Ga. Comp. R. & Regs. 290-2-6-.09

Current through Rules and Regulations filed through October 29, 2024

Rule 290-2-6-.09 - Administration and Organization

(1)Program Purpose. In accordance with these rules and regulations, a licensed children's transition care center shall develop, implement and comply with written policies and procedures that specify its philosophy, purpose, and program orientation. Such policies and procedures shall identify the characteristics of the children it serves, including the referral sources. The policies and procedures for transition care services shall include that the services are limited to short term stays of one to fourteen (14) consecutive days and for long-term stays of up to ninety (90) consecutive days depending on the transition needs of the child. Stays of over ninety (90) consecutive days must be individually approved by the Department by waiver, and may not exceed 12 consecutive months.

(2)Program Description and Implementation. In accordance with these rules and regulations, a licensed children's transition care center shall develop, implement and comply with written policies and procedures that describe the range of services and the manner in which such services will be provided by the center. Such policies and procedures shall describe how identified services will be provided, the specific emergency safety intervention plan, including the emergency safety interventions, that will be used, and how such services will be assessed and evaluated. A program description must show what services are provided directly by the center and what services are provided by other available community or contract resources. The program description must include which of the following services will be provided in addition to transition care services:

(a) Registered nursing and/or licensed practical nursing care;

(b) Medical day care;

(c) Diagnostic studies typically done in the home setting;

(d) Respite care; and/or

(e) Weekend camps.

(3)Director. The governing body of the center shall designate a director who shall be authorized to manage the center.

(a) The director shall possess at least one of the following qualifications:

1. A master's degree or higher from an accredited college or university in the area of nursing, social work or other health-related field plus at least two years of experience within the five years preceding the date of hire working with medically fragile children; or

2. A licensed registered nurse, physician, or other licensed health care professional with at least five years experience working with medically fragile children.

(b) The director must meet the following additional minimum qualifications:

1. Never have been shown by credible evidence (e.g. a court or jury, a department investigation, or other reliable evidence) to have abused, neglected, sexually exploited, or deprived a child or adult or to have subjected any person to serious injury as a result of intentional or grossly negligent misconduct as evidenced by an oral or written statement to this effect obtained at the time of application and evidence of having made efforts to obtain and evaluate references from previous employers;

2. Participate in the orientation and training required by these rules; and

3. Not have made any material false statements concerning qualifications requirements either to the department or the proposed licensee.

(c) When the director is absent from the center at any time, there shall be a similarly qualified person designated to assume responsibility for the operation of the center.

(4)Finances. The governing body shall provide for the preparation of an annual budget and approve such budget. Copies of the current year's budget and expenditure records shall be maintained for examination and review by the department.

(a) The director and all persons authorized to receive or disburse operating funds shall be bonded or insured.

(b) A schedule of fees shall be established and implemented and made available to a parent(s) or guardian(s), or representative(s) of children considered for admission to the center, regardless of payor source. The schedule shall detail the basic cost of services and any additional costs for other services.

(5)Recordkeeping.

(a) Case Records. A center shall maintain a written record for each child which shall include the following:

1. Identifying information including name, sex, and birth date or age;

2. Date of admission and source of referral including all documents related to the referral and admission of the child to the center;

3. Name, address, and telephone numbers of the parent(s) or guardian(s) or representative(s);

4. Name and telephone number of placing agency and agency's contact, if applicable;

5. Documentation of current custody if not placed by natural or adoptive parents;

6. A copy of the child's birth certificate, or an appropriate record of birth;

7. Assessment plans;

8. Service plans and review and progress notes and collateral communications with physicians and others involved in the child's care;

9. Medical records, including the name, address, and phone numbers of doctors involved in the child's care, sufficient information to validate the child's medical diagnosis and to establish the basis on which treatment is provided, treatment and medication orders, health history, records of administration of medicines, immunization records, and orders for modified diets, and nurses notes;

10. Records of behavior management, emergency safety interventions, and written grievances, as described in Rule .18 and Rule .19;

11. Educational and vocational information such as report cards, progress reports, and related materials received during a child's residency in the center; and

12. Discharge plans required by Rule .13.

(b) Retention of Case Records. Case records shall be retained in the center for at least five years following discharge of residents.

