Ariz. Admin. Code § R9-10-1025 - Respite Services
A. In addition
to the definitions in A.R.S. §
36-401,
R9-10-101, and
R9-10-1001, the following
definitions apply in this Section:
1.
"Emergency safety response" has the same meaning as in
R9-10-701.
2. "Outing" means travel by a child, who is
receiving respite services provided by an outpatient treatment center, to a
location away from the outpatient treatment center premises or, if applicable,
the child's residence for a specific activity.
3. "Parent" means a child's:
a. Mother or father, or
b. Legal guardian.
4. "Respite capacity" means the total number
of children for whom an outpatient treatment center is authorized by the
Department to provide respite services on the outpatient treatment center's
premises.
B. An
administrator of an outpatient treatment center that is authorized to provide
respite services shall ensure that:
1. Respite
services are not provided in a personnel member's residence unless the
personnel member's residence is licensed as a behavioral health respite
home;
2. Except for an outpatient
treatment center that is authorized to provide respite services for children on
the premises, respite services are provided:
a. In a patient's residence; or
b. Up to 10 continuous hours in a 24-hour
time period while the individual who is receiving the respite services is:
i. Supervised by a personnel
member;
ii. Awake;
iii. Except as stated in subsection (B)(3),
provided food;
iv. Allowed to
rest;
v. Provided an opportunity to
use the toilet and meet the individual's hygiene needs; and
vi. Participating in activities in the
community but is not in a licensed health care institution or child care
facility; and
3. If a child is provided respite services
according to subsection (B)(2)(b), the child is provided the appropriate meals
or snacks in subsection (J)(1) for the amount of time the child is receiving
respite services from the outpatient treatment center.
C. If an outpatient treatment center that is
authorized to provide respite services for children includes outings in the
outpatient treatment center's scope of services, an administrator shall ensure
that:
1. Before a personnel member takes a
child receiving respite services on an outing, written permission is obtained
from the child's parent that includes:
a. The
child's name;
b. A description of
the outing;
c. The name of the
outing destination, if applicable;
d. The street address and, if available, the
telephone number of the outing destination;
e. Either:
i. The date or dates of the outing;
or
ii. The time period, not to
exceed 12 months, during which the permission is given;
f. The projected time of departure from the
outpatient treatment center or, if applicable, the child's residence;
g. The projected time of arrival back at the
outpatient treatment center or, if applicable, the child's residence;
and
h. The dated signature of the
child's parent;
2. Each
motor vehicle used on an outing by a personnel member for a child receiving
respite services from the outpatient treatment center:
a. Is maintained in a mechanically safe
condition;
b. Is free from
hazards;
c. Has an operational
heating system;
d. Has an
operational air-conditioning system; and
e. Is equipped with:
i. A first-aid kit that meets the
requirements in subsection (S)(1), and
ii. Two large, clean towels or
blankets;
3. On
an outing, a child does not ride in a truck bed, camper, or trailer attached to
a motor vehicle;
4. The Department
is notified within 24 hours after a motor vehicle accident that involves a
child who is receiving respite services while riding in the motor vehicle on an
outing; and
5. A personnel member
who drives a motor vehicle with children receiving respite services from the
outpatient treatment center in the motor vehicle:
a. Requires that each door be locked before
the motor vehicle is set in motion and keeps the doors locked while the motor
vehicle is in motion;
b. Does not
permit a child to be seated in front of a motor vehicle's air bag;
c. Requires that a child remain seated and
entirely inside the motor vehicle while the motor vehicle is in
motion;
d. Requires that a child is
secured, as required in A.R.S. §
28-907 or
28-909, before the motor vehicle
is set in motion and while the motor vehicle is in motion;
e. Assists a child into or out of the motor
vehicle away from moving traffic at curbside or in a driveway, parking lot, or
other location designated for this purpose;
f. Carries drinking water in an amount
sufficient to meet the needs of each child on the outing and a sufficient
number of cups or other drinking receptacles so that each child can drink from
a different cup or receptacle; and
g. Accounts for each child while on the
outing.
