CABINET
FOR FAMILIES AND CHILDREN
Department for Community Based Services
Division of Policy Development
922 KAR 1:300.
Standards for child-caring facilities.
RELATES
TO: KRS 17.165, 164.740, 189.125(3), 198B.050 to 198B.090, 199.011(2), (3), (4), (6),
(7), (10), (11), 199.640,
199.650, 199.660, 199.670, 211.350 to 211.380, 214.034(4), 271B.8, 273.161(7), 600.020(23), 610.110(6), 615.010, 615.030, 615.040, 620.020, 620.030
STATUTORY
AUTHORITY: KRS 194B.050(1), 199.640(5), 199.645, 615.050
NECESSITY,
FUNCTION, AND CONFORMITY: KRS 199.640(5) authorizes
the Cabinet for Families and Children to promulgate administrative regulations
establishing basic standards of care and service for child-caring facilities
and child-placing agencies.
Section 1. Definitions.
(1) "Aftercare" means a service provided to a child after
discharge from a child-caring facility.
(2) "Board
of directors" is defined at KRS 273.161(7).
(3) "Cabinet"
means the Cabinet for Families and Children.
(4) "Case" means an individual
child or family being provided services by a social worker or counselor.
(5) "Chemical restraint" means a
drug used as a restraint that is a medication used
to control behavior or to restrict the patient's freedom of movement and is not
a standard treatment for the patient's medical or psychiatric condition.
(6) "Child"
is defined at KRS 199.011(4),
600.020 (8), and 610.110 (6).
(7) "Child-caring facility" is
defined at KRS 199.011
(6).
(8) "Child-placing
agency" is defined at KRS 199.011 (7).
(9) "Child-caring program" means
the method of delivering a child-caring service.
(10) "College or university" means an institution accredited by one (1) of the eleven (11) regional accrediting organizations recognized by the U.S. Department of Education, Office of Postsecondary Education, and:
(a) For a
(b) For an out-of-state institution, licensed in its home state if licensure is required in that state.
(11) "Community
resource" means a service or
activity available in the community that supplements those provided by the
child-caring facility or child-placing agency in the care and treatment of a
child.
(12) "Corporal physical discipline"
is defined at KRS 199.640(6).
(13) "Department"
means the Department for Community Based Services.
(14) "Crisis intervention unit" means
a unit that serves a child in need of short-term intensive treatment, to avoid
risk of placement to a higher level of care.
(15) "Direct child-care staff"
means an employee or volunteer providing face-to-face care and supervision of a
child.
(16) "Discharge" means a planned
release of a child from a program.
(17) "Division" means the Division
of Licensed Child Care, Cabinet for Health Services.
(18) "Emergency discharge" means the
release of a child from a program as a result of a circumstance that presents a
risk to the health or safety of a child.
(19) "Emergency shelter" is
defined at KRS 600.020
(23).
(20) "Emergency shelter child-caring
facility" means a child-caring facility that meets the requirements of
922 KAR 1:380.
(21) "Executive director" means the
person employed by the board of directors to be responsible for the
administration and management of a child-caring facility.
(22) "Group home" is defined at KRS 199.011 (10).
(23) "Individual treatment plan" or
"ITP" means a plan of action developed and implemented to address
the needs of a child.
(24) "Indoor living area" means an
area in the child-caring facility that is separate from a hallway, bedroom,
kitchen, stairway, vestibule, bathroom, closet, unfinished basement, or attic.
(25) "Institution" is defined at KRS 199.011 (11).
(26) "Living unit" means a
building or part thereof in which a child resides, not exceeding sixteen (16)
beds.
(27) "Permanence" is defined at KRS 620.020(8).
(28) "Residential child-caring
facility" means a child-caring facility that meets the standards
established in 922 KAR 1:390.
(29) "Residential treatment program"
means a residential child-caring facility that meets the treatment program
requirements of 922 KAR 1:390,
Section 4.
(30) "Service coordination" means
a service provided by the individual on the treatment team who has
responsibility for the coordinated implementation of the child's ITP.
(31) "Social services" means a
planned program of assistance to help an individual move toward a mutual
adjustment of the individual and his social environment.
