Family Services, Dept. of

Providers of Substitute Care Services, Certification of

Chapter 3: General Requirements

Effective Date: 09/03/2021 to Current

Rule Type: Current Rules & Regulations

Reference Number: 049.0029.3.09032021

GENERAL REQUIREMENTS

Section 1. Administration and Governance.

(a) The organization shall have a governing body, which exercises authority over and has responsibility for the operation, policy and practices of the organization.

(b) The governing body shall be:

(i) A board of directors in the case of a non-profit organization;

(ii) The members of a limited liability company;

(iii) The general partners of a limited partnership; or

(iv) The individual owner or owners of a for-profit organization or corporation.

(c) The organization shall maintain a list of the governing body, members, partners, owners and/or shareholders (whichever is applicable to the type of entity). This list shall include an address for each individual named. This information shall be submitted to the certifying authority on an annual basis.

(d) Organizations with required board of directors shall develop policy or bylaws defining the board's responsibilities, which shall include, but not limited to the following:

(i) Requirements and responsibilities of board members in the operation of the facility; and

(ii) Conflict of interest.

(e) If the organization, in order to transact business in this state or another state, is required to file documents of organization or incorporation with the Secretary of State, then such organization shall submit to the certifying authority copies of any documentation required to be submitted to the Secretary of State for that purpose and any documentation that is received from the Secretary of State, including, but not limited to: Articles of Incorporation; Articles of Organization; Certificate of Limited Partnership; Statement of Partnership Authority; and, Statement of Registered Office and Registered Agent.

Section 2. Responsibilities of the Organization.

(a) The organization shall develop policies and procedures that assure proper protection, care and treatment of children, as follows:

(i) Ensure that no child, on the basis of race, creed, color or national origin, is excluded from participation in, is denied benefits of, or is subjected to discrimination in receipt of services by the organization;

(ii) Provide services in compliance with Title VI of the Civil Rights Act of 1964, (Title VI of the 1964 Civil Rights Act, 42 U.S.C. §§2000d – 2000d-7 http://www.justice.gov/crt/about/cor/coord/titlevistat.php) and Wyoming statutes prohibiting discrimination;

(iii) Ensure that all clients are informed of their rights and that the program has written policies that describe the rights of clients and the means by which these rights are protected and exercised;

(iv) Written conflict of interest policies shall include staff and consultants of a voluntary or public organization and shall require they not have a direct or indirect financial interest in the organization and any member who is individually or as part of a business or professional firm involved in the business transactions or current professional services of the organization shall disclose this relationship and not participate in any vote taken in response to such transactions or services.

(v) Ensure that each child is informed and provided a copy of organization’s rules within twenty-four (24) hours of admission and signs an acknowledgement, to be maintained in child’s file.

(b) The organization shall ensure fiscal policies that make certain the availability of funds (including governing receipt and expenditure of money), resources, and equipment required to carry out the organization’s purpose, are in accordance with sound budgeting, disbursement, and audit control procedures and fiscal accounts of the organization are audited or reviewed annually and submitted to the certifying authority.

(c) The organization shall establish personnel policies.

(d) The organization shall select and hire a qualified administrator/executive director and provide documentation that an annual, formal evaluation is conducted.

(e) The organization shall oversee quality assurance of the program. In this regard, the organization shall make provisions for examining and evaluating its programs at predetermined intervals to:

(i) Ensure that the care and services provided are in accordance with the purpose of the organization;

(ii) Evaluate the effectiveness and efficiency of services provided;

(iii) Assure adherence to all required activities set forth in these rules;

and (iv) The overall scope of the quality assurance process shall be described in a written plan or outline which sets forth mechanisms, committees, or other means of assigning responsibility for carrying out and coordinating quality assurance activities.

(f) The organization shall report, within ten (10) calendar days, in writing to the certifying authority, if applicable, any civil or criminal action that is brought against the program or any person employed by the program which relates to the delivery of the service or which may impact on the continued operation of the facility.

(g) The organization is responsible for all licensing violations while the facility is in operation.

Section 3. Abuse and/or Neglect Reporting.

(a) The organization shall develop, adopt, follow and maintain on file written policies and procedures governing all aspects of reporting abuse and/or neglect, to include:

(i) A provision that any report made to the law enforcement authorities or DFS of an allegation of abuse and/or neglect of any child in the facility/program shall result in the temporary suspension or reassignment of duties (so as not to be in contact with child(ren) of the alleged perpetrator). Such suspension or reassignment of duties shall remain in effect pending the outcome of the investigation by the appropriate authorities.

(ii) Any caregiver or staff member in a facility who has reasonable cause to know or suspect that a child has been subjected to any abuse and/or neglect, or who has observed the child being subjected to circumstances or conditions that would reasonably result in abuse and/or neglect, must immediately report or cause a report to be made of such fact to the DFS office and/or the local law enforcement agency in the county where the abuse occurred.

(iii) If the suspected abuse and/or neglect occurred in the facility/program, the report shall be made to the DFS field office and/or the law enforcement agency in the community or county in which the facility/program is located and to the certifying authority.

(iv) If the suspected abuse and/or neglect did not occur in the facility/program, the report shall be made to the DFS field office in the county in which the child resides and/or to the local law enforcement agency in the community in which the incident is believed to have occurred.

(b) The organization shall require each staff person to read and sign a statement defining child abuse and/or neglect and outlining responsibilities to report all child abuse and/or neglect incidents as required by statute.

Section 4. Critical Incident and Incident Reporting.

(a) The organization shall develop, adopt, follow and maintain on file written policies, procedures and reporting forms governing all aspects of reporting critical incidents. The following types of incidents shall be reported as critical incidents:

(i) Child fatality;

(ii) Serious illness or injury requiring urgent or emergent medical attention;

(iii) Suicidal, homicidal or unable to meet basic needs;

(iv) All abuse and/or neglect allegations (if the allegation is against a parent who is also the legal guardian, the parent is not to be notified; however, procedures described in Section 3 above must be followed);

(v) Child-on-child sexual contact;

(vi) Child runaway;

(vii) Fire at the facility or foster home;

(viii) Riots (loss of staff control of a portion of a facility or unit);

(ix) Physical assaultive conduct/behavior;

(x) Bomb threats; and

(xi) Law enforcement intervention.

(b) The organization shall develop, adopt, follow and maintain on file written policies, procedures and reporting forms governing all aspects of reporting incidents. The following types of events shall be reported as incidents:

(i) Physical restraints;

(ii) Unscheduled medication used to target psychiatric symptoms or behaviors;

(iii) Self harm;

(iv) Use or possession of alcohol, controlled substances and the abuse of legal substances;

(v) Time out, room restriction, seclusion;

(vi) Medication error; and (vii) Other.

(c) A verbal report must be made immediately to the child’s legal guardian upon occurrence of a critical incident except as provided in (a)(iv) above.

(d) The verbal report must be followed by completion and submission of the DFS Critical Incident Report Form to the certifying authority within two (2) working days after the occurrence.

Section 5. Consent to Treatment and/or Placement.

(a) The organization shall have policy and procedures to ensure that at a minimum oral consent with a witness is obtained within forty-eight (48) hours from the child’s parent and/or legal guardian if not already addressed in a court order. When an oral consent is obtained, a follow up written consent is received within four (4) business days for the provision of:

(i) Placement of the child in the facility;

(ii) Routine health care (e.g., health examinations, dental care, vision care, hearing care and treatment for injuries and illnesses); and

(iii) Emergency medical, dental care and psychological care.

(b) The organization shall notify the local DFS office within forty-eight (48) hours of a child’s self-placement in a facility when the organization is unable to obtain oral consent from child’s parent and/or legal guardian.

Section 6. Parental Involvement.

Programs shall develop, adopt, follow and maintain on file written policies and procedures governing all aspects ensuring ties between the child and his/her family are developed, maintained and strengthened.

Section 7. Admissions and Discharge.

(a) Admissions. The facility shall develop, adopt, follow and maintain on file a written statement that clearly defines the purpose and goals of its service, the type of service it intends to provide, and the kinds and numbers of children it will serve.

(i) The program must identify those staff members authorized to make decisions regarding admission; and

(ii) If, at any time, it is determined that the program is unable to provide for the security or treatment needs of a child, the organization must notify DFS and/or the child’s legal guardian immediately.

(b) Discharge and Continuing Care Plans. The organization shall develop, adopt, follow and maintain on file written policies and procedures governing discharge and continuing care planning when applicable. The policies and procedures shall include:

(i) The roles and responsibilities of the child’s parent and/or legal guardian, the referring agency, and the organization, as applicable;

(ii) The handling of an emergency discharge of a child that ensures the immediate notification of his/her parent or legal guardian, as applicable;

(iii) The involvement of the child consistent with the child’s ability to understand the plan and process; and

(iv) A discharge report, which must be completed within 30 days of discharge, shall include:

(A) The name, address, telephone number of the person or organization to whom the child was discharged;

(B) A summary of the services provided to the child while in care;

(C) Goals specified within the ISPC and/or ITPC that have been achieved;

(D) Child’s needs that remain to be addressed;

(E) Recommendations for follow-up services including referral information with name, address, and phone number of where person is being referred.

(c) An unplanned discharge requires documentation of the following:

(i) The circumstances leading to the unplanned discharge;

(ii) The actions taken by the organization and other parties; and

(iii) The reason for the actions taken.

Section 8. Staff Requirements. The organization shall utilize employment policies and procedures to recruit and hire staff capable of providing quality services. The following safeguards shall be built into the policy:

(a) All staff (or any persons having direct care of children) shall be twenty-one (21) years of age or older.

(b) An orientation program and required background checks for new staff must be completed before staff can be the only staff person present who is providing direct care for children.

(c) An organization shall establish requirements related to education and experience for the administrator/executive director and all other staff with a minimum of a high school diploma or high school equivalency.

(d) If necessary, the organization may contract for services to fully meet the needs of the child. The organization must make available all such contracts to the certifying authority.

(e) Volunteers, Interns, Practicum Students (VIPS). The organization shall develop policies and procedures for the operation of programs in which volunteers or student field placements or internships are utilized in direct service, care, and treatment. The policies and procedures shall include:

(i) Designation to a supervisory staff person the responsibility for coordination of the VIPS program with a clear job description for the coordinator and for each category of volunteers;

(ii) A clear differentiation of functions and activities, including supervision, appropriate for paid staff members and VIPS in policy-making, advocacy, administrative, and direct services roles;

(iii) A process for screening and selecting VIPS, including background, character and reference checks as set forth in these rules for staff;

(iv) Orientation and in-service training activities in the VIPS’ specified roles; and

(v) Monitor and evaluate activities and contributions.

(f) Documentation of all staff qualifications must be made available to the certifying authority.

(g) The number of staff present at all times must be adequate to meet the required staff:child ratios for the program type. If more than one program is operated at the same location and children from more than one program type or age groups of children are commingled, the most restrictive staff:child ratios shall apply.

(h) A current employee who has qualified for a position under the previous rules and is serving in that position shall be exempt from meeting any increased educational requirements defined by these rules.

(i) The organization shall document staff requirements, including the completion of all required background check, by completion and submission of the DFS Staff Facility Record Summary annually.

Section 9. Staff Supervision.

(a) The program shall have a chart delineating supervision for each program.

(b) During every shift, there must be a designated individual responsible for that shift (and at a minimum available by phone).

(c) A direct care staff member shall always be present when a child resident is in the facility or living unit, off ground activity or appointments which require direct care and supervision.

