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MIS2008-00012 City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223 • • TIGARD July 22, 2008 ti G, Renew Consulting, Inc. 127 Broadalbin St. NW Albany, OR 97321 Re: Permit No. MIS2008 -00012 Dear Sir /Ms.: The City of Tigard has canceled the above referenced permit(s) and enclose a refund for the following: Site Address: 11830 SW 125 Ct. Project Name: Renew Consulting, Inc. Job No.: N/A Refund: ® Check #58404 in the amount of $607.00. ❑ Credit card "return" receipt in the amount of $ ❑ Trust account "deposit" receipt in the amount of $ Notes: Directors Interpretation not required; refund 100% of application fees. If you have any questions please contact me at 503.718.2430. • Sincerely, /( Dianna Howse Building Division Services Coordinator Enc. I: \Building\ Refunds\ Administration \LtrRefund- CancelPermitdoc 01/16/07 Phone: 503.639.4171 • Fax: 503.684.7297 • www.tigard- or.gov • TTY Relay: 503.684.2772 City of Tigard TIGARD Tidemark Refund Request This form is used for refund requests of land use, engineering and building application fees. Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be attached to this form. Refund requests are due to Tidemark System Administrator by Friday at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Tidemark System Administrator for distribution. Please allow 1 -2 weeks for processing. PAYABLE TO: Renew Consulting, Inc. DATE: 7/9/08 127 Broadalbin St. SW Albany, OR 97321 REQUESTED BY: Dianna Howse KJP TRANSACTION INFORMATION: Receipt #: 2008 -2247 Case #: MIS2008 -00012 Date: 6/25/08 Address /Parcel: 11830 SW 125th Ct. Pay Method: Check Project Name: Renew Consulting, Inc. EXPLANATION: Directors Interpretation not required per Dick Bewersdorff. Refund 100% of application fee. • REFUND INFORMATION: . . . ... •.... - Fee Description From Receipt :'.; .Revenue'Account No : = Refund • Example: [BUILD] Permit Fee', . • . • Exainple:"•.245- 0000 - 432000 • •. $ Amount [LANDUS] Interpretation of CDC 100- 0000 - 438000 $571.00 [LRPF] LR Planning Surcharge 100 - 0000 - 438050 36.00 TOTAL REFUND: $607.00 APPROVALS: If under $500 Professional Staff If under $7,500 Division Manager �(/"' -- 0 If under $22,500 Department Manager -. If under $50,000 City Manager If over $50,000 Local Contract Review Board . • • FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY' V Case Refund Processed: I Date: I 'WV' I By: I O I: \Building \Refunds \RefundRequest.doc 05/23/07 M I CITY OF TIGARD 6/26/2008 11 13125 SW hall Blvd. 1:20: I9PM Tigard, OR 97223 503.639.4171 TIGARD Receipt #: 27200800000000002247 Date: 06/25/2008 Line Items: Case No Trait Code Description Revenue Account No Amount Paid MIS2008 -00012 [LAN DUS] Interpretation of CDC 100- 0000 - 438000 571.00 M1S2008 -00012 [LRPF] LR Planning Surcharge 100- 0000 - 438050 36.00 Line Item Total: $607.00 Payments: Method Payer User ID Acct. /Check No. Approval No. Flow Received Amount Paid Check RENEW CONSULTING INC KJP 6336 In Person 607.00 Payment Total: $607.00 cltcccipl.rpl Pau,e I of I • 11 q Community Development TIGARD Request for Permit Action TO: CITY OF TIGARD Building Division Services Coordinator 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.718.2430 Fax: 503.598.1960 www.tigard - or.gov FROM: ❑ Owner ❑ Applicant ❑ Contractor ® City Staff (check one) REFUND OR Name: Renew Consulting Inc. INVOICE TO: (Business or Individual) Mailing Address: 127 Broadalbin St. SW \J 0 1 p City /State /Zip: Albany; OR 97321 /9 /C , a /' Phone No.: 541 - 981 -2458 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): ® CANCEL PERMIT APPLICATION. ® REFUND PERMIT FEES (attach receipt, if available). ❑ INVOICE FOR FEES DUE (attach case fee schedule and explain below). ❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit). Permit # : MIS2008 -00012 Site Address or Parcel # : 11830 SW 125` Q. Project Name: Renew Consulting Inc. Subdivision Name: Lot # : EXPLANATION: Refund fee Directors Interpertation not required per Dick Bewersdorff /0 V ``n 4u .z oL Signature: Date: 6 -26 -08 Kristie Peerman Print Name: Refund Policy 1. The Director or Building Official may authorize the refund of: a) any fee which was erroneously paid or collected. b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended. c) not more than 80% of the land use application fee for issued permits. d) not more than 80% of the building plan review fee when an application is canceled before any plan review effort has been expended. e) not more than 80% of the building permit fee for issued permits prior to any inspection requests. 