Current through Register Vol. 43, No. 02, November 27, 2024
(1) Staff to Child
Ratio. The child care facility shall have sufficient number of qualified paid
staff to provide for each child's physical and emotional needs at all times and
perform required tasks.
(a) The ratio of
child care workers to children shall not be less than one child care worker on
duty for each 8 children. Exception: During the hours of 10 PM to 7 AM the
ratio of child care workers to children shall not be less than one child care
worker on duty for each 10 children. When child care staff or other staff have
their own children living in the same living units as children under care, such
children shall be included in the licensed capacity of the child care
facility.
(b) The administrator
shall advise the Department in writing of the number of staff's children living
in the facility. The State Department may require a higher ratio of staff per
child for those child care facilities serving children with more specialized
needs as determined by a child's Care/Treatment Plan and or/ISP.
(2) Medical Care. An ongoing
relationship shall be established with a licensed practicing physician or
clinic to advise the child care facility staff concerning medical plans,
programs and treatment of children in care.
(a) Each child shall have a complete physical
examination or the benefit of medical screening or assessment, i.e., MediKids
or EPSDT, for children eligible for Medicaid. A copy of the complete physical
examination report or assessment shall be on file. Such examination shall be
made within three months prior to admission and at least annually thereafter.
(Another EPSDT may be requested if a Medicaid recipient had a screening longer
than 3 months prior to admission and they are entering foster care.) Exception:
In emergency placements where a medical is not available a medical examination
and report shall be obtained no later than ten (10) days after the
placement.
(b) The initial
examination for children shall consist of a complete history, physical
examination, and tests as listed on form DHR-DFC-623. A form is acceptable
which makes provisions for the same information as the DHR-DFC-623, Child's
Medical Record-Foster Care, which is furnished by the Department. Information
about the family health history is helpful.
(c) Each child care facility shall make
provision and establish procedures for routine medical services,
hospitalization and/or emergency medical or surgical treatment of children.
Financial arrangements for provisions of these services shall be part of the
Placement Agreement.
(3)
Dental Care. An ongoing relationship shall be established with a licensed
practicing dentist(s) to advise the child care facility staff concerning dental
plans, program and treatment of children in care.
(a) Each child shall have a routine dental
examination at least annually. Necessary follow-up treatment shall be
provided.
(b) Each child care
facility shall make provision and establish procedures for routine and
emergency dental services. Financial arrangements for provision of these
services shall be a part of the Placement or Inter Agency Agreement.
(4) Personal Hygiene. The child
care facility shall carry out a program of instruction to meet the individual
personal hygiene needs for all children. Individual items such as towels,
washcloths, toothbrushes and other toiletries shall be provided for each child
according to their individual needs. It is suggested that one child's personal
items not be allowed to touch that of another child's to avoid the possibility
of contamination. Also, children are to be discouraged from sharing the
personal items.
(5) Rest. The child
care facility shall provide opportunity for uninterrupted sleep for each child
according to his individual needs. Infants should be placed on their back to
sleep.
(6) Nutrition. The child
care facility shall provide wholesome nutritious and properly prepared daily
meals, including: meats or meat substitutes, vegetables, milk, fruit, cereal,
bread, and dessert. Special dietary needs shall be provided as recommended by a
physician. When special dietary needs are identified, professional consultation
shall be requested and modifications made as needed. At least three meals shall
be served each day, each with a different menu. Menus shall be written in
advance and shall be kept on file for one year and available for review.
Between-meal and nighttime snacks shall be available, except when restricted
for dietary or health reasons.
(a) The child
care facility shall annually review its food service menus to assure that
well-balanced, nutritious and appetizing food is served.
(b) Handling, storage, and preparation of
food shall comply with state health standards. Food shall be of a size and
consistency appropriate for the age, growth, and development ability of a
child.
(7) Clothing.
Clothing shall be stylish, properly fit, clean and of good quality and
appearance. The clothing shall not be different from clothes worn by children
in the community. Children shall have a part in the selection of their clothes.
Used clothes shall be used only when in good condition, when chosen by the
child, and when properly renovated and fitted. When shoes are needed, new shoes
shall be provided, and shall be fitted to the individual child. Used canvas
sneakers, if in good condition and sanitized, may be used. Each child shall
have his/her own clothing and a place for storing it. Responsibility for the
provision of clothing shall be outlined in the Placement Agreement.
