(c) The office may impose additional staffing and program requirements based on such factors as residents 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 families for emergency treatment. Facilities must assist families in accessing medical services for treatment for injury, illness or disease or to obtain preventative care.
2. (2) Facilities must provide family members 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) Family members with minor communicable diseases, or who have minor localized infections, must be properly isolated and quarantined if allowed to remain in the facility.
4. (4) Family members 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.

5. (5) Facilities housing homeless pregnant persons, irrespective of whether those pregnant persons have children residing with them, must demonstrate that prenatal care services are available. If the services are to be provided at the shelter, the medical provider must be licensed by the appropriate entity to provide services at the shelter site. Prenatal services include:

   1. (i) prenatal risk assessment;
   2. (ii) prenatal care visits and laboratory procedures;
   3. (iii) referral for special tests, consultations and hospitalization, and mechanisms to assure that services were received;
   4. (iv) health education regarding prenatal nutrition, alcohol and tobacco use, drug abuse, use of medication, other aspects of prenatal care, labor and delivery, family planning, breast feeding, infant care and parenting;
   5. (v) referral for pediatric care;
   6. (vi) referral for nutrition services including screening, education, counseling, follow-up and provision of services under the women, infants and children’s program and the SNAP;
   7. (vii) referral for mental health and related social services including screening and counseling; arrangements for delivery and post-partum services; and

   8. (viii) assistance with transportation for prenatal care services.

      (e) Social rehabilitation services.

6. (1) Social rehabilitation services shall be provided to residents of shelters for families, either directly or through contract or cooperative agreement, or through the social services district.

7. (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 benefits, SSI, title XX or child welfare or unemployment benefits;
   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) transportation between the shelter and any site used by the social services district or operator for intake.

8. (3) An operator providing social rehabilitation services must designate sufficient staff to meet resident need for such services.

   (f) Supervision services.

9. (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 the 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;
   7. (vii) handling, documenting and reporting incidents involving resident endangerment, injury or death;
   8. (viii) conducting and supervising facility evacuations and periodic evacuation drills;
   9. (ix) investigating, recording and reporting incidents involving resident endangerment, injury or death;
   10. (x) maintaining a list of school-age residents currently residing in the facility and the location of the school each child attends; and
   11. (xi) reporting or causing a report to be made to the SCR of incidents involving a resident under age 18 and a subject of a report as defined in section 412 of the Social Services Law, in accordance with the circumstances and procedures set forth in sections 413 and 415 of the Social Services Law and Subpart 901-1 of this Title.
10. (2) At least one staff member on each shift shall have completed an in person, basic first aid training course or its equivalent.
11. (3) All staff shall be trained in the means of rapidly evacuating the building.
12. (4) At least one staff person on each shift shall be designated as responsible for the conduct and supervision of any evacuation.

13. (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.

14. (6) In the event that a resident exhibits behavior which constitutes a danger to himself or herself or others:

    1. (i) the shelter operator shall immediately notify the social services district;
    2. (ii) the shelter operator or the social services district shall refer the resident for appropriate professional evaluation of their condition;
    3. (iii) the shelter operator or the social services district shall notify the resident’s representative, or next of kin, if known and if the resident’s consent has been provided; and

    4. (iv) the social services district shall, if necessary, arrange for transfer of the individual to a facility providing the proper level of care.

       (g) Preparation for permanent housing.

       Preparation for permanent housing must be provided which implements the independent living plan developed pursuant to section 900.9(h) of this Part and section 352.35 of this Title. At a minimum, preparation for permanent housing must include:

15. (1) assistance in obtaining permanent housing, including assistance in locating adequate available housing, providing referrals to such housing, providing assistance in obtaining needed documents, providing advocacy assistance in the completion and filing of housing applications, scheduling of appointments for viewings and inspections of premises, providing assistance in preparing for interviews, and providing assistance in establishing competency skills for permanent housing by addressing issues such as budgeting, accessing community resources, housekeeping, home repairs and landlord/tenant rights;
16. (2) securing necessary supportive social and mental health services including, but not limited to, psychiatric and drug and alcohol abuse services; and

17. (3) securing employment assessments, job training and job placement services, where appropriate.

    (h) Recreational services.

    Appropriate recreational services must be provided.

    (i) Information and referral services.

    Facilities must maintain a listing of local community agencies and programs whose services assist residents to return to permanent housing. Facility staff must refer residents to such programs, as needed and when appropriate.

    (j) Child care services.

    Supervised care of all children must be provided when such care is necessary to enable the parent or caretaker relative of such child to seek employment and/or permanent housing or to attend school or training as approved by the social services district. Staff responsible for such care and supervision of the children must have prior experience in child care or must receive adequate training to enable them to perform such functions.

18. (1) If child care is provided onsite, the staff/child ratios for adults providing supervised care, other than recreational services for preschool children and for school-age children not in attendance at school, must be a minimum of one adult per 8 children and one adult per 15 children, respectively. For the purpose of this section, a suitable adult resident may be counted as staff for the purpose of the supervised care ratios.
19. (2) If child care is provided off-site, the day care center or family day care home must be in compliance with all applicable State and local requirements concerning licensing and operations.
20. (3) Day care may be provided onsite, provided the appropriate agency has licensed the program and the social services district has committed to fund the program using title XX or other appropriate funding sources.

(d) Health services.