jswizzle3737/ontario_laws_and_regs huggingface dataset:
Therapy services
 59. Every licensee of a long-term care home shall ensure that therapy services for residents of the home are arranged or provided under section 9 of the Act that include, (a) on-site physiotherapy provided to residents on an individualized basis or in a group setting based on residents’ assessed care needs; and (b) occupational therapy and speech-language therapy.  O. Reg. 79/10, s. 59.
Space and supplies — therapy services
 60. (1) Every licensee of a long-term care home shall ensure that there is safe and appropriate space in the home for the provision of therapy services.  O. Reg. 79/10, s. 60 (1). (2) The licensee shall ensure that there is a sufficient supply of therapy equipment available at all times to meet the needs of residents.  O. Reg. 79/10, s. 60 (2).
Therapy services staff qualifications
 61. (1) Subject to subsection (2), every licensee of a long-term care home shall ensure that the therapy services referred to in section 59 of this Regulation and that the licensee arranges or provides under section 9 of the Act are only provided by therapists who have a current certificate of registration with the appropriate college of a regulated health profession.  O. Reg. 79/10, s. 61 (1). (2) Therapy services provided by the licensee may be provided by support personnel who are members of the staff of the home who work under the direction of a member of the appropriate regulated health profession and the supervision of the designated lead required under section 64 and who, (a) subject to subsection (3), have successfully completed a training program in restorative care, or are enrolled in such a program; or (b) have successfully completed a relevant training course provided by the licensee that is designed and supervised by a qualified therapist who is a member of the appropriate college of a regulated health profession.  O. Reg. 79/10, s. 61 (2). (3) The licensee shall cease to employ as support personnel a person who was required to be enrolled in a program described in clause (2) (a) if the person ceases to be enrolled in the program or fails to successfully complete the program within three years of being hired.  O. Reg. 79/10, s. 61 (3). (4) Subsections (2) and (3) apply with respect to support personnel who provided therapy services at the home before the coming into force of this section, but for such persons, the three-year period referred to in subsection (3) begins when this section comes into force, not when the person first provided therapy services.  O. Reg. 79/10, s. 61 (4). (5) Therapy services arranged by the licensee may be provided by support personnel of a regulated health professional referred to in subsection (1) working under the direction and supervision of that regulated health professional.  O. Reg. 79/10, s. 61 (5).
Social work and social services work
 62. Every licensee of a long-term care home shall ensure that there is a written description of the social work and social services work provided in the home and that the work meets the residents’ needs.  O. Reg. 79/10, s. 62.
Social work and social services work qualifications
 63. Every licensee of a long-term care home shall ensure that social workers or social service workers who provide services in the home are registered under the Social Work and Social Service Work Act, 1998.  O. Reg. 79/10, s. 63.
Designated lead
 64. (1) Every licensee of a long-term care home shall ensure that the home’s restorative care program, including the services of social workers and social service workers, are co-ordinated by a designated lead.  O. Reg. 79/10, s. 64 (1). (2) The designated lead, (a) must have a current general certificate of registration with a college of a regulated health profession or the Ontario College of Social Workers and Social Service Workers; or (b) must have, (i) a post-secondary diploma or degree in recreation and leisure studies, kinesiology, therapeutic recreation or other related field from a community college or university, and (ii) at least one year of experience in a health care setting.  O. Reg. 79/10, s. 64 (2). Recreational and Social Activities
Recreational and social activities program
 65. (1) This section and sections 66 and 67 apply to the organized recreational and social activities program for the home required under subsection 10 (1) of the Act.  O. Reg. 79/10, s. 65 (1). (2) Every licensee of a long-term care home shall ensure that the program includes, (a) the provision of supplies and appropriate equipment for the program; (b) the development, implementation and communication to all residents and families of a schedule of recreation and social activities that are offered during days, evenings and weekends; (c) recreation and social activities that include a range of indoor and outdoor recreation, leisure and outings that are of a frequency and type to benefit all residents of the home and reflect their interests; (d) opportunities for resident and family input into the development and scheduling of recreation and social activities; (e) the provision of information to residents about community activities that may be of interest to them; and (f) assistance and support to permit residents to participate in activities that may be of interest to them if they are not able to do so independently.  O. Reg. 79/10, s. 65 (2).
Designated lead
 66. (1) Every licensee of a long-term care home shall ensure that there is a designated lead for the recreational and social activities program.  O. Reg. 79/10, s. 66 (1). (2) The designated lead must have, (a) a post-secondary diploma or degree in recreation and leisure studies, therapeutic recreation, kinesiology or other related field from a community college or university; and (b) at least one year of experience in a health care setting.  O. Reg. 79/10, s. 66 (2). (3) Subsection (2) only applies with respect to designated leads designated after the coming into force of this section.  O. Reg. 79/10, s. 66 (3). (4) Despite subsection (2), a person who was working or employed as a designated lead in a long-term care home immediately before July 1, 2010 may be designated as the designated lead in a different long-term care home if the person worked or was employed as a designated lead in a long-term care home, (a) on a full-time basis for at least three years during the five years immediately before being designated in the different home; or (b) on a part-time basis for the equivalent of at least three full-time years during the seven years immediately before being designated in the different home. O. Reg. 246/13, s. 3.
