(1) The licensee must ensure residents receive care from qualified staff authorized and competent to carry out assigned responsibilities.
(2) A sufficient number of staff must be present on a twenty-four hour per day basis to:
(a) Meet the care needs of the residents served;
(b) Manage emergency situations;
(c) Provide crisis intervention;
(d) Implement individual service plans; and
(e) Carry out required monitoring activities.
(3) At least one staff trained in basic first aid and age appropriate cardiopulmonary resuscitation (CPR) must be on-site twenty-four hours per day. Additionally, all staff providing hands-on care to infants must have a current certification in infant CPR.
(4) Staff must be trained, authorized, and where applicable credentialed to perform assigned job responsibilities consistent with scopes of practice, resident population characteristics and the resident's individual service plan.
(5) The licensee must document that staff receive the following training as applicable:
(a) Initial orientation and ongoing training to address the safety and health care needs of the residents served for all staff;
(b) Bloodborne pathogen training inclusive of HIV/AIDS training for staff involved in direct resident care or potential for having contact with blood or body fluids;
(c) If restraint or seclusion is used in the facility, initial and annual training in the proper and safe use of restraint or seclusion for staff required to perform restraint or seclusion procedures inclusive of:
(i) Techniques to identify staff and resident behaviors, events, and environmental factors that may trigger circumstances that require the use of restraint or seclusion;
(ii) The use of nonphysical intervention skills;
(iii) Choosing the least restrictive intervention based on an individualized assessment of the resident's medical or behavioral status or condition;
(iv) The safe application and use of all types of restraint or seclusion used in the RTF, including training in how to recognize and respond to signs of physical and psychological distress;
(v) Clinical identification of specific behavioral changes that indicate that restraint or seclusion is no longer necessary; and
(vi) Monitoring the physical and psychological well-being of the resident who is restrained or secluded including, but not limited to, respiratory and circulatory status, skin integrity, and vital signs; and
(d) Current basic first aid and age appropriate cardiopulmonary resuscitation for staff required to provide first aid or CPR.
(6) In addition to the requirements in subsection (5) of this section, an RTF in its licensed capacity to provide pediatric transitional care services must document that staff providing direct care to infants have received the following training:
(a) For all staff providing direct care to infants:
(i) Infant safe sleep;
(ii) Period of infant crying which is at its peak, unexpected, resists soothing, done with a pain-like face, is long lasting, and during the evening (commonly referred to as P.U.R.P.L.E. crying);
(iii) Reading signs and signals;
(iv) Managing feeding difficulties;
(v) Managing stimulus;
(vi) Impact of drugs in utero on developmental milestones;
(vii) Recognizing symptoms in infants exposed to specific drugs;
(viii) Therapeutic management techniques;
(ix) Managing your stress; and
(x) Managing complex psychosocial family dynamics.
(b) In addition to (a) of this subsection, trained caregivers must also receive training on the care of infants:
(i) Linen changing;
(ii) Therapeutic handling;
(iii) Bathing;
(iv) Weighing and tracking weight;
(v) Proper charting;
(vi) Techniques for taking temperature;
(vii) Positioning;
(viii) Reading signs and signals;
(ix) Feeding techniques; and
(x) Infection control.
(7) The licensee shall have written documentation for each staff member including:
(a) Employment;
(b) Hire date;
(c) Verification of education and experience;
(d) Current signed job description;
(e) Criminal history disclosure statement and results of a background check, according to WAC
246-337-055, completed within the previous three months of hire date and annually thereafter;
(f) Current license, certification, or registration, if applicable;
(g) Current basic first aid and age appropriate CPR, if applicable;
(h) Current Washington state food and beverage service worker permit, if applicable;
(i) Current driver's license, if applicable;
(j) Initial and ongoing tuberculosis screening according to the facility risk assessment and tuberculosis written plan according to WAC
246-337-060;
(k) All vaccination documentation required by WAC
246-337-060; and
(l) Annual signed performance evaluation(s).