plans shall describe in
measurable terms the:
1. Strengths and needs of the resident;
2. Resident's current level of functioning;
3. Goals, objectives, and strategies established for the
resident;
4. Projected family involvement;
5. Projected date for accomplishing each objective; and
6. Status of the projected discharge plan and estimated
length of stay except that this requirement shall not apply to a facility that
discharges only upon receipt of the order of a court of competent jurisdiction.
C. The initial service plan shall be reviewed within 60
days of the initial plan and within each 90-day period thereafter and revised
as necessary.
D. The provider shall develop and implement written
policies and procedures to document progress of the resident towards meeting
goals and objectives of the service plan that shall include the:
1. Format;
2. Frequency; and
3. Person responsible.
E. There shall be a documented quarterly review of each
resident's progress 60 days following the initial service plan and within each
90-day period thereafter and shall report the:
1. Resident's progress toward meeting the plan's objectives;
2. Family's involvement;
3. Continuing needs of the resident;
4. Resident's progress towards discharge; and
5. Status of discharge planning.
F. Each plan and quarterly progress report shall include
the date it was developed and the signature of the person who developed it.
G. Staff responsible for daily implementation of the
resident's individualized service plan shall be able to describe the resident's
behavior in terms of the objectives in the plan.
H. There shall be documentation showing the involvement of
the following parties, unless clearly inappropriate, in developing and updating
the individualized service plan and in developing the quarterly progress
report:
1. The resident;
2. The resident's family, if appropriate, and legal
guardian;
3. The placing agency; and
4. Facility staff.
I. The initial individualized service plan, each update,
and all quarterly progress reports shall be distributed to the resident; the
resident's family, legal guardian, or legally authorized representative; the
placing agency; and appropriate facility staff if allowed by federal guidelines
and using all procedures as required by federal guidelines.
J. The requirements of this section do not apply to secure
detention facilities except when a juvenile is confined in postdispositional
detention.
6VAC35-51-730. Resident transfer between residential
facilities located in Virginia and operated by the same sponsor. (Repealed.)
A. Except when transfer is ordered by a court of competent
jurisdiction, the receiving provider shall document at the time of transfer:
1. Preparation through sharing information with the
resident, the family, and the placing agency about the facility, the staff, the
population served, activities, and criteria for admission;
2. Notification to the family (if appropriate), the
resident, the placement agency, and the legal guardian;
3. Receipt from the sending facility of a written summary of
the resident's progress while at the facility, justification for the transfer,
and the resident's current strengths and needs; and
4. Receipt of the resident's record.
B. The sending facility shall retain a copy of the face
sheet and a written summary of the child's progress while at the facility and
shall document the date of transfer and the name of the facility to which the
resident has been transferred.
6VAC35-51-740. Discharge. (Repealed.)
A. The provider shall have written criteria for discharge
that shall include:
1. Criteria for a resident's completing the program that are
consistent with the facility's programs and services;
2. Conditions under which a resident may be discharged
before completing the program; and
3. Procedures for assisting placing agencies in placing the
residents should the facility cease operation.
B. The provider's criteria for discharge shall be accessible
to prospective residents, legal guardians, and placing agencies.
C. The record of each resident discharged upon receipt of
the order of a court of competent jurisdiction shall contain a copy of the
court order.
D. Residents shall be discharged only to the legal guardian
or legally authorized representative.
E. A facility approved to provide residential respite care
shall discharge a resident when the legal guardian no longer intends to use the
facility's services.
F. Information concerning current medications, need for
continuing therapeutic interventions, educational status, and other items
important to the resident's continuing care shall be provided to the legal
guardian or legally authorized representative, as appropriate.
G. Unless discharge is ordered by a court of competent
jurisdiction, prior to the planned discharge date, each resident's record shall
contain:
1. Documentation that discharge has been planned and
discussed with the parent, legal guardian, child-placing agency, and resident;
and
2. A written discharge plan.
H. Discharge summaries.
1. No later than 30 days after discharge, a comprehensive
discharge summary shall be placed in the resident's record and sent to the
persons or agency that made the placement. The discharge summary shall review:
a. Services provided to the resident;
b. The resident's progress toward meeting service plan
objectives;
c. The resident's continuing needs and recommendations, if
any, for further services and care;
d. Reasons for discharge and names of persons to whom
resident was discharged;
e. Dates of admission and discharge; and
f. Date the discharge summary was prepared and the
signature of the person preparing it.
2. In lieu of a comprehensive discharge summary, the record
of each resident discharged upon receipt of the order of a court of competent
jurisdiction shall contain a copy of the court order.
6VAC35-51-750. Placement of residents outside the facility.
(Repealed.)
A resident shall not be placed outside the facility prior
to the facility's obtaining a child-placing agency license from the Department of
Social Services, except as permitted by statute or by order of a court of
competent jurisdiction.
6VAC35-51-760. Case management services. (Repealed.)
A. The program of the facility shall be designed to provide
case management services. In secure detention this requirement applies only to residents
confined in postdispositional detention. Case management services shall
address:
1. Helping the resident and the parents or legal guardian to
understand the effects on the resident of separation from the family and the
effect of group living;
2. Assisting the resident and the family to maintain their
relationships and prepare for the resident's future care;
3. Utilizing appropriate community resources to provide
services and maintain contacts with such resources;
4. Helping the resident strengthen his capacity to function
productively in interpersonal relationships;
5. Conferring with the child care staff to help them
understand the resident's needs in order to promote adjustment to group living;
and
6. Working with the resident, the family, or any placing
agency that may be involved in planning for the resident's future and in
preparing the resident for the return home or to another family, for
independent living, or for other residential care.
B. The provision of case management services shall be
documented in each resident's record.
6VAC35-51-770. Therapy. (Repealed.)
Therapy, if provided, shall be provided by an individual
(i) licensed as a therapist by the Department of Health Professions or (ii) who
is licensure eligible and working under the supervision of a licensed therapist,
unless exempted from these requirements under the Code of Virginia.
6VAC35-51-780. Structured program of care. (Repealed.)
A. There shall be evidence of a structured program of care
designed to:
1. Meet the residents' physical and emotional needs;
2. Provide protection, guidance, and supervision; and
3. Meet the objectives of any required service plan.
B. There shall be evidence of a structured daily routine
designed to ensure the delivery of program services.
C. A daily communication log shall be maintained to inform
staff of significant happenings or problems experienced by residents.
D. Health and dental complaints and injuries shall be
recorded and shall include the (i) resident's name, complaint, and affected
area; and (ii) time of the complaint.
