PURPOSE: This rule establishes the minimum requirements for adult day tax program staff, ratio of numbers of staff to participants and staff training.

1. (1) The adult day care program shall have a director. Either the director or his/her designee shall be present and in charge during all hours that participants are on the premises. The director and his/her designee shall be qualified by demonstrated competence, specialized background, education or experience to manage the day-to-day operation of the program.
2. (2) Direct care paid staff shall be at least eighteen (18) years of age and qualified by education and experience to perform the duties required by the written job description.
3. (3) Volunteer staff shall be qualified by education, experience, or both! to perform the duties required by the written lob description.
4. (4) The adult day care provider shall provide a sufficient number of direct care staff on duty at all times to meet the needs of each participant and assure that participants are never left unattended. At a minimum, there shall be at least two (2.1 direct care staff persons when two through sixteen (Z-16) participants are present and one (1) additional direct care staff person for any portion of eight (8) additional participants present.
5. (5) The director shall not be counted to meet the required staff ratio if there are nine (9) or more participants present. 13 CSR 15-8 , m
6. (6) Trained volunteers at least eighteen (18) years of age may be counted in the direct care staff to participant ratio provided a volunteer program description, including the training to be provided and the system, for assuring the presence of volunteer help as scheduled, has been submitted to and approved by the Division of Aging.
7. (7) Secretaries, cooks, accountants and other nondirect care staff members shall not be considered in calculating the staffing ratio.
8. (8) Direct care staff shall not be counted simultaneously to meet the required staffing ratios for both the long-term care or medical care facility and the associated adult day care program.
9. (9) All staff who have direct contact with participants shall be free of communicable disease, listed in 19 CSR 20-20.020 and physically and emotionally able to work in the adult day care program. Persons who have been diagnosed with a communicable disease may return to duty only with a physician’s written approval. The director shall be responsible for monitoring the health of employees.
10. (IO) No person shall be employed to work or allowed to volunteer, in the adult day care program who left employment with any other employer due to abuse or neglect to patients, residents or clients and the dismissal was upheld by administrativereview or conviction. The adult day care provider shall have made a reasonable check of references an all employees and volunteers.
11. (11) All staff, including nondirect care, direct care and volunteers, shall be given a general orientation to the program, its policies, fire, safety and emergency procedures prior to performing job responsibilities.

12. (12) In-service training shall be provided at least quarterly to staff, as appropriate to their job function and participant care needs.

    Auth: sections 660.050, RSMo (Cum. Supp. 1992) and 660.418, RSMo (2986).* Original rule filed Oct. 15, 1984, effective Jan. 11, 1985. *Original authority: 660.050, RSMo (196’4). amended 1988.1992 and 660.418, RSMo iJ984). 13CSR 15-8-SOCIALSERVICES