New York Codes, Rules and Regulations
Title 18 - DEPARTMENT OF SOCIAL SERVICES
Chapter II - Regulations of the Department of Social Services
Subchapter C - Social Services
Article 3 - Child-care Agencies
Part 448 - Group Homes
Section 448.3 - Requirements for each group home

Current through Register Vol. 46, No. 39, September 25, 2024

(a) Program.

A community-based program shall be provided for the children.

(b) Personnel.

Adequate supervision shall be provided for the children in each group home. Persons caring for children shall be sufficient in number for the children under care, and shall be selected on the basis of good moral character, interest in and an ability to care for children. Except on school days, when the following child-care staff-to-children ratios may be exceeded during the period between the waking of the children in a group home and the period when such children leave for school or vocational training, there shall be:

(1) The following minimum child-care staff-to-children ratios in effect during waking hours when children are under the care of such staff:
(i) each group home serving nine or fewer children must be staffed by at least one child-care worker; and

(ii) each group home serving 10 to 12 children must be staffed by at least two child-care workers.

(2) Qualified substitute child-care employees must be used to meet the child-care staff-to-children ratios set forth in paragraph (1) of this subdivision when child-care staff are not available due to vacation, illness or training.

(3) When deployment of child-care staff in a group home requires that a child-care worker be responsible for the supervision of 10 or more children as a result of activities planned for children residing in the home, a process for ensuring that the health and safety interests of the children residing in the group home are met must be implemented. Such process should include, but not be limited to, the following:
(i) a process for requiring child-care staff to notify the agency director of the group home or the director's designee that the required child-care staff-to-children ratios contained in paragraph (1) of this subdivision are being exceeded; and

(ii) a process for having qualified backup staff available when requested in order to meet the child-care staff-to-children ratios contained in paragraph (1) of this subdivision.

(4) Provision for a staff member to be in attendance to care for every four children of parenting youth who are infants under two years of age in a facility caring for parenting youth and children of parenting youth when the parenting youth is placed out of the home.

(5)
(i) In order to ensure that persons caring for the children in the home will be of good moral character with an interest in and ability to care for children, each agency or social services official operating a group home must establish a procedure to review and evaluate the backgrounds of and information supplied by all applicants for employee, voluntary or consultant positions in the group home program. This procedure must take into account any appropriate collective bargaining agreement(s) and, in the case of a home operated by a social services official, must also comply with applicable provisions of the Civil Service Law. As part of this procedure, each applicant must submit all of the following information:
(a) a statement or summary of the applicant's employment history, including but not limited to any relevant child-caring experience;

(b) the names, addresses and, where available, telephone numbers of references who can verify the applicant's employment history, work record and qualifications;

(c) the names, addresses and telephone numbers of at least three personal references, other than relatives, who can attest to the applicant's character, habits, reputation and personal qualifications; and

(d) a sworn statement by the applicant indicating whether, to the best of such applicant's knowledge, the applicant has ever been convicted of a crime in New York State or any other jurisdiction.

(ii) If an applicant discloses in the sworn statement furnished in accordance with clause (i)(d) of this paragraph that he/she has been convicted of a crime, the agency or social services official must determine, in accordance with guidelines developed and disseminated by the department, whether to hire the applicant or to use the applicant as a volunteer or consultant, except that any group home operated by a social services district which had guidelines for the review of persons with conviction records in use prior to January 1, 1986 may continue to use the district guidelines in making the required determination. If the agency determines it will hire the applicant or use the applicant as a volunteer, the agency must maintain a written record, as part of the application file or employment or other personnel record of such person, of the reason(s) why such person was determined to be appropriate and acceptable as an employee, volunteer or consultant.

(c) Personnel practices.

The following personnel practices shall be observed for the staff of each group home:

(1) With regard to any person who is actively being considered for employment, or to any individual or any person who is employed by an individual, corporation, partnership or association which provides goods or services to the group home, and who has or will have the potential for regular and substantial contact with children being cared for by the group home, the agency or social services official must inquire of the department whether any such person is the subject of an indicated report of child abuse or maltreatment on file with the Statewide Central Register of Child Abuse and Maltreatment. In addition, the agency or social services official may inquire whether any current employee or any person who is being considered for use as a volunteer or for hiring as a consultant and who has or will have the potential for regular and substantial contact with children who are being cared for in the group home is the subject of an indicated report on file with the Statewide Central Register of Child Abuse and Maltreatment. An inquiry regarding any current employee may be made only once in any six-month period.
(i) Prior to making an inquiry pursuant to this paragraph, the agency or social services official must notify, in the form prescribed by the department, the person who will be the subject of an inquiry that an inquiry will be made to determine whether such person is the subject of an indicated report of child abuse or maltreatment on file with the Statewide Central Register of Child Abuse and Maltreatment.

