Purpose: Adopting new chapter 388-147 WAC, Licensing requirements for pregnant and parenting teen programs and facilities is a set of new rules providing appropriate minimum licensing requirements for independent living facilities where teen families live in apartment-like settings. The WAC requirements appropriately fit this type of independent-living group residential care, while providing safe comfortable housing, basic case management services, and independent-living skills development.

     Statutory Authority for Adoption: RCW 74.15.030.

     Other Authority: Chapter 74.15 RCW.

      Adopted under notice filed as WSR 04-18-045 on August 26, 2004.

     A final cost-benefit analysis is available by contacting Jean L. Croisant, P.O. Box 45710, Olympia, WA 98504-5710, phone (360) 902-7992, fax (360) 902-7903, e-mail loje300@dshs.wa.gov. No changes were made. The preliminary cost-benefit analysis will be final.

     Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 72, Amended 0, Repealed 0.

     Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0;      Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 72, Amended 0, Repealed 0.

     Date Adopted: December 8, 2004.

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

     (2) The rules in this chapter are the minimum licensing requirements for residential programs for pregnant and parenting teens, age sixteen and seventeen and their children.

     (3) The department issues or denies a license on the basis of compliance with the minimum licensing requirements contained in this chapter.

     (4) Nothing is this chapter is intended to deny any individual access to services or the rights afforded him or her under other Revised Codes of Washington (RCW).

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     The department is committed to ensuring that the pregnant and parenting teens and their children who receive residential care experience health, safety, and well-being. Our licensing requirements reflect our commitment to children and youth.

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

     "Agency" as defined in RCW 74.15.020 (1)(a) through (k).

     "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 residential services to children and youth.

     "Case manager" means an agency employee who coordinates and links the youth to appropriate services.

     "Children" mean individuals who are under eighteen years old and are the children of the teen resident.

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

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

     "DLR" means the division of licensed resources.

     "DOH" means the department of health.

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

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

     "Hearing" means the administrative review process.

     "I" refers to anyone who is licensed, operates, or owns a facility for pregnant and parenting teens and their children.

     "Infant" means a child less than one year of age.

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

     "Licensee" means the individual or agency that is responsible for the operation of the program and health and safety of the facility.

     "Licensor" means a division of licensed resources (DLR) employee, children's administration of DSHS who:

     (1) Approves licenses for pregnant and parenting teen programs/facilities; and

     (2) Monitors facilities to ensure that they continue to meet minimum licensing requirements.

     "Maternity service" means an agency which provides or arranges for care or services to expectant mothers, before or during confinement, or which provides care as needed to mothers and their infants after confinement, as defined in RCW 74.15.020. Maternity services, in this chapter refer to services to youth who are less than eighteen years.

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

     "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 action to an individual or agency that has previously been issued a full license but is out of compliance with the minimum licensing requirements.

     "Provide care" to youth means the agency makes available residential services including case management to a client.

     "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.

     "Resident" means the pregnant or parenting teen and her child or children.

     "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 teen and the teen's child or children.

     "Social service staff" means a clinician, program manager, case manager, consultant, contractor, or other staff person who is an employee of the agency or hired to develop and implement the child's individual service plans.

     "Staff" means employees, interns, volunteers, or any individual operating under the auspices of the agency providing services to pregnant and parenting teens and their children.

     "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" is the name for the agency popularly known as the state fire marshal.

     "We" or "our" refers to the department of social and health services, including division of licensed resources (DLR) licensors.

     "You" refers to the licensee or anyone who owns or operates a program/facility for pregnant and parenting teens and their children.

     "Youth" means the pregnant or parenting teen resident, age sixteen or seventeen.

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     Note: See definition of relatives exempt from licensing RCW 74.15.030(2).

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     (1) Able to demonstrate an understanding, ability, physical health, emotional stability and personality suited to meet the physical, mental, emotional, and social needs of the children and youth in care.

     (2) Must not have been disqualified by the department's background check (chapter 388-06 WAC) prior to having unsupervised access to children.

     (3) 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 the individual does not pose a risk to a child's safety, well being, and long-term stability.

     (4) Must not have been found to have committed abuse or neglect of a child or a vulnerable adult, unless the department determines that the individual does not pose a risk to a child's safety, well being, and long-term stability.

     (5) The department may require additional information from the applicant, employee, intern, or contractor. This information may be requested at any time and may include, but is not limited to:

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

     (b) Psychiatric and psychological evaluations;

     (c) Psycho-sexual evaluations; and

     (d) Medical evaluations and/or medical records.

     (6) Any evaluation requested under subsection (5) of this section will be at the applicant/licensees expense.