2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 1 -2 weeks for processing refunds. FOR OFFICE USE ONLY Rte to Sys Admin: Date By Rte to Admin: Date -7 .?.. of- By 4 717 Refund Processed: Date V9 of- By 4 Invoice Processed: Date By Permit Canceled: Date - 9 of B �l„ Parcel Ta: Added: Date B Receipt kap - ar7 Date 4 /Os' 0J2 Method C �� Amount $ I: \Building \Forms \RegPermitAction.doc v 07/26/07 • City of Tigard, Ore g on 13125 SW Hall Blvd. • Ti g ard, OR 97223 ,14 T I GARIY= July 22, 2008 Renew Consulting, Inc. 127 Broadalbin St. NW Albany, OR 97321 Re: Permit No. MIS2008-00012 Dear Sir/Ms.: The City of Tigard has canceled the above referenced permit(s) and enclose a refund for the following: Site Address: 11830 SW 125th Ct. Project Name: Renew Consulting, Inc. Job No.: N/A Refund: ® Check#58404 in the amount of$607.00. ❑ Credit card "return"receipt in the amount of$ ❑ Trust account"deposit"receipt in the amount of$ Notes: Directors Interpretation not required;refund 100% of application fees. If you have any questions please contact me at 503.718.2430. Sincerely, Dianna Howse Building Division Services Coordinator Enc. I:\Building\Refunds\Administra tion\LtrRefund-CancelPermit.doc 01/16/07 Phone: 503.639.4171 • Fax: 503.684.7297 • www.tigard-or.gov • TTY Relay: 503.684.2772 • • City of Tigard TIGARD Tidemark Refund Request This form is used for refund requests of land use, engineering and building application fees. Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be attached to this form. Refund requests are due to Tidemark System Administrator by Friday at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Tidemark System Administrator for distribution. Please allow 1-2 weeks for processing. PAYABLE TO: Renew Consulting, Inc. DATE: 7/9/08 127 Broadalbin St. SW Albany, OR 97321 REQUESTED BY: Dianna Howse KJP TRANSACTION INFORMATION: Receipt#: 2008-2247 Case#: MIS2008-00012 Date: 6/25/08 Address/Parcel: 11830 SW 125th Ct. Pay Method: Check Project Name: Renew Consulting,Inc. EXPLANATION: Directors Interpretation not required per Dick Bewersdorff. Refund 100%of application fee. -REFUND INFORMATION: . ,:Fee Description From Receipt '' `jRevenue'Account No: Exariiple:�`'[BUILD]_PerniitFee . • F:. Exainplei',245-0000 432000' ' ` $`Amount+'=?' [LANDUS] Interpretation of CDC 100-0000-438000 $571.00 [LRPF]LR Planning Surcharge 100-0000-438050 36.00 TOTAL REFUND: $607.00 APPROVALS: If under$500 Professional Staff If under$7,500 Division Manager If under$22,500 Department Manager If under$50,000 City Manager If over$50,000 Local Contract Review Board t FOR TIDEMARK SYSTEM-ADMINISTRATION.USE ONLY'OP( Case Refund Processed: I Date: _ '� 9`Q� I By: I:\Building\Refunds\RefundRequest.doc 05/23/07 Er! CITY OF TIGARD 6/26/2008 - ' . 13125 SW Hall Blvd. 1:20:I9PM Tigard,OR 97223 503.639.4171 TIGARD Receipt #: 27200800000000002247 Date: 06/25/2008 Line Items: Case No 'Tan Code Description Revenue Account No Amount Paid MIS2008-00012 [LANDUS] Interpretation of CDC 100-0000-438000 571.00 MIS2008-00012 [LRPF] LR Planning Surcharge 100-0000-438050 36.00 Line Item Total: $607.00 Payments: • Method Payer User ID Acct./Check No. Approval No. 1-low Received Amount Paid Check- RENEW CONSULTING INC K.IP 6336 In Person 607.00 Payment Total: $607.00 • cReceipt.rpt Page I of I • • III ill Community Development TIGARD Request for Permit Action TO: CITY OF TIGARD Building Division Services Coordinator 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov FROM: ❑ Owner El Applicant ❑ Contractor ® City Staff (check one) REFUND OR Name: Renew Consulting Inc. INVOICF, TO: (Business or Individual) Mailing Address: 127 Broadalbin St. SW V0 1 1;1 City/State/Zip: Albany, OR 97321 MA I Phone No.: 541-981-2458 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED(✓): ® CANCEL PERMIT APPLICATION. ® REFUND PERMIT FEES (attach receipt, if available). El INVOICE FOR FEES DUE (attach case fee schedule and explain below). ❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit). Permit#: MIS2008-00012 Site Address or Parcel# : 11830 SW 125th Ct. Project Name: Renew Consulting Inc. Subdivision Name: Lot# : EXPLANATION: Refund fee Directors Interpertation not required per Dick Bewersdorff /d 0 7c) a(_ Signature: / ,.J Date: - 6-26-08 Kristie Peerman Print Name: Refund Policy 1. The Director or Building Official may authorize the refund of: a) any fee which was erroneously paid or collected. b) not more than 80%of the land use application fee when an application is withdrawn or canceled before any review effort has been expended. c) not more than 80%of the land use application fee for issued permits. d) not more than 80%of the building plan review fee when an application is canceled before any plan review effort has been expended. e) not more than 80%of the building permit fee for issued permits prior to any inspection requests. 