(i) Except as otherwise provided by this rule, children shall be supervised at all times. Short breaks in direct supervision shall be therapeutically indicated or necessary for the child to gain independence.

(ii) Youth actively working toward independence shall be permitted short breaks in supervision to pursue recreation, employment or educational opportunities that complement his or her plan of care.

(iii) The organization shall have sufficient staff to allow the number of children being served to be adequately supervised, taking into consideration the complexity of the needs of the children. The organization shall consider appointments requiring staff supervision, staff leave, possible illness of children and other relevant factors when scheduling staff and child activities.

(d) The organization shall not use electronic surveillance equipment devices in place of personal direct care staff supervision.

Section 10. Background Checks.

(a) A Wyoming abuse and/or neglect Central Registry check, an abuse and/or neglect Central Registry check from any other state lived in for the past 5 years, and a finger print based national criminal history record check shall be completed for all employees (including employees who do not work directly with children), foster parents, and adoptive parents before they begin working in the facility. In cases where a child abuse and/or neglect registry request was made to another state and a denial of that request has been received, a notarized affidavit from the staff person shall be required, certifying to the best of his/her knowledge, he/she has not appeared upon a child abuse and/or neglect registry in the state of previous residence. These same checks are necessary for adult household members in the case of foster homes, adoptive homes, and facilities that are operated in an individual's home, including any new adult proposing to move into the foster home, adoptive home or facility operated in an individual's home. Background checks for any new adult proposing to move into the foster home, adoptive home or facility operated in an individual’s home, shall be completed prior to the adult moving in.

(i) A person whose name appears on the Central Registry as substantiated must not be employed, approved for foster care, adoption or reside in any facility certified under these rules; and

(ii) A person with a criminal history record may not be employed, approved for foster care, adoption or reside in any facility certified under these rules if that person has been convicted or has a pending deferred prosecution of a felony or misdemeanor involving:

(A) Felony:

(I) Abuse, neglect, abandonment, exploitation or endangering children or vulnerable adults;

(II) A sexual offense against a person or child;

(III) Allowing the commission of a sexual offense against a child;

(IV) Violence, including rape, sexual assault, physical assault, kidnapping, battery or homicide;

(V) A crime against a child (including child pornography) or vulnerable adult; or

(VI) Physical assault;

(VII) Battery;

(VIII) Drug offense (within the last 10 years);

(IX) Arson;

(X) Alcohol related offense (within the last 10 years);

(XI) Domestic violence.

(B) Misdemeanor:

(I) Violent misdemeanor committed as an adult against a child;

(II) Battery, physical assault, or domestic violence within the last five (5) years;

(III) A sexual offense against an adult or child;

(IV) Allowing the commission of a sexual offense against a child; or

(V) Child endangerment or similar offense within the last five (5) years.

(C) Any other crime that causes the Department to be concerned for the safety or well-being of children or others.

(D) The organization shall determine if rehabilitation has occurred for individuals with criminal convictions outlined in (A[VI], [VII], [IX], [XI] and B[II], [V]) above that occurred more than five (5) years ago. The organization shall document its decision as to rehabilitation for any individuals that are to be employed or will reside in the facility or foster home or adoptive home and provide that information to the certifying authority prior to employing the person or allowing the individual to reside in the facility or foster home or adoptive home.

(b) No employee including volunteers and interns, foster parent, or adult household member residing in any facility who has been charged with a crime outlined in Section 10(a)(ii)(A) through (C) above and awaiting trial may provide care or be present in the facility pending the outcome of the criminal proceeding.

(c) A copy of background checks must be made available to the certifying authority.

(d) All employees, volunteers, interns, foster parents or adult household members shall complete a child abuse/neglect Central Registry background check once a year and a full fingerprint based national criminal history record background check every five (5) years. The DFS Certifying Authority may require a new child abuse/neglect Central Registry background check at any time for employees, volunteers, interns, foster parents or adult household members.

Section 11. Staff Training.

(a) Pre-Service Orientation Training. All staff (including foster parents) must complete a prescribed number of hours of pre-service orientation training, as set forth in each program-specific chapter of these rules.

(i) The pre-service orientation training shall include but not be limited to the following:

(A) Organization policies and organization staff member roles;

1. (B) Responsibilities for reporting child abuse and/or neglect;
2. (C) The staff member's role and responsibilities in relation to the child and family and permanency;
3. (D) Training in the area of universal precautions (blood borne pathogens);
4. (E) Procedures for adherence to personal and professional ethics and conduct;
5. (F) Orientation to the organization's approved crisis intervention procedures (if the crisis intervention procedures include emergency restraint of children who are a danger to themselves or others, staff shall be trained in a nationally certified or accredited program which provides physical restraint training) and reporting of critical incidents and adverse events;
6. (G) Record-keeping requirements;
7. (H) Cultural competency;
8. (I) Helping juveniles with acceptance of the residential setting and separation and loss inherent in out-of-home care for children and families, and for the staff members when children leave;
9. (J) Confidentiality;
10. (I) All staff must be instructed on the federal and state legal requirements of maintaining confidentiality; and
11. (II) Failure to comply with confidentiality requirements may result in employment termination and/or criminal prosecution;
12. (K) Risk and impact of substance abuse on child population;
13. (L) The overall importance of the direct supervision and safety of children;
14. (M) Rights of the persons served by the program;
15. (N) Suicide prevention and intervention;
16. (O) Prevention of workplace violence, homicide and other criminal acts;
17. (P) Procedures for safe transportation of children and orientation to organization vehicles, if applicable;

(Q) Implementation of the organization’s written emergency and evacuation plans;

(R) Recognition of eating disorders;

(S) Behavior management and appropriate discipline;

(T) Crisis prevention and intervention; and

(U) An overview of the DFS Substitute Care Rules.

(ii) If the facility utilizes a Seclusion Room, the designated staff authorized to place a child in the Seclusion Room shall be oriented and trained as outlined in Section 25.

(iii) If the organization is using physical restraint, all staff and foster parents who use restraint shall be oriented and trained in appropriate behavioral interventions procedures as outlined in Section 25.

(iv) All administrative and managerial staff shall receive training and the training may include but is not limited to:

(A) General management, including labor law and staff/management relations;

(B) Child welfare, juvenile justice and mental health systems;

(C) Relationships with other service organizations; and/or

(D) Best practices in program area.

(v) Within three (3) months of staff’s start date and prior to assuming responsibility for unsupervised direct care of children, all staff shall sign a statement acknowledging they have read the facility policies, procedures, an overview of the DFS Substitute Care Rules and completed required pre-service orientation training.

(b) CPR and First Aid training. All staff shall complete within ninety (90) days from the date of hire. All times that children are present in a facility, there must be one (1) direct care staff person present who has current certification in CPR and First Aid. Foster parents must have current certification in CPR and First Aid prior to receiving certification from the Child Placing Agency or Therapeutic Foster Care Agency.

(i) All CPR and First Aid training must meet the requirements of the American Heart Association, American Red Cross or National Safety Council including required updates; and (ii) CPR and First Aid training does not count toward pre-service orientation training hour requirements.

(c) Annual Training. All direct care staff (including foster parents) must complete a prescribed number of hours of annual training, as set forth in each program-specific chapter of these rules. Each year all employees shall receive ongoing training in:

1. (i) Emergency plans;
2. (ii) Suicide prevention and intervention;
3. (iii) Prevention of workplace violence, homicide and other criminal acts;
4. (iv) Confidentiality;
5. (v) Behavior management and appropriate discipline;
6. (vi) Crisis prevention and intervention; and
7. (vii) Other areas of annual training shall be child and family related.

(d) All staff shall sign off on all trainings attended, this includes electronic signatures.

(e) The individual(s) designated under the Reasonable and Prudent Parent Standard shall complete the training required by that Standard.

Section 12. Employee Health.

(a) TB Testing.

(i) All employees must have a current tuberculosis (TB) risk assessment. If the results of the TB risk assessment indicates a person is at high risk for TB, the employee file shall include the results of a TB risk assessment and/or a TB test conducted by a licensed health care professional that shows no symptoms/risks or negative TB results. The risk assessment shall be on file prior to starting employment. If a TB test is required, the test shall be completed within one (1) month of employment start date. If the employee is exhibiting symptoms or if he/she tests positive, the employee shall follow the licensed health care professional's direction and shall not be around the children until cleared;

(ii) Every staff must complete a TB Yearly Risk Factor Self Assessment and there shall be follow-up TB testing if recommended by a health professional; and (iii) In case of a positive exposure, employee shall follow the procedures of the Wyoming Department of Health (https://health.wyo.gov/wp-content/uploads/2016/04/WY-TB-Manual-2017.pdf).

(b) Reportable Communicable Disease. If an employee in a facility becomes ill with a reportable communicable disease (a disease or condition that is reportable to the Wyoming Department of Health) during his/her shift, he or she shall be isolated from the children until he or she can be examined or treated and cleared by a physician.

(c) Hepatitis B.

(i) Hepatitis B vaccinations shall be made available to employees on a volunteer basis as stated by the Occupational Safety and Health Administration (OSHA).

(ii) Specifically, this OSHA regulation states that employers must provide at no cost to the employee, hepatitis B vaccinations of all employees who are at risk of acquiring hepatitis B due to occupational exposure to blood or other potentially infectious materials.

(iii) If the employee chooses not to be vaccinated, the employer must obtain his/her signature on a statement.

Section 13. Child Health and Safety.

(a) The organization shall develop, adopt, follow and maintain on file written policies and procedures to keep children safe and healthy while in their facilities.

(b) Health and Safety Documentation. Within twenty-four (24) hours of admission to the program, the program intake staff shall document or obtain the health and safety status of the child including:

1. (i) Allergies;
2. (ii) Medications;
3. (iii) Immunization history;
4. (iv) Hospitalizations;
5. (v) Medical diagnoses;
6. (vi) Medical problems that run in the family;
7. (vii) Complications of pregnancy, if applicable;

8. (viii) Special dietary needs;

9. (ix) Illnesses;

10. (x) Injuries;
11. (xi) Dental problems;
12. (xii) Mental health issues;
13. (xiii) Emotional problems;
14. (xiv) Ongoing medical care needs;
15. (xv) History of aggressive or violent behavior;
16. (xvi) Substance abuse history;
17. (xvii) Sexual history or behavior patterns that may place the child or other children at risk;
18. (xviii) Known or suspected suicide or self-injury attempts or gestures;
19. (xix) Emotional history which may indicate a predisposition for self-injury or suicide;
20. (xx) History of fire setting;
21. (xxi) Homicidal thinking;
22. (xxii) Animal mutilation; and
23. (xxiii) Runaway history.

(c) Child’s Health and Safety Plan. If indicated in the health and safety documentation, an individual written plan to address the child’s health and safety issues shall be developed and implemented as soon as practical but not more than seven (7) calendar days from the date of the screening.

(i) A safety plan shall be developed (or updated) and implemented immediately if the needs of the child change or if an incident occurs which requires a higher level of supervision, observation or other special accommodation, including but not limited to suicide ideation or attempt, runaway, assaultive/conductive behavior, sexual behavior, when the child is a danger to himself/herself or others. These safety plans shall be communicated and available for all staff as well as parent(s), guardian(s), and/or DFS case worker.

(d) There shall be written policy and procedures to ensure that personal hygiene articles and guidance and instruction regarding personal hygiene are provided. Such articles shall include, but not be limited to soap, toothbrush, toothpaste, comb, toilet paper, sanitary products and deodorant.