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

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     (1) To apply for a license, the person or legal entity responsible for the facility must include with the application the following:

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

     (i) A tuberculosis (TB) test or an x-ray, unless the individual can demonstrate a religious 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 residents in care; and

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

     (2) The completed background check forms on anyone on the premises having unsupervised access to children who is at least sixteen years old or older who is not a resident must be sent to the licensor. Note: See chapter 388-06 WAC.

     (3) A completed FBI fingerprint form must be completed on a licensee, staff, employee, and any individual having unsupervised access to residents, who has lived outside Washington state within the last three years.

     (4) Certificates of compliance from the department of health (DOH) and Washington state patrol fire protection bureau (WSPFPB) demonstrating the facility has met the requirements for health, fire and life safety are required prior to licensing. Both agencies perform inspections of the facility, including apartments, at licensing and re-licensing of the facility. Proper notice to apartment residents is required.

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     (2) If a licensee is applying for a license renewal, the application forms must be sent to the licensor at least ninety days prior to the expiration of the current license.

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     (2) Exceptions are approved for nonsafety requirements only.

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

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

     (5) The applicant or licensee must keep a copy of the approved exception to the licensing requirements for their files.

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

     (7) The applicant or licensee does not have appeal rights if the department denies your request for an exception to our requirements.

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     (2) The department 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.

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     (2) The department must, also, disqualify an applicant or licensee for any of the reasons that follow. The applicant or licensee:

     (a) Has been disqualified by the background check (see chapter 388-06 WAC).

     (b) Has been found to have committed child abuse or neglect or treated, permitted or assisted in treating children or vulnerable adults in care with cruelty, indifference, abuse, neglect, or exploitation, unless the department determines that the applicant or licensee does not pose a risk to a child or youth's safety, well-being, and long-term stability.

     (c) Tries to get a license by deceitful means, such as making false statements or omitting critical information on the application.

     (d) Commits, permits, or assists in an illegal act on the premises of a facility providing care to children and youth.

     (e) Uses illegal drugs, or excessively uses alcohol and/or prescription drugs.

     (f) Knowingly allows employees or volunteers who made false statements or omit critical information on their applications to work at the agency or facility.

     (g) Knowingly allows employees or volunteers who use illegal drugs, alcohol, or prescription drugs that affect their ability to perform their job duties to work at the agency or be on the premises of the facility when children/youth are present.

     (h) Repeatedly lacks qualified or an adequate number of staff to care for the number and types of children and youth under care.

     (i) Has refused to allow the department's authorized staff and inspectors to have requested information or access to the facility, youth or child, program files, and/or your staff. Any inspection requires appropriate tenant notice. Immediate access to client residence is in emergency situations only.

     (j) Are unable to manage the property, fiscal responsibilities, or staff of the agency.

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     (1) Exceeds the conditions of the facility license by:

     (a) Having more youth or children residing at the facility than the license allows;

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

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

     (d) Failing to comply with any of the other minimum licensing requirements.

     (2) Fails to meet the health and safety requirements to receive a certificate of compliance as required by the department of health or the Washington state patrol fire protection bureau.

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     (1) Has a disqualifying background check result (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, youth, or vulnerable adult with cruelty, indifference, abuse, neglect, or exploitation, unless the department determines that he or she does not pose a risk to a child or youth's safety, well being, and long-term stability;

     (3) Attempted to become employed, volunteer, or otherwise have unsupervised access to children or youth 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; or

     (4) Used illegal drugs, alcohol, or prescription drugs that affected his or her ability to perform his or her job duties while on the premises when children or youth are present.

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

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

     (3) The applicant or licensee must send a letter to the office of administrative hearings requesting an administrative hearing. The letter must have the following attachments:

     (a) A specific statement of the applicant or licensee's reasons for disagreeing with the department decision and any laws that relate to the reasons; and

     (b) A copy of the certified letter from the department that the applicant or licensee is disputing.

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

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     (1) Safe and stable housing;

     (2) An assessment of the family's need(s);

     (3) Referral to an authorized medical care provider for prenatal and postnatal medical care;

     (4) Case management services; and

     (5) The provision of direct services or referrals to services, as assessed and to the extent those services are available.

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     (2) Assistance may be offered in the broad categories of:

     (a) Parenting skills development and support (including instruction that includes the prohibition of spanking or the use of cruel or frightening discipline of her child by the teen parent);

     (b) Skills for independence (budgeting, comparative shopping, cooking, cleaning, etc);

     (c) Basic educational competencies (including assisting in developing or arranging for an educational plan for each youth in care who has not completed high school or the GED, support for regular school attendance, homework completion, and tutoring;

     (d) Employment preparation (including volunteer experiences, job interview skills, resume development, appropriate work environment behavior, vocational training etc.);

     (e) Interpersonal skills and health care (including education in nutrition, pregnancy prevention, sexually transmitted infections, substance abuse, health insurance, etc.);

     (f) Housing (including skills needed to be a good roommate, options for housing, rental agreements, landlord/tenant relationships, etc.); and

     (g) Developing significant support systems (identifying adults who can be a positive example and support in the future).