(ii)
(a) Except as set forth in clause (b) of this subparagraph, an agency or social services official may not permit a person hired by the agency or social services official or a person who is employed by an individual, corporation, partnership or association which provides goods or services to the group home to have contact with children in the care of the group home prior to obtaining the result of the inquiry required by this paragraph.

(b) An employee of an agency or social services official or an employee of a provider of goods and services to the group home may have contact with children cared for by the group home prior to the receipt by the agency or social services official of the result of the inquiry required by this paragraph only where such employee is visually observed or audibly monitored by an existing staff member of the agency or social services district. Such employee must be in the physical presence of an existing staff member for whom:
(1) the result of an inquiry required by section 424-a of the Social Services Law has been received by the agency or social services official and the agency or social services official hired the existing staff member with knowledge of the result of the inquiry; or

(2) an inquiry was not made because such staff member was hired before the effective date of section 424-a of the Social Services Law.

(iii)
(a) When the person who is the subject of the inquiry is an applicant for employment, the department will charge a five dollar fee when it conducts a search of its records within the Statewide Central Register of Child Abuse and Maltreatment to determine whether such applicant is the subject of an indicated report.

(b) The required fee must either accompany the inquiry form submitted to the department or, for an inquiry submitted by a social services district, the district may elect to have the fee subtracted from its claims for reimbursement submitted pursuant to section 601.1 of this Title.

(c) Fees must be paid by agency business check, certified check, postal or bank money order, teller's check or cashier's check made payable to "New York State Department of Social Services". For social services districts electing to have the fees subtracted from their claims for reimbursement submitted pursuant to section 601.1 of this Title, the fees will be subtracted quarterly to match the number of inquiries made. Personal checks and cash are not acceptable forms of payment.

(iv) If an applicant, employee or other person about whom an inquiry is made is found to be the subject of an indicated report of child abuse or maltreatment, the agency or social services official must determine, on the basis of information it has available and in accordance with guidelines developed and disseminated by the department, whether to hire, retain or use the person as an employee, volunteer or consultant, or to permit the person providing goods or services to have access to children being cared for by the group home, except that any group home operated by a local social services district which had guidelines for the review of persons who are the subjects of indicated reports of child abuse or maltreatment operationally in use prior to January 1, 1986 may continue to use the district guidelines in making the required determination. Whenever such person is hired, retained, used or given access to children, the agency or social services official must maintain a written record, as part of the application file or employment or other personnel record of such person, of the specific reason(s) why such person was determined to be appropriate and acceptable as an employee, volunteer, consultant or provider of goods or services with access to children being cared for by the group home.

(v) If the agency or social services official denies employment or makes a decision not to retain an employee, not to use a volunteer, not to hire a consultant, or not to permit a person providing goods or services to have access to children being cared for by the group home, such agency or official must provide a written statement to the applicant, employee, volunteer, consultant or other person indicating whether the denial or decision was based in whole or in part on the existence of the indicated report and, if so, the reasons for the denial or decision. If the denial or decision was based in whole or in part on the existence of such report of child abuse or maltreatment, the statement must also include, in the form prescribed by the department, written notification to the applicant, employee, volunteer, consultant or other person that:
(a) he/she has the right, pursuant to section 424-a of the Social Services Law, to request a hearing before the department regarding the record maintained by the Statewide Central Register of Child Abuse and Maltreatment;

(b) the request for such hearing must be made within 90 days of the receipt of the notice indicating that the denial or decision was based on the existence of the indicated report; and

(c) the sole issue at any such hearing will be whether the applicant, employee, volunteer, consultant or other person has been shown by a fair preponderance of the evidence to have committed the act or acts of child abuse or maltreatment giving rise to the indicated report.