(e) Medical and Dental Care Documentation. The organization shall develop, adopt, follow and maintain on file written policies and procedures governing preventive, routine and emergency medical and dental care, including provisions for effective coordination of such dental and medical care with those responsible for the child's continuing care.

(f) Communicable Disease. When the facility has a child in placement who is infected, or who may be infected, with a communicable disease, the following guidelines shall apply:

(i) The organization shall work with the legal guardian at all stages of planning for the child;

(ii) All individual patient health records are strictly confidential; and

(iii) All programs must follow Wyoming Department of Health recommended procedures for infection control for both caregivers and children (http://www.health.wyo.gov/phsd/epiid/HAIevidence.html).

(g) Allergic Reactions.

(i) The organization shall develop, adopt, follow and maintain on file written policies and procedures to handle unanticipated allergic reactions by a child; and

(ii) Notation of allergic reactions shall be made in the child's file.

(h) Suicide Prevention and Intervention.

(i) The organization shall develop, adopt, follow and maintain on file written policies and procedures governing all aspects of suicide prevention and intervention.

(ii) The suicide prevention and intervention policy must be reviewed by a licensed medical or mental health professional;

(iii) All staff and foster parents having responsibility for the supervision of children shall be trained in the implementation of the policy; and

(iv) Documentation of training shall be in the staff member's personnel file and/or the foster parent's file.

(i) Family Planning.

(i) The organization shall have a written policy concerning family planning services that complies with federal and state statutes governing family planning.

(ii) A copy of the policy shall be made available to each child of the facility or program at the time of admission.

(iii) Family planning services shall be facilitated when requested.

(iv) Family planning services are voluntary.

(j) Sexually Transmitted Diseases. All programs must be in compliance with federal and state guidelines governing sexually transmitted diseases. Screening shall be provided by public health or licensed physician upon request of child.

(k) Children in substitute care shall not participate as human subjects in medical research or experimental medical projects.

(l) The organization shall ensure that each child in care has adequate, clean, well fitting, and seasonable clothing as required for health, comfort and physical well-being and as appropriate to age, sex and individual needs. A child’s clothing shall be identifiably his or her own and not shared in common.

(i) Clothing shall be kept clean and in good repair. The child shall be involved in the care and maintenance of his or her clothing. As appropriate, laundering, ironing and sewing facilities shall be accessible to the child.

(ii) When uniforms are required, the child and parent(s), guardian(s) or DFS caseworker shall be advised of this requirement prior to admission.

Section 14. Nutrition.

(a) Provision of Food.

(i) All facilities and/or foster parents shall provide children with nutritional, well-balanced meals and snacks.

(ii) Therapeutic diets that conform as closely as possible to the foods served to other children shall be available upon medical or dental authorization.

(iii) Religious diets that conform as closely as possible to the foods served to other children shall be available upon authorization of a parent and/or religious official.

(b) Quantity of Food.

(i) The quantity and type of food served shall meet minimum daily requirements as recommended by the U.S. Department of Agriculture, unless otherwise recommended in writing by a licensed physician, certified nurse practitioner, registered dietician, or licensed physician's assistant for a specific child.

(ii) Additional portions of meals or snacks shall be available for the children.

(c) Prohibition against Withholding or Forcing of Food.

(i) Facilities and/or foster parents may not withhold meals or drink as discipline.

(ii) A child may not be forced to eat food or drink liquids.

Section 15. Transportation.

(a) The organization shall develop, adopt, follow and maintain on file written policies and procedures governing the maintenance and safe operation of vehicles and transportation of children that comply with all applicable safety laws and regulations, including the mandatory use of safety belts and harnesses.

(i) Vehicles used to transport children shall be maintained in clean and safe condition and comply with applicable motor vehicle laws.

(ii) The operator of a vehicle transporting children:

(A) Must be at least twenty-one (21) years of age; and

(B) Shall have the appropriate type of driver's license as required by state law.

(iii) The operator and all passengers shall wear seat belts, unless being transported in a federally classified school bus.

(iv) The number of persons in a vehicle used to transport children shall not exceed the manufacturer's recommended capacity nor the number of seat belts installed when the vehicle was manufactured.

(v) Each child who is a passenger shall be secured in a child safety restraint system, as approved for age and weight, in accordance with state law and manufacturer's specifications.

(vi) If the vehicle is equipped with air bags, the manufacturer's specifications and state law must be followed.

(vii) All facility vehicles must be equipped with a first aid kit and fire extinguisher when transporting children.

(b) Staff:child ratios shall be adjusted based on the needs of the individual child(ren) but shall never be more than six (6) children to one (1) staff. It may not always be practical to have the driver of the vehicle counted in the staff:child ratio.

Section 16. Medication.

(a) Supervision and Administration of Medication. The organization shall develop, adopt, follow and maintain on file written policies and procedures governing the supervision, the administration and monitoring of medication to children.

(i) These policies shall include prescription medications, non-prescription medications and vitamins;

(ii) Prescription medication shall only be administered under the order of a physician, a nurse practitioner, physician's assistant or dentist;

(iii) All medications shall be administered by the appropriately trained personnel in the facility;

(iv) A medication consent form must be completed by the child's parent or legal guardian for all medications given within agreed upon dosage range;

(v) Before the recommended dosage for over the counter medication is exceeded, written permission must be given to the facility by the parent(s) or legal guardian and a health care professional;

(vi) The effects of medication must be documented in the child's health record and the prescribing physician should regularly review the child's response to medication;

(vii) If prescribed medications are used, daily monitoring and documentation is required; and

(viii) There shall be written policy, procedures and controls governing the destruction of out-of-date medication, unused medication or medication prescribed for former children and disposal of syringes and medical waste in accordance with state and local law.

(b) Storage of Medications. The organization shall develop, adopt, follow and maintain on file written policies and procedures ensuring that all medications (over-the-counter and prescribed) are stored in a locked area that is inaccessible to children.

(c) Labeling of Medications. The organization shall develop, adopt, follow and maintain on file written policies and procedures ensuring that all medications are accurately labeled.

(i) Medications must bear their original prescription label or a manufacturer's label; and

(ii) Any deviation from the recommend dosage on the label must be accompanied by a physician's written instructions.

(d) Repackaging of Medication. If medication repackaging (e.g., the placing of a limited supply of medication in a separate container for use during an absence/excursion from the facility) is to occur, it must be done in accordance with the following guidelines:

(i) The individual having the responsibility of repackaging the medication must have training and experience in all aspects of medication administration;

(ii) All medication that is repackaged must be labeled with the following information:

1. (A) Patient's name;
2. (B) Medication name;
3. (C) Correct dosage instructions;
4. (D) Name of physician;
5. (E) Prescription number; and
6. (F) Date of repackaging.

(iii) Repackaging may occur as often as needed; and

(iv) If there is medication left over from repackaging:

(A) It shall be documented in the child's record. Said documentation shall state why there was medication left over and a description of what the medication is for; and

(B) Medication left over from repackaging shall not be returned to the original bottle/container due to changes in potency and contamination.

(e) Medication Logs. The organization shall develop, adopt, follow and maintain on file written policies and procedures ensuring that medication logs are maintained for each child. The organization shall maintain a cumulative record of all medication dispensed to children, a copy of which shall be placed in the child's case record. This record shall include:

(i) Child's name; (ii) Name of physician prescribing medication; (iii) The name of the medication; (iv) Date and time the medication was administered; (v) Amount of medication given; (vi) Signature/initial of person monitoring medication and time administered documented at the time of administration of the medication; (vii) Any medication errors and reason for the errors; and (viii) A statement must be signed and documented by the staff member who witnessed medication refusal.

(f) Medication Errors. Documentation of medication errors shall be kept in the medication log.

(i) Medication errors may include: (A) The failure to administer medication; (B) Administering the incorrect medication; (C) Administering the correct medication in an incorrect dosage; (D) Administering the correct medication at the incorrect time; or (E) The failure to refill a medication. (ii) After each medication error: (A) Medical personnel (e.g., physician, registered nurse, nurse practitioner, licensed practical nurse, physician's assistant) shall be contacted as soon as possible for instructions; (B) Immediate actions shall be taken to prevent future medication errors and actions shall be documented; and (C) An incident report shall be submitted to the DFS Caseworker and the DFS Certifying Authority within two (2) working days.

(g) Adverse Reactions. The organization shall develop, adopt, follow and maintain on file written policies and procedures ensuring that all staff members are aware of the side effects of medication prescribed for the child.

(h) Medication Administration Training. The organization shall develop, adopt, follow and maintain on file written policies and procedures ensuring that medication administration training has been provided.

(i) Psychotropic Medication

(i) The organization shall develop, adopt, follow and maintain on file written policies and procedures ensuring that psychotropic medications shall be prescribed and administered only as a component of a comprehensive treatment plan;

(ii) If psychotropic medications are used, the organization must have a written policy governing the use of such medications that shall include the following:

(A) Criteria for the use and review of psychotropic medications as a part of the ITPC and/or ISPC;

(B) Procedures for monitoring and reviewing use of psychotropic medication by a physician, nurse practitioner, or physician’s assistant; and

(C) Procedures for reporting the suspected presence of side effects.

(iii) Special training shall be given to all staff and foster parents to enable them to recognize changes in a child’s appearance or behavior that may be related to the use of the psychotropic medication.

(j) Revocation of consent. If a parent or guardian revokes consent for the use of medication, the organization has the option of continuing to provide services to the child without the use of medications. The organization also has the option of not continuing to serve the child and DFS shall be notified immediately if the child is in DFS custody. In addition, the organization shall immediately file a statement describing the circumstances under which consent has been revoked.

(i) This statement shall be provided to all organization staff;

(ii) The child’s prescriber shall be notified; and

(iii) The child’s DFS caseworker shall be notified.

(k) Incident reporting. Any unscheduled use of medications, including any PRN orders, used to target psychiatric symptoms or behaviors shall be reported to the DFS Caseworker and the DFS Certifying Authority within two (2) working days.

Section 17. Recreation and Leisure.

(a) All organizations shall develop, adopt, follow and maintain on file written policies and procedures ensuring developmentally appropriate recreation, physical exercise and leisure time activities.

(b) The organization shall develop objectives pertaining to recreation within ISPC and/or ITPC plans.

(c) The facility and/or foster parents shall provide age appropriate recreational experiences, both indoors and out of doors, for all children in placement. Television is not to be considered a form of recreation.

(d) Organization Recreational Plan.

(i) Organizations with on- or off-ground activity programs, which by their nature significantly require a higher level of child supervision, shall clearly describe each activity, including risk, in their recreational plan, the supervision that would be appropriate for the activity and how the skill level of the child will be assessed. These include activities which could be described as physically or otherwise challenging, or those which utilize animals, or those which might involve a level of risk to children; and

(ii) The plan for each activity shall outline the qualifications of staff members involved, special equipment, supervision rules that will be used, and any changes in the usual behavioral rules for children and staff required by the activity. At a minimum, the plan specifically shall address each of the following:

(A) Special qualifications of staff.

(I) The organization shall make documentation available to the certifying authority that the staff member has specialized training, or extensive life experience in the recreational activity that qualify staff to supervise the activity; and

(II) Swimming shall be permitted only when an adult with a current lifeguard certificate, including CPR training, is present.

(B) Special safety equipment.