2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 1-2 weeks for processing refunds. FOR OFFICE USE ONLY Rte to Sys Admin: Date By Rte to Admin: Date .7 .?". pJ- By 717 Refund Processed: Date 2/9 O,& _ By 4 Invoice Processed: Date By Permit Canceled: Date 2//0P By,4f44/---Parcel Tag Added: Date By Receipt#Q,p aar7 Date I: 4/zs/OP Method (-4 elm Amount$ \Building\Forms\RegPernutAction. oc Rev 07/26/07 6/25/2008 People Associated With 3:10:29PM Case # : M1S2008-00012 s Role , Address 1 " -;:PhOrie-i Type Pri Name ,; ; '4 ddress2 : , Phone Company Name OWN N LEUENBERGER,MARCEL+ 11830 SW 125TH CT None TIGARD OR 97223 APL Y RENEW CONSULTING,INC. 127 BROADALBIN ST SW 541-981-2458 None ALBANY OR 97321 Page 1 of 1 CasePeople..rpt w _ • • . newJUN 2 5 2008 CITY OF TICAnD CONSULTING,INC. • • • • 127 Broadalbin St. SW • • Albany, OR • 97321 • • • Phone 541 • 981 • 2458 Fax 541 • 981 • 2495 kathy @renewconsulting.com • www.renewconsulting.com June 24, 2008 Dear Tom, Thanks for meeting with us yesterday to assist in a resolution to opening our 24 Residential Care Home in the Summer Lake Community. We are requesting a interpretation of Chapter 18.130.020 Number 2, Group living as described in the first sentence is a licensing practice of Adult Foster Homes; our home/facility is licensed 24 hour Residential. The example as stated in number 2 includes nursing homes, convalescent homes along with Residential facilities. Our 24 hour shift staffing being in the same lines as all other nursing homes, convalescent homes. Enclosed are the OAR Rules for 24 hour Residential Homes/Facilities and also OAR Rules for Adult Foster Homes. We are also requesting a Temporary Occupancy subject to final interpretation of the municipal code above. We are requesting the Temporary Occupancy since our original plan to open the home was Friday June 27, 2008, client's are in need of placement and the State license has been approved pending the final inspection on the fire escape. Feel free to contact Mary Brown at 503-819-7164 with any further questions and/or concerns Sincerely, Kat y Aronson, Executive Director and Mary L. Brown, Regional Manager 2"d Letter Revised June 24, 2008 2PM a- • • - - - R737 JUN 2 5 2008 CONSULTING,INC. UTY 07:IMAM • • • • 127 Broadalbin St. SW • • Albany, OR • 97321 • • • Phone 541 • 981 • 2458- Fax 541 • 981 • 2495 kathy@renewconsulting.com • www.renewconsulting.com June 24, 2008 Dear Tom, Thanks for meeting with us yesterday to assist in a resolution to opening our 24 Residential Care Home in the Summer Lake Community. We are requesting a interpretation of Chapter 18.130.020 Number 2, Group living as described in the first sentence is a licensing practice of Adult Foster Homes; our home/facility is licensed 24 hour Residential. The example as stated in number 2 includes nursing homes, convalescent homes along with Residential facilities. Our 24 hour shift staffing being in the same lines as all other nursing homes, convalescent homes. Enclosed are the OAR Rules for 24 hour Residential Homes/Facilities and also OAR Rules for Adult Foster Homes. We are also requesting a Temporary Occupancy subject to final interpretation of the municipal code above. Feel free to contact Mary Brown at 503-819-7164 with any further questions and/or concerns Sincerely, Kathy Aronson, Executive Director and Mary L. Brown, Regional Manager 'EGON SECRETARY OF STATE '`' gy .,; : Oregon State Archive tbx? crU3 oars °Ieg_ e i ro;r corgi Vm!: _,get eal(!gy gcv,rnt►r The Oregon Administrative Rules contain OARs filed through May 15, 2008 DEPARTMENT OF HUMAN SERVICES, SENIORS AND PEOPLE WITH DISABILITIES DIVISION DIVISION 50 ADULT FOSTER HOMES Licensure of Adult Foster Homes 411-050-0400 Definitions For the purpose of these rules, authorized under ORS 443.705 to 443.825,the following definitions apply: (1) "AAA" means an Area Agency on Aging (AAA) which is an established public agency within a planning and service area designated under Section 305 of the Older Americans Act which has responsibility for local administration of programs within the State of Oregon's Department of Human Services, Seniors and People with Disabilities. For the purpose of this rule, Type B AAAs contract with the Department to perform specific activities in relation to licensing adult-foster homes including processing applications, conducting inspections and investigations, issuing licenses, and making recommendations to the Division regarding adult foster home license denial,revocation, suspension,non- renewal and civil penalties. (2) "Abuse" means any of the following: (a) Any physical