Current through Register Vol. XLI, No. 50, December 13, 2024
Section 78-3-12 - Service Environment12.1. The organization shall meet all applicable federal, state, and local health, building, safety, and fire codes.12.2. Food Services. 12.2.1. Food shall be stored, prepared, and served according to local health department regulations.12.2.2. Use of paper or disposable plates, beverage containers, and utensils are to be limited and not used in day-to-day meal service. Outdoor therapeutic educational programs are exempt from this requirement when operating in the field.12.3. Transportation. 12.3.1. An organization that provides transportation in its vehicles for children as part of a service shall have procedures for ensuring:12.3.1.a. The use of age-appropriate passenger restraint systems;12.3.1.b. Adequate passenger supervision relative to the ages, sexes, behavioral challenges, and disabilities of the children;12.3.1.c. Proper and timely licensure and inspection of the vehicles;12.3.1.d. First aid kits in each organizational vehicle;12.3.1.e. Proper and timely maintenance of vehicles;12.3.1.f. That the number of persons in any vehicle used to transport children shall not exceed the number of available safety restraint systems;12.3.1.g. Sufficient liability insurance;12.3.1.h. Adequate aisle space in vans transporting wheelchair-bound children;12.3.1.i. Secure anchoring for wheelchairs except in automobiles; and12.3.1.j. Annual validation of driver licenses.12.3.2. An organization that permits the transportation of persons served in vehicles that belong to employees shall require:12.3.2.a. Passenger insurance coverage either through the organization's insurance or the driver's automobile liability insurance;12.3.2.b. Proof of insurance;12.3.2.c. Age-appropriate passenger restraints for all passengers;12.3.2.d. Annual validation of the driver's license; and12.3.2.e. Current registration and inspection validated annually.12.4. Organization Safety and Security. 12.4.1. The organization shall have a schedule of regular inspection and maintenance activity to ensure the safety of its premises, equipment, and fixtures.12.4.2. The organization shall have fire extinguishers reviewed by a qualified professional annually.12.4.3. The organization shall not maintain any firearm or chemical weapon on the grounds or within the structures of the facility.12.4.4. All power-driven equipment used by a facility shall be kept in safe and good repair. The equipment shall be used by children only under the supervision of an employee and according to state code. Lawn mowers shall be stored in areas separated with one-hour fire rated material.12.4.5. The organization shall have a Safety Committee or designated safety and maintenance officer whose function is to perform regular documented inspections for identification of potentially hazardous conditions (e.g., harmful water temperatures, improper use of small appliances, stairs without handrails, etc.) and items in need of repair or maintenance. At no time shall those inspections be less than quarterly.12.5. Emergency Response.12.5.1. The organization shall have procedures in place for responding to accidents, serious illness, fire, medical emergencies, floods, natural disasters, and other life-threatening situations that:12.5.1.a. Address the needs of any special population served by the organization;12.5.1.b. Specify evacuation procedures including an evacuation site, parties to notify, and emergency items to take when evacuating;12.5.1.c. Describe relocation plans for the service or program if it becomes necessary;12.5.1.d. Specify appropriate responses to medical emergencies; and12.5.1.e. Require notification of the child's parent or guardian and other appropriate authorities at the earliest opportunity.12.5.2. Residential facilities shall conduct monthly fire drills rotating all shifts at least once per quarter and shall meet legal requirements for fire drills as specified by the State Fire Marshal. Participation shall be mandatory for all employees and children. Organizations that do not operate by shifts (e.g., outdoor therapeutic educational programs) shall have monthly fire drills at various times of the day and night.12.5.3. The organization shall have procedures for dealing with injuries, accidents, and illnesses. The organization shall ensure that a communication device and first aid supplies are readily available in all organization buildings.12.5.4. The organization shall have procedures in place for dealing with: 12.5.4.a. Persons who are injured, lost or absent from care without permission; and12.5.4.b. Persons who threaten violence or harm to themselves or employees providing care and/or supervision.12.5.5. The organization shall assign an employee to orient each newly arrived child to organization emergency procedures and the location of emergency exits as appropriate during the first full day of the child's stay at the organization. The employee shall file a written confirmation in the child's case record that the orientation has taken place.12.5.6. The organization shall ensure that all employees have immediate access to current poison control information or procedures for referral for emergency medical attention.12.6. Contagious and Infectious Diseases.12.6.1. The organization shall have a procedure in place for minimizing the risk of exposure to airborne and blood-borne pathogens by implementing the use of Universal Safety Precautions. Procedures shall comply with related standards of the Centers for Disease Control and the Occupational Safety and Health Administration.12.6.2. The organization shall develop policies and procedures to prevent and control the spread of HIV/AIDS, hepatitis, tuberculosis, and other contagious or infectious diseases and shall review and update those policies as necessary or every two years at a minimum.12.6.3. The organization shall have policies that ensure that employees with direct contact with children:12.6.3.a. Receive a tuberculosis risk assessment or test prior to assumption of duties and at least every five years thereafter, as well as after incidents of exposure or manifestation of symptoms of tuberculosis; and12.6.3.b. Demonstrate completion of an approved treatment when test results are positive.12.6.4. The organization that prepares food for children shall have policies and procedures to ensure clean and safe food preparation and prevent the exchange of communicable diseases. The procedures shall:12.6.4.a. Require that food service employees do not prepare or serve food if they have symptoms of acute illness or an open, untreated wound;12.6.4.b. Set forth minimum dishwashing and laundry water temperatures to kill bacteria; and12.6.4.c. Conform with the requirements for food service as specified by the Department's rule, "Food Establishments," 64CSR17, including as appropriate, current food handler's cards.12.6.5. The organization shall immediately notify the health officer of the county in which it is located of any known or suspected cases of communicable diseases that are required by law to be reported.12.7. Building Exteriors and Grounds.12.7.1. An organization shall ensure that buildings, grounds, and recreational areas owned or leased by the organization are maintained in good repair and free from reasonable danger to health or safety.12.7.2. Children and transitioning adults shall have access to outdoor recreational space and suitable recreational equipment that is in good repair and free from defects.12.8. Interior Space. 