(I) All sports and outdoor equipment used in the program is selected on the basis of safety factors and is regularly checked or tested to ensure it is up to the organization’s standards, which comply at a minimum with applicable national standards for the equipment in use;

(II) First aid and emergency response kits and other emergency supplies and medications needed by participants are under the control of the designated group leader at all times; and

(III) The organization provides for adequate shelter from the elements, safe and healthful food and water, appropriate clothing and appropriate equipment required for the activities and the environment.

(iii) Staff:child ratios shall be maintained at all times or enhanced depending on the activity. Any overnight trip off campus requires awake staff at all times.

Section 18. Facility Health and Safety Requirements. The organization shall develop procedures for the maintenance of a safe, hygienic, and sanitary environment and monitor adherence to procedures in order to protect the health, safety and welfare of the children. Health and safety requirements for adoptive homes, foster care and therapeutic foster care can be found in the chapters pertaining specifically to those program types.

(a) Inspections.

(i) All programs shall request an annual fire and sanitation inspection, if required by the local jurisdiction and comply with all fire and sanitation requirements as applicable. The annual fire and sanitation inspections shall be submitted to the Certifying Authority; and

(ii) Any inspection conducted by other regulatory agencies shall be reviewed by the certifying authority at each site visit, including identification of any issues found and a review to determine if the issues were addressed adequately.

(b) Tobacco, Alcohol, Controlled Substances and the Abuse of Legal Substances.

(i) The organization shall prohibit the use of all forms of tobacco, alcohol and other controlled substances by children.

(ii) All forms of tobacco, and alcohol shall be prohibited in all substitute care facilities and all motor vehicles used to transport children. Use of tobacco, tobacco products or electronic vaping devices are prohibited when children are present, which includes time away from the facility.

(iii) The organization shall prohibit all use of alcohol and illegal drugs or the abuse of legal substances by any individual in any building, on the premises, or in any vehicle used by children and in the presence of children.

(iv) The organization shall offer referrals to tobacco cessation programs for children and staff.

(c) Animals.

(i) Domestic animals which reside in the living unit shall be current on all vaccinations as recommended by a licensed veterinarian. Verification of such vaccinations shall be present on the premises. Additionally, all domestic animals shall be examined annually by a licensed veterinarian.

(ii) When the organization has horses, cattle and any other livestock that are used with and by children, the following conditions apply:

(A) The animals must be under the care of a licensed veterinarian and how the animals are used must be conveyed to the veterinarian;

(B) The animals must be housed in appropriate enclosures; and

(C) Children at the facility who are in contact with the animals must be educated in the safe and appropriate handling of the animals.

(iii) Exotic animals or any animal who has a history of attacking even one (1) person or aggressive behavior that are kept as pets shall be inaccessible to the children in care;

(iv) Some reptiles carry salmonella and for that reason can be a health risk. Contamination can occur by direct contact with them or their environment. If facilities house reptiles or amphibians they shall take the following precautions to prevent children from exposure to salmonella:

(A) Reptiles and amphibians, and their living environment, must be made inaccessible to direct contact by children less than five (5) years of age and persons with immunocompromising conditions;

(B) Pet reptiles must not be allowed to roam freely throughout the home or living area.

(v) If an individual has had contact with the animal, animal feces, or any objects and surfaces that have been touched by the animal (especially holding areas and food and water bowls), he/she must wash his/her hands well with soap and running water; and

(vi) Cages cannot be cleaned in food preparation areas (including the kitchen sink) unless these areas are subsequently and properly disinfected; and

(vii) All birds capable of carrying psittacosis shall be certified as being psittacosis free, tested or treated by a licensed veterinarian to eliminate or prevent psittacosis or similar diseases.

(d) Pest Control. Insect and rodent control measures shall be implemented as needed to keep them under control. Approved methods, besides physical restraint, are fly strips, electronic killing devices, and other nontoxic methods or pesticides if approved by the Certifying Authority.

(e) Indoor Space and Equipment. The overall condition of the facility and grounds, including play areas, equipment, and toys, shall be maintained in a clean, uncluttered, safe condition and free from hazards. Indoor space and equipment shall include but not be limited to:

(i) Furniture and flooring. The organization shall ensure that buildings are furnished with clean, comfortable furniture in good repair and appropriate to the age, size and capabilities of children. This includes cabinets, sinks, and bathtubs. Flooring shall be clean and in good repair;

(ii) Porches, decks, and stairs:

(A) Shall have sturdy railings; and

(B) Open staircases shall have a child-safe gate if there are young children in the facility/home;

(iii) Fireplaces and wood-burning stoves. The organization and foster home shall ensure the safe disposal of ashes from coal or wood burning fireplaces or stove. Safeguards must be taken to protect small children from accidental contact with fireplaces, space heaters and other hot surfaces;

(iv) Elevators. Each elevator shall have a valid certificate of operation;

(v) Unused electrical outlets shall have safety shields if there are young children placed in the facility or home;

(vi) Space heaters shall not be used unless approved by the certifying fire authority;

(vii) Walls and ceiling surfaces:

(A) If present, lead-based paint shall not present a poisoning hazard. Building components including walls, doors and windows that have been painted with lead-based paint shall have the paint safely removed, covered over or shall be maintained to ensure dust lead levels do not exceed one hundred (100) micrograms/sq. ft. on the floors (including carpeted floors), five hundred (500) micrograms/sq. ft. on the interior window sills and eight hundred (800) micrograms/sq. ft. in the window troughs.

(B) Lead-poisoning hazards shall be minimized during lead-based paint removal and remodeling of all pre-1978 facilities.

(C) All other toxic or potentially hazardous compounds, to include urea formaldehyde and asbestos, shall be excluded from new construction material(s) in walls and ceilings and shall be effectively sealed in existing facilities.

(viii) Doors and windows:

(A) All doors, windows, and other entrances to the outside shall effectively protect against the entrance of all insects and rodents.

(B) Screening material shall not be less than sixteen (16) mesh to the inch.

(viii) Lighting:

(A) All rooms in which food or drink are prepared or in which utensils are washed or stored shall be uniformly lighted with a minimum of twenty (20) foot candles of light at work level.

(B) Lighting shall be from a permanently fixed artificial light source.

(C) Shielding to protect against broken glass falling into food shall be provided for all artificial lighting fixtures located over, by, or within food storage, preparation, service, or display areas and where utensils and equipment are cleaned and stored.

(ix) All rooms shall have sufficient ventilation to keep them free of excessive heat, steam, condensation, vapors, obnoxious odors, smoke, fumes, toxic gases, or stagnant air.

(f) Exterior Conditions.

(i) The overall condition of the buildings and grounds shall be maintained in a clean, uncluttered, sanitary and healthful manner;

(ii) Property shall be in compliance with all city/county/state codes;

(iii) Garbage and rubbish which is stored outside shall be stored securely in noncombustible, covered containers and shall be removed at least once every week or more frequently, if necessary;

(iv) Guardrails shall:

(A) Be located along open-sided walking surfaces, mezzanines, stairways, ramps and landings and along glazed sides of stairways, ramps and landings which are located more than thirty (30) inches above the floor or grade below; and (B) Form a protective barrier not less than forty-two (42) inches high.

(v) Areas determined to be unsafe, including steep grades, cliffs, open pits, swimming pools, high-voltage boosters, or high-speed roads, shall be fenced off or have natural barriers or the organization must have a plan in place on how it will protect children;

(vi) House numbers or addresses shall be plainly visible from the street;

(vii) Home shall have at least two (2) exits; and

(viii) Doors shall be operable from the inside without the use of a key or special effort, excluding secure facilities.

(g) Emergency Situations.

(i) All organizations shall develop, adopt, follow and maintain on file a written plan for action in case of emergencies (e.g., fire and bomb threats), natural disaster (e.g., earthquakes, floods, tornadoes, and severe weather), and missing child(ren) and the plan shall include:

(A) The procedure for reporting emergencies;

(B) Procedures for relocation and evacuation of children;

(C) Staff member duties during emergencies;

(D) Floor plans identifying the locations of portable fire extinguishers, other manual fire-extinguishing equipment, manual fire alarm pull stations and fire alarm control panels;

(E) Floor plans identifying the primary and secondary routes of evacuation for each room or portion of the occupancy;

(F) Site maps identifying the designated exterior assembly area for each evacuation route;

(G) Specific procedures to ensure prompt notification of parents and/or guardians; and

(H) Emergency transportation, if required.

(ii) There shall be evidence of an annual update and review of the plan;

(iii) Evacuation and emergency plans shall be posted throughout the facility with directions to and the location of exits, fire extinguishers, first aid equipment and other emergency equipment or supplies.

(iv) Copies of the emergency plan must be disseminated to appropriate local authorities.

(v) Fire/Evacuation Drills:

(A) The organization shall conduct monthly emergency evacuation drills with every shift conducting a drill not less than quarterly;

(B) These shall occur under varied conditions and during hours when a majority of children are present in the facility;

(C) Emergency drills shall be documented (including time and date of each drill held, the name of the person conducting such drill, and other information relative to the drill) and evaluated as to their effectiveness and a plan shall be developed if any issues arise due to the drill, including timelines to correct the issues and documentation of the resolution of the issues; and

(D) When drills are conducted, all persons who are subject to the drill requirements shall participate in the drill.

(vi) Smoke detectors. Underwriters Laboratory approved smoke detectors shall be installed on all floors of the facility including the basement, centrally located in the hall or area giving access to each sleeping area;

(vii) Fire Extinguishers:

(A) ABC portable fire extinguishers are available in the kitchen and other areas as recommended by the local fire department or fire official;

(B) Fire extinguishers are inspected and serviced annually by an individual certified by the State of Wyoming. New and serviced fire extinguishers shall have service tags attached showing date of purchase or date of service;

(viii) Carbon monoxide detectors. Every facility and foster home shall have a carbon monoxide detector following manufacturer's recommendations for placement;

(ix) Monthly check. The organization must conduct a monthly physical check ensuring that smoke detectors, carbon monoxide detectors and fire extinguishers are operational. The time, date and result of all inspections and any corrective actions will be documented in a monthly log and reviewed by DFS at the time of each site review;

(x) Hallways and entry ways must be free of obstructions at all times;

(xi) Fire exits must be accessible at all times; and

(xii) Sprinkler System. An automatic sprinkler system shall be installed as required by the local fire official.

(h) Storage of Chemicals, Cleaning Solvents, Flammable and Combustible Materials, Poisons, Toxins.

(i) All detergents, sanitizers and related cleaning compounds and other chemicals shall be stored in a safe location that is locked and inaccessible to children; and

(ii) Combustible and flammable materials and liquids shall be stored according to fire code, locked and kept outside of main living areas, and shall not create a fire hazard.

(i) Communication System.

(i) The organization shall ensure that each building used by children or the foster home has at least one (1) working telephone that is directly available for immediate access or that it is connected to an operating central telephone system;

(ii) The organization shall ensure that the facility's and foster home's telephone number is clearly posted and available to children, their parent(s), if appropriate, or legal guardian, and the general public if appropriate;

(iii) The organization shall provide children with reasonable access to a pay or free telephone and shall not charge children for telephone calls to the DFS caseworker;

(iv) The organization shall provide children with reasonable privacy for telephone use unless indicated differently on the child's ISPC or ITPC; and

(v) Emergency telephone numbers must be posted by every telephone or the telephone must have direct access to an emergency switchboard.

(j) First Aid. The organization shall ensure that first aid kits are readily available and accessible in the facility or foster home.

(k) Weapons/Firearms. The organization shall develop, adopt, follow and maintain on file written policies and procedures governing the safe management of firearms and weapons.

