W. Va. Code R. § 78-3-21

Current through Register Vol. XLI, No. 50, December 13, 2024

Section 78-3-21 - Program-specific Rules for Maternity and Parenting Facilities

21.1. Maternity Care.

Care to a pregnant or parenting adolescent or transitioning adult includes, but is not limited to:

21.1.1. Appropriate health care and health education;

21.1.2. Education needs specific to the pregnant or parenting youth;

21.1.3. Nutritional guidance and support;

21.1.4. Counseling services specific to making decisions and planning for his or her child;

21.1.5. Parenting educational services; and

21.1.6. Maintenance of an environment conducive to the safety of children (infant through toddler) and pregnant women.

21.2. Appropriate Health Care and Health Education.

21.2.1. The organization shall provide or arrange for health services to the expectant and parenting youth that includes:

21.2.1.a. A written health summary, including family medical history, immunizations, surgical procedures, and childhood illnesses;

21.2.1.b. A general medical examination that will occur at the time of admission, and an obstetrical/gynecological examination for the pregnant youth within the first two weeks of admission or sooner if the youth is considered to be high risk;

21.2.1.c. Thorough medical supervision of the pregnancy, including all needed prenatal care; testing and post-natal care shall be done by an appropriately licensed health care professional with a specialization in women's health; and

21.2.1.d. Direct provision or referral for services to meet the needs of high-risk pregnancy or high-risk infant care-related issues.

21.2.2. Registered nursing employees with obstetrical/gynecological experience are to be available on the grounds at least 12 hours per day, with 24-hour availability onsite.

21.2.3. The pregnant or parenting youth shall receive ongoing health education with age-appropriate instruction regarding pregnancy prevention, HIV/AIDS prevention, and general information about the prevention and treatment of disease.

21.2.4. The organization shall be located within 15 minutes of a hospital or birthing center that provides maternity care and labor and delivery services.

21.2.5. Standing medical orders for pregnant youth shall be carefully evaluated and shall take into consideration cautions necessary for pregnant youth.

21.2.6. All pregnant or parenting youth shall have access to educational services as appropriate:

21.2.6.a. All pregnant or parenting youth, once assessed, shall participate in some type of educational service such as GED classes, public school, or alternative education;

21.2.6.b. Child care services shall be in close proximity to the education facilities; and

21.2.6.c. Supportive services for child care shall be available to assure that the youth can have necessary study time.

21.3. Nutritional Guidance and Support.

21.3.1. All parenting and pregnant youth will be assessed at a minimum within the first 30 days of admission by a registered dietitian unless dietary problems are indicated at admission.

21.3.2. Ongoing dietary support shall be encouraged through a nutritional education program and if indicated by individual instruction provided by the registered dietitian or registered nurse.

21.3.3. All pregnant and parenting youth shall receive counseling services specific to parenting and alternative choices, on an ongoing basis.

21.3.4. The organization shall have policy and procedures related to the involvement of the putative father of the baby.

21.3.5. Supportive counseling services will be extended to the family of the young woman, the biological father (unless contra-indicated by court order) and the family of the biological father.

21.3.6. The organization shall offer an ongoing parent education program with a curriculum that comprehensively addresses at a minimum, the following topics:

21.3.6.a. Personal growth and maturity;

21.3.6.b. Interpersonal relationships;

21.3.6.c. Early childhood development;

21.3.6.d. Infant stimulation, cognitive development, and bonding/attachment;

21.3.6.e. Safety and accident prevention, including First Aid and CPR;

21.3.6.f. Physical care, nutrition, and health of infants and young children;

21.3.6.g. Signs and symptoms of child abuse and neglect;

21.3.6.h. Time, budget, and household management;

21.3.6.i. Community resources that provide assistance; and

21.3.6.j. Child care use and how to choose providers.

21.3.7. Parenting education may be offered in both a formal and informal setting using classroom instruction, small groups, and individual and experiential teaching methods, based on the needs of the youth.

21.3.8. The organization shall maintain an environment conducive to the safety of a child (infant through toddler) and a pregnant or parenting youth.

21.3.9. The facility shall contain at least one area for routine medical examination, counseling, and treatment for clients. This area shall be private and in adherence with all universal precautions, Occupational Safety and Health Administration (OSHA) standards and best medical practice.

21.3.10. All living areas shall be maintained in good repair and meet the Child Product Safety Commission (CPSC) guidelines.

21.3.11. The exposure of the pregnant teen and infant to cleaning supplies and pesticides should be limited. The organization shall be cognizant of the possible side effects of exposure and limit it accordingly.

21.4. Baby Care.

21.4.1. An organization shall provide a plan of care for babies that includes, but is not limited to the following:

21.4.1.a. Appropriate health care;

21.4.1.b. Appropriate daily care; and

21.4.1.c. Appropriate daily stimulation.

21.4.2. An organization shall also provide:

21.4.2.a. A warm and child friendly environment; and

21.4.2.b. Employees specifically trained to meet the needs of infants through toddlers.

21.4.3. The organization shall document that all babies receive a thorough assessment prior to leaving the hospital or at the time of admission to the organization.

21.4.4. The organization shall assure that all children receive health care according to the Early Periodic Screening, Diagnosis and Treatment Program (EPSDT) standards of care.

21.4.5. The organization shall have policy and procedures to assure that the health and well-being of the child is protected once he or she leaves the hospital.

21.4.6. The organization shall have policy and procedures to assess and treat babies and children who show signs of illness that include but are not limited to diarrhea, vomiting, fever, etc.