injury to a resident that has been caused by other than accidental means. This includes injuries that a reasonable and prudent person would have been able to prevent, such as those resulting from hitting, pinching, striking, rough handling or corporal punishment. These instances of abuse are presumed to cause physical harm, including pain, to all residents, including those in a coma or otherwise incapable of expressing harm. (b) Failure to provide basic care or services to a resident, which failure results in physical harm, unreasonable discomfort or serious loss of human dignity. Abuse under this definition includes abandonment, improper use of restraints and the deprivation by an individual, including a caregiver, of goods or services that are necessary to attain or maintain physical,mental and psychosocial well-being. (c) Sexual contact with a resident, including fondling, by an employee or agent of a long-term care facility by: use of physical force, physical or verbal threat of harm, or deprivation to the resident or others; use of position, authority or misinformation to compel the resident to do what that resident would not otherwise do; or where the resident has no reasonable ability to consent. For the purpose of this rule, consent means a voluntary agreement or concurrence of wills and may be demonstrated by resident behavior as well as by verbal acknowledgment.Mere failure of the resident to object does not, in and of itself, constitute an expression of consent. (d) Theft or diversion of a resident's pr , including money,personal propernd medications; illegal or improper use of a resident's resources for the per 1 profit or gain of another person; bo ing resident funds; spending resident funds without the resident's consent; if the resident is not capable of consenting, spending resident funds for items or services from which the resident cannot benefit or appreciate; spending resident funds to acquire items for use in common areas when such purchase is not initiated by the resident; or acting as a resident's guardian, conservator, trustee or attorney in fact unless related by birth, marriage or adoption, to the resident as.follows: parent, child, brother, sister, grandparent, grandchild, aunt,uncle,niece or nephew.Nothing in this rule shall be construed to prevent an owner, administrator or employee from acting as a representative payee for the resident. (e)Verbal or mental abuse, as prohibited by federal law, which includes in extreme forms: the use of oral, written or gestured communication that willfully includes disparaging and derogatory terms to the resident, or within their hearing distance,regardless of their age, ability to comprehend or disability; humiliation; intimidation; harassment; threats of punishment or deprivation directed toward the resident; and unwanted or inappropriate crude or sexual language, questions, comments or other communication. Examples of verbal and mental abuse include, but are not limited to: threats of harm; saying things to frighten a resident, such as telling a resident that he or she will never be able to see his or her family again; and making unwanted sexual comments about a resident's body. Verbal or mental abuse is distinguished from a resident rights violation by the extreme or offensive nature of the communication. (f) Involuntary seclusion for convenience or discipline. Involuntary seclusion is defined as the separation of a resident from other residents or from his or her room, or confinement to his or her room(with or without roommates) against the resident's will or the will of the resident's legal representative. Emergency or short-term, monitored separation from other residents will not be considered involuntary seclusion and may be permitted if used: for a limited period of time as a therapeutic intervention to reduce agitation until professional staff can develop a plan of care to meet the resident's needs; or as part of an inter-disciplinary care plan after other interventions have been attempted. (3) "Activities of Daily Living (ADL)" means those personal functional activities required by an individual for health and safety. For the purpose of these rules, ADLs consist of eating, dressing and grooming,bathing and personal hygiene,mobility (ambulation and transfer), elimination(toileting, bowel and bladder management), and cognition and behavior management. (a) "Independent" means the resident can perform an ADL without help. (b) "Assist" means the resident is unable to accomplish with all tasks of an ADL, even with assistive devices, without the assistance of another person. (c) "Full Assist" means the resident is unable to do any part of an ADL