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.
(a) The child-caring facility shall retain all records, books, and reports related to financial conditions and status for auditing purposes for a minimum of five (5) years.
(b) Make available all books, records, and financial information for review, inspection, auditing, and photocopying by the cabinet or cabinet designee, authorized federal and state agency reviewers and auditors.
Section 4. Physical Plant.
(1) A child-caring facility shall comply with
applicable state and local law relating to:
(a) Construction;
(b) Sanitation;
and
(c) Building
maintenance.
(2) The
child-caring facility shall conform to the
(3) A climate control system shall be provided
as follows:
(a) A
minimum temperature of sixty-five (65) degrees Fahrenheit maintained in
occupied areas in cold weather conditions;
(b) In
warm weather conditions and periods of extreme heat, an occupied area shall be
properly ventilated;
(c) If not
air-conditioned and the temperature in an occupied area exceeds eighty-five
(85) degrees Fahrenheit, the child-caring facility director shall assure that
the following occurs:
1. A
fan is utilized to circulate air;
2. The
child-caring facility is properly ventilated to outside air;
3. Ice
water is readily available and served to residents; and
4. Staff frequently monitor residents for a
sign or symptom of a heat-related illness.
(4) The water supply shall be from an approved
source and easily available from the
following:
1. Drinking
fountain;
2. Refrigerator;
or
3. Cold
water tap.
(5) The plumbing and waste disposal systems shall comply with applicable provisions of the Uniform State Building Code, KRS 198B.050, and with laws
regarding on-site sewage disposal, KRS 211.350 to 211.380,
if applicable.
(6) Housekeeping and maintenance service.
(a) The building
and its content shall be maintained in a clean and safe condition and in good
repair.
(b) A
maintenance plan shall be implemented.
(c) The child-caring facility shall ensure that
the grounds and outdoor equipment are well kept and the exterior of the
building is in good repair.
(d) The
interior of the building and its content shall be in good repair.
(e) Garbage
and trash shall be:
1. Stored
in an area separate from those used for the preparation and storage of food;
2. Removed
from the premises regularly; and
3. Placed
in a container that is cleaned regularly.
(f) Insecticides,
pesticides, and chemical poisons shall be plainly labeled and stored in a
secure, locked area. Access shall be given to:
1. The
facility's maintenance personnel; or
2. A
pest control company with which the facility has a contract.
(7) Bedroom.
(a) A bedroom
shall be:
1. Of
adequate size to permit at least three (3) linear feet between each bed or set
of bunk beds; and
2. Constructed
to allow no more than four (4) residents per room.
(b) A
bedroom for a child above age three (3) shall be equipped with an individual
bed for each child that shall be:
1. Long
and wide enough to accommodate the child's size;
2. Developmentally
appropriate for the child; and
3. Equipped
with a support mechanism and a clean mattress.
(c) A bed
occupied by a child shall be placed so that the child shall not experience
discomfort because of:
1. Proximity
to a radiator or heat outlet; or
2. Exposure
to drafts.
(d) Except
for a sibling indicated in an ITP, there shall be separate sleeping quarters
for boys and girls over the age of five (5).
(e) Closet
space and drawer space shall be provided for each child to accommodate his or
her personal belongings.
(f) A
child shall not be housed in a room, detached building, or enclosure that has
not previously been inspected and approved for resident use.
(g) A
child shall be provided with clean bed linens, laundered at least once a week,
and a waterproof mattress covering.
(8) Indoor living area. An indoor living
area shall have:
(a) At least
thirty-five (35) square feet per child; and
(b) Comfortable
furnishings adequate for the number of children served.
(9) Bathroom.
(a) For every
six (6) children residing with the living unit, a living unit shall have a
minimum of:
1. One
(1) wash basin with hot and cold water;
2. One
(1) flush toilet; and
3. One
(1) bath or shower with hot and cold water.
(b) A child
shall be provided with access to:
1. Toilet
paper;
2. Towels;
3. Soap;
and
4. Wastebasket.
(c) Each
bathtub and shower shall have an enclosure or screen for individual
privacy. If more than one (1) toilet is
located in the same bathroom, each toilet shall:
1. Be
partitioned; and
2. Include
a door capable of remaining closed.