Recreational and social activities qualifications
 67. (1) Every licensee of a long-term care home shall ensure that staff members providing recreational and social activities in the home, (a) have a post-secondary diploma or degree in recreation and leisure studies, therapeutic recreation, kinesiology or other related field from a community college or university; or (b) are enrolled in a community college or university in a diploma or degree program in such a field.  O. Reg. 79/10, s. 67 (1). (2) The licensee shall cease to employ as a recreational and social activities staff member a person who was required to be enrolled in a program described in clause (1) (b) if the person ceases to be enrolled in the program or fails to successfully complete the program within three years of being hired.  O. Reg. 79/10, s. 67 (2). (3) This section does not apply with respect to, (a) a staff member who was providing recreational and social activities in the home immediately before July 1, 2010; or (b) a person who was a staff member providing recreational and social activities in a long-term care home immediately before July 1, 2010, and who worked or was employed as a staff member providing recreational and social activities in a long-term care home, (i) on a full-time basis for at least three years during the five years immediately before being employed in a different home, or (ii) on a part-time basis for the equivalent of at least three full-time years during the seven years immediately before being employed in a different home. O. Reg. 246/13, s. 4. Nutrition Care and Hydration Programs
Nutrition Care and Hydration Programs
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Nutrition care and hydration programs
 68. (1) This section and sections 69 to 78 apply to, (a) the organized program of nutrition care and dietary services required under clause 11 (1) (a) of the Act; and (b) the organized program of hydration required under clause 11 (1) (b) of the Act.  O. Reg. 79/10, s. 68 (1). (2) Every licensee of a long-term care home shall ensure that the programs include, (a) the development and implementation, in consultation with a registered dietitian who is a member of the staff of the home, of policies and procedures relating to nutrition care and dietary services and hydration; (b) the identification of any risks related to nutrition care and dietary services and hydration; (c) the implementation of interventions to mitigate and manage those risks; (d) a system to monitor and evaluate the food and fluid intake of residents with identified risks related to nutrition and hydration; and (e) a weight monitoring system to measure and record with respect to each resident, (i) weight on admission and monthly thereafter, and (ii) body mass index and height upon admission and annually thereafter.  O. Reg. 79/10, s. 68 (2).
Weight changes
 69. Every licensee of a long-term care home shall ensure that residents with the following weight changes are assessed using an interdisciplinary approach, and that actions are taken and outcomes are evaluated: 1. A change of 5 per cent of body weight, or more, over one month. 2. A change of 7.5 per cent of body weight, or more, over three months. 3. A change of 10 per cent of body weight, or more, over 6 months. 4. Any other weight change that compromises the resident’s health status.  O. Reg. 79/10, s. 69.
Dietary services
 70. Every licensee of a long-term care home shall ensure that the dietary services component of the nutrition care and dietary services program includes, (a) menu planning; (b) food production; (c) dining and snack service; and (d) availability of supplies and equipment for food production and dining and snack service.  O. Reg. 79/10, s. 70.
Menu planning
 71. (1) Every licensee of a long-term care home shall ensure that the home’s menu cycle, (a) is a minimum of 21 days in duration; (b) includes menus for regular, therapeutic and texture modified diets for both meals and snacks; (c) includes alternative choices of entrees, vegetables and desserts at lunch and dinner; (d) includes alternative beverage choices at meals and snacks; (e) is approved by a registered dietitian who is a member of the staff of the home; (f) is reviewed by the Residents’ Council for the home; and (g) is reviewed and updated at least annually.  O. Reg. 79/10, s. 71 (1). (2) The licensee shall ensure that each menu, (a) provides for adequate nutrients, fibre and energy for the residents based on the current Dietary Reference Intakes (DRIs) established in the reports overseen by the United States National Academies and published by National Academy Press, as they may exist from time to time; and (b) provides for a variety of foods, including fresh seasonal foods, each day from all food groups in keeping with Canada’s Food Guide as it exists from time to time.  O. Reg. 79/10, s. 71 (2). (3) The licensee shall ensure that each resident is offered a minimum of, (a) three meals daily; (b) a between-meal beverage in the morning and afternoon and a beverage in the evening after dinner; and (c) a snack in the afternoon and evening.  O. Reg. 79/10, s. 71 (3). (4) The licensee shall ensure that the planned menu items are offered and available at each meal and snack.  O. Reg. 79/10, s. 71 (4). (5) The licensee shall ensure that an individualized menu is developed for each resident whose needs cannot be met through the home’s menu cycle.  O. Reg. 79/10, s. 71 (5). (6) The licensee shall ensure that a full breakfast is available to residents up to at least 8:30 a.m. and that the evening meal is not served before 5:00 p.m.  O. Reg. 79/10, s. 71 (6). (7) The licensee shall ensure that food and beverages that are appropriate for the residents’ diets are accessible to staff and available to residents on a 24-hour basis.  O. Reg. 79/10, s. 71 (7).