E. The identity of the individual making each entry in the
daily communication log shall be recorded.
F. Routines shall be planned to ensure that each resident
receives the amount of sleep and rest appropriate for his age and physical
condition.
G. Staff shall promote good personal hygiene of residents
by monitoring and supervising hygiene practices each day and by providing
instruction when needed.
H. The structured daily routine shall comply with any
facility and locally imposed curfews.
6VAC35-51-790. Health care procedures. (Repealed.)
A. The provider shall have and implement written procedures
for promptly:
1. Providing or arranging for the provision of medical and
dental services for health problems identified at admission;
2. Providing or arranging for the provision of routine
ongoing and follow-up medical and dental services after admission;
3. Providing emergency services for each resident as
provided by statute or by the agreement with the resident's legal guardian;
4. Providing emergency services for any resident
experiencing or showing signs of suicidal or homicidal thoughts, symptoms of
mood or thought disorders, or other mental health problems; and
5. Ensuring that the required information in subsection B of
this section is accessible and up to date.
B. The following written information concerning each
resident shall be readily accessible to staff who may have to respond to a
medical or dental emergency:
1. Name, address, and telephone number of the physician and
dentist to be notified;
2. Name, address, and telephone number of a relative or
other person to be notified;
3. Medical insurance company name and policy number or
Medicaid number;
4. Information concerning:
a. Use of medication;
b. All allergies, including medication allergies;
c. Substance abuse and use; and
d. Significant past and present medical problems; and
5. Written permission for emergency medical care, dental
care, and obtaining immunizations or a procedure and contacts for obtaining
consent.
Subdivisions 3 and 5 of this subsection do not apply to
secure detention facilities except when a resident is confined in
postdispositional detention.
C. Facilities approved to provide respite care shall update
the information required by subsection B of this section at the time of each
stay at the facility.
6VAC35-51-800. Medical examinations and treatment. (Repealed.)
A. Each child accepted for care shall have a physical
examination by or under the direction of a licensed physician no earlier than 90
days prior to admission to the facility or no later than seven days following
admission, except (i) the report of an examination within the preceding 12
months shall be acceptable if a child transfers from one residential facility
licensed or certified by a state agency to another, (ii) a physical examination
shall be conducted within 30 days following an emergency admission if a report
of physical examination is not available, and (iii) this requirement does not
apply if a child is admitted to a secure detention facility or to a temporary
care facility.
B. Within seven days of placement, except for secure
detention, each resident shall have had a screening assessment for tuberculosis
as evidenced by the completion of a screening form containing, at a minimum,
the elements found on the current screening form published by the Virginia
Department of Health. The screening assessment can be no older than 30 days.
Secure detention shall have completed the screening assessment on each resident
within five days of placement.
C. A screening assessment for tuberculosis shall be
completed annually on each resident as evidenced by the completion of a form
containing, at a minimum, the elements of the screening form published by the
Virginia Department of Health.
D. Each resident's health record shall include written
documentation of (i) the initial physical examination, (ii) an annual physical
examination by or under the direction of a licensed physician including any
recommendation for follow-up care, and (iii) documentation of the provision of
follow-up medical care recommended by the physician or as indicated by the
needs of the resident.
E. Each physical examination report shall include:
1. Information necessary to determine the health and
immunization needs of the resident, including:
a. Immunizations administered at the time of the exam;
b. Vision exam;
c. Hearing exam;
d. General physical condition, including documentation of
apparent freedom from communicable disease including tuberculosis;
e. Allergies, chronic conditions, and handicaps, if any;
f. Nutritional requirements, including special diets, if
any;
g. Restrictions on physical activities, if any; and
h. Recommendations for further treatment, immunizations,
and other examinations indicated.
2. Date of the physical examination; and
3. Signature of a licensed physician, the physician's
designee, or an official of a local health department.
F. A child with a communicable disease shall not be
admitted unless a licensed physician certifies that:
1. The facility is capable of providing care to the child
without jeopardizing residents and staff; and
2. The facility is aware of the required treatment for the
child and the procedures to protect residents and staff.
The requirements of this subsection shall not apply to
temporary shelters and secure detention facilities.
G. Each resident's health record shall include written
documentation of (i) an annual examination by a licensed dentist, and (ii)
documentation of follow-up dental care recommended by the dentist or as
indicated by the needs of the resident. This requirement does not apply to
secure detention facilities, temporary care facilities, and respite care
facilities.
H. Each resident's health record shall include notations of
health and dental complaints and injuries and shall summarize symptoms and
treatment given.
I. Each resident's health record shall include, or document
the facility's efforts to obtain, treatment summaries of ongoing psychiatric or
other mental health treatment and reports, if applicable. This subsection does
not apply to secure detention facilities except when a juvenile is confined in
detention with a suspended commitment to DJJ.
J. The provider shall develop and implement written
policies and procedures that include use of standard precautions and addresses
communicable and contagious medical conditions. These policies and procedures
shall be approved by a medical professional.
K. A well-stocked first-aid kit shall be maintained and
readily accessible for minor injuries and medical emergencies.
6VAC35-51-810. Medication. (Repealed.)
A. All medication shall be securely locked and properly
labeled.
B. All staff responsible for medication administration
shall have successfully completed a medication training program approved by the
Board of Nursing or be licensed by the Commonwealth of Virginia to administer
medications before they can administer medication.
C. Staff authorized to administer medication shall be
informed of any known side effects of the medication and the symptoms of the
effects.
D. A program of medication, including over-the-counter
medication, shall be initiated for a resident only when prescribed in writing
by a person authorized by law to prescribe medication.
E. Medication prescribed by a person authorized by law shall
be administered as prescribed.
F. A medication administration record shall be maintained
of all medicines received by each resident and shall include:
1. Date the medication was prescribed;
2. Drug name;
3. Schedule for administration;
4. Strength;
5. Route;
6. Identity of the individual who administered the
medication; and
7. Dates the medication was discontinued or changed.
G. In the event of a medication error or an adverse drug
reaction, first aid shall be administered if indicated. Staff shall promptly
contact a poison control center, pharmacist, nurse, or physician and shall take
actions as directed. If the situation is not addressed in standing orders, the
attending physician shall be notified as soon as possible and the actions taken
by staff shall be documented.
H. Medication refusals shall be documented including action
taken by staff.
I. The provider shall develop and implement written
policies and procedures for documenting medication errors, reviewing medication
errors and reactions and making any necessary improvements, the disposal of
medication, the storage of controlled substances, and the distribution of
medication off campus. The policy and procedures must be approved by a health
care professional. The provider shall keep documentation of this approval.
