Texas Department of Aging and Disability Services
Adult Day Care and Day Activity and Health Services Requirements
Revision: 11-1

Subchapter D

§98.61  General Requirements

(a)
For purposes of this subchapter, the term, "communicable diseases" has the meaning assigned to it under 25 TAC Chapter 97 (relating to Communicable Diseases).
(b)
The facility must:
(1)
comply with the requirements for advance directives as outlined under subsection (c) of this section;
(2)
comply with the provisions of Chapter 250 of the Health and Safety Code (relating to criminal history checks of employees and applicants for employment in certain facilities serving the elderly or persons with disabilities);
(3)
before offering employment, search the employee misconduct registry (EMR) established under §253.007, Health and Safety Code and the DADS nurse aide registry (NAR) to determine if an individual is designated in either registry as unemployable. Both registries can be accessed on the DADS Internet website.
(A)
A facility must not employ a person who is listed as unemployable in either registry.
(B)
A facility must provide written information about the EMR to an employee in accordance with §93.3 of this title (relating to Employment and Registry information).
(C)
In addition to the initial search of the EMR and NAR, a facility must:
(i)
conduct a search of the NAR and EMR to determine if the employee is designated in either registry as unemployable as follows:
(I)
for an employee most recently hired before September 1, 2009, by August 31, 2011 and at least every twelve months thereafter; and
(II)
for an employee most recently hired on or after September 1, 2009, at least every twelve months; and
(ii)
keep a copy of the results of the initial and annual searches of the NAR and EMR in the employee's personnel file;
(4)
develop policies to comply with standards for universal precautions for HIV/AIDS and related conditions in the workplace;
(5)
develop written policies for the control of communicable diseases in employees and clients, which include tuberculosis (TB) screening and provision of a safe and sanitary environment for clients and their families;
(6)
comply with all relevant federal and state standards; and
(7)
comply with all applicable provisions of the Human Resource Code, Chapter 102.
(c)
A facility must maintain policies and procedures regarding the following rules with respect to all adult clients receiving services provided by the facility:
(1)
The facility must provide a client with the following written information:
(A)
the client's rights under Texas law (whether statutory or as recognized by the courts of the state) to make decisions concerning medical care, including the right to accept or refuse medical or surgical treatment and the right to formulate advance directives;
(B)
the facility's policies respecting the implementation of these rights; and
(C)
a written list of the client's rights, as outlined under the Human Resource Code §102.004, Rights of the Elderly.
(2)
The facility must document in the client's record whether the client has executed an advance directive.
(3)
The facility must not condition the provision of care or otherwise discriminate against a client based on whether the client has executed an advance directive.
(4)
The facility must ensure compliance with the requirements of Texas law, whether statutory or as recognized by the courts of Texas, respecting advance directives.
(5)
The facility must educate the client, family members and staff, in a language they understand, on issues concerning advance directives.
(6)
The facility must provide the attending physician with any information relating to a known existing Directive to Physicians or Living Will or Durable Power of Attorney for Health Care and assist with coordinating physicians' orders with any directive.
(7)
When a client is in an incapacitated state and therefore is unable to receive information or articulate whether he has executed an advance directive, the family, surrogate or other concerned person must receive the information concerning advance directives. The facility must provide this information to the client in a language he understands, if he is no longer incapacitated.
(8)
When the client or a relative, surrogate or other concerned or related individual presents the facility with a copy of the client's advance directive, the facility must comply with the advance directive including recognition of a durable power of attorney for health care, to the extent allowed under state law. If no one comes forward with a previously executed advance directive and the client is incapacitated or otherwise unable to receive information or articulate whether he has executed an advance directive, the facility must note that the client was not able to receive information and was unable to communicate whether an advance directive existed.
(d)
A facility must:
(1)
contact DADS at 1-800-458-9858 on learning of alleged abuse or neglect of a client and send a written investigation report to DADS no later than the fifth working day after the oral report;
(2)
maintain incident reports;
(3)
ensure the confidentiality of individual client records and other information related to clients; and
(4)
inform the client orally and in writing of his rights, responsibilities and grievance procedures in a language he understands.