Food production
 72. (1) Every licensee of a long-term care home shall ensure that there is an organized food production system in the home.  O. Reg. 79/10, s. 72 (1). (2) The food production system must, at a minimum, provide for, (a) a 24-hour supply of perishable and a three-day supply of non-perishable foods; (b) a three-day supply of nutritional supplements, enteral or parenteral formulas as applicable; (c) standardized recipes and production sheets for all menus; (d) preparation of all menu items according to the planned menu; (e) menu substitutions that are comparable to the planned menu; (f) communication to residents and staff of any menu substitutions; and (g) documentation on the production sheet of any menu substitutions.  O. Reg. 79/10, s. 72 (2). (3) The licensee shall ensure that all food and fluids in the food production system are prepared, stored, and served using methods to, (a) preserve taste, nutritive value, appearance and food quality; and (b) prevent adulteration, contamination and food borne illness.  O. Reg. 79/10, s. 72 (3). (4) The licensee shall maintain, and keep for at least one year, a record of, (a) purchases relating to the food production system, including food delivery receipts; (b) the approved menu cycle; and (c) menu substitutions.  O. Reg. 79/10, s. 72 (4). (5) If any food or beverages are prepared in the long-term care home for persons who are not residents of the home, the licensee shall maintain, and keep for at least seven years, records that specify for each week, (a) the number of meals prepared for persons who are not residents of the home; and (b) the revenue and internal recoveries made by the licensee relating to the sale or provision of any food and beverage prepared in the home, including revenue and internal recoveries made from cafeteria sales and catering.  O. Reg. 79/10, s. 72 (5). (6) The licensee shall ensure that the home has, (a) sufficient storage capacity to support the home’s menu requirements; (b) institutional food service equipment with adequate capacity to prepare, transport and hold perishable hot and cold food at safe temperatures; and (c) institutional food service equipment with adequate capacity to clean and sanitize all dishes, utensils and equipment related to food production and dining and snack service.  O. Reg. 79/10, s. 72 (6). (7) The licensee shall ensure that the home has and that the staff of the home comply with, (a) policies and procedures for the safe operation and cleaning of equipment related to the food production system and dining and snack service; (b) a cleaning schedule for all the equipment; and (c) a cleaning schedule for the food production, servery and dishwashing areas.  O. Reg. 79/10, s. 72 (7).
Dining and snack service
 73. (1) Every licensee of a long-term care home shall ensure that the home has a dining and snack service that includes, at a minimum, the following elements: 1. Communication of the seven-day and daily menus to residents. 2. Review, subject to compliance with subsection 71 (6), of meal and snack times by the Residents’ Council. 3. Meal service in a congregate dining setting unless a resident’s assessed needs indicate otherwise. 4. Monitoring of all residents during meals. 5. A process to ensure that food service workers and other staff assisting residents are aware of the residents’ diets, special needs and preferences. 6. Food and fluids being served at a temperature that is both safe and palatable to the residents. 7. Sufficient time for every resident to eat at his or her own pace. 8. Course by course service of meals for each resident, unless otherwise indicated by the resident or by the resident’s assessed needs. 9. Providing residents with any eating aids, assistive devices, personal assistance and encouragement required to safely eat and drink as comfortably and independently as possible. 10. Proper techniques to assist residents with eating, including safe positioning of residents who require assistance. 11. Appropriate furnishings and equipment in resident dining areas, including comfortable dining room chairs and dining room tables at an appropriate height to meet the needs of all residents and appropriate seating for staff who are assisting residents to eat.  O. Reg. 79/10, s. 73 (1). (2) The licensee shall ensure that, (a) no person simultaneously assists more than two residents who need total assistance with eating or drinking; and (b) no resident who requires assistance with eating or drinking is served a meal until someone is available to provide the assistance required by the resident.  O. Reg. 79/10, s. 73 (2).
Registered dietitian
 74. (1) Every licensee of a long-term care home shall ensure that there is at least one registered dietitian for the home.  O. Reg. 79/10, s. 74 (1). (2) The licensee shall ensure that a registered dietitian who is a member of the staff of the home is on site at the home for a minimum of 30 minutes per resident per month to carry out clinical and nutrition care duties.  O. Reg. 79/10, s. 74 (2). (3) Where a registered dietitian for the home is also a nutrition manager for the home, any time spent working in the capacity of nutrition manager does not count toward the time requirements under subsection (2).  O. Reg. 79/10, s. 74 (3).
