(a) Therapeutic Environment. Detoxification, Residential Treatment, Therapeutic Community and Transitional Residential Treatment must meet the following requirements. - (i) Medication Oversight.
- (A) A case record shall contain medication records for programs monitoring the administration of medication.
- (B) A case record shall contain medication documentation that allows for ongoing monitoring of all administered medications and the documentation of adverse drug reactions.
- (C) A case record shall contain medication orders, when applicable, by the prescribing physician specifying the name of the medication, dose, route of administration, frequency of administration, person monitoring self-administration, and name of the physician who prescribed the medication.
- (D) All prescription and non-prescription medications shall be locked up in cool place stored away from where clients are located.
- (E) For clients with mental health problems, the issues of psychotropic medication, mental health treatment and their relationship to substance abuse disorders are addressed, as the need arises. Programs that provide co-occurring treatment offer therapies to actively address, monitor, and manage psychotropic medication, mental health treatment and the interaction with substance-related disorders. There may be close coordination with intensive case management and assertive community treatment for clients who have severe and persistent mental illness.
- (ii) Food Services.
- (A) The program shall be inspected and approved by the local health authority. Written documentation of this review and approval shall be available at the time of the site visit.
- (B) Meals shall be in compliance with Daily Dietary Allowances of the American Dietary Association for adults and adolescents.
- (C) The program shall provide for the special dietetic needs of specific clients and this information shall be maintained in the client's record.
- (D) Records of menus as served shall be posted for the review of clients.
- (E) All resident activities in food preparation areas shall be under the supervision of program staff that have received instruction in, and can instruct residents in, approved food handling techniques and practices in accordance with local health authority requirements.
- (F) Eating and serving utensils shall be washed by approved techniques in accordance with local health authority requirements.
- (G) All sharp objects such as knives must be locked up when kitchen area is not in use or not supervised by staff.
- (H) All toxic chemicals must be locked up when kitchen area is not in use or not supervised by staff.
- (I) Raw or unpasteurized milk and home-canned or preserved foods shall not be served.
- (J) No person while infected with, or suspected of being infected with, communicable diseases, boils, open sores, wounds, or acute respiratory infections, shall prepare meals or come into contact with food preparation surfaces.
- (iii) Physical Plant.
- (A) The facility must meet all local, State and Federal codes in regard to the construction of the facility. A Certificate of Occupancy must be obtained, where applicable, prior to clients living in structure.
- (B) The facility shall comply with the Americans with Disabilities Act of 1990, 42 of 1990, 42 U.S.C. 12101 - 12213, and any rules, regulations, and amendments related thereto, and with state and local building and fire safety laws and/or codes.
- (C) The facility shall meet all occupancy requirements of the local code authority, including how many persons are allowed to a room.
- (D) The facility must be maintained to assure safety needs of clients, staff and public.
- (E) The facility shall be conducive to the population served making special consideration to the general recovery environment.
- (F) Buildings and surrounding outside areas shall be kept clean, in good repair and free of infestations.
- (G) Appropriate furnishing for each room shall be available, and in clean good repair. At a minimum, each client shall have her own bed.
- (H) All windows shall be in good repair, with screens if window opens and window coverings to assure privacy.
- (I) Inspection of physical safety of building and its grounds shall be conducted and documented by staff at least monthly.
- (J) The facility shall provide adequate security assuring the safety of client, staff and public to include lighting, locks on doors and a security system, if merited by location.
- (K) The facility shall have fire detection and extinguishing equipment per local fire authority requirements.
- (L) The program shall annually have a fire inspection completed with the local fire authority. This report shall be available for review at the time of the site visit.
- (M) The program shall have fire extinguishers that are current and in compliance with local fire authority.
- (N) The program shall have smoke detectors that are working and in compliance with local fire authority.
- (O) Fire drills shall be conducted monthly and a record of the dates maintained.
- (P) Disaster drills addressing other possible disasters such as flood, earthquake, and severe weather shall be conducted at least twice annually and a record of the dates maintained.
- (Q) Inspection of smoke detectors shall be conducted and documented by the program staff at least monthly.
- (R) Evacuation routes and procedures shall be posted and shall be shown to each resident upon admission.
- (S) Portable space heaters shall not be used.
- (T) Plumbing systems shall be approved by local code requirements and maintained in good working condition.
- (U) Adequate hot water shall be available for each client.
- (V) Garbage and rubbish shall be stored in leak proof, non-absorbent containers with tight fitting lids and shall be removed from the inside of the facility daily and from the outside of the facility at least weekly.
- (W) Poisons and other toxic materials shall be properly locked, kept in the original container, and stored in a locked area in accordance with local health authority requirements.
- (X) Males and females and adults, children and adolescents shall not be housed in the same rooms and not share common bathrooms unless biologically related and in a program specific for parents and children. Appropriate separation of male and female living quarters is required. Adolescent services must have adequate separation from adult services, which assures that adults and adolescents do not interact.
- (Y) Laundry facilities shall be available in the facility or on a contractual basis. When provided in the facility, the laundry room shall be kept separate from bedrooms, living areas, dining areas, and kitchen.
048-4 Wyo. Code R. § 4-14