(vi) If in a hearing held pursuant to a request made in accordance with subparagraph (iii) of this paragraph and section 424-a of the Social Services Law, the department fails to show by a fair preponderance of the evidence that the applicant, employee, volunteer, consultant or other person committed the act or acts upon which the indicated report is based, the department will notify the agency or official which made the inquiry that, pursuant to the hearing decision, the decision to deny the application, discharge the employee, not to use the volunteer or consultant, or not to permit a person to have access to children being cared for in the group home should be reconsidered. Upon receiving such notification from the department, the agency or social services official should review its denial or other decision without considering the indicated report.

(2) Review of applicants.
(i) Each program under this section is required to check applicants for employment and volunteer positions as well as contractors and consultants, with the Register of Substantiated Category One Cases of Abuse or Neglect (staff exclusion list) maintained by Vulnerable Persons' Central Register (VPCR), as required by section 495 of the Social Services Law, before determining whether to hire or otherwise allow any person to be an employee, administrator, consultant, intern, volunteer or contractor who will have the potential for regular and substantial contact with a service recipient; or before approving an applicant for a license, certificate, permit or other approval to provide care to a service recipient.
(a) If an applicant is listed on the staff exclusion list, a facility or provider agency as defined in section 488 of the Social Services Law shall not hire such a person for a position in which the person would have the potential for regular and substantial contact with a service recipient in any such facility or program or otherwise permit such person to have a position in which the person would have the potential for regular and substantial contact with a service recipient in any such facility or program. Other providers or licensing agencies as defined in subdivision (3) or (4) of section 424-a of the Social Services Law shall determine whether to hire or allow such a person to have regular or substantial contact with a service recipient in accordance with the provisions of subdivision (5) of section 424-a of the Social Services Law.

(b) Any program that is required to conduct an inquiry pursuant to section 495 of the Social Services Law shall first conduct the inquiry required under such section. If the result of the inquiry under section 495 of the Social Services Law is that the person about whom the inquiry is made is on the staff exclusion list and the program is required to deny the application in accordance with article 11 of the Social Services Law, the facility or provider agency shall not be required to make an inquiry of the office under section 424-a of the Social Services Law.

(ii) If an applicant is not listed on the staff exclusion list, then a database check must be completed in accordance with section 424-a of the Social Services Law and this section.

(iii) Each program under this section is required by section 553 of the Executive Law, and subdivision 1 of section 378-a of the Social Services Law, to obtain criminal history background checks for certain prospective employees, or volunteers who will have the potential for substantial, unsupervised or unrestricted physical contact with children or vulnerable persons through the Justice Center as authorized by article 20 of the Executive Law.
(a) The Justice Center will review and evaluate the criminal history information for any person applying to be an operator, employee, or volunteer for whom a criminal background check is required by law at any facilities or provider agencies as defined in subdivision four of section 488 of the Social Services Law that are operated, licensed or certified by the Office of Children and Family Services.

(b) If an applicant has been convicted of a crime, the agency must determine, in accordance with guidelines or regulations developed and disseminated by the Office of Children and Family Services or the Justice Center, whether to hire or use the person as an employee, or volunteer. If the agency determines it will hire or use the person, the agency must maintain a written record, as part of the application file or employment or other personnel record of such person, of the reason(s) why such person was determined to be appropriate and acceptable as an employee, volunteer or consultant.

(iv) A custodian, as defined in section 488 of the Social Services Law, shall be subject to immediate termination if he or she is convicted of any felony or misdemeanor as defined in the Penal Law, that relates directly to the abuse or neglect of a vulnerable person, or is placed on the staff exclusion list.

(3) A report of physical examination conducted no later than twelve months from the date of application by a physician, physician assistant, nurse practitioner or other licensed and qualified health care practitioner, as appropriate, regarding the individual's general health, that indicates the absence of communicable disease, infection, illness or any physical or mental condition(s) which might affect the proper care of children, or that presence of any identified affliction does not pose a risk to the health and safety of children, shall be required as a condition of employment and annually thereafter for food handlers and person caring for children.

(4) All staff shall have adequate time off with pay.

(5) A plan for orientation of all staff, integration with the total agency service and education through in-service training, must be a permanent part of the group home personnel program.