Cooks
 76. (1) Every licensee of a long-term care home shall ensure that there is at least one cook who works at least 35 hours per week in that position on site at the home.  O. Reg. 79/10, s. 76 (1). (2) The licensee shall ensure that the cook referred to in subsection (1), if hired on or after the day this section comes into force, (a) has a chef training or culinary management diploma or certificate, (i) granted by a college established under the Ontario Colleges of Applied Arts and Technology Act, 2002, or (ii) granted by a registered private career college, for successfully completing a program approved by the Superintendent of Private Career Colleges under the Private Career Colleges Act, 2005; (b) has a diploma or certificate granted in another jurisdiction and has a set of skills that, in the reasonable opinion of the licensee, is equivalent to those that the licensee would expect of a person who has a diploma or certificate provided for in clause (a); (c) holds a certificate of qualification in the trade of Cook or Institutional Cook that was issued, (i) by the Director of Apprenticeship under the Apprenticeship and Certification Act, 1998, (ii) by the Registrar of the College under the Ontario College of Trades and Apprenticeship Act, 2009, or (iii) by the Registrar of Skilled Trades Ontario under the Building Opportunities in the Skilled Trades Act, 2021; or (d) meets the requirement set out in clause 78 (5) (c). O. Reg. 249/10, s. 1; O. Reg. 246/13, s. 6 (1); O. Reg. 897/21, s. 1. (3) The licensee shall ensure that the cook referred to in subsection (1), if employed at the home before this subsection came into force, (a) meets the qualifications required under subsection (2); (b) has successfully completed a Food Service Worker program at a college established under the Ontario Colleges of Applied Arts and Technology Act, 2002
or a Food Service Worker program provided by a registered private career college and approved by the Superintendent of Private Career Colleges under the Private Career Colleges Act, 2005; or (c) completes a food handler training program as defined in subsection 78 (6) within three months after the coming into force of this subsection unless he or she meets the requirements under clause (a) or (b) sooner.  O. Reg. 249/10, s. 1; O. Reg. 246/13, s. 6 (2). (4) Despite subsection (2), a person who was working or employed as a cook in a long-term care home immediately before July 1, 2010 may be hired as the cook in a different long-term care home if the person, (a) worked or was employed as a cook in a long-term care home, (i) on a full-time basis for at least three years during the five years immediately before being employed in the different home, or (ii) on a part-time basis for the equivalent of at least three full-time years during the seven years immediately before being employed in the different home; and (b) met the requirements under subsection (3) while at the former home. O. Reg. 246/13, s. 6 (3).
Food service workers, minimums
 77. (1) Every licensee of a long-term care home shall ensure that there are sufficient food service workers for the home to meet the minimum staffing hours as calculated under subsection (2) for, (a) the preparation of resident meals and snacks; (b) the distribution and service of resident meals; (c) the receiving, storing and managing of the inventory of resident food and food service supplies; and (d) the daily cleaning and sanitizing of dishes, utensils and equipment used for resident meal preparation, delivery and service.  O. Reg. 79/10, s. 77 (1). (2) For the purposes of subsection (1), but subject to subsection (3), the minimum staffing hours shall be calculated as follows: M =  A × 7 × 0.45 where, “M” is the minimum number of staffing hours per week, and “A” is, (a) if the occupancy of the home is 97 per cent or more, the licensed bed capacity in the home for the week, or (b) if the occupancy of the home is less than 97 per cent, the number of residents residing in the home for the week, including absent residents. O. Reg. 79/10, s. 77 (2). (3) An inspector may take into consideration the hours in a week, if any, devoted to producing meals and other food and beverages for non-residents for the sole purpose of determining, (a) whether the licensee is in compliance with subsection (1); and (b) whether any of the minimum staffing hours under subsection (1) are being devoted to producing meals and other food and beverages for non-residents.  O. Reg. 79/10, s. 77 (3); O. Reg. 89/16, s. 3. (4) A licensee of a long-term care home that was operated under the Nursing Homes Act, the Charitable Institutions Act
or the Homes for the Aged and Rest Homes Act immediately before the coming into force of this section is not required to comply with subsection (1) until six months after the day this section comes into force, but until the licensee is in compliance, the licensee is required to continue to comply with the applicable requirements under, (a) sections 61 and 61.1 of Regulation 832 of the Revised Regulations of Ontario, 1990 (General) made under the Nursing Homes Act; (b) sections 3.1 and 3.2 of Regulation 637 of the Revised Regulations of Ontario, 1990 (General) made under the Homes for the Aged and Rest Homes Act; or (c) sections 17.1 and 17.2 of Regulation 69 of the Revised Regulations of Ontario, 1990 (General) made under the Charitable Institutions Act.  O. Reg. 79/10, s. 77 (4).
Medical services program
 79. Sections 80 to 84 apply to the organized program of medical services for the home required under section 12 of the Act.  O. Reg. 79/10, s. 79.
Availability of medical services
 80. Every licensee of a long-term care home shall ensure that residents have access to medical services in the home 24 hours a day.  O. Reg. 79/10, s. 80.
Individualized medical directives and orders
 81. Every licensee of a long-term care home shall ensure that no medical directive or order is used with respect to a resident unless it is individualized to the resident’s condition and needs.  O. Reg. 79/10, s. 81. Attending Physicians and RNs (EC)
Attending physician or RN (EC)
 82. (1) Every licensee of a long-term care home shall ensure that either a physician or a registered nurse in the extended class, (a) conducts a physical examination of each resident upon admission and an annual physical examination annually thereafter, and produces a written report of the findings of the examination; (b) attends regularly at the home to provide services, including assessments; and (c) participates in the provision of after-hours coverage and on-call coverage.  O. Reg. 79/10, s. 82 (1). (2) The resident or the resident’s substitute decision-maker may retain a physician or registered nurse in the extended class to perform the services required under subsection (1).  O. Reg. 79/10, s. 82 (2). (3) If the resident or substitute decision-maker does not retain a physician or a registered nurse in the extended class, the licensee shall appoint one for the resident, in consultation with the Medical Director, the resident, and the resident’s substitute decision-maker, if any.  O. Reg. 79/10, s. 82 (3). (4) The licensee shall enter into the appropriate written agreement under section 83 or 84 with every physician or registered nurse in the extended class retained or appointed under subsection (2) or (3).  O. Reg. 79/10, s. 82 (4).
