Nov 3, 2005 — certificate holders to qualify them for renewal of their adult residential facility administrator certificate. (7) “Course” means either,
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Manual of Policies and Procedures COMMUNITY CARE LICENSING DIVISION ADULT RESIDENTIAL FACILITIES Title 22 Division 6 Chapter 6 STATE OF CALIFORNIA Arnold Schwarzenegger, Governor HEALTH AND WELFARE AGENCY S. Kimberly Belshé, Secretary DEPARTMENT OF SOCIAL SERVICES Tameron Mitchell, Chief Deputy Director Distributed Under the Library Distribution Act November 2005
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Regulations ADULT RESIDENTIAL FACILITIES TABLE OF CONTENTS TITLE 22, DIVISION 6 CHAPTER 6 ADULT RESIDENTIAL FACILITIES Article 1. General Requirements and Definitions Section General .. 85000 Definitions . . 85001 Definitions – Forms .. .. 85002 Article 2. Licensing Posting of License 85009 Article 3. Application Procedures Application for License . 85018 Plan of Operation . 85022 Article 4. Administrative Actions (Reserved) Article 5. Enforcement Provisions Serious Deficiencies 85051 Article 6. Continuing Requirements Basic Services 85060 Reporting Requirements .. 85061 Administrator Qualifications and Duties . 85064 Administrator Certification Requirements .. 85064.2 Administrator Recertifi cation Requirements . 85064.3 Denial or Revocation of a Certificate .. . 85064.4 Forfeiture of a Certificate . 85064.5 Personnel Requirements .. . 85065 Day Staff-Clie nt Ratio .. 85065.5 Night Supervision . .. 85065.6 Personnel Records . .. 85066 Admission Agreements . 85068 Admission Procedures . . 85068.1 CALIFORNIA-DSS-MANUAL-CCL MANUAL LETTER NO. CCL-01-03 Effective 1/5/01 Page 1
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ADULT RESIDENTIAL FACILITIES Regulations TABLE OF CONTENTS (Continued) Article 6 (Continued) Section Needs and Services Plan . . 85068.2 Modifications to Needs and Services Plan .. 85068.3 Acceptance and Retention Limitations . 85068.4 Eviction Procedures .. . 85068.5 Mental Health Intake Assessment .. . 85069.3 Client Records . .. 85070 Personal Rights . 85072 Health-Related Services . .. 85075 Hospice Care .. 85075.1 Facility Hospice Care Waiver .. . 85075.2 Advance Health Care Directives .. 85075.3 Observation of the Client .. .. 85075.4 Food Service .. 85076 Personal Services . 85077 Responsibility for Providing Ca re and Supervision 85078 Activities .. 85079 Resident Councils . .. 85080 Requirements for Emergency Adult Prot ective Services Placements 85081 Article 7. Physical Environment Buildings and Grounds . 85087 Outdoor Activity Space .. .. 85087.2 Indoor Activity Space 85087.3 Fixtures, Furniture, Equipment and Supplies .. .. 85088 Article 8. (Reserved) Article 9. Administrator Certification Training Programs Initial Certification Training Program Approval Requirements .. 85090 Denial of Request for Approval of an Initial Certification Training Program .. 85090.1 Revocation of an Initial Certification Training Program . 850 90.2 Continuing Education Training Program Vendor Requirements . 85091 Continuing Education Training Program Cour se Approval Requirements 85091.1 Administrative Review of Denial or Revocation of a Continuing Education Course .. 85091.2 Denial of a Request for Approval of a Continuing Education Training Program .. 85091.3 Revocation of a Continuing Education Training Program .. 85091.4 CALIFORNIA-DSS-MANUAL-CCL MANUAL LETTER NO. CCL-04-10 Effective 1/16/04 Page 2
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Regulations ADULT RESIDENTIAL FACILITIES This Users’ Manual is issued as an operational tool. This Manual contains: a) Regulations adopted by the California Departme nt of Social Services (CDSS) for the governance of its agents, licensees, and/or beneficiaries b) Regulations adopted by other Stat e Departments affecting CDSS programs c) Statutes from appropriate Codes which govern CDSS programs; and d) Court decisions e) Operational standards by which CDSS staff will evaluate performance within CDSS programs. Regulations of CDSS are printed in gothic type as is this sentence. Handbook material, which includes reprinted statutory mate rial, other department’s regulations and examples, is separated from the regulations by double lines and the phrases ” HANDBOOK BEGINS HERE”, “HANDBOOK CONTINUES”, and ” HANDBOOK ENDS HERE ” in bold print. Please note that both other department’s regulations and statutes are mandatory, not optional. In addition, please note that as a result of the changes to a new computer system revised language in this manual letter and subsequent community care licensing ma nual letters will now be identified by a line in the left margin. Questions relative to this Users’ Manual should be directed to your usual program policy office. CALIFORNIA-DSS-MANUAL-CCL MANUAL LETTER NO. CCL-04-10 Effective 1/16/04 Page 3