J. The telephone number of a regional poison control center
and other emergency numbers shall be posted on or next to each nonpay telephone
that has access to an outside line in each building in which children sleep or
participate in programs.
K. Syringes and other medical implements used for injecting
or cutting skin shall be locked.
6VAC35-51-820. Nutrition. (Repealed.)
A. Each resident shall be provided a daily diet that (i)
consists of at least three nutritionally balanced meals and an evening snack,
(ii) includes an adequate variety and quantity of food for the age of the
resident, and (iii) meets minimum nutritional requirements and the U.S. Dietary
Guidelines.
B. Menus of actual meals served shall be kept on file for
at least six months.
C. Special diets shall be provided when prescribed by a
physician, and the established religious dietary practices of the resident
shall be observed.
D. Staff who eat in the presence of the residents shall be
served the same meals as the residents unless a special diet has been
prescribed by a physician for the staff or residents or the staff or residents
are observing established religious dietary practices.
E. There shall not be more than 15 hours between the
evening meal and breakfast the following day.
F. Providers shall assure that food is available to
residents who need to eat breakfast before the 15 hours have expired.
G. Providers shall receive approval from their regulatory
authority if they wish to extend the time between meals on weekends and
holidays. There shall never be more than 17 hours between the evening meal and
breakfast the following day on weekends and holidays.
6VAC35-51-830. Staff supervision of residents. (Repealed.)
A. No member of the child care staff shall be on duty more
than six consecutive days without a rest day, except in an emergency or as
approved by the regulatory authority for live-in staff.
B. Child care staff shall have an average of at least two
rest days per week in any four-week period. Rest days shall be in addition to
vacation time and holidays.
C. Child care staff other than live-in staff shall not be
on duty more than 16 consecutive hours, except in an emergency.
D. There shall be at least one trained child care worker,
on duty and actively supervising residents at all times that one or more
residents are present.
E. Whenever children are being supervised by staff there
shall be at least one staff person present with a current basic certificate in
standard first aid and a current certificate in cardiopulmonary resuscitation
issued by the American Red Cross or other recognized authority.
F. Supervision policies.
1. The provider shall develop and implement written policies
and procedures that address staff supervision of children including contingency
plans for resident illnesses, emergencies, off-campus activities, and resident
preferences. These policies and procedures shall be based on the:
a. Needs of the population served;
b. Types of services offered;
c. Qualifications of staff on duty; and
d. Number of residents served.
2. At all times the ratio of staff to residents shall be at
least one staff to eight residents for facilities during the hours residents
are awake, except when the regulatory authority has approved or required a
supervision plan with a different ratio based on the needs of the population
served.
3. Providers requesting a ratio that allows a higher number
of residents to be supervised by one staff person than was approved or required
shall submit a justification to the regulatory authority that shall include:
a. Why resident care will not be adversely affected; and
b. How residents' needs will be met on an individual as
well as group basis.
4. Written policies and procedures governing supervision of
residents and any justifications for a ratio deviation that allows a higher
number of residents to be supervised by one staff than was approved or
required, shall be reviewed and approved by the regulatory authority prior to
implementation.
5. The supervision policies or a summary of the policies
shall be provided, upon request, to the placing agency or legal guardian prior
to placement.
6. The Board of Juvenile Justice shall determine the
supervision ratios for facilities regulated by DJJ.
6VAC35-51-840. Emergency telephone numbers. (Repealed.)
A. There shall be an emergency telephone number where a
staff person may be immediately contacted 24 hours a day.
B. Residents who are away from the facility and the adults responsible
for their care during the absence shall be furnished with the emergency phone
number.
6VAC35-51-850. Searches. (Repealed.)
A. Strip searches and body cavity searches are prohibited
except:
1. As permitted by other applicable state regulations; or
2. As ordered by a court of competent jurisdiction.
B. A provider that does not conduct pat downs shall have a
written policy prohibiting them.
C. A provider that conducts pat downs shall develop and
implement written policies and procedures governing them that shall provide
that:
1. Pat downs shall be limited to instances where they are
necessary to prohibit contraband;
2. Pat downs shall be conducted by personnel of the same
gender as the resident being searched;
3. Pat downs shall be conducted only by personnel who are
specifically authorized to conduct searches by the written policies and
procedures; and
4. Pat downs shall be conducted in such a way as to protect
the subject's dignity and in the presence of one or more witnesses.
6VAC35-51-860. Behavior support. (Repealed.)
A. Within 30 days of admission, the provider shall develop
and implement a written behavior support plan that allows the resident to
self-manage his own behaviors. Each individualized plan shall include:
1. Identification of positive and problem behavior;
2. Identification of triggers for behaviors;
3. Identification of successful intervention strategies for
problem behavior;
4. Techniques for managing anger and anxiety; and
5. Identification of interventions that may escalate
inappropriate behaviors.
B. Individualized behavior support plans shall be developed
in consultation with the:
1. Resident;
2. Legal guardian;
3. Resident's parents, if applicable;
4. Program director;
5. Placing agency staff; and
6. Other applicable individuals.
C. Prior to working alone with an assigned resident, each
staff member shall demonstrate knowledge and understanding of that resident's
behavior support plan.
D. This section shall not apply to secure detention and the
Reception and Diagnostic Center.
6VAC35-51-870. Timeout. (Repealed.)
A. The provider shall develop and implement written
policies and procedures governing the conditions under which a resident may be
placed in timeout and the maximum period of timeout. The conditions and maximum
period of timeout shall be based on the resident's chronological and
developmental level.
B. The area in which a resident is placed shall not be
locked nor the door secured in a manner that prevents the resident from opening
it, except that this subsection does not apply to secure custody facilities.
C. A resident in timeout shall be able to communicate with
staff.
D. Staff shall check on the resident in the timeout area at
least every 15 minutes and more often depending on the nature of the resident's
disability, condition, and behavior.
E. Use of timeout and staff checks on the residents shall
be documented.
6VAC35-51-880. Prohibitions. (Repealed.)
