13 CSR 40-72.010 - Group Homes Offering Residential Care
PUBLISHER'S NOTE: The secretary of state has determined that the publication of the entire text of the material which is incorporated by reference as a portion of this rule would be unduly cumbersome or expensive. Therefore, the material which is so incorporated is on file with the agency who filed this rule, and with the Office of the Secretary of State. Any interested person may view this material at either agency's headquarters or the same will be made available at the Office of the Secretary of State at a cost not to exceed actual cost of copy reproduction. The entire text of the rule is printed here. This note refers only to the incorporated by reference material.
(1) Legal Basis for
Licensing. The Division of Family Services has responsibility for licensing
those persons offering care to groups of children. The primary purpose of
licensure is the protection of children. Sections 210.481-210.536, RSMo provide
for the defining, licensing, inspection and regulation of group care for
children. The law directs the division to publish rules for the licensing of
residential facilities and to assist the agencies, groups or individuals
subject to licensing in meeting these requirements for group child care.
(A) Definitions.
1. Child means an individual who is under the
age of eighteen (18) and the word children means more than one (1) such
individual.
2. Person is any
individual, corporation, partnership, association, firm, agency or institution
acting in concert regardless of the name used.
3. Director is the director of the Division
of Family Services.
4. Division is
the Division of Family Services.
5.
License is a legal document issued for a maximum of two (2) years to a person
authorizing him/her to provide care for children, subject to his/her compliance
with the law and applicable rules published by the division.
6. Provisional license means the nonrenewable
legal document issued by the division, for a maximum of six (6) months, to a
group home which is not currently meeting requirements for full licensure in
accordance with sections 210.481-210.536, RSMo and applicable rules promulgated
and issued by the division.
7.
Foster parent(s) are individuals who provide twenty-four (24)-hour care in
their home to a group of children not related to them by blood, marriage or
adoption.
8. Child care staff means
persons employed to provide care and supervision for the children in the group
home.
9. Staff means full- and
part-time employees other than foster parents and child care staff.
10. Well-known religious order, church and
religious organization are defined as follows:
A. A church, synagogue or mosque;
B. An entity that would qualify for federal
tax exempt status as a not-for-profit religious organization under Section
501(c) of the Internal
Revenue Code of 1954; or
C. An
entity where the real property on which the child care facility is located is
exempt from local taxation because it is used for religious
purposes.
11. Types of
care are-
A. Foster family group home. A
private home of foster parents who provide twenty-four (24)-hour care for seven
to twelve (7-12) children under the custody and supervision of the division
only. This type of care is not recommended for any child under the age of six
(6) years;
B. Independent foster
family group home. A private home, independent of any agency auspices, of
foster parents who provide twenty-four (24)-hour care for seven to twelve
(7-12) children in the custody of parents, relatives, guardian or agencies.
This type of care is not recommended for any child under the age of six (6)
years;
C. Satellite group home. A
group home operated by a licensed child caring or child placing agency in a
single dwelling or apartment owned, rented or leased by the agency. Child care
staff are employed by the parent agency to provide twenty-four (24)-hour care
for twelve (12) children or less. This type of care is not recommended for any
child under the age of six (6) years; and
D. Independent group home. A group home
privately operated by a person in a single dwelling or apartment which is
owned, rented or leased by the person. Child care staff are employed to provide
twenty-four (24)-hour care for twelve (12) children or less. This type of care
is not recommended for any child under the age of six (6) years.
(B) When a nonreligious
organization, having as its principal purpose the provision of child care
services, enters into an arrangement with a religious organization to provide
continuing assistance in the maintenance or operation of a child care facility,
the facility is not under the exclusive control of the religious organization
and does not qualify for exemption from licensure under sections
210.211(5) or
210.516.1(5).
(2) Rules for Foster Family and Independent
Foster Family Group Homes.
(A) Basic
Requirements for Foster Families.