(d) A
bathroom shall contain at least one (1) nondistorting mirror secured to the
wall at a convenient height.
Section 5. Health, Safety, and Nutritional Requirements.
(1) Health.
(a) A
child-caring facility shall have written policy and procedure for health and
medical care, to include provisions for:
1. The
care and disposition of an ill child; and
2. Emergency
care.
(b) The
service of a physician shall be made available to a child. If a service of a
licensed physician is not available in the community, the child-caring facility
shall request the assistance of the:
1. County
health department; or
2. The Cabinet for Health Services, Department
for Public Health, Division of Adult and Child Health.
(c) Staff
shall follow licensed physician orders for:
1. Medicine;
2. Prescription;
and
3. Medical
care.
(d) Except
for a weekend or holiday, within forty-eight (48) hours of admission to a
child-caring facility, a child shall have:
1. An
initial health screening for illness, injury, and communicable disease or other
immediate needs, by a nurse or trained child-care staff;
2. After
the initial health screening, a physical examination by a licensed physician or
a qualified person under the supervision of a licensed physician, within two
(2) weeks of admission, unless it has been documented that the child has
received an examination during the past twelve (12) months; and
3. The
examining professional shall report, in writing, observations and findings
including:
a. Developmental
history of the child, illnesses, operations, and immunizations if available to
the physician;
b. A
limitation the child may have that may prevent participation in an activity
scheduled by the child-caring facility;
c. Visual
and auditory examination results;
d. Recommendation and order for future care,
treatment, and examinations;
e. TB
skin test results, unless contraindicated by a qualified person under the
supervision of a licensed physician; and
f. Other
tests for communicable disease as indicated by the medical and social history
of the child.
(e) An annual
physical examination shall be scheduled and documented as established in
paragraph (d)3 of this subsection.
(f) Upon
admission, the child-caring facility shall consult with a physician if there is
evidence that the child may require medical attention.
(g) The
child-caring facility shall develop a procedure for a child requiring a
specific provision for an infectious medical condition.
(h) A
separate health record shall be maintained for each child, kept on the
premises, and be made available to a:
1. Physician;
2. Nurse;
or
3. Designated
staff member.
(i) The
health record shall contain the following:
1. Copy
of each physical examination, including any recommendations for treatment;
2. Previous
and continuing health and medical history if available;
3. Record
or report of each test, immunization, periodic reexamination, and physician
order and instruction;
4. Report
and date of each dental examination and treatment;
5. Authorization for regular and emergency
medical, dental, and surgical care, signed at admission by the legal custodian;
6. Documentation
of medication administered to the child; and
7. Documentation of a special provision made
for the child in accordance with a physician's order.
(j) A child's
medical need shall be provided for as recommended by a licensed physician.
(k) The
facility shall keep an immunization certificate on file for each child, in
accordance with KRS 214.034(4).
(l) If a
child dies while in the care of a child-caring facility or in a home operated
or supervised by the child-caring facility:
1. The
child-caring facility shall immediately notify the:
a. County
coroner;
b. Child's
parent;
c. Guardian
or custodian; and
d. Cabinet
staff;
2. A
verbal report of the death shall be made immediately to the Commissioner of the
Department for Community-Based Services;
3. A
written comprehensive report from the executive director outlining the incident
shall be forwarded to the Office of the Commissioner, Department for
Community-Based Services, on the next working day following the verbal report;
and
4. If a
child's death occurred as a result of alleged abuse or neglect, the executive director
of the child-caring facility shall make verbal and written reports as required
by KRS 620.030(1) and
(2).
(m) Upon
discharge, medical information shall follow the child if a release form has
been obtained.
(n) With
the exception of a dental examination that has been performed in the six (6)
months preceding admission, the child-caring facility, within one (1) week
after a child's admission, shall schedule an appointment for a dental examination.
The facility shall ensure the treatment of emergency dental needs by a licensed
dentist as they arise.
