Original Notice.

     Preproposal statement of inquiry was filed as WSR 02-06-083 and 02-20-016.

     Title of Rule: Chapter 388-148 WAC, Licensing requirements for foster homes, staffed residential homes, group care facilities, and child-placing agencies.

     Purpose: To revise rules to comply with federal funding statute and clarify language of the licensing requirements for homes, facilities, and child-placing agencies. The chapter incorporates a new set of licensing requirements for group receiving centers.

New or Amended	WAC #	Title
Amended	388-148-0005	What is the purpose of this chapter?
Amended	388-148-0010	What definitions do I need to know to understand this chapter?
Amended	388-148-0015	Am I required to have a license to provide care to children?
Amended	388-148-0025	How do you decide how many children I may serve in my home or facility?
Amended	388-148-0035	What personal characteristics do I need to provide care to children?
Amended	388-148-0040	What first aid and cardiopulmonary resuscitation (CPA) training is required?
Amended	388-148-0045	What HIV/AIDS training is required?
Amended	388-148-0050	How do I apply for a license?
Amended	388-148-0055	How long do I have to complete the licensing application packet?
Amended	388-148-0058	May I receive more than one in-home family license?
Amended	388-148-0060	May my relative or I be certified by a child-placing agency to be a foster parent and be an employee of that same agency?
Amended	388-148-0065	When may I be certified to provide care to children?
Amended	388-148-0070	Is there a difference between licensing and certification?
Amended	388-148-0075	May I be licensed with the department and certified by a child-placing agency at the same time?
Amended	388-148-0085	Will the department license or continue to license a home or facility if the home or facility does not meet the licensing requirements?
Amended	388-148-0090	Does the department issue a probationary license?
Amended	388-148-0095	When are licenses denied, suspended or revoked?
New	388-148-0098	When is an employee or volunteer disqualified from having unsupervised access to a child at a licensed home, facility, or agency?
Amended	388-148-0100	Are there any other reasons that might cause me to lose my license?
Amended	388-148-0110	What may I do if I disagree with your decision to modify, deny, suspend or revoke my license?
Amended	388-148-0120	What incidents involving children must I report?
Amended	388-148-0125	What are your requirements for keeping client records?
New	388-148-0127	What are the requirements for information kept in facility logs for staffed residential homes and group care programs?
Amended	388-148-0130	What information may I share about a child or a child's family?
Amended	388-148-0135	What changes to my home or facility must I report to my licensor?
Amended	388-148-0140	What personnel policies must I have?
Amended	388-148-0150	Are local ordinances part of the licensing requirements?
Amended	388-148-0165	What are the requirements about the location of my home or facility?
Amended	388-148-0170	What steps must I take to ensure children's safety around outdoor bodies of water?
Amended	388-148-0180	Are alcoholic beverages or illegal drugs allowed at my home or facility?
Amended	388-148-0185	Is smoking permitted around children?
Amended	388-148-0200	Do I need first-aid supplies?
Amended	388-148-0220	What fire safety requirements must I follow to qualify for a license?
Amended	388-148-0225	What safety requirements are there for exits?
Amended	388-148-0230	Are there other fire safety requirements for inside a foster home or staffed residential home licensed for five or fewer children?
Amended	388-148-0235	What are the requirements for smoke detectors for foster homes and staffed residential homes licensed for five or fewer children?
Amended	388-148-0240	What are the requirements for fire extinguishers in homes and facilities?
Amended	388-148-0245	What fire escape measures must be taken for multi-level homes and facilities?
Amended	388-148-0250	What fire safety instructions must I give to children residing in a home or facility?
Amended	388-148-0255	What are the requirements for a fire evacuation plan?
Amended	388-148-0260	What are the general requirements for bedrooms?
Amended	388-148-0265	What are additional requirements for bedrooms for more than one person?
Amended	388-148-0270	What are the requirements for beds?
Amended	388-148-0275	Do I need a telephone at my home or facility?
Repealed	388-148-0285	Do I need a housekeeping sink?
Amended	388-148-0300	How must I ventilate my home or facility?
Amended	388-148-0305	What are the requirements for laundry facilities?
Amended	388-148-0315	What are the requirements for toilets, sinks, and bathing facilities?
Amended	388-148-0320	What are the requirements about drinking water?
Amended	388-148-0325	What are the requirements for sewage and liquid wastes?
Amended	388-148-0335	When must I get a physical exam for a child under my care?
Amended	388-148-0340	What are the requirements for immunizations for children?
Amended	388-148-0345	What must I do to prevent the spread of infections and communicable diseases?
Amended	388-148-0350	What are the requirements for obtaining consent for medical care for children under my care?
New	388-148-0352	What are the requirements for the management of medication for children in my care?
Amended	388-148-0355	May I accept medicine from a child's parent or guardian?
Repealed	388-148-0360	Whom do I notify about medication changes and reactions?
Amended	388-148-0365	When may children take their own medicine?
Amended	388-148-0375	How often must I feed children?
Amended	388-148-0380	How do I handle a child's special diet?
Amended	388-148-0395	What requirements must I meet for feeding babies?
Amended	388-148-0400	What are the requirements for diapers and diaper-changes areas?
New	388-148-0422	What are the requirements for privacy for children in out-of-home placements?
Amended	388-148-0425	What are the requirements about nondiscrimination?
Repealed	388-148-0427	Are there specific requirements regarding Native American children?
Amended	388-148-0430	May I take a foster child to church services, temple, mosque, or synagogue?
Amended	388-148-0445	What toys and activities must I provide to children?
Repealed	388-148-0450	What types of toys must I provide to children?
Amended	388-148-0455	Do I need permission to travel on an overnight trip, or out-of-state with my foster child?
Amended	388-148-0460	What requirements do you have for supervising children?
Amended	388-148-0470	What types of disciplinary practices are forbidden?
Amended	388-148-0480	When may a child be physically restrained?
Amended	388-148-0485	What types of physical restraint are not acceptable for children?
New	388-148-0487	What are the requirements for time-out or quiet rooms?
New	388-148-0488	Are time-delay mechanisms allowed on windows and doors of a facility or staffed residential home licensed for six?
Amended	388-148-0490	What must I do following an incident that involved using physical restraint?
Repealed	388-148-0500	May I receive more than one on-home care license?
Amended	388-148-0520	What are the training requirements for foster parents and prospective foster parents?
Amended	388-148-0525	How many children may my foster home serve?
Amended	388-148-0535	Do I need to have income separate from foster care payments?
Amended	388-148-0540	When may I use respite care?
New	388-148-0551	Who may provide care to a foster child in the foster home when the foster parent is away from the home?
New	388-148-0542	May someone under eighteen supervise a foster child in the foster home?
Amended	388-148-0555	Do I need a social summary for children under my care?
Amended	388-148-0560	Do I need a treatment plan for children under my care?
Amended	388-148-0585	What social service staff do I need?
Amended	388-148-0600	Do I need professional consultants for my program?
Amended	388-148-0605	Is in-service training required?
Amended	388-148-0610	What are the required ratios of social service staff to children under care?
Amended	388-148-0615	Are there specific fire safety requirements for the care of nonambulatory children?
Amended	388-148-0620	What safety features do I need for hazardous areas?
Amended	388-148-0625	What other requirements must I follow for smoke detectors?
Repealed	388-148-0630	What fire prevention measures must I take?
Repealed	388-148-0635	What are the requirements for fire sprinkler systems?
Amended	388-148-0640	What fire safety procedures do staff of a group care facility and a staffed residential home licensed for six children need to know?
Amended	388-148-0645	What are the requirements for fire drills and testing smoke detectors?
Repealed	388-148-0650	What requirements do you have regarding windows in staffed residential homes and group care facilities?
Amended	388-148-0655	Are there different construction and fire safety requirements for facilities that have multiple licenses in the same building?
Amended	388-148-0660	Do mealtimes need to be established?
Amended	388-148-0670	What types of group care programs are licensed to provide care to children?
Amended	388-148-0685	Who may I serve as a group care program provider?
Amended	388-148-0695	Must I give a child an allowance?
Amended	388-148-0700	What are the qualifications for an executive director for a group care program or child-placing agency?
Amended	388-148-0705	Do I need an on-site program manager or social service staff at each group care facility?
Amended	388-148-0710	What are the responsibilities of the on-site program manager or social services staff for a group care facility?
Amended	388-148-0715	What qualifications must the on-site program manager for a group care program for a CPA program manager have?
New	388-148-0718	What are the responsibilities for child care staff at a group care program?
Amended	388-148-0720	What are the qualifications for child care staff or case aides for a group care program and a child-placing agency?
New	388-148-0722	What are the qualifications for health care staff for a group care program or a child-placing agency caring for medically fragile children?
Amended	388-148-0725	What is the ratio of child care staff to children in group care facilities?
Amended	388-148-0730	Are there room requirements for group care facilities?
Repealed	388-148-0735	When do I need a special care room?
Amended	388-148-0750	What maternity services must I provide?
Amended	388-148-0765	What types of health education must I offer expectant and new mothers?
Amended	388-148-0775	Do expectant and new mothers need to be under a physician's care?
Amended	388-148-0785	What is the proper ratio of staff to children in home or group care facilities offering maternity services?
Amended	388-148-0795	How is capacity determined for a maternity services facility?
Amended	388-148-0800	What is the purpose of day treatment programs?
Amended	388-148-0805	What staff must my day treatment program have?
Amended	388-148-0810	What consultants must my day treatment program have?
Amended	388-148-0830	What services must I provide for medically fragile children and children with severe developmental disabilities?
Amended	388-148-0860	Are there room requirements for group care facilities for medically fragile children under age six?
Amended	388-148-0870	What additional record-keeping requirements exist for medically fragile children and children with severe developmental disabilities?
Amended	388-148-0875	What types of crisis residential centers may be licensed?
Amended	388-148-0880	What levels of secure CRCs exist?
Amended	388-148-0885	What are the requirements for a level-one secure CRC?
Amended	388-148-0890	What are the requirements for a level-two secure CRC?
New	388-148-0892	What are the requirements for a level-three secure CRC?
Amended	388-148-0895	May a juvenile detention center operate a separate secure CRC program?
Amended	388-148-0900	What youth may a CRC serve?
Amended	388-148-0905	Can law enforcement officers place youth in secure CRC?
Amended	388-148-0915	What steps must be taken after a youth is admitted into a CRC?
Repealed	388-148-0935	How long may a youth stay at a CRC?
Amended	388-148-0995	What are the ratio requirements of youth care staff to youth in crisis residential centers?
Repealed	388-148-1020	Must a staffed residential home operate in conjunction with another program?
Amended	388-148-1025	What must be included in a written program description for a staffed residential home?
Amended	388-148-1030	What services must a staffed residential home provide?
Amended	388-148-1035	Who must be on the premises when children are under care at a staffed residential home?
Amended	388-148-1045	What is the ratio of child care staff to children in staffed residential homes?
Amended	388-148-1050	How many children may I serve in my staffed residential home?
Amended	388-148-1060	What services may a child-placing agency provide?
Repealed	388-148-1065	Do child-placing agency foster homes and group care facilities need to be licensed before placements?
New	388-148-1066	What written information is needed before a child is accepted for care by a child-placing agency?
Amended	388-148-1070	What health histories need to be provided to adoptive parents?
New	388-148-1076	What are the qualifications for an executive director, a program manager/social service staff, and a consultant for a child-placing agency?
New	388-148-1077	What are the qualifications for a case aide for a child-placing agency program?
New	388-148-1078	What are the qualifications for health care staff hired or contracted by a child-placing agency to provide services to children in care?
New	388-148-1097	What are the qualifications for a foster home licensor for a child-placing agency?
Amended	388-148-1085	How may my child-placing agency certify a foster home for licensing by the department?
Amended	388-148-1115	What are the requirements for adoptive services?
Amended	388-148-1120	What is the process for adoptions?
New	388-148-1205	What is a group receiving center?
New	388-148-1210	What age children may a center serve?
New	388-148-1215	What hours must a center be open?
New	388-148-1220	What services are provided or arranged for by a group receiving center?
New	388-148-1225	Is a center required to provide an orientation for a child placed?
New	388-148-1230	Does each child need space for personal items at the center?
New	388-148-1235	What staff training is required?
New	388-148-1240	What is the ratio of child care staff to children at a center?
New	388-148-1245	What are the requirements for supervision of children at a center?
New	388-148-1250	Who must be on the premises while children are in care at a center?
New	388-148-1255	What are the requirements for an activity program?
New	388-148-1260	What activities must I provide to children?
New	388-148-1265	What are the requirements for indoor recreation areas?
New	388-148-1270	What are the requirements for an outdoor recreation area?
New	388-148-1275	What are the size requirements for an outdoor recreation area?
New	388-148-1280	What are the requirements for playground equipment?

     Statutory Authority for Adoption: RCW 74.15.030.

