(A) As used in Chapters 5101:2-5 and
5101:2-9 of the Administrative Code, a "children's crisis care
facility" means a facility that has as its primary purpose the provision
of residential and other care to the children described in paragraph (A)(1) or
(A)(2) of this rule:
(1) One or more pre-teens
voluntarily placed in the facility by the pre-teen's parent or other
caretaker who is facing a crisis that causes the parent or other caretaker to
seek temporary care for the pre-teen and referral for support
services;
(2) One or more pre-teens
placed in the facility by a public children services agency (PCSA) or private
child placing agency (PCPA) that has legal custody or permanent custody of the
pre-teen and determines that an emergency situation exists necessitating the
pre-teen's placement in the facility rather than an institution certified
under section 5103.03 of the Revised Code or elsewhere.
(3) "Children's
crisis care facility" does not include either of the
following:
(a) Any organization, society, association, school, agency, child
guidance center, detention or rehabilitation facility, residential infant care
center, or children's clinic licensed, regulated, approved, operated under
the direction of, or otherwise certified by the department of education, a
local board of education, the department of youth services, the department of
mental health and addiction services, or the department of developmental
disabilities;
(b) Any individual who provides care for only a single-family
group, placed there by their parents or other relative having
custody.
(B) "Pre-teen" means an
individual under thirteen years of age.
(C) No certified children's crisis care facility shall do
any of the following:
(1) Provide residential
care to a pre-teen for more than one hundred twenty days in a calendar
year;
(2) Subject to paragraph
(C)(3) of this rule and except as provided in paragraph (D) of this rule,
provide residential care to a pre-teen for more than ninety consecutive days,
which includes transfer of a pre-teen in a different location of the same
agency;
(3) Provide residential
care to a pre-teen for more than fourteen consecutive days if a PCSA or PCPA
placed the pre-teen in the facility;
(4) Fail to comply with
section 2151.86 of the Revised Code.
(D) The director of job and family services may suspend or
revoke a children's crisis care facility's certificate pursuant to
Chapter 119. of the Revised Code and in accordance with rule 5101:2-5-07 of the
Administrative Code if the facility ceases to meet any provision of this rule
or the facility's operator ceases to comply with any of the rules
governing the certification of children's crisis care facilities. A PCSA,
PCPA or PNA operating a children's crisis care facility shall comply with
all the requirements of Chapter 5101:2-5 of the Administrative Code as
applicable to the type of the agency, depending on whether the agency is a
PCSA, a PCPA, or a PNA. An agency operating a children's crisis care
facility shall comply with all applicable requirements of the rules in Chapter
5101:2-9 of the Administrative Code for residential facilities, depending on
whether the facility is a group home or a children's residential center,
including those rules specified for a residential parenting facility. If there
is a conflict between a requirement of any provision in this rule or any
provision of Chapter 5101:2-5 of the Administrative Code or Chapter 5101:2-9 of
the Administrative Code, the provisions of this rule shall take
precedence.
(E) An agency operating a children's crisis care
facility shall reasonably ensure that child care staff persons are assigned to
care for the same group of children each day and shall adhere to the following
child care staff to children ratios:
(1) For children under
the age of six years, including the children of child care staff, there shall
be at least one child care staff person on duty during awake hours for every
five children or fraction thereof.
(2) For children over the
age of six years, including children of child care staff, there shall be at
least one child care staff person on duty during awake hours for every six
children or fraction thereof.
(3) For children ages
zero to twelve, including the children of child care staff, there shall be at
least one awake child care staff person on duty during sleeping hours for every
eight children or fraction thereof.
(4) When a group of
children includes children from more than one of the age groups listed in
paragraph (E)(1), (E)(2) or (E)(3) of this rule, the staff to child ratio shall
be determined according to the age of the youngest child within any group of
children.
(5) There shall be at least two staff
members on duty at all times when children are present in a crisis care
facility.
(6) In case of an
emergency, the children's crisis care facility may include administrative
staff, interns and volunteers toward the required staff ratio for a period of
no more than three hours if the administrative staff, interns, or volunteers
meet the following requirements:
(a) Completed training in the mission of the
children's crisis care facility.
(b) Completed training pursuant to rule 5101:2-9-03 of the
Administrative Code.
(c) Are supervised by facility staff.
(d) Have completed a background check pursuant to rule
5101:2-5-09.1 of the Administrative Code.
(F) An agency may use contracted transportation providers
on whom a background check and driving record check has been conducted and is
on file with the contracted company or agency, if such use is necessary for the
facility to maintain the required child care staff to child ratio, while
children are being transported.
(G) In place of a service plan and a case plan, an
engagement plan is to be developed and completed no later than five business
days for any child placed for more than five business days. A children's
crisis care facility is to develop an engagement plan with the individual or
agency that placed the child and provide a copy at that time. The engagement
plan is to address at a minimum:
(1) Steps that will be
taken to resolve the issues that necessitated the placement.
(2) Obligations and
expectations of the individual or agency that placed the child while their
child is placed at the facility.