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85001 (Cont.) ADULT RESIDENTIAL FACILITIES Regulations 85001 DEFINITIONS (Continued) 85001 (4) fiAppropriately Skilled Professionalfl means an individual that has training and is licensed to perform the necessary medical procedures prescribed by a physician. This term includes, but is not limited to, the following: Registered Nurse (RN); Licensed Vocational Nurse (LVN); Physical Therapist (PT); Occupational Therapis t (OT); and Respiratory Therapist (RT). These professionals may include, but are not limited to, those persons employed by a home health agency, the resident, or adult residential facilities. (b) (Reserved) (c) (1) fiCertificate holderfl means a person who has a current administrator™s certificate issued by the Department regardless of whether the person is employed as an administrator in an adult residential facility. (2) “Certified administrator” means a person who has been issued an Administ rator Certification by the Department and whose certification is current. (3) “Classroom Hour” means sixty (60) minutes of classroom instruction with or without a break. It is recommended that no more than twenty (20) minutes of break time be included every four (4) hours of instruction. No credit is given for meal breaks. (4) “Co-locate” means that a vendor applicant is approved for more than one program type, i.e., ARF, RCFE, GH, and has received approval to teach specific continuing education courses at the same time and at the same location. Co-location is allowed for Continuing Education Training Program vendors only. (5) fiComplete Requestfl means the vendor applican t has submitted and the De partment has received all required information and materials necessary to approve or deny the request for certification program and/or course approval. (6) fiContinuing Education Training Program Vendorfl means a vendor approved by the Department to provide Continuing Education training courses to adult residential facility administrators and certificate holders to qualify them for renewal of their adult residential facility administrator certificate. (7) “Course” means either, (1) a quarter-or- semester-long structured sequence of classroom instruction covering a specific subject, or (2) a one -time seminar, workshop or lecture of varying duration. CALIFORNIA-DSS-MANUAL-CCL MANUAL LETTER NO. CCL-04-10 Effective 1/16/04 Page 4.1
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Regulations ADULT RESIDENTIAL FACILITIES 85001 (Cont.) 85001 DEFINITIONS (Continued) 85001 (d) (1) fiDo-Not-Resuscitate (DNR) Formfl means th e pre-hospital do-not-resuscitate forms developed by the California Emergency Medical Services Au thority and by other local emergency medical services agencies. These forms, wh en properly completed by a client or, in certain instances, a client™s Health Care Surrogate Decision Maker, and by a physician, alert pre-hospital emergency medical services personnel to the client™s wish to forego resuscitative measures in the event of the client™s cardiac or respiratory arrest. (e) (Reserved) (f) (1) fiFacility Hospice Care Waiverfl means a waiv er from the limitation on retention of clients who require more care and supervision than ordinar ily would be permitted in an Adult Residential Facility, and clients who are bedridden other than for a temporary illness. This waiver granted by the Department will permit the licensee to retain a designated maximum number of terminally ill clients who are receiving services from a Hospi ce Agency. The waiver will apply only to those clients who are receiving hospice care in compliance with a Hospice Care Plan meeting the requirements of Section 85075.1. (g) (Reserved) (h) (1) fiHealth Care Providerfl means that person or persons described in Probate Code Section 4621. HANDBOOK BEGINS HERE Section 4621 of the Probate Code states: fi‚Health