D. An
administrator of an outpatient treatment center that is authorized to provide
respite services for children on the premises shall ensure that:
1. Respite services are only provided on the
premises for up to 10 continuous hours per day between the hours of 6:00 a.m.
and 10:00 p.m.;
2. The specific 10
continuous hours per day during which the outpatient treatment center provides
respite services on the premises is stated in the outpatient treatment center's
hours of operation that is submitted as part of the outpatient treatment
center's initial or renewal license application and according to
R9-10-1002(D)
;
3. A personnel member, who is
expected to provide respite services eight or more hours a week, complies with
the requirements for tuberculosis screening in
R9-10-113 ;
4. At least one personnel member who has
current training in first aid and cardiopulmonary resuscitation is available on
the premises when a child is receiving respite services on the
premises;
5. At least one personnel
member who has completed training in crisis intervention according to
R9-10-716(F) is
available on the premises when a child is receiving respite services on the
premises;
6. A personnel member
does not use or possess any of the following items when a child receiving
respite services is on the premises:
a. A
controlled substance as listed in A.R.S. Title 36, Chapter 27, Article 2,
except where used as a prescription medication in the manner
prescribed;
b. A dangerous drug as
defined in A.R.S. §
13-3401, except where used as a
prescription medication in the manner prescribed;
c. A prescription medication as defined in
A.R.S. §
32-1901, except where used in the
manner prescribed; or
d. A firearm
as defined in A.R.S. §
13-105;
7. An unannounced fire and emergency
evacuation drill is conducted at least once a month, and at different times of
the day, and each personnel member providing respite services for children on
the premises and each child receiving respite services on the premises
participates in the fire and emergency evacuation drill;
8. Each fire and emergency evacuation drill
is documented, and the documentation is maintained for at least 12 months after
the date of the fire and emergency evacuation drill;
9. Before a child receives respite services
on the premises of the outpatient treatment center, in addition to the
requirements in
R9-10-1009, the following
information is obtained and maintained in the child's medical record;
a. The name, home address, city, state, zip
code, and contact telephone number of each parent of the child;
b. The name and contact telephone number of
at least two additional individuals authorized by the child's parent to collect
the child from the outpatient treatment center;
c. The name and contact telephone number of
the child's health care provider;
d. The written authorization for emergency
medical care of the child when the parent cannot be contacted at the time of an
emergency;
e. The name of the
individual to be contacted in case of injury or sudden illness of the
child;
f. If applicable, a
description of any dietary restrictions or needs due to a medical condition or
diagnosed food sensitivity or allergy;
g. A written record completed by the child's
parent or health care provider noting the child's susceptibility to illness,
physical conditions of which a personnel member should be aware, and any
specific requirements for health maintenance; and
10. Documentation is obtained and maintained
in the child's medical record each time the child receives respite services on
the premises that includes:
a. The date and
time of each admission to and discharge from receiving respite services;
and
b. A signature, which contains
at least a first initial of a first name and the last name of the child's
parent or other individual designated by the child's parent, each time the
child is admitted or discharged from receiving respite services on the
premises;
11. Policies
and procedures are developed, documented, and implemented to ensure that the
identity of an individual is known to a personnel member or is verified with
picture identification before the personnel member discharges a child to the
individual;
12. A child is not
discharged to an individual other than the child's parent or other individual
designated according to subsection (D)(9)(b), except:
a. When the child's parent authorizes the
administrator by telephone or electronic means to release the child to an
individual not so designated, and
b. The administrator can verify the telephone
or electronic authorization using a means of verification that has been agreed
to by the administrator and the child's parent and documented in the child's
medical record; and
13.
The number of personnel members providing respite services for children on the
premises is determined by the needs of the children present, with a minimum of
at least:
a. One personnel member providing
supervision for every five children receiving respite services on the premises;
and
b. Two personnel members on the
premises when a child is receiving respite services on the premises.
E. If swimming
activities are conducted at a swimming pool for a child receiving respite
services on the premises of an outpatient treatment center, an administrator
shall ensure that there is an individual at the swimming pool on the premises
who has current lifeguard certification that includes a demonstration of the
individual's ability to perform cardiopulmonary resuscitation. If the
individual is a personnel member, the personnel member cannot be counted in the
personnel member-to-children ratio required by subsection (D)(13).
F. An administrator of an outpatient
treatment center that is authorized to provide respite services for children on
the premises shall ensure that in each area designated for providing respite
services:
1. Drinking water is provided
sufficient for the needs of and accessible to each child in both indoor and
outdoor areas;
2. Indoor areas used
by children are decorated with age-appropriate articles such as bulletin
boards, pictures, and posters;
3.
Storage space is provided for indoor and outdoor toys, materials, and equipment
in areas accessible to children;
4.
Clean clothing is available to a child when the child needs a change of
clothing;
5. At least one indoor
area in the outpatient treatment center where respite services are provided for
children is equipped with at least one cot or mat, a sheet, and a blanket,
where a child can rest quietly away from the other children;
6. Except as provided in subsection
(AA)(2)(a), outdoor or large muscle development activities are scheduled to
allow not less than 75 square feet for each child occupying the outdoor area or
indoor area substituted for outdoor area at any time;
7. The premises, including the buildings, are
maintained free from hazards;
8.