(o) A
child age two (2) years and above shall be examined at least annually by a
licensed dentist.
(p) The
child-caring facility shall:
1. Document
the information required by this subsection; and
2. Assure
the confidentiality of the information.
(q) The
child-caring facility shall maintain a continuous program of personal hygiene.
(2) Safety.
(a) A child shall be instructed in fire prevention,
safety, and fire emergency procedures.
1. The
child-caring facility shall maintain and post a current, written emergency fire
evacuation plan and diagram to include:
a. An
evacuation route and procedure; and
b. Location
of fire extinguishers.
2. Documentation
of fire evacuation plan and emergency drills shall be performed quarterly for
each of the following emergency events:
a. Tornado
and severe thunderstorm warning;
b. Flash
flood if applicable;
c. Other
emergency situations.
3. An
emergency plan shall designate a suitable shelter in the event of an emergency.
(b) A
child-caring facility with a swimming pool shall be staffed with a Red Cross
certified lifeguard in accordance with 902 KAR 10:120,
Section 13.
(c) Donated
home processed foods shall be prohibited.
(d) Transportation.
1. If
transportation is provided directly, contracted for, or arranged, a
child-caring facility shall require:
a. Compliance
with state laws pertaining to vehicles, drivers, and insurance;
b. A seat
for each child and that the child remain seated while the vehicle is in motion;
c. A
seat belt be used to secure the child;
d. A vehicle used to transport a child off
campus to provide a seat for each passenger as manufactured standard equipment;
and
e. That
a child never be left unattended in a vehicle.
2. The
maximum number of children a driver shall supervise alone is four (4).
3. A
child under forty (40) inches tall or forty (40) pounds in weight shall not be
transported unless restrained in a safety seat approved in accordance with KRS 189.125(3).
4. A
vehicle shall not pick up and deliver a child under the age of six (6) to a
location that requires the child to cross a street or highway unless the child
is accompanied by an adult.
5. If
transportation is provided by a means other than licensed public transportation:
a. The
vehicle shall be maintained in a safe mechanical and operable condition;
b. A
thorough inspection of the vehicle shall be made and documented by a qualified
mechanic at least annually; and
c. If
the driver is not in his seat, the motor shall be turned off, keys removed, and
brake set.
(e) A child with a history of aggressive behavior or sexual acting-out shall be assessed by the treatment team to ensure the safety of the child and other children in the facility, including sleeping arrangements with the appropriate safety measures included in the child’s ITP.
(f) Therapeutic hold shall be used in an emergency or a crisis situation only:
1. After attempts to de-escalate the situation have been made;
2. By trained staff; and
3. To prevent:
a. A child from injury to self or others; or
b. Serious property damage or disruption of the child-caring facility's program
(g) Therapeutic hold shall not be used as:
1. Punishment;
2. Discipline; or
3. For the convenience of staff.
(h) Therapeutic hold shall be discontinued if a child displays adverse side effects including:
1. Illness;
2. Severe emotional or physical stress; or
3. Physical damage.
(3) Nutritional
requirements.
a) A child
shall be served meals that:
1. Meet
the nutritional guidelines of the U.S. Department of Agriculture that include
foods from the five (5) basic food groups; and
2. Satisfy
the quantity required to meet the needs of each child as to age, activity, and
prescribed diet or ITP.
(b) A child
shall be encouraged to eat the food served, but shall not be subjected to
coercion.
(c) An
order for a modified diet from a licensed physician shall be followed by the
child-caring facility.
(d) A menu
shall be planned at least one (1) week in advance, dated, posted, and kept on
file for one (1) year.
(e) With
the exception of a child receiving a meal at school, three (3) meals a day
shall be provided at regular intervals and, except for weekends and holidays,
no more than fourteen (14) hours shall lapse between the evening meal and
morning meal.
1. A
nourishing snack shall be provided and:
a. May
be part of the daily food needs;
b. Shall
not replace a regular meal; and
c. Shall
be recorded on the menu.
2. A meal
shall be scheduled at set times each day so that at least one (1) hot meal a
day is not hurried, allowing time for conversation.