The following actions are prohibited:
1. Deprivation of drinking water or food necessary to meet a
resident's daily nutritional needs, except as ordered by a licensed physician
for a legitimate medical purpose and documented in the resident's record;
2. Limitation on contacts and visits with the resident's
attorney, a probation officer, regulators, or placing agency representative;
3. Bans on contacts and visits with family or legal guardians,
except as permitted by other applicable state regulations or by order of a
court of competent jurisdiction;
4. Delay or withholding of incoming or outgoing mail, except
as permitted by other applicable state and federal regulations or by order of a
court of competent jurisdiction;
5. Any action that is humiliating, degrading, or abusive;
6. Corporal punishment;
7. Subjection to unsanitary living conditions;
8. Deprivation of opportunities for bathing or access to
toilet facilities, except as ordered by a licensed physician for a legitimate
medical purpose and documented in the resident's record;
9. Deprivation of health care;
10. Deprivation of appropriate services and treatment;
11. Application of aversive stimuli, except as permitted
pursuant to other applicable state regulations;
12. Administration of laxatives, enemas, or emetics, except
as ordered by a licensed physician or poison control center for a legitimate
medical purpose and documented in the resident's record;
13. Deprivation of opportunities for sleep or rest, except
as ordered by a licensed physician for a legitimate medical purpose and
documented in the resident's record; and
14. Limitation on contacts and visits with advocates
employed by DMHMRSAS or the Virginia Office for Protection and Advocacy.
6VAC35-51-890. Pharmacological or mechanical restraints. (Repealed.)
A. Use of mechanical restraints is prohibited, except as
permitted by other applicable state regulations or as ordered by a court of
competent jurisdiction.
B. Use of pharmacological restraints is prohibited.
6VAC35-51-900. Behavior interventions. (Repealed.)
A. The provider shall develop and implement written
policies and procedures for behavioral interventions and for documenting and monitoring
the management of resident behavior. Rules of conduct shall be included in the
written policies and procedures. These policies and procedures shall:
1. Define and list techniques that are used and available
for use in the order of their relative degree of restrictiveness;
2. Specify the staff members who may authorize the use of
each technique; and
3. Specify the processes for implementing such policies and
procedures.
B. Written information concerning the policies and
procedures of the provider's behavioral support and intervention programs shall
be provided prior to admission to prospective residents, legal guardians, and
placing agencies. For court-ordered and emergency admissions, this information
shall be provided to:
1. Residents within 12 hours following admission;
2. Placing agencies within 72 hours following the resident's
admission; and
3. Legal guardians within 72 hours following the resident's
admission, except that this requirement does not apply:
a. To secure detention facilities except when a juvenile is
confined in postdispositional;
b. When a facility is providing temporary care of 30 days
or less while conducting a diagnostic evaluation to identify the most
appropriate long-term placement for a child who has been committed to DJJ; and
c. When a state psychiatric hospital is evaluating a
child's treatment needs as provided by the Code of Virginia.
C. When substantive revisions are made to policies and
procedures governing management of resident behavior, written information
concerning the revisions shall be provided to:
1. Residents prior to implementation; and
2. Legal guardians and placing agencies prior to
implementation except that this requirement does not apply:
a. To secure detention facilities;
b. When a facility is providing temporary care of 30 days
or less while conducting a diagnostic evaluation to identify the most
appropriate long-term placement for a child who has been committed to DJJ; and
c. When a state psychiatric hospital is evaluating a
child's treatment needs as provided by the Code of Virginia.
D. The provider shall develop and implement written
policies and procedures governing use of physical restraint that shall include:
1. The staff position who will write the report and
timeframe;
2. The staff position who will review the report and
timeframe; and
3. Methods to be followed should physical restraint, less
intrusive interventions, or measures permitted by other applicable state
regulations prove unsuccessful in calming and moderating the resident's
behavior.
E. All physical restraints shall be reviewed and evaluated
to plan for continued staff development for performance improvement.
F. Use of physical restraint shall be limited to that which
is minimally necessary to protect the resident or others.
G. Trained staff members may physically restrain a resident
only after less restrictive interventions have failed or when failure to
restrain would result in harm to the resident or others.
H. Only trained staff members may manage resident behavior.
I. Each application of physical restraint shall be fully
documented in the resident's record including:
1. Date;
2. Time;
3. Staff involved;
4. Justification for the restraint;
5. Less restrictive interventions that were unsuccessfully attempted
prior to using physical restraint;
6. Duration;
7. Description of method or methods of physical restraint
techniques used;
8. Signature of the person completing the report and date;
and
9. Reviewer's signature and date.
J. Providers shall ensure that restraint may only be
implemented, monitored, and discontinued by staff who have been trained in the
proper and safe use of restraint, including hands-on techniques.
K. The provider shall review the facility's behavior
intervention techniques and policies and procedures at least annually to
determine appropriateness for the population served.
L. Any time children are present, staff must be present who
have completed all trainings in behavior intervention.
6VAC35-51-910. Seclusion. (Repealed.)
Seclusion is allowed only as permitted by other applicable
state regulations.
6VAC35-51-920. Education. (Repealed.)
A. Each resident of compulsory school attendance age shall
be enrolled, as provided in the Code of Virginia, in an appropriate educational
program within five school business days. Documentation of the enrollment shall
be kept in the resident's record.
B. The provider shall ensure that educational guidance and
counseling in selecting courses is provided for each resident and shall ensure
that education is an integral part of the resident's total program.
C. Providers operating educational programs for children
with disabilities shall operate those programs in compliance with applicable
state and federal statutes and regulations.
D. When a child with a disability has been placed in a
residential facility, the facility shall contact the division superintendent of
the resident's home locality. Documentation of the contact with the resident's
home school shall be kept in the resident's record.
E. A provider that has an academic or vocational program
that is not certified or approved by DOE shall document that teachers meet the
qualifications to teach the same subjects in the public schools.
F. Each provider shall develop and implement written
policies and procedures to ensure that each resident has adequate study time.
6VAC35-51-930. Religion. (Repealed.)
A. The provider shall have and implement written policies
regarding opportunities for residents to participate in religious activities.
B. The provider's policies on religious participation shall
be available to residents and any individual or agency considering placement of
a child in the facility.
C. Residents shall not be coerced to participate in
religious activities.
6VAC35-51-940. Recreation. (Repealed.)
A. The provider shall have a written description of its
recreation program that describes activities that are consistent with the
facility's total program and with the ages, developmental levels, interests, and
needs of the residents that includes:
1. Opportunities for individual and group activities;
2. Free time for residents to pursue personal interests that
shall be in addition to a formal recreation program, except this subdivision
does not apply to secure custody facilities;
3. Use of available community recreational resources and
facilities, except this subdivision does not apply to secure custody
facilities;
4. Scheduling of activities so that they do not conflict
with meals, religious services, educational programs, or other regular events;
and
5. Regularly scheduled indoor and outdoor recreational
activities that are structured to develop skills and attitudes.