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     (2) The childcare home or center used by teen parents must be licensed, when licensing is a legal requirement, as outlined in chapter 74.15 RCW.

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     (2) You must keep records about children/youth and their families in a secure place.

     (3) If the information is available, your records must contain, at a minimum, the following:

     (a) The child and youth parent's name and birth date;

     (b) Information on the child's biological father;

     (c) Name and telephone number of the social worker for each child/youth in care, if the child or youth is in the custody of the department of social and health services;

     (d) Name, address, and telephone number of the teen's parent or person to be contacted in case of emergency;

     (e) Appropriate medical history including any current medical problems, type of medical coverage and provider(s);

     (f) Other pertinent information related to the child and youth's physical health, current mental and emotional health, and dental records.

     (4) The youth's records must contain a copy of the parent or legal guardian's consent to place or a court order that gives the licensed agency approval to house the youth.

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     (2) You must keep a log with background check information, containing dates of request and completion of the checks on all staff, interns, volunteers, and contractors.

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

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

     (2) Have relevant education or four years of successful experience with similar duties and responsibilities for the administration, oversight, and fiscal management of a program or an agency.

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

     (2) The individual with the master's degree must have:

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

     (b) The ability to ensure that staff develop the skills and understanding needed to effectively manage their cases.

     (3) The person with a master's degree must consult, with any social service or case management staff having a bachelor's degree or less of formal education, one hour for every eighty hours the staff person works.

     (4) Consultants may be hired as staff or operate under a contract.

     (5) When case management is provided by another agency, the licensee must have a written agreement with the agency describing the scope of service they provide.

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

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

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     (1) An assessment of the teen's circumstances and needs;

     (2) Assist in the development of an individual or family services plan with attainable goals;

     (3) Assisting with independent living skills development;

     (4) The coordination of services;

     (5) Monitoring of the progress of service plan;

     (6) Appropriate recordkeeping; and

     (7) Client advocacy.

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

     (2) Have the skills and abilities to work successfully with teens; and

     (3) Have effective communication and problem solving skills.

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     (1) Ensuring lease compliance by the residents; and

     (2) Responding to emergency situations, such as medical and fire emergencies when he or she is present at the facility.

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     (2) The approved first aid and CPR training must be provided by a certified instructor in accordance with a nationally recognized standard.

     (3) Records must be kept at the facility or readily available to the licensor showing who has completed current first aid and CPR training.

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     (2) The infection control requirements and educational material must be 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.

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     (2) Applicants for a license or adults authorized to have unsupervised access to residents at the facility must have a tuberculin (TB) skin test by the Mantoux method of testing. They must have this skin test upon being employed, volunteering, 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; or

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

     (3) 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.

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

     (5) The department does not require retesting for license renewals unless a person believes he or she has been exposed to someone with tuberculosis or if testing is recommended by his or her health care provider.

     (6) The licensee must keep the results of the TB test results in the personnel files available for review by DLR.

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     (2) If the pregnant and parenting teen program has five or more employees or volunteers, a training plan must be in writing.

     (3) The licensee must discuss with staff the licensed agency's policies and procedures, mandatory reporting of suspected child abuse or neglect; as well as the rules contained in this chapter.

     (4) The licensee must provide or arrange for staff to have training for the services that are provided to children and youth in the program.

     (5) Training on behavioral management must be approved by DLR and must include nonphysical age-appropriate methods of redirecting and controlling behavior.

     (6) The licensee must record the amount of time and type of training provided to staff.

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

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     (2) The licensee or staff must not use cruel, unusual, frightening, unsafe or humiliating discipline practices, including but not limited to:

     (a) Spanking children with a hand or object;

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

     (c) Pulling the child or youth's hair;

     (d) Throwing the child or youth;

     (e) Purposely inflicting pain as a punishment;

     (f) Name calling, using derogatory comments;

     (g) Threatening the child or youth with physical harm;

     (h) Threatening or intimidating the child or youth; or

     (i) Depriving the child or youth of sleep;

     (j) Restricting a child or youth's breathing; or

     (k) Interfering with a child or youth's ability to take care of his or her own hygiene and toilet needs.

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     (2) The licensee or staff must report the following incidents as soon as possible, and in not instance later than forty-eight hours, to children's administration intake staff:

     (a) Death of a child or youth;

     (b) Any violations of the licensing requirements where the health and safety of a child or youth is at risk and the violations are not corrected immediately or may compromise the continuing health and safety of children or youth;

     (c) Any child or youth's suicide attempt that results in injury requiring medical attention or hospitalization;

     (d) Any use of physical restraint that is alleged improperly applied or excessive;

     (e) Sexual contact between two or more children that is not considered typical play between preschool age children;

     (f) Any disclosures of sexual or physical abuse by a child or youth resident;

     (g) Any physical assaults between two or more children or youth that result in injury requiring off-site medical attention or hospitalization;

     (h) Any assaults of staff by children or youth that result in injury requiring off-site medical attention or hospitalization; or

     (i) Any medication that is given incorrectly and requires off-site medical attention or hospitalization.

