Current through all regulations passed and filed through September 16, 2024
(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 preteen 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.
