Current through Register Vol. 48, No. 12, March 22, 2024
a) A separate and identifiable staff must be
designated for sole use by the adult day service program.
b) Each adult day service provider shall have
at the adult day service site adequate personnel in number and skill to comply
with subsection (c) of this Section and Section
240.1520(f)
and to provide for:
1) program and fiscal
administration;
2) nursing and
personal care services;
3)
nutritional services;
4) planned
therapeutic/recreational activities;
5) obtaining prompt services of emergency
personnel and hospitalization, if needed;
6) immediately notifying the participant's
authorized representative or family member of any illness, accident or injury
to the participant;
7)
provision/arrangement of transportation services to and from the adult day
service site;
8) record
keeping;
9) development,
implementation and semi-annual review of individualized person-centered plans
of care;
10) program evaluation and
marketing;
11) supervision and
evaluation of staff;
12) monitoring
and meeting staff training needs; and
13) maintenance of a clean and safe physical
environment.
c) The
minimum ratio of full-time staff (qualified adult day service staff, trained
volunteers or substitutes) or full-time equivalent (FTE) staff present at the
adult day service site to participants, when participants are in attendance,
shall be:
Staff 2
|
Participants 1 to 12
|
3
|
13 to 20
|
4
|
21 to 28
|
5
|
29 to 35
|
6
|
36 to 45
|
1) Add 1
additional staff person for each 7 additional participants.
2) Fifty percent or more of a staff member's
time shall be spent in on-site direct service or supervision on behalf of 1 or
more participants in order to be considered in the ratio.
3) Staff included in the staff-participant
ratio shall include only those who work on site, are actively involved with the
participants, and are immediately available in the activity area, except for
during client drop-off and pick-up times in normal business hours, to meet the
participants' needs.
d)
Each adult day service employee shall have:
1) Pre-service Training
Pre-service training totaling a minimum of 24 hours training
within the first week of employment (exclusive of orientation). A worker may be
exempted from pre-service training by the provider if the worker has had
previous documented training equivalent to 24 hours, with another CCP agency,
or in a related field, within the past 2 years prior to this employment or
holds a valid, active CNA, RN or LPN license, and/or a BA, BS, BSW or higher
degree. Pre-service training shall include at least 18 hours of training
selected from the following topics:
A)
Purpose and goals of adult day service;
B) Facility, environmental and safety
considerations;
C) Assistance with
activities of daily living;
D)
Basic principles of personal care;
E) Dealing with adverse behaviors: wandering,
aggression, mental illness and depression;
F) Promoting participant dignity,
independence, self-determination, privacy, choice and rights;
G) Understanding aging and
functionally-impaired persons;
H)
Recognizing participant abuse, neglect and/or exploitation; abuse and neglect
prevention and reporting requirements;
I) Confidentiality of participant
information;
J)
Communication/interaction skills;
K) Universal precautions, blood-borne
pathogens and infection control;
L)
Fire and life safety, including emergency procedures to be implemented under
the agency's all hazards disaster operations plan;
M) Family dynamics;
N) Understanding Alzheimer's Disease and
dementia;
O) Body mechanics and
normal range of motion, transfer techniques and positioning;
P) Cultural diversity;
Q) Recognizing changes in bodily functions
that should be reported to the supervisor;
R) Nutrition and safe food
handling;
S) CPR and first
aid;
T) Participant
activities;
U) Respiratory
services;
V) Use of seclusion and
restraint.
2) In-service
Training
A minimum of 12 hours of in-service training for continuing
education per year shall be mandatory for all adult day service employees.
Pre-service training received under subsection (d)(1) shall fulfill the
continuing education requirement for new employees for the first year.
In-service training shall include at least 9 hours of training selected from
among the following topics:
A)
Responding to emergency situations, including, but not limited to, site-related
emergencies (e.g., late pick-up of participants), participant-related
emergencies (e.g., participants leaving the site unattended), choking
prevention and intervention techniques;
B) Appropriate and safe techniques in
performing and assisting with personal care;
C) Developing and improving participant
centered activities;
D)
Modification of the environment to support engagement/well-being;
E) Promoting participant dignity,
independence, self-determination, privacy, choice and rights;
F) Special characteristics of the elderly
population; physical, emotional and developmental needs of the
participant;
G) Recognizing
participant abuse, neglect and/or exploitation; abuse and neglect prevention
and reporting requirements;
H)
Confidentiality of participant information;
I) Communication skills;
J) Universal precautions, blood-borne
pathogens and infection control;
K)
Fire and life safety, including emergency procedures to be implemented under
the agency's all hazards disaster operations plan;
L) Dealing with adverse behaviors, e.g.,
mental illness, depression, aggression and wandering;
M) Family dynamics;
N) Diseases of the elderly; understanding
Alzheimer's Disease and dementia;
O) Body mechanics and normal range of motion,
transfer techniques and positioning;
P) Chronic illness, death and
dying;
Q) Medicaid fraud and
abuse;
R) Cultural
diversity;
S) Recognizing changes
in bodily functions that should be reported to the supervisor;
T) CPR and first aid;
U) Understanding advance
directives;
V) Nutrition and safe
food handling;
W) Respiratory
services;
X) Use of seclusion and
restraint.
3) Progress
toward certification in a related field (e.g., CNA) may be used for up to 3
hours of in-service training per calendar year.
e) At least 2 program adult day service staff
shall be certified in CPR and trained in first aid, and at least 1 trained
staff shall be on-site when participants are present.