(i) The organization shall prohibit the storage or use of any firearms or other weapons on the grounds of the facility or program or in any building used by children, except by law enforcement personnel in emergency and non-emergency situations;

(ii) In foster homes, firearms and ammunition shall be stored and locked separately from each other in an area that is inaccessible to children; and

(iii) No explosives of any type shall be allowed on the premises.

(iv) A foster child on probation and/or an adjudicated delinquent shall abide by the court order or terms and conditions of probation concerning weapons and firearms.

(l) Bladed and Sharp Objects. The organization shall develop, adopt, follow and maintain on file written policies and procedures governing the safe management of bladed and sharp objects. Bladed and Sharp object include, but are not limited to: scissors, knives, razors and razor blades.

(m) Water Supply.

(i) Hot and cold potable water (under pressure) shall be provided to all rooms in which food is prepared and utensils are washed and to all restrooms.

(ii) The water supply shall be of such quantity as to provide enough water for food preparation, washing of hands, and washing of utensils and equipment.

(iii) Private water supplies serving child caring facilities shall have a bacterial test every six (6) months. If infants under one (1) year are present, the water supply shall be tested for nitrates every three (3) years. Water tests shall be conducted at an EPA certified laboratory and/or a laboratory accredited for microbiological testing in drinking water according to EPA approved testing methods.

(vi) All bottled, packaged, or transported water shall be potable.

Section 19. Kitchens & Food Safety.

(a) Utensils and equipment

(i) Multi-use utensils and equipment shall be constructed and repaired with safe materials. They shall be corrosion resistant, easily cleanable, and durable under conditions of normal use.

(ii) Single service articles shall be made from clean, sanitary, and safe materials.

(iii) Reuse of single service articles is prohibited.

(b) Multi-use utensils and food contact surfaces of equipment shall be washed, rinsed, and sanitized after each use or whenever contamination may have occurred. Food contact surfaces shall be corrosion resistant, durable, and easily cleanable under normal use.

(c) Non-food contact surfaces of equipment shall be cleaned as necessary to keep the equipment free of accumulation of dust, dirt, food particles and other debris.

(d) Manual washing and sanitizing of utensils and food contact surfaces:

(i) For manual washing, rinsing, and sanitizing of utensils and equipment, three (3) compartments or containers shall be used.

(ii) Each compartment shall be large enough to accommodate the utensils or equipment.

(iii) The first compartment shall contain a hot detergent that is kept clean. The second compartment shall contain hot, clear rinse water. The third compartment shall contain an approved sanitizing solution.

(iv) All utensils and equipment shall remain in the final sanitizing rinse for at least one (1) minute, and the utensils or equipment shall then be air dried. And

(v) When chemicals are used for sanitization, a test kit or other device that accurately measures the parts per million concentration of the sanitizer shall be provided and used.

(A) Commercial sprays which have been tested and are mixed at the appropriate strength may be used.

(B) Commercial wipes may not be used due to inability to be tested accurately.

(e) Mechanical washing and sanitizing

(i) Cleaning and sanitizing may be done by a spray type or immersion dishwashing machine or by any other type of machine or device if it can be demonstrated to the certifying authority that it thoroughly cleans and sanitizes utensils and equipment. Home type machines, followed by hand sanitizing, may be approved.

(ii) These machines and devices shall be maintained in good repair and shall be operated in accordance with the manufacturer's instructions.

(f) Storage of utensils and equipment

(i) Cleaned and sanitized utensils and equipment shall be stored at least six (6) inches above the floor level in a clean, dry location and in such a manner that protects them from contamination by splash, dust, or other means.

(ii) Food contact surfaces of fixed equipment shall also be protected from contamination by splash, dust, or other means.

(iii) Single service articles shall be stored at least six (6) inches above the floor in closed cartons or containers that protect them from contamination.

(g) Sewage disposal

(i) All sewage, including liquid waste, shall be disposed of by a public sewerage system or by a sewerage disposal system constructed and operated according to the requirements of the Department of Environmental Quality (DEQ) or it's authorized representative.

(ii) Non-water carried sewage disposal facilities are prohibited, except as permitted by the regulatory authority in remote areas or because of special situations.

(h) Solid waste (garbage)

(i) Inside garbage storage shall be kept in lined, durable, easily cleanable, insect and rodent-proof containers that will not leak or absorb liquids.

(ii) All containers used for garbage shall be kept covered with tight fitting lids and shall be available in sufficient numbers to accommodate all garbage and refuse. Outside containers shall be made inaccessible to dogs, cats, and wild animals.

(iii) Containers shall be kept clean at all times.

(iv) Garbage and refuse shall be disposed of often enough to prevent the development of odor(s) and/or the attraction of insects and rodents.

(i) Food care

(i) Food shall be of a sound condition, free from spoilage, filth, or other contamination and shall be safe for human consumption.

(ii) Food shall be obtained from sources that comply with all laws relating to food and food labeling. Wild game is prohibited from being served to the children.

(iii) The serving of 'home-canned' foods and ungraded eggs to the children is prohibited.

(iv) Fluid milk and milk products used or served shall be pasteurized and shall meet the Grade A Quality standards as established by law. (The serving of raw or unpasteurized milk is prohibited.)

(v) Dry milk and dry milk products shall be made from pasteurized milk or milk products and shall be used only in cooking.

(vi) At all times, including while being stored, prepared, displayed, served, or transported, food shall be protected from contamination by dust, insects, rodents, unclean utensils and equipment, unnecessary handling, coughs and sneezes, flooding, drainage, and overhead leakage.

(vii) The temperature of potentially hazardous food shall be kept at 41°F or below, or 135°F or above, at all times. Sufficient refrigerated or hot or cold storage equipment shall be available to maintain these temperatures. Thermometers shall be available at all times for monitoring food temperatures. Refrigeration thermometers shall be kept in top front of the unit.

(viii) Food, whether raw or prepared, if removed from the container or package in which it was obtained, shall be stored in a clean, covered, and labeled container.

(ix) Containers of food, except those packaged in waterproof containers shall be stored at least six (6) inches above the floor.

(x) Cooked or finished potentially hazardous food stored under refrigeration shall not exceed five (5) inches in depth.

(xi) Stored frozen food shall be maintained in a frozen condition.

(xii) There shall be no bare hand contact with any ready to eat food and suitable utensils, including deli tissues, spatulas, tongs, single-use gloves or dispensing equipment, shall be used. Food shall only be prepared on surfaces that, prior to use, have been cleaned, rinsed, and sanitized to prevent cross-contamination.

(xiii) Potentially hazardous frozen foods shall be thawed under the following conditions:

(A) In a refrigeration unit at a temperature not to exceed 41°F

(B) Completely submerged under running water: or directly below; or

(I) At a water temperature of 70°F or below;

(II) With sufficient water velocity to agitate and float off loose particles and overflow; and (III) For a period of time that does not allow thawed portions of ready-to-eat food to rise above 41°F; or

(IV) For a period of time that does not allow thawed portions of a raw animal food requiring cooking to be above 41°F for more than four (4) hours including:

(1.) The time the food is exposed to the running water and the time needed for preparation for cooking; or

(2.) The time it takes under refrigeration to lower the food temperature to 41°F.

(C) In a microwave or part of the continuous cooking process. Potentially hazardous, frozen foods shall not be thawed at room temperature.

(xiv) To keep potentially hazardous foods at safe, correct temperatures, use the following minimum temperature requirements:

(A) Cold foods shall be held at or below 41 degrees F.

(B) Hot foods shall be held at or above 135 degrees F.

(C) Beef roast shall be cooked to 145 degrees F and maintained at that temperature for 15 seconds; 140 degrees F and maintained at that temperature for 12 minutes; or 130 degrees F and maintained at that temperature for 121 minutes.

(D) Pork products shall be cooked to 145 degrees F and maintained at that temperature for 15 seconds.

(E) Poultry and stuffed food products containing meat, fish, or poultry shall be cooked to 165 degrees F and maintained at that temperature for 15 seconds.

(F) Rapidly reheat leftovers to 165 degrees F within two (2) hours.

(G) Fish and shellfish shall be cooked to 145 degrees F and maintained at that temperature for 15 seconds.

(H) Fresh egg products shall be cooked to 155 degrees F and maintained at that temperature for 15 seconds.

(I) Ground beef patties shall be cooked to 155 degrees and maintained at that temperature for 15 seconds.

(xv) Potentially hazardous foods shall be cooled from 135 degrees F to 41 degrees F or less within six (6) hours (135 degrees F to 70 degrees F within two (2) hours, and 70 degrees F to 41 degrees F within four (4) hours).

(xvi) All food shall be served and displayed in a clean and sanitary manner.

(xvii) Programs may serve milk according to the following rules:

(A) Grade A pasteurized milk bottled in one half (1/2) or one (1) gallon containers may be used for pouring glasses of milk.

(B) The use of the one half (1/2) or one (1) gallon commercially filled containers shall be contingent on the following:

(I) No milk, once poured from the original container, shall be reused for beverages or cooking; and

(II) The one half (1/2) or one (1) gallon container shall be returned to the refrigerator as soon as the individual glasses are filled and shall not remain on the table during lunch, snack, or other dining times.

(C) The USDA commodity code does not allow dry or powdered milk products to be reconstituted and used for drinking purposes.

(xviii) Once served to a child, that unwrapped portion of any leftover food or drink shall not be served again.

(xix) Only pasteurized juice shall be served in the child care setting.

(j) Hair control shall be employed by all those engaged in food preparation. Hair shall be restrained in such a manner as to prevent hairs from contaminating food or food contact surfaces.

(k) Persons engaged in food preparation or who come in contact with the children shall maintain good hygienic practices during all working periods at the child-caring facility.

Section 20. Requirements for New (Purchased or Leased) Construction and Additions to Existing Structures.

(a) All new occupancies, new construction, remodeling or conversions of facilities shall comply with these rules as well as:

(i) Local plumbing codes or in their absence, the International Plumbing Code, International Code Council (http://www.iccsafe.org/Pages/default.aspx), latest edition;

(ii) Local building codes, or in their absence, the International Building Code, International Code Council (http://www.iccsafe.org/Pages/default.aspx), latest edition;

(iii) The Federal Safe Drinking Water Act (http://water.epa.gov/lawsregs/rulesregs/sdwa/currentregulations.cfm);

(iv) The Americans with Disabilities Act, 42 USC §12101 et seq.; and

(v) Local or state fire safety and sanitation requirements, as applicable.

(b) Prior to purchase, lease, construction or remodeling of a new or existing facility, there shall be a plan review completed by DFS and the State Fire Marshal or other local fire authority. After construction or remodeling is completed, a fire inspection shall be conducted and a certificate of occupancy shall be submitted to the certifying authority.

(c) Prior to the purchase or leasing of an existing structure, sanitation inspections shall be completed and submitted to the certifying authority.

(d) All construction and remodeling, regardless of cost or size, shall comply with the minimum adopted state codes and/or local codes.

(e) In all remodeling and new construction, required smoke detectors shall receive their primary power from the building wiring when such wiring is served from a commercial source and shall be equipped with a battery backup.

Section 21. Bedrooms.

(a) The facility and foster home shall have sufficient bedroom space to allow at least seventy-five (75) square feet for the first occupant of a bedroom, and fifty (50) square feet for each additional occupant.

(b) Windows in rooms designated sleeping areas shall be adequate for emergency escape or rescue. For all facilities required to have fire inspection those windows shall be approved by the certifying fire authority.