(c) Confidentiality of Case Records.

1. Written policies and procedures shall be established and implemented for the maintenance and security of case records specifying who shall supervise the maintenance of records, who shall have custody of records, and to whom records may be released and for what purposes.

2. A center shall maintain the confidentiality of all children's case records. Employees of the center shall not disclose or knowingly permit the disclosure of any information in a case record except to appropriate direct care staff, the parent(s) or guardian(s), their respective legal counsel, a court of legal jurisdiction, licensing staff, and other authorized public officials in the performance of their mandated duties, or the child's placing agency.

(d) Personnel Records. A center shall maintain written records for each employee and the director. Such records shall include the following:

1. Identifying information such as name, address, telephone number, and emergency contact person(s);

2. A 10-year employment history or a complete employment history if the person has not worked 10 years, including explanations for any gaps in employment;

3. Records of educational qualifications;

4. Documentation of at least two professional, educational, or personal references that attest to the person's capabilities of performing the duties for which they are employed and to the person's suitability of working with or around children;

5. Satisfactory preliminary criminal history background check determination and a satisfactory fingerprint records check determination as required by law for the director and foster parents, and a satisfactory determination on a preliminary records check and fingerprint records check for employees as required by law;

6. Documentation from a licensed physician or other licensed healthcare professional of a health screening examination within thirty (30) days of hiring sufficient in scope to identify conditions that may place the children at risk of infection, injury or improper care, and documentation of such screening annually thereafter;

7. Date of employment;

8. The person's job description or statements of the person's duties and responsibilities;

9. Documentation of orientation and training, including dates of all such training, as required by Rule .09(6)(g) of these rules; and

10. Any documentation of the individual's performance, including all records of employee discipline arising from the inappropriate use of behavior management techniques and emergency safety interventions and grievance reports described in Rule .18 and Rule .19 related to children in care and the employee.

(6)Staffing. There shall be sufficient staff members on duty at all times to assure each child proper care according to his or her needs. When children are present at the center, there shall be, at a minimum, one awake registered nurse (RN) on duty per residence at all times.

(a) In addition to the RN, staffing for child care shall be, at a minimum, no less than one awake qualified and trained staff member per three children.

(b) All staff and volunteers shall be supervised to ensure that assigned duties are performed adequately and to protect the health, safety and well-being of the children in care.

(c) Volunteers shall not be substituted for paid staff to meet the staffing requirements set forth in Rule .09(6)(a)and(b).

(d) All staff employed on or after the effective date of these rules must meet the following minimum qualifications:

1. Never have been shown by credible evidence (such as a decision of a court or jury, or a department investigation or other reliable evidence) to have abused, neglected, sexually exploited, or deprived a child or adult or to have subjected any person to serious injury as a result of intentional or grossly serious injury as a result of intentional or grossly negligent misconduct as evidenced by an oral or written statement to this effect obtained at the time of application;

2. Participate in the orientation and training as stated in subparagraph (g) of this Rule; and

3. Not have made any material false statements concerning qualifications requirements either to the department or the proposed licensee.

4. All prospective foster parents, adoptive parents or any adult living in the foster or adoptive home must be checked against the child abuse and neglect registry for information, and must provide information from any other state in which any such prospective parent or other adult has resided in the previous 5 years to check any child abuse and neglect registry maintained by that state. Providers will need to comply with these requirements before they approve prospective homes when such information is available.

(e) Human Services Professionals. The center shall have designated HSPs to provide services to children and their families. There shall be one human services professional employed for every separate residence. The center's director, if qualified by education, may perform the duties of a human services professional.

