(a) A facility described in subdivision (a) of Section 1180.2 or subdivision (a) of Section 1180.3 shall conduct an initial assessment of each person prior to a placement decision or upon admission to the facility, or as soon thereafter as possible. This assessment shall include input from the person and from someone whom the person desires to be present, such as a family member, significant other, or authorized representative designated by the person, and if the desired third party can be present at the time of admission. This assessment shall also include, based on the information available at the time of initial assessment, all of the following:

1. (1) A person’s advance directive regarding de-escalation or the use of seclusion or behavioral restraints.
2. (2) Identification of early warning signs, triggers, and precipitants that cause a person to escalate, and identification of the earliest precipitant of aggression for persons with a known or suspected history of aggressiveness, or persons who are currently aggressive.
3. (3) Techniques, methods, or tools that would help the person control the person’s behavior.
4. (4) Preexisting medical conditions or any physical disabilities or limitations that would place the person at greater risk during restraint or seclusion.
5. (5) Any trauma history, including any history of sexual or physical abuse that the affected person feels is relevant.

(c) A facility described in subdivision (a) of Section 1180.2 or subdivision (a) of Section 1180.3 shall not use either of the following:

1. (1) A physical restraint or containment technique that obstructs a person’s respiratory airway or impairs the person’s breathing or respiratory capacity, including techniques in which a staff member places pressure on a person’s back or places the staff member’s body weight against the person’s torso or back.
2. (2) A pillow, blanket, or other item covering the person’s face as part of a physical or mechanical restraint or containment process.

(e)

1. (1) A facility described in subdivision (a) of Section 1180.2 or subdivision (a) of Section 1180.3 shall not use prone mechanical restraint on a person at risk for positional asphyxiation as a result of one of the following risk factors that are known to the provider:

   1. (A) Obesity.
   2. (B) Pregnancy.
   3. (C) Agitated delirium or excited delirium syndromes.
   4. (D) Cocaine, methamphetamine, or alcohol intoxication.
   5. (E) Exposure to pepper spray.
   6. (F) Preexisting heart disease, including, but not limited to, an enlarged heart or other cardiovascular disorders.
   7. (G) Respiratory conditions, including emphysema, bronchitis, or asthma.
2. (2) Paragraph (1) shall not apply when written authorization has been provided by a physician, made to accommodate a person’s stated preference for the prone position or because the physician judges other clinical risks to take precedence. The written authorization may not be a standing order, and shall be evaluated on a case-by-case basis by the physician.