WSR 04-03-010D

EMERGENCY RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Children's Administration)

[ Filed January 9, 2004, 4:26 p.m. ]

     Date of Adoption: January 5, 2004.

     Purpose: The purpose of the proposed emergency rules for group receiving centers (GRC), chapter 388-140 WAC, is to establish licensing standards for facilities providing out-of-home receiving or emergency care to children for up to thirty days. Licensing standards do not currently exist for GRCs. The emergency rules would provide protection for children placed in facilities in emergency situations. Currently, the one group receiving center in operation is licensed under standards that do not accurately or adequately address the program.

     Statutory Authority for Adoption: RCW 74.15.030(2), 74.08.090.

     Under RCW 34.05.350 the agency for good cause finds that immediate adoption, amendment, or repeal of a rule is necessary for the preservation of the public health, safety, or general welfare, and that observing the time requirements of notice and opportunity to comment upon adoption of a permanent rule would be contrary to the public interest; and that state or federal law or federal rule or a federal deadline for state receipt of federal funds requires immediate adoption of a rule.

     Reasons for this Finding: Children's Administration has licensed a facility as a group care program with several waivers as there are no current licensing standards for a group receiving center. After consulting with the state Attorney General's Office and representatives of the federal IV-E program, we have learned that the approval of waivers jeopardizes federal funds received by Children's Administration to support services to children. A stakeholder work group has been involved in preparation of these emergency rules and the rules being drafted for permanent adoption. The emergency rules are needed to protect the health and safety of children placed in these facilities until permanent rules are adopted. Children's Administration is amending licensing standards (chapter 388-148 WAC) for group care facilities and plans to incorporate these group receiving center rules into chapter 388-148 WAC. Stakeholders have reviewed the draft of revised chapter 388-148 WAC. Children's Administration will be filing the proposed rules in late January 2004.

     Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 125, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0;      Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 125, Amended 0, Repealed 0.
     Effective Date of Rule: Immediately.

January 5, 2004

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

3173.5
Chapter 388-140 WAC

LICENSING STANDARDS FOR GROUP RECEIVING CENTERS

PURPOSE
NEW SECTION
WAC 388-140-0005   What is the purpose of this chapter?   The department issues or denies a license on the basis of compliance with licensing requirements. This chapter defines general and specific licensing requirements for group receiving centers. Unless noted otherwise, these requirements apply to people who want to be licensed or re-licensed to provide care as a group receiving center.

     The department is committed to ensuring that children who receive receiving care in a group setting experience health, safety, and well-being. We want these children's experiences to be beneficial to them not only in the short term, but also in the long term. Our licensing requirements reflect our commitment to children.

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DEFINITIONS
NEW SECTION
WAC 388-140-0010   What definitions apply to this chapter?   The following definitions are important to understand these rules:

     "Abuse or neglect" means injury, sexual abuse, sexual exploitation, negligent treatment or mistreatment of a child where the child's health, welfare and safety are harmed.

     "Assessment" means the appraisal or evaluation of a child in terms of his or her physical, mental, and emotional condition.

     "Capacity" means the maximum number of children that a home or facility is licensed to care for at a given time.

     "Children" or "youth," means individuals who are under eighteen years old, including expectant mothers under eighteen years old.

     "Compliance agreement" means a written licensing improvement plan to address specific skills, abilities, or other issues of a fully licensed home or facility to maintain and/or increase the safety and well-being of children in their care.

     "DCFS" means the division of children and family services.

     "DDD" means the division of developmental disabilities.

     "DSHS" or "department" means the department of social and health services (DSHS).

     "DLR" means the division of licensed resources.

     "DOH" means the department of health.

     "Group receiving center" or "GRC" is a facility providing the basic needs of food, shelter, and supervision for more than six children placed by the department, generally for thirty or less days.

     "Firearms" means guns or weapons, including but not limited to the following: BB guns, pellet guns, air rifles, stun guns, antique guns, bows and arrows, handguns, rifles, and shotguns.

     "Full licensure" means an entity meets the requirements established by the state for licensing or approved as meeting state licensing requirements.

     "Hearing" means the department's administrative review process.

     "I" refers to anyone who operates or owns group receiving center.

     "Individual with developmental disabilities" means an individual who meets the eligibility requirements in RCW 71A.10.020 and WAC 388-825-030 for services. A developmental disability is any of the following: Mental retardation, cerebral palsy, epilepsy, autism, or another neurological condition described in WAC 388-825-030. These conditions must originate before the age of eighteen years; be expected to continue indefinitely; and result in a substantial handicap.

     "Infants" means children under one year of age.

     "License" means a permit issued by the department affirming that a home or facility meets the licensing requirements.

     "Licensee" means the name of the individual or legal entity granted the license for a group receiving center.

     "Licensor" means a division of licensed resources (DLR) employee at DSHS that:

     (1) Approves licenses for group receiving centers; and

     (2) Monitors centers to ensure that they continue to meet health and safety requirements.

     "Medically fragile" means the condition of a child who has a chronic illness or severe medical disabilities requiring regular nursing visits, extraordinary medical monitoring, or under a physician's care.

     "Nonambulatory" means not able to walk.

     "Nonmobile" refers to children who are not yet walking, are unable to walk, or unable to use a wheelchair or other device to move about freely.

     "Out-of-home placement" means a child's placement in a home or facility other than the child's parent, guardian, or legal custodian.

     "Premises" means a facility's buildings and adjoining grounds that are managed by a person or agency in charge.

     "Probationary license" means a license issued as a disciplinary measure to an individual or agency that has previously been issued a full license but is out of compliance with licensing standards.

     "Psychotropic medication" means a type of medicine that is prescribed to affect or alter thought processes, mood, sleep, or behavior. These include anti-psychotic, antidepressants and anti-anxiety medications.

     "Severe developmental disabilities" means significant disabling, physical and/or mental conditions(s) that cause a child to need external support for self-direction, self-support and social participation.

     "Service plan" means a description of the services to be provided or performed and who will provide or perform the activities.

     "Universal precautions" is a term relating to procedures designed to prevent transmission of blood borne pathogens in health care and other settings. Under universal precautions (sometimes call standard precautions), blood or other potentially infectious materials of all people should always be considered potentially infectious for HIV and other pathogens. Individuals should take appropriate precautions using personal protective equipment like gloves to prevent contact with blood.

     "We" or "our" refers to the department of social and health services, including DLR licensors and DCFS social workers.

     "You" refers to anyone who operates a group receiving center.

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GENERAL INFORMATION
NEW SECTION
WAC 388-140-0015   What is a group receiving center?   A group receiving center is a facility licensed by the division of licensed resources to provide the basic needs of food, shelter, and supervision for more than six children placed by the department, generally for thirty or less days.

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NEW SECTION
WAC 388-140-0020   Which children may I serve?   If you are licensed as a group receiving center, you may serve children who meet one of the following conditions:

     (1) Need temporary placement after being taken into protective custody by law enforcement or the court;

     (2) Need temporary placement awaiting a more permanent placement; or

     (3) Need emergency placement during a temporary disruption of a current placement.

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NEW SECTION
WAC 388-140-0025   What age children may a center serve?   Group receiving centers may provide care for children from age two through seventeen.

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NEW SECTION
WAC 388-140-0030   Who may place children at a group receiving center?   The department of social and health services, a law enforcement officer, or the court may place children at a group receiving center.

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NEW SECTION
WAC 388-140-0035   What hours must a center be open?   A group receiving center must be open twenty-four hours a day, seven days a week.

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NEW SECTION
WAC 388-140-0040   What are the basic expectations of a group receiving center program?   (1) Your group receiving care center must provide a safe and healthy group living environment that meets the developmental needs of the children in your care, including;

     (a) A clean, homelike environment;

     (b) Basic necessities such as adequate food and appropriate clothing;

     (c) Safety; and

     (d) An age-appropriate environment with necessary structure, routine, and rules.

     (2) Your center must be staffed with employees who are competent to provide for the safety and needs of the children in your care.

     (3) You must provide a written statement that includes your mission, goals, and a description of the services you provide.

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NEW SECTION
WAC 388-140-0045   What services are provided or arranged for by the group receiving center?   (1) A group receiving center must provide direct receiving care and assessment or an appraisal of a child in terms or his or her physical, mental, and emotional condition.

     (2) A group receiving center may provide transportation and/or family support services, such as the supervision of family visits.

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NEW SECTION
WAC 388-140-0050   What school arrangements are required?   A group receiving center must meet the following requirements for providing education instruction to the children under your care. You must:

     (1) Arrange for transportation for each child in care to travel to school;

     (2) Support each child participating in their education plan; and

     (3) Provide suitable study areas for children under your care.

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NEW SECTION
WAC 388-140-0055   Is an orientation for a child required at a center?   (1) As part of admission to a center, the staff must give an orientation to children that includes, but is not limited to:

     (a) A description of the program and services;

     (b) The physical facility;

     (c) The department-approved policy that states that youth may not have guns and other weapons, alcohol, tobacco, and drugs within the facility; and

     (d) The department approved policy on client visitation that includes access to the youth's attorney.

     (2) Written documentation of this orientation must be in each child's file.

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APPLICATION, LICENSING, AND PROGRAM APPROVAL
NEW SECTION
WAC 388-140-0060   Is a license required?   A license is required to provide care to children at a group receiving center.

