1. (1) Staff shall provide direct supervision of all youth in placement, including at a minimum the following levels of visual contact:

   1. (a) All youth confined in their rooms due to seclusion or medical requirements shall be observed every fifteen (15) minutes.
   2. (b) Youth who are actively violent or intoxicated shall be observed every five (5) minutes.

   3. (c) Youth exhibiting or expressing suicidal behavior or ideation shall be under constant direct observation and the following procedures shall be followed:

      1. 1. Referral to appropriate and pre-designated mental health practitioner or mobile crisis unit shall be immediately made and documented;
      2. 2. Reasons for removal from the general population shall be documented;
      3. 3. Behavior of youth during this period shall be clearly documented every fifteen (15) minutes; and AND TEMPORARY HOLDING RESOURCES
      4. 4. Written authorization for release from constant supervision shall be made by a licensed and designated mental health professional or in accordance with internal local protocol.
   4. (d) All youth shall be monitored every fifteen (15) minutes for the first twenty-four (24) hours of their detention and at least every thirty (30) minutes thereafter until release. Monitoring intervals do not pertain to routine direct line-of-sight supervision; however all such supervision shall be denoted as such.
2. (2) The time of all supervision checks shall be logged and the behavior of the youth shall be documented.
3. (3) The facility shall visually count youth and record the results at the beginning and end of each shift change.
4. (4) Incidents which involve or endanger the lives or physical welfare of facility staff or youth or which involve escape or attempted escape shall be documented and such documentation retained.

5. (5) A female facility staff member or law enforcement officer shall be available when there are female youth in the facility to conduct and document:

   1. (a) Searches;
   2. (b) Supervision of showers;
   3. (c) Health checks; and
   4. (d) Constant periodic observations as defined in paragraph 1 of this Rule.
6. (6) Policies governing supervision of female youth by male staff and male youth by female staff shall be based on privacy needs and accepted legal standards. Except in emergencies, facility staff shall not observe residents of the opposite sex in toilet and shower areas, including such areas maintained in individual living units. Reasonable accommodation of privacy needs shall be consistently observed, and departure from these standards shall be documented for review by the Department’s licensing office.
7. (7) Youth shall not supervise, control, assume or exert authority over other youth.
8. (8) There shall be at least one (1) direct care staff for every eight (8) youth during waking hours and at least one (1) direct care staff for every sixteen (16) youth during sleeping hours or other staffing plan approved by the Department’s licensing office. At a minimum, there shall never be less than 2 direct care staff on duty.

Authority: T.C.A. §§ 37-5-105; 37-5-106; and 37-5-501, et. seq. Administrative History: New rules filed March 17, 2017; effective June 15, 2017.