1. Foster
parents shall have personal characteristics and have experienced relationships
which will make it possible for them to perform the responsibilities entailed
in caring for children. Foster parents shall be individuals who demonstrate
affection, an ability to care for children and to be responsive to their needs,
who can enjoy being foster parents; who can accept the individuality of each
child; who give of themselves without expecting immediate returns; who have
satisfactory interpersonal relationships; who have emotional stability and are
able to function in relation to family responsibilities and employment; who
have maturity and good physical health to enable them to provide appropriate
care for children; who have a reputable character, values and ethical standards
conducive to the well-being of children; who show flexibility in their ability
to change their expectations, attitudes and behavior in relation to the needs
and problems of children; who show ability to help in meeting problems of
family living; to recognize the need for and who have the ability to accept a
child's relationship with his/her parents or a social agency or both.
2. The foster parent-child ratio shall be at
least one to six (1:6).
3.
Relationships between all members of the foster family shall be such as to
assure a favorable influence and atmosphere for the children accepted for
care.
4. There shall be agreement
among the members of the foster family as to the advisability of the sharing of
their home for twenty-four (24)-hour care with a group of children not related
to the family.
5. The foster family
shall be economically self-sufficient.
6. At least three (3) nonrelated references
shall attest to the characteristics, motivations and abilities of the foster
family offering twenty-four (24)-hour care to children.
7. Health of foster family group home
members.
A. All members of the foster family
and employed staff shall pass a complete physical examination within six (6)
months prior to application. Their physician shall provide a statement that
each employee or member of the family is free from communicable disease. A
tuberculin test and/or chest X ray shall be completed if recommended by the
physician.
B. All members of the
foster family and employed staff must be determined by a physician to be in
good physical and mental health. The licensing agency shall review the
examination reports.
C. After
initial licensure, a physical examination is required every two (2) years. If
the licensing agency has reason to question the physical or mental health of
any member of the foster family or employed staff, the agency may require a
mental or physical examination more frequently.
8. A foster family shall care for a maximum
of twelve (12) children, including any children of the foster family. The
number of children in residence at any given time shall not exceed the number
for which it is licensed.
9. At
least one (1) foster parent shall not be gainfully employed.
(B) Care of the Child in the Group
Home.
1. Provision for any indicated services
shall be made available to the children in the group home. Services include:
family counseling; preventive and therapeutic medical services; psychological
services; psychiatric services; remedial education; vocational counseling;
recreation; and any other indicated social services.
2. Physical care.
A. Responsibility for medical and dental care
shall be negotiated between the placing agency and group facility before
admission of the child to the group facility.
(I) Provision shall be made for the services
of licensed physician.
(II)
Provision shall be made for hospital care when recommended by a
physician.
(III) Provision shall be
made for the correction or treatment of all remedial defects.
(IV) Children shall have a complete physical
examination, including any necessary tests or inoculations, immediately before
admission and at least annually thereafter. Results of the physical
examinations shall be on file in the group home.
(V) Children shall have annual dental
examinations and any necessary correction of teeth or mouth shall be
begun.
(VI) First-aid equipment
shall be readily available and foster parents shall be knowledgeable of its
use.
B. Hygiene. A
routine shall be established to insure good hygiene.
C. Nutrition.
(I) Food of good quality and quantity shall
be served and meet Department of Health's dietary standards.
(II) All foods shall be from sources approved
by the Department of Health. All milk shall be pasteurized.
(III) Nourishing between meal snacks shall be
provided and may be part of the daily food needs.
(IV) A regular meal schedule shall be
established.
(V) At all times food
shall be prepared, served and stored under the conditions acceptable to
Department of Health's rules.
D. Clothing.
(I) Clothing provided to children shall be of
good quality and quantity.
(II)
Clothing worn by children in group homes shall be similar to that worn by
children in average homes in the community.
(III) Children should be allowed to
participate in the selection of their own clothing.
3. Education.
A. The group home shall observe the legal
requirements regarding school attendance and child labor.
B. Educational experience or appropriate
training opportunities, or both, shall be made available to all children in
group homes.
4. Moral and
religious training. Children shall be given the opportunity to attend the
church of their choice, subject to parental approval of the biological
parents.
5. Discipline.
A. Discipline shall be used in a
constructive, fair and consistent manner.
B. All discipline shall be reasonable and
related to the individual needs and behavior of the child.
C. No cruel or unusual forms of punishment
shall be used; for example, no child shall be confined in any dark
spaces.
D. Corporal punishment
shall be not used.
E. Children
shall not be deprived of meals as punishment.
6. Recreation and leisure. The group home
shall provide for leisure time programs and activities.