(6) At the commencement of employment, and annually thereafter, the agency must provide each staff employee a copy of the applicable Justice Center created or approved code of conduct required to read and to acknowledge that he or she has read and understands such code of conduct. Failure on the part of staff to acknowledge the code of conduct can result in disciplinary action including termination, consistent with appropriate collective bargaining agreements.

(7) At the time of application to be an employee or volunteer and again at the time of commencement of employment or work as a volunteer, each staff member must be informed of the agency's personnel practices and policies and must be informed of any subsequent changes made in the agency's personnel practices or policies.

(d) Physical facility.

(1) Location. The group home shall be in an appropriate neighborhood and so located that it is readily accessible to religious, school and recreational facilities and other community resources. Suitable outdoor play areas shall be readily available to the children.

(2) Buildings and grounds. Buildings used in whole or in part as a group home must comply with all applicable laws, ordinances, rules, regulations and codes relating to buildings, fire protection, health and safety.

(3) General requirements.
(i) The home shall be of sufficient size to provide adequate living accommodations for the residents and shall be suitably furnished and equipped.

(ii) The home shall be kept in sanitary condition and good repair.

(iii) The home shall be effectively screened against flies and other insects.

(iv) Adequate and safe water supply and sewage facilities shall be provided and shall comply with State and local laws.

(v) Temperature in the home shall be maintained at a comfortable level.

(vi) Rooms shall be adequately lighted and ventilated.

(4) Sleeping rooms.
(i) Every sleeping room occupied by children and/or children of parenting youth shall have good natural light and ventilation, and shall have one or more windows opening directly to the exterior.

(ii) Separate and accessible drawer space for personal belongings and sufficient closet space for indoor and outdoor clothing shall be available for each child and each child of a parenting youth.

(iii) No bed shall be located in any unfinished attic, basement, stair hall, closet, or room commonly used for other than bedroom purposes.

(iv) Except for parenting youth and any child of a parenting youth, children of different genders over the age of five shall not sleep in the same room unless such children are siblings, and unless it has been determined to be in the best interest of the children who are either part of a parenting youth and a child of a parenting youth unit, as such term is defined in section 427.2 of this Title or part of a sibling group. Where children of different genders occupy the same sleeping room in accordance with this subparagraph, they must have separate sleeping accommodations appropriate to their age and developmental stage, and consistent with safe sleep protocols.

(v) The minimum floor area of a single sleeping room occupied by a child, including a parenting youth shall contain not less than 80 square feet of floor area and a minimum horizontal dimension of seven feet, and for a child of a parenting youth, not less than 40 square fee.

(vi) The minimum floor area of a multiple sleeping room for children, including children of parenting youth, shall contain not less than 60 square feet of floor area per child and a minimum horizontal dimension of eight feet per child, or parenting youth, and for a child of a parenting youth.
(a) No more than three children shall occupy any bedroom unless such children are a parenting youth and a child of a parenting youth, and there is sufficient space in the bedroom to allow for such arrangement.

(b) Each child and child of a parenting youth shall have a separate bed or crib, consistent with their age and developmental stage, spaced at least two feet apart from other beds or cribs. Any crib provided must conform to safe sleep protocols.

(5) Bathing and toilet facilities. Bathing and toilet facilities shall be provided as follows:
(i) minimum requirements as to lavatories, tubs and showers:

Children

Lavatories

Tubs or showers

7-8

2

1

9-12

3

2

(ii) a minimum of two toilets for the children;

(iii) be provided with their own towel, washcloth, tooth brush and comb;

(iv) Appropriate bathing and toileting equipment specific to the ages and developmental stages of the children, parenting youth and any child of a parenting youth served by the facility must be provided and shall be kept in safe and sanitary condition; and

(v) separate staff lavatory and toilet facilities.

(6) Living rooms. Living room or rooms of sufficient size shall be provided to serve the needs of the residents.

(7) Dining facilities. Dining facilities shall be provided with sufficient space and equipment to serve all the residents.

(8) Kitchen. The kitchen shall be equipped to provide adequate food preparation storage and service.

(9) Facilities for storage and laundry. Facilities for storage and laundry shall be provided and shall include:
(i) space for storage of household supplies, larger personal items, seasonal clothing and outside sports equipment;

(ii) linen closet.