(f) Any HSP employed shall either possess a bachelor's degree from an accredited college or university in social work, psychology, childhood education, education counseling and psychology, or a related field and either have two years experience in the field of child care or be supervised by another human service professional with a master's degree in one of the above disciplines; possess a master's degree from an accredited college or university in one of the above disciplines, or be a licensed LPN or registered nurse.

(g) Child Care Workers. The center shall have designated child care workers to supervise children, provide oversight for activities, provide for assistance with activities of daily living and be responsible for the areas where the children reside.

1. Any child care worker shall be at least 21 years of age and possess a high school diploma or general education diploma (GED) and have current evidence of successful completion of a biennial training program relating to specific care techniques appropriate for the position and shall include cardiopulmonary resuscitation (CPR) and a triennial training program in first aid which have been offered by certified or licensed health care professionals.

2. Such training programs shall be completed within the first year of employment.

(h) Staff Training. Prior to working with children, all staff and volunteers, including the director, who work with children shall be oriented in accordance with these rules and shall thereafter receive annual additional training in accordance with these rules.

1. Orientation shall include instruction in:

(i) The center's purpose and description of services and its policies and procedures;

(ii) The employee's assigned duties and responsibilities;

(iii) Grievance policies and procedures;

(iv) Child abuse and exploitation policies and procedures;

(v) Reporting requirements for suspected cases of child abuse and exploitation and notifiable diseases and serious injuries;

(vi) Policies and procedures for handling medical emergencies (life-threatening, limb-threatening, or function-threatening conditions), and managing use of medications by children in care;

(vii) Infection control policies and procedures; and

(viii) The center's policies and procedures regarding appropriate behavior management and emergency safety interventions.

2. Additional training shall include twenty-four (24) clock hours of formal, annual training or instruction in child care issues related to the employee's job assignment and to the types of services provided by the center.

(i) There shall be, at a minimum, one awake RN or other staff member on duty at all times when children are present at the center who is trained in first aid and has a current CPR certificate.

(7)Reporting of Serious Occurrences or Incidents. Whenever the children's transition care center has reason to believe any of the occurrences or incidents listed below has occurred, the center shall make a report summarizing the occurrence or incident to the Department of Human Resources, Office of Regulatory Services, Residential Child Care Unit.

(a) The summary report shall be made via email or facsimile within 24 hours of the occurrence or incident or when the center first became aware of the occurrence or incident, and must contain all of the information required on the incident intake information form (ITF), as relevant.

(b) The report shall be made regarding any serious occurrences or incidents involving children in care, including but not limited to:

1. Accidents or injuries requiring medical treatment and/or hospitalization;

2. Death;

3. Suicide attempts;

4. Closure of the center or any part of the center due to disaster or emergency situations such as fire or severe weather;

5. Emergency safety interventions resulting in any injury that requires treatment beyond first aid; or

6. Any incident which results in any federal, state or private legal action by or against the center which affects any child or the conduct of the center. However, legal action involving the juvenile justice system is not required to be reported.

(c) A detailed investigative report which includes steps taken by the center to prevent further incidents of a similar nature from occurring shall follow in five work days if not provided initially.

(8)Child Abuse Reports. Whenever the children's transition care center has reason to believe that a child in care has been subjected to child abuse it shall cause a report of such abuse to be made to the child welfare agency of the county of occurrence providing protective services as designated by the Department of Human Resources (Division of Family and Children Services) or in the absence of such an agency to an appropriate police authority or district attorney in accordance with the requirements of O.C.G.A. Sec. 19-7-5. A copy of such report shall also be filed with the Office of Regulatory Services.

Ga. Comp. R. & Regs. R. 290-2-6-.09

O.C.G.A. Secs. 19-7-5, 49-5-8, 49-5-12.

Original Rule entitled "Inspections and Reports" adopted. F. Apr. 22, 1976; eff. May 12, 1976.

Repealed: F. June 30, 1994; eff. August 1, 1994, as specified by the Agency.

Amended: New Rule entitled "Administration and Organization" adopted. F. Jan. 27, 2009; eff. Feb. 16, 2009.