1. (1) RESIDENT RECORDS. The AFCH provider shall maintain a separate record for each resident on the premises and available for inspection by the agency.

   1. (a) The record shall contain:

      1. AHCA Form 3110-1023 (AFCH-1110) 01/08, Resident Health Assessment for Adult Family-Care Homes (AFCH), required by Rule 59A-37.004, F.A.C. A completed and signed form faxed by the health care provider shall be acceptable. The resident’s health care provider’s certification whether he or she may be left without supervision in the AFCH for up to 2 hours in a 24-hour period (Section H of the form) must be completed and included pursuant to paragraphs (a) and (b), of subsection 59A-37.006(2), F.A.C.

      2. A copy of the residency agreement which meets the requirements of Rule 59A-37.005, F.A.C., including a copy of any notices of rate increases sent to the resident or the residents representative and any addendums.

      3. For residents who are OSS recipients, a copy of the Alternate Care Certification for Optional State Supplementation (OSS) Form, CF-ES 1006, February 2005, provided by the Department of Children and Family Services.

      4. Resident information which includes:

      a. The name, address and telephone number of the resident’s guardian, attorney-in-fact, health care surrogate, next-of-kin, and any other responsible party with authority to make decisions on behalf of the resident.

      b. The name, address and telephone number of the resident’s health care provider, health maintenance organization, dentist and case manager as applicable.

      5. A complete accounting of any resident funds being received or distributed by the provider as required by Section 429.85, F.S.

      6. For residents who self-administer, with or without supervision or assistance, a list of the resident’s current medications; or for resident’s receiving administration, the record of medications administered, as required under Rule 59A-37.006, F.A.C.

      7. For residents receiving nursing services provided or arranged for by the provider, the nursing progress notes required under Rule 59A-37.006, F.A.C., and the health care provider’s order authorizing the nursing service.

      8. A copy of any special diet order prescribed by the resident’s health care provider as required under Rule 59A-37.006, F.A.C.

      9. A record of any major incidents or significant health changes and action taken in response to such incidents or changes as required under Rule 59A-37.006, F.A.C.

      10. The resident’s monthly weight record as required by Rule 59A-37.006, F.A.C.

      11. Documentation that the resident’s bill of rights and the procedure for lodging complaints has been discussed with the resident or the resident’s representative, as required by Rule 59A-37.004, F.A.C.

      12. Documentation that the house rules have been discussed with the resident or the resident’s representative as required by Rule 59A-37.004, F.A.C.

      13. A copy of any notice of discharge sent to the resident or the resident’s representative pursuant to Rule 59A-37.004, F.A.C.

   2. (b) Closed resident records shall be retained for a period of 5 years after the resident leaves the AFCH. The provider shall be permitted 1 working day to produce closed records.

2. (2) STAFF RECORDS.

   1. (a) An AFCH provider shall, at a minimum, maintain the following personnel records on the premises and available for inspection by the agency:

      1. For the AFCH provider, each relief person, each adult household member, and each staff person verification of freedom from communicable disease as required under Rule 59A-37.007, F.A.C.

      2. For the AFCH provider, each relief person, and each staff person:

      a. Written documentation of all training required by Rule 59A-37.007, F.A.C.

      b. A copy of any professional license.

      3. For each staff member employed by the provider, a copy of the employment application which shall include the date of beginning employment.

      4. For any person left in sole charge of residents written documentation of First Aid and CPR training as required by Rule 59A-37.007, F.A.C.

   2. (b) If the AFCH provider contracts with a staffing agency to provide services to residents, the contract between the AFCH provider and the staffing agency must specifically describe the services the agency will be providing to residents. The AFCH provider is not required to maintain personnel records for staff provided by a staffing agency.

3. (3) FACILITY RECORDS. The AFCH provider shall maintain the following records on the premises and ensure the records are available for inspection by the agency:

   1. (a) The AFCH license issued by the agency, which shall also be available to the public upon request.
   2. (b) A copy of the most recent county health department inspection required by Rule 59A-37.009, F.A.C.
   3. (c) A copy of the most recent fire safety inspection required by Rule 59A-37.010, F.A.C.
   4. (d) Documentation of radon testing.
   5. (e) The emergency plan required by Rule 59A-37.010, F.A.C.

   6. (f) An up-to-date log listing all residents, and each resident’s:

      1. Date of admission, the place admitted from and the reason for moving into the home, if known; and,

      2. Date of discharge, the reason for discharge, and the location to which the person has been discharged, or if the person is deceased, the date of death.

   7. (g) All completed survey and complaint investigation reports, and notices of sanctions and moratoriums issued to the AFCH by the agency within the last 3 years, which shall also be available to the public upon request.
   8. (h) For AFCHs which claim to provide special care for persons with Alzheimer’s disease or related disorders, a copy of all advertisements or documents distributed to the public as described in Rule 59A-37.003, F.A.C.
   9. (i) The facility shall maintain a record of each fire exit drill on Form DI4-1437, revised 1/2001, Fire Exit Drill Records for Adult Family Care Homes as set forth in subsections 59A-37.006(6) and (7), F.A.C.

Rulemaking Authority 429.67, 429.73, 429.75, 429.81 FS. Law Implemented 429.67, 429.73, 429.75, 429.81, 429.85 FS. History–New 6-6-99, Amended 7-30-06, 4-29-08, Formerly 58A-14.0085, 7-1-19.