7. Earning and spending money.
A. Children shall be provided with
opportunities for experience in earning or spending money or both based on age
and individual requirements.
B.
Allowances shall be provided when opportunities to earn money are not
available.
8.
Supervision.
A. Adult supervision shall be
available at all times. When there are more than six (6) children in residence
with only one (1) foster parent, there shall be a plan for an assistant to be
on call if there is an emergency.
B. It is recommended that the foster parents
provide for relief help in order that they may have some time away from the
children and for themselves alone. Meeting the constant demands in daily care
in a group of children can be an exhausting and exacting business. Time off
allows for rest and the ability to remain alert and responsive.
9. Transportation. If children are
transported in the foster family car, provision shall be made for proper
insurance coverage. Safety locks on doors and a seat belt for each child should
be provided.
(C) Physical
Facility.
1. General requirements.
A. The group home shall be in a neighborhood
that is readily accessible to school, recreational, religious and other
community resources. Suitable indoor and outdoor play space shall be available
to children of the appropriate age.
B. All buildings and immediate surroundings
used in whole or in part as a group home shall comply with all applicable state
and local building, sanitation, zoning, fire and safety regulations.
C. The group home shall be large enough to
provide living accommodations for all residents and shall be suitably furnished
and equipped.
D. The group home
shall be kept in sanitary condition and good repair.
E. Safe water supply and sewage facilities
shall be provided and shall comply with Department of Health's
requirements.
F. The home shall be
effectively safeguarded against insects and rodents.
G. Heating, electrical, ventilating and other
mechanical systems, home appliances and outlets shall be designed and
maintained so that under normal conditions of use danger to the health and
safety of the children from that equipment will be held to a minimum.
H. All rooms shall be well-lighted and
ventilated.
I. There shall be a
minimum of two (2) toilets for the children and one (1) tub or shower for each
six (6) children. Separate bathing and toilet facilities should be provided for
boys and girls where practical.
J.
Dining facilities shall be provided with space and equipment to serve all
residents at the same time.
K. The
kitchen shall be equipped to provide for food preparation, storage and
service.
L. A telephone shall be
provided with emergency instructions posted nearby for fire, police and medical
assistance.
M. The foster family
shall have a plan for evacuation of the group home in case of fire. Written
instructions for evacuation should be posted in a conspicuous place and fire
drills shall be held monthly to assure efficient evacuation of the facility in
case of emergency. Children shall be instructed in the evacuation plan at time
of admission.
2. Sleeping
rooms.
A. Children of different sex shall not
sleep in the same room.
B. All
sleeping rooms shall be outside rooms and shall be above the lowest level of
the ground.
C. Each child shall
have a separate bed with a space of at least three feet (3') on all sides of
the bed except where it touches the wall.
D. Third floor level sleeping quarters shall
be prohibited.
E. Sleeping rooms
shall be so located that night supervision will be available at all
times.
F. Separate, accessible
drawer space for personal belongings and closet space for clothing shall be
available for each child.
(D) Records and Reports.
1. Records shall be kept to identify each
child and to enable communication with the parents or person responsible for
the child in the foster family group home and in an emergency situation. These
shall include: child's name, birth date and the date of admission; full name of
both parents, or person or agency responsible for the child, family's home
address, work addresses, hours of work and telephone numbers; a written plan
which outlines the steps necessary to obtain emergency care for the child and a
written consent from the parent, person or agency responsible for the child
giving permission to proceed with any routine and ordinary medical care;
instructions for reaching the parent(s), guardian or agency; name, address and
telephone number of the child's or family's physician or both; financial
arrangements with the parents or others, including the rate of pay for care;
record of all physical examinations, immunizations and other pertinent health
information; record of any accidents, illnesses or unusual situation.
2. Reports to the division shall be submitted
as required.
(3) Rules for Independent and Satellite Group
Homes.
(A) Incorporation and Bylaws. The group
home or its parent body shall be incorporated. Bylaws shall be written and
usually include the following:
1. General
function of the organization as stated in the articles of
incorporation;
2. Frequency, time
and place of meetings, requirements regarding board members' attendance at
meetings and number necessary for a quorum;
3. Size, selection, duties and organization
of the board of directors;
4.