Toys and play equipment, required in this Section, are maintained:
a. Free from hazards, and
b. In a condition that allows the toy or play
equipment to be used for the original purpose of the toy or play
equipment;
9.
Temperatures are maintained between 70° F and 84° F in each room or
indoor area used by children;
10.
Except when a child is napping or sleeping or for a child who has a sensory
issue documented in the child's behavioral health assessment, each room or area
used by a child is maintained at a minimum of 30 foot candles of
illumination;
11. When a child is
napping or sleeping in a room, the room is maintained at a minimum of five foot
candles of illumination;
12. Each
child's toothbrush, comb, washcloth, and cloth towel that are provided for the
child's use by the child's parent are maintained in a clean condition and
stored in an identified space separate from those of other children;
13. Except as provided in subsection (F)(14),
the following are stored separate from food storage areas and are inaccessible
to a child:
a. All materials and chemicals
labeled as a toxic or flammable substance;
b. All substances that have a child warning
label and may be a hazard to a child; and
c. Lawn mowers, ladders, toilet brushes,
plungers, and other equipment that may be a hazard to a child;
14. Hand sanitizers:
a. When being stored, are stored separate
from food storage areas and are inaccessible to children; and
b. When being provided for use, are
accessible to children; and
15. Except when used as part of an activity,
the following are stored in an area inaccessible to a child:
a. Garden tools, such as a rake, trowel, and
shovel; and
b. Cleaning equipment
and supplies, such as a mop and mop bucket.
G. An administrator of an outpatient
treatment center that is authorized to provide respite services for children on
the premises shall ensure that a personnel member:
1. Supervises each child at all
times;
2. Does not smoke or use
tobacco:
a. In any area where respite services
may be provided for a child, or
b.
When transporting or transferring a child;
3. Except for a child who can change the
child's own clothing, changes a child's clothing when wet or soiled;
4. Empties clothing soiled with feces into a
toilet without rinsing;
5. Places a
child's soiled clothing in a plastic bag labeled with the child's name, stores
the clothing in a container used for this purpose, and sends the clothing home
with the child's parent;
6.
Prepares and posts in each indoor area, before the first child arrives to
receive respite services that day, a current schedule of age-appropriate
activities that meet the needs of the children receiving respite services that
day, including the times the following are provided:
a. Meals and snacks,
b. Naps,
c. Indoor activities,
d. Outdoor or large muscle development
activities,
e. Quiet and active
activities,
f. Personnel
member-directed activities,
g.
Self-directed activities, and
h.
Activities that develop small muscles;
7. Provides activities and opportunities,
consistent with a child's behavioral health assessment, for each child to:
a. Gain a positive self-concept;
b. Develop and practice social
skills;
c. Acquire communication
skills;
d. Participate in large
muscle physical activity;
e.
Develop habits that meet health, safety, and nutritional needs;
f. Express creativity;
g. Learn to respect cultural diversity of
children and staff;
h. Learn
self-help skills; and
i. Develop a
sense of responsibility and independence;
8. Implements the schedule in subsection
(G)(6);
9. If an activity on the
schedule in subsection (G)(6) is not implemented, writes on the schedule the
activity that was not implemented and what activity was substituted;
10. Ensures that each indoor area has a
supply of age-appropriate toys, materials, and equipment, necessary to
implement the schedule required in subsection (G)(6), in a quantity sufficient
for the number of children receiving respite services at the outpatient
treatment center that day, including:
a. Art
and crafts supplies;
b.
Books;
c. Balls;
d. Puzzles, blocks, and toys to enhance
manipulative skills;
e. Creative
play toys;
f. Musical instruments;
and
g. Indoor and outdoor equipment
to enhance large muscle development;
11. Does the following when a parent permits
or asks a personnel member to apply personal products, such as petroleum jelly,
diaper rash ointments, sun screen or sun block preparations, toothpaste, and
baby diapering preparations on the parent's child:
a. Obtains the child's personal products and
written approval for use of the personal products from the child's
parent;
b. Labels the personal
products with the child's name; and
c. Keeps the personal products inaccessible
to children; and
12.
Monitors a child for overheating or overexposure to the sun.