3. Food,
or withholding of food, shall not be used as a punishment.
4. Only
pasteurized milk and milk products, and
5. Food
shall be prepared to preserve nutritive value and heighten flavor and
appearance.
6. The
same food shall be served to children under care and to staff members, unless a
food is not suitable for a person because of:
a. The person's age;
b. A dietary restriction; or
c. A religious preference.
(f) Table
service shall be provided for a child capable of eating at a table.
1. Tables
and chairs shall be:
a. Of a
height that corresponds to the size of the child served; and
b. Constructed
of material that can be easily sanitized.
2. A
child who has not had an opportunity to learn how to handle food with the usual
table service shall be managed in a way that he shall not be embarrassed or
subjected to ridicule
(g) A
written report of a food inspection by municipal, county, or federal
authorities shall:
1. Be
kept on file at the child-caring facility; and
2. Meet
local, state, and federal regulations.
(h) If a
child-caring facility subcontracts a food service, applicable federal and state
administrative regulations shall apply.
Section 6. General Requirements.
(1) An incident of suspected child abuse or
neglect shall be reported as required by KRS 620.030.
(2) (a) The
facility shall, with regard to suspected child abuse or
neglect by an employee:
1. Document
each incident;
2. Keep
each incident document on file;
3. Make
the files accessible to the cabinet.
(b) A
child shall not be exploited for promotional purposes, or in a manner that
shall cause the child or family to suffer discomfort or embarrassment.
(c) Except
as indicated in paragraph (d) of this subsection, a child shall not be used
personally for a fund-raising purpose for the child-caring facility.
(d) If a
picture, slide, recording, or other private, personal effect of a child is used
in fund-raising or promotional effort of a child-caring facility, written
permission shall be obtained from:
1. A
parent or guardian; or
2. An
authorized:
a. Representative
of the cabinet;
b. Representative of the Department of
Juvenile Justice; or
c. Legal
representative.
(3) For an activity conducted away from a child-caring facility, the
facility shall:
(a) Safeguard the health and safety of the children during the activity;
(b) Have a written policy and procedures governing the activity;
(c) Maintain staff-to-child ratios in accordance with Section 3 of this administrative regulation; and
(d) Provide transportation in a manner that complies with Section 5(2)(d) of this administrative regulation.
(4) Clothing and personal possessions.
(a) Through
agreement with the child's legal custodian, the child-caring facility shall
provide a child with clothing and footwear that is clean, well-fitting, and
seasonal.
(b) A child
shall be provided individual articles of personal hygiene.
(c) The child-caring facility shall allow a
child to have personal belongings and property consistent with this
administrative regulation and child-caring facility policy.
(5) A child's money.
(a) The
child-caring facility shall have written policy and procedure relating to money
belonging to a child.
(b) A
child shall have access to information regarding the balance of his fund.
(c) Within
thirty (30) days of discharge, funds belonging to a child shall be transferred
with or returned to the child.
(6) Visitation and communication shall include:
(a) Written
policy on visitation and communication;
(b) An
arrangement for visitation that is not in conflict with the ITP;
(c) Documentation
of each visit in the case record; and
(d) Access to a telephone to make and receive a
telephone call consistent with the child's ITP, current court orders, and the
facility's child-caring policy.
(e) Allowing
a child to contact cabinet staff by telephone within twenty-four (24) hours of
the request of the child.
(7) Religion, culture, and ethnic origin.
(a) Facility
policy shall demonstrate consideration for and sensitivity to:
1. The
racial, cultural, ethnic, and religious background of a child in care; and
2. Availability
of activities appropriate to the child's cultural or ethnic origin.
(b) With
the exception of a religious practice that is destructive, an opportunity shall
be provided for a child to:
1. Practice
the religious belief and faith of the child's individual or family preference;
and
2. Participate
in a religious activity without coercion.
(8) Education.
(a) If a
child-caring facility operates its own school program, it shall have written
policy and procedure regarding the development and implementation of the
educational program. The policy and
procedure shall include:
1. School
attendance;
2. Teaching
staff;
3. School
records;
4. Educational
supplies and equipment;
5. Individual
educational plans; and
6. Use
of a community school.