Agreement with attending physician
 83. Where a written agreement between a licensee and a physician is required under subsection 82 (4), the agreement must provide for, at a minimum, (a) the term of the agreement; (b) the responsibilities of the licensee; and (c) the responsibilities or duties of the physician, including, (i) accountability to the Medical Director for meeting the home’s policies, procedures and protocols for medical services, (ii) provision of medical services, and (iii) provision of after-hours coverage and on-call coverage.  O. Reg. 79/10, s. 83.
Agreement with registered nurse in extended class
 84. Where a written agreement between a licensee and a registered nurse in the extended class is required under subsection 82 (4), the agreement must provide for, at a minimum, (a) the term of the agreement; (b) the responsibilities of the licensee; and (c) the responsibilities or duties of the registered nurse in the extended class, including, (i) accountability to the Medical Director for meeting the home’s policies, procedures and protocols for medical services, (ii) provision of services, (iii) informing the licensee of the name of the physician with whom the registered nurse in the extended class has a consultative relationship, and (iv) provision of after-hours coverage and on-call coverage.  O. Reg. 79/10, s. 84. Religious and Spiritual Practices
Religious and spiritual practices
 85. (1) This section applies to the organized program for the home to give residents reasonable opportunity to practise their religious and spiritual beliefs required under section 14 of the Act.  O. Reg. 79/10, s. 85 (1). (2) Every licensee of a long-term care home shall ensure that the program includes arrangements to provide worship services, resources and non-denominational spiritual counselling on a regular basis for all residents who desire them based on availability within the community.  O. Reg. 79/10, s. 85 (2). (3) The licensee shall ensure that, (a) mechanisms are in place to support and facilitate residents’ participation in the program; (b) arrangements are made for one-to-one visitation, according to the resident’s wishes, based on availability within the community; and (c) arrangements are made to facilitate the participation in the program of residents who have hearing or visual impairments, based on availability within the community.  O. Reg. 79/10, s. 85 (3). (4) The licensee shall ensure that there is a designated lead for the program who has sufficient knowledge and experience to co-ordinate religious services and spiritual care in a multi-faith setting.  O. Reg. 79/10, s. 85 (4). Accommodation Services
Accommodation services programs
 86. (1) This section and sections 87 to 92 apply to the organized programs required under subsection 15 (1) of the Act.  O. Reg. 79/10, s. 86 (1). (2) Where services under any of the programs are provided by a service provider who is not an employee of the licensee, the licensee shall ensure that there is in place a written agreement with the service provider that sets out the service expectations.  O. Reg. 79/10, s. 86 (2). (3) The licensee shall ensure that there are written policies and procedures to monitor and supervise persons who provide occasional maintenance or repair services to the home pursuant to the agreement referred to in subsection (2).  O. Reg. 79/10, s. 86 (3). (4) The licensee’s policies and procedures under subsection (3) may take into account whether the person is subject to the requirements for a police record check and declarations set out in subsections 215 (1) to (5).  O. Reg. 79/10, s. 86 (4); O. Reg. 451/18, s. 1.
Housekeeping
 87. (1) Every licensee of a long-term care home shall ensure that housekeeping services are provided seven days per week.  O. Reg. 79/10, s. 87 (1). (2) As part of the organized program of housekeeping under clause 15 (1) (a) of the Act, the licensee shall ensure that procedures are developed and implemented for, (a) cleaning of the home, including, (i) resident bedrooms, including floors, carpets, furnishings, privacy curtains, contact surfaces and wall surfaces, and (ii) common areas and staff areas, including floors, carpets, furnishings, contact surfaces and wall surfaces; (b) cleaning and disinfection of the following in accordance with manufacturer’s specifications and using, at a minimum, a low level disinfectant in accordance with evidence-based practices and, if there are none, in accordance with prevailing practices: (i) resident care equipment, such as whirlpools, tubs, shower chairs and lift chairs, (ii) supplies and devices, including personal assistance services devices, assistive aids and positioning aids, and (iii) contact surfaces; (c) removal and safe disposal of dry and wet garbage; and (d) addressing incidents of lingering offensive odours.  O. Reg. 79/10, s. 87 (2); O. Reg. 363/11, s. 6 (1). (2.1) The licensee shall ensure that the staff member designated under subsection 229 (3) to co-ordinate the infection prevention and control program is involved in selecting the disinfectant referred to in clause (2) (b).  O. Reg. 363/11, s. 6 (2). (3) The licensee shall ensure that a sufficient supply of housekeeping equipment and cleaning supplies is readily available to all staff at the home.  O. Reg. 79/10, s. 87 (3).