     Statute Being Implemented: Chapter 74.15 RCW.

     Summary: The changes to the chapter enhance health and safety for children and youth in homes and facilities licensed by Children's Administration, including a section on a new type of facility, group receiving centers, now available to provide emergency foster care to sibling groups. The other changes improve Children's Administration's ability to claim federal funding under the Social Security Act. These changes include amendments that provide clarification and flexibility to licensees regarding safety around swimming pools, respite care, fire safety, and minimum qualifications for health care staff in facilities.

     Reasons Supporting Proposal: The addition of group receiving center licensing requirements, compliance with federal statutes, overall clarity of language, and efficacy of rules affecting homes and facilities licensed by Children's Administration.

     Name of Agency Personnel Responsible for Drafting and Implementation: Jean L. Croisant, P.O. Box 45710, Olympia, WA 98504-5710, (360) 902-7992; and Enforcement: Children's Administration, Division of Licensed Resources, Office of Foster Care Licensing, P.O. Box 45700, Olympia, WA 98504-5700.

     Name of Proponent: Department of Social and Health Services, governmental.

     Rule is necessary because of federal law, 45 C.F.R. 1355.

     Explanation of Rule, its Purpose, and Anticipated Effects: The purpose of the chapter is to define the minimum general and specific licensing requirements for foster homes, staffed residential homes, group care facilities, and child-placing agencies. These homes and facilities must be regulated to ensure that children and youth experience safe and health care while in out-of-home placement. The anticipated effect will be the overall clarification of the licensing requirements and compliance with federal statutes to increase funding and support for children and youth residing in out-of-home placements.

     Proposal Changes the Following Existing Rules: See Purpose above for list of amended, repealed, and new rules.

     Some of the changes include:

•     Licensing requirements for group receiving centers.

•     Added flexibility in meeting the safety requirements for supervision around swimming pools.

•     Addition of two sections allowing foster children to be supervised, occasionally, by relatives or friends of the foster parents who are under the age of eighteen.

•     Clarification on the fire safety requirements.

•     Clarification of the fire safety requirements for staffed residential homes (SRH). Separation of the requirements for SRH licensed for six and those licensed for five or fewer.

•     Addition of qualifications for health care staff working in group care facilities.

     No small business economic impact statement has been prepared under chapter 19.85 RCW. Children's Administration conducted a survey of all group care providers, child-placing agencies, and a random sample of foster parents outlining proposed changes. It was determined from the survey results that their costs would be minor. Therefore, only minor costs will be imposed on small businesses affected by the changes. The preparation of a comprehensive small business economic impact statement is not required.

     RCW 34.05.328 applies to this rule adoption. The proposed rule changes for chapter 388-148 WAC, Licensing requirements for foster homes, staffed residential homes, group care facilities, and child-placing agencies are "significant legislative rules" as defined in RCW 34.05.325 and require a cost-benefit analysis (CBA). A copy of the CBA may be requested by contacting Jean L. Croisant, at Children's Administration, Division of Program and Policy Development, P.O. Box 45710, Olympia, WA 98504-5710, (360) 902-7992, or loje300@dshs.wa.gov.

     Hearing Location: Lacey Government Center, (public parking behind Sakura Japanese Restaurant), Room 104-B, 1009 College Street S.E., Lacey, WA 98503, on March 23, 2004, at 10:00 a.m.

     Assistance for Persons with Disabilities: Contact Andy Fernando, DSHS Rules Coordinator, by March 16, 2004, phone (360) 664-6094, TTY (360) 664-6178 e-mail fernaax@dshs.wa.gov.

     Submit Written Comments to: Identify WAC Numbers, DSHS Rules Coordinator, Rules and Policies Assistance Unit, P.O. Box 45850, Olympia, WA 98504-5850, fax (360) 664-6185, e-mail fernaax@dshs.wa.gov, by 5:00 p.m., March 23, 2004.

     Date of Intended Adoption: No earlier than March 24, 2004.

January 15, 2004

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

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

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0005, filed 8/28/01, effective 9/28/01.]

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

     "Agency" is defined in RCW 74.15.020(1).

     "Assessment" means the appraisal or evaluation of a child's physical, mental, social and/or emotional condition.

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

     "Care provider" means any licensed or certified person or organization or staff member of a licensed organization that provides twenty-four-hour care for children.

     "Case manager" means the private agency employee who coordinates the planning efforts of all the persons working on behalf of a child. ((They)) Case managers are responsible for implementing the child's case plan, assisting in achieving those goals, and assisting with day-to-day problem solving.

     "Certification" means:

     (1) Department approval of a person, home, or facility that does not legally need to be licensed, but wishes to have evidence that ((they met)) it meets the minimum licensing requirements; or

     (2) Department licensing of a child-placing agency to certify that a foster home ((and/or a group care program)) meets licensing requirements.

     "Children" or "youth," for this chapter, means individuals who are:

     (1) Under eighteen years old, including expectant mothers under eighteen years old; or

     (2) Up to twenty-one years of age and ((enrolled in)) pursuing a high school, equivalent course of study((,)) (GED), or ((educational)) vocational program;

     (3) Up to twenty-one years of age with developmental disabilities; or

     (4) Up to twenty-one years of age if under the custody of the Washington state juvenile rehabilitation administration.

     "Child-placing agency" means an agency licensed to place children for temporary care, continued care or adoption.

     "Crisis residential center (CRC)" means an agency under contract with DSHS that provides temporary, protective care to children in a foster home, regular (semi-secure) or secure group setting.

     "Compliance agreement" means a written licensing improvement plan to address deficiencies in specific skills, abilities or other issues of a fully licensed home or facility in order 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 division of developmental disabilities.

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

     "Developmental ((disabilities)) disability" ((means the language used by DSHS, division of developmental disabilities)) is a disability as defined in RCW 71A.10.020.

     "DLR" means the division of licensed resources.

     "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.

     "Foster-adopt" means placement of a child with a foster parent(s) who intends to adopt the child, if possible.

     "Foster home or foster family home" means person(s) licensed to regularly ((providing)) provide care on a twenty-four-hour basis to one or more children in the person's home.

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

     "Group care facility for children" means a location maintained and operated for a group of children on a twenty-four-hour basis.

     "Group receiving center" or "GRC" means a facility providing the basic needs of food, shelter, and supervision for more than six children placed by the department, generally for thirty or fewer days. A group receiving center is considered a group care program and must comply with the group care facility licensing requirements.

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

     "I" refers to anyone who operates or owns a foster home, staffed residential home, and group facilities, including group homes, child-placing agencies, maternity homes, day treatment centers, and crisis residential centers.

     (("Infants")) "Infant" means ((children)) a child under one year of age.

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

     "Licensor" means:

     (1) A division of licensed resources (DLR) employee at DSHS who:

     (a) Approves licenses or certifications for foster homes ((and)), group facilities, and child-placing agencies; and

     (b) Monitors homes and facilities to ensure that they continue to meet minimum health and safety requirements.

     (2) An employee of a child-placing agency who:

     (a) Attests that ((a)) foster ((home and/or group home facility)) homes supervised by the child-placing agency meets licensing requirements; and

     (b) Monitors ((the)) those foster homes ((and facilities)) to ensure they continue to meet the minimum licensing standards ((for the health and safety of the children in care)).

     "Maternity service" ((means an individual, program or facility providing or arranging for care for:

     (1) Expectant mothers before and during pregnancy; and

     (2) Mothers and their infants after pregnancy.

     These services are provided to mothers who are under eighteen years of age)) as defined in RCW 74.15.020.

     "Medically fragile" means the condition of a child who has a chronic illness or severe medical disabilities requiring regular nursing visits, ((regular)) extraordinary medical ((check-ups, or under a)) monitoring, or on-going (other than routine) physician's care.

     "Multidisciplinary teams (MDT)" means groups formed to assist children who are considered at-risk youth or children in need of services, and their parents.

     "Nonambulatory" means not able to walk or traverse a normal path to safety without the physical assistance of another individual.

     (("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 part of a disciplinary ((measure)) action to an individual or agency that has previously been issued a full license but is out of compliance with minimum licensing ((standards)) requirements and has entered into an agreement aimed at correcting deficiencies to minimum licensing requirements.

     "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.

     "Relative" means a person who is related to the child as defined in RCW 74.15.020 (4)(a)(i), (ii), (iii), and (iv) only.

     "Respite" means brief, temporary relief care provided to a child and his or her parents, legal guardians, or foster parents with the respite provider fulfilling some or all of the functions of the care-taking responsibilities of the parent, legal guardian, or foster parent.

     "Secure facilities" means a crisis residential center that has locking doors and windows, or secured perimeters intended to prevent children from leaving without permission.

     "Service plan" means a description of the services to be provided or performed and who has responsibility to provide or perform the activities for a child or child's family.

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

     "Social service staff" means ((child placing agency or group care program staff)) a clinician, program manager, case manager, consultant, or other staff person who is an employee of the agency or hired to ((provide consultation on developing and implementing)) develop and implement the child's individual service and treatment plans.

     "Staffed residential home" means a licensed home providing twenty-four-hour care for six or fewer children or expectant mothers. The home may employ staff to care for children or expectant mothers. It may or may not be a family residence.

     "((Universal)) Standard precautions" is a term relating to procedures designed to prevent transmission of blood borne pathogens in health care and other settings. Under 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 or other bodily fluids.

     "Washington state patrol fire protection bureau" or "WSP/FPB" means the state fire marshal.

     "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 foster home, staffed residential home, and group facilities, including group homes, maternity programs, day treatment programs, crisis residential centers, group receiving centers, and child-placing agencies.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0010, filed 8/28/01, effective 9/28/01.]

     Reviser's note: The typographical error in the above section occurred in the copy filed by the agency and appears in the Register pursuant to the requirements of RCW 34.08.040.
AMENDATORY SECTION(Amending WSR 01-18-037, filed 8/28/01, effective 9/28/01)

WAC 388-148-0015   Am I required to have a license to provide care to children?   (1) If you regularly provide care on a twenty-four hour basis to a child who is not related to you, you must be licensed.

     (2) The types of homes or facilities that need a license include:

     (a) Foster homes;

     (b) Group care programs;

     (c) Programs for medically fragile children and children with severe developmental disabilities;

     (d) Maternity services;

     (e) Day treatment programs;

     (f) Crisis residential centers;

     (g) Staffed residential homes; ((and))

     (h) Child-placing agencies; and

     (i) Group receiving centers.

     Note: Homes and facilities offering maternity services, day treatment, crisis residential centers, group receiving centers, services to medically fragile children and/or children with severe developmental disabilities will need to follow the specific program requirements outlined in this chapter as well.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0015, filed 8/28/01, effective 9/28/01.]

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0020, filed 8/28/01, effective 9/28/01.]

     (a) Physical accommodations in your home or facility;

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

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

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

     (e) The certification of occupancy from the Washington state patrol fire protection bureau if your facility is a group care program, or a staffed residential home licensed for six children.

     (2) Based on the evaluation, the department may license you for the care of fewer children than you normally would serve in your category of care.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0025, filed 8/28/01, effective 9/28/01.]

     (1) You must demonstrate that you have the 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 disqualified by our background check (chapter 388-06 WAC) prior to having unsupervised access to children.

     (3) You have not had a license denied or revoked from an agency that regulates the care of children or vulnerable adults, unless the department determines that you do not pose a risk to a child's safety, well being, and long-term stability.

     (4) 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.

     (5) You must have the ability to furnish the child with a nurturing, respectful, supportive, and responsive environment.

     (((4))) (6) The department may require you to give additional information. We may request this 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 or psychological evaluations;

     (c) Psycho-sexual evaluations; and

     (d) Medical evaluations and/or medical records.

     (((5))) (7) Any evaluation requested under WAC 388-148-0035 (((4)))(6)(a)-(d) will be at the applicant/licensees expense.

     (((6))) (8) The licensor must be given permission to speak with the evaluator/provider prior to and after the evaluation.

     (9) Misrepresentation by a prospective employee, intern, or volunteer may be grounds for termination or denial of employment or volunteer service by that individual.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0035, filed 8/28/01, effective 9/28/01.]

     (1) If you have a home or facility that provides licensed care, ((the care givers)) you, your staff, interns, volunteers, and any individual who may at any time be the sole caregiver, must have ((current training in:

     (a))) basic standard first aid((;)) and

     (((b))) age-appropriate cardiopulmonary resuscitation (CPR) training.

     (2) The approved first((-)) aid and CPR training must be in accordance with a nationally recognized standard ((such as the American Red Cross or American Heart Association)).

     (3) For ((any)) licensed facilities ((other than foster)) and homes, ((the)) a person with first((-)) aid and CPR training must be on the premises ((at all times)) when children are present.

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

     (5) You must keep records in your home or facility showing who has completed current first-aid and CPR training.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0040, filed 8/28/01, effective 9/28/01.]