H. An administrator of an
outpatient treatment center that is authorized to provide respite services for
children on the premises and includes in the outpatient treatment center's
scope of respite services for children wearing diapers shall ensure that there
is a diaper changing space in the area designated for providing respite
services for children that contains:
1. A
nonabsorbent, sanitizable diaper changing surface that is:
a. Seamless and smooth, and
b. Kept clear of items not required for
diaper changing;
2. A
hand-washing sink adjacent to the diaper changing surface, for a personnel
member's use when changing diapers and for washing a child during or after
diapering, that provides:
a. Running
water,
b. Soap from a dispenser,
and
c. Single-use paper hand towels
from a dispenser;
3. At
least one waterproof, sanitizable container with a waterproof liner and a
tight-fitting lid for soiled diapers; and
4. At least one waterproof, sanitizable
container with a waterproof liner and a tight-fitting lid for soiled
clothing.
I. In a diaper
changing space, an administrator of an outpatient treatment center that is
authorized to provide respite services for children on the premises shall
ensure that:
1. A diaper changing procedure is
established, documented, and implemented that states that a child's diaper is
changed as soon as it is soiled and that a personnel member when diapering:
a. Washes and dries the child, using a
separate wash cloth and towel only once for each child;
b. If applicable, applies the child's
individual personal products labeled with the child's name;
c. Uses single-use non-porous
gloves;
d. Washes the personnel
member's own hands with soap and running water according to the requirements in
R9-10-1028(5)
;
e. Washes each child's hands with
soap and running water after each diaper change; and
f. Cleans, sanitizes, and dries the diaper
changing surface following each diaper change; and
2. A personnel member:
a. Removes disposable diapers and disposable
training pants from a diaper changing space as needed or at least twice every
24 hours to a waste receptacle outside the building; and
b. Does not:
i. Permit a bottle, formula, food, eating
utensil, or food preparation in a diaper changing space;
ii. Draw water for human consumption from the
hand-washing sink adjacent to a diaper changing surface, required in subsection
(H)(2); or
iii. If responsible for
food preparation, change diapers until food preparation duties have been
completed for the day.
J. Except as provided in subsection (K)(3),
an administrator of an outpatient treatment center that is authorized to
provide respite services for children on the premises shall:
1. Serve the following meals or snacks to a
child receiving respite services on the premises:
a. For the following periods of time:
i. Two to four hours, one or more
snacks;
ii. Four to eight hours,
one or more snacks and one or more meals; and
iii. More than eight hours, two snacks and
one or more meals;
b.
Make breakfast available to a child receiving respite services on the premises
before 8:00 a.m.;
c. Serve lunch to
a child who is receiving respite services on the premises between 11:00 a.m.
through 1:00 p.m.; and
d. Serve
dinner to a child who is receiving respite services on the premises from 5:00
p.m. through 7:00 p.m. and who will remain on the premises after 7:00
p.m.;
2. Ensure that a
meal or snack provided by the outpatient treatment center meets the meal
pattern requirements in Table 10.1; and
3. If the outpatient treatment center
provides a meal or snack to a child:
a. Make a
second serving of a food component of a provided snack or meal available to a
child who requests a second serving, and
b. Substitute a food that is equivalent to a
specific food component if a requested second serving of a specific food
component is not available.
K. An administrator of an outpatient
treatment center that is authorized to provide respite services for children on
the premises:
1. May serve food provided for a
child by the child's parent;
2. If
a child's parent does not provide a sufficient number of meals or snacks to
meet the requirements in subsection (J)(1), shall supplement, according to the
requirements in Table 10.1, the meals or snacks provided by the child's parent;
and
3. If applicable, shall serve
food to a child at the times and in quantities consistent with the information
documented according to subsection (D)(9)(f) for the child and the child's
behavioral health assessment, to meet the child's dietary and nutritional
needs.
L. An
administrator of an outpatient treatment center that is authorized to provide
respite services for children on the premises that has a respite capacity of
more than 10 shall obtain a food establishment license or permit according to
the requirements in 9 A.A.C. 8, Article 1, and, if applicable, maintain
documentation of the current food establishment license or permit.
M. If an administrator of an outpatient
treatment center that is authorized to provide respite services for children on
the premises serves food to a child receiving respite services on the premises
that is not prepared by the outpatient treatment center or provided by the
child's parent, the administrator shall ensure that the food was prepared by a
food establishment, as defined according to A.A.C.
R9-8-101.