Appointment and duties of committees and staff; and
5. Provision for changes in the
bylaws.
(B) The Board of
Directors.
1. Every independent group home or
parent agency of a satellite group home shall have a governing board which is
representative of the community. The sources of an independent group home or
satellite group home's financing, the geographical area it encompasses and the
groups that it serves determine to some extend the desirable composition of its
board.
2. The board shall meet as
often as necessary to conduct the business of the agency, but at least three
(3) times annually.
3. Functions of
the board shall include:
A. Selection and
appointment of a well-qualified administrator to provide a program for children
according to policies set forth by the board.
B. Responsibility for funding a quality
program;
C. Responsibility for
formulating and reviewing the general program plans and policies of the group
home: operating procedures such as intake, release and day-to-day operations of
the group home; job descriptions and responsibilities of all staff; personnel
policies which include action to be taken regarding hiring, suspension,
termination and any appeal procedures available; and
D. Good public relations through presentation
and interpretation of the group home's services.
(C) Finances.
1. There shall be financial resources which
will provide a quality program of services for the group home.
2. Annual financial statements prepared by a
certified public accountant shall be made available to the division upon
request. The division shall hold all these statements confidential.
3. A budgetary estimate for each year shall
be prepared and approved by the board before the beginning of each
year.
(D) Personnel and
Personnel Practices. Administration shall establish personnel policies and
practices in compliance with the following guidelines:
1. Administrator or project director. When an
administrator or project director is appointed by the board of directors, s/he
shall-
A. Be qualified by education, training
or experience or both in the child care field;
B. Have administrative ability and be in full
charge of management of the group home in accordance with policies and
procedures established by the board;
C. Be a person of sound judgment;
D. Be temperamentally adapted to work with
children;
E. Attend board meetings,
participate in the formulation of policies and procedures and make reports
regularly to the board;
F. Assume
responsibility for interpretation to the board of all appropriate state laws
and rules for child caring facilities;
G. Provide opportunity for the continued
education and professional growth of staff; and
H. Be responsible for establishing and
maintaining good working relationships with other social agencies and, along
with the board members, provide interpretation of the group home's program to
the community;
2. Social
work staff.
A. The group home or parent agency
shall have the responsibility to see that social services are provided to each
child in care and his/her family.
B. If a social worker is employed by the
group home, s/he, as a minimum, shall have graduated from an accredited four
(4)-year college or university. Supervision or consultation shall be provided
by an individual who has achieved a graduate degree in social work or related
behavioral sciences;
3.
Child care staff. In the recruitment and selection of child care staff, careful
consideration shall be given tot he implications of having staff's biological
children living in the group home.
A.
Desirable qualifications are-a genuine liking for young people and some
understanding of their problems; practical experience in working with children;
the ability to give of themselves without demanding a warm response from the
children; good physical health with no disqualifying physical or mental
handicaps; emotional maturity; flexibility; a sense of humor; commitment to
helping problem youth; the ability to tolerate demanding and sometimes annoying
behavior; the ability to set limits and have reasonable expectations of the
children; the ability to work with the administrator or project director and
other staff members to understand and evaluate the children to make plans for
the child's treatment or living program, and to carry out these plans; and the
ability to communicate effectively with the children's parents and community
groups.
B. Child care staff shall
be at least twenty-one (21) years of age.
C. Child care staff shall have at least two
(2) work days off during each seven (7)-day period;
4. Staff/child ratio. Provision shall be made
for no less than one (1) staff member for each six (6) children in care and for
at least one (1) adult to be available at all times;
5. Staff development.
A. Regularly scheduled inservice training
sessions shall be established for staff and volunteers.
B. Additional learning experiences should be
made available through various resources such as workshops, seminars and child
care associations;
6.
Personnel policies and records.
A. Written
minimum qualifications as outlined in subsection (3)(D) for each staff position
shall be established and maintained on file.
B. Each staff member shall receive a written
job description.
C. Personnel
records shall be maintained on each staff member and shall include job
application; reports from references and former employer; the required annual
health report; and an annual evaluation prepared by the immediate
supervisor;
7.
Volunteers.
A. Services to be provided by the
volunteers shall be specifically defined.