task, even with assistive devices, without the assistance of another person. This means the resident requires the hands-on assistance of another person through all phases of the activity, every time the activity is attempted. (4) "Adult Foster Home (AFH)" means any family home or other facility in which residential care is provided in a Thome-like environment for compensation to five or fewer adults who are elderly or physically disabled and are not related to the licensee or resident manager by blood, marriage or adoption. For the purpose of this rule, adult foster home does not include any house, institution, hotel or other similar living situation that supplies room or board only, if no resident thereof requires any element of care. (5) "Advance Directive for Health Care" means the legal document signed by the resident giving heath care instructions if he or she should no longer be.able to give directions regarding his or her wishes. The directive gives the resident the means to continue to control her/his own health care in any circumstance. (6) "Applicant" means any person who completes an application for a license who will also be an owner of the business. (7) "Approved" (pertaining to the criminal history check process)means that a subject individual has completed that process and has been found to have no potentially disqualifying criminal history;or following an evaluation of factors • identified in OAR chapter 407, divisiorA117,the Authorized Designee determinAle subject individual's history does not indicate a likelihood of behavior thM1Pould endanger the welfare of persons Wiving care. (8) "Authorized Designee (AD)" means an employee of the Department of Human Services, Seniors and People with Disabilities or an Area Agency on Aging who is qualified to have access to the Law Enforcement Data System.(LEDS) information. (9) "Behavioral Interventions" means those interventions that will modify the resident's behavior or the resident's environment. (10) "Board of Nursing Rules" means the standards for Registered Nurse Teaching and Delegation to Unlicensed Persons according to the Statutes and rules of the Oregon State Board of Nursing, ORS 678.010 to 678.445 and OAR chapter 851, division 047. - (11) "Care" means the provision of room, board, services and assistance with activities of daily living, such as assistance with bathing, dressing, grooming, eating, money management, recreation or medication management, except that assistance with self-medication is not included as part of care for purposes of these rules. Care also means assistance to promote maximum independence and enhance the quality of life for residents. (12) "Caregiver" means any person responsible for providing care and services to residents, including the licensee;the resident manager; shift caregiver; and any temporary, substitute or supplemental staff or other person designated to provide care and services to residents. (13) "Care Plan" means the licensee's written description of a resident's needs,preferences, and capabilities, including by whom, when, and how often care and services will be provided. (14) "Classification" means a designation of license assigned to a licensee based on the qualifications of the licensee, resident manager, and shift caregiver's qualifications, as applicable. (15) "Client" means a resident in an adult foster home for whom the Department pays for care and for whom case management services are provided. "Client" also means a Medicaid recipient. (16) "Compensation" means monetary or in-kind payments by or on behalf of a resident to a licensee in exchange for room, board, care and services. Compensation does not include the voluntary sharing of expenses between or among roommates. (17) "Complaint" means an allegation that a licensee or caregiver has violated the adult foster home rules or an expression of dissatisfaction relating to the resident(s) or the condition of the adult foster home. (18) "Condition" means a provision attached to a new or existing license that limits or restricts the scope of the license or imposes additional requirements on the licensee. (19) "Criminal History Check Rules" refers to OAR chapter 407, division 007. (20) "Day Care" means care, assistance, and supervision of a person who does not stay overnight. (21) "Delegation" means the process by which a registered nurse teaches and supervises a skilled nursing task. (22) "Denied" (pertaining to the criminal history check process) means that a subject individual, following a final • fitness determination, has been determined to pose a risk to the physical, emotional or financial well-being of the elderly or persons with disabilities according