N. An administrator of an outpatient
treatment center that is authorized to provide respite services for children on
the premises shall ensure that:
1. Children,
except infants and children who cannot wash their own hands, wash their hands
with soap and running water before and after handling or eating food;
2. A personnel member:
a. Washes the hands of an infant or a child
who cannot wash the child's own hands before and after the infant or child
handles or eats food, using:
i. A
washcloth,
ii. A single-use paper
towel, or
iii. Soap and running
water; and
b. If using a
washcloth, uses each washcloth on only one child and only one time before it is
laundered or discarded;
3. Non-single-use utensils and equipment used
in preparing, eating, or drinking food are:
a.
After each use:
i. Washed in an automatic
dishwasher and air dried or heat dried; or
ii. Washed in hot soapy water, rinsed in
clean water, sanitized, and air dried or heat dried; and
b. Stored in a clean area protected from
contamination;
4.
Single-use utensils and equipment are disposed of after being used;
5. Perishable foods are covered and stored in
a refrigerator at a temperature of 41§ F or less;
6. A refrigerator at the outpatient treatment
center maintains a temperature of 41§ F or less, as shown by a thermometer
kept in the refrigerator at all times;
7. A freezer at the outpatient treatment
center maintains a temperature of 0§ F or less, as shown by a thermometer
kept in the freezer at all times; and
8. Foods are prepared as close as possible to
serving time and, if prepared in advance, are either:
a. Cold held at a temperature of 45§ F
or less or hot held at a temperature of 130§ F or more until served,
or
b. Cold held at a temperature of
45§ F or less and then reheated to a temperature of at least 165§ F
before being served.
O. An administrator of an outpatient
treatment center that is authorized to provide respite services for children on
the premises:
1. May allow a personnel member
to separate a child who is receiving respite services on the premises from
other children for unacceptable behavior for no longer than three minutes after
the child has regained self-control, but not more than 10 minutes without the
personnel member interacting with the child, consistent with the child's
behavioral health assessment;
2.
Shall ensure that:
a. A personnel member,
consistent with the child's behavioral health assessment:
i. Defines and maintains consistent and
reasonable guidelines and limitations for a child's behavior;
ii. Teaches, models, and encourages orderly
conduct, personal control, and age-appropriate behavior; and
iii. Explains to a child why a particular
behavior is not allowed, suggests an alternative, and assists the child to
become engaged in an alternative activity;
b. An emergency safety response is:
i. Only used:
(1) By a personnel member trained according
to R9-10-716(F)(1)
to use an emergency safety response,
(2) For the management of a child's violent
or self-destructive behavior, and
(3) When less restrictive interventions have
been determined to be ineffective; and
ii. Discontinued at the earliest possible
time, but no longer than five minutes after the emergency safety response is
initiated;
c. If an
emergency safety response was used for a child, a personnel member, when the
child is discharged to the child's parent:
i.
Notifies the child's parent of the use of the emergency safety response for the
child and the behavior, event, or environmental factor that caused the need for
the emergency safety response; and
ii. Documents in the child's medical record
that the child's parent was notified of the use of the emergency safety
response;
d. Within 24
hours after an emergency safety response is used for a child receiving respite
services on the premises, the following information is entered into the child's
medical record:
i. The date and time the
emergency safety response was used;
ii. The name of each personnel member who
used an emergency safety response;
iii. The specific emergency safety response
used;
iv. The behavior, event, or
environmental factor that caused the need for the emergency safety response;
and
v. Any injury that resulted
from the use of the emergency safety response;
e. Within 10 working days after an emergency
safety response is used for a child receiving respite services on the premises,
a behavioral health professional reviews the information in subsection
(O)(2)(d) and documents the review in the child's medical record;
f. After the review required in subsection
(O)(2)(e), the following information is entered into the child's medical
record:
i. Actions taken or planned to prevent
the need for a subsequent use of an emergency safety response for the
child,
ii. A determination of
whether the child is appropriately placed at the outpatient treatment center
providing respite services for children on the premises, and
iii. Whether the child's treatment plan was
reviewed or needs to be reviewed and amended to ensure that the child's
treatment plan is meeting the child's treatment needs;
g. Emergency safety response training is
documented according to the requirements in
R9-10-716(F)(2) ;
and
h. Materials used for emergency
safety response training are maintained according to the requirements in
R9-10-716(F)(3) ;
and
3. A personnel member
does not use or permit:
a. A method of
discipline that could cause harm to the health, safety, or welfare of a
child;
b. Corporal
punishment;
c. Abusive
language;
d. Discipline associated
with:
i. Eating, napping, sleeping, or
toileting;
ii. Medication;
or
iii. Mechanical restraint;
or
e. Discipline
administered to any child by another child.