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NEW SECTION
WAC 388-140-0065   How old do I have to be to apply for a license?   You must be at least twenty-one years old to apply for a license to provide care to children at a group receiving center.

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NEW SECTION
WAC 388-140-0070   What personal characteristics must I have to provide care to children at a center?   If you are requesting a license or a position as an employee, volunteer, or intern in a group receiving center, you must:

     (1) Demonstrate an understanding, ability, physical health, emotional stability and personality suited to meet the physical, mental, emotional, and social needs of the children under your care.

     (2) You must not have been found to have committed abuse or neglect of a child or vulnerable adult, unless the department determines that you do not pose a risk to a child's safety, well-being, and long-term stability.

     (3) Be able to furnish the child with a nurturing, respectful, supportive, and responsive environment.

     (4) Not have been disqualified by our background check (chapter 388-06 WAC) before having unsupervised access to children.

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NEW SECTION
WAC 388-140-0075   What personal information may I be required to provide to be licensed?   (1) The department may request additional information at any time and it may include, but is not limited to:

     (a) Substance and alcohol abuse evaluations and/or documentation of treatment;

     (b) Psychiatric evaluations;

     (c) Psycho-sexual evaluations; and

     (d) Medical evaluations and/or medical records.

     (2) The applicant/licensees pays for any evaluation requested by the department.

     (3) The applicant/licensee must give permission for the licensor to speak with the evaluator/provider before and after the evaluation.

     (4) If an applicant or licensee refuses to comply with subsections (1), (2), or (3) above, then DLR may deny the application or revoke the license.

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NEW SECTION
WAC 388-140-0080   How do I apply for a license?   (1) To apply for a group receiving center license, the person or legal entity responsible for the center must send the application form to your licensor at DLR.

     (2) With the application form, you must send written verification for each applicant of the following information:

     (a) A tuberculosis test or chest X-ray unless you can demonstrate medical or religious reasons prohibiting the test;

     Note: Written documentation from your physician that indicates that you are free of the signs and symptoms of tuberculosis may be accepted.

     (b) First-aid and cardio-pulmonary resuscitation (CPR) training appropriate to the age of the children in care; and

     (c) HIV/AIDS and blood borne pathogens training including infection control standards.

     (3) You must send a completed background check form to your licensor on anyone on the premises having unsupervised access to children who:

     (a) Is not a foster child; and

     (b) Is at least sixteen years old.

     (4) You must send a completed FBI fingerprint form for any individual at your facility who has lived outside Washington state within the last three years and meets subsection (3) above.

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NEW SECTION
WAC 388-140-0085   What is required to document completed background checks on staff?   You must keep a log of all background check results of employees, volunteers, and interns having unsupervised access to children on the premises of the group receiving center.

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NEW SECTION
WAC 388-140-0090   What first aid and cardiopulmonary resuscitation (CPR) training is required?   (1) You, your staff, volunteer, intern, or any individual who may at anytime be the sole caregiver at the group receiving center, must have the following current first-aid and CPR training:

     (a) Basic standard first aid; and

     (b) Approved age-appropriate cardiopulmonary resuscitation (CPR) training provided by an instructor certified in accordance with a nationally recognized standard.

     (2) A person with first aid and CPR training must be on the premises of a group receiving center at all times, when children are present.

     (3) The CPR training may be waived for persons with a statement from their physician that the training is not advised for medical reasons. However, another person with CPR training must be on the premises when children are present.

     (4) You must keep records in your center showing who has completed current first aid and CPR training. This includes copies of the certificate of completion for the training for each staff person.

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NEW SECTION
WAC 388-140-0095   What HIV/AIDS and blood borne pathogens training is required?   (1) You must provide or arrange for training for yourself, your staff, or any person who may at any time be the sole caregiver at a group receiving center, on infection control, prevention, and transmission of HIV and AIDS and blood borne pathogens.

     (2) You must comply with infection control requirements and educational material consistent with the approved current curriculum "Know - HIV/AIDS Prevention Education for Health Care Facility Employees," published by the department of health, office on HIV/AIDS.

     (3) Child care workers and anyone else providing direct care to children at a group receiving center must use Universal Precautions (see definitions) when coming in contact with the bodily fluids or secretions of a child.

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NEW SECTION
WAC 388-140-0100   How long do I have to complete the licensing application packet?   (1) You must complete your licensing application with supporting documents, such as training certificates, within ninety days of first applying for a group receiving center license.

     (2) If you fail to meet this deadline and have not contacted your licensor, your licensor may consider your application withdrawn.

     (3) If you are applying for a license renewal, you must send the application form to your licensor at least ninety days prior to the expiration of your current license.

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NEW SECTION
WAC 388-140-0105   Does the department need to approve the program I offer?   (1) The department must approve the program that you have developed for children under your care at group receiving center.

     (2) You must send to DLR a detailed written program description outlining assessment, educational, recreational, therapeutic, and other services you will provide to children and their families.

     (3) A sample of the schedule of daily activities for children under care must be included with the program description.

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NEW SECTION
WAC 388-140-0110   How does the department decide how many children a center may serve?   (1) The department approves the number of children that a group receiving center may serve based on an evaluation of these factors:

     (a) Physical accommodations in the center;

     (b) The number of staff and volunteers available for providing care;

     (c) Your skills and the skills of your staff;

     (d) The ages and characteristics of the children you are serving;

     (e) The evaluation of fire safety by the office of the state fire marshal; and

     (f) The evaluation of health and safety by the department of health.

     (2) Based on the evaluation, the department may license you for the care of fewer children or different age groups than your facility could house.

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NEW SECTION
WAC 388-140-0115   Will the department approve exceptions to the licensing requirements?   (1) At its discretion, the department may make exceptions to the licensing requirements for a group receiving center. The exceptions:

     (a) Must only be nonsafety requirements; and

     (b) Must not compromise the safety and well being of the children receiving care.

     (2) You must make a written request for an exception to the licensing requirements.

     (3) After granting an exception to a licensing requirement, the department may:

     (a) Limit or restrict your license; and/or

     (b) Require you to enter into a compliance agreement to ensure the safety and well being of the children in your care.

     (4) You must keep a copy of the approved exception and any compliance agreement to the licensing requirements for your files.

     (5) You do not have appeal rights if the department denies your request for an exception to our licensing requirements.

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CORRECTIVE ACTION
NEW SECTION
WAC 388-140-0120   Does the department issue probationary licenses?   (1) The department may issue a group receiving center a probationary license as part of a corrective action plan with a licensed provider.

     (2) The department must base its decision about whether to issue a probationary license on the following:

     (a) Intentional or negligent noncompliance with the licensing rules;

     (b) A history of noncompliance with the rules;

     (c) Current noncompliance with the rules;

     (d) Evidence of a good faith effort to comply; and

     (e) Any other factors relevant to the specific situation.

     (3) A probationary license may be issued for up to six months. At its discretion, the department may extend the probationary license for an additional six months.

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NEW SECTION
WAC 388-140-0125   When is a license denied, suspended or revoked?   (1) A group receiving center license must be denied, suspended or revoked if the department decides that you cannot provide care for children in a way that ensures their safety, health and well-being.

     (2) The department must disqualify you for any of the reasons that follow:

     (a) Your facility fails to meet the health and safety requirements to receive a certificate of compliance as required by the department of health and/or office of the state fire marshal.

     (b) You have been disqualified by your background check (see chapter 388-06 WAC).

     (c) You or your staff have been found to have committed abuse, neglect, or you treat, permit or assist in treating children in your care with cruelty, indifference, or exploitation, unless the department determines that you do not pose a risk to a child's safety, well-being, and long term stability.

     (d) You or anyone on the premises had a license denied or revoked from an agency that provided care to children or vulnerable adults.

     (e) You try to get a license deceitfully, such as making false statements or leaving out important information on the application.

     (f) You commit, permit or assist in an illegal act on the premises of a group receiving center providing care to children.

     (g) You are using illegal drugs, or excessively using alcohol and/or prescription drugs.

     (h) You knowingly allowed employees or volunteers with false statements on their applications to work at your agency.

     (i) You repeatedly lack qualified or an adequate number of staff to care for the number and types of children under your care.

     (j) You have refused to allow our authorized staff and inspectors to have requested information or access to your facility, child and program files, and/or your staff and clients.

     (k) You are unable to manage the property, fiscal responsibilities, or staff in your agency.

     (l) You have failed to comply with the federal and state laws for any Native American children that you have under care.

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NEW SECTION
WAC 388-140-0130   Are there any other reasons that could potentially cause me to lose my license?   (1) The department may suspend or revoke your group receiving center license if you go beyond the conditions of your license by:

     (a) Having more children than your license allows; or

     (b) Having children with ages different than your license allows.

     (2) The department also may suspend or revoke your license if you:

     (a) Fail to provide a safe, healthy and nurturing environment for children under your care; or

     (b) Fail to comply with any of our other licensing requirements.

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NEW SECTION
WAC 388-140-0135   What happens when a licensor is notified that a licensee has received a noncompliance support order from the division of child support?   (1) The department must suspend a group receiving center license, if the licensor receives a notice from the division of child support that the licensee is not in compliance with a support order under authority of RCW 43.20A.205 and 74.20A.320.