to OAR chapter 407, division 007. (23) "Department" means the State of Oregon Department of Human Services. - (24) "Director" means the Director of tl epartment of Human Services or tha rson's designee. (25) "Disabled" means a person with a physical, cognitive, or emotional impairment which, for the individual, constitutes or results in a functional limitation in one or more activities of daily living. (26) "Division" means the Seniors and People with Disabilities (SPD) of the Department of Human Services. Division also includes the local Division units and the AAAS who have contracted to perform specific functions of the licensing process. (27) "Elderly" or "Aged," for the purposes of these rules, means any person age 65 or older. (28) "Exception" means a variance from a regulation or provision of these rules, granted in writing by the Division, upon written application by the licensee. (29) "Exempt Area" means a county where there is a county agency that provides similar programs for licensing and inspection of adult foster homes which the Director finds are equal to or superior to the requirements of ORS 443.705 to 443.825 and which the Director has exempted from the license, inspection, and fee provisions of ORS 443.705 to 443.825. Exempt area county licensing rules must be submitted to the Director for review and approval prior to implementation. (30) "Family Member," for the purpose of these rules, means husband or wife,natural parent, child, sibling, adopted child, adoptive parent, stepparent, stepchild, stepbrother, stepsister, father-in-law,mother-in-law, son-in-law, daughter- in-law,brother-in-law, sister-in-law, grandparent, grandchild, aunt, uncle,niece, nephew, or first cousin. (31) "Fitness Determination" means an evaluation by an Authorized Designee(AD) of the subject individual's criminal history and any mitigating information that is provided by that subject individual. (32) "Home" means the physical structure in which residents live.Home is synonymous with adult foster home. (33) "Home-like" means an environment that promotes the dignity, security and comfort of residents through the provision of personalized care and services and encourages independence, choice, and decision-making by the residents. (34) "House Policies" mean written and posted statements addressing house activities in an adult foster home. (35) "Legal Representative" means a person who has the legal authority to act for the resident. For health care decisions,this is a court-appointed guardian, a health care representative under an Advance Directive for Health Care, or Power of Attorney for Health Care. For financial decisions,this is a legal conservator, an agent under a power of attorney, or a representative payee. (36) "License" means a certificate issued by the Division to applicants who are in compliance with the requirements of these rules. (37) "Licensed Health Care Professional" means an individual who possesses a professional medical license that is valid in the State of Oregon. Examples include, but are not limited to, a registered nurse (RN), nurse practitioner(NP), licensed practical nurse (LPN), medical doctor(MD), osteopathic physician(DO), respiratory therapist(RT), physical therapist(PT) or occupational therapist(OT). (38) "Licensee" means the person(s)who applied for, was issued,a license, and whose name(s) is on the license and who is responsible for the operation of the home(s). The licensee of the adult foster home does not include the owner or lessor of the building in which the adult foster home is situated unless he or she is also the operator. "Licensee" is _ synonymous with "licensed provider". (39) "Limited License" means a license is issued to a licensee who intends to provide care for compensation to a specific individual who is unrelated to eicensee but with whom there is an eseished relationship. • (40) "Liquid Resource'' means cash or those assets that can readily be converted to cash such as a life insurance policy that has a cash value or stock certificates, or a guaranteed line of credit from a financial institution. (41) "National Criminal History Check" means a review by the Department of a subject individual's criminal history outside of the State of Oregon obtained from the Federal Bureau of Investigation(FBI)through the submission of fingerprint cards. (42) "Neglect" (whether intentional, careless, or due to inadequate experience, training, or skill) means failure to seek appropriate medical care or failure to provide care necessary to ensure the health, safety, and well-being of a resident; failure to follow the care plan; failure to make a reasonable effort to discover what care is necessary