B. The provider shall develop and implement written
policies and procedures to ensure the safety of residents participating in
recreational activities that include:
1. How activities will be directed and supervised by
individuals knowledgeable in the safeguards required for the activities;
2. How residents are assessed for suitability for an activity
and the supervision provided; and
3. How safeguards for water-related activities will be
provided including ensuring that a certified life guard supervises all swimming
activities.
C. For all overnight recreational trips away from the
facility, the provider shall document trip planning to include:
1. A supervision plan for the entire duration of the
activity including awake and sleeping hours;
2. A plan for safekeeping and distribution of medication;
3. An overall emergency, safety, and communication plan for
the activity including emergency numbers of facility administration;
4. Staff training and experience requirements for each
activity;
5. Resident preparation for each activity;
6. A plan to ensure that all necessary equipment for the
activity is in good repair and appropriate for the activity;
7. A trip schedule giving addresses and phone numbers of
locations to be visited and how the location was chosen/evaluated;
8. A plan to evaluate residents' physical health throughout
the activity and to ensure that the activity is conducted within the boundaries
of the resident's capabilities, dignity, and respect for self-determination;
9. A plan to ensure that a certified life guard supervises
all swimming activities in which residents participate; and
10. Documentation of any variations from trip plans and
reason for the variation.
D. All overnight out-of-state or out-of-country
recreational trips require written permission from each resident's legal
guardian. Documentation of the written permission shall be kept in the
resident's record.
6VAC35-51-950. Community relationships. (Repealed.)
A. Opportunities shall be provided for the residents to
participate in activities and to utilize resources in the community, except
this subsection does not apply to secure custody facilities.
B. The provider shall develop and implement written
policies and procedures for evaluating persons or organizations in the
community who wish to associate with residents on the premises or take
residents off the premises. The procedures shall cover how the facility will
determine if participation in such community activities or programs would be in
the residents' best interest.
C. Each facility shall have a staff community liaison who
shall be responsible for facilitating cooperative relationships with neighbors,
the school system, local law enforcement, local government officials, and the
community at large.
D. Each provider shall develop and implement written
policies and procedures for promoting positive relationships with the neighbors
that shall be approved by the regulatory authority.
6VAC35-51-960. Clothing. (Repealed.)
A. Provision shall be made for each resident to have an
adequate supply of clean, comfortable, and well-fitting clothes and shoes for
indoor and outdoor wear.
B. Clothes and shoes shall be similar in style to those generally
worn by children of the same age in the community who are engaged in similar
activities, except this requirement does not apply to secure custody
facilities.
C. Residents shall have the opportunity to participate in
the selection of their clothing, except this requirement does not apply to
secure custody facilities.
D. Residents shall be allowed to take personal clothing
when leaving the facility.
6VAC35-51-970. Allowances and spending money. (Repealed.)
A. The provider shall provide opportunities appropriate to
the ages and developmental levels of the residents for learning the value and use
of money, except this requirement does not apply to secure detention
facilities.
B. There shall be a written policy regarding allowances
that shall be made available to legal guardians at the time of admission,
except that this requirement does not apply to secure detention facilities.
C. The provider shall develop and implement written
policies for safekeeping and for recordkeeping of any money that belongs to
residents.
D. A resident's funds, including any allowance or earnings,
shall be used for the resident's benefit.
6VAC35-51-980. Work and employment. (Repealed.)
A. Assignment of chores, that are paid or unpaid work
assignments, shall be in accordance with the age, health, ability, and service
plan of the resident.
B. Chores shall not interfere with school programs, study
periods, meals, or sleep.
C. Work assignments or employment outside the facility,
including reasonable rates of pay, shall be approved by the program director
with the knowledge and consent of the legal guardian, except this requirement
does not apply to secure detention facilities.
D. In both work assignments and employment, the program
director shall evaluate the appropriateness of the work and the fairness of the
pay.
6VAC35-51-990. Visitation at the facility and to the
resident's home. (Repealed.)
A. The provider shall have and implement written visitation
policies and procedures that allow reasonable visiting privileges and flexible visiting
hours, except as permitted by other applicable state regulations.
B. Copies of the written visitation policies and procedures
shall be made available to the parents, when appropriate, legal guardians, the
resident, and other interested persons important to the resident no later than
the time of admission except that when parents or legal guardians do not
participate in the admission process, visitation policies and procedures shall
be mailed to them within 24 hours after admission.
C. In secure detention, except when a juvenile is confined
in postdispositional detention and temporary care facilities, written
visitation policies and procedures shall be provided upon request to parents,
legal guardians, residents, and other interested persons important to the
residents.
6VAC35-51-1000. Resident visitation at the homes of staff.
(Repealed.)
If a provider permits staff to take residents to the
staff's home, the facility must receive written permission of the resident's legal
guardian or placing agency before the visit occurs. The written permission
shall be kept in the resident's record.
6VAC35-51-1010. Vehicles and power equipment. (Repealed.)
A. Transportation provided for or used by children shall
comply with local, state, and federal laws relating to:
1. Vehicle safety and maintenance;
2. Licensure of vehicles;
3. Licensure of drivers; and
4. Child passenger safety, including requiring children to
wear appropriate seat belts or restraints for the vehicle in which they are
being transported.
B. There shall be written safety rules for transportation
of residents appropriate to the population served that shall include taking
head counts at each stop.
C. The provider shall develop and implement written safety
rules for use and maintenance of vehicles and power equipment.
6VAC35-51-1020. (Reserved.) (Repealed.)
Historical Notes
Derived from Virginia Register Volume 24, Issue 25, eff. September 17, 2008; repealed, Virginia Register Volume 31, Issue 9, eff. February 13, 2015.
6VAC35-51-1030. Serious incident reports. (Repealed.)
A. Any serious incident, accident, or injury to the
resident; any overnight absence from the facility without permission; any runaway;
and any other unexplained absence shall be reported within 24 hours: (i) to the
placing agency, (ii) to either the parent or legal guardian, or both, as
appropriate; and (iii) noted in the resident's record.
B. The provider shall document the following:
1. The date and time the incident occurred;
2. A brief description of the incident;
3. The action taken as a result of the incident;
4. The name of the person who completed the report;
5. The name of the person who made the report to the placing
agency and to either the parent or legal guardian; and
6. The name of the person to whom the report was made.
C. The provider shall notify the regulatory authority
within 24 hours of any serious illness or injury, any death of a resident, and
all other situations as required by the regulatory authority. Such reports
shall include:
1. The date and time the incident occurred;
2. A brief description of the incident;
3. The action taken as a result of the incident;
4. The name of the person who completed the report;
5. The name of the person who made the report to the placing
agency and to either the parent or legal guardian; and
6. The name of the person to whom the report was made.
6VAC35-51-1040. Suspected child abuse or neglect. (Repealed.)
