Cal. Code Regs. Tit. 22, § 80075 - Health-Related Services
(a)
The licensee shall ensure that each client receives first aid and other needed
medical or dental services, including arrangement for and/or provision of
transportation to the nearest available services.
(b) Clients shall be assisted as needed with
self-administration of prescription and nonprescription medications.
(1) In adult CCFs, facility staff who receive
training may assist clients with metered-dose inhalers, and dry powder inhalers
if the following requirements are met:
(A) In
ARFs, facility staff must receive training from a licensed professional.
1. The licensee shall obtain written
documentation from the licensed professional outlining the procedures and the
names of facility staff who have been trained in those procedures.
2. The licensee ensures that the licensed
professional reviews staff performance as the licensed professional deems
necessary, but at least once a year.
(B) All staff training shall be documented in
the facility personnel files.
(2) Facility staff, except those authorized
by law, shall not administer injections but staff designated by the licensee
shall be authorized to assist clients with self-administration of injections as
needed.
(3) Assistance with
self-administration does not include forcing a client to take medications,
hiding or camouflaging medications in other substances without the client's
knowledge and consent, or otherwise infringing upon a client's right to refuse
to take a medication.
(4) If the
client's physician has stated in writing that the client is able to determine
and communicate his/her need for a prescription or nonprescription PRN
medication, facility staff shall be permitted to assist the client with
self-administration of their PRN medication.
(5) If the client's physician has stated in
writing that the client is unable to determine his/her own need for
nonprescription PRN medication, but can communicate his/her symptoms clearly,
facility staff designated by the licensee shall be permitted to assist the
client with self-administration, provided all of the following requirements are
met:
(A) There is written direction from a
physician, on a prescription blank, specifying the name of the client, the name
of the medication, all of the information specified in Section
80075(e),
instructions regarding a time or circumstance (if any) when it should be
discontinued, and an indication of when the physician should be contacted for a
medication reevaluation.
(B) Once
ordered by the physician the medication is given according to the physician's
directions.
(C) A record of each
dose is maintained in the client's record. The record shall include the date
and time the PRN medication was taken, the dosage taken, and the client's
response.
(6) If the
client is unable to determine his/her own need for a prescription or
nonprescription PRN medication, and is unable to communicate his/her symptoms
clearly, facility staff designated by the licensee, shall be permitted to
assist the client with self-administration, provided all of the following
requirements are met:
(A) Facility staff shall
contact the client's physician prior to each dose, describe the client's
symptoms, and receive direction to assist the client in self-administration of
that dose of medication.
(B) The
date and time of each contact with the physician, and the physician's
directions, shall be documented and maintained in the client's facility
record.
(C) The date and time the
PRN medication was taken, the dosage taken, and the client's response, shall be
documented and maintained in the client's facility record.
(D) For every prescription and
nonprescription PRN medication for which the licensee provides assistance,
there shall be a signed, dated written order from a physician on a prescription
blank, maintained in the client's file, and a label on the medication. Both the
physician's order and the label shall contain at least all of the following
information:
(1) The specific symptoms which
indicate the need for the use of the medication.
(2) The exact dosage.
(3) The minimum number of hours between
doses.
(4) The maximum number of
doses allowed in each 24-hour period.
(c) The isolation room or area specified in
Section 80087(d) shall be
used where separation from others is required.
(d) There shall be privacy for first aid
treatment of minor injuries and for examination or treatment by a physician if
required.
(e) In adult CCFs, when a
client requires oxygen the licensee is responsible for the following:
(1) Monitoring the client's ongoing ability
to operate and care for the equipment in accordance with the physician's
instructions, or if the client is unable to do so:
(A) Ensuring that an adequate number of
facility staff persons are designated to operate and care for the equipment and
that those staff persons receive.
1. The
licensee shall comply with all of the requirements for training in Sections
80075(b)(1)(A) through
(C).
(2) Ensuring that the following conditions
are met if oxygen equipment is in use:
(A)
The licensee makes a written report to the local fire jurisdiction that oxygen
is in use at the facility.
(B) "No
Smoking - Oxygen in Use" signs shall be posted in appropriate areas.
(C) Smoking is prohibited where oxygen is in
use.
(D) All electrical equipment
is checked for defects that may cause sparks.
(E) Oxygen tanks that are not portable are
secured either in a stand or to the wall.
(F) Plastic tubing from the nasal canula
(mask) to the oxygen source is long enough to allow the client movement within
his/her room but does not consitutute a hazard to the client or
others.
(G) Clients use oxygen from
a portable source when they are outside of their rooms or when walking in a day
care setting.
(H) Equipment is
operable.
(I) Facility staff have
knowledge and ability to operate and care for the oxygen equipment.
(J) Equipment is removed from the facility
when no longer in use by the client.