(10) Safety.
(i) Hazardous conditions. A group home must be free from all conditions which constitute a hazard to the life, health or safety of any person. The following are prohibited:
(a) portable electric space heaters or self-contained fuel-burning space heaters;

(b) solid-fuel-burning, free-standing stoves, except where approved in writing by the department;

(c) use of fuel-burning or electric "hot plates";

(d) rubber tubing used as connections for gas burners;

(e) combustible or flammable containers for ashes;

(f) the accumulation of combustible or flammable materials in any part of any building except in storerooms approved by the department in writing for such purpose;

(g) non-secure areas used for bulk storage of cleaning agents, bleaches, insecticides or any other poisonous, dangerous, combustible or flammable materials;

(h) damaged equipment, furnishings or physical plant, when their condition makes them unsafe for normal use;

(i) broken plumbing or stopped sewers that are not promptly repaired;

(j) exposed steam pipes, heating pipes and radiators and unenclosed heating plants and equipment with which children may come in contact;

(k) use of materials containing asbestos in any construction, renovation or repair of any group home where such construction, renovation or repair occurs on or after July 1, 1993;

(l) any furniture or toys containing lead-based paint and the use of lead-based paint in any construction, renovation or repair of any building or part of a building used by children;

(m) any lead paint hazard or paint condition conducive to lead poisoning, as such term is defined in 10 NYCRR 67.1. Any building used in whole or in part as a group home which is occupied by children six years of age or younger must be inspected to determine if it presents such hazard. A group home must request the local health department to perform such inspection and is responsible for correcting any hazard called to its attention as a result of such inspection. In the event that such requests for inspections are rejected by the local health departments, the group home must notify the department immediately;

(n) extension cords, unless approved in writing by the department; and

(o) any other condition deemed hazardous by the department.

(ii) Fire extinguishers must be provided and maintained in accordance with the New York State Uniform Fire Prevention and Building Code. Fire extinguishers must be wall-hung between two feet and four-and-one-half feet above the floor. All staff members must be instructed in the proper operation of extinguishers. There must be a minimum of one fire extinguisher on each floor and, additionally, one in the kitchen, one in the laundry room and one outside any heating equipment room.

(iii) A minimum of one non-coin-operated, single-line telephone must be provided and must be accessible at all times in each building occupied by children. Emergency telephone numbers for fire, police and medical assistance must be posted on or adjacent to all telephones.

(iv) Children and staff must be instructed in how to evacuate the building. Newly admitted children and newly hired staff must be instructed in evacuation procedures as part of their orientation to the group home. Fire drills must take place at least every 30 days and must be held at different times of the day and night. A written record of all fire drills must be kept on file at the group home for a period of one year.

(v) A group home must have a plan for evacuation of the home, posted in a conspicuous place on each floor level in the group home.

(vi) A group home must be protected by a fire detection system or a sprinkler system. Such system must be designed, installed and maintained in accordance with the New York State Uniform Fire Prevention and Building Code and shown on a diagram of the floor plan approved by the department. A fire detection system must include the following: (a) smoke detectors located at the top of each stairway, in each hallway, in each room leading to a means of egress, in the laundry room, and in each bedroom; and (b) heat detectors in the kitchen and in rooms enclosing heating equipment. A sprinkler system must include a complete system of valves and piping, with sprinkler heads in all accessible rooms and spaces, including closets, throughout the building. A fire detection system or a sprinkler system must include interconnection to alarm devices audible throughout a home and must be provided with a back-up power supply sufficient to operate the entire system or systems.

(vii) All areas of fire hazard must be protected by a sprinkler or fire detection system. Areas of fire hazard must be separated from other areas by construction having a fire resistance rating of at least one hour. An area of fire hazard means a heating equipment room; a woodworking shop; a paint shop; a storeroom for mattresses, furniture, paints and/or other combustible or flammable materials or liquids; and any other space or room exceeding 100 square feet in floor area where other combustible or flammable materials are regularly stored. Other than quantities of flammable materials necessary for the operation and maintenance of the home, which must be kept in closed containers in storage cabinets, and fuel oil, which must be kept in oil storage tanks, flammable materials must not be stored in the home.