(e)
A facility must prominently and conspicuously post for display in a public area of the facility that is readily available to clients, employees and visitors:
(1)
the license issued under this chapter;
(2)
a sign prescribed by DADS that describes complaint procedures and specifies how complaints may be filed with DADS;
(3)
a notice in the form prescribed by DADS stating that inspection and related reports are available at the facility for public inspection and providing DADS' toll-free telephone number that may be used to obtain information concerning the facility;
(4)
a copy of the most recent inspection report relating to the facility;
(5)
a brochure or letter that outlines the facility's hours of operation, holidays and a description of activities offered; and
(6)
emergency telephone numbers, including the abuse hotline telephone number, near all telephones.

§98.62  Program Requirements

(a)
Staff qualifications.
(1)
Director.
(A)
The director must:
(i)
have graduated from an accredited four-year college or university and have no less than one year of experience in working with people in a human service or medically related program or have an associate degree or 60 semester hours from an accredited college or university with three years of experience in working with people in a human service or medically related program; or
(ii)
be a registered nurse with one year of experience in a human service or medically related program; or
(iii)
meet the training and experience requirements for a license as a nursing facility administrator under the rules of the Texas Board of Licensure for Nursing Facility Administrators; or
(iv)
have met, on July 16, 1989, the qualifications for the position under the requirements in effect at that time and have served continuously in the capacity of director of a Texas Department of Human Services-certified facility since that date.
(B)
The director must show evidence of 12 contact hours of annual continuing education in at least two of the following areas:
(i)
individual and provider rights and responsibilities, abuse, neglect and confidentiality;
(ii)
basic principles of supervision;
(iii)
skills for working with individuals, families and other professional service providers;
(iv)
individual characteristics and needs;
(v)
community resources;
(vi)
basic emergency first aid, such as CPR or choking; or
(vii)
federal laws, such as Americans with Disabilities Act, Civil Rights Act of 1991, the Rehabilitation Act of 1993 and the Family and Medical Leave Act of 1993.
(C)
The activities director may fulfill the function of facility director if he meets the qualifications for facility director.
(D)
One person may not serve as facility nurse, activities director and facility director, regardless of qualifications.
(E)
The facility must have a policy regarding the delegation of responsibility in the administrator's absence, not to exceed 10 working days.
(F)
The facility must request a waiver from Long Term Care-Regulatory (LTC-R) Regional Office for exceptional circumstances. Exceptional circumstances include, but are not limited to, hospitalization, death, etc.
(2)
Nurse. The facility nurse must be a registered nurse (RN) or a licensed vocational nurse (LVN).
(A)
The RN must have a current license from the Board of Nurse Examiners for the State of Texas and must practice in compliance with the Nurse Practice Act and rules and regulations of the Board of Nurse Examiners.
(B)
The LVN must have a current license from the Board of Vocational Nurse Examiners of Texas and must practice in compliance with the Vocational Nurse Act and rules and regulations of the Board of Vocational Nurse Examiners.
(C)
If a nurse serving as director leaves the facility to perform other duties related to the provisions of the day care program, an LVN or another RN must fulfill the duties of the facility nurse.
(D)
Licensed facilities that do not have a Day Activity and Health Services (DAHS) contract, but have a Special Services to Persons with Disabilities contract, are not required to have a registered nurse on duty, as long as the client receiving services has no medical needs and is able to self medicate.
(3)
Activities director.
(A)
The activities director must be a high school graduate (or equivalent) and have:
(i)
a bachelor's degree from an accredited college or university, plus one year of full-time experience in working with the elderly or people with disabilities in a human service or medically related program; or
(ii)
60 semester hours from an accredited college or university, plus two years of full-time experience in working with the elderly or people with disabilities in a human service or medically related program; or
(iii)
completed a state-approved activities director's course, plus two years of full-time experience in working with the elderly or people with disabilities in a human service or medically related program.
(B)
Anyone hired prior to May 1, 1999, as an activities director with four years of full-time experience in working with elderly or people with disabilities in a human service or medically related program, will be considered a qualified activities director.
(4)
Attendants. Attendants must be 18 years old or older and may include, but are not limited to, bus drivers, aides, cooks, janitors, porters, maids and laundry workers.