for the well-being of a resident; improper administration of medication; or failure to provide a safe and sanitary environment. (43) "Nursing Care" means the practice of nursing by a licensed nurse, including tasks and functions relating to the provision of nursing care that are taught or delegated under specified conditions by a registered nurse to persons other than licensed nursing personnel, as governed by ORS chapter 678 and rules adopted by the Oregon State Board of Nursing in OAR chapter 851. (44) "Occupant"means anyone residing in or using the facilities of the adult foster home including residents, licensees, resident managers, friends or family members, day care persons, and boarders. (45) "Ombudsman" means the State of Oregon Long-Term Care Ombudsman or an individual designee appointed by the Long-Term Care Ombudsman to serve as a representative of the Ombudsman Program in order to investigate and resolve complaints on behalf of the adult foster home residents. (46) "Physical Restraint" means any manual method or physical or mechanical device,material, or equipment attached to, or adjacent to,the resident's body which the resident cannot easily remove and restricts freedom of movement or normal access to his or her body. Physical restraints include,but are not limited to,wrist or leg restraints, soft ties or vests,hand mitts, wheelchair safety bars, lap trays, and any chair that prevents rising (such as a Geri-chair). Side rails (bed rails) are considered restraints when they are used to prevent a resident from getting out of a bed. The side rail is not considered a restraint when a resident requests a side rail for the purpose of assistance with turning. (47) "P.R.N. (pro re nata) Medications and Treatments" means those medications and treatments that have been ordered by a qualified practitioner to be administered as needed. (48) "Provider" means any person operating an adult foster home (i.e., licensee,resident manager or shift caregiver). "Provider" does not include the owner or lessor of the building in which the adult foster home is situated unless the owner or lessor is also the operator of the adult foster home. (49) "Potentially Disqualified" means the Division has determined a subject individual has a conviction for a potentially disqualifying crime or there is a discrepancy between the history disclosed by the subject individual and the information obtained through the criminal history check. The Authorized Designee must then make a fitness determination. (50) "Provisional License" means a 60-day license issued to a qualified person in an emergency situation when the licensed provider is no longer overseeing the operation of the adult foster home. The qualified person must meet the standards of OAR 411-050-0440 and 411-050-0443 except for completing the training and testing requirements. (See OAR 411-050-0415(9)) (51) "Psychoactive Medications" means various medications used to alter mood, anxiety, behavior or cognitive processes. For the purpose of these rules, they include,but are not limited to, antipsychotics, sedatives, hypnotics, and antianxiety medications. (52) "Relative" means those persons id1fied as family members in section(301this rule. (53) "Relative Adult Foster Home" means a home in which care and services are provided only to adult family members of the licensed provider who are 18 years or older and are elderly or physically disabled. The adult family member receiving care must be eligible for Medicaid assistance from the Department. A spouse is not eligible for compensation as a relative adult foster care licensee. (54) "Reside" means for a person to make an adult foster home his or her residence on a frequent or continuous basis. (55) "Resident" means any person who is receiving room, board, care, and services for compensation in an adult foster home on a 24-hour day basis. (56) "Residential Care" means the provision of care on a 24-hour day basis. V57) "Resident Manager" means an employee of the licensee who lives in the home and is directly responsible for the care of residents on a 24-hour day basis for five consecutive days. (58) "Resident Rights" or "Rights" means civil, legal or human rights, including but not limited to those rights listed in the Adult Foster Home Residents' Bill of Rights. (See ORS 443.739) (59) "Respite Resident" means a person who receives care for a period of 14 days or less or who only stays overnight. (60) "Room and Board" means receiving compensation for the provision of meals, a place to sleep, laundry and housekeeping to adults who are elderly or physically disabled and do not need assistance with their activities of daily living. Room and