16 Del. Admin. Code § 3360-13.0

Current through Register Vol. 28, No. 3, September 1, 2024

Section 3360-13.0 - Personnel/administrative

13.1 Adult day care providers must comply with the special employment practices relating to health care and child care facilities (19 Del.C. § 708 and 11 Del.C. § 8563) and adult abuse registry check (11 Del.C. § 8564) and the regulations promulgated by the Department of Labor regarding same.

13.2 No employee shall be less than 18 years of age and no person shall be employed who has been convicted of a crime where the victim was a person regardless of whether the crime was a felony or a misdemeanor.

13.3 The facility shall have written personnel policies and procedures that adequately support sound care and services to participants.

13.4 Personnel records of each employee shall be kept current and available upon request by the Department's representatives and shall contain sufficient information to support placement in the positions to which assigned.

13.5 Minimum requirements for pre-employment and annual tuberculosis (TB) testing are those currently recommended by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services.

13.5.1 No person, including volunteers, found to have active tuberculosis in an infectious stage shall be permitted to give care or service to participants.

13.5.2 Any person having a positive skin test but a negative X-ray must complete a statement annually attesting that they have experienced no symptoms which may indicate active TB infection.

13.5.3 A report of all test results and all attestation statements shall be on file at the facility of employment.

13.6 All new employees shall be required to have a pre-employment physical examination. A copy of the pre-employment physical examination shall be maintained in individual personnel files.

13.7 Any individual who cannot adequately perform her/his duties or who may jeopardize the health or safety of the participants shall be relieved of his duties and removed from the center until such time as the condition is resolved. This includes infections of a temporary nature.

13.8 The adult day care provider shall provide for systematic performance review to communicate expectations and responsibilities, recognize achievement, and identify areas for skill development and work performance improvement. Performance reviews shall be completed annually and shall be maintained in the employee personnel record.

13.9 The directordministrator shall be responsible for complying with the regulations herein contained. In the absence of the director, a qualified substitute shall be authorized, in writing, to be in charge.

13.10 The director'sdministrator's responsibilities shall include, but not be limited to, the following areas:

13.10.1 The development of the content of the program offered to the participants;

13.10.2 Programmatic functions, including orientation, training, and scheduling of all staff whether or not the director personally performs these functions; and

13.10.3 Assignment of a sufficient number of qualified staff to meet the participant's needs for:

13.10.3.1 Adequate nutrition;

13.10.3.2 Health supervision and maintenance;

13.10.3.3 Personal care;

13.10.3.4 Socialization;

13.10.3.5 Recreation;

13.10.3.6 Activities and stimulation; and,

13.10.3.7 Supervision, protection, and safety.

13.11 The director shall have a Bachelor's Degree in health or social services or a related field, with one (1) year supervisory experience (full-time or equivalent) in a social or health service setting; have comparable technical and human service training with demonstrated competence and experience managing in a health or human service setting; or, be a registered nurse with two (2) years of supervisory experience (full-time or equivalent) in a social or healthcare setting.

13.12 Volunteers

13.12.1 All volunteers shall be under the supervision of the directordministrator or designated staff person.

13.12.2 The duties of volunteers shall be clearly defined.

13.12.3 The adult day care facility shall maintain a record of volunteer hoursctivities and provide appropriate supervision of volunteers.

13.13 Aides/Assistants/Technicians

13.13.1 All aides must meet the following minimum criteria:

13.13.1.1 Completion of an orientation/training program which meets the requirements contained within these regulations; AND,

13.13.1.2 Certification as a nurse aide (CNA); or,

13.13.1.3 Possession of one year of experience in a health care setting; or,

13.13.1.4 Enrollment in a nursing program and completion of a medical surgical clinical practicum.

13.13.2 All aides must pass a competency evaluation test prior to providing unsupervised care to participants in the program.

13.13.3 It is the responsibility of the adult day care program to ensure that aides are proficient to carry out the care assigned in a safe, effective, and efficient manner.

13.14 Staff Training and Development

13.14.1 Prior to assuming job responsibilities, all personnel shall receive training in:

13.14.1.1 Their individual responsibilities in the event of fire, including the location and operation of any fire extinguisher and fire alarm box;

13.14.1.2 Their individual responsibilities in the event of illness or injuries, including the location and use of the first aid emergency supplies;

13.14.1.3 Their individual responsibilities in the event of any emergency;

13.14.1.4 Infection control, body mechanics and first aid; and

13.14.1.5 Special needs of the elderly, persons with cognitive disabilities or persons with other disabilities, including the specific needs of the participants being served.

13.14.2 Ongoing staff development is required to maintain and improve the skills of the adult day care team and should include:

13.14.2.1 The needs of the elderly and persons with disabilities.

13.14.2.2 Assisting participants to achieve maximum self-reliance through re-learning and modifying activities of daily living.

13.14.2.3 Physical restraint and the use of less restrictive alternatives.

13.14.2.4 Maintaining an environment that encourages morale building and self-help.

13.14.2.5 Review of participant care policies and procedures.

13.14.2.6 Prevention and control of infection.

13.14.2.7 Confidentiality of participant information.

13.14.2.8 Rights of participants.

13.14.3 Personnel who are primarily responsible for the direct care of the participants shall attend at least twelve (12) hours annually of staff development activities which shall consist of in-service training programs, workshops, or conferences related to adult day care or specific needs of participants.

13.15 Aide Orientation and Training

13.15.1 An orientation/training program should be based on an instruction plan that includes learning objectives, clinical content and minimum acceptable performance standards.

13.15.2 The orientation program must include at least forty (40) hours of instruction and supervised practicum.

13.15.3 An orientation/training program must include the following:

13.15.3.1 The aide's role as a member of the adult day care team.

13.15.3.2 Personal care services.

13.15.3.3 Principles of good nutrition.

13.15.3.4 Process of growth, development, and aging.

13.15.3.5 Principles of infection control.

13.15.3.6 Observation, reporting, and documentation of participant status.

13.15.3.7 Maintaining a clean, safe, and healthy environment.

13.15.3.8 Maintaining a least restrictive environment.

13.15.3.9 Verbal/nonverbal communication skills.

13.15.3.10 Principles of body mechanics.

13.16 The adult day care program must maintain sufficient documentation to demonstrate that all requirements of this section have been met.

13.17 An Adult Day Care facility that provides direct healthcare services to persons diagnosed as having Alzheimer's disease or other forms of dementia shall provide dementia specific training each year to those healthcare providers who must participate in continuing education programs. The mandatory training must include: communicating with persons diagnosed as having Alzheimer's disease or other forms of dementia; the psychological, social, and physical needs of those persons; and safety measures which need to be taken with those persons. This paragraph shall not apply to persons certified to practice medicine under the Medical Practice Act, Chapter 17 of Title 24 of the Delaware Code.

16 Del. Admin. Code § 3360-13.0

15 DE Reg. 220 (08/01/11)
25 DE Reg. 776( 2/1/2022) (Final)