21.4.7. If at any time the baby's mother is unable or refuses to care for her baby, the organization shall have policy and procedures to assure that appropriate interventions are used to secure the health of the child.

21.4.8. Appropriate daily care:

21.4.8.a. The organization shall ensure that all babies have the necessities to meet their basic daily needs.

21.4.8.b. The organization shall ensure the basic needs of the baby are consistently met;

21.4.8.c. All babies under twelve months of age shall have a feeding and diet plan prescribed by the physician.

21.4.9. The organization shall handle breast milk and formula in the following manner:

21.4.9.a. Prepared bottles shall be capped and clearly labeled with the child's name, contents, and the date prepared;

21.4.9.b. Prepared bottles shall be refrigerated in a separate section of the refrigerator and accessible only to employees;

21.4.9.c. Breast milk shall be stored in containers specific to the purpose;

21.4.9.d. Breast milk or formula when it remains at a temperature higher than forty-one (41) degrees Fahrenheit for more than one hour shall be discarded;

21.4.9.e. Refrigerated breast milk shall be used within 48 hours of receipt, frozen breast milk within two weeks of receipt and deep-frozen breast milk within three months of receipt;

21.4.9.f. Formula bottles shall be used within time frames established by the manufacturer and listed on the package; and

21.4.9.g. A microwave oven is not permitted for the heating of breast milk or formula bottles.

21.4.10. Solid food, including cereals are not to be placed in a bottle unless prescribed by a physician.

21.4.11. Jar baby food is to be served from a bowl and not from the jar.

21.4.12. Until a baby is able to hold a bottle securely, a baby and the bottle shall be held while the baby is being fed. At no time is the bottle to be propped.

21.4.13. All babies shall receive daily stimulation to encourage the emotional, physical, and intellectual development of the child. This includes:

21.4.13.a. Holding, rocking, and playing whenever possible, including while bathing, dressing, and carrying the child;

21.4.13.b. Encouraging positive communications and language development by making eye-to-eye contact with the child, singing, talking, reacting to the child's sounds, naming objectives, reading stories, and playing musical games;

21.4.13.c. Paying attention to crying and meeting the immediate needs of the child;

21.4.13.d. Ensuring that no child is routinely left in a crib or playpen, except for sleep or rest; and

21.4.13.e. Providing a child who is awake with play equipment and opportunities to play freely on a clean floor.

21.4.14. The organization shall ensure that all products containing potentially hazardous chemicals, including identified poisons, medications, certain cleaning supplies, and art supplies not clearly labeled as "nontoxic", are inaccessible to all children in a locked cabinet away from food, and when possible, stored in their original containers and never in containers originally designed for food.

21.4.15. The organization shall ensure that all electrical outlets within the reach of a child when not in use are protected by a cover.

21.4.16. The organization shall ensure that when an electrical appliance is used, an adult is present at all times to supervise the use of the appliance.

21.4.17. The organization shall provide a shield to protect a child from hot pipes or radiators and shall not use unvented fuel fire heaters.

21.4.18. The organization shall ensure that barriers and gates are appropriately used.

21.4.18.a. All temporary walls or items being used as physical barriers shall be firmly anchored so that they pose no threat to the safety of the child.

21.4.18.b. Stairways to which the child has access shall have appropriate railing and safety gates or other barriers at the top and at the bottom.

21.4.19. The organization shall ensure that strings, cords and hanging items are of no threat to the children.

21.4.19.a. The drawstring on clothing such as on hoods or collars shall be removed or secured to prevent potential risk to the child.

21.4.19.b. Pacifiers attached to a string or ribbon that is 6 inches or more in length shall not be placed around a child's neck or affixed to the child's clothing; and

21.4.19.c. No child is to have access to a string or cord that is 6 inches or more in length and attached to a fixed object, such as a window shade, nor access to any other potentially dangerous hanging item, such as a tablecloth.

21.4.20. The organization shall ensure that there is an outdoor play area appropriate and safe for young children.

21.4.21. The organization shall ensure the safety of the child during transportation. The driver or qualified employee shall ensure that each child three years of age and under is secured in an approved child safety seat.

21.4.22. The organization shall ensure that the overall environment of the children's area of the facility is clean, pleasant in appearance, well-lighted and conducive to the development of children.

21.5. Employee Training.

21.5.1. The organization shall ensure that all employees are specifically trained to meet the needs of the very young child.

21.5.2. All employees shall be trained within the first 30 days of employment on basic infant care. Prior to completion of the training, the new employees shall be scheduled to work only with fully trained employees.

21.5.3. At a minimum, all employees shall be trained in:

21.5.3.a. Child development;

21.5.3.b. Infant CPR and first aid;

21.5.3.c. Basic child care;

21.5.3.d. Sick baby care; and

21.5.3.e. Parenting skills.

21.6. Children shall be cared for and supervised at the following levels:

21.6.1. A minimum of employee-to-child ratio of 1-to-6 shall be maintained during waking hours when children are on the grounds with a minimum of one employee present per residential living unit at all times when more than one child is present in the living unit;

21.6.2. Additional or back-up care employees shall be available for emergency situations or to meet special needs presented by the persons in care; and

21.6.3. A minimum employee-to-child ratio of 1-to-12 shall be maintained during sleeping hours with a minimum, of at least one employee per residential living unit to be awake at all times when children are present in the living unit.

W. Va. Code R. § 78-3-21