(A)
If the facility employs a bus driver, the driver must have a current operator's license, issued by the Texas Department of Public Safety, which is appropriate for the class of vehicle used to transport clients.
(B)
If an attendant handles food in the facility, he must meet the requirements described in the Texas Department of Health rules on food service sanitation as described under 25 TAC §§229.161-229.171 and §§229.173-175 (relating to Texas Food Establishments).
(5)
Food service personnel. If the facility prepares meals on site, the facility must have sufficient food service personnel to prepare meals and snacks. Food service personnel must meet the requirements described in the Texas Department of Health rules on food service sanitation as described under 25 TAC §§229.161-229.171 and §§229.173-229.175 (relating to Texas Food Establishments).
(6)
Additional requirements for Day Activity and Health Services (DAHS) employees.
(A)
Housekeeper. A DAHS facility may employ a part-time or full-time housekeeper.
(B)
Driver. If a DAHS facility employs a part-time or full-time driver, the driver must:
(i)
operate the facility's vehicles in a safe manner; and
(ii)
maintain adult cardiopulmonary resuscitation (CPR) certification.
(b)
Staffing ratio. The facility must ensure that:
(1)
the ratio of direct service staff to clients is at least one to eight, which must be maintained during provision of all covered services except during facility-provided transportation;
(2)
at a minimum, one registered nurse or licensed vocational nurse must be working on site, eight hours per day. The facility may schedule nursing hours according to client needs. Sufficient licensed nursing staff must be on site to meet the nursing needs of the clients;
(3)
the facility director works a minimum of 40 hours per week performing duties relating to the provision of adult day care services;
(4)
the activities director works 40 hours a week; and
(5)
clients whose needs cannot be met by the facility are not admitted or retained. Sufficient staff must be on duty at all times to meet the needs of the clients. The facility is responsible for all care provided at the facility.
(c)
Staff health. All direct staff must be free of communicable diseases.
(1)
The facility must screen all employees for tuberculosis within two weeks of employment and annually, according to Center for Disease Control screening guidelines. All persons providing services under an outside resource contract must also screen all employees for tuberculosis within two weeks of employment and annually according to Center for Disease Control screening guidelines. When requested to do so by the facility, persons providing services under an outside resource contract must provide evidence of compliance with this requirement.
(2)
If employees contract a communicable disease that is transmissible to individuals through food handling or direct individual care, the employee must be excluded from providing these services as long as a period of communicability is present.
(d)
Staff responsibilities.
(1)
Facility director. The facility director is responsible for:
(A)
managing the adult day care program and/or the facility;
(B)
training and supervising facility staff;
(C)
monitoring the facility building and grounds to ensure compliance;
(D)
maintaining all financial and client records;
(E)
developing relationships with community groups and agencies for identification and referral of clients;
(F)
maintaining communication with the client's family members or responsible parties;
(G)
assuring the development and maintenance of the individual plan of care; and
(H)
ensuring that, if he serves as the nurse consultant during the same eight-hours-per-day period, he is fulfilling his responsibility as director.
(2)
Facility nurse. The facility nurse is responsible for:
(A)
assessing the client's nursing and medical needs;
(B)
developing a client's individual plan of care;
(C)
obtaining physician's orders for medication and treatments to be administered;
(D)
determining whether self-administered medications have been appropriately taken, applied or used;
(E)
entering, dating and signing monthly progress notes on medical care provided;
(F)
administering medication and treatments;
(G)
providing health education; and
(H)
maintaining medical records.
(3)
Activities director. The activities director is responsible for:
(A)
planning and directing the daily program of activities, including physical fitness exercises or other recreational activities;
(B)
recording the client's social history;
(C)
assisting the client's related support needs;
(D)
assuring that the identified related support services are included in the client's individual plan of care; and
(E)
signing and dating monthly progress notes about social and related support services activities provided.
(4)
Attendant. The attendant is responsible for:
(A)
providing personal care services (assistance with activities of daily living);
(B)
assisting the activities director with recreational activities; and
(C)
providing protective supervision (observation and monitoring).
(5)
Food service personnel. Food service personnel are responsible for:
(A)
preparing meals and snacks; and
(B)
maintaining the kitchen area and utensils in a safe and sanitary condition.
(6)
Dietitian consultant.