     (2) In this situation, the suspension of a center license, for noncompliance of a support order, would be effective on the date the licensee receives a notice from the licensor.

     (3) The license remains suspended until the licensee provides proof that he or she is in compliance with the child support order.

     (4) The licensee does not have a right to an administrative hearing based on a suspension of the center license due to noncompliance of a child support order.

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NEW SECTION
WAC 388-140-0140   How will the department notify me if my license is denied, suspended, or revoked?   (1) The department will send you a certified letter informing you of any decision to deny, suspend or revoke your group receiving center license.

     (2) In the letter, the department also will tell you what you may do if you disagree with the decision of the department to deny, suspend or revoke your group receiving center license.

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NEW SECTION
WAC 388-140-0145   What may I do if I disagree with the department's decision to deny, suspend or revoke my license?    (1) You have the right to appeal any decision the department makes to amend, deny, suspend, or revoke your group receiving center license. The exception is outlined in WAC 388-140-0135 and deals with noncompliance of a child support order.

     (2) Your right to appeal and the procedures for that process are outlined in RCW 43.20A.205 and 74.14.130; chapter 34.05 RCW, and chapter 388-02 WAC.

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POSTING LICENSE AND REPORTING CHANGES
NEW SECTION
WAC 388-140-0150   Where do I post my license?   You must post your group receiving center license where the public can easily view it.

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NEW SECTION
WAC 388-140-0155   What changes to my center must I report to my licensor?   (1) You must report to your licensor immediately any changes in the original group receiving center licensing application. This includes changes in:

     (a) Your location or designated space, including address;

     (b) Your phone number;

     (c) The maximum number, age ranges, and sex of children you wish to serve; or

     (d) The changes in the structure of your facility or on the premises from events causing damage, such as a fire, or from remodeling.

     (2) A license is valid only for the person or organization named on the license at a specific address. If you operate a group receiving center, you must also report any of the following changes to your licensor:

     (a) A change of your agency's executive director;

     (b) The death, retirement, or incapacity of the person who holds the license;

     (c) A change in the name of a licensed corporation, or the name by which your center is commonly known; or

     (d) Changes in an agency's articles of incorporation and bylaws that apply to the operation or the license of the facility.

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FIRE SAFETY
NEW SECTION
WAC 388-140-0160   Must I comply with the requirements of the State Fire Marshal to receive a license?   (1) A group receiving center must comply with the requirements for fire safety of the office of the state fire marshal under WAC 212-12-210.

     (2) The office of the state fire marshal will issue a notice of approval for licensing to the licensing agency when you have met their requirements for fire safety.

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NEW SECTION
WAC 388-140-0165   Do I need to notify the local fire department of the location of my center?   You must notify the local fire department of the location of your group receiving center so that medics and firefighters can easily locate your facility.

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NEW SECTION
WAC 388-140-0170   Are local ordinances part of the licensing requirements?   (1) Local ordinances (laws), such as zoning regulations and local building codes, are outside the scope of the licensing requirements for a group receiving center.

     (2) The department may require you to provide proof that you have met local ordinances.

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NEW SECTION
WAC 388-140-0175   Are there fire safety requirements?   A group receiving center must comply with the fire safety requirements that follow.

     (1) Every sleeping room used by children under care must have at least one operable window or door approved for emergency escape or rescue that must open directly into a public street, public alley, yard, or exit court.

     (2) Centers with floors located more than four feet above or below ground (one-half story) must not be used for care of nonmobile children.

     (3) Emergency windows must:

     (a) Be operable from the inside to provide a full, clear opening without the use of separate tools;

     (b) Have a minimum net clear open area of 5.7 square feet (0.53 mm);

     (c) Have a minimum net clear open height dimension of 24 inches (610 mm);

     (d) Minimum net clear open width dimension of 20 inches (508 mm);

     (e) Have a finished sill height of not more than 44 inches (1118 mm) above the floor.

     (4) No child may occupy a space that is accessible only by a ladder, folding stairs, or a trap door.

     (5) Every bathroom door lock must be designed to permit the opening of the locked door from the outside.

     (6) Every closet door latch must be designed to open from the inside.

     (7) Open-flame devices and fireplaces, heating and cooking appliances, and products capable of igniting clothing must not be left unattended or used incorrectly.

     (8) Fireplaces, wood stoves and other heating systems that have a surface hot enough to cause a burn must have a barrier to prevent access by children under age six years.

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NEW SECTION
WAC 388-140-0180   What are the requirements for smoke detectors?   (1) Group receiving centers licensed for sixteen or more residents must have an approved automatic and manual fire alarm system.

     (2) Operation of any fire alarm activating device must automatically, without delay, activate off-site monitoring and signal a general alarm indication and sound an audible alarm throughout the building or affected part of the building.

     (3) Group receiving centers licensed for fewer than sixteen persons must have smoke detectors installed in all sleeping room, corridors, and in areas separating use areas from sleeping areas.

     (4) Smoke detectors must be installed following the approved manufacturer's instructions.

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NEW SECTION
WAC 388-140-0185   What are the requirements for a fire evacuation plan?   (1) You must develop a written fire evacuation plan for your group receiving center.

     (2) The evacuation plan must include:

     (a) An evacuation floor plan, identifying exit doors and windows;

     (b) Action that the person discovering a fire must take;

     (c) Methods for sounding an alarm on the premises;

     (d) Ways to evacuate the building that ensures responsibility for children; and

     (e) Action that staff must take while waiting for the fire department.

     (3) The plan must be posted at each exit door.

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NEW SECTION
WAC 388-140-0190   What fire prevention measures must I take?   The department requires that you must take the following fire prevention measures for your group receiving center:

     (1) You must assure that furnace rooms are:

     (a) Maintained free of lint, grease, and rubbish; and

     (b) Suitably isolated, enclosed, or protected.

     (2) Flammable or combustible materials must be stored away from exits and in areas that are not accessible to children. Combustible rubbish must not be allowed to collect and must be removed from the building or stored in closed, metal containers away from building exits.

     (3) All trash must be removed daily from the building and thrown away in a safe manner outside the building. All containers used for the disposal of waste material must consist of noncombustible materials and have tops.

     (4) All electrical motors must be kept free of dust.

     (5) Open-flame devices capable of igniting clothing must not be left on, unattended or used in a manner that could result in an accidental ignition of children's clothing.

     (6) Candles must not be used.

     (7) All electrical circuits, devices and appliances must be properly maintained. Circuits must not be overloaded. Extension cords and multi-plug adapters must not be used in place of permanent wiring and proper outlets.

     (8) Fireplaces, woodstoves, and similar devices must be installed and approved according to the rules that were in effect at the time of installation (see the local building permit). These devices must be properly maintained and must be cleaned and certified at least once a year or maintained according to the manufacturer's recommendations.

     (9) Separate hazardous areas by at least a "one-hour" fire-resistant wall. Hazardous areas include rooms or spaces containing:

     (a) A commercial-type cooking kitchen;

     (b) A boiler;

     (c) A maintenance shop;

     (d) A janitor closet;

     (e) A woodworking shop;

     (f) A vehicle garage;

     (g) Flammable or combustible materials; or

     (h) Painting operations.

     (10) The department does not require a fire-resistant wall when:

     (a) A kitchen contains only a domestic cooking range; and

     (b) Food preparation does not produce smoke or grease-laden vapors.

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NEW SECTION
WAC 388-140-0195   What are the requirements for fire drills?   (1) You must conduct monthly fire drills to test and practice the evacuation procedures.

     (2) The monthly fire drill must be conducted on each shift, so that each person providing care to children participates in the drill.

     (3) You must consult with and follow the state fire marshal protocol for "mock" fire drills, if you care for nonambulatory children.

     (4) You must maintain a written record on the premises that indicates the date and time that drill practices were completed at your group receiving center.

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NEW SECTION
WAC 388-140-0200   What fire safety procedures do center staff need to know?   You and your staff at a group receiving center must be familiar with:

     (1) Safety procedures related to fire prevention; and

     (2) All aspects of a fire drill.

     (3) Your and your staff must be able to:

     (a) Operate all fire extinguishers installed on the premises;

     (b) Test smoke detectors (single station types);

     (c) Conduct frequent inspections of the facility to identify fire hazards; and

     (d) Correct any hazards noted during the inspection.

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NEW SECTION
WAC 388-140-0205   What are the requirements for fire sprinkler systems?   (1) Where a sprinkler system is required, a system complying with the uniform building code standards must be installed.

     (2) A Washington state licensed fire sprinkler contractor must annually test and certify sprinkler systems installed in a group receiving center for fire prevention.

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HEALTH AND ENVIRONMENT
NEW SECTION
WAC 388-140-0210   Does a center need approval from the department of health to operate?   (1) A group receiving center must receive a certificate of compliance from the department of health before the division of licensed resources (DLR) will issue a group receiving center license.

     (2) The department of health (DOH) conducts the health and safety survey. A registered nurse (RN) and/or a public health sanitarian may complete the survey.

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NEW SECTION
WAC 388-140-0215   What are the physical structure safety requirements for a center?   You must keep the equipment and the physical structures in your group receiving center safe and clean for the children you serve. You must:

     (1) Maintain your buildings, premises, and equipment in a clean and sanitary condition, free of hazards, and in good repair.