A. Written policies and procedures related to child abuse
and neglect shall be distributed to all staff members. These shall include
procedures for:
1. Handling accusations against staff; and
2. Promptly referring, consistent with requirements of the
Code of Virginia, suspected cases of child abuse and neglect to the local child
protective services unit and for cooperating with the unit during any
investigation.
B. Any case of suspected child abuse or neglect shall be
reported to the local child protective services unit as required by the Code of
Virginia.
C. Any case of suspected child abuse or neglect occurring
at the facility, on a facility-sponsored event or excursion, or involving
facility staff shall be reported immediately (i) to the regulatory authority
and placing agency, and (ii) to either the resident's parent or legal guardian,
or both, as appropriate.
D. When a case of suspected child abuse or neglect is
reported to child protective services, the resident's record shall include:
1. The date and time the suspected abuse or neglect
occurred;
2. A description of the suspected abuse or neglect;
3. Action taken as a result of the suspected abuse or
neglect; and
4. The name of the person to whom the report was made at the
local child protective services unit.
6VAC35-51-1050. Grievance procedures. (Repealed.)
A. The provider shall develop and implement written
policies and procedures governing the handling of grievances by residents. If not
addressed by other applicable standards, the policies and procedures shall:
1. Be written in clear and simple language;
2. Be communicated to the residents in an age or
developmentally appropriate manner;
3. Be posted in an area easily accessible to residents and
their parents and legal guardians;
4. Ensure that any grievance shall be investigated by an
objective employee who is not the subject of the grievance; and
5. Require continuous monitoring by the provider of any
grievance to assure there is no retaliation or threat of retaliation against
the child.
B. All documentation regarding grievances shall be kept on
file at the facility for three years unless other regulations require a longer
retention period.
6VAC35-51-1060. Emergency and evacuation procedures. (Repealed.)
A. The provider shall develop a written emergency
preparedness and response plan for all locations. The plan shall address:
1. Documentation of contact with the local emergency coordinator
to determine (i) local disaster risks, (ii) communitywide plans to address
different disasters and emergency situations, and (iii) assistance, if any,
that the local emergency management office will provide to the facility in an
emergency;
2. Analysis of the provider's capabilities and potential
hazards, including natural disasters, severe weather, fire, flooding, work
place violence or terrorism, missing persons, severe injuries, or other
emergencies that would disrupt the normal course of service delivery;
3. Written emergency management policies outlining specific
responsibilities for provision of administrative direction and management of
response activities, coordination of logistics during the emergency,
communications, life safety of employees, contractors, students/interns,
volunteers, visitors and residents, property protection, community outreach,
and recovery and restoration;
4. Written emergency response procedures for assessing the
situation; protecting residents, employees, contractors, students/interns,
volunteers, visitors, equipment and vital records; and restoring services.
Emergency procedures shall address:
a. Communicating with employees, contractors, and community
responders;
b. Warning and notification of residents;
c. Providing emergency access to secure areas and opening
locked doors;
d. Conducting evacuations to emergency shelters or
alternative sites and accounting for all residents;
e. Relocating residents, if necessary;
f. Notifying family members and legal guardians;
g. Alerting emergency personnel and sounding alarms; and
h. Locating and shutting off utilities when necessary;
5. Supporting documents that would be needed in an
emergency, including emergency call lists, building and site maps necessary to
shut off utilities, designated escape routes, and list of major resources such
as local emergency shelters; and
6. Schedule for testing the implementation of the plan and
conducting emergency preparedness drills.
B. The provider shall develop emergency preparedness and response
training for all employees, contractors, students/interns, and volunteers that
shall include responsibilities for:
1. Alerting emergency personnel and sounding alarms;
2. Implementing evacuation procedures, including evacuation
of residents with special needs (i.e., deaf, blind, nonambulatory);
3. Using, maintaining, and operating emergency equipment;
4. Accessing emergency information for residents including
medical information; and
5. Utilizing community support services.
C. The provider shall document the review of the emergency
preparedness plan annually and make necessary revisions. Such revisions shall
be communicated to employees, contractors, students, and volunteers and
incorporated into training for employees, contractors, students/interns, and
volunteers and orientation of residents to services.
D. In the event of a disaster, fire, emergency, or any
other condition that may jeopardize the health, safety and welfare of
residents, the provider shall take appropriate action to protect the health,
safety, and welfare of the residents and take appropriate action to remedy the
conditions as soon as possible.
E. Employees, contractors, students/interns, and volunteers
shall be knowledgeable in and prepared to implement the emergency preparedness
plan in the event of an emergency.
F. In the event of a disaster, fire, emergency, or any
other condition that may jeopardize the health, safety, and welfare of
residents, the provider should first respond and stabilize the
disaster/emergency. After the disaster/emergency is stabilized, the provider
shall report the disaster/emergency to the legal guardian and the placing
agency as soon as possible of the conditions at the facility and report the
disaster/emergency to the regulatory authority as soon as possible, but no
later than 72 hours after the incident occurs.
G. Floor plans showing primary and secondary means of
egress shall be posted on each floor in locations where they can easily be seen
by staff and residents.
H. The procedures and responsibilities reflected in the
emergency procedures shall be communicated to all residents within seven days
following admission or a substantive change in the procedures.
I. At least one evacuation drill (the simulation of the
facility's emergency procedures) shall be conducted each month in each building
occupied by residents.
J. Evacuation drills shall include, at a minimum:
1. Sounding of emergency alarms;
2. Practice in evacuating buildings;
3. Practice in alerting emergency authorities;
4. Simulated use of emergency equipment; and
5. Practice in securing resident emergency information.
K. During any three consecutive calendar months, at least
one evacuation drill shall be conducted during each shift.
L. A record shall be maintained for each evacuation drill
and shall include the following:
1. Buildings in which the drill was conducted;
2. Date and time of drill;
3. Amount of time to evacuate the buildings;
4. Specific problems encountered;
5. Staff tasks completed including:
a. Head count, and
b. Practice in notifying emergency authorities; and
6. The name of the staff members responsible for conducting
and documenting the drill and preparing the record.
M. The record for each evacuation drill shall be retained
for three years after the drill.
