Current through September 24, 2024
(1) Intermediate
Care. Residents must not be kept in-runaway house agencies over twenty-eight
(28) days except on an emergency basis. In such cases, the record must reflect
diligence in pursuing appropriate alternative living resources. Documentation
of referrals for alternative living resources must be contained in the case
record.
(2) Health.
(a) An ongoing medical record of each
resident must be maintained in the agency.
(b) Doctor's orders must be observed during
the course of an illness.
(b)
Doctor's orders must be observed during the course of an illness
(c) Regulation of visitors and the
sterilization of dishes must be observed as the nature of illness
dictates
(d) First aid supplies
must be kept on hand and must be placed in a locked area.
(e) A record of all medication dispensed must
appear both in an ongoing agency medical log and in the case record of the
individual resident.
(f) All legend
drugs must be double-locked within the agency.
(g) In the event that any medication is used
as an attitude manipulator, a tranquilizer, a legend pain killer, a
barbiturate, or an amphetamine, there must be safeguards of a double entry
medication system whereby each medication and the quantity is recorded as it
comes into the agency and as it is administered.
(h) All controlled substances administered
must be clearly evidenced in the controlled substance log, in the agency
medication log, and in the individual record of the resident.
(i) No medication may be administered without
a specific order from a licensed physician. The drug must be given to the
individual for whom the drug was ordered in strict conformity with the
directions given by the prescribing physician.
(j) No agency shall have legend/controlled
substance as stock items. Such drugs must be individually prescribed and kept
in the original containers with the name of the patient, drug, dosage,
frequency of administration and prescription number unless filled directly by
the physician.
(k) Each agency must
develop a system for screening prospective residents for possible communicable
diseases and an attitude must exist in the agency which would facilitate the
trust of residents in sharing possible suspicions of communicable diseases with
staff members.
(l) A formalized
plan for providing both emergency and ongoing medical care must be developed
with services to at least include the services of a pediatrician, a
gynecologist, and a general surgeon.
(m) An emergency plan for dental and optical
care must be developed.
(3) Nutritional Needs.
(a) Food of adequate quality and quantity
must be served and meet the child's daily dietary allowances as recommended by
USDA. (See Appendix C.)
(b) Three
meals and snacks must be provided daily (See Appendix C.), with not more than a
14hour span between a substantial evening meal and breakfast of the following
day, and not more than 10 hours between breakfast and the evening meal of the
same day.
(c) All special diets
must be prepared as prescribed by the physician.
(d) Denial of a nutritionally adequate diet
must not be used as a punishment,
(4) Menus. Menus for the week must be
prepared in advance. These menus must be followed and varied from week t o
week, although reasonable substitutions are permissible if the substituted food
contains approximately the same nutrients.
(5) Food Sanitation and Preparation.
(a) State and local regulations for food
sanitation must be met, which include but are not limited to the following:
1. When food is transported, it must be done
in a manner that maintains proper temperature, protects the food from
contamination and spoilage, and insures the preservation of nutritive
value.
2. All food must be from
sources approved or considered satisfactory by the health authority. All milk
must be pasteurized.
3. Raw fruits
and vegetables must be washed before use. Stuffing, poultry, and pork products
must be thoroughly cooked before being served.
4. Leftover food not brought to the table for
service must be covered, refrigerated properly and used promptly. Food brought
to the table for family-style service must be discarded if not
consumed.
5. Reliable thermometers
must be kept in the refrigerators. The temperature of refrigerated food must be
maintained at 45 degrees F. or below. To keep food at this temperature the
refrigerator temperature must be 37 degrees F. or below. Freezer temperatures
must be 0 degrees F. or below.
6.
Milk and other perishable foods must be kept in the refrigerator except during
the time of preparation and service.
7. All dry food supplies must be stored in
closed containers and stored at least ten (10) inches from the floor.
(b) Food preparation must be the
responsibility of a staff member,
(6) Child Behavior and Discipline
(a) Corporal punishment of any form must be
specifically prohibited in the agency.
(b) Some plan for discipline and order must
be established as a part of the ongoing policy and philosophy of the agency of
which each resident and staff member is aware.
(7) Education and Religion
(a) Children in the runaway house program
must comply with the Tennessee State Law on compulsory school
attendance.
(b) The agency shall
provide the opportunity for the individual residents to fulfill religious
preferences.
Authority: T.C.A. §§
4-5-226(b)(2);37-5-101;
37-5-105; 37-5-106; 37-5-112(a); 37-1604 and 37-1605.