P. An administrator of an outpatient
treatment center that is authorized to provide respite services for children on
the premises shall:
1. Provide each child who
naps or sleeps on the premises with a separate cot or mat and ensure that:
a. A cot or mat used by the child
accommodates the child's height and weight;
b. A personnel member covers each cot or mat
with a clean sheet that is laundered when soiled, or at least once every seven
days and before use by a different child;
c. A clean blanket or sheet is available for
each child;
d. A rug, carpet,
blanket, or towel is not used as a mat; and
e. Each cot or mat is maintained in a clean
and repaired condition;
2. Not use bunk beds or waterbed mattresses
for a child receiving respite services;
3. Provide an unobstructed passageway at
least 18 inches wide between each row of cots or mats to allow a personnel
member access to each child;
4.
Ensure that if a child naps or sleeps while receiving respite services at the
outpatient treatment center, the administrator:
a. Does not permit the child to lie in direct
contact with the floor while napping or sleeping;
b. Prohibits the operation of a television in
a room where the child is napping or sleeping; and
c. Requires that a personnel member remain
awake while supervising the napping or sleeping child; and
5. Ensure that storage space is provided on
the premises for cots, mats, sheets, and blankets, that is:
a. Accessible to an area used for napping or
sleeping; and
b. Separate from food
service and preparation areas, toilet rooms, and laundry rooms.
Q. An administrator of
an outpatient treatment center that is authorized to provide respite services
for children on the premises shall, in the area of the premises where the
respite services are provided:
1. Maintain the
premises and furnishings:
a. Free of insects
and vermin,
b. In a clean
condition, and
c. Free from odor;
and
2. Ensure that:
a. Floor coverings are:
i. Clean; and
ii. Free from:
(1) Dampness,
(2) Odors, and
(3) Hazards;
b. Toilet bowls, lavatory fixtures, and
floors in toilet rooms and kitchens are cleaned and sanitized as often as
necessary to maintain them in a clean and sanitized condition or at least once
every 24 hours;
c. Each toilet room
used by children receiving respite services on the premises contains, within
easy reach of children:
i. Mounted toilet
tissue;
ii. A sink with running
water;
iii. Soap contained in a
dispenser; and
iv. Disposable,
single-use paper towels, in a mounted dispenser, or a mechanical hand
dryer;
d. Personnel
members wash their hands with soap and running water after toileting;
e. A child's hands are washed with soap and
running water after toileting;
f.
Except for a cup or receptacle used only for water, food waste is stored in a
covered container and the container is clean and lined with a plastic
bag;
g. Food waste and other refuse
is removed from the area of the premises where respite services are provided
for children at least once every 24 hours or more often as necessary to
maintain a clean condition and avoid odors;
h. A personnel member or a child does not
draw water for human consumption from a toilet room hand-washing
sink;
i. Toys, materials, and
equipment are maintained in a clean condition;
j. Plumbing fixtures are maintained in a
clean and working condition; and
k.
Chipped or cracked sinks and toilets are replaced or repaired.
R. If laundry belonging
to an outpatient treatment center providing respite services for children on
the premises is done on the premises, an administrator shall:
1. Not use a kitchen or food storage area for
sorting, handling, washing, or drying laundry;
2. Locate the laundry equipment in an area
that is separate from areas used by children and inaccessible to
children;
3. Not permit a child to
be in a laundry room or use a laundry area as a passageway for children;
and
4. Ensure that laundry soiled
by vomitus, urine, feces, blood, or other body fluid is stored, cleaned, and
sanitized separately from other laundry.
S. An administrator of an outpatient
treatment center that is authorized to provide respite services for children on
the premises shall ensure that there is a first aid kit in the designated area
of the outpatient treatment center where respite services are provided that:
1. Contains first aid supplies in a quantity
sufficient to meet the needs of the children receiving respite services,
including the following:
a. Sterile bandages
including:
i. Self-adhering bandages of
assorted sizes,
ii. Sterile gauze
pads, and
iii. Sterile gauze
rolls;
b. Antiseptic
solution or sealed antiseptic wipes;
c. A pair of scissors;
d. Self-adhering tape;
e. Single-use, non-porous gloves;
and
f. Reclosable plastic bags of
at least one-gallon size; and
2. Is accessible to personnel members but
inaccessible to children receiving respite services on the premises.
T. An administrator of an
outpatient treatment center that is authorized to provide respite services for
children on the premises shall:
1. Prepare and
date a written fire and emergency plan that contains:
a. The location of the first aid
kit;
b. The names of personnel
members who have first aid training;
c. The names of personnel members who have
cardiopulmonary resuscitation training;
d. The directions for:
i. Initiating notification of a child's
parent by telephone or other equally expeditious means within 60 minutes after
a fire or emergency; and
ii.