(32) "Therapeutic hold" means a
technique used by a specially-trained staff member for the purpose of
restricting a child's freedom of movement, in order to maintain a safe
environment for the child and others.
(33) "Time-out" means a treatment
intervention utilized by child-caring staff to separate a child from others in
a nonsecure area for a time limited period, in order to permit the child to
regain control over his behavior.
(34) "Treatment" means
individualized management and care of a child, utilizing professionally
credentialed and certified staff and a component of the treatment environment
to assist the child in resolving his emotional conflict or behavioral disorder.
(35) "Treatment team" means a
representative group of people who provide services to the child and the
child's family.
(36) "Unplanned discharge" means
the release of a child from the child-caring facility that is not in accordance
with the ITP.
(37) "Youth wilderness camp" means a specific program of a child-caring facility that is designed to provide an outdoor experience consistent with a child’s ITP.
Section 2. Operations and Services.
(1) This administrative regulation establishes standards for the following
child-caring facilities:
(a) An emergency shelter child-caring
facility, also governed by 922 KAR 1:380;
(b) An emergency shelter child-caring
facility with treatment, also
governed by 922 KAR 1:380, Section
3;
(c) A residential child-caring facility, also governed by 922 KAR 1:390, including:
1. A group home; and
2. An institution.
(d) A residential treatment program, also governed by 922 KAR 1:390, Section 4, including:
1. A
crisis intervention unit, also governed by 922 KAR 1:390, Section 5;
2. A
group home, also governed by 922 KAR
1:390, Section 7;
3. An institution; and
(e) A youth wilderness camp program, also governed by 922 KAR 1:460.
(2)
Except for a child-caring facility maintaining a
license prior to
Section 3. Administration and Operation.
(1) The
licensing procedure for a
child-caring facility shall:
(a) Be administered as established in 922 KAR 1:305; and
(b) Based upon the services provided, meet
the requirements of this administrative regulation and 922 KAR 1:380, 922 KAR 1:390, or 922 KAR 1:460.
(2) Board of directors.
(a) The
child-caring facility shall have a board of directors in accordance with KRS Chapter 271B,
Subtitle 8.
(b) The board of directors shall:
1. Consist of at least seven (7) members;
2. Meet at least quarterly;
3. Cause minutes of each meeting to be
taken and kept in written form;
4. Have
the authority and responsibility to ensure continuing compliance with this
administrative regulation and other relevant federal, state, and local law;
5. Have
procedures in place to insure that its staff receives ongoing training as
defined in subsection (6)(o) of this section;
6. Obtain
a criminal records check of prior convictions of the executive director prior
to employment; and
7. Approve a mission statement
delineating:
a. The purpose;
b. Objective; and
c. Scope of service to be provided.
(3) Executive director.
(a) Duties of the executive director shall be
determined by the board of directors.
(b) The
executive director shall be responsible for the child-caring facility and its
affiliates in accordance with the child-caring facility's written policy.
(c) If
the executive director is not on the premises, a designated staff person shall
be responsible for the day-to-day operation of the child-caring program.
(d) The
executive director shall oversee and report to the board on a quarterly basis,
providing an evaluation of program services addressing measurable goals, staff
training, and incident reports.
(e) The
criteria and process of the quarterly evaluation shall be
approved by the board.
(4) Staff qualifications.
(a) A person employed as an executive
director after the effective date of this administrative regulation shall
possess the following qualifications:
1. A
master's degree in a human services field from a college or university,
supplemented by two (2) years of work experience in management of a human
services program related to working with families and children; or
2. A bachelor's
degree in a human services field from a college or university, supplemented by
four (4) years work experience in management of a human services program
related to working with families and children.
(b) A
treatment director or person employed by the child-caring facility in a
position responsible for supervising, evaluating, or monitoring social work and
related activities shall possess at least:
1. A
master's degree in the human services area from a college or university
including the areas of:
a. Social work;
b. Sociology;
c. Psychology;
d. Guidance and counseling;
e. Pastoral counseling and religion; and
2. Two (2) years work experience in a
human services field.
(c) An
employee responsible for social work, counseling, or planning and coordinating
these services to a child shall have at least a bachelor's degree in a human
services field from a college or university.
(d) A
person employed in a position responsible for supervising, evaluating, or
monitoring the daily work of direct child-care staff shall possess at least:
1. Two
(2) years of education from a college or university and two (2) years of work
experience in a child-caring facility; or
2. A
high school diploma, or an equivalence certificate, and at least five (5) years
work experience in a child-caring facility.
(e) A
person employed in a position responsible for the daily direct care or
supervision of a child shall possess at least a high school diploma or
equivalency certificate.
(f) If
an employee is responsible for varied job responsibilities and falls within
more than one (1) of the categories specified, the employee shall meet the more
rigorous qualifications.
(g) A child-caring facility contracting for
the services of a social worker or treatment director not on the staff of the
child-caring facility shall document that the social worker or treatment
director meets the qualifications established in paragraphs (b) and (c) of this
subsection. An agreement for provision
of service shall be on file at the child-caring facility, and shall specify the
qualifications of the social worker or social services professional.
(5) Staffing requirements.
a) The child-caring facility shall have:
1. A
written policy describing a child-to-direct-child-care staff ratio that is
consistent with the staff-to-child ratios required in paragraph (b) of this
subsection; and
2. An explanation of the assignment of
staff in order to:
a. Ensure the health and safety of a
child; and
b. Implement the child-caring program.
(b) Staff-to-child ratios for each type of facility shall be as follows:
1. An emergency shelter child-caring facility: one (1) staff member to ten (10) children.
2. An emergency shelter child-caring facility with treatment: one (1) staff member to six (6) children.
3. A residential child-caring facility:
a. One (1) staff member to ten (10) children age six (6) and over; or
b. One (1) staff member to five (5) children under age six (6).
4. A residential child-caring facility with treatment:
a. One (1) staff member to six (6) children; and
b. One (1) staff member to twelve (12) children during sleeping hours.
5. A crisis intervention unit:
a. One (1) staff member to four (4) children; and
b. One (1) staff member to six (6) children during sleeping hours.
6. A group home:
a. One (1) staff member to four (4) children; and
b. One (1) staff member to accompany a child while away from the home.
7. An institution: one (1) staff member to ten (10) children.
8. A youth wilderness camp program to include:
a. A base camp:
(i) One (1) staff member to four (4) children age eleven (11) and (12) years old; and
(ii) One (1) staff member to six (6) children age thirteen (13) and above; and
b. A field program, for which two (2) staff members shall be on location at all times:
(i) One (1) staff for three (3) children age eleven (11) and (12) years old;
(ii) One (1) staff for four (4) children age thirteen (13) and above;
(iii) Group size, including staff, shall not exceed more than twelve (12) at one (1) time;
(iv) In a mixed gender group, one (1) woman and one (1) man, with one (1) staff member remaining awake during sleeping hours;
(v) A staff-to-child ratio shall be based on the age of the youngest child; and
(vi) A volunteer shall not be included in the
staff-to-child ratio.
(c) There
shall be at least one (1) staff member present in each child-caring facility
building if a child is present.
(d) At
least one (1) staff member certified in first aid and cardiopulmonary
resuscitation shall be on the premises, if a child is present.
(e) The
child-caring facility shall have a written work schedule and a policy that
provides for utilization of relief staff.
(f) The
child-caring facility shall employ an individual who is responsible for the
overall planning and coordinating of social services to a family and child.
(g) Social
services staff shall not carry a caseload of more than fifteen (15) children
and their families.
(6) Personnel policy.
(a) A
child-caring facility shall have a written personnel policy and procedure.
(b) An
employee of the child-caring facility shall be at least eighteen (18) years of
age.
(c) The employment of an individual shall be governed by KRS
17.165, with regard to a criminal record
check.
(d) A new criminal record check shall be completed at least every two (2) years on each employee or volunteer.
(e) An employee under indictment or legally
charged with a violent or sex crime as defined in KRS 17.165 shall
be immediately removed from contact with a child within the child-caring
facility until the employee is cleared of the charge.
(f) Each employee or volunteer shall submit to a check of the
central registry described by 922 KAR 1:470. An
individual listed on the central registry shall not be a volunteer at or be
employed by a child-caring facility.
(g) Each
licensee shall report to the Cabinet for Health Services and each child-caring
facility employee or volunteer shall report to the licensee or facility’s
director, an incident that occurs subsequent to the most recent central
registry check, if the employee or volunteer:
1. Is the
subject of a cabinet child abuse or neglect investigation; or
2. Has been
found by the cabinet or a court to have abused or neglected a child.
(h) An individual shall not be left alone in the presence of a child if a central registry check has not been completed.
(i) Determination by the cabinet of risk of potential harm by an employee to a child in a child-caring facility shall result in:
1. Investigation of the employee for evidence of child abuse or neglect; and
2. The removal of the employee from direct contact with a child pending:
a. The duration of the investigation; and
b. Completion of the administrative appeal process in accordance with 922 KAR 1:320.
(j) A
current personnel record shall be maintained for each employee, that includes
the following:
1. Name,
address, Social Security number, date of employment, and date of birth;
2. Evidence
of a current registration, certification, licensure, and college credentials,
if required by the position;
3. Record
of ongoing participation in an agency staff development program as specified in
paragraphs (n) and (o) of this subsection;
4. Record of performance evaluation;
5. Criminal records check as established
in paragraph (c) of this subsection;
6. Documentation
of a central registry check completed every two (2) years in accordance with 922
KAR 1:470;
7. Personnel action; and
8. Application for employment and resume
or contract.
(k) A
child-caring facility shall retain an employee personnel record for at least
five (5) years after termination of employment.
(l) An
employee shall document compliance with a requirement for meeting state or
national professional standards, as set forth in the job description.
(m) The
child-caring facility shall have a record of participation and successful
completion of an ongoing staff and volunteer development program.
(n) The
staff development program shall be under the supervision of a designated staff
member; and
(o) Full-time
direct child care staff shall have at least forty (40) hours, and part-time
direct child care staff shall have at least twenty-four (24) hours, of training
specific to task to be performed and of annual training in the following:
1. Emergency and safety procedure;
2. Principle and practice of child residential
care;
3. Behavior management, including
de-escalation training;
4. Therapeutic hold for a child-caring
facility using the technique;
5. First aid; and
6. Personnel orientation.
(p) A volunteer who functions as a professional
or direct staff member without compensation shall meet the same general
requirements and qualifications.
(q) A child-caring facility using therapeutic hold shall:
1. Develop and maintain clearly-written policy and procedure governing the use of therapeutic hold of a child, including a requirement for a de-escalation plan, in accordance with 922 KAR 1:390, Section 4;
2. Require a staff member who conducts therapeutic hold, to complete at least sixteen (16) hours of annual training in approved methods of de-escalation and therapeutic hold from a nationally-recognized accreditation organization approved by the cabinet, as part of the annual training established in paragraph (o) of this subsection, to include:
a. Assessing physical and mental status, including signs of physical distress;
b. Assessing nutritional and hydration needs;
c. Assessing readiness to discontinue use of the intervention; and
d. Recognizing when medical or other emergency personnel are needed.
(r) The program director shall review and analyze instances of therapeutic hold in order to:
1. Assure compliance with Section 5(2)(f) through (h) of this administrative regulation and the child-caring facility policy;
2. Provide documentation of a plan of action to prevent injury to a child or staff as a result of the use of therapeutic hold; and
3. Review each incident no later than one (1) working day after its use.
(7) Interstate placement.
(a) Before
accepting a child from another state or placing a child in another state, the
child-caring facility shall be in compliance with:
1. Applicable
provisions of the Interstate Compact on Placement of Children, KRS 615.030, and 615.040; and
2. The Interstate Compact on Juveniles, KRS 615.010.
(b) If a
child committed to the cabinet makes a brief visit out of state, not
accompanied by child-caring facility personnel, the child-caring facility shall
obtain prior consent from cabinet staff member responsible for the case.
(c) If
an emergency placement of a child into a licensed child-caring facility is
made, the placement source shall be responsible for compliance with KRS 615.030 to 615.040. If the receiving child-caring facility is
aware of noncompliance by the placement source, the child-care facility shall
notify the cabinet's interstate compact coordinator.
(8) Record retention.