Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 384 - BEHAVIOR TREATMENT IN RESIDENTIAL CHILD CARE FACILITIES › Section 384.70 - Behavior Management Requirements for the Use of Seclusion

Current through Register Vol. 48, No. 28, July 12, 2024
Seclusion is limited to children age six and older who have
				been placed in a child care facility and who pose a threat of physical harm to
				themselves or others. Such threat may include any dangerous behavior reasonably
				expected to lead to physical harm to self or others. Seclusion shall not be
				used until after other, less restrictive procedures or measures have been
				explored and found to be inappropriate. Seclusion shall not be used for a child
				whose medical condition, mental illness or developmental or psychological
				status contraindicates the use of the technique, as documented in the
				individual treatment plan.
a)
			 Seclusion may be administered provided:
1) the
			 use of seclusion is under the direct management and supervision of a mental
			 health professional specifically trained in behavior management who has
			 demonstrated both written and applied competency in the use of this procedure.
			 Supervision of a seclusion episode does not require in person supervision
			 provided that the "mental health professional" has viewed the seclusion in
			 person and is confident that the seclusion is being applied according to the
			 agency's selected model. (The "mental health professional" must review the
			 seclusion episode immediately upon conclusion of the seclusion to ensure that
			 the seclusion continued and concluded in a manner that is consistent with the
			 model and the child's interest.);
2) seclusion shall be in a room at least 40
			 square feet with the shortest wall at least 6 foot and with an 8 foot ceiling,
			 which is heated, lighted, and ventilated as the other rooms of the facility.
			 Seclusion rooms are to be unfurnished and may have padding that is designed
			 specifically for use in psychiatric or similar settings and approved by the
			 local health and fire authorities. Light fixtures are to be screened or
			 recessed, and interior door knobs are to be removed. Seclusion rooms shall be
			 approved by the Department's licensing unit prior to usage. The Department is
			 authorized to waive certain space requirements that represent a minimal
			 variance from the requirements of this subsection (a)(2). Seclusion rooms must
			 be inspected and approved under the regulations adopted by the Office of the
			 State Fire Marshal;
3) a staff
			 member trained in the use of the seclusion shall monitor the child by direct,
			 in-person, visual observation on a continuous basis. A staff member assigned to
			 monitor a child in a seclusion room shall have this monitoring as his or her
			 sole job duty throughout the period of seclusion in order to ensure the child's
			 safety while in the room, and will maintain a written record of the
			 observations. Such observation may be through an uncovered one way mirror or
			 regular window that provides for observation of the entire room at all times,
			 if the staff person has unimpeded access to the seclusion room and normal daily
			 sounds are audible. (There shall be sufficient staff to insure appropriate
			 supervision of all other children while the staff member is monitoring the
			 child in seclusion.);
4) a written
			 log is to be kept of each seclusion episode. The staff member monitoring the
			 seclusion shall make an entry in the log at least once every 15 minutes,
			 clearly describing the behavior of the child at that time and a clinical
			 impression of whether the behavior requires continuation of the
			 seclusion;
5) a child may not be
			 kept in seclusion more than 15 minutes beyond the point at which the child
			 ceases presenting the specific behavior for which the seclusion was ordered or
			 any other behavior for which seclusion is an appropriate
			 intervention;
6) no child may be
			 kept in seclusion longer than a total of four hours in any 24 hour period. If
			 continuous seclusion is necessary for more than two hours, a mental health
			 professional shall approve continuing the seclusion on an hourly basis with a
			 total episode of seclusion not to exceed four hours. The treatment team must
			 explore alternative treatment strategies, such as an emergency SASS or
			 transporting the child to a hospital or mental health facility.
7) belts, shoes, matches, weapons, or any
			 other object that can be used to inflict self-injury are to be taken from the
			 child or removed from the room prior to placement of the child in the seclusion
			 room if there are indications in the child's record or the child's current
			 behavior that such precautions are warranted;
8) children placed in seclusion shall not be
			 deprived of clothing (other than belts or items that may be used to inflict
			 self-injury), food, toileting, medication, or other basic living
			 functions.