12.8.1. Each living unit of an organization shall contain space for the free and informal use of children in care.12.8.2. Dining areas shall be arranged so as to allow children, employees, and guests to eat together in small groups.12.8.3. Dining areas shall be well-lighted, ventilated and appropriately furnished.12.8.4. Except for outdoor therapeutic educational programs, there shall be a minimum of 60 square feet per occupant in bedrooms. Bedrooms for single occupants shall have a minimum of 70 square feet.12.8.5. No more than four children may occupy a designated bedroom space.12.8.6. The bedroom space shall have a direct source of natural light.12.8.7. Except for outdoor therapeutic educational programs, each child shall have his or her own bed with sufficient linens and covers. Linen shall be changed at least weekly, but more frequently if necessary. Cots or other portable beds are not to be used on a routine basis. The uppermost mattress of any bunk bed in use shall be far enough from the ceiling to allow the occupant to sit up in bed.12.8.8. Each child shall have his or her own dresser or other storage space for private use, and a designated space for hanging clothes and placing possessions.12.8.9. Bathrooms and plumbing fixtures shall be kept clean and maintained in good repair.12.8.10. Water temperatures in sinks, showers, and bathtubs shall not exceed 120 degrees Fahrenheit. There shall be a safe and adequate supply of potable hot and cold running water. Water from any source other than a public water supply shall be tested annually by the appropriate state or local authority in accordance with state or local law.12.8.11. Fixtures in bathrooms shall be situated so as to be accessible to the average sized child of the household. If the organization serves individuals with physical challenges, accessible or adapted equipment shall be provided and there shall be sufficient space in the bathroom to permit employee assistance if necessary.12.8.12. A facility shall have one toilet, one lavatory and one bathtub or shower for every six children, at a minimum. 12.8.12.a. Bathroom floors and walls shall be moisture resistant and non-absorbent.12.8.13. There shall be no open flame heaters in any facility operated by the organization and used by children.12.8.14. Bathroom and bedroom facilities shall allow individual privacy unless there is a clear, clinical justification otherwise that shall be documented on the plan of care. There shall be doors on sleeping areas and bathrooms that can be readily opened from both sides.12.8.15. No locks shall be placed on any door that hinders the exit of a person from that area. Locks may be used to restrict access to certain areas but must not require a key to exit. Upon written approval by the Secretary, a facility may use delayed-egress electrically locking systems. The facility shall submit a written request that includes (i) the area(s) where the delayed-egress electrically locking systems will be used; (ii) documentation from State Fire Marshal that the delayed-egress electrically locking systems complies with all building and fire codes; and (iii) the reason the delayed-egress electrically locking system is necessary to serve the children in the facility. The Secretary shall determine if the needs of the children served by facility require this level of restriction given the need for children to maintain normalcy. The Secretary may revoke the approval at his or her sole discretion.12.8.16. Kitchens used for meal preparation shall be provided with the necessary equipment for the preparation, storage, serving and cleanup of all meals for all the children and employees regularly served by the kitchen. All equipment shall be maintained in working order. Kitchens serving more than eleven children shall meet all applicable provisions of the Department's rule, "Food Establishments," 64CSR17. Kitchens serving less than twelve may use a family-type kitchen provided that: 12.8.16.a. Food shall be protected from contamination during storage, preparation, and service;12.8.16.b. Food contact utensils and equipment shall be of appropriate material, easily cleaned and maintained in good repair;12.8.16.c. Refrigeration equipment shall assure the maintenance of food at or below 45 degrees Fahrenheit; and12.8.16.d. Kitchen sinks shall have at least two bowls. If a dishwasher is used, the temperature shall reach a level sufficient to sanitize dishes. If no dishwasher is used, proper sanitation treatments in the washing process shall be used.12.8.17. An organization using live-in employees or house parents shall provide adequate, separate living space for these employees. 12.8.17.a. A bed shall be provided in employee quarters for live-in employees or house parents.12.8.17.b. Employees shall not share bedrooms with children.12.8.18. Furniture provided for children shall be appropriately designed to meet the size and capabilities of the children. Furnishings shall be maintained in good repair.12.8.19. An organization shall have securely locked storage spaces for all potentially harmful materials. Poisonous or toxic materials shall be stored in locked storage spaces not used for any other purpose.12.8.20. Drugs, employee files and case records are to be kept in locked storage spaces with authorized access only.12.8.21. Any room, corridor or stairway within a facility shall be sufficiently illuminated. Corridors in sleeping areas shall be illuminated at night.12.8.22. Each separate living unit within an organization shall have telephone service.12.8.23. Every access and exit to the building shall be continuously maintained free of all obstruction or impediments to immediate use.12.8.24. The use of candles is prohibited.12.8.25. Children shall swim only in areas that are supervised by a certified individual. A certified individual shall have a current water safety instructor certificate or senior lifesaving certificate from the Red Cross.12.8.26. On ground pools shall be in a secured area and shall comply with the Department's rule, Recreational Water Facilities, 64CSR16.12.8.27. Windows shall have insect screening unless the facility is centrally air-conditioned. The screening should be readily removable in emergencies and shall be in good repair. All exterior doors shall be close fitting and self-closing.