     (2) Provide handrails for steps, stairways, and ramps, if required by the department.

     (3) Have emergency lighting devices available and in operational condition.

     (4) Furnish your center appropriately, based on the age and activities of the children under care.

     (5) Have washable, water-resistant floors in your center bathrooms, kitchens, and any other rooms exposed to moisture. The department may approve washable, short-pile carpeting that is kept clean and sanitary for your facility's kitchens.

     (6) Provide tamper proof or tamper resistant electrical outlets or blank covers installed in areas accessible to children under the age of six or other persons with limited mental capacity or who might be endangered by access to them.

     (7) Have easy access to rooms occupied by children in case an emergency arises. Some examples are bedrooms, toilet rooms, shower rooms, and bathrooms.

     (8) Have a written disaster plan for emergencies such as fire and earthquakes.

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NEW SECTION
WAC 388-140-0220   What are the requirements for the location of a center?   (1) Your group receiving center must be located on a well-drained site, free from hazardous conditions. Some examples of hazards are natural or man-made water hazards such as lakes or streams, steep banks, ravines, and busy streets.

     (2) The safety of the children in care is paramount. You must discuss with the licensor any potential hazardous conditions, considering the children's ages, behaviors, and abilities.

     (3) If DLR decides that hazardous conditions are present at the group receiving center, a supervision plan must be written for the children in care.

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NEW SECTION
WAC 388-140-0225   What are the requirements for emergency aid vehicle access to my center?   (1) Your group receiving center must be accessible to emergency vehicles.

     (2) Your address must be clearly visible on the facility or mailbox so that firefighters or medics can easily find your center location.

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NEW SECTION
WAC 388-140-0230   What steps must I take to ensure children's safety around outdoor bodies of water?   (1) You must ensure children in your care at a group receiving center are safe around bodies of water.

     (2) On a daily basis, you must empty and clean any portable wading pool that children use.

     (3) When they are swimming, wading, or near a body of water, children under twelve must be in continuous visual range at all times by an adult with current first aid and age appropriate CPR.

     (4) You must ensure age and developmentally appropriate supervision of any child that uses hot tubs, swimming pools, spas, and other man-made and natural bodies of water.

     (5) All safety devices and rescue equipment, such as life jackets, must meet state water safety regulations.

     (6) You must lock or secure hot tubs and spas when they are not in use.

     (7) You must place a fence designed to discourage climbing and have a locking gate around a pool or have another DLR approved safety device. The pool must be inaccessible to children when not in use.

     (8) A certified lifeguard must be on duty when children are using a swimming pool.

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NEW SECTION
WAC 388-140-0235   What measures must I take for pest control?   You must make reasonable attempts, using the least toxic methods, to keep the premises of the group receiving center free from pests. This includes rodents, flies, cockroaches, fleas, and other insects.

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NEW SECTION
WAC 388-140-0240   What are the requirements regarding pets and animals at a center?   (1) In a group receiving center, you must not have any common household pets, exotic pets, other animals, birds, insects, reptiles, or fish that are dangerous or provide a risk to the children in care.

     (2) Common household pets, exotic pets, animals, birds, insects, reptiles, and fish must:

     (a) Be cared for in compliance with state regulations and local ordinances; and

     (b) Be free from disease and cared for in a safe and sanitary manner.

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NEW SECTION
WAC 388-140-0245   Are alcoholic beverages allowed at a center?   You must not have alcohol on the premises of a group receiving center. The staff of the center may not consume alcohol on the premises or during breaks.

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NEW SECTION
WAC 388-140-0250   Is smoking permitted around children?   (1) You must prohibit smoking in the group receiving center and in motor vehicles while transporting children.

     (2) You may permit adults to smoke outdoors away from children.

     (3) Nothing in this section is meant to interfere with traditional or spiritual Native American ceremonies involving the use of tobacco.

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NEW SECTION
WAC 388-140-0255   May I have firearms at a center?   The department prohibits firearms, ammunition, and other weapons on the premises of a group receiving center.

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NEW SECTION
WAC 388-140-0260   May I use wheeled baby walkers?   The department prohibits the use of wheeled baby walkers in a group receiving center.

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STORAGE OF MEDICATIONS AND CHEMICALS
NEW SECTION
WAC 388-140-0265   Are there requirements for the storage of medications?   At a group receiving center:

     (1) You must keep all medications, including pet medications, vitamins and herbal remedies, in locked storage.

     (2) You must store external medications separately from internal medications.

     (3) You must store medications according to the manufacturer or pharmacy instructions.

     (4) Pet and human medications must be stored in separate places.

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NEW SECTION
WAC 388-140-0270   Are there requirements for storing dangerous chemicals or other substances?   (1) At a group receiving center, you must store the following items in a place that is not accessible to children, persons with limited mental capacity, or anyone who might be endangered by access to the following products:

     (a) Cleaning supplies;

     (b) Toxic or poisonous substances;

     (c) Aerosols; and

     (d) Items with warning labels.

     (2) When containers are filled with toxic substances from a stock supply, you must label the containers filled from a stock supply.

     (3) Toxic substances must be stored separately from food items.

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FIRST-AID SUPPLIES
NEW SECTION
WAC 388-140-0275   Are first-aid supplies required?   (1) At a group receiving center, first-aid supplies must be kept on hand for immediate use, including nonexpired syrup of ipecac that is to be used only when following the instruction of the poison control center.

     (2) The following first-aid supplies must be kept on hand:

     (a) Barrier gloves and one-way resuscitation mask;

     (b) Bandages;

     (c) Scissors and tweezers;

     (d) Ace bandage;

     (e) Gauze;

     (f) Thermometer; and

     (g) A first-aid manual.

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MEDICAL CARE AND MEDICATION MANAGEMENT
NEW SECTION
WAC 388-140-0280   What are the requirements for medical policies and procedures for a center?   (1) Group receiving centers must have written policies and procedures about the control of infections. These policies must include, but are not limited to, the following areas:

     (a) Isolation;

     (b) Aseptic procedures;

     (c) Reporting communicable diseases;

     (d) Hygiene, including hand washing, using the toilet, diapering, and laundering.

     (2) Group receiving centers must maintain current written medical policies and procedures to be followed on:

     (a) Prevention of the transmission of communicable diseases including:

     (i) Hand washing for staff and children; and

     (ii) Management and reporting of communicable diseases.

     (b) Medication management, including steps to be taken if medication is incorrectly administered;

     (c) First aid;

     (d) Care of minor illnesses;

     (e) Actions to be taken for medical emergencies;

     (f) Infant care procedures when infants are under care; and

     (g) General health practices.

     (3) You must arrange to have one of the following help you develop and periodically review your medical policies and procedures:

     (a) An advisory physician,

     (b) A physician's assistant, or

     (c) A registered nurse.

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NEW SECTION
WAC 388-140-0285   Must all children accepted for care have current immunizations?   (1) Group receiving centers may accept a child for care who is not current with immunizations or whose immunization status is unknown.

     (2) If a child's placement at a center extends beyond thirty days, you must obtain the child's immunization records and if the child is not current update immunizations as soon as medically possible.

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NEW SECTION
WAC 388-140-0290   What must I do to prevent the spread of infections and communicable diseases?   (1) You must take precautions to guard against infections and communicable diseases infecting the children under care in your center.

     (2) In a group receiving center, staff with a reportable communicable disease or notifiable disease conditions, as defined by the department of health, in chapter 246-101 WAC, in an infectious stage must not be on duty until they have a physician's approval for returning to work.

     (3) Applicants for a license or adults authorized to have unsupervised access to children in a center must have a tuberculin (TB) skin test by the Mantoux method of testing. They must have this skin test upon being employed or licensed unless:

     (a) The person has evidence of testing within the previous twelve months;

     (b) The person has evidence that they have a negative chest x-ray since a previously positive skin test;

     (c) The person has evidence of having completed adequate preventive therapy or adequate therapy for active tuberculosis.

     (4) The department does not require a tuberculin skin test if:

     (a) A person has a tuberculosis skin test that has been documented as negative within the past twelve months; or

     (b) A physician indicates that the test is medically unadvisable.

     (5) Persons whose tuberculosis skin test is positive must have a chest x-ray within thirty days following the skin test.

     (6) The department does not require re-testing unless a person believes they have been exposed to someone with tuberculosis or if testing is recommended by their health care provider.

     (7) The center must keep the results of the applicant and employees TB test results in the personnel file available for review by DLR.

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NEW SECTION
WAC 388-140-0295   How do I manage medications for children?   (1) You must meet the department's requirements for managing prescription and nonprescription medication for children under your care.

     (2) If you care for children in the custody of a tribal court you must follow the direction of that court regarding giving or applying prescription and nonprescription medications or ointments.

     (3) Only you or another authorized care provider (staff) may:

     (a) Have access to medications for the child under your care; and

     (b) Give medications, prescription and nonprescription, only on the written approval of a parent, person or agency having authority by court order to approve medical care.

     Exception: There are several over-the-counter medications that may be given without a physician's order. Those medications are listed in WAC 388-140-0295(13).

     (4) You or another authorized care provider must give medications, prescription and nonprescription:

     (a) Only as specified on the prescription label; or

     (b) As otherwise approved by a physician or another person legally authorized to prescribe medication.