B. Volunteers shall receive training and
supervision from a qualified staff member; and
8. Health requirements for staff.
A. Any person who is suffering from a
communicable disease shall not be employed.
B. All staff members having direct contact
with children shall have a physical examination before employment and annually
thereafter. A statement regarding the health status of each such employee shall
be signed by a licensed physician and be on file.
C. Each staff member shall have a yearly
tuberculin skin or chest X ray, tests for venereal diseases and any other
indicated laboratory procedures.
(E) Program.
1. Intake policies.
A. Intake policies and procedures shall be
written and shall include acceptable referral sources, admission criteria and
other forms or reports necessary before a child is considered for placement.
Admission procedures, policies and planning shall include preparation of the
child and parents as appropriate with preadmission visits planned for both
parent and child whenever possible.
B. The division shall review the criteria for
admission for its appropriateness to the program of the group home.
C. Criteria for admission to a group home
shall include the following:
(I) The
appropriate age range and sex for the facility in question;
(II) Able to benefit from and contribute to a
group living experience;
(III) Able
to attend school or be employed in the community, able to utilize community
resources and to move about the community freely with a minimum of
supervision;
(IV) Preschool age
children shall not be admitted except on an emergency basis not to exceed a
period of thirty (30) days, unless the children are members of a sibling group
and it is considered to be in their best interest to remain together.
D. The number of children in
residence at any given time shall not exceed the number for which the facility
is licensed.
E. Written provision
for medical care shall be required from the person legally responsibility for
the child.
F. Visitation policy
shall be clearly written and available to both parent and child before or at
time of admission.
G. Information
shall not be released on the child without permission from the person legally
responsible for the child.
2. Plan of services for the child and family.
The group home shall collaborate with the child, parent, referring agency or
parent agency in preparing a written plan for services for the child and
family. This plan for services shall include:
A. A statement of goals and objections for
providing services to the child and family including social work services on a
regular basis for each child; responsibilities assumed by parents, agency and
court and tentative plans for discharge;
B. Provision for services needed by the child
and family where indicated including: family counseling; preventive and
therapeutic medical services; psychological services; psychiatric services;
remedial education; vocational counseling, recreation; and any other indicated
social services;
C. Regular review
of plans for the services for the child and family at least every six (6)
months;
D. Release of a child shall
be part of a well-planned, individualized program with the decision being made
in a conference with appropriate staff or other group home representative, the
referring or parent agency and the child's family; and
E. The group home should make arrangement
with the referring agency to assure aftercare services to the child in his/her
new environment.
3.
Records and reports.
A. Care records.
(I) Every group home shall keep on file a
record of each child's birth date, correct name, names of parents and relatives
and name of the contact person with the referring agency.
(II) The record shall also provide a health
history of the child, including immunizations and an account of any illness or
injury suffered while in care of the group home.
(III) The record shall include a statement
regarding plan of services for the child and his/her family.
(IV) There shall be a school
record.
(V) There shall be
information in the record concerning the child's release. This should include
the date of discharge, the name, address and relationship of the person(s)
taking him/her and the circumstances of release.
(VI) The records shall be
confidential.
B. Every
group home shall keep accurate listings of children in care and statistical
reports that give the complete scope of the services provided.
C. All records and reports shall be available
upon request to any authorized licensing agent of the division. Records may be
destroyed three (3) years after the date of the child's discharge.
(F) Care in the Group
Home.
1. Physical care.
A. Responsibility for medical and dental care
shall be negotiated between the placing agency and group facility before
admission of the child to the group facility.
(I) Provision shall be made for the services
of a qualified physician licensed in the state of Missouri.
(II) Provision shall be made for hospital
care when recommended by a physician.
(III) Provision shall be made for the
correction or treatment for remediation of defects.
(IV) Provision shall be made for a physical
examination, tests or inoculations for each child immediately before admission
and at least annually thereafter. Results of the physical examination shall be
on record in the group home for these children and for any child placed by a
parent agency.
(V) Provision shall
be made for an annual dental examination for each child.
(VI) First-aid equipment shall be readily
available and child care and other staff shall be knowledgeable of its
use.
(VII) Health education and
preventative medical care should be a major part of the health
services.
B. Hygiene. A
routine shall be established to insure good personnel hygiene.
