(c) The office may impose additional staffing and program requirements based on such factors as resident need and the size, physical layout and location of the facility.

1. (1) Facilities must have an established relationship with a fully accredited medical institution or clinic for the referral of residents for emergency treatment. Facilities must assist residents to access medical services for treatment for injury, illness or disease, or to obtain preventative care.
2. (2) Facilities must provide residents with a means to safely store and secure prescription medications. The operator of a facility may offer a resident the opportunity to store prescription medications in the operator’s custody for safe keeping.

3. (3) Residents with a generalized systemic communicable disease, or a readily communicable local infection that cannot be properly isolated and quarantined in the facility must be transferred to an appropriate medical facility or to another shelter facility that has the capability to accommodate such a condition.

   (e) Social rehabilitation services.

4. (1) Social rehabilitation services shall be provided to residents of shelters for adults, small-capacity shelters, and shelters for adult families, either directly, through contract or cooperative agreement, or through the social services district.

5. (2) Social rehabilitation services include, but are not limited to:

   1. (i) assistance in making applications for public benefits such as public assistance, MA, SNAP, SSI, and unemployment benefits, as needed. In a shelter operated by a social services district, action to secure such benefits must be initiated on or before the 15th consecutive day after the admission of the resident to the facility;
   2. (ii) assistance in securing supportive, social and mental health services;
   3. (iii) assistance in obtaining permanent housing;
   4. (iv) assistance in securing employment assessments, job training and job placement services;
   5. (v) provision of a program of individual and group activities which enables each resident to sustain and improve physical and psychosocial functioning. Such programming must be available at times when residents are in the facility;
   6. (vi) provision of case management and counseling; and
   7. (vii) transportation between the shelter and any site used by the social services district or operator for intake.
6. (3) An operator providing social rehabilitation services must designate sufficient staff to meet resident need for such services.

7. (4) Social rehabilitation shall be available at least five days each week, including evenings, for periods sufficient to meet resident needs.

   (f) Supervision services.

8. (1) Supervision services shall include, but are not limited to:

   1. (i) intake;
   2. (ii) recording a daily census of residents;
   3. (iii) monitoring residents to identify abrupt or progressive changes in behavior or appearance which may signify the need for clinical or medical assessment;
   4. (iv) surveillance of the grounds, facility and activities of residents to prevent theft and resident harm;
   5. (v) handling and documenting individual emergencies, including arranging for medical care or other emergency services;
   6. (vi) conducting and supervising evacuations and periodic fire or evacuation drills; and
   7. (vii) investigating, documenting and reporting incidents involving resident endangerment, injury or death.
9. (2) At least one staff member on each shift shall have completed an in person, basic first aid training course or its equivalent.
10. (3) All staff shall be trained in the means of rapidly evacuating the building.
11. (4) At least one staff person on each shift shall be designated as responsible for the conduct and supervision of any evacuation.

12. (5) If an operator learns that a resident has developed a medical condition requiring immediate or continual medical or skilled nursing services that cannot be provided on an outpatient basis or which constitutes a danger to the resident or to others, the operator shall:

    1. (i) notify the social services district;
    2. (ii) with the approval and assistance of the social services district, make arrangements for the transfer of such resident to an appropriate medical facility; and
    3. (iii) notify the resident’s representative, or next of kin, if known and if the resident’s consent has been provided.

13. (6) In the event that a resident exhibits behavior which constitutes a danger to him or herself or others, the operator shall:

    1. (i) notify the social services district;
    2. (ii) refer the resident for appropriate professional evaluation of their condition;
    3. (iii) notify the resident’s representative, or next of kin, if known and if the resident’s consent has been provided; and
    4. (iv) if necessary, arrange for transfer of the individual to a facility providing the proper level of care.
14. (7) Each operator shall designate sufficient staff to monitor and supervise residents during all hours of operation.

15. (8) The minimum number of staff required to supervise and monitor residents shall be determined by resident census. The resident census shall be the number of residents of a shelter facility unless otherwise directed by the office. The following number of staff shall be on duty and on site at all times:

    Resident census	Staff required
    1– 19	1
    20– 40	2
    41– 80	3
    81–120	4
    121–150	5
    151–200	6

16. (9) Staff shall be immediately accessible while on duty.
17. (10) Provision shall be made for backup staff.

18. (11) Staff may be assigned other duties which do not interfere with their accessibility, provided that such staff remain responsible for, and available to supervise and monitor residents.

    (g) Information and referral services.

19. (1) The operator shall have knowledge of, and linkages with, community resources which can assist each resident to maintain or improve his/her level of functioning.

20. (2) Information and referral services shall include:

    1. (i) establishing linkages with and arranging for services from public and private sources for income, housing, health and social services;
    2. (ii) cooperating with providers of services essential to residents;
    3. (iii) assisting residents to secure services needed; and
    4. (iv) arranging for resident participation in community-based and community-sponsored activities.

21. (3) The operator shall utilize and cooperate with external services providers and shall:

    1. (i) identify persons in need of services and assist external services providers in establishing a relationship with these residents;
    2. (ii) cooperate with service providers in executing a plan for service for individual residents;
    3. (iii) permit residents to meet in privacy with service providers; and
    4. (iv) in no way inhibit residents from accessing external service providers of their choice.
22. (4) Each operator shall designate sufficient staff to perform information and referral services.

(d) Health services.