(f) Staff responsible for providing direct
care and supervision shall receive training in first aid from persons qualified
by agencies including but not limited to the American Red Cross.
(g) If the facility has no medical unit on
the grounds, first aid supplies shall be maintained and be readily available in
a central location in the facility.
(1) The
supplies shall include at least the following:
(A) A current edition of a first aid manual
approved by the American Red Cross, the American Medical Association or a state
or federal health agency.
(B)
Sterile first aid dressings.
(C)
Bandages or roller bandages.
(D)
Adhesive tape.
(E)
Scissors.
(F) Tweezers.
(G) Thermometers.
(H) Antiseptic
solution.
(h)
There shall be at least one person capable of and responsible for communicating
with emergency personnel in the facility at all times. The following
information shall be readily available:
(1)
The name, address and telephone number of each client's physician and dentist,
and other medical and mental health providers, if any.
(2) The name, address and telephone number of
each emergency agency, including but not limited to the fire department, crisis
center or paramedical unit. There shall be at least one medical resource
available to be called at all times.
(3) The name and telephone number of an
ambulance service.
(i)
When a client requires prosthetic devices, or vision or hearing aids, the staff
shall be familiar with the use of these devices and aids and shall assist the
client with their utilization as needed.
(j) Medications shall be centrally stored
under the following circumstances:
(1)
Preservation of the medication requires refrigeration.
(2) Any medication determined by the
physician to be hazardous if kept in the personal possession of the client for
whom it was prescribed.
(3) Because
of physical arrangements and the condition or the habits of persons in the
facility, the medications are determined by either the administrator or by the
licensing agency to be a safety hazard.
(k) The following requirements shall apply to
medications which are centrally stored:
(1)
Medication shall be kept in a safe and locked place that is not accessible to
persons other than employees responsible for the supervision of the centrally
stored medication.
(2) Each
container shall identify the items specified in (7)(A) through (G)
below.
(3) All medications shall be
labeled and maintained in compliance with label instructions and state and
federal laws.
(4) No person other
than the dispensing pharmacist shall alter a prescription label.
(5) Each client's medication shall be stored
in its originally received container.
(6) No medications shall be transferred
between containers.
(7) The
licensee shall ensure the maintenance, for each client, of a record of
centrally stored prescription medications which is retained for at least one
year and includes the following:
(A) The name
of the client for whom prescribed.
(B) The name of the prescribing
physician.
(C) The drug name,
strength and quantity.
(D) The date
filled.
(E) The prescription number
and the name of the issuing pharmacy.
(F) Expiration date.
(G) Number of refills.
(H) Instructions, if any, regarding control
and custody of the medication.
(l) Prescription medications which are not
taken with the client upon termination of services, or which are not to be
retained shall be destroyed by the facility administrator, or a designated
substitute, and one other adult who is not a client.
(1) Both shall sign a record, to be retained
for at least one year, which lists the following:
(A) Name of the client.
(B) The prescription number and the name of
the pharmacy.
(C) The drug name,
strength and quantity destroyed.
(D) The date of
destruction.
Notes
2. New subsections (a)(2)(A)-(B) and (h)-(h)(2)(J), subsection relettering, and amendment of NOTE filed 9-1-98; operative 10-1-98 (Register 98, No. 36).
3. Amendment filed 8-9-2002; operative 9-8-2002 (Register 2002, No. 32).
4. Repealer of subsections (b)(1)(B)-(b)(1)(B)2. and subsection relettering filed 12-13-2006; operative 1-12-2007 (Register 2006, No. 50).
5. Renumbering of subsections (i)-(o) to subsections (f)-(l) filed 2-6-2012; operative 3-7-2012 (Register 2012, No. 6).
6. Change without regulatory effect amending subsection (b)(1)(A) filed 1-5-2016 pursuant to section 100, title 1, California Code of Regulations (Register 2016, No. 2).
Note: Authority cited: Section 1530, Health and Safety Code. Reference: Sections 1501, 1502, 1507, 1530 and 1531, Health and Safety Code.
2. New subsections (a)(2)(A)-(B) and (h)-(h)(2)(J), subsection relettering, and amendment of Note filed 9-1-98; operative 10-1-98 (Register 98, No. 36).
3. Amendment filed 8-9-2002; operative 9-8-2002 (Register 2002, No. 32).
4. Repealer of subsections (b)(1)(B)-(b)(1)(B)2. and subsection relettering filed 12-13-2006; operative 1-12-2007 (Register 2006, No. 50).
5. Renumbering of subsections (i)-(o) to subsections (f)-(l) filed 2-6-2012; operative 3-7-2012 (Register 2012, No. 6).
6. Change without regulatory effect amending subsection (b)(1)(A) filed 1-5-2016 pursuant to section 100, title 1, California Code of Regulations (Register 2016, No. 2).
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