(viii) All floors used by children must be separated from each other by a smoke stop separation and have alternate means of egress remotely located from each other and readily accessible to the children. A group home must have a minimum of two means of egress from each floor. For a window opening to qualify as a means of egress, it must be at least 30 inches in its smallest dimension with the bottom of the window no higher than three feet six inches above the floor unless acceptable access is provided by steps or furniture fixed in place. An upper level window, to qualify as a means of egress, must also have a platform outside the window and a stair, permanently affixed to the building, leading to ground level.

(ix) Children are not permitted above the second story in a building of type 5, wood frame construction (that type of construction in which the walls, partitions, floors and roof are wholly or partly of wood or other combustible materials). Children of limited mobility are not permitted above the first story in a building of wood frame construction. A building of wood frame construction occupied by children of limited mobility must be protected by a sprinkler system and the first story must be accessible to children of limited mobility and accommodate the needs of such children.

(x) All exit doors and means of egress, halls and stairs must be well lighted and kept clean, free of obstruction and ready at all times for immediate use. Battery-operated or generator-powered emergency lighting units or systems must be provided and maintained in accordance with the New York State Uniform Fire Prevention and Building Code. All stairwells must be equipped with battery-operated emergency lights. Doors used as smoke stop separations must be equipped with self-closing devices and magnetic hold-open devices.

(xi) Staff must be provided with emergency lights, such as flashlights or battery-operated lanterns, in good working order.

(xii) Electrical wiring and equipment must comply with the New York State Uniform Fire Prevention and Building Code and any other applicable laws, ordinances, rules, regulations and codes. Certification of such compliance is required for all new group homes prior to opening and a record of such certification of compliance must be kept on file in the group home and a copy forwarded to the department. The department may require recertification of the safety of an electrical system in any group home where the electrical system appears to be unsafe or inadequate, or if new electrical work has been done.

(xiii) Heating, ventilating and other mechanical systems must comply with the New York State Uniform Fire Prevention and Building Code and any other applicable laws, ordinances, rules, regulations and codes and must be designed, installed, located and maintained so that under normal conditions of use such equipment and systems are not a danger to the health or welfare of children or staff in the home. Heating plants and equipment must be protected from tampering by children.

(xiv) All shop, maintenance, grounds and farm equipment must be equipped with approved safety devices and must be maintained in safe working condition. Children must not operate such equipment except under the close supervision of responsible staff members.

(xv) Combustible or flammable materials or liquids must not be used by children except under the direct personal supervision of responsible staff members. Such materials must be stored in a fire resistive receptacle or room or in a separate building.

(xvi) Each group home must request in writing an annual safety inspection of the buildings and all fire protection equipment by local fire authorities and/or the group home's fire and casualty insurance carrier who must be requested to give the group home a written report of their findings. A group home is responsible for correcting any hazards called to its attention as a result of such inspection and for keeping a copy of the report and a written record of the action taken, with date, on file. A group home must keep a copy of the written request for inspection and the response on file and must notify the department immediately in the event that such request for inspection is rejected by the local fire authorities or the group home's fire and casualty insurance carriers.

(xvii) A child care agency must report promptly by telephone to the department the occurrence of any fire in any group home operated by such agency, which report must be made as soon as possible and in no event later than 24 hours after the fire, and must then confirm the occurrence of the fire by a written report to the department within 10 working days after the date of the fire. The written report must include:
(a) the date and time of the fire;

(b) the extent of personal injuries;

(c) the extent of property damage;

(d) the probable cause of the fire, if known;

(e) which fire department responded;

(f) whether children were relocated and, if so, where;

(g) whether fire and smoke detection and alarm devices or systems operated properly;

(h) whether fire drill and evacuation procedures were followed;

(i) the location of the fire;

(j) a description of the progress of the fire, the manner in which the fire spread and what efforts were made and methods were used to combat the fire; and

(k) any problems encountered with evacuation procedures, response by the fire department and ability of the fire department to combat the fire effectively.

(xviii) All chimneys and fireplaces must be inspected annually by a qualified person and must be cleaned annually.

(xix) All fire protection systems and equipment must be designed, installed, and maintained in accordance with the New York State Uniform Fire Prevention and Building Code and must be tested monthly. All fire protection systems and equipment must be inspected annually by a person qualified to install and service such systems and equipment who is not a staff member of the sponsoring agency. A written report of such inspection must be kept on file by the group home. All identified defects in systems or equipment must be corrected and reinspected immediately.

(e) [Reserved]

(f) Medical policies and procedures.