Providing written notification to the child's parent within 24 hours after a
fire or emergency; and
e.
The outpatient treatment center's street address and the emergency telephone
numbers for the local fire department, police department, ambulance service,
and poison control center;
2. Maintain the plan required in subsection
(T)(1) in the area designated for providing respite services;
3. Post the plan required in subsection
(T)(1) in any indoor area where respite services are provided that does not
have an operable telephone service or two-way voice communication system that
connects the indoor area where respite services are provided with an individual
who has direct access to an in-and-out operable telephone services;
and
4. Update the plan in
subsection (T)(1) at least once every 12 months after the date of initial
preparation of the plan or when any information changes.
U. An administrator of an outpatient
treatment center that is authorized to provide respite services for children on
the premises shall in the area designated for providing respite services:
1. Post, near a room's designated exit, a
building evacuation plan that details the designated exits from the room and
the facility where the outpatient treatment center is located; and
2. Maintain and use a communication system
that contains:
a. A direct-access, in-and-out,
operating telephone service in the area where respite services are provided;
or
b. A two-way voice communication
system that connects the area where respite services are provided with an
individual who has direct access to an in-and-out, operating telephone
service.
V. If,
while receiving respite services at an outpatient treatment center authorized
to provide respite services for children on the premises, a child has an
accident, injury, or emergency that, based on an evaluation by a personnel
member, requires medical treatment by a health care provider, an administrator
shall ensure that a personnel member:
1.
Notifies the child's parent immediately after the accident, injury, or
emergency;
2. Documents:
a. A description of the accident, injury, or
emergency, including the date, time, and location of the accident, injury, or
emergency;
b. The method used to
notify the child's parent; and
c.
The time the child's parent was notified; and
3. Maintains the documentation required in
subsection (V)(2) for at least 12 months after the date the child last received
respite services on the outpatient treatment center's premises.
W. If a parent of a child who
received respite services at an outpatient treatment center authorized to
provide respite services for children on the premises informs a personnel
member that the child's parent obtained medical treatment for the child from a
health care provider for an accident, injury, or emergency the child had while
on the premises, an administrator shall ensure that a personnel member:
1. Documents any information about the
child's accident, injury, or emergency received from the child's parent;
and
2. Maintains the documentation
required in subsection (W)(1) for at least 12 months after the date the child
last received respite services on the outpatient treatment center's
premises.
X. If a child
exhibits signs of illness or infestation at an outpatient treatment center
authorized to provide respite services for children on the premises, an
administrator shall ensure that a personnel member:
1. Immediately separates the child from other
children,
2. Immediately notifies
the child's parent by telephone or other expeditious means to arrange for the
child's discharge from the outpatient treatment center,
3. Documents the notification required in
subsection (X)(2), and
4. Maintains
documentation of the notification required in subsection (X)(3) for at least 12
months after the date of the notification.
Y. An administrator of an outpatient
treatment center that is authorized to provide respite services for children on
the premises shall comply with the following physical plant requirements:
1. Toilets and hand-washing sinks are
available to children in the area designated for providing respite services or
on the premises as follows:
a. At least one
flush toilet and one hand-washing sink for 10 or fewer children;
b. At least two flush toilets and two
hand-washing sinks for 11 to 25 children; and
c. At least one flush toilet and one
hand-washing sink for each additional 20 children;
2. A hand-washing sink provides running water
with a drain connected to a sanitary sewer as defined in A.R.S. §
45-101;
3. A glass mirror, window, or other glass
surface that is located within 36 inches of the floor is made of safety glass
that has been manufactured, fabricated, or treated to prevent the glass from
shattering or flying when struck or broken, or is shielded by a barrier to
prevent impact by or physical injury to a child; and
4. There is at least 30 square feet of
unobstructed indoor space for each child who may be receiving respite services
on the premises, which excludes floor space occupied by:
a. The interior walls;
b. A kitchen, a bathroom, a closet, a
hallway, a stair, an entryway, an office, an area designated for isolating a
child from other children, a storage room, or a room or floor space designated
for the sole use of personnel members;
c. Room space occupied by desks, file
cabinets, storage cabinets, or hand-washing sinks for a personnel member's use;
or
d. Indoor area that is
substituted for required outdoor area.
