Ala. Admin. Code r. 660-5-37-.04
Current through Register Vol. 43, No. 1, October 31, 2024
Section 660-5-37-.04 - Program(1) Staff to Child Ratio. The child care facility shall have sufficient number of qualified paid staff to provide for each child's physical and emotional needs at all times and perform required tasks. (a) The ratio of child care workers to children shall not be less than one child care worker on duty for each 8 children. Exception: During the hours of 10 PM to 7 AM the ratio of child care workers to children shall not be less than one child care worker on duty for each 10 children. When child care staff or other staff have their own children living in the same living units as children under care, such children shall be included in the licensed capacity of the child care facility.(b) The administrator shall advise the Department in writing of the number of staff's children living in the facility. The State Department may require a higher ratio of staff per child for those child care facilities serving children with more specialized needs as determined by a child's Care/Treatment Plan and or/ISP.(2) Medical Care. An ongoing relationship shall be established with a licensed practicing physician or clinic to advise the child care facility staff concerning medical plans, programs and treatment of children in care. (a) Each child shall have a complete physical examination or the benefit of medical screening or assessment, i.e., MediKids or EPSDT, for children eligible for Medicaid. A copy of the complete physical examination report or assessment shall be on file. Such examination shall be made within three months prior to admission and at least annually thereafter. (Another EPSDT may be requested if a Medicaid recipient had a screening longer than 3 months prior to admission and they are entering foster care.) Exception: In emergency placements where a medical is not available a medical examination and report shall be obtained no later than ten (10) days after the placement.(b) The initial examination for children shall consist of a complete history, physical examination, and tests as listed on form DHR-DFC-623. A form is acceptable which makes provisions for the same information as the DHR-DFC-623, Child's Medical Record-Foster Care, which is furnished by the Department. Information about the family health history is helpful.(c) Each child care facility shall make provision and establish procedures for routine medical services, hospitalization and/or emergency medical or surgical treatment of children. Financial arrangements for provisions of these services shall be part of the Placement Agreement.(3) Dental Care. An ongoing relationship shall be established with a licensed practicing dentist(s) to advise the child care facility staff concerning dental plans, program and treatment of children in care. (a) Each child shall have a routine dental examination at least annually. Necessary follow-up treatment shall be provided.(b) Each child care facility shall make provision and establish procedures for routine and emergency dental services. Financial arrangements for provision of these services shall be a part of the Placement or Inter Agency Agreement.(4) Personal Hygiene. The child care facility shall carry out a program of instruction to meet the individual personal hygiene needs for all children. Individual items such as towels, washcloths, toothbrushes and other toiletries shall be provided for each child according to their individual needs. It is suggested that one child's personal items not be allowed to touch that of another child's to avoid the possibility of contamination. Also, children are to be discouraged from sharing the personal items.(5) Rest. The child care facility shall provide opportunity for uninterrupted sleep for each child according to his individual needs. Infants should be placed on their back to sleep.(6) Nutrition. The child care facility shall provide wholesome nutritious and properly prepared daily meals, including: meats or meat substitutes, vegetables, milk, fruit, cereal, bread, and dessert. Special dietary needs shall be provided as recommended by a physician. When special dietary needs are identified, professional consultation shall be requested and modifications made as needed. At least three meals shall be served each day, each with a different menu. Menus shall be written in advance and shall be kept on file for one year and available for review. Between-meal and nighttime snacks shall be available, except when restricted for dietary or health reasons. (a) The child care facility shall annually review its food service menus to assure that well-balanced, nutritious and appetizing food is served.(b) Handling, storage, and preparation of food shall comply with state health standards. Food shall be of a size and consistency appropriate for the age, growth, and development ability of a child.(7) Clothing. Clothing shall be stylish, properly fit, clean and of good quality and appearance. The clothing shall not be different from clothes worn by children in the community. Children shall have a part in the selection of their clothes. Used clothes shall be used only when in good condition, when chosen by the child, and when properly renovated and fitted. When shoes are needed, new shoes shall be provided, and shall be fitted to the individual child. Used canvas sneakers, if in good condition and sanitized, may be used. Each child shall have his/her own clothing and a place for storing it. Responsibility for the provision of clothing shall be outlined in the Placement Agreement.(8) Discipline. Discipline shall be used as a positive educational influence that seeks to develop inner controls and provide structure. The child shall be advised of all rules and regulations of the child care facility which apply to him/her. The staff members shall be aware of the rules and regulations of the child care facility, and consistent in their enforcement thereof. The administration shall be responsible for the thorough understanding by all staff members of policies and practices concerning discipline and punishment.