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

     (((3) The staff of group care programs are required to complete blood borne pathogen training.))

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0045, filed 8/28/01, effective 9/28/01.]

     (1) To apply for a license, the person or legal entity responsible for your home or facility must ((follow these procedures:

     (1) You must send the application form to your licensor at DLR or a child-placing agency.

     (2))) include with the application ((form, you must send)) the following ((information)):

     (a) Written verification for ((applicant of)) each applicant(s), staff, interns, volunteers and individuals who may have unsupervised access to children in care of the following information:

     (i) A negative tuberculosis test or an X ray, unless you can demonstrate a religious ((reasons)) or a medical reason prohibiting the test;

     Note: Written documentation from your physician that indicates you are free of the signs and symptoms of tuberculosis may be accepted for individuals with a religious or a medical prohibition to the TB test.

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

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

     (((b))) (2) You must send a completed background check form ((for each applicant, family member, staff person, board member, intern or volunteer)) to your licensor on anyone on the premises having unsupervised access to children who:

     (((i))) (a) Is at least sixteen years old or older;

     (((ii))) (b) Is not a foster child; ((and

     (iii) Has unsupervised access to children)) or

     (c) An individual eighteen through twenty years old authorized to remain in foster care (see chapter 388-06 WAC).

     (((c) If you have lived in Washington state less than three years,))

     (3) You must ((provide us with)) send a completed FBI fingerprint form on any individual in your home or facility who has lived outside Washington state within the last three years and meets WAC 388-148-0050 (2)(a)(b).

     (((d) We may require additional information from you including, but not limited to:

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

     (ii) Psychiatric evaluations;

     (iii) Psycho-sexual evaluations; and

     (iv) Medical evaluations and/or medical records.

     (3) Except foster homes, 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))

     (4) A group care facility or staffed residential home licensed for six is required to meet the health and fire safety requirements to receive a certificate of compliance from the department of health and the Washington state patrol fire protection bureau.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0050, filed 8/28/01, effective 9/28/01.]

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

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0055, filed 8/28/01, effective 9/28/01.]

     (2) In rare situations, a family that has demonstrated exceptional abilities in relation to meeting the special needs of children to be cared for may be granted approval to be licensed for foster care and another type of in-home family care. Approval may be granted if it appears to be in the best interest of the child and would not jeopardize the health and safety of children in the home.

     (3) The following conditions apply to a home with more than one in-home family license:

     (a) It must be clear that one type of care does not interfere with the health and safety of any child while providing the other type of care; and

     (b) The total number of children in all categories of care must not exceed te number permitted by the most stringent capacity standards for the licensed care of children.

     (4) The approval for more than one in-home family license must be in writing and signed by the director of the division of licensed resources or designee and the appropriate authority of the other division.

[]

     (a) Foster home certification((,));

     (b) Placement((,));

     (c) Case management; or

     (d) Authorization of payment to yourself or your relative for that same child-placing agency.

     (2) ((You or your relative may apply to a different)) A foster parent certified by a child-placing agency ((for a license.

     (3) Licensed foster parents who become)) who becomes employed by ((the department or a child-placing agency must be relicensed)) that agency, in one of the roles listed in WAC 388-148-0060(1) must be recertified through an agency other than their employer or licensed directly by DLR within six months of employment.

     Note: Relative as defined under RCW 74.15.020 (4)(i) through (iv).

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0060, filed 8/28/01, effective 9/28/01.]

     Reviser's note: RCW 34.05.395 requires the use of underlining and deletion marks to indicate amendments to existing rules. The rule published above varies from its predecessor in certain respects not indicated by the use of these markings.
AMENDATORY SECTION(Amending WSR 01-18-037, filed 8/28/01, effective 9/28/01)

WAC 388-148-0065   When may I be certified to provide care to children?   When you meet the licensing requirements, you may apply for certification of your home or facility by the department rather than a license, if ((you)) the following conditions apply:

     (1) You are exempt from needing a license (per chapter 74.15 RCW); and

     (2) ((Meet the licensing requirements; and

     (3))) You wish to serve department-funded children; or

     (3) You are licensed by authority of an Indian tribe within the state under RCW 74.15.190.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0065, filed 8/28/01, effective 9/28/01.]

     (2) The department may license a child-placing agency, including a Tribal CPA, to operate foster home, staffed residential home, and/or group care facilities.

     (3) The child-placing agency is only authorized to "certify" or attest to the department that the foster home ((or facility)) meets the licensing requirements.

     (4) The certification requirements are the same as the licensing requirements ((are the same)) and are contained in this chapter.

     (5) The department has the final approval for licensing the home or facility that the CPA will be supervising.

     (6) The department's representative signs the license of the home or facility.

     (7) A home "certified" by a child-placing agency (CPA) and licensed by the department must be supervised by that CPA to have a valid license ((to care for children)).

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0070, filed 8/28/01, effective 9/28/01.]

     Reviser's note: RCW 34.05.395 requires the use of underlining and deletion marks to indicate amendments to existing rules. The rule published above varies from its predecessor in certain respects not indicated by the use of these markings.
AMENDATORY SECTION(Amending WSR 01-18-037, filed 8/28/01, effective 9/28/01)

WAC 388-148-0075   May I be licensed with the department and certified by a child-placing agency at the same time?   You may not be licensed directly by the department to provide foster care to children ((at the same time by both the department)) and be certified and supervised by a child-placing agency, at the same time.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0075, filed 8/28/01, effective 9/28/01.]

     (2) Exceptions are approved for nonsafety requirements only.

     (3) The safety and well-being of the children receiving care must not be compromised.

     (4) The request for an exception to the licensing requirements must be in writing.

     (5) You must keep a copy of the approved exception to the licensing requirements for your files.

     (6) Along with an exception to the licensing requirements, the department may limit or restrict a license issued to you and/or require you to enter into a compliance agreement to ensure the safety and well-being of the children in your care.

     (7) You do not have appeal rights if the department in its discretion denies your request for an exception to ((our)) the minimum licensing requirements.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0085, filed 8/28/01, effective 9/28/01.]

     (2) The department ((must)) will base its decision as to whether a probationary license will be issued on a consideration of 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. A decision not to issue a probationary license is not subject to appeal.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0090, filed 8/28/01, effective 9/28/01.]

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

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

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

     (c) You or anyone living on the premises had a license denied or revoked from an agency that ((provided)) regulates care ((to)) of children or vulnerable adults, unless the department determines that you do not pose a risk to children or vulnerable adults.

     (d) You try to get a license by deceitful means, such as making false statements or ((leaving out important)) omitting critical information on the application.

     (e) You commit, permit or assist in an illegal act on the premises of a home or facility providing care to children.

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

     (g) You knowingly allowed employees or volunteers who made false statements or omit critical information on their applications to work at your agency.

     (h) You knowingly allowed employees or volunteers who use illegal drugs, alcohol, or prescription drugs that affect their ability to perform their job duties to work at your agency or be on the premises when children are present.

     (i) You repeatedly lack qualified or an adequate number of staff to care for the number and types of children under your care. Repeatedly means more than twice during a six-month period.

     (((i))) (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.

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

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

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0095, filed 8/28/01, effective 9/28/01.]

     (1) Has a disqualifying background check (see chapter 388-06 WAC);

     (2) Has been found to have committed child abuse or neglect or have treated, permitted, or assisted in treating children with cruelty, indifference, abuse, neglect, or exploitation;

     (3) Had a license denied or revoked from an agency that regulates the care of children or vulnerable adults;

     (4) Attempted to become employed, volunteer, or otherwise have unsupervised access to children by deceitful means, such as making false statements or omitting critical information on an application to work or volunteer at a licensed home, facility, or agency;

     (5) Used illegal drugs, alcohol, or prescription drugs that affected their ability to perform their job duties while on the premises when children are present; or

     (6) Has committed, permitted, or assisted in an illegal act on the premises of a home or facility providing care to children.

[]

     (1) Exceed the conditions of your home or facility license by:

     (a) Having more children than the license allows;

     (b) Having children with ages or genders different than the license allows;

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

     (d) Failing to comply with any of ((our)) the other licensing requirements((; or

     (e) Failing)).

     (2) Fail 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.

     (2) The department must suspend your license to provide care to children, if we receive a notice from the division of child support that you are not in compliance with a support order.

     Note: The governing authority is RCW 43.20A.205 and 74.20A.320.

     (3) The suspension of your license for noncompliance of a support order would be effective the date you receive a notice that we received the certificate of noncompliance from the division of child support.

     (4) Your license would remain suspended until you provide proof that you are in compliance with the child support order.

     (5) You would not have a right to an administrative hearing based on a suspension of your license due to noncompliance of a child support order)) the Washington state patrol fire protection bureau.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0100, filed 8/28/01, effective 9/28/01.]

     (1) You may request ((a department)) an administrative hearing to disagree with the department's decision to modify, suspend, revoke or deny your license.

     (2) You must request ((a department)) an administrative hearing within twenty-eight days of receiving a certified letter with the department's decision (see chapter 34.05 RCW).

     (3) You must send a letter to the office of administrative hearings, P.O. Box ((42489)) 42488, Olympia, Washington ((98504-2489)) 98504-2488, 1-800-583-8271 requesting an administrative hearing. The letter must have the following attachments:

     (a) A specific statement of your reasons for disagreeing with the department decision and any laws that relate to your reasons; and

     (b) A copy of the certified letter from the department that you are disputing.

     (4) The administrative hearing will take place before an ((employee of)) administrative law judge employed by the office of administrative hearings.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0110, filed 8/28/01, effective 9/28/01.]

     (a) Children's administration intake staff, and

     (b) The child's social worker or case manager.

     (2) The incidents to be reported include:

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

     (b) Any violations of the licensing or certification requirements where the health and safety of a foster child is at risk and the violations are not corrected immediately;

     (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 ((improper)) improperly applied or excessive;

     (f) Sexual contact between two or more children that is not considered typical play between preschool 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)) attention or hospitalization;

     (i) ((Unexpected health problems that require)) Physical assaults of foster parent or staff by children that result in injury requiring off-site medical ((treatment)) attention or hospitalization;

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

     (k) Serious property damage or other significant licensing requirement that is a safety hazard and is not immediately corrected((; or

     (l) Any emergent medical care)) or may compromise the continuing health and safety of children.

     (3) You or your staff must report ((immediately)) the following incidents as soon as possible or in no instance later than forty-eight hours, ((any of the following incidents)) to the child's social worker, if the child is in the department's custody or to the case manager if placed with a child-placing agency program:

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

     (b) Unexpected health problems outside the anticipated range of reactions caused by medications, that do not require professional medical ((treatment)) attention;

     (c) Any incident of medication incorrectly administered;

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

     (e) Runaways; ((and))

     (f) Any emergent medical or psychiatric care that requires off-site attention; and

     (g) Use of prohibited physical restraints for ((routine)) behavior management as described in WAC 388-148-0485.

     (4) Programs providing care to medically fragile children who have nursing care staff on duty may document the incidents described in WAC 388-148-0120 (3)(b)(c) in the facility daily logs, rather than contacting the social worker or case manager, if agreed to in the child's ISSP.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0120, filed 8/28/01, effective 9/28/01.]

     Reviser's note: RCW 34.05.395 requires the use of underlining and deletion marks to indicate amendments to existing rules. The rule published above varies from its predecessor in certain respects not indicated by the use of these markings.

     Reviser's note: The typographical error in the above section occurred in the copy filed by the agency and appears in the Register pursuant to the requirements of RCW 34.08.040.
AMENDATORY SECTION(Amending WSR 01-18-037, filed 8/28/01, effective 9/28/01)

WAC 388-148-0125   What are your requirements for keeping client records?   (1) Any identifying and personal information about a child and the child's family must be kept confidential.

     (2) You must keep records about children and their families in a secure place. For foster homes, if the child is in the department's custody, at the end of the child's placement, reports and information written by ((others)) the department about the child or the child's family must be returned to the child's social worker.

     (3) During a placement in your foster home, your records must be kept at your home and contain, if available, at a minimum, the following information:

     (a) The child's name, birth date, and legal status;

     (b) Name and telephone number of the social worker for each child in care;

     (c) Names, address and telephone numbers of parents or persons 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;

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

     (g) Other pertinent information related to the child's health, including dental records;

     (h) ((Record of)) Immunizations((.)) are not required to be current for children placed in:

     (i) Receiving and interim care homes and facilities ((do not need to keep records of immunizations for children in their care less than thirty days.));

     (ii) Crisis residential centers ((do not need to keep records of immunizations for children in their care;)); and

     (iii) A foster home licensed by a child-placing agency to provide emergency respite services to parents on a voluntary placement agreement.

     Note: If a child's placement extends beyond thirty days, you must obtain the child's immunization records. If the child is not current with immunization, they must be updated as soon as medically possible.

