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Minimum Standards for General Residential Operations

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Minimum Standards for General Residential Operations Minimum Standards for General Residential Operations Child Care Regulation Texas Health and Human Services Commission June 2021 1 Revised August 9, 2021 Table of Contents Table of Contents ................................................................................... 2 Introduction ........................................................................................... 6 Minimum Standards ............................................................................ 6 Deficiencies ....................................................................................... 6 Weights ............................................................................................ 6 Maintaining Compliance ....................................................................... 7 The Inspection ................................................................................... 7 Technical Assistance ............................................................................ 7 Investigations .................................................................................... 8 Your Rights and Entitlements ................................................................ 8 For Further Information ....................................................................... 8 Subchapter A, Purpose and Scope .......................................................... 9 Subchapter B, Definitions and Services ................................................ 12 Division 1, Definitions ........................................................................ 12 Division 2, Services ........................................................................... 23 Subchapter C, Organization and Administration ................................... 29 Division 1, Plans and Policies Required For the Application Process ............ 29 Division 2, Operational Responsibilities and Notifications ......................... 43 Division 3, General Fiscal Requirements ............................................... 48 Division 4, Required Postings .............................................................. 48 Subchapter D, Reports and Record Keeping ......................................... 49 Division 1, Reporting Serious Incidents and Other Occurrences ................ 49 Division 2, Operation Records ............................................................. 65 Division 3, Personnel Records ............................................................. 66 Division 4, Child Records .................................................................... 69 Division 5, Record Retention ............................................................... 71 Division 6, Unauthorized Absences ...................................................... 71 Subchapter E, Personnel ...................................................................... 77 Division 1, General Requirements ........................................................ 77 Division 2, Child-Care Administrator .................................................... 79 Division 3, Professional Level Service Providers ..................................... 81 Division 4, Treatment Director ............................................................ 88 Division 5, Caregivers ........................................................................ 90 Division 6, Normalcy ......................................................................... 92 Division 7, Contract Staff and Volunteers .............................................. 96 Subchapter F, Training and Professional Development ........................ 99 Division 1, Definitions ........................................................................ 99 Division 2, Orientation ..................................................................... 100 2 Revised August 9, 2021 Division 3, Pre-Service Experience and Training ................................... 101 Division 4, General Pre-Service Training and Pre-Service Training Regarding Normalcy .................................................................................. 106 Division 5, Pre-Service Training Regarding Emergency Behavior Intervention ............................................................................................... 109 Division 6, Annual Training ............................................................... 111 Division 7, First-Aid and CPR Certification ........................................... 123 Subchapter G, Child/Caregiver Ratios ................................................ 126 Subchapter H, Child Rights ................................................................. 128 Subchapter I, Admission, Service Planning, and Discharge ................ 136 Division 1, Admission ...................................................................... 125 Division 2, Emergency Admission ...................................................... 141 Division 3, Educational Services ........................................................ 144 Division 4, Service Plans .................................................................. 146 Division 5, Service Plan Reviews and Updates ...................................... 157 Division 6, Discharge and Transfer Planning ........................................ 159 Division 7, Release of Child .............................................................. 164 Subchapter J, Child Care .................................................................... 165 Division 1, Dental Care .................................................................... 165 Division 2, Medical Care ................................................................... 167 Division 3, Communicable Diseases ................................................... 174 Division 4, Protective Devices ........................................................... 176 Division 5, Supportive Devices .......................................................... 178 Division 6, Tobacco and E-Cigarette Use ............................................. 180 Division 7, Nutrition and Hydration .................................................... 180 Division 8, Additional Requirements for Infant Care .............................. 193 Division 9, Additional Requirements for Toddler Care ............................ 203 Division 10, Additional Requirements for Pregnant Children ................... 205 Subchapter K, Operations That Provide Care for Children and Adults . 208 Division 1, Scope ............................................................................ 208 Division 2, General Requirements ...................................................... 208 Subchapter L, Medication ................................................................... 212 Division 1, Administration of Medication ............................................. 212 Division 2, Self-Administration of Medication ....................................... 214 Division 3, Medication Storage and Destruction .................................... 216 Division 4, Medication Records .......................................................... 217 Division 5, Medication and Label Errors .............................................. 219 Division 6, Side Effects and Adverse Reactions to Medication ................. 222 Division 7, Use of Psychotropic Medication .......................................... 223 Subchapter M, Discipline and Punishment .......................................... 227 Subchapter N, Emergency Behavior Intervention ............................... 231 3 Revised August 9, 2021 Division 1, Definitions ...................................................................... 231 Division 2, Types of Emergency Behavior Intervention That May Be Administered ............................................................................. 231 Division 3, Orders ........................................................................... 235 Division 4, Responsibilities During Administration of Any Type of Emergency Behavior Intervention ................................................................. 239 Division 5, Additional Responsibilities During Administration of a Personal Restraint ................................................................................... 242 Division 6, Additional Responsibilities During Administration of Seclusion .. 244 Division 7, Additional Responsibilities During Administration of a Mechanical Restraint ................................................................................... 245 Division 8, Successive Use and Combinations of Emergency Behavior Intervention .............................................................................. 247 Division 9, Time Restrictions for Emergency Behavior Intervention ......... 250 Division 10, General Caregiver Responsibilities, Including Documentation, After the Administration of Emergency Behavior Intervention ............ 254 Division 11, Triggered Reviews ......................................................... 258 Division 12, Overall Operation Evaluation ........................................... 260 Subchapter O, Safety and Emergency Practices ................................. 263 Division 1, Sanitation and Health Practices .......................................... 263 Division 2, Natural Gas and Liquefied Petroleum .................................. 268 Division 3, Fire Safety Practices ........................................................ 270 Division 4, Heating Devices .............................................................. 274 Division 5, Carbon Monoxide Safety Practices .....................................
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