Pennsylvania Code › Title 55 - HUMAN SERVICES › Part V - Children, Youth and Families Manual › Subpart E - Residential Agencies, Facilities and Services › Article I - Licensing/Approval › Chapter 3800 - CHILD RESIDENTIAL AND DAY TREATMENT FACILITIES › SECURE CARE › Section 3800.274 - Additional requirements

Current through Register Vol. 54, No. 28, July 13, 2024
The following additional requirements apply to
						  facilities in which secure care is provided:
(1) The facility shall have a valid fire
						safety occupancy approval appropriate for locked facilities from the
						appropriate authority, listing the type of occupancy, prior to receiving a
						certificate of compliance under this chapter.
(2) A reportable incident as specified in
						§
												3800.16(a)
						(relating to reportable incidents) includes a child's absence from the premises
						for any period of time, an assault on a staff person by a child that requires
						medical treatment for the staff person, the use of handcuffs or leg restraints
						beyond 2 hours, and the use of seclusion beyond 4 hours.
(3) Children shall be directly supervised at
						all times during awake hours.
(4) A
						minimum of two child care workers shall be present in the facility at all
						times.
(5) There shall be one child
						care worker present with the children for every six children during awake
						hours.
(6) There shall be one child
						care worker present with the children for every 12 children during sleeping
						hours.
(7) Children shall be
						supervised by conducting observational checks of each child within 15 minute
						intervals during sleeping hours.
(8) Observational checks of children during
						sleeping hours shall include actual viewing of each child.
(9) Observational checks of children during
						sleeping hours shall be recorded in writing noting the date, time, person
						making the check and any unusual circumstances observed.
(10) The driver and at least one additional
						staff person shall be present in the vehicle at all times one or more children
						are being transported. There shall be one child care worker present with the
						children for every three children during transportation of children either by
						the facility or another transportation source. The driver of the vehicle may
						not be counted in the staffing ratio.
(11) No more than two children may share a
						bedroom.
(12) Glass windows,
						windows in doors, shower doors and light fixtures and other glass surfaces
						shall be protected with a secure, nonbreakable covering or composed of
						shatterproof glass.
(13) Glass
						mirrors are not permitted.
(14)
						Furnishings or other items such as drapery cords, electrical outlets, shower
						curtains, shoe strings, razors and noncollapsing clothing hooks, that may
						create a risk for self-injury or suicide may not be accessible to a child whose
						health and safety assessment specified in §
												3800.141 (relating to child health
						and safety assessment) indicates known or suspected suicide or self-injury
						attempts or gestures or an emotional history which may indicate a
						predisposition to self-injury or suicide, except during specific activities
						while these items are in use and the child is under direct supervision by staff
						persons.
(15) Items such as knives,
						razors, matches and tools, that may create an opportunity for use as a weapon
						or tool in an assault or other violent behavior may not be accessible to a
						child whose health and safety assessment specified in §
												3800.141 indicates known incidents
						of aggressive or violent behavior, except during specific activities while
						these items are in use and the child is under direct supervision by staff
						persons.
(16) The following
						requirements apply to the use of mechanical restraints:
(i) Handcuffs behind the back, leg restraints
						and locking transportation waist belts with handcuffs in front of the child
						used during transportation, are the only types of mechanical restraints that
						are permitted.
(ii) A child may not
						be handcuffed to an object or another person.
(iii) Oral or written authorization by
						supervisory staff is required prior to each use of a mechanical restraint,
						except for those restraints used during transportation.
(iv) The use of handcuffs or leg restraints,
						except for those used during transportation, may not exceed 2 hours, unless a
						licensed physician, a licensed physician's assistant or registered nurse
						examines the child and gives written orders to continue the use of the
						restraint. Reexamination and new written orders are required for each 2-hour
						period the restraint is continued. If a restraint is removed for any purpose
						other than for movement and reused within 24 hours after the initial use of the
						restraint, it is considered continuation of the initial restraint.
(v) The restraint shall be checked for proper
						fit by a staff person at least every 15 minutes, except for those used during
						transportation.
(vi) The physical
						needs of the child shall be met promptly.
(vii) Handcuffs and leg restraints, except
						for those used during transportation, shall be removed completely for at least
						10 minutes during every 2 hours the restraint is used.
(viii) Handcuffs and leg restraints, except
						those used during transportation, shall be checked and observed by a
						supervisory staff person who is not administering the restraint, at least every
						1 hour the restraint is used.
(ix)
						The use of handcuffs and leg restraints for any child, except those used during
						transportation, may not exceed 4 hours in any 48-hour period without a written
						court order.