(i) Exception: facilities licensed as Juvenile Detention Centers or secure Residential Treatment Centers.

(c) Each child shall be provided with room and board and is to be assigned a bedroom which shall include, as a minimum, an individual bed, mattress, mattress cover, pillow, supply of bed linen and space for the storage of personal items. There shall be no more than four (4) children to a facility or foster home bedroom.

(d) Children of the opposite sex shall not sleep in the same room. In the case of foster homes, children of the opposite sex may sleep in the same bedroom, if they are biological siblings and if under age eight (8), unless written approval is given by the DFS caseworker stating that it is in the children's best interest to share a room.

(e) Staff and foster parents shall never share a bed or bedroom with a child in care.

Section 22. Bathrooms.

(a) All residential facilities shall have bathroom and shower (or bath tub for Foster Homes) facilities that are separated by a wall from the bedroom except in Juvenile Detention Centers. There shall be at least one (1) toilet and one (1) sink per bathroom.

(b) All bathrooms shall have covered trash receptacles, single service hand towels or hand drying devices (or regular hand towels for Foster Homes), toilet tissue and hand cleanser at all times.

(c) Sinks shall be located in all bathrooms and shall be supplied with hot and cold running water and located at a height between twenty-four (24) and thirty-six (36) inches high for children, or stools shall be provided.

(d) Children of the opposite sex shall not share the same bathroom at the same time.

(e) Facilities shall comply with the requirements of the International Plumbing Code, International Code Council (http://www.iccsafe.org/Pages/default.aspx) latest edition or the plumbing code adopted by the local jurisdiction.

Section 23. Child and Family (Parent, Guardian) Rights.

All organizations shall develop and maintain a child's rights policy that supports and protects the fundamental human, civil, constitutional, and statutory rights of all children. These rights shall include, but are not limited to, the following:

(a) Every child and family shall have the right to be free from abuse, financial or other exploitation, retaliation, humiliation and neglect;

(b) Every child and family shall have equal access to services regardless of race, religion, ethnicity, sexual orientation, disability, socio-economic status or gender;

(c) Every child and family shall have access to services as applicable and as required by the Americans with Disabilities Act, 42 USC §12101 et seq.;

(d) Every child shall have access to educational services per Wyoming State law, Title 25, Education;

(e) The dignity of every child and family shall be recognized and respected in the delivery of services;

(f) Every child and family shall receive care according to individual need;

(g) To the greatest extent possible, service shall be provided within the most appropriate and least restrictive setting;

(h) Every child and parent or legal guardian shall reserve the right to request a service review;

(i) Every child shall have a right to personal privacy and the organization shall allow privacy for each child when not contrary to treatment and safety of the child; and

(j) The organization shall allow contact (i.e. visits, approved gifts, mail and telephone calls) between the child and his/her family. Contact with the family will observe the following guidelines:

(i) Contacts between the child and his/her family shall be allowed while the child is in care unless:

(A) The rights of the parents have been terminated by court order; or

(B) Family contact is not in the child’s best interest, as determined by the child’s treatment team and legal guardian, legal custodian or prohibited by court order.

(ii) The frequency of contact shall be based on the needs of the child, determined with the participation of the child’s parent and/or legal guardian, and organization and shall be documented.

(iii) Limits put on communications or visits shall be documented and communicated to child and all staff.

(k) A person may be excluded from visitation with the child if he/she:

(i) Has a past history of disruptive conduct at the foster home or facility;

(ii) Appears to be under the influence of alcohol or drugs; and/or

(iii) Represents reasonable danger to the child, the foster family, or facility.

(l) Children’s parent(s), legal guardian(s), and/or DFS caseworker’s opinions and recommendations shall be considered in the development of the ISPC and/or ITPC and the organization shall develop and implement a policy describing how this shall be accomplished. Parent(s), legal guardian(s) and/or DFS caseworker shall be included and involved in progress meetings.

(m) There shall be written policy, procedure and practice to ensure and facilitate children’s access to the legal system, as well as confidential contact with legal counsel, and spiritual counsel.

(n) Children in substitute care shall not participate as human subjects in research or experimental projects.

(o) The organization shall not place a child in a position of being forced to acknowledge his/her dependency, delinquency, abuse and/or neglect, unless for treatment purposes (e.g., during a therapeutic counseling session) and shall not exploit a child in any way for organization gain (e.g. public statements of gratitude, fund raising).

(p) The organization shall not use reports or pictures from which children can be identified without written consent from the child and the parents and/or legal guardian and DFS if the child is in DFS custody.

(q) Notification of Rights. There shall be documentation in each child’s record that he/she is familiar with his/her rights and have a signed a statement to that effect, if age appropriate.

Section 24. Discipline.

(a) The organization shall develop, adopt, follow and maintain on file written policies and procedures ensuring the appropriate discipline of children in care.

(i) Written copies of the discipline policy shall be provided to staff, foster parents and the children;

(ii) Documentation shall be kept of the imposition of all discipline and/or restrictions;

(iii) Only staff with direct child care or supervisory responsibility shall discipline children;

(iv) Children residing in the facility and foster home shall not discipline other children, nor are they allowed to engage in any physical intervention with another child. Children shall not have authority over other children;

(v) Physical restraint of a child shall not be used as a form of punishment;

(vi) Corporal punishment, defined as any act of inflicting punishment directly on the body, causing pain or injury, shall not be used;

(b) Examples of inappropriate discipline and/or punishment:

(i) Humiliating or degrading confrontation or consequences that undermine the child's respect, such as ridicule, sarcasm, shaming, scolding, forcing a child to dress in attire that would humiliate or degrade;

(ii) Verbal remarks that belittle or ridicule the child or his/her family;

(iii) The denial of food, liquids, mail or visits with their families as punishment;

(iv) Any form of discipline, control, or punishment that violates state laws that protect children from abuse and/or neglect; or

(v) Other unacceptable forms of punishment or behavioral control include, but are not limited to, the following:

(A) Slapping;

(B) Spanking;

(C) Shaking;

(D) Paddling;

(E) Belting;

(F) Kicking;

(G) Hitting including hitting with objects with an intent to do harm;

(H) Unreasonable forced physical exertion or meaningless repetitive activities (e.g., marching, push-ups), when used solely as a punishment;

(I) Requiring or forcing the child to take an uncomfortable position, such as squatting or bending, standing, or kneeling rigidly in one spot;

(J) Group discipline for misbehaviors of individuals;

(K) Excessive denial of on-grounds program services or denial of any essential program service solely for disciplinary purposes;

(L) Requiring the child to remain completely silent for more than 60 minutes, consecutive or otherwise, within a two (2) hour period and used for a child more than four (4) times within one (1) twenty-four (24) hour period;

(M) Assignment of physically strenuous or harsh work which could result in harm to child;

(N) Deprivation of sleep;

(O) Punishment for bedwetting or actions related to toilet training;

(P) Failure to comply with elements of the child’s ISPC and/or ITPC as a form of punishment;

(Q) Confinement of a child within a room for an extended period of time;

(R) Physical restraint; or

(S) Seclusion.

(vi) Other impingement upon the basic rights of children to care, protection, safety, and security.

(c) Time out is the removal of a child from the child’s immediate environment and restricting the child alone to a room or area. Time out is an approved method of discipline, if used according to the following guidelines:

(i) May not be used for more than sixty (60) minutes, consecutive or otherwise, within a two (2) hour period, with frequent interaction and monitoring by staff and foster parent;

(ii) May not be used for a child more than four (4) times within one (1) twenty-four (24) hour period;

(iii) Staff and foster parent shall observe a child in time out at least every fifteen (15) minutes and more often if the behavior warrants; and

(iv) The door to the time out area must be left open, allowing the child free movement to leave the time out area.

(d) Room Restriction is a disciplinary action that takes place in an area that is segregated from the other residents of the facility, and:

(i) The Seclusion Room cannot be used for room restriction;

(ii) Room restriction cannot be a lock-down situation except in juvenile detention centers;

(iii) It should only be used when less restrictive forms of discipline have been unsuccessful; and

(iv) While the child is in room restriction, he/she must be allowed to, unless by doing so there is imminent risk to themselves or others:

(A) Have normal meals;

(B) Participate in any type of clinically directed and/or program directed services,

(C) Participate in educational activities; and

(D) Have hygiene privileges.

(v) Children placed in room restriction must be checked on at least every ten (10) minutes during the first twelve (12) hours of room restriction and every fifteen (15) minutes thereafter during the room restriction.

(vi) When room restriction lasts for more than twenty-four (24) hours, a plan shall be developed or the treatment plan amended to list the goals or what needs to be accomplished and these goals must be re-evaluated daily as to the purpose, length of time and status of the confinement.

(vii) When a child is placed in room restriction, the following information must be documented in the child’s record or ITPC:

(A) The specific behavior that necessitated room restriction;

(B) Alternative interventions that were unsuccessful in controlling the behavior;

(C) The time and date the room restriction began and ended;

(D) Monitoring reports with observations and notations regarding the child’s physical and emotional condition at no greater than fifteen (15) minute intervals; and

(E) How the issues that resulted in room restriction were resolved.

Section 25. Emergency Safety Interventions.

(a) An emergency safety intervention is allowable only when unanticipated child behavior places the child or others at serious threat of violence or injury if no intervention occurs.

(b) Allowable emergency safety interventions include physical restraint and/or seclusion.

(c) Prohibited Emergency Safety Interventions. The following emergency safety interventions are prohibited:

(i) Aversive conditioning, which means the application of startling, painful or noxious stimuli (e.g., pepper spray);

(ii) Use of pressure point techniques, which means the application of pain for the purpose of achieving compliance;

(iii) Chemical restraint, which means a drug used to control acute, episodic behavior that restricts the movement or function of a child; and

(iv) Use of mechanical restraints, except in Juvenile Detention programs.

(d) Physical/Manual Restraint.

(i) The purpose of physical restraint shall be to provide only that degree of physical control that the child is unwilling or unable to provide for him or herself and to prevent physical harm to self or others;

(ii) The following precautions must be observed at all times:

(A) The organization shall ensure that a child is released from a restraint as soon as the child gains control; and

(B) An organization shall not permit the application of a restraint if a child has a documented physical or mental condition that would contraindicate its use, unless a licensed physician or licensed mental health professional has previously and specifically authorized its use in writing. Such documentation shall be maintained in the child’s file.

(iii) Policy and Procedure. Each program choosing to use physical restraint shall have a written physical restraint policy. The written policy shall include at a minimum the following information:

(A) The name of the nationally certified or accredited program which provided or provides the physical restraint training for staff members prior to restraining a child. Such program shall be approved by the certifying authority prior to implementation;

(B) Which staff members and foster parents shall be approved by the organization to use physical restraint with children in care;

(C) The type and number of hours of ongoing training each staff member and foster parent shall be required to take;

(D) What and how the preventive/de-escalation techniques and positive behavioral intervention shall be used by staff prior to any physical restraint;

(E) How the program observes and evaluates the use of physical restraint on a child at the facility or foster home including evaluation of appropriateness and effectiveness of preventive/de-escalation techniques on each physical restraint;

(F) The type of written documentation the facility and foster parent maintains of each physical restraint that describes the details of the incident and the staff and foster parent involvement;

(G) The type of written documentation the facility and foster parent maintains that describes the debriefing with the child and staff and foster parent following the restraint;

(H) The requirement that staff and foster parent not restrain children in areas of the facility/home that may pose a threat to the health and safety of the child including, but not limited to, soft, pliable surfaces, concrete, asphalt or areas which may result in broken glass;

(I) How the program monitors the physical well-being of the child during and after the restraint, including but not limited to breathing, pulse, color, and signs of choking or respiratory distress;

(J) Emergency procedures, including first aid and how medical personnel will be contacted, that shall be used if a child, staff member and foster parent is injured during a restraint; and

(K) The internal review process of the program to assess all injuries.

