9 CAR § 31-1006. Behavior management

(a) The agency shall have a written discipline policy that is consistently followed. (b) Discipline shall be directed toward teaching the child acceptable behavior and self-control. (c) Discipline shall be appropriate to the child’s: (1) Age; (2) Development; and (3) History. (d) The following disciplinary actions shall not be used: (1) Denial of: (A) Meals; (B) Sleep; (C) Shelter; (D) Essential clothing; or (E) Treatment plan activities; (2)(A) Denial of parental visits or regular phone and mail contact with family. (B) Nondisciplinary treatment planning issues are accepted; (3) Lewd or obscene language; (4) Derogatory comments about the child or the child’s: (A) Family; (B) Race; or (C) Gender; (5) Restriction to a room for more than a short period of time without periodic observation; (6) Restriction to a dark room or area; (7) Physical injury or threat of bodily harm; (8) Humiliating or degrading action; or (9) Extremely strenuous work or exercise. (e) A child shall not be allowed to administer discipline. (f) Searches of a child or a child’s personal property shall be for reasons limited to: (1) Safety and security of children and staff; (2) Cases of suspected theft; or (3) Suspicion of possession of items that are not permitted by agency policy. (g) Any searches requiring removal of clothing shall be: (1) Done in privacy; and (2) Witnessed by two (2) staff of the same gender as the child. (h) The agency shall have a written policy governing the use of behavior control measures with children, including: (1) Physical, mechanical, or chemical restraints; and (2) Seclusion rooms. (i)(1) Physical restraints shall be performed using minimal force and time necessary. (2) “Physical restraint” means the application of physical force without the use of any device, for the purpose of restraining the free movement of a resident's body. (3) Briefly holding a child without undue force in order to calm or comfort them or holding a hand to safely escort a child from one (1) area to another is not considered a physical restraint. (j)(1) Physical restraint: (A) Shall be initiated only by staff who are trained by a certified instructor in a nationally recognized curriculum, and only to prevent injury to: (i) The child; (ii) Other people; or (iii) Property; and (B) Shall not be initiated solely as a form of discipline. (2) The agency shall maintain documentation that staff is deemed competent in physical restraint. (k)(1) Chemical restraints shall be used only if ordered by a physician. (2) A chemical restraint is an emergency behavioral intervention that uses pharmaceuticals by topical application, oral administration, injection, or other means to modify a child’s behavior. (3) Prescribed treatment medications that have a secondary effect on the child’s behavior are not considered chemical restraint. (l) Seclusion or mechanical or physical restraints shall be used only if ordered by a physician. (m)(1) Each written order for a physical restraint or seclusion is limited to: (A) Two (2) hours for children nine through seventeen (9 – 17) years of age; or (B) One (1) hour for children under nine (9) years of age. (2) A physician, clinically qualified registered nurse, or other authorized licensed independent practitioner shall conduct a face-to-face assessment of the child within one (1) hour after the initiation of the ordered intervention. (n)(1) The original order may only be renewed in accordance with these limits for up to a total of twenty-four (24) hours. (2) After the original order expires, a physician, clinically qualified registered nurse, or other authorized licensed independent practitioner shall see and assess the child before issuing a new order. (o) Staff shall search each child before placement into seclusion, and all potentially hazardous items shall be removed. (p) Staff shall continually monitor each child in seclusion or restraints and shall document. (q) Documentation of all restraints shall be maintained and shall include the: (1) Child’s name; (2) Date; (3) Time; (4) Reason; (5) Staff involved; and (6) Measures taken prior to restraint.