N. The facility shall assign one staff member who shall
ensure that all requirements regarding the emergency preparedness and response
plan and the evacuation drill program are met.
6VAC35-51-1070. Independent living programs. (Repealed.)
A. Each independent living program must demonstrate that a
structured program using materials and curriculum, approved by the regulatory authority,
is being used to teach independent living skills. The curriculum must include
information regarding each of the following areas:
1. Money management and consumer awareness;
2. Food management;
3. Personal appearance;
4. Social skills;
5. Health/sexuality;
6. Housekeeping;
7. Transportation;
8. Educational planning/career planning;
9. Job-seeking skills;
10. Job maintenance skills;
11. Emergency and safety skills;
12. Knowledge of community resources;
13. Interpersonal skills/social relationships;
14. Legal skills;
15. Leisure activities; and
16. Housing.
B. Within 14 days of placement the provider must complete
an assessment, including strengths and needs, of the resident's life skills
using an independent living assessment tool approved by the regulatory agency.
The assessment must cover the following areas:
1. Money management and consumer awareness;
2. Food management;
3. Personal appearance;
4. Social skills;
5. Health/sexuality;
6. Housekeeping;
7. Transportation;
8. Educational planning/career planning;
9. Job-seeking skills;
10. Job maintenance skills;
11. Emergency and safety skills;
12. Knowledge of community resources;
13. Interpersonal skills/social relationships;
14. Legal skills;
15. Leisure activities; and
16. Housing.
C. The resident's individualized service plan shall
include, in addition to the requirements found in 6VAC35-51-630, goals,
objectives, and strategies addressing each of the following areas, as
applicable:
1. Money management and consumer awareness;
2. Food management;
3. Personal appearance;
4. Social skills;
5. Health/sexuality;
6. Housekeeping;
7. Transportation;
8. Educational planning/career planning;
9. Job-seeking skills;
10. Job maintenance skills;
11. Emergency and safety skills;
12. Knowledge of community resources;
13. Interpersonal skills/social relationships;
14. Legal skills;
15. Leisure activities; and
16. Housing.
D. Each independent living program shall develop and
implement policies and procedures to train all direct care staff within 14 days
of employment on the content of the independent living curriculum, the use of
the independent living materials, the application of the assessment tool, and
the documentation methods used. Documentation of the orientation shall be kept
in the employee's staff record.
E. If residents age 18 years or older are to share in the
responsibility for their own medication with the provider, the independent
living program shall develop and implement written policies and procedures that
include:
1. Training for the resident in self-administration and
recognition of side effects;
2. Method for storage and safekeeping of medication;
3. Method for obtaining approval for the resident to
self-administer medication from a person authorized by law to prescribe
medication; and
4. Method for documenting the administration of medication.
F. Each independent living program shall develop and
implement written policies and procedures that ensure that each resident is
receiving adequate nutrition as required in 6VAC35-51-820 A, B, and C.
6VAC35-51-1080. Mother/baby programs. (Repealed.)
A. Each provider shall develop and implement written
policies and procedures to orient direct care staff within 14 days of hire
regarding the following:
1. Responsibilities of mothers regarding the child;
2. Child development including age-appropriate behavior for
each stage of development;
3. Appropriate behavioral interventions for infants and
toddlers;
4. Basic infant and toddler care including but not limited
to nutritional needs, feeding procedures, bathing techniques; and
5. Safety issues for infants and toddlers.
B. Each direct care worker shall have certification in
infant CPR and first aid prior to working alone with infants or toddlers.
C. A placement agreement shall be signed by the legal
guardian for each adolescent mother, and a separate placement agreement shall
be signed for each child at the time of admission.
D. In addition to the requirements of 6VAC35-51-680 B, the
application for admission for the adolescent's child must include:
1. The placement history of the child;
2. The developmental milestones of the child; and
3. The nutritional needs of the child.
E. In addition to the requirements of 6VAC35-51-700, the
face sheet for the adolescent's child shall also include:
1. Type of delivery;
2. Weight and length at birth;
3. Any medications or allergies; and
4. Name and address, if known, of the biological father.
F. A combined service plan following the requirements of
6VAC35-51-720 must be written for the adolescent mother and her child within 30
days of the admission of the adolescent's child.
G. There shall be a combined documented review of the
adolescent mother's and her child's progress following the requirements of the
quarterly report 60 days following the first combined service plan and within
each 90-day period thereafter.
H. The developmental milestones of the adolescent's child
must be documented in each quarterly progress report.
I. The record of each child 18 months or younger shall
include the child's feeding schedule and directions for feeding. This
information shall be posted in the kitchen.
J. The provider shall develop and implement written
policies and procedures for tracking:
1. What a child 18 months or younger is eating;
2. How much a child 18 months or younger is eating; and
3. The response to newly introduced foods of the child 18
months or younger.
K. The provider shall develop and implement written
policies and procedures to record all diaper changes.
L. The provider shall monitor that all infants are held and
spoken to and placed in a position to observe activities when they are awake.
M. Bottle-fed infants who cannot hold their own bottles
shall be held when fed. Bottles shall not be propped.
N. The provider shall monitor that all children of
adolescent mothers have access to age-appropriate toys and are provided
opportunity for visual and sound stimulation.
O. The provider shall ensure that when an adolescent mother
is in school or is working, her child is appropriately cared for, either in a licensed
child day program or at the facility.
P. A daily activity log must be kept for each child of the
adolescent mother showing what activities the child actually participated in
during the day. The daily log must show that children have the opportunity to
participate in sensory, language, manipulative, building, large muscle, and
learning activities.
Q. The provider shall develop and implement written
policies and procedures regarding health care of the adolescent's child
including:
1. Obtaining health care:
2. Ensuring follow-up care is provided;
3. Ensuring adolescent mothers administer to their children
only prescription and nonprescription medication authorized by a health care
professional licensed to prescribe medication; and
4. Medication administration.
R. The provider shall develop and implement written
policies and procedures to ensure that all toys and equipment to be used by
children are sturdy, of safe construction, nontoxic and free of hazards, and in
compliance with industry safety standards.
S. The facility shall develop and implement written
policies and procedures for inspecting toys and equipment on a regular basis
for cleanliness and safety.
T. Cribs shall be placed where objects outside the crib
such as cords from the blinds or curtains are not within reach of infants or
toddlers.
U. Pillows and filled comforters shall not be used by
children under two years of age.
V. Infant walkers shall not be used.
W. Adolescent mothers and their babies may share a bedroom
as allowed by 6VAC35-51-480 E, but shall not share a room with other
adolescents or their children.
