Care Of Residents

(1) Intermediate Care. Residents must not be kept in-runaway house agencies over twenty-eight (28) days except on an emergency basis. In such cases, the record must reflect diligence in pursuing appropriate alternative living resources. Documentation of referrals for alternative living resources must be contained in the case record. (2) Health. (a) An ongoing medical record of each resident must be maintained in the agency. (b) Doctor’s orders must be observed during the course of an illness. (b) Doctor’s orders must be observed during the course of an illness (c) Regulation of visitors and the sterilization of dishes must be observed as the nature of illness dictates (d) First aid supplies must be kept on hand and must be placed in a locked area. (e) A record of all medication dispensed must appear both in an ongoing agency medical log and in the case record of the individual resident. (f) All legend drugs must be double-locked within the agency. (g) In the event that any medication is used as an attitude manipulator, a tranquilizer, a legend pain killer, a barbiturate, or an amphetamine, there must be safeguards of a double entry medication system whereby each medication and the quantity is recorded as it comes into the agency and as it is administered. STANDARDS FOR RUNAWAY HOUSE AGENCIES CHAPTER 0250-4-10 (h) All controlled substances administered must be clearly evidenced in the controlled substance log, in the agency medication log, and in the individual record of the resident. (i) No medication may be administered without a specific order from a licensed physician. The drug must be given to the individual for whom the drug was ordered in strict conformity with the directions given by the prescribing physician. (j) No agency shall have legend/controlled substance as stock items. Such drugs must be individually prescribed and kept in the original containers with the name of the patient, drug, dosage, frequency of administration and prescription number unless filled directly by the physician. (k) Each agency must develop a system for screening prospective residents for possible communicable diseases and an attitude must exist in the agency which would facilitate the trust of residents in sharing possible suspicions of communicable diseases with staff members. (1) A formalized plan for providing both emergency and ongoing medical care must be developed with services to at least include the services of a pediatrician, a gynecologist, and a general surgeon. (m) An emergency plan for dental and optical care must be developed. (3) Nutritional Needs. (a) Food of adequate quality and quantity must be served and meet the child’s daily dietary allowances as recommended by USDA. (See Appendix C.) (b) Three meals and snacks must be provided daily (See Appendix C.), with not more than a 14- hour span between a substantial evening meal and breakfast of the following day, and not more than 10 hours between breakfast and the evening meal of the same day. (c) All special diets must be prepared as prescribed by the physician. (d) Denial of a nutritionally adequate diet must not be used as a punishment, (4) Menus. Menus for the week must be prepared in advance. These menus must be followed and varied from week t o week, although reasonable substitutions are permissible if the substituted food contains approximately the same nutrients. (5) Food Sanitation and Preparation. (a) State and local regulations for food sanitation must be met, which include but are not limited to the following: 1. When food is transported, it must be done in a manner that maintains proper temperature, protects the food from contamination and spoilage, and insures the preservation of nutritive value. 2. All food must be from sources approved or considered satisfactory by the health authority. All milk must be pasteurized. STANDARDS FOR RUNAWAY HOUSE AGENCIES CHAPTER 0250-4-10 3. Raw fruits and vegetables must be washed before use. Stuffing, poultry, and pork products must be thoroughly cooked before being served. 4. Leftover food not brought to the table for service must be covered, refrigerated properly and used promptly. Food brought to the table for family-style service must be discarded if not consumed. 5. Reliable thermometers must be kept in the refrigerators. The temperature of refrigerated food must be maintained at 45 degrees F. or below. To keep food at this temperature the refrigerator temperature must be 37 degrees F. or below. Freezer temperatures must be 0 degrees F. or below. 6. Milk and other perishable foods must be kept in the refrigerator except during the time of preparation and service. 7. All dry food supplies must be stored in closed containers and stored at least ten (10) inches from the floor. (b) Food preparation must be the responsibility of a staff member, (6) Child Behavior and Discipline (a) Corporal punishment of any form must be specifically prohibited in the agency. (b) Some plan for discipline and order must be established as a part of the ongoing policy and philosophy of the agency of which each resident and staff member is aware. (7) Education and Religion (a) Children in the runaway house program must comply with the Tennessee State Law on compulsory school attendance. (b) The agency shall provide the opportunity for the individual residents to fulfill religious preferences.