(9) Punishment. When punishment is required, it shall be fair, consistent, brief, related and in proportion to the offense and in accordance with the child care facility's written child care policies. Harsh and humiliating punishment, including corporal punishment, physical or emotional abuse, is prohibited. Verbal abuse of a child and derogatory remarks about a child or his/her family is prohibited. (a) Punishment shall not be administered by peers. Limited peer input into consequences of negative behavior may be appropriate as part of a therapeutic program under the supervision of a professional staff member. Positive corrective measures are to be used and may include, but are not limited to: 2. Time out (usually age of child plus two minutes).3. Grounding to a certain area.4. Redirecting the child's activity.5. Develop a behavioral contract.7. Restitution by child of other person's property damaged or destroyed by child.(b) Withholding of sleep, meals or mail, arbitrarily sending a child to bed early, and the curtailment of visits by the child's family to the child, shall not be used as a type of punishment at any time. A child who must be temporarily isolated from his/her peers shall be under adult supervision. When a child is isolated, provisions shall be made for humane and safe conditions including room space appropriate to the developmental level of the child, adequate ventilation and lighting, and a room temperature consistent with the rest of the home or facility. Meals, routine medication and water must be provided. Observation of a child in isolation shall occur at least every 30 minutes or more often as necessary. The behavior management plan will describe how frequently the child must be observed and will authorize any restrictions imposed while the child is in isolation, e.g., no TV or radio.(10) Behavior Management. Child care facilities will develop written policies regarding behavior management. The policy will be explained to each child upon placement and a copy will be provided to the person placing the child or holding custody of the child.(11) Public Appearances. Public appearance of the children shall not be for the purpose of display, and shall be permitted only when such appearances have positive and constructive value for the children and with the consent of the custodian or person or agency responsible for the child. Children shall not be required to attend parties, church functions, fund raising drives, picnics, etc., sponsored by various groups. Children shall never be exploited for the benefit of the child care facility. All public appearances by the children as representative of the child care facility shall be voluntary. The child's sleeping area and personal belongings shall not be on display to the public except for those rare occasions when the child care facility observes open house, homecoming, etc., and always with the permission of the child.(12) On-Campus Work Assignments. Work assignments shall be considered as part of the participatory responsibility of living together, or as a means of earning money. Children shall not be considered as substitutes for employed adult staff, nor shall they be employed as a means of avoiding the hiring of adult staff. Work assignments shall be made in accordance with the age and ability of the child. Jobs for children shall be assigned so that they will not conflict with schoolingeducational needs, playtime, extracurricular activities, or normal community visits, or visits with their families and friends. Children shall have some choice in their chores, and a change of routine duties shall be offered periodically to reduce monotony and to provide a variety of experiences. Children shall not be employed for the financial gain of the facility and monies earned shall be the property of the child.(13) Sponsors. Where sponsorship of specific children by church or other unrelated groups or individuals exists, no child shall be compelled against his/her will to visit. A visit shall be planned with the child's consent, and subject to the approval of the legal custodian or person or agency responsible for the child.(14) Telephone and Mail Contacts. Child care facilities will develop written policies regarding telephone and mail contacts. The policy will be explained to each child upon placement and a copy will be provided to the person placing/holding custody of the child.(15) Visiting Practices. (a) Family ties shall be encouraged and maintained in accordance with the Care/Treatment Plan. Visitation rights of the family and child shall be honored unless specific, definable and documented reasons to the contrary have been established through the Care/Treatment Plan and/or ISP. Families shall be afforded privacy with their children during visitation on the facility campus, unless specific, definable and documented reasons to the contrary have been established through the Care/Treatment Plan and/or ISP.(b) Children shall have the right to be with their own relatives on all possible occasions, especially at holiday time. Holiday visits shall be determined to be in the child's best interest, as allowed in the Care/Treatment Plan and/or ISP. If there are compelling reasons to prohibit visits, those reasons shall be documented.(c) Siblings in residence in the child care facility shall have the right to contact each other on their own initiative. If possible, siblings shall live together.(d) The child care facility's professional social service staff may approve families in the community for overnight visits after an assessment of the request and the visiting family. The length of such visits shall be limited to 48 hours. Longer planned visits shall require the prior approval of the person or agency having legal custody or planning responsibility of the child. If the child care facility's professional social service staff and the agency having primary planning responsibility concur in the written Care/Treatment plan that the child needs to be provided with developmental experiences through visitation in a family home with unrelated persons who may or may not have been previously known to the child, it shall be the responsibility of the facility to make a written request of a County Department of Human Resources or a licensed child-placing agency to approve a designated family as a visiting home for the child.(e) When the agency having primary responsibility for the child receives written approval of a visiting resource and forwards a copy to the child care facility, the child care facility's social worker service staff shall plan visits directly with the visiting resource parents in accordance with the Care/Treatment Plan and/or ISP for the child. The child care facility social worker service staff shall report to the County Department of Human Resources or licensed child placing agency which approved the visiting resource pertinent information concerning the visits which are made. If only one visit is made, a report on that visit shall be sent soon thereafter. If visits are made on a regular basis, then reports shall be sent on a quarterly basis. All visits will be reported on the Progress Reports.(f) Sound, appropriate plans shall be made well in advance of proposed vacations and holidays. The child care facility shall make arrangements for on-campus care for children who have no natural family to visit during vacations and holidays or for whom there is no consent for visitation with an approved visiting family member or visiting resource.(g) A child shall not be taken from, sent from, or allowed to leave the state without written consent of the natural parents who hold custody, or the juvenile court having jurisdiction of the child when custody has been removed from the natural parent.(16) Allowances. The child care facility shall ensure that each child receives an allowance, spending money, or has the opportunity to earn money.(17) Educational Opportunities. (a) Children shall attend school in accordance with the school attendance laws. Space and suitable equipment, such as reference books, adequate lighting and quiet work space, shall be provided in the child care facility for home study. When practical, participation of children in extracurricular activities of the school which they attend shall be encouraged and transportation shall be provided or arranged.(b) Vocational training, if available in the community for age appropriate children, may be provided in lieu of public school attendance. Such attendance shall be subject to the requirements of the Alabama State Department of Education.(c) Education relating to human health and physiology shall be an integral part of the child care facility's program, and shall be geared to the child's age, stage of development and level of understanding.(d) The child care facility's professional staff shall be involved in the IEP's with the school to ensure that children are properly placed and making adequate adjustment and to plan jointly with school personnel in alleviating problems which arise. Tutoring shall be made available to children who will benefit from additional assistance in obtaining or maintaining grade level.(18) Recreation. (a) Positive community contacts shall be provided, i.e., church, civic groups, and YMCA's.(b) The child care facility shall provide facilities and staff to make recreation and other activities available within the child care facility. Provision shall be made for adequate playtime, both for organized and free play, indoor and out, for all children under care.(c) The child care facility shall provide time for each child to be alone if appropriate, and places to go where the child will not be disturbed. He/She shall also be provided an opportunity to exercise some free choices of activity.(d) It is the responsibility of the facility to consider the safety and appropriate supervision of children in planning the transportation to and from recreational activities, and to consider the appropriateness of the activity. The facility shall develop guidelines specifying levels of supervision. These shall consider such factors as: a child's developmental level, level of maturity, kinds of activities in which a child may participate, and methods by which a child may receive increased or decreased supervision. The guidelines will be explained to a child upon entry and will be posted for review by staff, children, and DHR. Any facility staff who provides transportation shall have a valid driver's license and a copy of the license shall be on file with the facility.(19) Off-Campus Employment. When appropriate, children of legal work age shall be encouraged to earn their own money through employment in the community. Exceptions may be made in shelter care placements.(20) Grievance Process for Children. Each facility shall develop specific grievance policies and procedures for implementation. Copies of each shall be provided to each child in care and their families. Grievance procedures shall be activated upon the request of the child or the child's family and continue until a resolution is obtained. The grievance requests and procedures taken shall be documented in the child's file. Documentation of this grievance and resolution shall be placed in the child's file and the grievance shall be reported to the legal guardian and/or agency having primary planning responsibility. Author: Linda S. Stephens
Ala. Admin. Code r. 660-5-37-.04
Repealed and New Rule: Filed November 15, 1999; effective December 20, 1999; operative March 1, 2000.Statutory Authority:Code of Ala. 1975, §§ 38-7-1 through -17, §§ 41-22-1 through -27.