(b) A
child-caring facility shall ensure that a child attends an accredited
educational program the number of days required by law.
(c) A
child shall be enrolled in an accredited educational program within one (1)
week of admission.
(d) A
school-age child ineligible or unable to attend an accredited school shall have
an educational program specific to the individualized need of the child that
may include a General Education Diploma or vocational training.
(e) If a
child-care facility operates an educational program, maintenance of school
records shall comply with state law and administrative regulations of the
educational body having jurisdiction.
(f) The
child-caring facility shall provide a quiet area and designated time for study.
(9) Work and chore assignment.
(a) An
assigned chore or work assignment shall not place the child in physical danger.
(b) A chore
assignment shall be posted within the child's living quarters.
(c) A child may be given a job in compliance
with child labor laws for which he receives payment that shall be clearly
differentiated from a chore expected of him to be completed in relation to the
routine of daily living.
(d) A work
assignment outside of a daily routine chore at the child-caring facility shall
not be used as a form of punishment. An additional chore assignment beyond what
is regularly assigned to a child may be:
1. Performed
as restitution for intentional property damage made by the child; or
2. Given
to a child for violation of a child-caring facility rule upon mutual agreement
between the child and supervisory child-caring staff without the child being
coerced to enter into an agreement.
(e) A
child shall be given a rest period of at least ten (10) minutes during each
hour worked.
(f) Use
of a child to perform a chore or work assignment shall not negate the
child-caring facility's ultimate responsibility for the maintenance of the
child-caring facility nor the employment of staff sufficient to maintain the
child-caring facility.
(10) Discipline.
(a) A child-caring facility shall have written
policy and procedure governing disciplinary action.
(b) Discipline shall be:
1. Utilized
as an educational tool and be related to the child's actions initiating the
disciplinary process; and
2. Consistent
with the child's ITP and in response to the child's lack of control or
misbehavior.
(c) A
group of children shall not be punished due to the misbehavior of one (1) or
more individual group members.
(d) The
following practices shall not be allowed:
1. Cursing;
2. Screaming;
3. Name
calling;
4. Threatening
of physical harm;
5. Intimidation;
6. Humiliation;
7. Denial
of food or sleep;
8. Corporal physical discipline, in accordance
with KRS 199.640(6);
9. Hitting;
10. Unnecessarily
rough handling;
11. Other
physical punishment; or
12. Denial of visitation with family or custody
holder as punishment.
(e) With
the exception of a parent disciplining a child, a child shall not directly
discipline another child.
(f) Handcuffs,
weapons, mechanical restraining, chemical restraints, or other restraint
devices shall not be used.
(g) A child
placed in a time-out area shall be:
1. In
sight or hearing of staff; and
2.
Checked by
staff at least every five (5) minutes until it is determined the child is ready
to continue normal activity.
Section 7. Child-caring Program Services.
(1) Admissions
and intake.
(a) The child-caring
facility shall have clearly defined written policy and procedure for an
admission that identifies the age, sex, and detailed description of the type of
child served.
(b) Acceptance
of a referral shall be based on the assessment that the child's need is one
that:
1. The
service of the child-caring facility is designed to address; and
2. Cannot
be met in a less restrictive setting.
(c) The
child-caring facility shall not accept into care a child for whom a service
cannot be provided based on the child-caring program's mission statement and
its available resources.
(d) The
child-caring facility shall have a written placement agreement with the child's
custodian.
(e) There
shall be a preadmission interview with the child.
(f) The following information regarding the
child shall be obtained by the child-caring facility from the child's custodian
during intake, or it shall be documented that the information was requested and
not available:
1. Commitment
order or signed voluntary admission form;
2. Verification
of birth;
3. Immunization
record; and
4. Social history and needs assessment that
includes medical, educational, developmental, and family history.
(g) A
written consent pertaining to the child's care shall be obtained from the
child's custodian for:
1. Photograph,
video, and audio tape;
2. Emergency
and routine medical care; and
3. Release
of case record information.