C. Nutrition.
(I) Food of good quality shall be served and
meet Department of Health's standards.
(II) All foods shall be from sources approved
by the Department of Health. All milk shall be pasteurized.
(III) Nourishing between-meal snacks shall be
provided and may be part of the daily food needs.
(IV) A regular meal schedule shall be
established.
(V) At all times food
shall be prepared, served and stored under conditions acceptable to Department
of Health's rules.
D.
Clothing.
(I) Clothing provided to children
shall be of good quality and quantity.
(II) Clothing shall be similar to that worn
by children in average homes in the community.
(III) Children should be allowed to
participate in the selection of their own clothing.
2. Education.
A. The group home shall observe the legal
requirements regarding school attendance and child labor.
B. Educational experience or appropriate
training opportunities or both shall be made available.
3. Moral and religious training. Children
shall be given the opportunity to attend the church of their choice, subject to
parental approval.
4. Discipline.
A. Discipline shall be used in a
constructive, fair and consistent manner.
B. All discipline shall be reasonable and
related to the individual needs of the child.
C. No cruel or unusual forms of punishment
shall be used, for example, no child shall be confined in any dark
spaces.
D. Corporal punishment
shall not be used.
E. Children
shall not be deprived of meals as punishment.
5. Recreation and leisure. The group home
shall provide leisure time activities.
6. Earning and spending money.
A. Children shall be provided with
opportunities for experience in earning or spending money or both based on age
and individual requirements.
B.
Allowances shall be provided when opportunities to earn money are not
available.
(G)
Physical Facility.
1. General requirements.
A. The group home shall be in a neighborhood
that is readily accessible to school, recreational, religious and other
community resources.
B. All
buildings and immediate surroundings used in whole or in part as a group home
shall comply with all applicable state and local building, sanitation, zoning,
fire and safety regulations.
C. The
facility shall be of a size to provide living accommodations for all residents,
including separate and comfortable quarters for child care staff. The facility
shall be suitably furnished and equipped.
D. The facility shall be kept in sanitary
condition and good repair.
E. Safe
water supply and sewage facilities shall be provided and shall comply with
Department of Health's requirements.
F. The home shall be effectively safeguarded
against insects and rodents.
G.
Heating, electrical, ventilating and other mechanical systems, home appliances
and outlets shall be designed and maintained so that under normal conditions of
use, danger to the health and safety of the children from that equipment will
be held to a minimum.
H. All rooms
shall be well-lighted and ventilated.
I. There shall be minimum of one (1) toilet
for every four (4) children and one (1) tub or shower for each six (6)
children. Separate bathing and toilet facilities should be provided for boys
and girls where practical. There should also be separate toilet facilities for
child care staff.
J. Dining
facilities shall be provided with space and equipment to serve all
residents.
K. The kitchen shall be
equipped to provide for food preparation, storage and service.
L. A telephone shall be provided with
emergency instructions posted nearby for fire, police and medical
assistance.
M. Written fire drill
procedures should be posted in a conspicuous place. Fire drills shall be held
monthly. Children shall be instructed in the evacuation plan at time of
admission.
2. Sleeping
rooms.
A. Children of different sex shall not
sleep in the same room.
B. All
sleeping rooms shall be outside rooms and shall be above the lowest level of
the ground.
C. Each child shall
have a separate bed with a space of at least three feet (3') on all sides of
the bed except where it touches the wall.
D. Third floor level sleeping quarters shall
be prohibited.
E. Sleeping rooms
shall be so located that night supervision will be available at all
times.
F. Separate, accessible
drawer space for personal belongings and closet space for clothing shall be
available for each child.
(H) Hearing and Judicial Review.
1. Entitlement to a hearing and review. Any
person or organization aggrieved by a final decision of the division with
regard to the license issuance, license revocation or license denial shall be
entitled to a hearing and review by the director or his/her designee.
2. Written notice and request for hearing.
Ten (10) days' written notice, specifying reason for proposed revocation shall
be given an agency before a revocation occurs. If a request for a hearing,
either written or verbal is received within the ten (10)-day period, revocation
shall not occur until the decision of the director is issued.
3. Appeal of administrative decision. Any
agency wishing to appeal the administrative decision of the director shall be
entitled to judicial review as provided in Chapter 536, RSMo.
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.