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     (2) The licensee must report to the licensor immediately any changes in the original licensing application. Changes include any of the following:

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

     (b) Changes in facility phone number;

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

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

     (e) A change of the organization or agency's executive director or any staff changes;

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

     (g) A change in the name of a licensed corporation, or the name by which the facility is commonly known; or

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

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     (2) The department may issue a license to an applicant or licensee for the care of fewer youth and children than normally would reside at a facility based on an evaluation of the following factors:

     (a) The number of staff and volunteers available for providing services;

     (b) The skills of the staff and experience with the population of a pregnant and parenting teen program; and

     (c) The ages and characteristics of the youth and children to be served.

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     (2) When a staff person is preparing or assisting in preparing food he or she must have a food handler's permit.

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

     (3) Internal and external medications must be stored in separate places.

     (4) Only the child's parent or another authorized care provider (example: respite provider) is allowed to have access to medications for a child.

     (5) The child's parent 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.

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     (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 traveling without their parent in the vehicle; or

     (b) 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 insurance policy.

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

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

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

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

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     (2) Bedding must be clean.

     (3) Infants must have a crib that ensures the safety of the infant and complies with chapter 70.11 RCW, Infant Crib Safety Act.

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

     (5) 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.

     (6) 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.

     (7) The teen mother 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.

     (8) The teen mother 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.

     (9) Children may not 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 children, expectant mothers, and children with a disability.

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     (2) The department may require the applicant or licensee provide proof that the facility complies with local ordinances.

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     (2) The facility must be:

     (a) Accessible to emergency vehicles; and

     (b) Located on a well-drained site, free from hazardous conditions.

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

     (2) Provide handrails for steps, stairways, and ramps; if required by the department of health or Washington state patrol fire protection bureau;

     (3) Have emergency lighting devices, such as flashlights, available and in operational condition;

     (4) Furnish the facility appropriately, based on the age and activities of the children and youth residing at the facility;

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

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

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

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     (2) The department, at its discretion, may limit the type and number of common household pets, exotic pets, animals, birds, insects, reptiles or fish accessible to children if the department determines there are risks to the children/youth in care.

     (3) The licensee must ensure that common household pets, exotic pets, animals, birds, insects, reptiles, and fish are free from disease and cared for in a safe and sanitary manner.

     (4) Common household pets, exotic pets, animals, birds, insects, reptiles, and fish must be cared for in compliance with state regulations and local ordinances.

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     (2) The licensee may permit adults to smoke outdoors away from children/youth.

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

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     (a) Cleaning supplies;

     (b) Toxic or poisonous substances;

     (c) Aerosols; and

     (d) Items with warning labels.

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

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

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

     (b) Bandages and gauze;

     (c) Ace bandage;

     (d) Scissors and tweezers; and

     (e) A thermometer.

     (2) The Poison Control Center's 1-800 number must be readily accessible to facility staff and teen parents.

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     (2) Emergency telephone numbers must be posted next to the telephone or in a specified location with easy access.

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

     (2) The licensee must locate laundry equipment in an area separate from the kitchen and childcare areas.

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

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

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     (1) A public sewer system;

     (2) A functioning septic system; or

     (3) A department of health approved alternative system.

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     (2) Residents must be educated and familiar with the plan.

     (3) The licensee must post a written disaster plan for easy access to staff and residents.

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     (2) The staff must be familiar with all aspects of the fire drill.

     (3) The 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 facility to identify fire hazards and take action to correct any hazards noted during the inspection.

     (4) If the facility has individual apartments for residents inspections of the apartments must be conducted with proper notice to apartment residents.

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     (a) Conduct a fire drill at least once each month or as required under WAC 212-12-044 by WSPFPB, at varying times of the day and night so that staff on all shifts practice the procedures.

     (b) Instruct children and youth who are capable of understanding and following emergency evacuation procedures how to exit the building in case of fire.

     (c) Maintain a written record of such testing on the premises that indicates the date and time the test was completed.

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

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

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     (2) The evacuation plan must include a floor plan, identifying exit doors and windows.

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

     (4) The licensee must ensure that the plan includes:

     (a) Action to take by the person discovering a fire or other situation requiring emergency evacuation;

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

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

     (d) Action to take while waiting for the fire department or other emergency personnel; 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.

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     (2) If the same facility has multiple Washington state licenses the licensee must notify the following of this:

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

     (b) All of the licensing and certification agents.

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