Care Provider™ means an individual licensed, certified, or otherwise authorized or permitted by the law of this state to provide h ealth care in the ordinary course of business or practice of a profession.fl HANDBOOK ENDS HERE (2) fiHealth Care Surrogate Decision Makerfl mean s an individual who participates in health care decision-making on behalf of an in capacitated client. This indivi dual may be formally appointed (e.g., by the client in an Advance Health Care Directive or by a court in a conservatorship proceeding) or be recognized by virtue of a relati onship with the client (e.g., the client™s next of kin). The licensee or any staff member of the facility shall not be appointed by any client to be a Health Care Surrogate Decision Maker. CALIFORNIA-DSS-MANUAL-CCL MANUAL LETTER NO. CCL-04-10 Effective 1/16/04 Page 4.2
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85001 (Cont.) ADULT RESIDENTIAL FACILITIES Regulations 85001 DEFINITIONS (Continued) 85001 (3) fiHospice or Hospice Agency fl means an entity that provides hospice services to terminally ill persons. This entity is Medicare certified and hol ds either a Hospice license or a Home Health Agency license from the California Department of Health Services. The definition includes any organization(s), appropriately skilled professi onal(s), or other professional person(s) or entity(ies) that are subcontracted by the hospice to provide services to the client. The hospice agency providing services in an Adult Residential Facility shall not subcontract with the licensee or any facility staff for the provision of services. (4) fiHospice Care Planfl means the hospice™s written plan of care for a terminally ill client. The hospice shall retain overall responsibility for the development and maintenance of the plan and quality of hospice services delivered. (i) (1) fiInitial Certification Training Program Vendorfl means a vendor approved by the Department to provide the initial thirty-five (35) hour certifi cation training program to persons who do not possess a valid adult residential facility administrator certification. (2) “Initial Vendor Application” means the app lication form, LIC 9141, used to request approval from the Department to become a vendor for the first time. (j) (Reserved) (k) (Reserved) (l) (1) “Licensed Mental Health Professional” means a licensed clinical psychologist; a psychiatrist; a licensed clinical social worker; or a licensed marriage, family and child counselor. (m) (Reserved) (n) (1) “Needs and Services Plan” means a written plan that identifies the specific needs of an individual client, including those items specified in Sections 80068.2 and 85068.2, and delineates those services necessary to meet the c lient’s identified needs. (o) (Reserved) (p) (Reserved) (q) (Reserved) CALIFORNIA-DSS-MANUAL-CCL MANUAL LETTER NO. CCL-04-10 Effective 1/16/04 Page 4.3
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Regulations ADULT RESIDENTIAL FACILITIES 85001 85001 DEFINITIONS (Continued) 85001 (r) (1) “Renewal Vendor Application” means the app lication form, LIC 9141, used to request approval from the Department to continue anot her two (2) years as an approved vendor. (s) (Reserved) (t) (1) fiTerminally Ill Clientfl means a client who ha s a prognosis by his/her attending physician that the client™s life expectancy is six months or less if his/her illness or condition runs its normal course. (u) (Reserved) (v) (1) fiVendorfl means a Department-approved institu tion, association, individual(s), or other entity that assumes full responsibility or control ove r a Department-approved Initial Certification Training Program and/or a Continuing Education Training Program. (2) fiVendor Applicantfl means any institution, associ ation, individual(s) or other entity that submits a request for approval of an Initial Certificati on Training Program and/or a Continuing Education Training Program. (w) (Reserved) (x) (Reserved) (y) (Reserved) (z) (Reserved) NOTE: Authority cited: Sections 1530 and 1562.3(i), H ealth and Safety Code. Reference: Sections 1501, 1502.2, 1507, 1530, 1531, and 1562.3, Health and Sa fety Code, and Section 15610.13, Welfare and Institutions Code, and Sections 1800, 4605, and 4753, Probate Code. CALIFORNIA-DSS-MANUAL-CCL MANUAL LETTER NO. CCL-04-10 Effective 1/16/04 Page 5
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