(iv) Restraint Training. If the organization is using physical restraint, all staff and foster parents using physical restraint shall be oriented and trained in a nationally recognized program for appropriate behavioral intervention procedures which shall include:

(A) Participation in annual, ongoing training that concludes with successful completion of a mandated competency test;

(B) Periodic observation of each staff member performing a physical restraint must be done by a supervisor of the facility who has been trained in restraint; and (C) If a supervisor of the facility or designee determines a staff member did not correctly perform a physical restraint or performed an inappropriate or unnecessary physical restraint, the staff member must be immediately retrained and be restricted from performing further restraints until retraining can occur.

(v) Notification of Physical Restraint Usage.

(A) At the time of admission to the program, the child, child's parent and/or legal guardian, shall be told, in a language or manner of communication understandable to him/her, of the purpose of restraint, the restraint model/method used and the type of behavior that might result in the child being restrained; and

(B) All use of physical restraint of a child must be reported to the parent/legal guardian and reported in writing to the certifying authority within two (2) working days following occurrence.

(vi) Charting Restraint Incidents. The following information must be included in the documentation:

(A) The name of the child, date and time of day, staff members and foster parent involved, his/her position at the facility, his/her involvement in the physical restraint, how long the restraint lasted, and the signature of the reporter and date and time of the documentation;

(B) The precipitating incident(s) and the child's behavior before the restraint occurred;

(C) What specific actions were taken to de-escalate the situation and control, calm, or contain the child and the effect of these de-escalating actions upon the child;

(D) A description of the debriefing and evaluation with the child and with the staff and foster parent; and

(E) The child's physical and emotional/behavioral condition prior to, during, and following the restraint.

(vii) Debriefing. Following every restraint, a face-to-face discussion between staff and/or foster parent(s) involved in the intervention and the child shall take place in order to:

(A) Minimize the psychological harm inherent in the use of restraints;

(B) Help staff, foster parent and child plan for alternative interventions to reduce the need for restraints in the future; and (C) Encourage culture change among facility staff and foster parent.

(viii) Review of Restraint. A supervisor or licensed mental health professional, of the organization, shall review each physical restraint within 48 hours of each restraint if:

(A) It appears that the child is being physically restrained one (1) or more times per day for more than four (4) days, the child's ITPC must be reviewed by the certifying authority;

(B) Any particular de-escalation technique appears to be causing escalation in the behavior of a child or a group of children, the use of the technique shall be evaluated for its effectiveness. De-escalation techniques that are not effective or are counter-productive must be terminated at the earliest opportunity; or

(C) A staff member and foster parent appears to be involved in a larger number of physical restraints than other staff members and foster parents and is not a part of a specially trained team, or is unsuccessful at using de-escalation effectively, the program administrator/executive director must conduct a thorough review of the staff member's and foster parent's interactions with children, prior restraint training, and need for further training as required by organization policies.

(e) Seclusion refers to the involuntary confinement of a child alone in a room where the child is physically prevented (either by a closed door or by staff) from leaving when all other reasonable means to control or calm the child have failed;

(i) A Seclusion Room is a safe and secure individual room in which a child, who is beyond control and a danger to himself/herself or others, may be temporarily confined;

(ii) Seclusion Policy and Procedures:

(A) The facility shall have written policies and procedures for dealing with children who are temporarily beyond control and are a danger to themselves or others. These shall include identifying, developing, and promoting preventive strategies and the use of safe and effective alternatives to using the Seclusion Room;

(B) When the Seclusion Room is used, a written statement of purpose, organization policy or operational procedures shall include the following:

(I) The philosophy and use of the room;

(II) The intake process;

(III) The evaluation of the child while in the room;

(IV) Emergency procedure while in seclusion; (V) Child's grievance procedure regarding the use of the room; and (VI) Release from the Seclusion Room.

(C) Use of the Seclusion Room is expressly prohibited as a means of dealing with non-violent or non-assaultive behaviors.

(iii) If a child is placed in the Seclusion Room more than three (3) times in a seventy-two (72) hour period (or a maximum of six [6] hours in a seventy-two [72] hour period), the ITPC for the child shall be reviewed and revisions made if necessary.

(iv) Time Limits. Time limits are as follows: (A) One (1) hour for children nine (9) years of age and under; and (B) Two (2) hours for children ten (10) years of age and above.

(v) Staff Requirements. (A) There shall be a Seclusion Room supervisor who is designated and trained to be responsible for the use of the Seclusion Room;

(B) The supervisor shall be either a full-time staff member or a licensed mental health professional;

(C) If the Seclusion Room supervisor is not a licensed mental health professional, there shall be a contract with a licensed mental health professional to provide consultation with the Seclusion Room supervisor and staff; and

(D) A staff member shall be present when a child is placed inside the room and shall have constant visual contact with the child.

(vi) The facility that operates a Seclusion Room shall appoint a review team, which includes a neutral observer.

(A) The neutral observer may be a staff member of the facility or human services professional;

(B) The neutral observer shall not be the Seclusion Room supervisor or the person who placed the child in the Seclusion Room;

(C) The review team shall determine within seventy-two (72) hours if the situation resulting in the seclusion of a child in a Seclusion Room merited such a decision; and

(vii) The facility shall identify staff members, who have ongoing training and supervision in the area of seclusion policy and procedures, authorized to place a child in the Seclusion Room within its statement of Seclusion Room policy. Authorized staff shall be employed as:

(A) Administrator/Executive Director;

(B) Direct care staff;

(C) Licensed, provisionally licensed and/or certified mental health professional; or

(D) Teacher.

(viii) Authorization.

(A) At the time of admission of the child to the facility, the child’s parent or legal guardian shall be informed of the use of the Seclusion Room and the circumstances under which it will be employed and a written consent must be obtained from the child’s parent or legal guardian authorizing the use of the Seclusion Room;

(B) If the consent form is unsigned, the child may not be placed in a Seclusion Room and an alternative plan shall be developed; and

(C) Prior to the placement of the child in the Seclusion Room, the child shall be oriented, in a language or manner of communication understandable to him/her, to the room regarding the purpose of its use and the type of behavior that might result in its use and the child shall sign a statement indicating such orientation was complete.

(ix) At the time of placement of the child in the Seclusion Room all articles of potential harm to the child (e.g., sharp objects, belt) shall be removed from his/her person.

(x) Documentation.

(A) Each incident of seclusion shall be documented. The following information must be included:

(I) The child’s name;

(II) Date and time;

1. (III) Name of the staff member;
2. (IV) The staff member who was notified of the placement;
3. (V) The precipitating incident and the child's behavior before placement in the room;
4. (VI) Actions taken by staff members of a less restrictive nature to try to control, calm, or contain the child;
5. (VII) Observable physical and emotional/behavioral condition of the child when entering the Seclusion Room; and
6. (VIII) The child shall be in constant visual contact of direct care staff. At least every fifteen (15) minutes there shall be documentation which shall include the time and a description of what the child was doing;
7. (IX) When the child was last given access to restroom facilities;
8. (X) When and what type of medications were given and by whom, if applicable;
9. (XI) When the child's last staff contact occurred; and
10. (XII) Initials of the person supervising.(B) The resolution process shall be documented as follows:- (I) Description of the resolution between staff members and the child at the termination of the use of the room and process used in assisting the child to reenter the group; and
11. (II) The observable physical and emotional/behavioral condition of the child after leaving the Seclusion Room including attitude, affect and emotional intensity;(C) The review team report shall include:- (I) Record of persons on the review team;
12. (II) Conclusions as to the appropriateness of placing the child in the Seclusion Room;
13. (III) The record review process; and

(IV) The identification of issues that need to be addressed, and how they will be assessed and evaluated.

(D) The record of the use of the Seclusion Room shall be reviewed daily by the Seclusion Room supervisor.

(E) The record of the use of the Seclusion Room shall be reviewed weekly by the facility administrator.

(xi) Physical Requirements for a Seclusion Room.

(A) The Seclusion Room shall be located in reasonable proximity to the living unit or other areas of activity;

(B) The Seclusion Room shall be a minimum of eight (80) square feet in size;

(C) The Seclusion Room shall be kept in a clean and sanitary condition;

(D) All switches for light, heat and ventilation, as well as other electrical outlets, shall be outside the room and shall be accessible only to staff;

(E) There shall be no features by which a child might injure him or herself within the Seclusion Room (e.g., utility pipes, sprinkler system, cleaning equipment and materials, mirrors);

(F) Exterior windows to the outside of the building are not recommended. If the Seclusion Room does have exterior windows, the window panes shall be of shatter resistant material and have psychiatric screening;

(G) There shall be an observation window from which all parts of the room are visible for purposes of supervision;

(H) The windows shall be made of non-breakable, shatter-resistant materials and the facility shall document maintenance by a professional;

(I) There shall be an approved ventilation system;

(J) The Seclusion Room shall be constructed to meet all appropriate fire regulations;

(K) The child shall not be subjected to glaring lights and all lights shall be recessed into the ceiling and covered with a non breakable, shatter resistant guard that is flush with the ceiling;

(L) There shall be no more than one (1) locked door between the child and the staff member, unless a mechanism for supportive monitoring is in place; and

(M) If the Seclusion Room is soundproof, there must be an intercom system that is activated when a child is in the room.

(xii) Approvals Necessary to Operate the Seclusion Room.

(A) It is the responsibility of the facility to provide the certifying authority with the written approval of the fire official prior to the initial use of the Seclusion Room;

(B) The certifying authority must approve the Seclusion Room prior to the initial use of the room;

(C) If it is found at the time of inspection of the Seclusion Room that the facility does not meet all the regulations for operation of the room, the following will occur:

(I) The certifying authority shall give written notice of specific deficiencies to be corrected; and

(II) The facility shall cease confining any child in the Seclusion Room until corrections are completed and authorization is given by the certifying authority.

Section 26. Personal Possessions and Money.

(a) The organization shall develop, adopt, follow and maintain written policy and procedure on the control and safeguarding of each child’s personal property and funds;

(b) If limits are placed on the type of possessions a child may retain, it shall be documented in the child’s record, ISPC and/or ITPC and reviewed with the child, and his/her parents or legal guardian;

(c) Personal property confiscated by the organization shall be itemized in a written list where each item is checked and initialed by staff that is kept in a permanent case file and the child shall receive a current copy of this list. Upon discharge from the program, the child’s property shall be returned; and

(d) Children may be allowed to earn money by doing odd jobs, if consistent with his/her ISPC and/or ITPC and:

(i) Children’s personal funds shall be held by the organization and the record shall be maintained for each individual child; and (ii) If interest is earned on any account involving children’s funds, the interest must be prorated to the children accordingly.

Section 27. Education.

(a) The organization shall develop, adopt, follow and maintain on file written policies and procedures governing educational needs of a child;

(b) Each child who is of compulsory school age shall participate in a Wyoming Department of Education-approved and/or local school district-approved school program;

(c) High School Equivalency programs shall be made available for children who are not participating in a Wyoming Department of Education-approved and/or local school district-approved school program;

(d) The organizations shall provide appropriate space and supervision for quiet study after school hours;

(e) The organizations shall ensure that each child has access to necessary educational reference materials; and

(f) The organization shall ensure that developmental issues, learning disabilities, and/or behavioral issues, are assessed and addressed as indicated.

