N.H. Admin. Code § He-C 4001.14

Current through Register No. 50, December 12, 2024

Section He-C 4001.14 - Prevention and Management of Injuries, Incidents, Emergencies and Infection Control

(a) The program shall develop policies for how direct care staff shall respond to incidents, including but not limited to:

(1) Addressing threats of self-harm and suicidal behaviors by residents;

(2) Medical emergencies;

(3) Addressing threatening behaviors such as physical and sexual assaults on other residents or staff;

(4) The reporting requirements in He-C 4001.23(g);

(5) Screening any child who runs away for indications that the child may be a victim of human trafficking and notifying necessary personnel;

(6) Managing the behavior of children, including how and under what circumstances seclusion or restraint is used, pursuant to RSA 126-U:2;

(7) Accessibility to respite or temporary care arrangements; and

(8) How staff will be orientated and trained in accordance with He-C 4001.19(k) and (l) to prepare to work with the population served by the program.

(b) All program staff responsible for the care and supervision of residents shall be familiar with the program's policies and procedures for managing injuries and emergencies and have access to information necessary to handle emergencies.

(c) Each building that residents will spend time in shall be equipped with a telephone that is operable and accessible to residents and staff for incoming and outgoing calls.

(d) The licensee shall maintain an information data sheet in the resident's record and promptly give a copy to emergency medical personnel in the event of an emergency transfer to a medical facility.

(e) The information data sheet referenced in (d) above shall include:

(1) Full name and the name the resident prefers, if different;

(2) Name, address, and telephone number of the resident's parent(s), guardian, or agent, if any;

(3) Diagnosis;

(4) Medications, both prescription and over the counter, including last dose taken and when the next dose is due;

(5) Allergies;

(6) Functional limitations;

(7) Date of birth;

(8) Insurance information; and

(9) Any other pertinent information not specified in (1)-(8) above.

(f) At least one residential child care program staff person, who is trained and currently certified in cardiopulmonary resuscitation (CPR) and first aid by the American Red Cross, American Heart Association, Emergency Care and Safety Institute, National Safety Council or other nationally recognized organization or an individual certified by such organization to train, shall be present:

(1) In each building that is used as a residence, at all times when residents are present; and

(2) When residents are participating in any field trips off the premises of the residential child care program.

(g) The residential child care program director or designee shall obtain and maintain on file, available for review by the department, copies of current CPR and first aid certifications documenting coverage as required in (f) above.

(h) Each building and program vehicle that is used by residents shall be equipped with first aid supplies adequate to meet the needs of the residents.

(i) The first aid supplies shall be stored in a container that is accessible by residential child care program staff but not accessible to residents.

(j) First aid supplies adequate to meet the needs of the residents shall be available during all field trips.

(k) When the first aid treatment provided for minor scrapes or bruises is not effective or when a resident's injury is more than a minor scrape or bruise, residential child care program staff shall:

(1) If the injuries appear to be life threatening or appear to be severe, call emergency medical services for transport to a medical facility by ambulance;

(2) For all other injuries, take the injured resident to a licensed health care practitioner for medical evaluation and treatment;

(3) As soon as possible after the injury occurs, notify the person or agency responsible for the resident's placement and the parents of the injured resident whenever possible; and

(4) Complete a written incident report as specified in He-C 4001.23(a) and (b) within 24 hours of the incident.

(l) The program director or designee shall notify the unit, the parent, and the person or agency responsible for the resident's placement within 24 hours of the death of any resident.

(m) The program director or designee shall provide a written report, detailing the circumstances of the death, to the unit and the person or agency responsible for the resident's placement, within 72 hours of the death of any resident.

(n) In (l) or (m) above, in cases involving serious injury or death to a resident subject to restraint or seclusion in a program, the program shall, in accordance with and addition to the provisions of RSA 126-U:10, notify the commissioner, the attorney general, and the disability rights center (DRC). Such notice shall include the notification required in RSA 126-U:7, II.

(o) The program director or designee shall conduct fire drills once each month in each building that is used as residential child care space.

(p) Monthly fire drills required in (o) above shall be held at varying times, including night time hours.

(q) Programs shall activate the actual fire alarm system for the building for at least 2 of the monthly fire drills required each year.

(r) Programs shall ensure that all residents and program staff evacuate the building during each fire drill including, if applicable, descent using the route designated on the posted fire evacuation plan.

(s) The staff person conducting the fire drill shall complete a written record of each fire drill that shall:

(1) Be maintained on file at the program for one year; and

(2) Be available for review by the fire inspector and the department.