(8) Discipline. Discipline shall be used as a
positive educational influence that seeks to develop inner controls and provide
structure. The child shall be advised of all rules and regulations of the child
care facility which apply to him/her. The staff members shall be aware of the
rules and regulations of the child care facility, and consistent in their
enforcement thereof. The administration shall be responsible for the thorough
understanding by all staff members of policies and practices concerning
discipline and punishment.
(9)
Punishment. When punishment is required, it shall be fair, consistent, brief,
related and in proportion to the offense and in accordance with the child care
facility's written child care policies. Harsh and humiliating punishment,
including corporal punishment, physical or emotional abuse, is prohibited.
Verbal abuse of a child and derogatory remarks about a child or his/her family
is prohibited.
(a) Punishment shall not be
administered by peers. Limited peer input into consequences of negative
behavior may be appropriate as part of a therapeutic program under the
supervision of a professional staff member. Positive corrective measures are to
be used and may include, but are not limited to:
2. Time out (usually age of child plus two
minutes).
3. Grounding to a certain
area.
4. Redirecting the child's
activity.
5. Develop a behavioral
contract.
7. Restitution by child of
other person's property damaged or destroyed by child.
(b) Withholding of sleep, meals or mail,
arbitrarily sending a child to bed early, and the curtailment of visits by the
child's family to the child, shall not be used as a type of punishment at any
time. A child who must be temporarily isolated from his/her peers shall be
under adult supervision. When a child is isolated, provisions shall be made for
humane and safe conditions including room space appropriate to the
developmental level of the child, adequate ventilation and lighting, and a room
temperature consistent with the rest of the home or facility. Meals, routine
medication and water must be provided. Observation of a child in isolation
shall occur at least every 30 minutes or more often as necessary. The behavior
management plan will describe how frequently the child must be observed and
will authorize any restrictions imposed while the child is in isolation, e.g.,
no TV or radio.
(10)
Behavior Management. Child care facilities will develop written policies
regarding behavior management. The policy will be explained to each child upon
placement and a copy will be provided to the person placing the child or
holding custody of the child.
(11)
Public Appearances. Public appearance of the children shall not be for the
purpose of display, and shall be permitted only when such appearances have
positive and constructive value for the children and with the consent of the
custodian or person or agency responsible for the child. Children shall not be
required to attend parties, church functions, fund raising drives, picnics,
etc., sponsored by various groups. Children shall never be exploited for the
benefit of the child care facility. All public appearances by the children as
representative of the child care facility shall be voluntary. The child's
sleeping area and personal belongings shall not be on display to the public
except for those rare occasions when the child care facility observes open
house, homecoming, etc., and always with the permission of the child.
(12) On-Campus Work Assignments. Work
assignments shall be considered as part of the participatory responsibility of
living together, or as a means of earning money. Children shall not be
considered as substitutes for employed adult staff, nor shall they be employed
as a means of avoiding the hiring of adult staff. Work assignments shall be
made in accordance with the age and ability of the child. Jobs for children
shall be assigned so that they will not conflict with schoolingeducational
needs, playtime, extracurricular activities, or normal community visits, or
visits with their families and friends. Children shall have some choice in
their chores, and a change of routine duties shall be offered periodically to
reduce monotony and to provide a variety of experiences. Children shall not be
employed for the financial gain of the facility and monies earned shall be the
property of the child.
(13)
Sponsors. Where sponsorship of specific children by church or other unrelated
groups or individuals exists, no child shall be compelled against his/her will
to visit. A visit shall be planned with the child's consent, and subject to the
approval of the legal custodian or person or agency responsible for the
child.
(14) Telephone and Mail
Contacts. Child care facilities will develop written policies regarding
telephone and mail contacts. The policy will be explained to each child upon
placement and a copy will be provided to the person placing/holding custody of
the child.
(15) Visiting Practices.
(a) Family ties shall be encouraged and
maintained in accordance with the Care/Treatment Plan. Visitation rights of the
family and child shall be honored unless specific, definable and documented
reasons to the contrary have been established through the Care/Treatment Plan
and/or ISP. Families shall be afforded privacy with their children during
visitation on the facility campus, unless specific, definable and documented
reasons to the contrary have been established through the Care/Treatment Plan
and/or ISP.
(b) Children shall have
the right to be with their own relatives on all possible occasions, especially
at holiday time. Holiday visits shall be determined to be in the child's best
interest, as allowed in the Care/Treatment Plan and/or ISP. If there are
compelling reasons to prohibit visits, those reasons shall be
documented.
(c) Siblings in
residence in the child care facility shall have the right to contact each other
on their own initiative. If possible, siblings shall live together.