Section 28. Religion.

(a) An organization shall respect the religious preference of the child and his/her parent(s) or legal guardian and shall ensure that each child is afforded opportunities to attend or participate in religious services or activities in his/her religious faith of choice that are deemed essential by the faith’s judicatory, limited only by documentation showing threat to the safety of persons involved in such activity or that the activity itself disrupts order in the facility;

(b) An organization that has a particular religious or denominational orientation shall provide a written description of its orientation or beliefs to the child and to the child’s parent(s) or legal guardian prior to the child’s admission, or within seven (7) consecutive calendar days following the admission of the child;

(c) If an organization requires mandatory religious observance or mandatory church attendance, information shall be shared and consent given from the child and parent(s) or legal guardian or both upon admission;

(d) Non-mandatory religious programs shall not require or coerce children to participate in religious services or activities, shall not discipline, discriminate against, or deny privileges to any child who chooses not to participate, and shall not reward any child who chooses to participate;

(e) The child’s parent(s) or legal guardian shall provide written authorization regarding any change in religious affiliation by the child while he/she is in care; and

(f) An organization shall recognize and take into account the racial, cultural, ethnic and religious backgrounds of children when planning various activities or religious services.

Section 29. Grievance Procedures.

(a) The organization shall develop, adopt, follow and maintain on file written policies and procedures governing the grievance process, including that the person has the option to notify DFS if the grievance is not resolved to a satisfactory level; and

(b) The grievance policy shall be provided and explained to the child and his/her parent or legal guardian at the time of admission.

(c) The DFS certifying authority shall provide the facility with the toll free hotline number to be displayed with the grievance policy in all living spaces.

Section 30. Individual Service Plan of Care (ISPC).

(a) An Individual Service Plan of Care (ISPC) shall be developed for each child within fourteen (14) calendar days of placement.

(b) The ISPC shall be developed by the organization’s administrator/executive director (or designee), foster parent, parent or legal guardian, DFS if the child is in DFS custody, and the child, if age appropriate.

(c) The ISPC shall include, but not be limited to, the following:

(i) Written, measurable objective(s) of what is to be accomplished, including how the staff will facilitate engagement of child with his/her family (to develop, maintain and strengthen relationship) during the estimated period of service;

(ii) Activities and tasks assigned to the organization or foster parent, child and family members (others as indicated) along with time frames for achievement of each task and clearly stated expectations and resources to be provided by the organization, child, family members, or other agencies or community organizations;

(iii) Delivery of competent, regular and emergency medical, dental, and optical care, with attention to special medical needs (the child’s health and safety plan shall be integrated into the ISPC, when available);

(iv) Discharge plan to include a time-line, anticipated discharge date, and continuing care plan with other programs and/or community service providers identified as appropriate;

(v) Time frames for the periodic review of progress;

(vi) Description of the potential benefits of achieving the ISPC objectives and a description of potential ramifications of not achieving the ISPC objectives;

(vii) When age appropriate, independent living skill building;

(viii) A description of any Reasonable and Prudent Parent decisions made by the designated official (executive director) or his/her designee.

(d) The organization shall have a system for the implementation of ISPCs that included keeping a record of progress and sharing with the foster family, the child, the parent or legal guardian, and DFS if the child is in DFS custody, on a regular basis.

(e) Copies of the ISPC shall be provided to the foster family, the child (if age appropriate), the parent or the legal guardian and DFS if the child is in DFS custody.

(f) The ISPC shall be reviewed and revised at least every thirty (30) days by the organization's administrator/executive director (or designee), foster family, the child (if age appropriate), parent or legal guardian and DFS if the child is in DFS custody. Participants shall sign and date the ISPC. Phone and video participation should also be noted and signed for by someone physically present at the review. Copies of revised ISPC's and progress reports shall be provided to the DFS Caseworker within 10 days of the review.

Section 31. Individual Treatment Plan of Care (ITPC).

(a) An ITPC shall be developed for each child within fourteen (14) calendar days of placement in a Residential Treatment Center (RTC), a RTC with a Qualified Residential Treatment Program (QRTP) Endorsement or a Board of Cooperative Education Services (BOCES).

(b) The ITPC shall be developed by the organization's administrator/executive director (or designee) foster parent, professional staff, parent or legal guardian, DFS if the child is in DFS custody, and the child (if age appropriate).

(c) All ITPCs shall be written, reviewed and conducted under the supervision of the therapeutic staff/case manager.

(d) The ITPC shall include, but not be limited to:

(i) Written, measurable behavioral objectives, including how the staff will facilitate engagement of child with his/her family (to develop, maintain and strengthen relationship) of what is to be accomplished during the estimated period of service;

(ii) Activities and tasks assigned to the organization or foster parent, child and family members (others as indicated) along with time frames for achievement of each task and clearly stated expectations and resources to be provided by the organization, child, family members, or other agencies or community organizations;

(iii) Delivery of competent, regular and emergency medical, dental and optical care, with attention to special medical needs (the child’s health and safety plan shall be integrated into the ITPC, when available);

(iv) Discharge plan to include a time-line, anticipated discharge date, and continuing care plan with other programs and/or community service providers identified as appropriate;

(v) Time frames for the periodic review of progress toward the objectives;

(vi) Description of the potential benefits of achieving the ITPC objectives and a description of potential ramifications of not achieving the ITPC objectives;

(vii) When age appropriate, independent living skill building; and

(viii) A description of any Reasonable and Prudent Parent decisions made by the designated official (executive director) or his/her designee.

(e) The organization shall have a system for the implementation of ITPCs that included keeping a record of progress and sharing information with the staff and foster parents, DFS if the child is in DFS custody, the child, and the parent or legal guardian on a regular basis.

(f) Copies of the ITPC shall be provided to the staff and foster parents, DFS if the child is in DFS custody, the child (if age appropriate), and the parent or legal guardian.

(g) The ITPC shall be reviewed and revised at least every thirty (30) days by the therapeutic staff, parent or legal guardian, foster parent, DFS if the child is in DFS custody and the child. Participants shall sign and date the ITPC. Phone and video participation of any member shall be acknowledged and signed for by someone physically present at the review. Copies of revised ITPC’s and progress reports shall be provided to the DFS Caseworker within 10 days of the review.

Section 32. Records.

(a) Child Records.

(i) The organization shall develop, adopt, follow and maintain on file written policies and procedures governing the personal records of every child, including compliance with The Health Insurance Portability and Accountability Act (HIPAA), 45

CFR and Substance Abuse Confidentiality, 42 CFR Part 2, and the Family Educational and Privacy Rights Acts, 20 USC § 1232(g) when applicable. The organization shall ensure the records, whether paper or electronic, are available and accessible at any time.

(ii) The content of records shall include, but not be limited to:

(A) Personal Data Record;

(I) The child’s name;

(II) Date of birth;

(III) Social Security number;

(IV) Gender or gender identity;

(V) Religion (if known);

(VI) Race;

(VII) Date and time of placement;

(VIII) Child’s immediate needs;

(IX) Name of referral source;

(X) Reason for placement;

(XI) Description of the child’s condition as observed by the intake worker. This shall include notation of the child’s response to the placement;

(XII) Names and addresses of parents, brothers and sisters;

(XIII) Names of others who have a significant relationship with the child;

(XIV) Child’s special needs such as medical, emotional, educational, and child and/or familial substance abuse.

(B) Emergency information, including:

(I) Name, address, telephone number and relationship of a designated person to be contacted in case of an emergency;

(II) Name, address, telephone number and relationship of the child’s physician or source of health care;

(III) Name, address, telephone number of the person able to give consent for emergency medical treatment (excluding surgery); and

(IV) A copy of the child’s most recent health examination, when available.

(C) Signed Consent to Treatment forms;

(D) Intake/Placement record;

(E) Health and safety documentation;

(F) Health record, to include dental, vision, hearing;

(G) Medication record;

(H) ISPC, ITPC, and/or Transition Plan;

(I) Reportable incidents;

(J) Court orders;

(K) Signed notification of rights and grievance procedures;

(L) Signed notification of awareness of the rules;

(M) Education record;

(N) Progress reports;

(O) Required documentation as specified in these rules (e.g., use of emergency safety interventions); and

(P) Record of family contact/visitation.

(iii) Confidentiality. A child’s record, information concerning a child or birth/adoptive family, and information that may identify a child or family by name or address is confidential and may not be disclosed or used other than in the course of official duties.

(iv) Locked Records. The organization shall develop, adopt, follow and maintain on file written policies and procedures ensuring that a child’s record is inaccessible to all but staff bound by confidentiality rules and the certifying authority. Hard copy records must be locked up in a secure area and electronic records must be protected by a password with automatic back-up to assure protection against loss of information.

(b) Staff Records. The staff records shall include:

(i) Name;

(ii) Documentation and verification of education and training;

(iii) Verification of work experience;

(iv) TB screening and/or test and Hepatitis B (if applicable) results;

(v) Copy of resume or application;

(vi) Employee signature verifying that they have reviewed all policy and procedures for the organization;

(vii) Employee signature verifying the employee understands his/her statutory responsibility for reporting child abuse and/or neglect per W.S. §§ 14-3-205 through 14-3-206;

(viii) Documented proof of all training received by staff to include the number of hours, dates, titles of training and name of trainer;

(ix) Documentation in writing, signed by each staff member that to the best of his/her knowledge he/she is not on a child abuse and/or neglect registry in Wyoming or any other state;

(x) A completed abuse and/or neglect Central Registry check, and evidence of a FBI criminal history record check;

(xi) Documentation of the completion of an annual evaluation; and

(xii) For contract staff, a copy of their employment contract.

(c) Certification Records.

(i) The records maintained by DFS concerning the certification/licensing of facilities and organizations are open to the public except for the following, which are confidential and not available for review:

(A) Information identifying children or their families;

(B) Scholastic records, health reports, social or psychological reports;

(C) Personnel records; and (D) Reports and records received from other agencies, including police and child protection investigation reports and any other regulatory reports.

(ii) Anyone wishing to review a record must make a written request to DFS and that information shall only be released in accordance with applicable state and federal law.

(d) Organization Record Retention. The organization shall develop, adopt, follow and maintain on file written policies and procedures governing record retention including time frame for keeping records, (at least six (6) years from date of last official involvement following the child's departure and until any audit or litigation is resolved).

Section 33. Requirements Pertaining to Children in the Custody of the State of Wyoming, Department of Family Services.

(a) Certified facilities who accept court ordered placements of children in DFS custody or placements funded by DFS and/or the State of Wyoming shall adhere to the Department's Court Ordered Placement Rules.

(b) Child Placing Agencies and Therapeutic Foster Care Agencies must send a copy of the foster parent certification and documentation that background checks have been completed to the appropriate DFS Foster Care Coordinator.

(c) If the child in placement is in the legal custody of DFS, the facility or foster home shall:

(i) Allow full access by the DFS caseworker to the child in placement; (ii) Cooperate with DFS in all reunification efforts and permanency planning; and

(iii) Cooperate with the DFS caseworker in providing medical services to child in placement.

(d) Programs wishing to accept children DFS custody must comply with all requirements of 42 USC §§ 670 through 679(b).

(e) The facility shall have a designated official, who is the executive director, and a trained designee, to make determinations related to the Reasonable and Prudent Parent Standard, per Wyoming Statute 14-13-101 through 104.