(A)
The facility must receive consultation at least four hours each month from a dietitian. The dietitian consultant plans and/or reviews menus and must:
(i)
prior approve and sign each snack and luncheon menu;
(ii)
review menus monthly to ensure that substitutions were appropriate; and
(iii)
develop any special diets ordered by physicians for individual clients.
(B)
The dietitian consultant is required for all facilities, even those that have their meals delivered from another facility with its own dietitian consultant. A consultant may provide consultation to several facilities as long as each facility receives at least four hours a month. The four hours cannot be "shared" by several facilities.
(C)
Facilities that contract for the preparation and delivery of meals with management companies employing their own registered dietitians are required to have the four hours of consultation from a dietitian consultant.
(7)
Registered nurse consultant. In facilities where the nurse is a licensed vocational nurse, a registered nurse consultant must provide on-site consultation four hours per week. The RN consultant must document the consultation provided. The RN consultant must provide the consultation during the time when clients are present in the facility. The RN consultant may provide the following types of assistance:
(A)
reviewing plans of care and suggesting changes, if appropriate;
(B)
assessing clients' health conditions;
(C)
consulting with the LVN in solving problems involving client care and service planning;
(D)
counseling clients on their health needs;
(E)
training, consulting and assisting the LVN in maintaining proper medical records; and
(F)
providing in-service training for direct service staff.
(e)
Training.
(1)
Initial training.
(A)
The facility must:
(i)
provide all staff with training in the fire, disaster and evacuation procedures within three workdays of employment. The training must be documented in the facility records.
(ii)
provide direct delivery staff a minimum of 18 hours of training during the first three months of employment. Training must be documented in the facility records. Training must include:
(I)
any nationally or locally recognized adult cardiopulmonary resuscitation (CPR) course/certification;
(II)
first aid; or
(III)
orientation to health care delivery including the following components:
(-a-)
safe body function and mechanics;
(-b-)
personal care techniques and procedures; and
(-c-)
overview of client population served at the facility; and
(IV)
identification and reporting of abuse, neglect or exploitation.
(B)
Staff employed as substitutes on an infrequent and irregular basis are not required to have 18 hours of initial training. Substitute and consultant staff must receive a minimum of three hours of orientation. Substitutes for direct service staff used by a facility on a regular basis must meet all training requirements as specified under this subsection.
(2)
Ongoing training.
(A)
The facility must provide a minimum of three hours of ongoing training to direct service staff quarterly. The facility must ensure that direct delivery staff maintain current certification in CPR.
(B)
The facility must practice evacuation procedures with staff and clients not less than once a month. The evacuation results must be documented in the facility records.
(f)
Medications.
(1)
Administration.
(A)
Clients who choose not to or cannot self-administer their medications must have their medications administered by a person who holds a current license under state law which authorizes the licensee to administer medications.
(B)
All medication prescribed to clients must be dispensed through a pharmacy or by the client's treating physician or dentist.
(C)
Physician sample medications may be given to a client by the facility provided the medication has specific dosage instructions for the individual client.
(D)
Each client's medications must be listed on an individual client's medication profile record. The recorded information obtained from the prescription label must include, but is not limited to, the medication name, strength, dosage, amount received, directions for use, route of administration, prescription number, pharmacy name and the date each medication was issued by the pharmacy.
(2)
Assistance with self administration. Assistance with self administration of client's medication regimen by licensed nursing staff may be provided to clients who are incapable of self-administering without assistance. Assistance with self-medication includes and is limited to:
(A)
reminders to take their medications at the prescribed time;
(B)
opening containers or packages and replacing lids;
(C)
pouring prescribed dosage according to medication profile record;
(D)
returning medications to the proper locked areas;
(E)
obtaining medications from a pharmacy; and
(F)
listing on an individual client's medication profile record the medication name, strength, dosage, amount received, directions for use, route of administration, prescription number, pharmacy name and the date each medication was issued by the pharmacy.
(3)
Self-administration.
(A)
Clients who self-administer their own medications must be counseled at least once a month by licensed nursing staff to ascertain if the clients continue to be capable of self-administering their medications and/or treatments. A written record of counseling must be kept by the facility.