(d) The child care facility's professional
social service staff may approve families in the community for overnight visits
after an assessment of the request and the visiting family. The length of such
visits shall be limited to 48 hours. Longer planned visits shall require the
prior approval of the person or agency having legal custody or planning
responsibility of the child. If the child care facility's professional social
service staff and the agency having primary planning responsibility concur in
the written Care/Treatment plan that the child needs to be provided with
developmental experiences through visitation in a family home with unrelated
persons who may or may not have been previously known to the child, it shall be
the responsibility of the facility to make a written request of a County
Department of Human Resources or a licensed child-placing agency to approve a
designated family as a visiting home for the child.
(e) When the agency having primary
responsibility for the child receives written approval of a visiting resource
and forwards a copy to the child care facility, the child care facility's
social worker service staff shall plan visits directly with the visiting
resource parents in accordance with the Care/Treatment Plan and/or ISP for the
child. The child care facility social worker service staff shall report to the
County Department of Human Resources or licensed child placing agency which
approved the visiting resource pertinent information concerning the visits
which are made. If only one visit is made, a report on that visit shall be sent
soon thereafter. If visits are made on a regular basis, then reports shall be
sent on a quarterly basis. All visits will be reported on the Progress
Reports.
(f) Sound, appropriate
plans shall be made well in advance of proposed vacations and holidays. The
child care facility shall make arrangements for on-campus care for children who
have no natural family to visit during vacations and holidays or for whom there
is no consent for visitation with an approved visiting family member or
visiting resource.
(g) A child
shall not be taken from, sent from, or allowed to leave the state without
written consent of the natural parents who hold custody, or the juvenile court
having jurisdiction of the child when custody has been removed from the natural
parent.
(16) Allowances.
The child care facility shall ensure that each child receives an allowance,
spending money, or has the opportunity to earn money.
(17) Educational Opportunities.
(a) Children shall attend school in
accordance with the school attendance laws. Space and suitable equipment, such
as reference books, adequate lighting and quiet work space, shall be provided
in the child care facility for home study. When practical, participation of
children in extracurricular activities of the school which they attend shall be
encouraged and transportation shall be provided or arranged.
(b) Vocational training, if available in the
community for age appropriate children, may be provided in lieu of public
school attendance. Such attendance shall be subject to the requirements of the
Alabama State Department of Education.
(c) Education relating to human health and
physiology shall be an integral part of the child care facility's program, and
shall be geared to the child's age, stage of development and level of
understanding.
(d) The child care
facility's professional staff shall be involved in the IEP's with the school to
ensure that children are properly placed and making adequate adjustment and to
plan jointly with school personnel in alleviating problems which arise.
Tutoring shall be made available to children who will benefit from additional
assistance in obtaining or maintaining grade level.
(18) Recreation.
(a) Positive community contacts shall be
provided, i.e., church, civic groups, and YMCA's.
(b) The child care facility shall provide
facilities and staff to make recreation and other activities available within
the child care facility. Provision shall be made for adequate playtime, both
for organized and free play, indoor and out, for all children under
care.
(c) The child care facility
shall provide time for each child to be alone if appropriate, and places to go
where the child will not be disturbed. He/She shall also be provided an
opportunity to exercise some free choices of activity.
(d) It is the responsibility of the facility
to consider the safety and appropriate supervision of children in planning the
transportation to and from recreational activities, and to consider the
appropriateness of the activity. The facility shall develop guidelines
specifying levels of supervision. These shall consider such factors as: a
child's developmental level, level of maturity, kinds of activities in which a
child may participate, and methods by which a child may receive increased or
decreased supervision. The guidelines will be explained to a child upon entry
and will be posted for review by staff, children, and DHR. Any facility staff
who provides transportation shall have a valid driver's license and a copy of
the license shall be on file with the facility.
(19) Off-Campus Employment. When appropriate,
children of legal work age shall be encouraged to earn their own money through
employment in the community. Exceptions may be made in shelter care
placements.
(20) Grievance Process
for Children. Each facility shall develop specific grievance policies and
procedures for implementation. Copies of each shall be provided to each child
in care and their families. Grievance procedures shall be activated upon the
request of the child or the child's family and continue until a resolution is
obtained. The grievance requests and procedures taken shall be documented in
the child's file. Documentation of this grievance and resolution shall be
placed in the child's file and the grievance shall be reported to the legal
guardian and/or agency having primary planning responsibility.
Author: Linda S. Stephens
Statutory Authority:
Code of Ala.
1975, §§
38-7-1 through -17, §§
41-22-1 through -27.