     (i) Child's school records, report cards, school pictures, and individual education plans (IEP);

     (j) Special instructions including supervision requirements and suggestions for managing problem behavior;

     (k) Inventory of the child's personal belongings at the time of placement; and

     (l) The child's visitation plan.

     (4) During a child's placement in a ((staffed residential home or a group care program, your recprds)) home or facility, the child's record must be kept secure at ((your)) the site and contain, at a minimum, the following information in addition to the information in subsection (3)(a) through (l) of this section:

     (a) Written consent from the child placing agency, if any, for providing medical care and emergency surgery (unless that care is authorized by a court order);

     (b) Names, addresses, and telephone numbers of persons authorized to take the child under care out of the facility;

     (c) A copy of the court order or voluntary placement agreement that gives approval to place the child;

     (d) Case plans, such as children's administration's "individual service and safety plan (ISSP);" and

     (e) ((Daily logs)) Documentation of therapy treatment received by children with the signature of the person making the entry ((in the log)) to the therapy or progress notes.

     (5) If you operate a group care program, staffed residential home, or child-placing agency and have client files with 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.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0125, filed 8/28/01, effective 9/28/01.]

     (a) Serious child health or safety issues;

     (b) Dates and illnesses or accidents while in care;

     (c) Medications and treatments given with the child's name;

     (d) After-hours telephone number of the supervisor;

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

     (f) The signature of the staff person reviewing the log.

     (2) Staffed residential homes and group care programs must keep current:

     (a) Medication logs;

     (b) Incident logs, including a copy of any suspected child abuse and/or neglect referrals made to children's administration; and

     (c) Daily or shift logs.

[]

     (c) Neighbors.))

     (2) You may discuss information about the child, the child's family and the case plan only with:

     (a) A representative of the department, including staff from DCFS and DLR; department of health and the office of the state fire marshal;

     (b) A child-placing agency case manager assigned to the child;

     (c) The child's assigned guardian ad litem or court-appointed special advocate; or

     (d) Others designated by the child's social worker.

     (3) You may check with your child's social worker for guidance about sharing information with the child's teacher, counselor or doctor, respite care provider or any other professional.

     (4) Child-placing agencies and the department must share with the child's care provider any information about the child and child's family related to the case plan.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0130, filed 8/28/01, effective 9/28/01.]

     (a) Changes in your location or designated space, including address;

     (b) Changes in your phone number;

     (c) Changes in the maximum number, age ranges, and sex of children you wish to serve;

     (d) Changes in the structure of your facility or premises from events causing damage, such as a fire, or from remodeling;

     (e) Addition of any new staff person, employee, intern, contractor, or volunteer, who might have unsupervised contact with the children in care; or

     (f) Changes in household composition, such as:

     (i) A marriage, separation or divorce;

     (ii) Incapacity or serious physical or mental illness of a foster parent or member of the household;

     (iii) The death of anyone in the household;

     (iv) A change in employment status or significant change in income; or

     (v) A change in who resides in the household or is on the premises for more than fourteen days.

     (g) Any arrests or convictions that occur between the date of your license and the expiration date of your license for you or anyone sixteen years or older residing at your home.

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

     (a) A change of your agency's executive director or any staff changes;

     (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 facility is commonly known; or

     (d) Changes in an agency's articles of incorporation and bylaws.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0135, filed 8/28/01, effective 9/28/01.]

     (((1) Each employee, intern, contractor, or volunteer who has unsupervised access to children must have completed an application for employment and signed a form enabling us to do a)) You must keep a background check (((chapter 388-06 WAC))) log that contains information on dates of request and completion of the checks.

     (2) ((Misrepresentation by the prospective employee, interns, or volunteer will be grounds for termination or denial of employment or volunteer service.

     (3))) If you have five or more staff, volunteers, or interns you must have written policies covering qualifications, training, and duties for employees, interns, and volunteers.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0140, filed 8/28/01, effective 9/28/01.]

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

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0150, filed 8/28/01, effective 9/28/01.]

     (2) Your home or facility must be accessible to emergency vehicles.

     (3) Your home or facility must be located on a well-drained site, free from hazardous conditions. 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.

     (4) A supervision plan must be written for ((the children)) each child in care if ((it is decided)) the department determines that hazardous conditions are present. Some examples of hazards are natural or man-made water hazards such as lakes or streams, steep banks, ravines, and busy streets.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0165, filed 8/28/01, effective 9/28/01.]

     (2) You must daily empty and clean any portable wading pool that children use.

     (3) Children under twelve must be in continuous visual or auditory range at all times, when ((they)) the children are swimming, wading, or boating, by an adult with current age appropriate first aid and CPR.

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

     (5) All safety devices and rescue equipment, such as personal flotation devices must meet state and federal water safety regulation.

     (6) You must lock or secure hot tub and spa areas when they are not in use.

     (((6))) (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) Foster homes with pools must have a written safety and supervision plan for each child.

     (9) Individuals supervising children in foster homes and staffed residential homes licensed for five or fewer children must know how and be able to use rescue equipment or have a current life-saving certification, when children are using a pool on the premises.

     (10) All group care facilities and staffed residential homes licensed for six children must have a person with current life-saving certification on-duty when children are using a pool at the facility.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0170, filed 8/28/01, effective 9/28/01.]

     (2) ((Any other)) Licensed homes and facilities must not have illegal drugs on the premises.

     (3) A group care facility or staffed residential home must not have alcohol or illegal drugs on the premises. The staff of these facilities may not consume alcohol or illegal drugs on the premises or during breaks.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0180, filed 8/28/01, effective 9/28/01.]

     (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 or religious ceremonies involving the use of tobacco.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0185, filed 8/28/01, effective 9/28/01.]

     (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; and

     (f) Thermometer.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0200, filed 8/28/01, effective 9/28/01.]

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

     (8) 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.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0210, filed 8/28/01, effective 9/28/01.]

     (2) All foster homes and those staffed residential homes ((need)) licensed for five or fewer children must have inspections by ((fire marshal or)) WSP/FPB or the local fire ((department if)) authority only if, either:

     (a) ((Licensors)) The licensor request the inspections due to questions of fire safety; or

     (b) Local ordinances or WSP/FPB require these inspections.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0220, filed 8/28/01, effective 9/28/01.]

     (2) All foster homes and those staffed residential home licensed for five or fewer children must comply with the fire safety requirements that follow concerning ((exists)) exits from homes ((and facilities)).

     (((1))) (a) Exit doors and rescue windows must be easily and quickly opened ((to the fully open position)) from the inside without requiring a key or special instructions.

     (((2) Locks on outside exit doors must automatically unlock when the doorknob is turned from the inside.

     (3) Except in foster homes, night latches, dead bolts, security chains, manually operated edge or surface-mounted flush bolts and surface bolts must not be used.

     (4))) (b) Each home and facility must have at least one swinging exit door that is pivoted or hinged on the side.

     (((5) Other exit doors in your home or facility may be sliding doors.

     (6))) (c) Each home or facility must have two ((exits, located at opposite ends of the building or)) means of exit, from the apartment, house, or facility, with at least one exit on each floor. The requirement for one of the two exits may be deleted if:

     (((a))) (i) A residential sprinkler system (complying with the ((state fire Marshal standards)) WSP/FPB regulations and the currently adopted edition of the National Fire Protection Association (N.F.P.A.) #13) is provided throughout the entire building; and

     (((b))) (ii) The remaining exit is a door.

     (((7))) (d) Every occupied area must have access to ((at least)) one exit ((that does not pass through rooms or spaces that can)). Such exits may not be locked or blocked from the opposite side.

     (((8))) (e) Obstacles must not be placed in corridors, aisles, doorways, exit doors, stairways, ramps, or ((rescue)) windows that could delay exiting in case of emergency.

     (((9))) (f) Barriers to exiting must be restricted to baby gates or ((other)) DLR-approved electronic monitoring devices that ((are easily opened and)) do not delay exiting in case of emergency.

     (((10))) (g) Stoves or heaters must not block escape or exit routes.

     (((11))) (h) Flammable, combustible, or poisonous material must be stored away from exits and away from areas that are accessible to children under care.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0225, filed 8/28/01, effective 9/28/01.]

     (1) Every ((room)) bedroom used by children under care must have easy entry and exit, including one of these features:

     (a) Two separate doors; or

     (b) One door leading to an area with an exit; and

     (c) A window that opens to the outside and is large enough for emergency ((escape or rescue)) personnel or rescuer access.

     (2) No space may be lived-in by the children in care that is accessible only by a ladder, folding stairs, or a trap door.

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

     (4) Every closet door latch must be designed to be opened from the inside.

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

     (6) 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.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0230, filed 8/28/01, effective 9/28/01.]

     (2) If a sleeping or napping room has a ceiling height that is at least twenty-four inches higher than its adjoining hallway, you must install a smoke detector in both the hallway and the sleeping or napping room.

     (3) ((In foster homes,)) Smoke detectors must be tested twice a year to ensure they are in working order.

     (4) Document date and time of test.

     (5) If questions arise concerning fire danger, the local fire protection authority must be consulted.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0235, filed 8/28/01, effective 9/28/01.]

     Note: Approved 2A10BC-rated means a fire extinguisher with an Underwriters' Laboratory label on the nameplate classifying the extinguisher as 2A10BC-rated. These extinguishers are usually multipurpose, five-pound dry chemical units.

     (2) Approved fire extinguisher(s) must be located in the area of the normal path of exiting. The maximum travel distance to an extinguisher from any place on the premises must not exceed seventy-five feet. When the travel distance exceeds seventy-five feet, additional extinguisher(s) are required.

     (3) Fire extinguishers must be ready for use at all times.

     (4) Fire extinguishers must be kept on a shelf or mounted in a bracket so that the top of the extinguisher is not more than five feet above the floor.

     (5) Fire extinguishers must receive a maintenance certification by a licensed firm specializing in this work, based on the manufacturer's recommended schedule. Maintenance means a thorough check of the extinguisher for:

     (a) Mechanical parts;

     (b) Extinguishing agent; and

     (c) Expelling means.

     (6) Exception: New fire extinguishers do not need to receive an additional certification test during the first year.

     (7) For all foster homes and staffed residential homes licensed for five or fewer children, if local fire authorities require installation of a different type or size of fire extinguisher, those requirements apply instead of the departments, as long as at least the minimum size is maintained.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0240, filed 8/28/01, effective 9/28/01.]

     (2) If a fire ladder is needed to escape from an upper story window, it must be functional and stored in a location that is easily accessible.

     (3) For all foster homes and those staffed residential homes((, a)) licensed for five or fewer children, the local fire ((department official)) authority may be consulted to determine if a fire ladder is needed to ensure adequate safety.

     (4) For group care programs((, this determination is made by the state fire marshal)) and staffed residential homes licensed for six children fire escape measures from multi-level buildings is determined by the WSP/FPB representative.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0245, filed 8/28/01, effective 9/28/01.]

     Reviser's note: RCW 34.05.395 requires the use of underlining and deletion marks to indicate amendments to existing rules. The rule published above varies from its predecessor in certain respects not indicated by the use of these markings.
AMENDATORY SECTION(Amending WSR 01-18-037, filed 8/28/01, effective 9/28/01)

WAC 388-148-0250   What fire safety instructions must I give to children residing in a home or facility?   (1) You must instruct children, under your care, who are capable of understanding and following emergency evacuation procedures ((and)) how to exist the building in case of fire.

     (2) You must conduct fire drills at ((regular)) quarterly intervals or as required by WAC 212-12-044 by the WSP/FPB to test and practice ((the)) evacuation procedures.

     (3) Any simulated fire drills for medically fragile or nonambulatory children must meet WAC 212-12-005 as required by the WSP/FPB.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0250, filed 8/28/01, effective 9/28/01.]

     (2) You must ensure that the plan includes:

     (a) Action to take by the person discovering a fire;

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

     (c) Action to take for evacuating the building that ensures responsibility for the children; ((and))

     (d) Action to take while waiting for the fire department; and

     (e) If the use of a fire ladder is part of the evacuation plan it must be inspected at least annually to ensure it is in working order.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0255, filed 8/28/01, effective 9/28/01.]

     (1) An adult must be on the same floor or within easy hearing distance and ((accessibility)) access to where children under six years of age are sleeping . Infants under age one year must be on the same floor as an adult.

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

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

     (4) For facilities licensed after December 31, 1986, bedrooms must have both:

     (a) Adequate ceiling height for the safety and comfort of the occupants. Normally, this would be seven and a half feet; and

     (b) A window ((of not less than one-tenth of the required floor space)) that can open into the outside, allowing natural light into the bedroom and permitting emergency access or exit.

     (5) ((For any)) Foster children ((six years of age and over, you must furnish separate sleeping quarters for each)) must not share the same bedroom with children six years or older of a different gender.

     (6) Children in care must not share the same bed.

     (7) In group care facilities and staffed residential homes licensed for six children, single occupancy bedrooms must provide at least fifty square feet of floor space.