Z. An administrator of an outpatient
treatment center authorized to provide respite services for children on the
premises shall ensure that, in addition to the policies and procedures required
in this Article, policies and procedures are established, documented, and
implemented for the children's use of a toilet and hand-washing sink that
ensure the children's health and safety and include:
1. Supervision requirements for children
using the toilet, based on a child's age, gender, and behavioral health issue;
and
2. If the outpatient treatment
center does not have a toilet and hand-washing sink available for the exclusive
use of children receiving respite services, a method to ensure that an
individual, other than a child receiving respite services or a personnel member
providing respite services, is not present in the toilet and hand-washing sink
area when a child receiving respite services is present in the toilet and
hand-washing sink area.
AA. To provide activities that develop large
muscles and an opportunity to participate in structured large muscle physical
activities, an administrator of an outpatient treatment center authorized to
provide respite services for children on the premises shall:
1. Provide at least 75 square feet of outdoor
area per child for at least 50% of the outpatient treatment center's respite
capacity; or
2. Comply with one of
the following:
a. If no child receives respite
services on the premises for more than four hours per day, provide at least 50
square feet of indoor area for each child, based on the outpatient treatment
center's respite capacity;
b. If a
child receives respite services on the premises for more than four hours but
less than six hours per day, provide at least 75 square feet of indoor area per
child for at least 50% of the outpatient treatment center's respite capacity,
in addition to the indoor area required in subsection (Y)(4); or
c. Provide at least 37.5 square feet of
outdoor area and 37.5 square feet of indoor area per child for at least 50% of
the outpatient treatment center's respite capacity, in addition to the activity
area required in subsection (Y)(4).
BB. If an administrator of an outpatient
treatment center that is authorized to provide respite services for children on
the premises is substituting indoor area for outdoor area, the administrator
shall:
1. Designate, on the site plan and the
floor plan submitted with the license application or a request for an intended
change or modification, the indoor area that is being substituted for an
outdoor area; and
2. In the indoor
area substituted for outdoor area, install and maintain a mat or pad designed
to provide impact protection in the fall zone of indoor swings and climbing
equipment.
CC. An
administrator of an outpatient treatment center that is authorized to provide
respite services for children on the premises shall ensure that:
1. An outdoor area used by children receiving
respite services:
a. Is enclosed by a fence:
i. A minimum of 4.0 feet high,
ii. Secured to the ground, and
iii. With either vertical or horizontal open
spaces on the fence or gate that do not exceed 4.0 inches;
b. Is maintained free from hazards, such as
exposed concrete footings and broken toys; and
c. Has gates that are kept closed while a
child is in the outdoor area;
2. The following is provided and maintained
within the fall zones of swings and climbing equipment in an outdoor area:
a. A shock-absorbing unitary surfacing
material manufactured for such use in outdoor activity areas; or
b. A minimum depth of 6.0 inches of a
nonhazardous, resilient material such as fine loose sand or wood
chips;
3. Hard surfacing
material such as asphalt or concrete is not installed or used under swings or
climbing equipment unless used as a base for shock-absorbing unitary surfacing
material;
4. A swing or climbing
equipment is not located in the fall zone of another swing or climbing
equipment; and
5. A shaded area for
each child occupying an outdoor area at any time of the day is
provided.
DD. An
administrator of an outpatient treatment center that is authorized to provide
respite services for children on the premises shall install and maintain a
portable, pressurized fire extinguisher that meets, at a minimum, a 2A-10-BC
rating of the Underwriters Laboratories in an outpatient treatment center's
kitchen and any other location required for Existing Health Care Occupancies in
National Fire Protection Association 101, Life Safety Code, incorporated by
reference in
R9-10-104.01.
EE. In addition to the requirements in
R9-10-1029(F), an
administrator of an outpatient treatment center that is authorized to provide
respite services for children on the premises shall ensure that:
1. Combustible material, such as paper,
boxes, or rags, is not permitted to accumulate inside or outside the
premises;
2. An unvented or
open-flame space heater or portable heater is not used on the
premises;
3. A gas valve on an
unused gas outlet is removed and capped where it emerges from the wall or
floor;
4. Heating and cooling
equipment is inaccessible to a child;
5. Fans are mounted and inaccessible to a
child;
6. Toilet rooms are
ventilated to the outside of the building, either by a screened window open to
the outside air or by an exhaust fan and duct system that is operated when the
toilet room is in use;
7. A toilet
room with a door that opens to the exterior of a building is equipped with a
self-closing device that keeps the door closed except when an individual is
entering or exiting; and
8. A
toilet room door does not open into a kitchen or laundry.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.