X. Pregnant adolescents may share a room as allowed by
6VAC35-51-480.
Y. Providers shall develop and implement written policies
and procedures to protect infants, toddlers, and young children from dangers in
their environment. The policies and procedures must include but not be limited
to protection from:
1. Electrocution;
2. Falling down steps or ramps or gaining access to
balconies, porches, or elevated areas;
3. Poisons, including poisonous plants; and
4. Drowning.
6VAC35-51-1090. Campsite programs or adventure activities.
(Repealed.)
A. All wilderness campsite programs and providers that take
residents on wilderness/adventure activities shall develop and implement
policies and procedures that include:
1. Staff training and experience requirements for each
activity;
2. Resident training and experience requirements for each
activity;
3. Specific staff-to-resident ratio and supervision plan
appropriate for each activity including sleeping arrangements and supervision
during night time hours;
4. Plans to evaluate and document each participant's
physical health throughout the activity;
5. Preparation and planning needed for each activity and
time frames;
6. Arrangement, maintenance, and inspection of activity
areas;
7. A plan to ensure that any equipment and gear that is to
be used in connection with a specified wilderness/adventure activity is
appropriate to the activity, certified if required, in good repair, in operable
condition, and age and body size appropriate;
8. Plans to ensure that all ropes and paraphernalia used in
connection with rope rock climbing, rappelling, high and low ropes courses, or
other adventure activities in which ropes are used are approved annually by an
appropriate certifying organization and have been inspected by staff
responsible for supervising the adventure activity before engaging residents in
the activity;
9. Plans to ensure that all participants are appropriately
equipped, clothed, and wearing safety gear, such as a helmet, goggles, safety
belt, life jacket, or a flotation device that is appropriate to the adventure
activity in which the resident is engaged;
10. Plans for food and water supplies and management of
these resources;
11. Plans for the safekeeping and distribution of
medication;
12. Guidelines to ensure that participation is conducted
within the boundaries of the resident's capabilities, dignity, and respect for
self-determination;
13. Overall emergency, safety, and communication plans for
each activity including rescue procedures, frequency of drills, resident
accountability, prompt evacuation, and notification of outside emergency
services; and
14. Review of trip plans by the trip coordinator.
B. All wilderness campsite programs and providers that take
residents on wilderness/adventure activities must designate one staff person to
be the trip coordinator who will be responsible for all facility wilderness or
adventure trips.
1. This person must have experience in and knowledge
regarding wilderness activities and be trained in wilderness first aid. The
individual must also have at least one year experience at the facility and be
familiar with the facility procedures, staff, and residents.
2. Documentation regarding this knowledge and experience
shall be found in the individual's staff record.
3. The trip coordinator will review all trip plans and
procedures and will ensure that staff and residents meet the requirements as
outlined in the facility's policy regarding each wilderness/adventure activity
to take place during the trip.
4. The trip coordinator will review all trip plans and
procedures and will ensure that staff and residents meet the requirements as
outlined in the facility's policy regarding each wilderness/adventure activity
to take place during the trip.
C. The trip coordinator shall conduct a posttrip debriefing
within 72 hours of the group's return to base to evaluate individual and group
goals as well as the trip as a whole.
D. The trip coordinator will be responsible for writing a
summary of the debriefing session and shall be responsible for ensuring that
procedures and policies are updated to reflect improvements needed.
E. A trip folder will be developed for each
wilderness/adventure activity conducted away from the facility and shall
include:
1. Medical release forms including pertinent medical
information on the trip participants;
2. Phone numbers for administrative staff and emergency
personnel;
3. Daily trip logs;
4. Incident reports;
5. Swimming proficiency list if trip is near water;
6. Daily logs;
7. Maps of area covered by the trip; and
8. Daily plans.
F. Initial physical forms used by wilderness campsite
programs and providers that take residents on wilderness or adventure
activities shall include:
1. A statement notifying the doctor of the types of
activities the resident will be participating in; and
2. A statement signed by the doctor stating the individual's
health does not prevent him from participating in the described activities.
G. First-aid kits used by wilderness campsite programs and
providers that take residents on adventure activities shall be activity
appropriate and shall be accessible at all times.
H. Direct care workers hired by wilderness campsite
programs and providers that take residents on wilderness/adventure activities
shall be trained in a wilderness first-aid course.
I. The provider shall ensure that before engaging in any
aquatic activity, each resident shall be classified by the trip coordinator or
his designee according to swimming ability in one of two classifications:
swimmer and nonswimmer. This shall be documented in the resident's record and
in the trip folder.
J. The provider shall ensure that lifesaving equipment is
provided for all aquatic activities and is placed so that it is immediately
available in case of an emergency. At a minimum, the equipment shall include:
1. A whistle or other audible signal device; and
2. A lifesaving throwing device.
K. A separate bed, bunk, or cot shall be made available for
each person.
L. A mattress cover shall be provided for each mattress.
M. Sleeping areas shall be protected by screening or other
means to prevent admittance of flies and mosquitoes.
N. Bedding shall be clean, dry, sanitary, and in good
repair.
O. Bedding shall be adequate to ensure protection and
comfort in cold weather.
P. Sleeping bags, if used, shall be fiberfill and rated for
0°F.
Q. Linens shall be changed as often as required for
cleanliness and sanitation but not less frequently than once a week.
R. Each resident shall be provided with an adequate supply
of clean clothing that is suitable for outdoor living and is appropriate to the
geographic location and season.
S. Sturdy, water-resistant, outdoor footwear shall be
provided for each resident.
T. Each resident shall have adequate personal storage area.
U. Fire extinguishers of a 2A 10BC rating shall be
maintained so that it is never necessary to travel more than 75 feet to a fire
extinguisher from combustion-type heating devices, campfires, or other source
of combustion.
V. Artificial lighting shall be provided in a safe manner.
W. All areas of the campsite shall be lighted for safety
when occupied by residents.
X. Staff of the same sex may share a sleeping area with the
residents.
Y. A telephone or other means of communication is required
at each area where residents sleep or participate in programs.
FORMS (6VAC35-51)
Initial Application for a Virginia State
License/Certificate to Operate a Children's Residential Facility,
032-05-5535-DJJ (eff. 12/07).
Renewal Application for a Virginia State
License/Certificate to Operate a Children's Residential Facility,
032-05-5545-DJJ (eff. 12/07).
Renewal Application for a Facility Holding a Conditional
License/Certificate, 032-05-588-DJJ (eff. 12/07).