(1) The medical policies and procedures shall be described in writing and interpreted to all the personnel of the home. They shall be subject to frequent and regular review.

(2) Each child must have complete periodic medical examinations in accordance with section 441.22 of this Title.

(3) Each child will be provided, when necessary, with eyeglasses, hearing aids, and prosthetic or other adaptive devices.

(4) Written procedures concerning the actions to be taken in a medical emergency will be made known to staff and volunteers of a group home.

(5) First aid kits will be provided in such numbers as are necessary to meet the needs of the children in each group home. The contents of the kit will be appropriate to the needs of the children served and be approved by a physician most familiar with the population of each group home. The kits will be placed in convenient locations, so that the kits are readily accessible to staff of each group home.

(6) Whenever a group home is located more than five miles from any facility which can provide medical services in an emergency, all child care personnel of the group home must be certified in first aid by the American Red Cross. If a group home is located five miles or less from any facility which can provide medical services in an emergency, the agency must make reasonable efforts to have one person on each shift who is certified by the American Red Cross as trained in first aid.

(7) During a period of one month following the birth of their child, no mother in a facility caring for a parenting youth and a child of a parenting youth, as such term is defined in section 427.2 of this Title, may engage in work, work training, school, or any other program which requires them to be away from the group home, without written approval from a physician.

(g) Child care.

(1) Food supplied to the children shall be of good quality, properly prepared, served at regular hours and sufficient in quantity. The diet shall meet the nutritional standards recommended by the National Research Council. All milk and milk products shall be pasteurized.

(2) No child will be denied a meal for any reason, except as ordered by a physician; where meals are denied as a result of a doctor's order, the reason for the denial shall be contained in the child's case record.

(3) To the extent possible, nutritional requirements based on the client's/patient's religious beliefs will be met.

(4) Medically prescribed dietary or nutritional needs of children will be met.

(5) Food and beverage will be prepared and stored in a safe and sanitary manner.

(6) Meals are to be eaten in an upright position unless medically contraindicated; the reason why meals cannot be eaten in an upright position must be documented in the child's case record.

(7) Staff of a group home will take all necessary steps to prevent any resident(s) from intimidating another resident(s), especially in relation to coerced physical and sexual activities. Where an incident of intimidation or coercive physical or sexual activity is discovered, appropriate actions to prevent the recurrence of such activity must be initiated and sustained by the group home.

(8) Menus, as served, shall be retained on file for one year after date of use.

(9) Each child shall be provided with appropriate clothing, individually selected and properly fitted. Clothing shall be adequate in amount, attractive and of good quality, and properly maintained for comfort and health.

(10) Treatment services shall be provided children in accordance with their individual needs, and shall include:
(i) casework service for all children and their families. This shall be provided by a caseworker, a provisional caseworker, or a caseworker in training;

(ii) psychiatric and psychological services, including tests and examinations.

(11) Provision shall be made to meet the educational and recreational needs of the children in care.

(h) Records.

There shall be in every home a record of each child received for care, showing the name, date of birth, and religious faith of the child, and other information pertinent for identification and supervision of children in the home.

(i)

(1) Room isolation is prohibited.

(2) No child shall be confined to a locked room for any reason.

(j) Children under five years of age-special provisions.

(1) An agency must not accept any child under five 5 years of age in a group home unless:
(i) the child is a sibling of another child over such age who is a resident in the group home; or

(ii) the child is part of a parenting youth and child of a parenting youth unit, as such term is defined in section 427.2 of this Title, and both the parenting youth and the child of the parenting youth would be residents of the group home, and the group home has been approved by the Office of Children and Family Services;

(2) For each child under the age of five there shall be provided:
(i) Separate sleeping accommodations appropriate to their age and developmental stage and in accordance with safe sleep protocols, provided further that a crib shall be provided for any children under two years of age.

(ii) Highchairs or tables and chairs suitable to the size of the children under five years of age in care shall be provided at feeding time.

(iii) Safe and developmentally appropriate equipment including educational items and toys.

(3) An agency must not accept any child under five years of age in a group home in accordance with this subdivision unless it has notified the Office of Children and Family Services of its intent to care for such child and the plan of care thereof and it has received a written statement from the Office of Children and Family Services that its program and facilities for the care of such child are in compliance with the rules of the department.

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