     (5) You must keep a record of all medications you give a child.

     (6) You and other authorized care provider must consult with a pharmacist on the proper disposal of medications that are no longer being taken or have expired.

     (7) The disposal of any prescription medication must be documented and contain the following information:

     (a) What medication was disposed;

     (b) The name of the child the medication was prescribed for;

     (c) The amount disposed;

     (d) The name of the individual disposing of the medication; and

     (e) The name of the individual witnessing the disposal.

     (8) Children taking oral medications must have the prescribing physician's written authorization before any medications, herbal supplements or remedies, or vitamins and minerals are given.

Nonprescription medications

     (9) Nonprescription medications may be given with a physician's standing order, if the order is child specific.

     (10) The prescribing physician must be aware of all prescription and nonprescription medication the child is taking.

     (11) You or another authorized care provider (staff) may give the following medications without a physician's order:

     (a) Nonaspirin antipyretics/analgesics, fever reducers/pain relievers;

     (b) Nonnarcotic cough suppressants;

     (c) Decongestants;

     (d) Antacids and anti-diarrhea medication;

     (e) Anti-itching ointments or lotions intended specifically to relieve itching;

     (f) Shampoo for the removal of lice;

     (g) Diaper ointments and powders intended specifically for use in the diaper area of children;

     (h) Sun screen for children over six months; and

     (i) Antibacterial ointment for first aid use.

Psychotropic medications

     (12) Care providers must not approve giving or stopping psychotropic medications to a child in care. Approval can only be given by one of these:

     (a) The child's parent;

     (b) Dependency guardians;

     (c) A court order; or

     (d) The child's social worker, if:

     (i) The child is legally free and in the permanent custody of the department; or

     (ii) It is impossible to obtain informed parental consent after normal work hours, on weekends, or on holidays.

     (13) Children who are at least thirteen years old may decline to take prescription psychotropic medication. If this happens contact the child's social worker immediately and document the child's refusal.

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NEW SECTION
WAC 388-140-0300   What medicine may I accept for a child?   The only medicine you may accept from the child's parent, legal guardian, law enforcement officer, or department social worker is medicine in the original container labeled with:

     (1) The child's first and last names;

     (2) The date the prescription was filled;

     (3) The medication's expiration date; and

     (4) Legible instructions for the administration of the drug (manufacturer's instructions or prescription label).

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NEW SECTION
WAC 388-140-0305   When may children take their own medicine?   (1) You may permit children under your care to take their own medicine as long as:

     (a) They are physically and mentally capable of properly taking the medicine; and

     (b) The child's parent or legal guardian approves in writing.

     (2) You must keep the written approval by the child's parent or legal guardian in your records.

     (3) When children take their own medication, the medication and medical supplies must be kept locked or inaccessible to other children and unauthorized persons.

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NEW SECTION
WAC 388-140-0310   When must I get medical exams for the children under my care?   (1) In consultation with the child's social worker, you must schedule a physical exam (EPSDT) for any child who, within the past year, has not:

     (a) Been under regular medical supervision; or

     (b) Had a physical exam by a physician, a physician's assistant, or an advanced registered nurse practitioner (ARNP).

     (2) A physical exam (EPSDT) must be completed within thirty days of placement and annually thereafter.

     Note: You may contact the child's social worker for information on this.

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NEW SECTION
WAC 388-140-0315   Whom do I notify about medication changes and reactions?   (1) You must notify the child's social worker of changes in prescribed medications.

     (2) You must notify the child's social worker and physician about any adverse reactions the child has to medications.

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FOOD/DIET/MENUS
NEW SECTION
WAC 388-140-0320   Are there general menu requirements?   The department has menu requirements for group receiving centers.

     (1) Your program must be in compliance with the department of health standards in chapter 246-215 WAC on food service sanitation.

     (2) You must prepare and date daily menus, including snacks, at least one week in advance.

     (3) You must provide for the proper storage, preparation, and service of food to meet the needs of the program.

     (4) A menu must specify a variety of foods for adequate nutrition and meal enjoyment.

     (5) You must keep the menus on file for a minimum of six months so that we can review your menus.

     (6) You must post each person's dietary restrictions, if any, for staff to follow.

     (7) You must post a schedule of mealtimes.

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NEW SECTION
WAC 388-140-0325   How often must I feed children at a center?   (1) You must provide all children a minimum of three meals in each twenty-four hour period. You may vary from this guideline only if you write to your licensor requesting a change and the request is approved by DLR.

     (2) The time interval between the evening meal or snack and breakfast must not be more than fourteen hours.

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NEW SECTION
WAC 388-140-0330   How do I handle a child's special diet?   Unless a child is admitted to a group receiving center with a written physician's order as medically necessary for the child, the following must not be served:

     (1) Nutrient concentrates, supplements, or amino-acids;

     (2) Vitamins; or

     (3) Modified diets.

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NEW SECTION
WAC 388-140-0335   What home canned foods may I use?   You may not serve home canned foods to children at a group receiving center.

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ROOM REQUIREMENTS
NEW SECTION
WAC 388-140-0340   Are there room requirements?   (1) You must provide rooms that are ample in size and properly furnished for the number of children you serve at a group receiving center.

     (2) With thirteen or more children, you must provide at least one separate indoor recreation area. Its size and location must be sufficient for the age and number of the children using it to engage in recreational and informal education activities.

     (3) You must provide a room or area that is used as an administrative office. In addition, suitable offices must be provided for social service staff. In facilities caring for fewer than thirteen children, these offices may be combined with the administrative office.

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NEW SECTION
WAC 388-140-0345   When do I need a special care room?   (1) A group receiving center must provide a special care room reserved for the care of a person who needs to be separated from the group due to injury, illness or the need for additional rest.

     (2) A special care room must:

     (a) Be located in a place that easily allows the person to be supervised;

     (b) Have toilet and lavatory facilities that are easily accessible to any person staying in the special care room.

     (3) After each use have the area and equipment sanitized if used by any person who is suspected of having a communicable disease.

     (4) The special care room may be used for other purposes when it is not needed for the separation and care of an ill or injured person.

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NEW SECTION
WAC 388-140-0350   What does the room temperature at a center need to be?   (1) You must maintain the temperature within your group receiving center facility at a reasonable level while occupied. This would normally be a minimum of sixty-eight degrees Fahrenheit during waking hours and a minimum of sixty-five degrees Fahrenheit during sleeping hours.

     (2) You must consider the age and needs of the children under your care in determining appropriate temperature.

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NEW SECTION
WAC 388-140-0355   What are the kitchen requirements?   (1) You must provide facilities to properly store, prepare, and serve food to meet the needs of the children under your care at your group receiving center.

     (2) All food service facilities and food handling practices must comply with rules and regulations of the state board of health governing food service sanitation (chapter 246-215 WAC). This includes food handler's permit for all staff.

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NEW SECTION
WAC 388-140-0360   May I use the kitchen for activities for children?   Children are not allowed in the kitchen of a group receiving center without age-appropriate supervision.

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NEW SECTION
WAC 388-140-0365   May a room be used for more than one purpose?   At your group receiving center you may use a room for multiple purposes such as playing, dining, napping, and learning activities, provided that:

     (1) The room is of sufficient size; and

     (2) The room's usage for one purpose does not interfere with usage of the room for another purpose.

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NEW SECTION
WAC 388-140-0370   What are the general requirements for bedrooms?   You must meet all the following requirements for bedrooms at a group receiving center.

     (1) An adult must be on the same floor or within easy hearing distance and accessibility to where children less than six years of age are sleeping.

     (2) For children six years and older, you must furnish separate sleeping quarters for each gender.

     (3) Any room used for sleeping must provide adequate floor space for the safety and comfort of the child. Normally, this would be at least fifty square feet of floor space, not including closets, per child.

     (4) Bedrooms must have both:

     (a) Adequate ceiling height for the safety and comfort of the children (normally, at least seven and a half feet); and

     (b) At least one window of not less than one-tenth of the required floor space that opens to the outside. This allows natural light into the bedroom and permits emergency access or exit.

     (5) You must use only bedrooms that have unrestricted direct access to hallways, corridors, living rooms, day rooms, or other such common use areas.

     (6) You must not use hallways, kitchens, living rooms, dining rooms, and unfinished basements as bedrooms.

     (7) The number of beds allowed at a group receiving center is established in by the licensor in consultation with the DOH surveyor for each center.

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BEDS
NEW SECTION
WAC 388-140-0375   What are the requirements for beds?   (1) Children must have their own bed at a group receiving center. The bed must be at least twenty-seven inches wide with a clean and comfortable mattress in good condition.

     (2) For each child in care, you must provide a pillow and pillowcase, blankets, and sheets.

     (3) Pillows must be covered with waterproof material or be washable.

     (4) Bedding must be clean.

     (5) You must provide waterproof mattress covers or moisture resistant mattresses, if needed.

     (6) You may use toddler beds with a standard crib mattress that is sufficient in length and width for the comfort of a toddler.

     (7) You must not allow children to use the loft style beds or upper bunks of double-deck beds if using them due to age, development or condition could hurt them. Examples: Preschool age children and children with disabilities.

