1. (a) Program staff shall provide care and supervision at all times to ensure that residents are safe and that their needs are met according to their developmental level, age, emotional or behavioral needs, and in accordance with their treatment plan.

2. (b) The program shall develop policies for direct care staff, including but not limited to:

   1. (1) Addressing threats of self-harm and suicidal behaviors by residents;
   2. (2) Medical emergencies, including when to immediately call emergency responders;
   3. (3) Addressing threatening behaviors such as physical and sexual assaults on other residents or staff;
   4. (4) Responding to and managing injuries that are not medical emergencies;
   5. (5) The reporting requirements in He-C 4001.23, RSA 126-U, and He-C 901;
   6. (6) Screening any resident who runs away for indications that the resident may be a victim of human trafficking and notifying necessary personnel and authorities;
   7. (7) Supporting residents and managing the behavior of residents, consistent with RSA 126-U, and He-C 901;
   8. (8) Access to respite or temporary care;
   9. (9) How staff will be orientated and trained in accordance with He-C 4001.19(b) to prepare to work with the population served by the program; and
   10. (10) How staff will supervise residents during overnight hours and when taking residents off-site.
3. (c) All program staff responsible for the care and supervision of residents shall be familiar with the program’s policies required in (b) above.
4. (d) Each building that residents will spend time in shall be equipped with a telephone that is operable and accessible to residents and staff for incoming and outgoing calls.
5. (e) The licensee shall maintain an information data sheet in the resident’s record and promptly give a copy to emergency medical personnel in the event of an emergency transfer to a medical facility.

6. (f) The information data sheet referenced in (e) above shall include:

   1. (1) Full name and the name the resident prefers, if different;
   2. (2) Name, address, and telephone number of the resident’s parent(s), guardian, or agent, if any;
   3. (3) Diagnosis or diagnoses, if more than one;
   4. (4) Medications, both prescription and over the counter, including last dose taken and when the next dose is due;
   5. (5) Allergies;
   6. (6) Functional limitations;
   7. (7) Date of birth;
   8. (8) Insurance information; and
   9. (9) Any other pertinent information not specified in (1)-(8) above.

7. (g) At least one program staff person who is trained and currently certified in cardiopulmonary resuscitation (CPR) and first aid by the American Red Cross, American Heart Association, Emergency Care and Safety Institute, National Safety Council, or other nationally recognized organization or an individual certified by such organization to train, shall be present:

   1. (1) In each building that is used as a residence, at all times when residents are present; and
   2. (2) When residents are participating in any field trips, outings, or excursions off the premises of the program.
8. (h) The program director or designee shall obtain and maintain on file, available for review by the unit, copies of current CPR and first aid certifications documenting coverage as required in (g) above.
9. (i) Each building and program vehicle that is used by residents shall be equipped with first aid supplies adequate to meet the needs of the residents.
10. (j) The first aid supplies shall be stored in a container that is accessible by program staff but not accessible to residents.
11. (k) If a resident sustains a serious injury requiring medical transportation, evaluation, or treatment, loses consciousness, or is found or believed to be impaired while at the program, the program director or designee shall notify the unit within one business day and complete and provide the unit with an incident report within 48 hours.
12. (l) The program director or designee shall conduct fire drills at varying times, including night time hours, once each month in each building that is used as residential child care space.
13. (m) Programs shall activate the actual fire alarm system for the building for at least 2 of the monthly fire drills required each year.
14. (n) Programs shall ensure that all residents and program staff evacuate the building during each fire drill.

15. (o) The staff person conducting the fire drill shall complete a written record of each fire drill that shall:

    1. (1) Be maintained on file at the program for 2 years; and
    2. (2) Be available for review by the fire inspector and the department.

16. (p) The written record of fire drills required under (o) above shall include at least the following:

    1. (1) The date and time of the drill, and whether the actual fire alarm system was activated;
    2. (2) Exits used;
    3. (3) Number of residents evacuated and total number of people in the building at the time of the drill;
    4. (4) Name of the person conducting drill;
    5. (5) Time taken to evacuate the building;
    6. (6) Any problems encountered; and
    7. (7) A plan for correcting those problems.
17. (q) The program director or designee shall conduct a fire drill in the presence of a representative of the unit or the local fire department upon request by either of those entities.
18. (r) If providing withdrawal management, any new SCPs shall comply with the appropriate chapter of NFPA 101 as published by the National Fire Protection Association and as amended by the state board of fire control and ratified by the general court pursuant to RSA 153:5, consistent with the level of needs of residents served.

19. (s) All programs shall have the following as approved by their local fire inspector:

    1. (1) Smoke detectors consistent with the appropriate level of care being provided by the program;

    2. (2) At least one UL Listed, ABC type portable fire extinguisher, with a minimum rating of 2A-10BC installed on every level of the building with a maximum travel distance to each extinguisher not to exceed 50 feet and maintained as follows:

       1. a. Fire extinguishers shall be inspected either manually or by means of an electronic monitoring device or system at least once per calendar month, at intervals not exceeding 31 days;
       2. b. Records for manual inspection, or electronic monitoring shall be kept to demonstrate that at least 12 monthly inspections have been performed;
       3. c. Annual maintenance shall be performed on each extinguisher by trained personnel, and a tag or label shall be securely attached that indicates that maintenance was performed; and
       4. d. The components of the electronic monitoring device or system in a. above, if used, shall be tested and maintained annually in accordance with the manufacturers listed maintenance manual; and
    3. (3) A carbon monoxide monitor on every level of the program, in accordance with Saf-C 6015.04.

20. (t) In addition to the policies required in (b) above, the program shall have an emergency operations plan (EOP), which shall:

    1. (1) Be based on the incident command system and coordinated with the emergency response agencies in the community in which the residential program is located;
    2. (2) Contain guidelines for personnel responsible for critical tasks, including, but not limited to the role of center incident commander, resident care, medical treatment, and notification to parents or guardians; and

    3. (3) Include response actions for natural, human-caused, or technological incidences including, but not limited to:

       1. a. Evacuation, both within building and off-site, relocation;

          b Secure campus;

          c Drop, cover, and hold;

       2. d. Lockdown;
       3. e. Reverse evacuation;
       4. f. Shelter-in-place; and
       5. g. Bomb threat and scan.
21. (u) Programs shall develop a continuity of operations plan (COOP) to ensure that essential functions continue to be performed during, or resumed rapidly after, a disruption of normal activities.
22. (v) All response actions in (t)(3) above shall include accommodations for residents with chronic medical conditions, and residents with disabilities or with access and functional needs.
23. (w) Programs shall ensure that all staff are trained on the EOP and response actions, and are aware of the location of the plan.
24. (x) Programs shall conduct evacuation drills at least twice a calendar year and shall record the dates and times of the drills, and maintain the records for review as described in He-C 4001.10(m)(3).
25. (y) All staff shall review the program's EOP within the first 30 days of employment and any time that the program revises the EOP.

26. (z) The written policies and procedures and the EOP shall be available in each building of the residential program, in an area easily accessible to program staff.

    Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

    New. #8581, eff 4-20-06, EXPIRED: 4-20-14

    New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20; amd by #13991, EMERGENCY RULE, eff 5-29-24, EXPIRED:

    11-25-24

Source. New. #14123, eff 11-26-24, EXPIRED: 11-26-25; ss by #14214, eff 4-1-25, EXPIRES: 4-1-35