(t) The written record of fire drills required under (s) above shall include at least the following:

(1) The date and time the drill was conducted, and whether the actual fire alarm system was activated;

(2) Exits used;

(3) Number of residents evacuated and total number of people in the building at the time of the drill;

(4) Name of the person conducting drill;

(5) Time taken to evacuate the building;

(6) Any problems encountered; and

(7) A plan for correcting those problems.

(u) The program director or designee shall conduct a fire drill in the presence of a representative of the department or the local fire department upon request by either of those entities.

(v) If providing withdrawal management, any new SCPs shall comply with the appropriate chapter of NFPA 101 as published by the National Fire Protection Association and as amended by the state board of fire control and ratified by the general court pursuant to RSA 153:5, consistent with the level of needs of residents being served.

(w) All programs shall have:

(1) Smoke detectors as approved in accordance with the State Fire Code, under RSA 153:1, VI-a, Saf-C 6000, and Saf-FMO 300, including but not limited to NFPA 1 and NFPA 101, as amended by the state board of fire control and ratified by the general court pursuant to RSA 153:5, consistent with the appropriate level of care being provided by the program;

(2) At least one UL Listed, ABC type portable fire extinguisher, with a minimum rating of 2A-10BC installed on every level of the building with a maximum travel distance to each extinguisher not to exceed 50 feet and maintained as follows:

a. Fire extinguishers shall be inspected either manually or by means of an electronic monitoring device or system at least once per calendar month, at intervals not exceeding 31 days;

b. Records for manual inspection, or electronic monitoring shall be kept to demonstrate that at least 12 monthly inspections have been performed;

c. Annual maintenance shall be performed on each extinguisher by trained personnel, and a tag or label shall be securely attached that indicates that maintenance was performed; and

d. The components of the electronic monitoring device or system in a. above, if used, shall be tested and maintained annually in accordance with the manufacturers listed maintenance manual; and

(3) A carbon monoxide monitor on every level of the program, in accordance with Saf-C 6015.04.

(x) An emergency and fire safety program shall be developed and implemented to provide for the safety of residents and personnel.

(y) In addition to the policies required in (a) above, the program shall develop and implement an emergency operations plan (EOP), which shall:

(1) Be based on the incident command system and coordinated with the emergency response agencies in the community in which the residential program is located;

(2) Contain guidelines for personnel responsible for critical tasks, including, but not limited to the role of center incident commander, child care, medical treatment, and parental notification; and

(3) Include response actions for natural, human-caused, or technological incidences including, but not limited to:

a. Evacuation, both within building and off-site, relocation;

b. Secure campus;

c. Drop, cover, and hold;

d. Lockdown;

e. Reverse evacuation;

f. Shelter-in-place; and

g. Bomb threat and scan.

(z) Programs shall develop a continuity of operations plan (COOP) to ensure that essential functions continue to be performed during, or resumed rapidly after, a disruption of normal activities.

(aa) All response actions in (y)(3) above shall include accommodations for children with chronic medical conditions, and children with disabilities or with access and functional needs.

(ab) Programs shall practice no less than 2 components of their EOP as described in (y) above with all staff and children at least twice per year.

(ac) All staff shall review the program's EOP in accordance with the following:

(1) For currently employed staff, within the first 30 days of the development of the EOP pursuant to (y) above; or

(2) For newly hired staff, within the first 30 days of employment.

(ad) In each building of the residential program, the written policies and procedures in (a) above and the EOP in (y) above shall be in an area easily accessible and known to residential staff.

(ae) Programs operating an SCP shall appoint an individual who will oversee the development and implementation of an infection control program that educates and provides procedures for staff for the prevention, control, and investigation of infectious and communicable diseases.

(af) The infection control program shall include written procedures for:

(1) Proper hand washing techniques;

(2) The utilization of universal precautions;

(3) The management of residents with infectious or contagious diseases or illnesses;

(4) The handling, storage, transportation, and disposal of those items identified as infectious waste in Env-Sw 904; and

(5) The reporting of infectious and communicable diseases as required by He-P 301.

(ag) The infection control education program shall address at a minimum the:

(1) Causes of infection;

(2) Effects of infections;

(3) Transmission of infections; and

(4) Prevention and containment of infections.

N.H. Admin. Code § He-C 4001.14

#2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-06

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14

Amended byVolume XXXIV Number 46, Filed November 13, 2014, Proposed by #10705, Effective 10/23/2014, Expires10/23/2024.

Amended by Volume XLI Number 06, Filed February 11, 2021, Proposed by #13151, Effective 12/30/2020, Expires 12/30/2020.

The amended version of this section by New Hampshire Register Number 24, eff. 5/29/2024 is not yet available.

The amended version of this section by New Hampshire Register Number 50, eff. 11/26/2024 is not yet available.