Pest control
 88. (1) As part of organized programs of housekeeping and maintenance services under clauses 15 (1) (a) and (c) of the Act, every licensee of a long-term care home shall ensure that an organized preventive pest control program using the services of a licensed pest controller is in place at the home, including records indicating the dates of visits and actions taken.  O. Reg. 79/10, s. 88 (1). (2) The licensee shall ensure that immediate action is taken to deal with pests.  O. Reg. 79/10, s. 88 (2).
Laundry service
 89. (1) As part of the organized program of laundry services under clause 15 (1) (b) of the Act, every licensee of a long-term care home shall ensure that, (a) procedures are developed and implemented to ensure that, (i) residents’ linens are changed at least once a week and more often as needed, (ii) residents’ personal items and clothing are labelled in a dignified manner within 48 hours of admission and of acquiring, in the case of new clothing, (iii) residents’ soiled clothes are collected, sorted, cleaned and delivered to the resident, and (iv) there is a process to report and locate residents’ lost clothing and personal items; (b) a sufficient supply of clean linen, face cloths and bath towels are always available in the home for use by residents; (c) linen, face cloths and bath towels are kept clean and sanitary and are maintained in a good state of repair, free from stains and odours; and (d) industrial washers and dryers are used for the washing and drying of all laundry.  O. Reg. 79/10, s. 89 (1). (2) Despite clause (1) (d), the licensee may provide residential washers and dryers within the home that are, (a) accessible to residents and family members; and (b) available to address the laundry needs arising from programs if industrial sanitation is not necessary to meet those needs.  O. Reg. 79/10, s. 89 (2).
Maintenance services
 90. (1) As part of the organized program of maintenance services under clause 15 (1) (c) of the Act, every licensee of a long-term care home shall ensure that, (a) maintenance services in the home are available seven days per week to ensure that the building, including both interior and exterior areas, and its operational systems are maintained in good repair; and (b) there are schedules and procedures in place for routine, preventive and remedial maintenance.  O. Reg. 79/10, s. 90 (1). (2) The licensee shall ensure that procedures are developed and implemented to ensure that, (a) electrical and non-electrical equipment, including mechanical lifts, are kept in good repair, and maintained and cleaned at a level that meets manufacturer specifications, at a minimum; (b) all equipment, devices, assistive aids and positioning aids in the home are kept in good repair, excluding the residents’ personal aids or equipment; (c) heating, ventilation and air conditioning systems are cleaned and in good state of repair and inspected at least every six months by a certified individual, and that documentation is kept of the inspection; (d) all plumbing fixtures, toilets, sinks, grab bars and washroom fixtures and accessories are maintained and kept free of corrosion and cracks; (e) gas or electric fireplaces and heat generating equipment other than the heating system referred to in clause (c) are inspected by a qualified individual at least annually, and that documentation is kept of the inspection; (f) hot water boilers and hot water holding tanks are serviced at least annually, and that documentation is kept of the service; (g) the temperature of the water serving all bathtubs, showers, and hand basins used by residents does not exceed 49 degrees Celsius, and is controlled by a device, inaccessible to residents, that regulates the temperature; (h) immediate action is taken to reduce the water temperature in the event that it exceeds 49 degrees Celsius; (i) the temperature of the hot water serving all bathtubs and showers used by residents is maintained at a temperature of at least 40 degrees Celsius; (j) if the home is using a computerized system to monitor the water temperature, the system is checked daily to ensure that it is in good working order; and (k) if the home is not using a computerized system to monitor the water temperature, the water temperature is monitored once per shift in random locations where residents have access to hot water.  O. Reg. 79/10, s. 90 (2). (3) The licensee shall ensure that the home’s mechanical ventilation systems are functioning at all times except when the home is operating on power from an emergency generator.  O. Reg. 79/10, s. 90 (3).
Hazardous substances
 91. Every licensee of a long-term care home shall ensure that all hazardous substances at the home are labelled properly and are kept inaccessible to residents at all times.  O. Reg. 79/10, s. 91.
Designated lead — housekeeping, laundry, maintenance
 92. (1) The licensee shall ensure that there is a designated lead for each of the housekeeping, laundry services and maintenance services programs, but the same person may be the designated lead for more than one program.  O. Reg. 79/10, s. 92 (1). (2) The designated lead must have, (a) a post-secondary degree or diploma; (b) knowledge of evidence-based practices and, if there are none, prevailing practices relating to housekeeping, laundry and maintenance, as applicable; and (c) a minimum of two years experience in a managerial or supervisory capacity.  O. Reg. 79/10, s. 92 (2). (3) Subsection (2) only applies with respect to designated leads designated after the coming into force of this section.  O. Reg. 79/10, s. 92 (3). (4) Despite subsection (2), a person who was working or employed as a designated lead in a long-term care home immediately before July 1, 2010 may be designated as the designated lead in a different long-term care home if the person worked or was employed as a designated lead in a long-term care home, (a) on a full-time basis for at least three years during the five years immediately before being designated in the different home; or (b) on a part-time basis for the equivalent of at least three full-time years during the seven years immediately before being designated in the different home. O. Reg. 246/13, s. 8. Pets
Pets
 93. Every licensee of a long-term care home shall ensure that there are in place written policies respecting pets in the home.  O. Reg. 79/10, s. 93. Volunteers
Volunteer program
 94. (1) This section and section 95 apply to the organized volunteer program required under subsection 16 (1) of the Act.  O. Reg. 79/10, s. 94 (1). (2) Every licensee of a long-term care home shall ensure that a staff member monitors or directs a volunteer whenever it is necessary to ensure the safety of a resident.  O. Reg. 79/10, s. 94 (2).