     (8) In foster homes and staffed residential homes licensed for five or fewer children, single occupancy bedrooms 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.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0260, filed 8/28/01, effective 9/28/01.]

     (2) There must be no more than four persons to a bedroom.

     (3) Multiple occupancy bedrooms must provide adequate floor space for safety and comfort of the children. Normally this would be at least fifty square feet of floor space per occupant, not including closets.

     (4) When a mother and her infant sleep in the same room, the room must contain at least eighty square feet of usable floor space.

     (5) You must allow only one mother and her newborn infant(s) to occupy a bedroom.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0265, filed 8/28/01, effective 9/28/01.]

     (2) For each child in care, you must provide a bed at least ((thirty)) twenty-seven inches wide with a clean and comfortable mattress in good condition, pillow, sheets, blankets, and pillowcases. Each child's pillow must be covered with waterproof material or be washable.

     (3) Bedding must be clean.

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

     (5) You must provide an infant with a crib that ensures the safety of the infant and complies with chapter 70.111 RCW, Infant Crib Safety Act.

     (6) Cribs must have no more than two and three-eighths inches space between vertical slats when used for infants under six months of age.

     (7) Cribs, infant beds, bassinets, and playpens must:

     (a) Have clean, firm, snug fitting mattresses covered with waterproof material that is easily sanitized; and

     (b) Be made of wood, metal, or approved plastic with secure latching devices.

     (8) Crib bumpers, stuffed toys and pillows must not be used in cribs, infant beds, bassinets, or playpens with an infant unless advised differently by the child's physician.

     (9) You must follow the recommendation of the American Academy of Pediatrics, 1-800-505-CRIB, placing infants on their backs each time for sleep, unless advised differently by the child's physician.

     (10) You may use toddler beds with a standard crib mattress that is sufficient in length and width for the comfort of children under six years of age.

     (11) 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, expectant mothers, and children with ((disabilities)) a disability.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0270, filed 8/28/01, effective 9/28/01.]

     (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, or at a specified place for easy access.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0275, filed 8/28/01, effective 9/28/01.]

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0300, filed 8/28/01, effective 9/28/01.]

     (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) Except for foster homes, you must locate laundry equipment in an area separate from the kitchen and child care areas ((unless you are doing foster care in your home)).

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0305, filed 8/28/01, effective 9/28/01.]

     (1) You must provide at least one indoor flush-type toilet, one nearby hand-washing sink with hot and cold running water, and a bathing facility.

     (2) You must comply with all of the following requirements for toilet and bathing facilities:

     (a) Toilet and bathing facilities must allow privacy for children who are five years of age or older and opposite genders.

     (b) Toilet, urinals, and hand-washing sinks must be the appropriate height for the children served, or have a safe and easily cleaned step stool or platform that is water-resistant.

     (c) Hand-washing and bathing facilities must be provided with hot running water that does not exceed one hundred twenty degrees.

     (d) All bathing facilities must have a conveniently located grab bar unless we approve other safety measures, such as nonskid pads.

     (e) You must provide potty-chairs and toilet training equipment for toddlers. You must regularly maintain this equipment and keep it in sanitary condition. You must put potty-chairs, when in use, on washable, water-resistant surfaces.

     (f) In group care facilities, whenever urinals are provided, the number of urinals must not replace more than one-third of the total number of required toilets.

     (g) You must provide soap and clean towels, disposable towels or other approved hand-drying devices to the persons under your care.

     (h) In programs providing care to expectant mothers:

     (i) Bathing facilities must have adequate grab bars in convenient places; and

     (ii) Except in foster homes, all sleeping areas must have at least one toilet and hand-washing sink on the same floor.

     (3) ((There shall be at least one indoor flush-type toilet and one nearby handwashing sink with hot and cold or tempered running water.)) The following ratios of persons normally on the premises to bathrooms at the facilities shall apply:

	Toilets	Handwashing Sinks	Bathing Facilities
Group care ((programs and)) facilities and SRH licensed for six children	Two minimum and 1:8 ratio	Two minimum and 1:8 ratio	One minimum and 1:8 ratio
Foster ((family home)) homes and staffed residential ((home)) homes licensed for five or fewer children	One minimum	One minimum	One minimum

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0315, filed 8/28/01, effective 9/28/01.]

     (((a))) (1) A public water supply or a private water supply approved by the local health authority at the time of licensing or relicensing; and

     (((b))) (2) 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.))

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0320, filed 8/28/01, effective 9/28/01.]

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0325, filed 8/28/01, effective 9/28/01.]

     (2))) A physical exam (EPSDT) must be completed ((within)) for any child in care more than thirty days ((of placement and annually thereafter)), who within the past year, has not had a physical exam by a physician, a physician's assistant, or an advanced registered nurse practitioner (ARNP).

     (2) In consultation with the child's social worker and physician, you must schedule an early and periodic screening, diagnosis and treatment (EPSDT) exam by a physician, a physician's assistant, or an advanced registered nurse practitioner (ARNP) according to the published frequency schedule.

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

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0335, filed 8/28/01, effective 9/28/01.]

     (2) You may accept a child who has not received all immunizations on a conditional basis if immunizations are started as soon as medically possible.

     (3) If you are providing care and have minor children of your own who are on the premises of a home or facility, your children must have proof of current immunizations.

     (4) The department may give conditional approval for any of your own children who have not received all immunizations as long as their immunizations are started soon as medically possible.

     (5) The department may grant exceptions to this requirement for immunizations for your children in two situations:

     (a) You, as parent or guardian, have signed a statement indicating your religious, philosophical or personal objections to the requirement; or

     (b) You have a physician's statement indicating that a valid medical reason exists for not obtaining immunizations for your own child.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0340, filed 8/28/01, effective 9/28/01.]

     General communicable diseases and infections

     (1) In each home or facility, other than a foster home, staff with a reportable communicable disease or notifiable disease condition, 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.

     (2) Each home or facility, other than a foster home, that cares for ((severely and multiple-handicapped)) medically fragile children and children with a severe developmental disability must have an infection control program supervised by a registered nurse.

     (3) Foster homes ((with)) and staffed residential homes licensed for five or fewer children who are medically fragile ((children)) may use other alternatives, such as in-home nursing services, to consult on infection control procedures.

     Tuberculosis

     (4) Applicants for a license or adults authorized to have unsupervised access to children in a home or facility 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.

     (5) 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.

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

     (7) The department does not require retesting for license renewals unless a person believes they have been exposed to someone with tuberculosis or if testing is recommended by their health care provider.

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

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0345, filed 8/28/01, effective 9/28/01.]

     (b) Give any other nonprescription medications only when approved in writing by a physician. These nonprescription medications may be given with a physician's standing order. Physician's standing orders must be patient specific)) (1) In general, the department is the legal custodian of a child in foster care. The department has the authority to consent to emergent and routine medical services on behalf of the child. The department delegates some of that authority to out-of-home placement providers (both foster parents and facility-based programs). You must contact the child's social worker or children's administration intake (emergency placements) for specific information for each child.

     (2) In case of medical emergency, contact children's administration intake as soon as possible.

     (3) If you care for children in the custody of another agency, tribal court or other court you must follow the direction of that agency or court regarding permission to provide consent for medical care.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0350, filed 8/28/01, effective 9/28/01.]

     (1) Medication must not be used for behavior control, unless prescribed for that purpose by a physician or another person legally authorized to prescribe medication.

     (2) Only you or another authorized care provider (such as a respite provider) are allowed to have access to medications for a child under your care.

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

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

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

     (4) If you care for children in the custody of another agency, tribal or other court you must follow the direction of that agency or court regarding giving or applying prescription and nonprescription medications.

     (5) Foster homes must keep a record of all prescription medication given to a foster child.

     (6) All licensees, except foster homes, must keep a record of all prescription and nonprescription medications given to children in care.

     Nonprescription medications

     (7) You or another authorized care provider may give the following nonprescription medications according to product instructions, without prior approval of the department:

     (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 ointments.

     Note: Other nonprescription medications may be given with a physician's standing order, if the order is child specific.

     Prescription medications

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

     (9) You must notify the child's social worker of changes in prescribed medications.

     (10) Except for foster homes, 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.

     Note: You may consult with a pharmacist on the proper disposal of medications that are no longer being taken or have expired.

     Psychotropic medications

     (11) Care providers must not consent to giving or stopping a psychotropic medication. Consent to begin or to stop a psychotropic medication for a child can only be given by one of these:

     (a) The child's parent;

     (b) Dependency guardians based on the authority of the dependency guardianship court order;

     (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.

[]

     (a) The child's first and last ((names)) name;

     (b) The date the prescription was filled;

     (c) The medication's expiration date; and

     (d) Legible instructions for administration (manufacturer's instructions or prescription label) of the medication.

     (2) You must notify the child's social worker when you receive a prescription from a child's parent or guardian.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0355, filed 8/28/01, effective 9/28/01.]

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

     (b) ((The social worker or guardian if they have custody, approves in writing.

     (2))) You must keep the written approval by the child's social worker in your records.

     (((3))) (2) When a child is taking their own medication, the medication and medical supplies must be kept locked ((so they are)) or inaccessible to unauthorized persons.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0365, filed 8/28/01, effective 9/28/01.]

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

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0375, filed 8/28/01, effective 9/28/01.]

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0380, filed 8/28/01, effective 9/28/01.]

     (1) Serve only pasteurized milk or a pasteurized milk product.

     (2) Not serve the following types of milk to any child less than twenty-four months of age unless you have written permission by a physician:

     (a) Skim milk;

     (b) Reconstituted nonfat dry milk; and

     (c) One and two percent butterfat milk.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0385, filed 8/28/01, effective 9/28/01.]

     (1) In group care settings, all formulas must be in sanitized bottles with nipples and labeled with the child's name and date prepared if more than one child is bottle-fed.

     (2) You must refrigerate filled bottles if bottles are not used immediately and contents must be discarded if not used within twenty-four hours.

     (3) If you reuse bottles and nipples, you must sanitize them.

     (4) If breast milk is provided by anyone other than a baby's biological mother, approval must be obtained from the child's social worker.

     (5) Infants who are six months of age or over may hold their own bottles as long as an adult remains in the room and within observation range. You must take bottles from the child when the child finishes feeding or when the bottle is empty, or when the child falls asleep.

     (6) You must not prop bottles while feeding infants.

     (7) To prevent uneven heating, formula must not be warmed in a microwave oven in the bottle that will be used for feeding the baby.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0395, filed 8/28/01, effective 9/28/01.]

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

     (2) You must sanitize diaper-changing areas and toilet-training equipment 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) In group care programs, you must use disposable diapers, a commercial diaper service, or reusable diapers supplied by the child's family.

     (6) In group care programs, diaper-changing procedures must be posted at the changing areas.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0400, filed 8/28/01, effective 9/28/01.]

     (2) The department and its delegates may censor the child's mail and monitor telephone calls to the extent necessary and in the manner specified by the court order for the child's safety or well-being.

[]

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0425, filed 8/28/01, effective 9/28/01.]

     (2) You must respect the religious ((rights)) backgrounds or preferences of the children under your care.

     (3) Children have the right to practice their own faith.

     (4) Children have the right not to practice your faith without consequences.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0430, filed 8/28/01, effective 9/28/01.]

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0445, filed 8/28/01, effective 9/28/01.]

     ((Note: The social worker with the agency having legal custody of the child is the contact person.))

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0455, filed 8/28/01, effective 9/28/01.]

     (2) ((You must supervise children who help with food preparation in the kitchen, based on their age and skills.

     (3))) Preschool children and children with severe developmental disabilities must not be left unattended in a bathtub or shower.

     (((4))) (3) Foster parents and facility staff must provide the children in their care with appropriate adult supervision, emotional support, personal attention, and structured daily routines and living experiences.

     (((5))) (4) Except group receiving centers, children in group care ((children)) must be supervised during sleeping hours by at least one awake staff when:

     (a) There are more than six children in care; and

     (b) The major focus of the program is behavioral rather than the development of independent living skills such as a teen parent program or responsible living skills program; or

     (c) The youth's behavior poses a risk to self or others.

     (((6))) (5) In foster homes and staffed residential homes, children must be supervised during sleeping hours by at least one awake staff only when it is part of the child's written supervision plan ((with the child's social worker)).

     (((7))) (6) Adequate supervision should be arranged and maintained during times of crisis when one or more family members or staff members may be unavailable to provide the necessary supervision or coverage for other children in care.

     (((8))) (7) When special supervision is required and agreed upon between the department and the agency or foster parent, the agency or foster parent provides the necessary supervision. This supervision may require auditory or visual supervision at all times.

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

     (((10) When a child exhibits behavior that poses a safety risk to other children in care, the child must not share a bedroom with other children.))

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0460, filed 8/28/01, effective 9/28/01.]

     (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, 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 methods that interfere with a child's basic needs. These include, but are not limited to:

     (a) Depriving the child of sleep;

     (b) Providing inadequate food, clothing, living space, 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 dental care.

     (3) You must not use methods that deprive a child of necessary services. These include, but are not limited to, contacting:

     (a) The assigned social worker;

     (b) The assigned legal representative;

     (c) Parents or other family members who are identified in the ((case)) service plan; or

     (d) Individuals providing the child with therapeutic activities as part of the child's ((case)) service plan.

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

     (5) You must not use medications for a child that ((has)) have been prescribed for someone else.

     (((6) You must not physically lock doors or windows in a way that prohibits a child from exiting.))

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0470, filed 8/28/01, effective 9/28/01.]

     (2) ((In foster homes, in emergencies and only when the)) When a child's behavior poses an immediate risk to physical safety you may you use physical restraint. The restraint must be reasonable and necessary to:

     (a) Prevent a child ((on the premises)) from harming ((themself)) him or herself, or others; or

     (b) Protect property from serious damage.

     (3) If ((your)) a group care program is approved by DLR for the use of physical restraint, the licensee and staff must be trained in the appropriate use of restraining techniques in accordance with the ((department's)) children's administration's behavior management policy before restraining a child.

     (4) Medication prescribed by a physician to control behavior must be only given as prescribed.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0480, filed 8/28/01, effective 9/28/01.]

     Reviser's note: RCW 34.05.395 requires the use of underlining and deletion marks to indicate amendments to existing rules. The rule published above varies from its predecessor in certain respects not indicated by the use of these markings.
AMENDATORY SECTION(Amending WSR 01-18-037, filed 8/28/01, effective 9/28/01)

WAC 388-148-0485   What types of physical restraint are not acceptable for children?   Homes and facilities must follow these requirements. You must not:

     (1) Use physical restraint as a form of punishment or discipline.

     (2) Use mechanical restraints, such as handcuffs and belt restraints, unless ordered by the child's physician, such as a belt restraint for an infant with reflux who must be secured to a wedge.

     (3) ((Use locked time-out rooms.

     (4))) Use physical restraint techniques that restrict breathing, inflict pain as a strategy for behavior control, or that ((might injure)) is likely to cause injury that is more than transient to 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.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0485, filed 8/28/01, effective 9/28/01.]

     (2) Locked time-out or quiet rooms are prohibited in group care facilities and staffed residential homes licensed for six unless, the group facility or staffed residential home:

     (a) Has approval from the Washington state patrol fire protection bureau or a certificate of compliance stating that the facility is in compliance with the fire codes with Washington state amendments;

     (b) Has approval from the DLR licensor stating the facility is in compliance with the children's administration's behavior management guidelines; and

     (c) Has current written approval of the DLR director.

[]

     (1) There is an exterior door(s) that ensures egress when the building needs to be evacuated;

     (2) The time-delay mechanism(s) automatically unlocks when the fire alarm goes off;

     (3) The licensee has approval from the DLR licensor stating that the program is in compliance with the children's administration's behavior management guidelines; and

     (4) The licensee has current written approval of the DLR director.

[]

     (2) The CPA case manager ((will)) must furnish a copy of the incident report to the child's DCFS social worker and DLR licensor.

     (((2))) (3) For group care programs and all staffed residential homes, the director or program supervisor must:

     (a) Review any incident with the staff who used physical restraint to ensure that the decision to use physical restraint and its application were appropriate; and

     (b) Report the incident if it meets criteria in WAC 388-148-0120.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0490, filed 8/28/01, effective 9/28/01.]

     (1) ((To receive a foster home license, you must)) Attend required orientation and preservice training programs that the department sponsors, or that your licensed child-placing agency offers((.)); and

     (2) ((You need proof of completion of current first-aid/CPR training that is geared for the ages of the foster children you want in your home.

     (3) You need proof of completion of HIV/AIDS training.

     (4) The primary care givers must)) Complete all other required DLR-approved training after licensing.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0520, filed 8/28/01, effective 9/28/01.]

     (2) In a two-parent household, the maximum number of children in your home ((is restricted to)) may be no more than six children, including your own children.

     (3) In a single parent household, the ((total)) maximum number of children in your home ((is restricted to)) may be no more than four children, including your own children.

     (4) A home may at the discretion of the department be licensed for the care of at least one child when the foster parent(s) have more of their own children than specified in subsection (2) and (3) of this section, if they meet the other licensing requirements.

     (5) You may have only two children under two years of age in your home at a time. This includes foster children and your own children.

     (6) The capacity restrictions in this section may at the discretion of the department be exceeded in extraordinary situations, such as to place a sibling group, to place a child with a relative, or because the foster family has demonstrated exceptional abilities in relation to the special needs of a foster child, if this appears to be in the best interest of the child and would not jeopardize the health and safety of the other children in the home. Approval to exceed the capacity restrictions must be in writing and signed by the DLR manager or designee.

     (7) The department may license a foster home for up to three medically fragile foster children ((with mental or physical disabilities)) that are severe enough to need semi-skilled maintenance or supportive services if:

     (a) Your training and/or experience qualifies you to provide proper care;

     (b) The children's treatment requires nursing service oversight; and

     (c) The maximum number of medically fragile children ((with mental or physical disabilities)) in your home is three or fewer; and

     (d) You have a written plan on how you will evacuate children in case of fire or other emergency.

     (8) The department may license a foster family for up to two nonmobile children.

     (9) While providing respite care, you may only exceed the number of children you are licensed to serve with prior approval by the DLR director or designee.

     (10) The department may license a foster home to serve up to four children with developmental disabilities as defined in RCW 71A.10.020, at any one time.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0525, filed 8/28/01, effective 9/28/01.]

     Reviser's note: RCW 34.05.395 requires the use of underlining and deletion marks to indicate amendments to existing rules. The rule published above varies from its predecessor in certain respects not indicated by the use of these markings.FOSTER HOMES -- FOSTER PARENT EMPLOYMENT AND RESPITE
AMENDATORY SECTION(Amending WSR 01-18-037, filed 8/28/01, effective 9/28/01)

WAC 388-148-0535   Do I need to have income separate from foster care payments?   You must have sufficient regular income, at least, an amount that meets current TANF standards for the number of persons in your home, to maintain your own family, without the foster care payments made for the children in care.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0535, filed 8/28/01, effective 9/28/01.]

     (2) Respite care may be arranged in advance or on an emergency basis.    

     (3) Respite care may be arranged to support the care a foster parent is providing or to provide substitute care in the absence of foster parents.

     (4) Respite care given outside the foster parent's home must be provided by licensed providers.

     (5) While providing respite, licensees must not exceed their licensed capacity and must maintain compliance with the licensing requirements.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0540, filed 8/28/01, effective 9/28/01.]

     (a) Has a criminal or founded child abuse or neglect history that would disqualify them from caring for a department child; or

     (b) Would be a risk to the foster child while in the substitute's care.

     (2) Occasionally, and for less than twenty-four hours, a foster parent, at their own expense, may allow a friend, or a relative to provide care to a foster child in the foster home when the conditions that follow are met. The foster parent must:

     (a) Be familiar and comfortable with the individual who will be caring for the foster child;

     (b) Meet with the substitute caregiver and review the expectations regarding supervision and discipline of the foster child, including the requirement that no physical discipline is used on foster children;

     (c) Be responsible for providing the caregiver any special care instructions;

     (d) Provide information on how to be contacted by the substitute caregiver; and

     (e) Ensure the child has a safety plan.

     (3) If the care by the friend or relative is a regular arrangement, the foster parents must have written approval of the social worker for the arrangement and provide the social worker with evidence from the substitute caregiver of:

     (a) Current first aid and age-appropriate CPR training;

     (b) HIV/AIDS and blood borne pathogens training;

     (c) A nondisqualifying background check; and

     (d) A tuberculosis test.

[]

     (a) The foster parent knows the youth babysitter to be reliable and mature enough to provide appropriate care to the foster child.

     (b) The youth babysitter has completed a background check within the past year. Exception: For occasional care of less than twenty-four hours, the verification of the background check is not required, as provided in WAC 388-148-0541 (1)(a)(b).

     (c) The youth babysitter must not be responsible for more than three children.

     (2) If the care by the youth babysitter is a regular arrangement, the foster parents must have the written approval of the social worker and provide the social worker with evidence from the youth babysitter of:

     (a) Current first aid and age-appropriate CPR training;

     (b) HIV/AIDS training including blood borne pathogens training;

     (c) A nondisqualifying background check; and

     (d) A tuberculosis test.

[]

     (2) The social summary must serve as the basis of the child's admission to care.

     (3) If a child needs to be accepted for emergency care, such as placement in a crisis residential center, the department does not require the social study to be completed prior to admission. In these cases, if the child remains in care beyond thirty days, a summary must be completed as soon as possible.

     (4) The study must contain the following information for the child:

     (a) Copies of psychological or psychiatric evaluations, if any, on the child under care.

     (b) A narrative description of the child's background and family that identifies the immediate and extended family resources;

     (c) The child's interrelationships and the problems and behaviors that have required care away from his or her own home;

     (d) The child's primary and alternate permanency plan;

     (e) Previous placement history, if any; and

     (f) An evaluation of the child's need for the particular services and type of care you provide.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0555, filed 8/28/01, effective 9/28/01.]

     (2) The treatment plan must:

     (a) Identify the service needs of the child, parent or guardian;

     (b) Describe the treatment goals and strategies for achieving those goals;

     (c) Include a running account of the treatment received by the child and others involved in the treatment plan, such as any group treatment or individual counseling; and

     (d) Be updated at least quarterly to show the progress toward meeting goals and list barriers to the permanent plan.

     (3) A social service staff person must review and sign approving the child's treatment plan.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0560, filed 8/28/01, effective 9/28/01.]

     (((1))) (a) One person who provides social services must have a master's degree in social work or a closely related field from an accredited school.

     (((2))) (b) Social service staff without a master's degree in social work or closely related field must have a bachelor's degree in social work or a closely related field from an accredited school. A person with a master's degree must consult ((at least eight hours per month)) with any social service staff who ((have)) has only a bachelor's degree one hour for every twenty hours the staff person works.

     (((3))) (2) When social services are provided by another agency, you must have a written agreement with the agency describing the scope of service they provide. ((Written agreements must meet the requirements of this rule.

     (4) A social service staff person must review and sign approving the child's treatment plan.

     (5) A social service staff person must review and sign approving licensing application packets before they are submitted to DLR.))

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0585, filed 8/28/01, effective 9/28/01.]

     (a) A master's degree from a recognized school of social work or ((similar academic training in the)) closely related field ((they will be advising));

     (b) The training, experience, knowledge and demonstrated skills in each area that he or she will be supervising or advising; and

     (c) The ability to ensure ((your)) staff develop their skills and understanding needed to effectively manage their cases.

     (2) Consultants may be hired as staff or operate under a contract with ((your)) the program.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0600, filed 8/28/01, effective 9/28/01.]

     (1) If you have five or more employees or volunteers, your training plan must be in writing.

     (2) You must discuss with the staff your policies and procedures as well as the rules contained in this chapter.

     (3) You must provide or arrange for your staff to have training for the services that you provide to children under your care.

     (4) Your training on behavioral management must be approved by DLR and must include nonphysical age-appropriate methods of redirecting and controlling behavior, as described in ((the department's)) children's administration's guidelines on behavior management ((policy)).

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

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

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0605, filed 8/28/01, effective 9/28/01.]

Type of ((Program)) Facility	Minimum Ratio of Full-Time Social Service Staff to Children Under Care
Day treatment program	1	to	15
Group homes	1	to	25
Child-placing agency	1	to	25
Maternity services	1	to	25
Regular and secure crisis residential centers	1	to	5

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0610, filed 8/28/01, effective 9/28/01.]

     (b) Food preparation does not produce smoke or grease-laden vapors)) licensed for six children meet the facility fire and life safety requirements as developed by the chief of the Washington state patrol through the director of the fire protection bureau.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0620, filed 8/28/01, effective 9/28/01.]

     (5) Single-station smoke detectors must be tested at monthly intervals or in a manner specified by the manufacturer. Records of such testing must be maintained upon the premises)) that are UL or Factory Mutual approved.

     (2) Smoke detectors must have a strobe and be in compliance with the Americans with Disabilities Act (ADA).

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0625, filed 8/28/01, effective 9/28/01.]

     (1) You and your staff must be familiar with all aspects of the fire drill.

     (2) You and your staff must be able to:

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

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

     (c) Conduct frequent inspections of the home or facility to identify fire hazards and take action to correct any hazards noted during the inspection.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0640, filed 8/28/01, effective 9/28/01.]

     (((2))) You must maintain a written record on the premises that indicates the date and time that all drill practices were completed.

     (2) Single-station smoke detectors must be tested monthly or in a manner specified by the manufacturer. You must maintain a written record of such testing on the premises that indicates the date and time the test was completed.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0645, filed 8/28/01, effective 9/28/01.]

     (2) If ((a)) the same facility ((is certified by the department of health, such as a secure residential treatment center, the facility must meet construction and fire safety standards for psychiatric hospital security rooms when they have a secure CRC or a secure residential treatment center within the physical structure)) has multiple Washington state licenses the licensee must notify:

     (a) The Washington state patrol fire protection bureau inspector; and

     (b) All of the licensing and certification agents.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0655, filed 8/28/01, effective 9/28/01.]

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0660, filed 8/28/01, effective 9/28/01.]

     (((1))) (a) Group ((home)) residential programs;

     (((2))) (b) Independent living skills programs;

     (((3))) (c) Maternity services;

     (((4))) (d) Services to children with severe developmental disabilities and medically fragile children; ((and

     (5))) (e) Crisis residential centers and secure crisis residential centers; ((and

     (6))) (f) Group receiving centers; and

     (g) Day treatment programs. Day treatment programs are considered group care programs under this chapter, though they are not twenty-four-hour residential programs.

     (2) If your group care facility provides services named in WAC 388-148-0670 (1)(c) through (g) you will need to comply with the licensing requirements specific to those programs. A license may be issued for that specific type of care, such as a crisis residential center in addition to the group care license.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0670, filed 8/28/01, effective 9/28/01.]

     (a) Have behavior that cannot be safely or effectively managed in foster care;

     (b) Need temporary placement awaiting a more permanent placement;

     (c) Need emergency placement during a temporary disruption of a current placement;

     (d) Have emotional, physical, or mental disabilities; ((or))

     (e) Need a transitional living setting;

     (f) Need respite care from a licensed provider; or

     (g) Are age sixteen or older and need to acquire independent living skills.

     (2) If your group care program serves children with severe developmental disabilities, medically fragile children, maternity services, or is a group receiving center or meets RCW 74.15.020 (2)(m), the children may be younger than six years of age.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0685, filed 8/28/01, effective 9/28/01.]

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0695, filed 8/28/01, effective 9/28/01.]

     (((a))) (1) Be able to communicate to the department the roles, expectations and purposes of the program; ((and

     (b))) (2) 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 social science or closely related field from an accredited school; or

     (b) Have a minimum of two years of successful, full-time relevant experience, such as working in a group care facility; or

     (c) Have a minimum of two years as a foster parent with a letter of recommendation from the licensing agency and supervising agency)); and

     (3) Have appropriate education and four years of successful experience with similar duties and responsibilities for the administration oversight, and fiscal management of an agency.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0700, filed 8/28/01, effective 9/28/01.]

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0705, filed 8/28/01, effective 9/28/01.]

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

     (2) Supervises the child care staff;

     (3) Oversees the completion of each child's plan of care and treatment.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0710, filed 8/28/01, effective 9/28/01.]

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

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

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

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

     (((5))) (2) The same person may have the responsibilities of the executive director and the group care on-site program manager, social service staff or a CPA program manager, if that person meets the qualifications for both positions.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0715, filed 8/28/01, effective 9/28/01.]

[]

     (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.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0720, filed 8/28/01, effective 9/28/01.]

     (2) The health care staff must maintain their certification or licensure as required by the department of licensing.

[]

     (1) The ratio for group ((homes)) care is at least one child care staff member on site for every eight children during waking and sleeping hours.

     Note: Crisis residential centers, group receiving centers, staffed residential homes, maternity programs, and programs for children with severe developmental disabilities have different requirements.

     (2) At least two adults, including at least one child care staff person, must be on site whenever more than eight children are on the premises.

     (3) To keep the proper ratio of staff to children, the executive director, health care staff, on-site program manager, support staff and maintenance staff may serve temporarily as child care staff if they ((have adequate)) meet all other child care staff qualifications and training.

     (4) During sleeping hours of youth, at least one staff person must be awake in all group home programs when:

     (a) There are more than six youth in care; and

     (b) The major focus of the program is behavioral change rather than the development of independent living skills, such as teen parent and independent living skills programs; or

     (c) The youth's behavior poses a safety risk to self or others.

     (5) When only one child care staff is on site, a second staff must be on call.

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

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

     (8) For ((certified)) juvenile detention facilities certified as meeting the minimum licensing requirements, at least one child care staff member must be on duty for every ten children in care during the sleeping and waking hours.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0725, filed 8/28/01, effective 9/28/01.]

     (1) You must provide rooms that are ample in size and properly furnished for the number of children you serve.

     (2) You must have a comfortably furnished living room.

     (3) You must have a dining room area that is ample in size and suitably furnished for your residents.

     (4) Juvenile detention facilities, certified as meeting the licensing requirements, are not required to meet these first three standards, (WAC 388-148-0730 (1)(2)(3)).

     (5) With more than twelve 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 to engage in recreational and informal education activities.

     (6) 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.

     (7) You must provide a space that can be used as a visiting area.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0730, filed 8/28/01, effective 9/28/01.]

     Reviser's note: RCW 34.05.395 requires the use of underlining and deletion marks to indicate amendments to existing rules. The rule published above varies from its predecessor in certain respects not indicated by the use of these markings.
AMENDATORY SECTION(Amending WSR 01-18-037, filed 8/28/01, effective 9/28/01)

WAC 388-148-0750   What maternity services must I provide?   If you operate a licensed program for expectant mothers and new mothers with infants, you must provide or arrange for the following services:

     (1) Information and referral services to every expectant and new mother who applies for care.

     (2) Individual or group counseling sessions, if necessary, about the following topics:

     (a) Pregnancy counseling;

     (b) Independent living education;

     (c) Infant and child care training;

     (d) Living arrangements;

     (e) Medical care planning;

     (f) Legal issues;

     (g) Vocational or educational guidance;

     (h) Plans for the child;

     (i) Financial, emotional or psychological problems;

     (j) Relations with parents and birth father; and

     (k) Home management and consumer education.

     (3) An expectant mother's delivery in a licensed hospital or licensed birthing facility.

     (4) Postpartum medical examinations, as prescribed by a physician, to a new mother.

     (5) Childcare, as needed.

     (6) Case management services.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0750, filed 8/28/01, effective 9/28/01.]

     (1) ((Pregnancy)) Hygiene;

     (2) Suitable preparation for childbirth;

     (3) The physiological changes during pregnancy;

     (4) Examinations and childbirth procedures;

     (5) Postnatal and pediatrics care;

     (6) Contraception and family planning;

     (7) Nutritional requirements for mother and child;

     (8) Child health and development; and

     (9) Psychological and emotional changes during and after pregnancy.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0765, filed 8/28/01, effective 9/28/01.]

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0775, filed 8/28/01, effective 9/28/01.]

     (1) These programs must employ sufficient numbers of residential staff to meet the physical, safety, health and emotional needs of the residents. Residential staff are in charge of supervising the day-to-day living situation for youth.

     Note: Child care staff may carry out any maintenance tasks that do not detract from their primary function.

     (2) When youth are on the premises, the ratio of staff to residents must be as follows:

     (a) At least one residential staff member must be on duty for every eight mothers.

     (b) When more than eight ((persons (including mothers and children))) mothers are on the premises, at least two adults, including at least one child care staff must be on duty.

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

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0785, filed 8/28/01, effective 9/28/01.]

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0795, filed 8/28/01, effective 9/28/01.]

     (2) Day treatment is for children who are:

     (a) Unable to adjust to school programs due to disruptive behavior, family stress, learning disabilities or other serious emotional disabilities; and/or

     (b) ((Are unable to profit from outpatient child guidance clinic services and related programs)) Have intensive needs, which can not be adequately met through out-patient community mental health services.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0800, filed 8/28/01, effective 9/28/01.]

     Note: The executive director and on-site program manager may be the same person if that person is qualified for both positions.

     (2) Either the executive director or on-site program manager must be on the premises while the children are in care. Another competent person may be left in charge during the director's and/or program supervisor's temporary absence.

     (3) The qualifications for executive director and on-site program manager are ((outline)) outlined in WAC 388-148-0700 and 388-148-0715, respectively.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0805, filed 8/28/01, effective 9/28/01.]

     (1) Receive regular consultation from a child psychiatrist;

     (2) Provide or arrange for a psychologist for psychological testing and related services if the child's school does not provide these services;

     (3) Provide or arrange for teaching by certified teachers qualified by training or experience in remedial education; and

     (4) Use group counselors who are qualified by training or by experience in the care of emotionally disturbed children.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0810, filed 8/28/01, effective 9/28/01.]

     (a) An individualized treatment plan suited to the unique needs of each child in care; and

     (b) Care by physicians, including surgeons, general and family practitioners, and specialists in the child's particular diagnosis on either a referral, consultative, or ongoing treatment basis.

     (2) You must also provide the following nursing services, if prescribed by a physician, if you care for medically fragile children, or children with severe developmental disabilities unless these children are in a foster home:

     (a) Sufficient licensed nursing staff to meet the nursing care needs of the children; or

     (b) Regular nursing consultation that includes at least one weekly on-site visit by a registered nurse.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0830, filed 8/28/01, effective 9/28/01.]

     (1) If you are licensed to care for thirteen or more children, you must provide separate, safe play areas for children ((under)) less than one year ((of age)) or children not walking. The department must approve the rooms or areas.

     (2) Children ((under)) less than one year ((of age)) must be cared for in rooms or areas separate from older children.

     (3) No more than eight children ((under)) less than one year of age may be in the room at a time.

     (4) Hand-washing facilities must be available ((in these rooms)) nearby.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0860, filed 8/28/01, effective 9/28/01.]

     (a) Information you received upon admission including family background, current diagnosis and medical status, an inventory of personal belongings, medical history, and a report of a physical examination and diagnosis by a physician;

     (b) Information about the child's daily care including treatment plans, medications, observations, medical examinations, physicians' orders, allergic responses, consent authorizations, releases, diagnostic reports, and revisions of assessments;

     (c) Upon discharge, a summary including diagnoses, treatments, and prognosis by the person responsible for providing care, and any instructions and referrals for continuity of care; and

     (d) Evidence of meeting criteria for eligibility for services from the division of developmental disabilities.

     (2) If the child has died, you must also have the following information:

     (a) The time and date of death;

     (b) Apparent cause of death;

     (c) Notification of the physician and relevant others (including the coroner if necessary); and

     (d) Regarding the disposal of the child's body and how the child's personal effects will be dealt with.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0870, filed 8/28/01, effective 9/28/01.]

     (2) A foster home may be licensed as a family CRC. The foster home licensed, as a CRC, must meet the licensing standards for foster homes outlined in this chapter.

     (3) Family CRCs and regular CRCs are not locked facilities, but are operated in a way that reasonably assures that youth placed there will not run away.

     Note: Regular CRCs are also known as semi-secure CRCs, as referred to in RCW 13.32A.030 (((13) and (14)))(16).

     (4) A secure facility is designed and operated to prevent a youth from leaving without permission of the staff. ((This facility has locking doors, locking windows, or secured perimeters.))

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0875, filed 8/28/01, effective 9/28/01.]

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0880, filed 8/28/01, effective 9/28/01.]

     (1) Be a free-standing facility, separate unit, or separate building within a campus with windows and exterior doors that prevent exit.

     (2) Meet or exceed the current state building code when locking doors and windows prevent exit.

     (3) Ensure that no youth is kept in a locked room that isolates the youth from the general population and/or staff.

     (4) Maintain a recreation area, within the secured facility or secured on the property of the facility, that can support youth's vigorous physical activity. ((())Any fences used to secure the recreation area must meet or exceed the specifications of the level-two CRC referenced in WAC 388-148-0890(3)(())).

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0885, filed 8/28/01, effective 9/28/01.]

     (1) ((Prevent)) Be a free-standing facility, separate unit, or separate building within a campus that prevents unauthorized entering and exiting with a nonscalable fence around the perimeter of the facility property;

     (2) Not prevent exit by locking facility doors or windows;

     (3) Design the nonscalable fence so that it does not cause injury, such as avoiding use of electrification, razor wire or concertina wire;

     (4) Ensure that no youth is kept in a locked room that isolates him or her from the general population and/or staff; and

     (5) Maintain a recreation area surrounded by a nonscalable fence that can support youth's vigorous physical activity.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0890, filed 8/28/01, effective 9/28/01.]

     (1) Be a free-standing facility, separate unit or separate building within a campus with exterior doors that have special egress-control devices;

     (2) Meet or exceed the current state building code for facilities with special egress-control devices; and

     (3) Maintain a recreation area, within the secured facility or secured on the property of the facility, that can support youth's vigorous physical activity. Any fences used to secure the recreation area must meet or exceed the specifications of the level-two secure CRC referenced in WAC 388-148-0890(3).

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     (2) Staff assigned to the secure crisis residential center youth must not be simultaneously assigned to the juvenile detention center residents on the same shift.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0895, filed 8/28/01, effective 9/28/01.]

     All CRCs

     A crisis residential center (CRC) provides emergency, temporary residence to youth ages twelve through seventeen who meet one of the following criteria:

     (1) Are beyond the control of their parents or guardians and behave in a way that endangers any person's welfare;

     (2) Need assistance getting food, shelter, health care, clothing, educational services, and/or resolving family conflicts;

     (3) Need temporary protective custody; or

     (4) Have parents who are not able or willing to continue efforts to keep the family together.

     Secure CRCs

     (5) Youth ordered by the court to serve time for contempt on CHINS, ((APY)) ARP, or truancy orders may be ordered into a secure CRC that is co-located with a detention facility.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0900, filed 8/28/01, effective 9/28/01.]

     (1) Are runaways;

     (2) Are in dangerous situations; or

     (3) Are in violation of curfew.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0905, filed 8/28/01, effective 9/28/01.]

     All CRCs

     (1) The director or designee of a crisis residential center (CRC) must immediately notify the parents of the youth who has been admitted.

     (2) If the director or designee of any CRC is unable to contact the youth's parents within, forty-eight hours, he or she must:

     (a) Contact the department and request that the case be reviewed for dependency filing under chapter 13.34 RCW or "child in need of services" filing under chapter 13.32A RCW; and

     (b) Document the contact with the department in the youth's case record.

     Secure CRCs

     (3) Within the first twenty-four hours after admitting a youth to a secure crisis residential center, and each twenty-four hours after, the director or designee must assess the youth's risk of running.

     (4) The secure CRC director or designee must determine what type of CRC, regular or secure, would be best for the youth.

     (5) The secure CRC director or designee must use the following criteria in making the decision, considering the safety, health and welfare of the youth and others:

     (a) The youth's age and maturity;

     (b) The youth's physical, mental, and emotional condition upon arrival at the center;

     (c) The circumstances that led to the youth's placement at the facility;

     (d) The youth's behavior;

     (e) The youth's history of running away;

     (f) The youth's willingness to cooperate in conducting the assessment;

     (g) The youth's need for continued assessment, protection, and intervention services in a CRC; and

     (h) The likelihood the youth will remain at a CRC.

     (6) The secure CRC director or designee must put the decision about the youth's status in writing in the youth's file.

     (7) After a youth is admitted, the secure CRC director or designee must ensure that a youth is assessed for any health needs requiring immediate attention.

     (8) By the first school day after admission, the crisis residential center staff must:

     (a) Notify the youth's school district about the youth's placement; and

     (b) Assess the youth for any educational needs as a part of the assessment process for inclusion in the discharge summary.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0915, filed 8/28/01, effective 9/28/01.]

     Regular CRCs

     (2) At all times, regular crisis residential centers must have at least one youth care staff on duty for every four youth in care when youth are present.

     (3) Regular crisis residential centers must have at least two awake youth care staff on duty during waking hours of the youth when youth are present.

     (4) Regular crisis residential centers must have at least one awake youth care staff on duty during sleeping hours of the youth. One or more additional (back-up) staff must be on the premises during sleeping hours to maintain staffing ratios.

     Under extraordinary circumstances, the DLR director may approve an alternative back-up plan.

     Secure CRCs

     (5) At all times, secure crisis residential centers must have at least two staff on duty ((at all times)) when youth are present.

     (6) At all times, secure crisis residential centers not co-located with a detention center must have at least one youth care staff on duty for every three youth in care.

     (7) At all times, secure crisis residential centers that are located in the same facility as a detention ((facilities)) center must have ((the)) at least one awake youth care staff on duty for every four youth in care.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-0995, filed 8/28/01, effective 9/28/01.]

     (2) The program description must include but is not limited to:

     (((1))) (a) The number of children served at one time;

     (((2))) (b) The expectations of services to be provided;

     (((3))) (c) The steps to be taken to include the child's family;

     (((4))) (d) The plan on how coordination will occur with community partners;

     (((5))) (e) The plan on how permanency planning for the children will take place;

     (((6))) (f) A safety and supervision plan for each child; and

     (((7))) (g) A behavior management plan for each child, as appropriate.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-1025, filed 8/28/01, effective 9/28/01.]

     (2) You must provide ((care)) a safety and supervision plan for children you serve ((in a staffed residential home,)) considering their ages and physical conditions.

     (3) ((You must submit a written program description for department approval that includes:

     (a))) A list of services that you will provide to children and their families must include but is not limited to:

     (a) The steps to be taken to include the child's family in the services;

     (b) Who and how these services will be carried out; and

     (c) A schedule of typical daily activities for the children under your care.

     (4) Services for children must include:

     (a) Transportation;

     (b) Teaching social and living skills;

     (c) Opportunities for play and recreation; and

     (d) Opportunities to participate in community and cultural activities.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-1030, filed 8/28/01, effective 9/28/01.]

     (1) The major focus of the program is behavioral rather than the development of independent living skills such as a teen parent program or responsible living skills program; and

     (2) ((The)) A youth's behavior poses a risk to self or others.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-1035, filed 8/28/01, effective 9/28/01.]

     (2) To keep the proper ratio of staff to children, the director, support staff and maintenance staff may serve as child care staff if they have adequate training.

     (3) The ratio for staffed residential homes is, at least, one child care staff for every six children during waking hours of children.

     (4) During sleeping hours of youth, at least, one staff person must be awake when:

     (a) There is a written supervision agreement or a contract with the department of social and health services specifying an awake staff is needed for either the program or a specific child; ((or))

     (b) ((The)) A youth's behavior poses a safety risk to self and/or others; or

     (c) A child's medical condition requires constant monitoring.

     (5) The need for overnight supervision must be documented in each child's treatment plan, if awake supervision is necessary.

     (6) You may only be licensed for maximum of three pregnant or parenting youth.

     (7) When only one child care staff person is on duty, a second person must be on call and available to respond within one half-hour.

     (8) You must have relief staff so that all staff can have the equivalent of two days off a week. This is not required for family members if the staffed residential home is a family residence.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-1045, filed 8/28/01, effective 9/28/01.]

     (1) The department may license a staffed residential home for six or fewer children. The ((total)) maximum number of children in your home or facility must not exceed six at any time.

     (2) The department may restrict the number of children in a staffed residential home according to the age and needs of the children.

     (3) If only one staff person is on duty at a staffed residential home providing maternity services, that home must not care for more than four persons under the age of eighteen. An additional staff person is required to care for more than four ((children)) persons under the age of eighteen.

     (4) Except for maternity program, you may have only two children under two years of age in your home at a time.

     (5) The department may license a staffed residential home for up to three children with mental or physical disabilities that are severe enough to require nursing care if you meet the following conditions:

     (a) You provide staff that are qualified by training and experience to provide proper care, including necessary medical procedures; and

     (b) The children's treatment is under the supervision of physicians.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-1050, filed 8/28/01, effective 9/28/01.]

     (1) Certification of eligible foster homes meeting full licensing requirements, including respire care foster homes;

     (2) Maternity services to expectant mothers;

     (3) Specialized (treatment) foster care;

     (4) Residential care programs, such as group homes, crisis residential centers, and independent living skills programs; and

     (5) Adoption services.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-1060, filed 8/28/01, effective 9/28/01.]

     (1) Permission from the child's parent or legal guardian authorizing the placement of the child;

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

     (3) Permission to transport the child;

     (4) Basic family information, including address, telephone numbers, and emergency contacts; and

     (5) Basic medical information, including current medication, immunization history (if available), known allergies, and at-risk behaviors of the child.

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     (3) When the child is being placed for adoption, your report must not contain information that might identify the birth parents)) that meets the federal and state statutes on full disclosure of health information.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-1070, filed 8/28/01, effective 9/28/01.]

     (1) The executive director of a child-placing agency must meet the executive director qualifications outlined for programs and agencies in WAC 388-148-0700.

     (2) A program manager/social service staff for a child-placing agency must meet the program manager qualifications outlined in WAC 388-148-0715.

     (3) A consultant for a child-placing agency must meet the consultant qualifications outlined in WAC 388-148-0600.

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

     (2) Have a bachelor's degree in social services or related field; or

     (3) Four years of relevant full-time experience serving children may be substituted for the bachelor's degree with DLR administrative approval.

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     (2) A foster home must be certified by your child-placing agency as meet the licensing requirements your child-placing in order to be licensed by the department.

     (3) A social service staff person must review and sign approving the foster home licensing application packet before the application is submitted to DLR.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-1085, filed 8/28/01, effective 9/28/01.]

     (2) You must)):

     (a) Comply with federal and state adoption and adoption support laws and policies;

     (b) Recruit potential adoptive families that reflect the diversity of children in your community((.

     (3) You must)); and

     (c) Provide adoptive applicants with the following services, at a minimum:

     (((a))) (i) Information about the adoption process;

     (((b))) (ii) Adoption support programs;

     (iii) Your agency's policies, practices and legal procedures;

     (((c))) (iv) Types of children available for adoption and implications for parenting different types of children; and

     (((d))) (v) Information on adoption support programs.

     (((4))) (2) You must document that you provided this information to the adoptive applicant in the applicant's file.

     (3) You must have contact with each adoptive home of all adoptive placements at least once every thirty days, until the adoption is finalized. Contact may include a home visit, telephone call, or office visit.

     (4) Every ninety days you must complete a face-to-face visit in the adoptive home to observe the parent and child and complete a health and safety check.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-1115, filed 8/28/01, effective 9/28/01.]

     (1) The applicants must submit an application (including a completed background inquiry form) to the child-placing agency.

     (2) Once you have received an application, but before you ((have)) sign a contract for services, you must give the applicants a written statement about:

     (a) The adoption agency's fixed fees and fixed charges to be paid by the applicant;

     (b) An estimate of additional itemized expenses to be paid by applicant; and

     (c) Specific services covered by fees that you offer for child placement or adoption.

     (3) Your staff must complete an adoptive home study as required in RCW 26.33.190 with the participation of the applicant(s). For the study, your staff and the applicants ((need to decide about)) must decide the following:

     (a) The suitability of the applicant(s) to be adoptive parent(s) including completion of background checks of the applicant(s) independent of the department; and

     (b) The type of child(ren) for which the applicant or applicants are best suited.

     (4) Your staff must accept or deny the application and give an explanation for your decision.

     (5) You must file preplacement (home study) reports with the court (as required by RCW 26.33.180 through 26.33.190).

     (6) Your staff must prepare the potential adoptive parent(s) for placement of a specific child by:

     (a) Locating and providing information about the child and the birth family to the prospective adoptive family ((as described in chapter 388-25 WAC)) provided under federal and state statute;

     (b) Discussing the likely implications of the child's background for adjusting in the adoptive family.

     (7) Your staff must reevaluate the applicant(s) suitability for adopting a child each time an adoptive placement is considered.

     (8) You must advise the family of the existence of the adoption support program and procedures for applying.

[Statutory Authority: RCW 74.15.030. 01-18-037, § 388-148-1120, filed 8/28/01, effective 9/28/01.]

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

     (3) Arrange for or provide transportation for each school-age child in care to attend school.

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     (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 or other weapons, alcohol, tobacco, or illegal drugs within the facility; and

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

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

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     (a) Presentation of the group receiving centers policies and procedures as well as 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 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 identification;

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

     (l) Monthly fire drill proactive 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' file or in a separate training file.

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     (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 age 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) If a DLR-approved safety plan addressing the age groups is in effect, the center may provide care for more than one of the following age groups:

     (a) Age two through five;

     (b) Six through twelve; and

     (c) Thirteen through seventeen.

     (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, if the same staff are supervising both programs.

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

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

     (4) 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.

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

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

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     (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 the children.

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     (a) Adequate area for the child play; and

     (b) Sufficient space to house a developmentally appropriate program.

     (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.

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     (2) The fenced or approved enclosed outdoor recreation 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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     (2) If not all of the children are using the outdoor recreation area at the same time, you may reduce the size to the number of children normally using the area at one time.

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

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

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     The following sections of the Washington Administrative Code are repealed:

WAC 388-148-0285	Do I need a housekeeping sink?
WAC 388-148-0360	Whom do I notify about medication changes and reactions?
WAC 388-148-0450	What types of toys must I provide to children?
WAC 388-148-0500	May I receive more than one in-home care license?
WAC 388-148-0615	Are there specific fire safety requirements for the care of nonmobile children?
WAC 388-148-0630	What fire prevention measures must I take?
WAC 388-148-0635	What are the requirements for fire sprinkler systems?
WAC 388-148-0650	What requirements do you have regarding windows in staffed residential homes and group care facilities?
WAC 388-148-0735	When do I need a special care room?
WAC 388-148-0935	How long may a youth stay at a CRC?
WAC 388-148-1020	Must a staffed residential home operate in conjunction with another program?
WAC 388-148-1065	Do child-placing agency foster homes and group care facilities need to be licensed before placements?

© Washington State Code Reviser's Office