     (8) If a cot is used as the bed, the licensee must ensure the child's cot is of sufficient length and width, and constructed to provide adequate comfort for the child to sleep. You must ensure that the cot surface is of a material that can be cleaned with a detergent solution, disinfected, and allowed to air dry.

     (9) You must not use canvas cots.

     (10) A mat may be used for napping but not as a substitute for a bed.

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DIAPER CHANGING AND BATHING FACILITIES
NEW SECTION
WAC 388-140-0380   What are the requirements for diapers and diaper-changing areas?   At a group receiving center, you must follow the requirements for diapers, diaper-changing rooms, and potty-chairs, if you provide care to children who are not toilet trained.

     (1) You must separate diaper-changing areas from food preparation areas.

     (2) You must sanitize diaper-changing areas between each use or you must use a nonabsorbent, disposable covering that is discarded after each use.

     (3) For cleaning children, you must use either disposable towels or clean cloth towels that have been laundered between each use.

     (4) You and any caregiver must wash hands before and after diapering each child.

     (5) You must use disposable diapers, a commercial diaper service, or reusable diapers supplied by the child's family.

     (6) Diaper-changing procedures must be posted at the changing areas.

     (7) Diaper-changing areas must be adjacent to a hand-washing sink.

     (8) The staff must be within arms-length of the child being diapered at all times while changing diapers. The use of safety belts is prohibited.

     (9) Diaper-changing tables or surfaces must have a barrier or edge that is a minimum of four inches above the pad or six inches above the top of the table.

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NEW SECTION
WAC 388-140-0385   What are the requirements for bathing facilities?   Group receiving centers must comply with the requirements that follow.

     (1) Bathing facilities must be inaccessible to preschool age and younger children when not in use.

     (2) Preschool age and younger children must be supervised while using bathing facilities.

     (3) Bathing facilities must be equipped with a conveniently located grab bar or other safety device such as a nonskid pad.

     (4) The ratio of bathing facilities to children in care must be at least one bathing facility for eight children.

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TELEPHONE/LIGHTING/VENTILATION/WATER/WASTE DISPOSAL
NEW SECTION
WAC 388-140-0390   Do I need a telephone?   (1) You must have at least one telephone on the premises for incoming and outgoing calls. The telephone must be accessible for emergency use at all times.

     (2) You must post emergency phone numbers next to the phone.

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NEW SECTION
WAC 388-140-0395   What are the lighting requirements?   (1) You must locate light fixtures and provide lighting that promotes good visibility and comfort for the children under your care at your group receiving center.

     (2) Group receiving centers must have nonhazardous light fixture covers or shatter resistant (or otherwise made safe) light bulbs or tubes.

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NEW SECTION
WAC 388-140-0400   What are the requirements for ventilation?   (1) You must ensure that your physical facility is ventilated for the health and comfort of the persons under your care at the group receiving center.

     (2) A mechanical exhaust fan to the outside must ventilate toilets and bathrooms, and utility rooms with mop sinks that do not have windows opening to the outside.

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NEW SECTION
WAC 388-140-0405   What are the requirements about drinking water?   (1) You must provide the following:

     (a) A public water supply or a private water supply approved by the local health authority at the time of licensing or re-licensing; and

     (b) Disposable paper cups, individual drinking cups or glasses, or angled jet type drinking fountains.

     (2) You must not use bubbler type fountains or common drinking cups.

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NEW SECTION
WAC 388-140-0410   What are the requirements for sewage and liquid wastes?   Group receiving centers must discharge sewage and liquid wastes into a public sewer system or into a functioning septic system.

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LAUNDRY, SINKS, AND TOILETS
NEW SECTION
WAC 388-140-0415   What are the requirements for laundry facilities?   The department has specific requirements for laundry facilities at a group receiving center.

     (1) You must have separate and adequate facilities for storing soiled and clean linen.

     (2) You must provide adequate laundry and drying equipment, or make other arrangements for getting laundry done on a regular basis.

     (3) You must locate laundry equipment in an area separate from the kitchen and child care areas.

     (4) Laundry equipment must be vented to the outdoors.

     (5) You must make laundry equipment inaccessible to young children.

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NEW SECTION
WAC 388-140-0420   What are the requirements for washing clothes?   You must use an effective way to sanitize laundry contaminated with urine, feces, lice, scabies, or other potentially infectious materials at your group receiving center. You must sanitize laundry through temperature control or the use of chemicals.

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NEW SECTION
WAC 388-140-0425   Do I need a housekeeping sink?   Facilities licensed to provide emergency respite care must have and use a housekeeping sink or DOH-approved method of drawing clean mop water and disposing of the wastewater.

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NEW SECTION
WAC 388-140-0430   What are the requirements for hand-washing sinks?   (1) A group receiving center must supply children with warm running water for hand washing. The water must be kept at a temperature range of not less than eighty-five degrees Fahrenheit and not more than one hundred and twenty degrees Fahrenheit.

     (2) The children's hand washing facilities must be located in or adjacent to rooms used for toileting.

     (3) The center must provide the child with soap and individual towels or other appropriate devices for washing and drying the child's hands and face.

     (4) Hand washing sinks must be of appropriate height and size for children in care or your center must furnish safe, easily cleanable platforms impervious to moisture.

     (5) A group receiving center must provide:

     (a) A minimum of two hand washing sinks; and

     (b) A ratio of one sink for every eight children at the center.

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NEW SECTION
WAC 388-140-0435   What are the requirements for toilets?   (1) A group receiving center must provide a minimum of two toilets and a ratio of one toilet for every eight children at the center.

     (2) Children eighteen months of age or younger and other children using toilet training equipment need not be included when determining the number of required flush-type toilets.

     (3) If urinals are provided, the number of urinals must not replace more than one-third of the total required toilets.

     (4) Privacy for toileting must be provided for children of the opposite sex who are six years of age and older and for other children demonstrating a need for privacy.

     (5) A mounted toilet paper dispenser for each toilet must be provided.

     (6) Toilets and urinals must be of appropriate height and size for children in care or your center must furnish safe, easily cleanable platforms impervious to moisture.

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NEW SECTION
WAC 388-140-0440   Must a center have toilet training equipment for children?   (1) A group receiving center must have developmentally appropriate toilet-training equipment, when the center serves children who are not toilet trained.

     (2) The equipment must be sanitized after each child's use.

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INDOOR RECREATION AREAS
NEW SECTION
WAC 388-140-0445   What are the requirements for indoor recreation areas?   (1) The group receiving center's indoor premises must contain adequate area for child play and sufficient space to house a developmentally appropriate program for the number and age range of children served.

     (2) You must provide a minimum of thirty-five square feet of usable floor space per child, not counting bathrooms, hallways, and closets.

     (3) You may use and consider the napping area as child care space, if there are not beds or cots on the floor space.

     (4) Any room used for napping or sleeping must have a window to allow natural light into the room.

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OUTDOOR RECREATION AREAS
NEW SECTION
WAC 388-140-0450   What are the requirements for an outdoor recreation area?   (1) You must provide a safe and securely-fenced or department-approved, enclosed outdoor recreation area at a group receiving center.

     (2) The fenced or approved enclosed outdoor recreation area must prevent child access to roadways and other dangers.

     (3) The fence or enclosure must protect the play area from unauthorized exit or entry. Any fence or enclosure must be designed to discourage climbing.

     (4) The outdoor recreation area must adjoin directly the indoor premises or be reachable by a safe route and method.

     (5) The outdoor recreation area must promote the child's active play, physical development, and coordination.

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NEW SECTION
WAC 388-140-0455   What are the size requirements for an outdoor recreation area?   (1) You must ensure the recreation area at a group receiving center contains a minimum of seventy-five usable square feet per child.

     (2) If not all of the children are using the outdoor recreation area at the same time, you may reduce the outdoor recreation area size by the number of children normally using the area at one time.

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NEW SECTION
WAC 388-140-0460   What are the requirements for playground equipment?   (1) You must provide a variety of age appropriate play equipment for climbing, pulling, pushing, riding, and balancing activities at a group receiving center.

     (2) You must arrange, design, construct, and maintain equipment and ground cover to prevent child injury.

     (3) The quantity of outdoor play equipment must offer the child a range of outdoor recreation options.

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TRANSPORTATION
NEW SECTION
WAC 388-140-0465   Are there requirements to follow when I transport children?   When you transport children under your care, you must follow these requirements.

     (1) The vehicle must be kept in a safe operating condition.

     (2) The driver must have a valid driver's license.

     (3) There must be at least one adult other than the driver in a vehicle when:

     (a) There are more than five preschool-aged children in the vehicle;

     (b) Staff-to-child ratio guidelines or your contract require a second staff person; or

     (c) The child's specific needs require a second adult person.

     (4) The driver or owner of the vehicle must be covered under an automobile liability and insurance policy.

     (5) Your vehicles must be equipped with seat belts, car seats and booster seats, and/or other appropriate safety devices for all passengers as required by law.

     (6) The number of passengers must not exceed the vehicle's seat belts.

     (7) All persons in the vehicle must use seat belts or approved child passenger restraint systems, as appropriate for age, whenever the vehicle is in motion.

     (8) Buses approved by the state patrol are not required to have seat belts.