Designated lead
 95. (1) The licensee shall ensure that there is a designated lead for the volunteer program who is a member of the staff.  O. Reg. 79/10, s. 95 (1). (2) The designated lead must have, (a) at least one year of experience with seniors in an organized program or one year of experience with persons in a health care setting; and (b) experience or knowledge in recruitment, selection, orientation, placement and supervision of volunteers.  O. Reg. 79/10, s. 95 (2). Prevention of Abuse and Neglect
Policy to promote zero tolerance
 96. Every licensee of a long-term care home shall ensure that the licensee’s written policy under section 20 of the Act to promote zero tolerance of abuse and neglect of residents, (a) contains procedures and interventions to assist and support residents who have been abused or neglected or allegedly abused or neglected; (b) contains procedures and interventions to deal with persons who have abused or neglected or allegedly abused or neglected residents, as appropriate; (c) identifies measures and strategies to prevent abuse and neglect; (d) identifies the manner in which allegations of abuse and neglect will be investigated, including who will undertake the investigation and who will be informed of the investigation; and (e) identifies the training and retraining requirements for all staff, including, (i) training on the relationship between power imbalances between staff and residents and the potential for abuse and neglect by those in a position of trust, power and responsibility for resident care, and (ii) situations that may lead to abuse and neglect and how to avoid such situations.  O. Reg. 79/10, s. 96.
Notification re incidents
 97. (1) Every licensee of a long-term care home shall ensure that the resident’s substitute decision-maker, if any, and any other person specified by the resident, (a) are notified immediately upon the licensee becoming aware of an alleged, suspected or witnessed incident of abuse or neglect of the resident that has resulted in a physical injury or pain to the resident or that causes distress to the resident that could potentially be detrimental to the resident’s health or well-being; and (b) are notified within 12 hours upon the licensee becoming aware of any other alleged, suspected or witnessed incident of abuse or neglect of the resident.  O. Reg. 79/10, s. 97 (1). (2) The licensee shall ensure that the resident and the resident’s substitute decision-maker, if any, are notified of the results of the investigation required under subsection 23 (1) of the Act, immediately upon the completion of the investigation.  O. Reg. 79/10, s. 97 (2). (3) Despite subsections (1) and (2), a licensee is not required to, but may, notify a person of anything under this section if the licensee has reasonable grounds to believe that the person is responsible for the alleged, suspected or witnessed incident of abuse or neglect of the resident.  O. Reg. 363/11, s. 7.
Police notification
 98. Every licensee of a long-term care home shall ensure that the appropriate police force is immediately notified of any alleged, suspected or witnessed incident of abuse or neglect of a resident that the licensee suspects may constitute a criminal offence.  O. Reg. 79/10, s. 98. Note: On the day subsection 2 (1) of Schedule 1 to the Safer Ontario Act, 2018 comes into force, section 98 of the Regulation is amended by striking out “police force” and substituting “police service”. (See: O. Reg. 451/18, s. 2)
Evaluation
 99. Every licensee of a long-term care home shall ensure, (a) that an analysis of every incident of abuse or neglect of a resident at the home is undertaken promptly after the licensee becomes aware of it; (b) that at least once in every calendar year, an evaluation is made to determine the effectiveness of the licensee’s policy under section 20 of the Act to promote zero tolerance of abuse and neglect of residents, and what changes and improvements are required to prevent further occurrences; (c) that the results of the analysis undertaken under clause (a) are considered in the evaluation; (d) that the changes and improvements under clause (b) are promptly implemented; and (e) that a written record of everything provided for in clauses (b) and (d) and the date of the evaluation, the names of the persons who participated in the evaluation and the date that the changes and improvements were implemented is promptly prepared.  O. Reg. 79/10, s. 99. Reporting and Complaints
Complaints procedure: licensee
 100. Every licensee of a long-term care home shall ensure that the written procedures required under section 21 of the Act incorporate the requirements set out in section 101.  O. Reg. 79/10, s. 100.