(h) Before
admission, the child and custodian shall be informed in writing of their rights
and the child-caring facility's responsibilities, including policy pertaining
to services offered to the child.
(i) A
child shall be informed upon admission of the right to file a grievance.
(j) Upon
admission, the child shall be oriented to life at the child-caring facility,
including rules and consequences for violation of the rules.
(2) Casework planning.
(a) The
child-caring facility shall have written policy and procedure for the ITP
process including:
1. Assessment;
2. Assignment;
3. Designation
of a case coordinator; and
4. Development, implementation, and evaluation
of the ITP and family involvement.
(b) An initial
assessment shall be completed by designated staff within twenty-four (24) hours
of admission to include:
1. Identifying
information;
2. Presenting
problem;
3. History (developmental, social, emotional
health, education); and
4. Current
level of functioning including strengths and weakness.
(c) An
initial ITP shall be developed by designated staff and implemented within
twenty-four (24) hours of admission.
(3) Comprehensive assessment and treatment plan.
(a) A
comprehensive emotional and behavioral assessment of a child shall be completed
by the treatment team and entered in the case record within twenty-one (21)
days of admission, including the following:
1. A history of previous emotional,
behavioral, and substance abuse problems and treatment
2. The child's current emotional, behavioral,
and developmental functioning, including strengths and weakness
3. A psychiatric or psychological evaluation
if recommended by the treatment team;
4. Other
functional evaluation of language, self-care, social effectiveness, and
visual-motor functioning, if recommended by the treatment team;
5. Social
assessment that includes:
a. Environment
and home;
b. Religion;
c. Ethnic
group;
d. Developmental
history;
e. Family
dynamics and composition; and
f. Education;
and
6. Recommendation
for provision of treatment.
(b) A
coordinated treatment team approach shall be utilized in the development,
implementation, and evaluation of a comprehensive ITP.
(c) A comprehensive
ITP shall be developed and implemented, in accordance with KRS 199.640(5)(a)4, to
improve child functioning based upon the individual need of the child, and the
child's family if appropriate, and shall include at least the following
components:
1. Goals and objectives for permanence;
2. Time frame projected for completion of each
goal and objective;
3. Method
for accomplishing each goal and objective, including utilization of community
providers;
4. Person
responsible for completion of each goal and objective; and
5. Projected
discharge date and placement plan.
(d) The
comprehensive ITP shall be developed within twenty-one (21) days of admission.
1. A
treatment team review of the child's and family's progress toward meeting each
treatment goal shall occur at least monthly.
2. Every
effort shall be made to involve the child and his family in the monthly
treatment team review.
3. Treatment
team evaluation of the comprehensive ITP shall occur at least quarterly.
4. An
additional assessment shall be completed upon the recommendation of the
treatment team.
5. Evaluation
and assessment information shall be documented and maintained in the child's
record.
(e) The child
shall be offered the opportunity to sign an ITP and ITP review, signifying
understanding of the ITP.
1. If the
child refuses to sign or is developmentally unable to understand the
circumstance, this shall be documented in the record.
2. The
child and his family or custodian shall receive a copy of the ITP.
(4) Treatment environment. The daily child-caring program shall be planned
in the following manner in order to create an atmosphere conducive to
treatment:
(a) The
child-caring facility shall have written policy and procedure describing its
daily routine, rules, activity, and child and staff interaction.
(b) The daily
child-caring program shall be:
1. Planned
to provide a framework for daily living; and
2. Reviewed and revised as the needs of the
individual child or living group change.
(c) The daily
routine shall be written and available to each child.
(d) Each rule shall be clearly stated in
language that a child can understand.
(e) Staff
shall interact with a child in a warm, supportive, constructive, and
confidential manner and shall treat the child with respect.
(f) Counseling
and interviewing a child and the child's family shall be conducted in a private
area.
(g) A daily
recreational activity shall be available to promote mastery of:
1. Developmental
tasks;
2. Development
of relationships; and
3. Increase
in self-esteem, in accordance with the child's ITP.