(B)
Clients who choose to keep their medications locked in the central medication storage area may be permitted entrance or access to the area for the purpose of self-administering their own medication and/or treatment regimen. A facility staff member must remain in or at the storage area the entire time any client is present.
(4)
General.
(A)
The facility director, the activities director or a facility nurse must immediately report to the client's physician and responsible party any unusual reactions to medications or treatments.
(B)
When the facility supervises or administers the medications, a written record must be kept when the client does not receive or take his medications and/or treatments as prescribed. The documentation must include the date and time the dose should have been taken and the name and strength of medication missed.
(5)
Storage.
(A)
The facility must provide a locked area for all medications. Examples of areas include, but are not limited to:
(i)
central storage area; and
(ii)
medication cart.
(B)
Each client's medication must be stored separately from other clients' medications within the storage area.
(C)
A refrigerator must have a designated and locked storage for medications requiring refrigeration. Medications requiring refrigeration must be stored in a refrigerator used only for medicine storage or in a separate, permanently attached and locked medication storage box in a refrigerator.
(D)
Poisonous substances and medications labeled for "external use only" must be stored separately within the locked medical area.
(E)
The medication room or cabinet medication storage area must have a separate, permanently attached cabinet, box or drawer with a lock to store drugs covered by Schedule II of the Controlled Substances Act of 1970.
(6)
Disposal.
(A)
Medications no longer being used by the client for the following reasons must be kept separate from current medications and are to be disposed of by a registered pharmacist licensed in the State of Texas:
(i)
medications discontinued by order of the physician;
(ii)
medications which remain after a client is deceased; or
(iii)
medications which have passed the expiration date.
(B)
Needles and hypodermic syringes with needles attached must be disposed as required by 25 TAC 1, Subchapter K (relating to the Definition, Treatment and Disposal of Special Waste from Health Care Related Facilities).
(C)
Medications kept in a central storage area are released to discharged clients when a receipt has been signed by the client or responsible party.
(g)
Accident, injury or acute illness.
(1)
The facility must stock and maintain in a single location first aid supplies to treat burns, cuts and poisoning.
(2)
In the event of accident or injury requiring emergency medical, dental or nursing care or in the event of apparent death, the adult day care facility must:
(A)
make arrangements for emergency care and/or transfer to an appropriate place for treatment (including, but not limited to, physician's office, clinic or hospital);
(B)
immediately notify the client's physician and next of kin, responsible party or agency who placed the client in the facility; and
(C)
describe and document the accident, injury or illness on a separate report. The report must contain a statement of final disposition and be maintained on file.
(h)
Menus.
(1)
Menus must be planned at least two weeks in advance, dated, maintained on file and posted in the facility. Meals must be served according to approved menus.
(2)
Special diet meals ordered by the client's physician and developed by the dietician must be labeled with the client's name and type of diet.

§98.63  Peer Review

A facility must adopt and enforce a written policy to ensure that all professional disciplines comply with their professional practice acts or title acts relating to reporting and peer review.

§98.64  Emergency Preparedness and Response

(a)
Definitions. In this section:
(1)
"emergency situation" means an impending or actual situation that:
(A)
interferes with normal activities of a facility or its clients;
(B)
may:
(i)
cause injury or death to a client or staff member of the facility; or
(ii)
cause damage to facility property;
(C)
requires the facility to respond immediately to mitigate or avoid the injury, death, damage or interference; and
(D)
does not include a situation that arises from the medical condition of a client such as cardiac arrest, obstructed airway, cerebrovascular accident; and
(2)
"plan" refers to a facility's emergency preparedness and response plan.
(b)
Administration. A facility must:
(1)
develop and implement a written plan as described in subsection (c) of this section;
(2)
maintain a written copy of the plan that is accessible to all staff at all times;
(3)
evaluate and revise the plan as necessary:
(A)
within 30 days after an emergency situation;
(B)
as soon as possible after the remodeling or construction of an addition to the facility; and
(C)
at least annually; and
(4)
revise the plan within 30 days after information included in the plan changes.