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CLIENT RECORDS
NEW SECTION
WAC 388-140-0470   What does the department require for keeping client records?   (1) Your records must be kept at your group receiving center and contain, at a minimum, the following information:

     (a) The child's name and birthdate;

     (b) Inventory of personal belongings at the time of placement; and

     (c) Names, address and telephone numbers of department social worker to be contacted in case of emergency;

     (d) Information on specific cultural needs of the child;

     (e) Medical history including any medical problems, name of doctor, type of medical coverage and provider, when available;

     (f) Mental health history and any current mental health and behavioral issues, including medical and psychological reports when available; and

     (g) Any other pertinent information related to the child, such as his or her visitation plan.

     (2) Daily center logs are required with the signature of the person making the entry in the log. The logs must document the following:

     (a) Date, time, and which residents and staff are participating in an activity;

     (b) Narrative to note behavior and issues of residents;

     (c) Any health or safety issues;

     (d) Staff to resident ratio on each shift;

     (e) On-call and relief staff on duty during emergencies;

     (f) The after-hours telephone number of the supervisor;

     (g) Dates and illnesses or accidents while at the center;

     (h) Medications and treatments given at the center with the child's name;

     (i) A copy of any suspected child abuse and/or neglect referrals made to children's administration; and

     (j) Other information determined relevant by the department.

     (3) Identifying and personal information about the child and their family must be kept confidential, unless permission has been given for release by the parent.

     (4) You must keep information about the child and their families in a secure place.

     (5) You must keep client files containing information not returned to the department, you must keep them for six years following the termination or expiration of any contract you have with the department.

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NEW SECTION
WAC 388-140-0475   What written information is needed before a child is admitted to a center?   Before accepting a child for care at a group receiving center you must obtain the following written consent and information from the placing authority:

     (1) Permission authorizing the placement of the child;

     (2) Permission to seek emergency medical care or surgery on behalf of the child;

     (3) The name and telephone number of the children's administration's social worker and emergency contacts; and

     (4) Basic medical information, including current medication, known allergies, and at-risk behaviors of the child.

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CLIENT PROTECTION
NEW SECTION
WAC 388-140-0480   What are the requirements for protecting a child under my care from abuse and neglect?   As part of ensuring a child's health, welfare and safety, you must protect children under your care from all forms of child abuse and neglect (see RCW 26.44.020(12) and chapter 388-15 WAC for more details).

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NEW SECTION
WAC 388-140-0485   What are the nondiscrimination requirements?   You must follow all state and federal laws regarding nondiscrimination while providing services to children at your group receiving center.

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NEW SECTION
WAC 388-140-0490   Do I have to admit or retain all children at the center?   A group receiving center has the right to refuse to admit or retain a child who can not be served safely or who may pose a significant risk to other children.

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NEW SECTION
WAC 388-140-0495   What must I consider in assigning work to children in my home or facility?   (1) Children may do regular "household" tasks without payment.

     (2) Children may do work assignments other than "household" tasks that are appropriate to their age and physical conditions and receive monetary compensation if this is part of their service plan.

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CLIENT RIGHTS
NEW SECTION
WAC 388-140-0500   Do I have responsibility for a child's personal hygiene?   (1) You must provide or arrange for children under your care to have items needed for grooming and personal hygiene.

     (2) You must assist these children in using these items, based on the child's developmental needs.

     (3) Clothing must be clean and age-appropriate.

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NEW SECTION
WAC 388-140-0505   Does each child need space for personal items at the center?   You must provide separate space for the storage of personal items such as clothing, radios, and toys for each child at your group receiving center.

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DISCIPLINE
NEW SECTION
WAC 388-140-0510   What requirements must I follow when disciplining children?   (1) You are responsible for disciplining children in your care. This responsibility may not be delegated to a child.

     (2) Discipline must be based on an understanding of the child's needs and stage of development.

     (3) Discipline must be designed to help the child under your care to develop inner control, acceptable behavior and respect for the rights of others.

     (4) Discipline must be fair, reasonable, consistent, and related to the child's behavior.

     (5) Your discipline must comply with children's administration's behavior management guidelines for residential programs.

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NEW SECTION
WAC 388-140-0515   What types of disciplinary practices are forbidden?   (1) You must not use cruel, unusual, frightening, unsafe or humiliating discipline practices, including but not limited to:

     (a) Spanking children with a hand or object;

     (b) Biting, jerking, kicking, hitting, or shaking the child;

     (c) Pulling the child's hair;

     (d) Throwing the child;

     (e) Purposely inflicting pain as a punishment;

     (f) Name-calling or using derogatory comments;

     (g) Threatening the child with physical harm;

     (h) Threatening or intimidating the child; or

     (i) Placing or requiring a child to stand under a cold water shower.

     (2) You must not use discipline methods that interfere with a child's basic needs. These include, but are not limited to:

     (a) Depriving the child of sleep;

     (b) Depriving the child of adequate food, clothing or shelter;

     (c) Restricting a child's breathing;

     (d) Interfering with a child's ability to take care of their own hygiene and toilet needs; or

     (e) Providing inadequate medical or emergency dental care.

     (3) You must not use medication in an amount or frequency other than that prescribed by a physician or psychiatrist.

     (4) You must not give one child's medications to another child.

     (5) You must not use medication for behavior management unless a physician prescribes the medication to control that child's behavior.

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NEW SECTION
WAC 388-140-0520   Does the department require a written statement describing my discipline methods?   (1) With your application and re-application for licensure, you must provide a written statement describing the discipline methods you use, including your de-escalation and restraint policies and procedures.

     (2) If your discipline methods change, you must immediately provide a new statement to your licensor describing your current practice.

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PHYSICAL RESTRAINT
NEW SECTION
WAC 388-140-0525   What types of physical restraint are acceptable?   (1) You must use efforts other than physical restraint to redirect or de-escalate a situation.

     (2) You must comply with children's administration's behavior management guidelines for residential programs for child de-escalation and physical restraint

     (3) If a child's behavior poses an immediate risk to physical safety, you may use a physical restraint on a child. The restraint must be reasonable and necessary to:

     (a) Prevent a child on the premises from harming himself/herself or others; or

     (b) Protect property from serious damage.

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NEW SECTION
WAC 388-140-0530   What types of physical restraint are not acceptable for children?   You must not use:

     (1) Physical restraint as a form of punishment or discipline;

     (2) Mechanical restraints, such as handcuffs and belt restraints;

     (3) Locked time-out rooms; or

     (4) Physical restraint techniques that restrict breathing, or inflict pain as a strategy for behavior control, or that might injure a child. These include, but are not limited to:

     (a) Restriction of body movement by placing pressure on joints, chest, heart, or vital organs;

     (b) Sleeper holds, which are holds used by law enforcement officers to subdue a person;

     (c) Arm twisting;

     (d) Hair holds;

     (e) Choking or putting arms around the throat; or

     (f) Chemical restraints, including but not limited to pepper spray.

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NEW SECTION
WAC 388-140-0535   What must I do following an incident that involved using physical restraint?   The director or program manager of a group receiving center must review any incident with the staff who used physical restraint to ensure that the decision to use physical restraint and its application were appropriate.

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NEW SECTION
WAC 388-140-0540   What incidents involving children must I report?   (1) You or your staff at a group receiving center must report any of the following incidents immediately to children's administration intake staff:

     (a) Any reasonable cause to believe that a child has suffered child abuse or neglect;

     (b) Any violations of the licensing or certification requirements;

     (c) Death of a child;

     (d) Any child's suicide attempt that results in injury requiring medical treatment or hospitalization;

     (e) Any use of physical restraint that is alleged to be improper, excessive, or results in injury;

     (f) Sexual contact between two or more children that is not considered typical play between pre-school age children;

     (g) Any disclosures of sexual or physical abuse by a child in care;

     (h) Physical assaults between two or more children that result in injury requiring off-site medical treatment or hospitalization;

     (i) Any medication that is given incorrectly and requires off-site medical treatment;

     (j) Serious property damage that is a safety hazard and is not immediately corrected; or

     (k) Anytime a child refuses to take any medication that may result in a situation that is life threatening.

     (2) You or your staff must report immediately, any of the following incidents, to the child's social worker:

     (a) Suicidal/homicidal ideation, gestures, or attempts that do not require professional medical treatment;

     (b) Unexpected health problems that require professional medical attention or raise questions for the staff;

     (c) Any significant incident of medication administered incorrectly;

     (d) Physical assaults between two or more children that resulted in injury but did not require professional medical treatment;

     (e) Runaways;

     (f) Any emergency medical or psychiatric care that requires offsite attention; and

     (g) Use of physical restraints for routine behavior management.

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STAFFING RATIO
NEW SECTION
WAC 388-140-0545   What is the ratio of child care staff to children at a center?   The department has specific requirements for the ratio of child care staff to children at group receiving centers.

     (1) At least two staff, including at least one child care staff person, must be on site whenever children are on the premises.

     (2) The ratio for a group receiving center is at least one child care staff person on site for every four children who are under six during waking and sleeping hours.

     (3) The ratio for a group receiving center is at least one child care staff person on site for every six children age six years and older, during waking and sleeping hours.

     (4) The center may only provide care for two or more of the following age groups: Age two through five, six through twelve, and thirteen through seventeen, if a DLR approved safety plan addressing this circumstance is fully in effect.

     (5) If the center provides care for children under age six and children six and older, you may allow common activities for the children of different age groups provided you maintain the staffing ratio designated for the youngest child in the group and have an approved safety plan in place.

     (6) To keep the proper ratio of staff to children, the executive director, on-site program manager, support staff, and maintenance staff may serve temporarily as child care staff if they have adequate training and are performing child care staff duties.

     (7) You must have relief staff so that all staff can have the equivalent of two days off a week.

     (8) If you have more than one program in one building, such as a group receiving center and a crisis residential center, you must follow the most stringent staffing ratio requirements.

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SUPERVISION OF CHILDREN
NEW SECTION
WAC 388-140-0550   What are the requirements for supervision of children at the center?   (1) A group receiving center must operate under a DLR approved, written supervision and safety plan for the children in care.

     (2) A group receiving center must provide or arrange for care and supervision that is appropriate and assures the safety of each child depending on:

     (a) The child's age, developmental level, and condition;

     (b) The activities, including recreation, the child is involved in; and

     (c) The age and gender of other children involved in any group activity.

     (3) At a group receiving center, children under age six must be within visual range at all times during waking hours.

     (4) You must ensure that the staff providing direct care and supervision of the children is free of other duties at the time of care.

     (5) When a child has exhibited behavior that posed a safety risk to other children in a previous placement or the placing agency believes the child poses a risk to other children the placing agency must inform the provider and jointly develop a plan to address the risk.

     (6) When a child exhibits behavior that poses a safety risk to other children in care, sleeping arrangements, bedroom assignments, and shared activity plans must be made, in consultation with the child's social worker, to ensure the safety of other children.

     (7) Group receiving centers must supervise children who help with activities involving food preparation, based on their age and skills.

     (8) Preschool children and children with severe developmental disabilities must not be left unattended in a bathtub or shower at a group receiving center.

     (9) Staff and others caring for children at a group receiving center must provide the children with:

     (a) Appropriate adult supervision;

     (b) Emotional support;

     (c) Personal attention; and

     (d) Structured daily routines and living experiences.

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STAFF POSITIONS AND QUALIFICATIONS
NEW SECTION
WAC 388-140-0560   Are there general qualifications for all staff in a group receiving center?   You, your staff, and other persons at a group receiving center who have access to the children must be able to demonstrate the understanding, ability, personality, emotional stability, and physical health suited to meet the cultural, emotional, mental, physical, and social needs of the children in care.

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NEW SECTION
WAC 388-140-0565   What are the qualifications for an executive director for a group receiving center?   (1) A group receiving center executive director or person responsible for the agency administration, agency oversight, and fiscal operation must meet, at a minimum, the requirements that follow.

     (a) Be able to communicate to the department the roles, expectations and purposes of the program; and

     (b) Work with representatives of other agencies.

     (2) They must also meet one of these education or experience requirements:

     (a) Have a bachelor's degree in business management or administration, or related field from an accredited school; or

     (b) Have a minimum of two years of successful, full-time relevant experience.

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NEW SECTION
WAC 388-140-0570   What are the responsibilities of the director?   (1) The director of a group receiving center is responsible for the overall management of the center's facility and operation.

     (2) The director serves as the administrator of the center.

     (3) The director must ensure the group receiving center complies with the licensing requirements contained in this chapter.

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NEW SECTION
WAC 388-140-0575   What are the qualifications for the on-site program manager?   Each on-site program manager must have the following qualifications:

     (1) A bachelor's degree in a social service or closely related field from an accredited school; or

     (2) Five years of successful full-time experience in a relevant field; and

     (3) Supervisory abilities that promote effective staff performance; and

     (4) Relevant experience, training, and demonstrated skills in each area that he or she will be supervising.

     (5) The same person may have the responsibilities of the executive director and the on-site program manager if that person meets the qualifications for both positions.

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NEW SECTION
WAC 388-140-0580   Do I need an on-site program manager at each group receiving center?   Each group receiving center must have an on-site program manager or person with the equivalent training and experience at each facility during business hours.

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NEW SECTION
WAC 388-140-0585   What are the responsibilities of the program manager or supervisor?   The on-site program manager has the following responsibilities:

     (1) Coordinates the day-to-day operations of the program;

     (2) Supervises the child care staff;

     (3) Oversees the completion of each child's assessment or plan of care.

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NEW SECTION
WAC 388-140-0590   What qualifications must the child care staff for a group receiving center have?   The child care staff person of a group receiving center is responsible for the care, supervision, and behavior management of children under your care. The department requires that child care staff of a group receiving center:

     (1) Be at least twenty-one years old;

     (2) Exception: Child care staff may be eighteen to twenty years old if enrolled and participating in an internship or practicum program with an accredited college or university; and supervised by staff twenty-one years or older;

     (3) Have a high school diploma or GED;

     (4) Have one year of experience working with children;

     (5) Have the skills and abilities to work successfully with the challenging behaviors of children in care; and

     (6) Have effective communication and problem solving skills.

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NEW SECTION
WAC 388-140-0595   What are the minimum qualifications and training requirements for group receiving center staff?  
Position Qualifications Background Check TB Test Food Handlers Permit First Aid and CPR HIV/AIDS & Blood Borne Pathogens Training
Director • Twenty-one years of age;

•Bachelor's degree in business management or administration or a related field; or

• Two years of relevant experience.

X X X X X
On-site Program Manager •Twenty-one years of age;

•Bachelor's degree in social services or a related field; or

• Five years of experience in relevant field.

X X X X X
Child Care Worker •Twenty-one years of age.

•High school diploma or GED.

• One year of experience caring for children.

X X X X X

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NEW SECTION
WAC 388-140-0600   May one person hold two positions at a center?   (1) The director or program manager at a group receiving center may be one and the same person when qualified for both positions.

     (2) The director and program manager may also serve as child care staff when the role does not interfere with the director's or program manager's responsibilities.

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NEW SECTION
WAC 388-140-0605   Who must be on the premises while children are in care at a center?   (1) The director or program manager at a group receiving center must normally be on the premises during daytime hours when children are in care.

     (2) If temporarily absent (for two hours or less) from the center, the director and program manager must leave a competent, designated staff person in charge. This person must meet the qualifications of child care staff person.

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NEW SECTION
WAC 388-140-0610   What clerical, accounting and administrative services do I need?   You must have sufficient clerical, accounting and administrative services to maintain proper records and carry out your program at a group receiving center.

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NEW SECTION
WAC 388-140-0615   What support and maintenance staff do I need?   You must have sufficient support and maintenance services to maintain and repair your facility and prepare and serve meals at a group receiving center.

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STAFF TRAINING
NEW SECTION
WAC 388-140-0620   What staff training is required?   (1) All staff working at a group receiving center (GRC) must complete a minimum of sixteen hours of pre-service job orientation prior to beginning unsupervised child care responsibilities. Training must include:

     (a) Presentation of the group receiving centers policies and procedures as well and the standards contained in this chapter;

     (b) Behavior management techniques;

     (c) Crisis intervention techniques;

     (d) Family dynamics and family intervention techniques;

     (e) Child abuse and neglect reporting requirements;

     (f) Youth supervision requirements; and

     (g) HIV/AIDS/Blood-borne pathogen training.

     (2) Staff working at a group receiving center must complete a minimum of twenty-four hours of on-going education and in-service training annually. This training must include:

     (a) Crisis intervention techniques, including verbal de-escalation, positive behavior support, and physical response/restraint training as approved by the department;

     (b) Behavior management techniques;

     (c) Substance abuse;

     (d) Suicide assessment and intervention;

     (e) Family intervention techniques;

     (f) Cultural diversity;

     (g) Mental health issues and interventions;

     (h) Mediation skills;

     (i) Conflict management/problem-solving skills;

     (j) Physical and sexual abuse;

     (k) Characteristics and management of sexually aggressive and physically assaultive behavior;

     (l) Monthly fire drill practice and disaster training for each staff.

     (3) You must record the amount of time and type of training provided to staff.

     (4) This information must be kept in each employee's file or in a separate training file.

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PROGRAM ACTIVITIES AND TOYS
NEW SECTION
WAC 388-140-0625   What are the requirements for an activity program?   (1) You must provide an activity program at a group receiving center that is designed to meet the developmental, cultural, and individual needs of the children served at a group receiving center.

     (2) You must ensure the group receiving center's activity program allows time for children to have daily opportunities for small and large muscle activities and outdoor play.

     (3) You must operate the group receiving center's activity program under a regular schedule of activities with allowances for a variety of special events.

     (4) You must provide a planned program of activities and have a current, written activity schedule.

     (5) You must provide appropriate supervision for the number of children participating is any activity.

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NEW SECTION
WAC 388-140-0630   What activities must I provide to children?   (1) Activities must be designed for the developmental stages of the children you serve at a group receiving center, allowing a balance between:

     (a) Child-initiated and staff-initiated activities;

     (b) Free play and organized events;

     (c) Individual and group activities; and

     (d) Quiet and active experiences.

     (2) You must ensure that children at a group receiving center are grouped to ensure the safety of children.

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NEW SECTION
WAC 388-140-0635   Do I need to provide recreational equipment?   (1) You must provide safe and suitable recreational equipment for all children in your care at a group receiving center.

     (2) You must have toys that relate to the different developmental stages of the children you serve at a group receiving center.

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