(h) The
child-caring facility shall provide recreational equipment, maintained in
usable and safe condition, to implement the recreational program.
(5) The child-caring facility shall make
available a quality program for substance abuse prevention and treatment in
compliance with KRS 199.640(5)(a)7.
(6) Discharge and aftercare.
(a) The
child-caring facility shall have written policy and procedure that describe the
condition under which a child may be discharged, including criteria for an
unplanned or emergency discharge and a discharge inconsistent with the ITP.
(b) The
approval of the program director shall be required for an unplanned or
emergency discharge.
(c) Discharge
planning shall begin with the development of the ITP and shall continue throughout
subsequent ITP reviews. The treatment team shall consider the following matters
related to discharge planning:
1. Identification
of placement;
2. Community
resources to provide support for youth; and
3. Family
services.
(d) When a
child is leaving a facility as a planned discharge, a predischarge conference
shall be held to ensure that the child and family are prepared for successful
transition into placement. The parent,
guardian or custodian, the child, and the treatment team shall attend this
conference.
(e) The
child shall have at least one (1) preplacement visit prior to the planned
discharge, or the facility shall document unsuccessful efforts to arrange a
visit.
(f) The
child-caring facility shall prepare a written discharge summary within fourteen
(14) days following the date of discharge. A copy shall be provided to the
custody holder. The summary shall
include:
1. Information
related to progress toward completion of each ITP goal;
2. Each
barrier to treatment;
3. Each
treatment method used in working with the child;
4. Date
of discharge;
5. Reason
for discharge; and
6. Name, telephone number and address of
person or child-caring facility to whom the child was discharged.
(g) An aftercare
service shall be provided to a child where no other agency has responsibility
for the child's transition or adjustment to a new environment. Upon discharge,
the following needs of the child shall be assessed and a referral made for
needed aftercare service:
1. Educational;
2. Medical;
3. Vocational;
4. Psychological;
5. Legal;
and
6. Social.
(7) Case record. The child-caring facility shall:
(a) Maintain,
in a confidential and secure manner, a current case record on each child,
including:
1. Identifying
information on the child to include:
a. Name,
ethnic origin and gender;
b. Date
of birth and Social Security number;
c. Former
residence;
d. Name, address, and occupation of each parent,
if available;
e. Date
of admission; and
f. Type
of commitment;
2. Commitment
order or custodian's consent form for admission;
3. Birth
and immunization certificates;
4. Education;
5. Medical and dental records that may be maintained
separately from the case record;
6. Assessment
data or social history;
7. ITP
and each review;
8. Each
incident report;
9. Chronological
recording;
10. Correspondence with court, family, and
custody holder;
11. Discharge
summary; and
12. Written
consent;
(b) Document,
at least weekly, progress made by the child and his family toward meeting the
treatment goal;
(c) Record
the aftercare service it provides until the service is terminated;
(d) Have a
written policy regarding maintenance, security, and disposal of a case record
maintained by, or in possession of, the child-caring facility;
(e) Not
disclose information concerning a child or his family to a person not directly
involved in the case, without the written consent of the custodian of the
child;
(f) Immediately
forward a request made by an individual or an agency to review the case record
of a committed child, to the Commissioner, Department for Community-Based
Services, Cabinet for Families and Children, or other legal custodian;
(g) With
the exception of a sealed adoptive record, release identifying or personal
information including a Social Security card, birth certificate, or driver's
license to the child at discharge;
(h) After the
discharge of a child:
1. Maintain
the case record at the child-caring facility for at least three (3) years; and
3. Maintain
the case record permanently at the child-caring facility;
(i) If
the child-caring facility ceases to operate, transfer the case record to the
Cabinet for Families and Children;
(8) The cabinet shall maintain a file on each record
transferred to one (1) of its record centers. The file shall include the
following information:
(a) The
child's name, case number, date of birth; and
(b) Date the
case record was sent to the cabinet.
(9) All records maintained by the child-caring
facility shall be made available to the cabinet or designee upon request.
Viola Miller, Secretary
Dietra
Paris, Commissioner
Adopted: