Ariz. Admin. Code § 21-7-227

Current through Register Vol. 31, No. 2, January 10, 2025

Section R21-7-227 - Nurture; Supervision; Positive Behavior Management

A. An Agency shall nurture a child in care by:

1. Providing the child with opportunities to develop emotionally, socially, culturally, physically, and educationally, as appropriate to the child's skill and developmental level;

2. Helping the child develop a positive identity by respecting the child's race, ethnicity, religion, gender, gender identity, gender expression, culture, and sexual orientation by making active efforts to create an inclusive environment including celebrating holidays, displaying artwork, and providing meals that reflect the child's identity, and seeking out opportunities for the child to increase their connectedness to communities that reflect their identities;

3. Providing the child with opportunities to express preferences and make choices appropriate to the child's age and developmental level;

4. Providing the child with a variety of safe and developmentally appropriate play equipment, toys, and recreational supplies;

5. Practicing positive discipline;

6. Assisting the child with day-to-day concerns;

7. Providing the child with assistance, comfort, and emotional support to ease the distress associated with coming into care and with related transitions;

8. Assisting in maintaining the child's connection to their family, friends, community, and culture; and

9. Providing opportunities for the child to contact family members, friends and other persons the child identifies as significant to the child's well-being by means of face-to-face contact, mail, telephone, or other modes of communication, unless otherwise directed by a court order, the Placing Entity or, if there is no Placing Entity, the parent or guardian.

B. An Agency shall commit to provide each child in care with the support and supervision in accordance with licensing requirements and based on the child's age, developmental level, and maturity.

C. The licensee shall:

1. Provide positive discipline that is appropriate to the age, life experience, and developmental level of a child in care;

2. Establish well-defined and clearly communicated rules that set the limits of behavior;

3. Develop and implement reasonable, developmentally appropriate, and consistent rewards and consequences;

4. Use disciplinary methods that help a child in care build self-control, self-reliance, and self-esteem; and

5. Inform the Placing Entity, or if there is no Placing Entity, parent or guardian, of any behavior displayed by the child in care that endangers the health, safety, or well-being of the child or others.

D. An Agency shall have a written behavior management policy and procedure for a child in care that shall:

1. Be based on positive discipline methods that are developmentally appropriate for a child;

2. Be designed to encourage and support the development of self-control;

3. Describe the following:

a. Behavior expectations of a child;

b. The consequence to a child for a violation of the Agency's policy and procedure. A consequence shall:

i. Reasonably relate to the violation, and

ii. Be administered without prolonged and unreasonable delay;

c. The circumstances when a licensee permits the use of restrictive behavior management;

d. The kind of behavior warranting use of restrictive behavior management;

e. The licensee's methods of documenting use of restrictive behavior management;

f. Any restrictive behavior management technique that requires supervisory authorization or written documentation before being used;

g. The licensee's process for supervisory review to evaluate whether staff properly applied restrictive behavior management in a particular case; and

h. Any behavior management technique prohibited by the licensee; and

4. Abide by the requirements in this Chapter related to positive discipline and prohibited practices.

E. The licensee and direct care staff are responsible for control and discipline of a child in care. The licensee shall not allow a child to discipline another child.

F. The licensee shall not allow any child in care to be subjected to maltreatment, abuse, neglect, cruel, unusual, or physical discipline.

G. The licensee shall not use or threaten to use, or engage in and shall not permit any other person to use or threaten to use, or engage in, the following or similar punishment or maltreatment of a child in care including:

1. Any form of physical punishment, including hitting, spanking, biting, pinching, shaking, slapping, smacking, punching, or kicking;

2. Verbal abuse, including ridicule, profane language targeting a child, or humiliation;

3. Deprivation of medical care, medicine, shelter, bedding, food, water, clothing, sufficient sleep, or opportunity for toileting;

4. Force-feeding, except as prescribed by a licensed medical practitioner;

5. Seclusion, confinement in a locked room or small area or restricting access to the facility;

6. A consequence that requires a child to remain silent or motionless or to be isolated for a time period that is not developmentally appropriate;

7. Require a child to take a painfully uncomfortable position, including squatting or bending;

8. Behavior management involving chemical restraint, including over-the-counter or prescription medication for the purpose of restraining or sedating a child;

9. Restrictive behavior management involving mechanical or physical restraint except:

a. When the restraint is necessary to prevent danger to the child or danger to another;

b. After staff has tried less restrictive measures that have failed; and

c. When the licensee has documentation of the restrictive behavioral management training in the personnel file of the staff using the restraint;

10. Derogatory remarks about the child, the child's race, religion, ethnic origin, sexual orientation, gender identity, gender expression or about a person who is significant to the child;

11. Cruel, severe, depraved, humiliating, or frightening actions or statements;

12. Noxious stimuli as a consequence, including washing a child's mouth with soap, vinegar or hot sauce;

13. Denial of visitation or communication with a significant persons outside the facility solely as a consequence for inappropriate behavior; or

14. Required physical exercises such as running laps or performing push-ups, and assignment of physically strenuous activities, except:

a. As expressly prescribed in a child's service plan and as part of a regular physical conditioning program, or as part of a work experience that meets the programs requirements;

b. With documented clearance by a physician who is knowledgeable about the physical activities in which the child will participate; and

c. Within sight supervision of staff.

H. The licensee shall not use disciplinary measures against a group of children because of the behavior of one or more children in the group.

I. Only staff specifically trained in crisis intervention may use restrictive behavior management on a child in care and:

1. No person shall use restrictive behavior management for the purposes of discipline or convenience;

2. A trained staff shall administer restrictive behavior management in the least restrictive manner possible to protect the child or others and cease when the child becomes calm;

3. After child becomes calm, staff shall speak with the child and develop a strategy to reduce the likelihood of the need for restrictive behavior management in the future; and

4. The licensee shall provide written notice to the Placing Entity, or if there is no Placing Entity, parent or guardian within 24 hours of the use of restrictive behavior management.

J. To determine the licensee's compliance with the use of appropriate behavior management, the Department shall consider all the circumstances at the time of the behavior management, including the following:

1. The child in care's physical condition;

2. Whether the child in care was taking any medications that may have affected the child's behavior;

3. Whether or not the climatic conditions made the behavior management severe or unreasonable, such as intense heat or cold, rain, or snow;

4. The level of physical force, if any, the licensee used to implement the behavior management and whether any use of force resulted in injury to the child in care; and

5. Whether the behavior management was consistent with the licensee's program description, procedures, and the requirements of this Section.

K. The licensee may use physical restraint only when the practice and the circumstances warranting its use are:

1. Consistent with the licensee's program description and purpose,

2. Described in the licensee's behavior management policy,

3. Used as prescribed in this Section, and

4. Not otherwise prohibited by these rules.

L. If the licensee cannot use a specific restrictive behavior management practices on a particular child, the child's service plan shall describe the restriction.

Ariz. Admin. Code § R21-7-227

New Section made by final rulemaking at 29 A.A.R. 2231, effective 11/6/2023.