(c)
Emergency Preparedness and Response Plan. A facility's plan must:
(1)
include a risk assessment of all potential internal and external emergency situations relevant to the facility operations and geographical area, such as a fire, failure of heating and cooling systems, a power outage, an explosion, a hurricane, a tornado, a flood, extreme snow and ice for the area, a wildfire, terrorism, or a hazardous materials accident;
(2)
include a description of the facility's client population;
(3)
include a description of the services and assistance needed by the clients in an emergency situation;
(4)
include a section for each core function of emergency management, as described in subsection (d) of this section, that is based on a facility's decision to either shelter-in-place or evacuate during an emergency; and
(5)
include a fire safety plan that complies with subsection (f) of this section.
(d)
Plan Requirements Regarding Eight Core Functions of Emergency Management.
(1)
Direction and control. A facility's plan must contain a section for direction and control that:
(A)
designates by name or title the emergency preparedness coordinator (EPC) who is the facility staff person with the authority to manage the facility's response to an emergency situation in accordance with the plan;
(B)
designates by name or title the alternate EPC who is the facility staff person with the authority to act as the EPC if the EPC is unable to serve in that capacity;
(C)
documents the name and contact information for the local emergency management coordinator (EMC) for the area where the facility is located, as identified by the office of the local mayor or county judge; and
(D)
documents coordination with the local EMC as required by the local EMC's guidelines relating to emergency situations.
(2)
Warning. A facility's plan must contain a section for warning that:
(A)
describes how the EPC will be notified of an emergency situation;
(B)
identifies who the EPC will notify of an emergency situation and when the notification will occur; and
(C)
ensures monitoring of local news and weather reports.
(3)
Communication. A facility's plan must contain a section for communication that:
(A)
identifies the facility's primary mode of communication and alternate mode of communication to be used in the event of power failure or the loss of the facility's primary mode of communication in an emergency situation;
(B)
includes procedures for maintaining a current list of telephone numbers for clients and responsible parties;
(C)
includes procedures for maintaining a current list of telephone numbers for the facility's staff that also identifies the facility's EPC;
(D)
identifies the location of the lists described in paragraphs (B) and (C) of this subsection where facility staff can obtain the list quickly;
(E)
includes procedures to notify:
(i)
facility staff about an emergency situation;
(ii)
a receiving facility about an impending or actual evacuation of clients; and
(iii)
clients, legally authorized representatives and other persons about an emergency situation;
(F)
describes how the facility will provide, during an emergency situation, general information to the public, such as the change in the facility's location and hours, or that the facility is closed due to the emergency situation;
(G)
includes procedures for the facility to maintain communication with:
(i)
facility staff during an emergency situation;
(ii)
a receiving facility if applicable; and
(iii)
facility staff who will transport clients to a secure location during an evacuation in a facility vehicle;
(H)
includes procedures for reporting to DADS an emergency situation that caused the death or serious injury of a client as follows:
(i)
by telephone, at 1-800-458-9858, within 24 hours after the death or serious injury; and
(ii)
in writing, on the DADS form titled "DADS Provider Investigation Report," within 5 working days after the facility makes the telephone report required by clause (i) of this subparagraph.
(4)
Sheltering-in-place. A facility's plan must contain a section that includes procedures to shelter clients in place during an emergency situation.
(5)
Evacuation. A facility's plan must contain a section for evacuation that:
(A)
requires posting building evacuation routes prominently throughout the facility, except in small, one-story buildings where all exits are obvious;
(B)
includes procedures for evacuating clients to a pre-arranged location in an emergency situation, if applicable;
(C)
includes a mutual aid agreement with a receiving facility which must specify the arrange ments for receiving clients in the event of an evacuation;
(D)
identifies primary and alternate evacuation destinations and routes, and includes a map that shows the destination and routes;
(E)
includes procedures for:
(i)
ensuring facility staff accompany evacuating clients;
(ii)
ensuring that all persons present in the building have been evacuated;
(iii)
accounting for clients and staff after they have been evacuated;
(iv)
accounting for clients who are absent from the facility at the time of the evacuation;
(v)
contacting the local EMC, if required by the local EMC guidelines, to find out if it is safe to return to the geographical area; and
(vi)
determining if it is safe to re-enter and occupy the building after an evacuation;
(F)
includes procedures for notifying the local EMC regarding an evacuation of the facility, if required by the local EMC guidelines;
(G)
includes procedures for notifying DADS by telephone, at 1-800-458-9858, within 24 hours after an evacuation that clients have been evacuated;
(H)
includes procedures for notifying DADS Regulatory Services regional office for the area in which the facility is located, by telephone, as soon as safely possible after a decision to evacuate is made; and
(I)
includes procedures for notifying DADS regional office for the area in which the facility is located, by telephone, that clients have returned to the facility after an evacuation, within 48 hours after their return.