(3) Identification of any
special care needs of the child that will need to be addressed while in
placement.
(4) Projected timeline
for discharge.
(5) Develop a visitation plan for the
pre-teen's parent or caretaker, which may include:
(a) On-site visitation, which will not include overnight
visits.
(b) Off-site, overnight visitation with parent or caretaker
and other approved relatives.
(H) If a certified crisis care agency has multiple
facilities, a preteen may be transferred between facilities one time during
their stay. A transfer summary is to be completed and is to
include:
(1) Reason for
transfer.
(2) Originating location and location of
transfer.
(3) Parent or caretaker
contact information.
(4) Upcoming
appointments.
(5) Dietary restrictions.
(6) Medical services provided and
medications.
(7) School.
(8) Adjustment summary.
(9) Projected discharge and discharge
caregiver.
(I) Comprehensive health care for a child admitted to a
children's crisis care facility shall be in accordance with rules
5101:2-42-66.1 and 5101:2-42-66.2 of the Administrative Code. If there is a
conflict between a requirement of any provision in this rule or any provision
of rule 5101:2-42-66.1 or rule 5101:2-42-66.2 of the Administrative Code, the
provisions of this rule shall take precedence.
(J) An agency is to employ a licensed social worker, a
licensed independent social worker, a licensed professional counselor or a
licensed professional clinical counselor.
(K) Upon admission to an agency, there is to be a dedicated
and private enclosed space for completing admission paperwork and medical
forms.
(L) If pediatric medical services are provided at the
facility, the following is to be provided:
(1) Medical service is to
be provided by a qualified licensed and insured medical
professional.
(2) Ensure all staff,
volunteers and interns comply with the privacy requirements of the Health
Insurance Portability and Accountability Act of 1996.
(3) An examining room which
contains:
(a) A sink or tub.
(b) Medical exam table,
(c) Pediatric medical equipment.
(d) Medical record system.
(M) Upon discharge, if a pre-teen is admitted by the parent
or caretaker and the pre-teen requires on-going medical care following
discharge from the facility, a medical professional or licensed social worker
is to ensure the parent or caretaker is competent to provide the on-going care.
If the medical professional or licensed social worker determines the parent or
caretaker is not able to provide the on-going care, a referral to the PCSA will
be completed.
(N) For the purpose of the management and prevention of
communicable diseases, a children's crisis care facility shall adhere to
the following procedures:
(1) A child with any of
the following signs or symptoms of illness shall be immediately isolated from
other children. The child, while isolated shall be carefully watched for
symptoms listed in paragraph (N)(2) of this rule.
(a) Unusual spots or rashes;
(b) Sore throat or difficulty in swallowing;
(c) Elevated temperature of one hundred degrees or
above;
(d) Vomiting;
(e) Evidence of lice, scabies or other parasitic
infection.
(2) A child with any of
the following signs or symptoms of illness is to be immediately isolated and
medically assessed by a licensed physician or registered nurse.
(a) Diarrhea (more than one abnormally loose stool within a
twenty-four hour period);
(b) Severe coughing, causing the child to become red or blue in
the face or to make a whooping sound;
(c) Difficult or rapid breathing;
(d) Yellowish skin or eyes;
(e) Vomiting more than one time or in combination with any other
sign or symptom of illness;
(f) Temperature of one hundred degrees Fahrenheit taken by the
auxiliary method when in combination with any other sign of
illness;
(g) Untreated infected skin patches, unusual spots or
rashes;
(h) Unusually dark urine and/or grey or white stool;
(i) Stiff neck with elevated temperature.
(j) Redness of the eye or eyelid, with eye discharge,
matted eyelashes, burning, itching or eye pain.
(3) A child isolated due
to suspected communicable disease shall be:
(a) Cared for in a room or portion of a room not being used for
other types of child care, within sight and hearing at all times by the child
care staff.
(b) Checked on every fifteen minutes and a notation made on an
isolation log regarding the observation made.
(c) Made comfortable and provided with a bed. All linens and
blankets used by the ill child shall be laundered before being used by another
child. After use, the bed shall be disinfected with an appropriate germicidal
agent, or, if soiled with blood, feces, vomit or other body fluids, the bed
shall be cleaned with soap and water and then disinfected with an appropriate
germicidal agent.
(d) Observed carefully for worsening condition. If the condition
has worsened, a physician shall be contacted.
(4) The universal blood
and body fluid precautions according to the United States department of health
and human services' centers for disease control and prevention
(CDC).
(5) A procedure for
immediate notification of the person or agency holding custody of a child when
the child is exhibiting signs or symptoms of illness or has been exposed to a
communicable disease.
(6) The children's
crisis care facility's procedures regarding the care of a mildly ill
child. A "mildly ill child" is defined as one of the
following:
(a) A child who is experiencing minor common cold symptoms, but
who is not exhibiting any of the symptoms specified in paragraph (N)(1) or
(N)(2) of this rule, or
(b) A child who does not feel well enough to participate in
activities, but who is not exhibiting any of the symptoms specified in
paragraph (N)(1) or (N)(2) of this rule.