Dealing with complaints
 101. (1) Every licensee shall ensure that every written or verbal complaint made to the licensee or a staff member concerning the care of a resident or operation of the home is dealt with as follows: 1. The complaint shall be investigated and resolved where possible, and a response that complies with paragraph 3 provided within 10 business days of the receipt of the complaint, and where the complaint alleges harm or risk of harm to one or more residents, the investigation shall be commenced immediately. 2. For those complaints that cannot be investigated and resolved within 10 business days, an acknowledgement of receipt of the complaint shall be provided within 10 business days of receipt of the complaint including the date by which the complainant can reasonably expect a resolution, and a follow-up response that complies with paragraph 3 shall be provided as soon as possible in the circumstances. 3. A response shall be made to the person who made the complaint, indicating, i. what the licensee has done to resolve the complaint, or ii. that the licensee believes the complaint to be unfounded and the reasons for the belief.  O. Reg. 79/10, s. 101 (1). (2) The licensee shall ensure that a documented record is kept in the home that includes, (a) the nature of each verbal or written complaint; (b) the date the complaint was received; (c) the type of action taken to resolve the complaint, including the date of the action, time frames for actions to be taken and any follow-up action required; (d) the final resolution, if any; (e) every date on which any response was provided to the complainant and a description of the response; and (f) any response made in turn by the complainant.  O. Reg. 79/10, s. 101 (2). (3) The licensee shall ensure that, (a) the documented record is reviewed and analyzed for trends at least quarterly; (b) the results of the review and analysis are taken into account in determining what improvements are required in the home; and (c) a written record is kept of each review and of the improvements made in response.  O. Reg. 79/10, s. 101 (3). (4) Subsections (2) and (3) do not apply with respect to verbal complaints that the licensee is able to resolve within 24 hours of the complaint being received.  O. Reg. 79/10, s. 101 (4).
Transitional, complaints
 102. Where a complaint was made before the coming into force of this section, but not finally dealt with, the complaint shall be dealt with as provided for in section 101 to the extent possible.  O. Reg. 79/10, s. 102.
Complaints — reporting certain matters to Director
 103. (1) Every licensee of a long-term care home who receives a written complaint with respect to a matter that the licensee reports or reported to the Director under section 24 of the Act shall submit a copy of the complaint to the Director along with a written report documenting the response the licensee made to the complainant under subsection 101 (1).  O. Reg. 79/10, s. 103 (1). (2) The licensee shall comply with subsection (1) immediately upon completing the licensee’s investigation into the complaint, or at an earlier date if required by the Director.  O. Reg. 79/10, s. 103 (2).
Licensees who report investigations under s. 23 (2) of Act
 104. (1) In making a report to the Director under subsection 23 (2) of the Act, the licensee shall include the following material in writing with respect to the alleged, suspected or witnessed incident of abuse of a resident by anyone or neglect of a resident by the licensee or staff that led to the report: 1. A description of the incident, including the type of incident, the area or location of the incident, the date and time of the incident and the events leading up to the incident. 2. A description of the individuals involved in the incident, including, i. names of all residents involved in the incident, ii. names of any staff members or other persons who were present at or discovered the incident, and iii. names of staff members who responded or are responding to the incident. 3. Actions taken in response to the incident, including, i. what care was given or action taken as a result of the incident, and by whom, ii. whether a physician or registered nurse in the extended class was contacted, iii. what other authorities were contacted about the incident, if any, iv. whether a family member, person of importance or a substitute decision-maker of any resident involved in the incident was contacted and the name of such person or persons, and v. the outcome or current status of the individual or individuals who were involved in the incident. 4. Analysis and follow-up action, including, i. the immediate actions that have been taken to prevent recurrence, and ii. the long-term actions planned to correct the situation and prevent recurrence. 5. The name and title of the person making the report to the Director, the date of the report and whether an inspector has been contacted and, if so, the date of the contact and the name of the inspector.  O. Reg. 79/10, s. 104 (1). (2) Subject to subsection (3), the licensee shall make the report within 10 days of becoming aware of the alleged, suspected or witnessed incident, or at an earlier date if required by the Director.  O. Reg. 79/10, s. 104 (2). (3) If not everything required under subsection (1) can be provided in a report within 10 days, the licensee shall make a preliminary report to the Director within 10 days and provide a final report to the Director within a period of time specified by the Director.  O. Reg. 79/10, s. 104 (3).
Non-application re certain staff
 105. Paragraph 4 of subsection 24 (5) of the Act does not apply to a staff member who, (a) falls under clause (b) or (c) of the definition of “staff” in subsection 2 (1) of the Act; (b) only provides occasional maintenance or repair services to the home; and (c) does not provide direct care to residents.  O. Reg. 79/10, s. 105.
Transitional, investigation and reports
 106. (1) Section 23 of the Act and section 104 of this Regulation apply with respect to incidents that the licensee knew of or that were reported to the licensee after the coming into force of this section, even if the incident occurred before the coming into force, unless the incident was investigated and resolved before the coming into force.  O. Reg. 79/10, s. 106 (1). (2) Section 24 of the Act applies only with respect to matters that occur or may occur after that section comes into force.  O. Reg. 79/10, s. 106 (2). (3) Section 25 of the Act applies with respect to information received by the Director after that section comes into force, even if the information is with regard to a matter that occurred before that section came into force.  O. Reg. 79/10, s. 106 (3). (4) Section 26 of the Act applies with respect to retaliation that occurs after the coming into force of that section, even if the retaliation relates to something that was disclosed or given in evidence before the coming into force of that section.  O. Reg. 79/10, s. 106 (4).