(6)
Transportation. A facility's plan must contain a section for transportation that:
(A)
provides for a sufficient number of vehicles that are safe and suitable for any special needs of the clients or requires that the facility maintain a contract for transporting clients during an evacuation;
(B)
identifies facility staff authorized to drive a vehicle during an evacuation;
(C)
establishes alternate transportation arrangements if the vehicles or contracted transportation described in subparagraph (A) of this paragraph are not available;
(D)
includes procedures for safely transporting oxygen tanks currently being used by clients and any extra oxygen tanks that may be needed during an evacuation; and
(E)
includes procedures that will ensure:
(i)
safe transport of records, food, water, equipment, and supplies needed during an evacuation; and
(ii)
that the records, food, water, equipment, and supplies, described in clause (i) of this subparagraph, arrive at the receiving facility at the same time as the clients.
(7)
Health and Medical Needs. A facility's plan must contain a section for client health and special needs that:
(A)
identifies all of the facility's special needs clients including clients with conditions requiring assistance during an evacuation; and
(B)
ensures the needs of those clients are met during an emergency.
(8)
Resource Management. A facility's plan must contain a section for resource management that:
(A)
includes procedures for accessing medications, records, food, water, equipment and supplies needed during an emergency;
(B)
identifies facility staff who are assigned to locate and ensure the transportation of items described in subparagraph (A) of this paragraph during an emergency situation; and
(C)
includes procedures to ensure medications are secure and stored at the proper temperatures during an emergency situation.
(e)
Training. A facility must:
(1)
train all staff on their responsibilities under the plan when hired in accordance with 98.62(e) of this chapter (relating to Program Requirements);
(2)
retrain staff at least annually on the staff member's responsibilities under the plan and when the staff member's responsibilities under the plan change; and
(3)
conduct unannounced drills with facility staff for severe weather and other emergency situations identified by the facility as likely to occur, based on the results of the risk assessment required by subsection (c)(1) of this section.
(f)
Fire Safety Plan. A facility's fire safety plan must:
(1)
include the provisions described in the Operating Features section of the NFPA 101 Life Safety Code, 2000 Edition, Chapter 16 (for new day-care occupancies) and Chapter 17 (for existing day-care occupancies) concerning:
(A)
use of alarms;
(B)
transmission of alarm to fire department;
(C)
response to alarms;
(D)
isolation of fire;
(E)
evacuation of immediate area;
(F)
evacuation of smoke compartment;
(G)
preparation of floors and building for evacuation; and
(H)
fire extinguishment;
(2)
include procedures to contact DADS by telephone, at 1-800-458-9858, within 24-hours after a fire in accordance with 98.42 of this chapter (relating to Safety); and
(3)
include procedures to submit to DADS, within 15 days after the fire, the form entitled "Fire Report for Long Term Care Facilities;"
(4)
include in the fire safety plan the provisions described in the Operating Features section of the NFPA 101 Life Safety Code, 2000 Edition, Chapter 16 (for new day-care occupancies) and Chapter 17 (for existing day-care occupancies) concerning drills and inspections, except as superseded by this section; and
(5)
establish procedures to:
(A)
perform a monthly fire drill with all occupants of the building at expected and unexpected times and under varying conditions;
(B)
relocate, during the monthly fire drill, all occupants of the building to a predetermined location where participants must remain until a recall or dismissal signal is given;
(C)
complete the DADS Fire Drill Report Form for each required fire drill;
(D)
conduct a monthly fire prevention inspection performed by a trained and senior member of the facility and prepare a report of the inspection results;
(E)
maintain copies of the fire prevention inspection report, described in subparagraph (D) of this paragraph, that were prepared by the facility within the last 12 months; and
(F)
post a copy of the most recent fire prevention inspection report, described in subparagraph (D) of this paragraph, in a conspicuous place in the facility.