(O) The children's crisis care facility shall keep the
person who placed a child informed of health care provided to the child while
residing in the facility on a weekly basis and at discharge.
(P) The children's crisis care facility is to adhere
to the following handwashing procedures:
(1) All staff and
volunteers shall wash their hands with soap and running water upon entering and
when leaving the children's crisis care facility, after each diaper
change, after assisting a child with toileting, after cleaning, after
toileting, before preparing or eating food, before feeding any child, before
and after administering medication, and after handling animals.
(2) Handwashing
facilities shall be available within the area where children receive diaper or
bathroom care.
(3) A handwashing
facility is defined as a permanent-type fixture with running
water.
(4) Children are to wash
hands after toileting.
(5) Children shall wash hands before and
after eating.
(6) Children are to wash hands after
going outside to a play area.
(7) Children are to wash
hands after handling animals.
(8) Disposable towels shall be available
at the handwashing site at all times and shall be used to dry hands and turn
off the water after handwashing.
(Q) In addition to the diaper care procedures specified in
rule 5101:2-9-05 of the Administrative Code, the following procedures shall be
followed:
(1) No child's
diaper shall be changed in the child's bed or crib;
(2) Each diaper changing
area shall be disinfected after each diaper change with an appropriate
germicidal agent. If the diaper changing area is soiled after the diaper
change, it shall be cleaned with soap and water and then disinfected with an
appropriate germicidal and virus killing agent.
(3) Disposable separation
materials at a central diaper changing station are recommended for diaper
changing, and if used, shall be used once and discarded. If washcloths or other
washable materials are used, they shall be used once and stored in an
appropriate germicidal and virus killing solution until laundered.
(R) Each child admitted to a children's crisis care
facility shall be provided with an opportunity to safely and comfortably sit,
crawl, toddle, or walk and play according to the child's stage of
development, under supervision and in a designated space apart from sleeping
quarters each day in order to enhance development.
(1) Children of both
genders and under twenty-four months in age who are not siblings may share the
same bedroom.
(2) No children over
twenty-four months of age and of different genders may share the same bedroom
unless they are from the same sibling group.
(3) Siblings of differing
genders are, at the discretion of the agency, allowed to share the same
bedroom.
(4) All sleeping children
shall be observed at least once per hour by agency staff.
(S) Each infant in care in a children's crisis care
facility shall be removed from his/her crib for all feedings and removed from
the crib at other intervals during each day for individual attention. For the
purpose of feeding, all infants without the ability to sit up shall either be
placed in an infant seat, or held by a child care worker, other adult over
twenty-one years of age, or the child's parent, as appropriate to the
child's age. No child shall be placed in a crib or bassinet for feeding
and no bottle shall be propped to feed an infant. Infants with the ability to
sit up may be placed in a high chair for feeding.
(T) A video monitor may be used to observe napping or
sleeping children under the age of two. The video monitor is to:
(1) Be positioned out of
reach of the child.
(2) Have only one child
in an individual crib in its view.
(3) Monitor and not have
recording capabilities.
(U) Infant food shall be prepared and served in a manner
appropriate to the developmental needs of each child according to the
child's stage of development and in sufficient quantities to promote
healthy growth and development.
(V) There shall be at least one bathroom designated for use
by children in a children's crisis care facility and it shall have at
least one wash basin and one toilet accessible for small sized
children.
(W) Each dining area in a children's crisis care
facility shall be equipped with tables, chairs and eating utensils appropriate
to the age, physical condition, and developmental stage of the children who
will eat in the area.
(X) A children's crisis care facility shall plan and
provide, for each child twelve months and older, an opportunity for an on-site
safely accessible, supervised and developmentally appropriate outdoor activity
each day in suitable weather unless the child's medical condition does not
allow the child to participate.
(1) All children shall be
provided with appropriate outerwear and/or sunscreen as applicable to the
weather conditions.
(2) The supervision of
children by staff shall adhere to the required child/staff ratios specified in
paragraph (E) of this rule when the children are using the outdoor play area
including going to and coming from the play area. No child shall be left
unsupervised in the outdoor play area.
(3) When a group of
children is outdoors, the child care staff person(s) responsible for the group
shall be able to summon another adult without leaving the group alone or
unsupervised.
(4) The play area shall
be supervised so that all children are within the sight and hearing of the
supervising child care staff person(s) at all times.
(5) The surface of the
outdoor play area shall be drained well enough so that standing water does not
prohibit the use of the play area on a daily basis.
(6) The play area shall
be free of hazards such as, but not limited to, broken glass, potholes,
garbage, flammable materials, and other debris.
(7) The play area shall
be well defined by a fence, hedge, natural or other barrier to protect the area
from traffic, animals, or other hazards.
(8) The outdoor play area
shall provide at least sixty square feet of usable space per child using the
play area at any one time, regardless of the number of children the
children's crisis care facility is certified to serve.
(Y) A children's crisis care facility shall be
compliant with section 5103.132 of the Revised Code.
