New Hampshire Code of Administrative Rules
He - Department of Health and Human Services
Subtitle He-C - Commissioner, Department of Health and Human Services
Chapter He-C 4000 - CHILD CARE LICENSING RULES
Part He-C 4001 - NH RESIDENTIAL CHILD CARE LICENSING RULES
Section He-C 4001.22 - Discipline

Universal Citation: NH Admin Rules He-C 4001.22

Current through Register No. 40, October 3, 2024

(a) Program staff shall:

(1) Establish and make residents aware of rules or limits for acceptable behavior which are consistently applied, realistic, designed to promote cooperation and respect, and are appropriate and understandable to the development level of the resident; and

(2) Make residents aware of the consequences of not complying with the established limits or rules for acceptable behavior.

(b) Program staff shall not:

(1) Abuse or neglect residents;

(2) Use corporal punishment;

(3) Attempt to control any resident's behavior by actions which are humiliating, threatening, shaming, frightening, or otherwise damaging to residents;

(4) Withhold food from residents;

(5) Shame, humiliate, or discipline any resident for toileting accidents;

(6) Prevent a resident from using bathroom facilities, except as necessary to protect a resident's safety, as documented in the resident's case plan or treatment plan;

(7) As a means of discipline or punishment:
a. Require or deny residents sleep or rest;

b. Require residents younger than 6 years of age to go to their crib, bed, or playpen;

c. Withhold a resident's shoes or clothing, except as necessary to protect the resident's health or safety or to prevent the resident from running away;

d. Require a resident to perform physical exercise or perform tasks, which are humiliating, unusual, or physically exhausting; or

e. Use group punishment for misbehaviors of individuals except when documented as part of the treatment plan;

(8) Use sensory deprivation;

(9) Use mechanical restraints, and specifically any equipment, material, or device that is applied to a resident for the purpose of restricting his or her movement or activity; or

(10) Allow residents to discipline other residents.

(c) Each use of time out shall:

(1) Not be in a locked room;

(2) Be appropriate to the resident's developmental level and circumstances; and

(3) Be limited to the minimum amount of time necessary to:
a. Allow the resident to regain self-control;

b. Be effective as a consequence; or

c. Protect the safety of the resident in time out or other residents.

(d) The applicant, licensee, program director and program staff shall take prompt action to protect residents from abuse, neglect, corporal punishment, or other mistreatment by any individual.

(e) Program staff shall use restraint in accordance with RSA 126-U.

(f) Program staff shall use seclusion in accordance with RSA 126-U.

(g) The staff person in charge shall evaluate each use of seclusion at least every 60 minutes to determine if further use of this intervention is necessary.

(h) Each use of seclusion or restraint shall be documented on an incident report in accordance with He-C 4001.23, He-C 4001.14(t)(5), and RSA 126-U:7.

(i) The program director, treatment coordinator, or designee shall review the documentation regarding each use of seclusion no later than one working day after its use, and sign and date the documentation.

(j) Before any program staff participates in a physical intervention or the use of seclusion he or she shall have completed a curriculum in physical intervention techniques that is designed to protect the child from risk of harm to self, others, property, or the public.

(k) Physical intervention methods used shall be consistent with the curriculum required in (j) above and be reviewed annually with program staff to maintain competency.

(l) Physical intervention shall be used only:

(1) After less restrictive behavior management techniques have been tried and found to be ineffective in helping the resident gain control; and

(2) When necessary to:
a. Ensure the physical safety and security of the out of control resident, or other residents;

b. Prevent harm to program staff or other persons; or

c. Prevent serious damage to property.

(m) To reduce the risk of injury to a resident as a result of physical intervention, program staff shall use the minimum amount of force necessary to control the resident.

(n) During any physical intervention process, program staff shall evaluate the resident throughout the process, to ensure that the resident is not being injured, and to determine whether continued physical intervention is necessary. If the physical intervention exceeds 15 minutes, approval from the program director or a supervisory employee designated by the program director shall be required, per RSA 126-U:11, III.

(o) In the event that a physical intervention continues for longer than 30 minutes:

(1) Program staff trained to conduct such assessments shall conduct a face-to-face assessment of the resident's mental, emotional, and physical well-being;

(2) Program staff shall contact the program director or designee so that he or she can evaluate the need for continued physical intervention and the need for services from law enforcement, or a licensed health care practitioner;

(3) Such assessments shall be completed at least every 30 minutes throughout the physical intervention; and

(4) Program staff shall document all assessments as required in He-C 4001.23(b)(2).

#2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-06

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14

The amended version of this section by New Hampshire Register Number 24, eff. 5/29/2024 is not yet available.

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