board facilities for two or more persons must register with the Division under OAR chapter 411, division 068. (61) "Self-Administration of Medication" means the act of a resident placing a medication in or on his or her own body. The resident identifies the medication, the time and manner of administration, and places the medication internally or externally on his or her own body without assistance. (62) "Self-Preservation" in relation to fire and life safety means the ability of residents to respond to an alarm without additional cues and reach a point of safety without assistance. (63) "Services" means activities that help the residents develop skills to increase or maintain their level of functioning or which assist them to perform personal care or activities of daily living or individual social activities. (64) "Shift Caregivers" mean caregivers who,by written exception of the Division, are responsible for providing care for regularly scheduled periods of time, such as 8 or 12 hours per day, in homes where there is no licensee or resident manager living in the home. (65) "SPD" means Seniors and People with Disabilities of the State of Oregon, Department of Human Services. (66) "Subject Individual" means any person, 16 years of age or older who has regular contact with residents, resides, receives training, works in an adult foster home or is the recipient of a Medicaid service payment in a relative adult foster home. A resident and his or her visitors are not "subject individuals". (67) "Substitute Caregiver" means any person other than the licensee, resident manager, or shift caregiver who provides care and services in an adult foster home under the jurisdiction of Seniors and People with Disabilities. Stat. Auth.: ORS 410.070 Stats. Implemented: ORS 443.705 Hist.: SSD 14-1985, f. 12-31-85, ef. 1-1-86; SSD 11-1988, f. 10-18-88, cert. ef. 11-1-88; SSD 3-1992, f. 5-26-92, cert.- ef. 6-1-92; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1996, f. 3-29-96, cert. ef. 4-1-96; SDSD 4-2001, f. & cert. ef. 3-1-01; SPD 31-2006, f. 12-27-06, c.ef. 1-1-07 • 411-050-0401 Purpose The purpose of these rules is to establish standards and procedures for adult foster homes that provide care for adults who are elderly or physically disabled in a home-like environment that is safe and secure. The goal of adult foster care is to provide necessary care while emphasizing the resident's independence. This goal is reached through a cooperative relationship between the care providers and the resident(or court-appointed guardian) in a setting that protects and encourages resident dignity, choice, and decision-making. Residents'needs are to be addressed in a manner that supports and enables residents to maximize their ability to function at the highest level of independence possible. Stat. Auth.: ORS 410.070 Stats. Implemented: ORS 443.720 Hist.: SSD 3-1996, f. 3-29-96, cert. ef. 4-1-96; SDSD 4-2001,f. & cert. ef. 3-1-01; SPD 31-2006, f. 12-27-06, cert. ef. 1-1-07 411-050-0405 License Required (1)Any facility, which meets the definition of an adult foster home as defined in OAR 411-050-0400,must apply for and obtain a license from the Division or an exempt area county. (2)A person or entity must not represent themselves operating an adult foster home or accept placement of a person without being licensed. (3) Relative Adult Foster Home. Any home,which meets the definition of a Relative Adult Foster Home, must have a, license from the Division if receiving compensation from the Department. To qualify for this license and for compensation from the Department,the applicant or licensee must submit a completed application and Department's Health History and Physician or Nurse Practitioner's Statement, obtain a criminal history approval from the Department, demonstrate a clear understanding of the resident's care needs,meet minimal fire safety standards including the installation of smoke detectors and fire extinguishers, and obtain any training deemed necessary by the Division to provide adequate care for the resident. A spouse is not eligible for compensation as a relative adult foster care licensee. A relative adult foster home license is not required if services are provided to a relative without compensation to the license from the Department. (4) Limited Foster Home. If a home meets the definition of a limited license it must be licensed by the Division if the caregiver receives compensation privately or from the Department. The person requesting a limited license must meet the standards of a relative adult foster home and acquire any additional training deemed necessary by the Division to provide adequate care for the resident. The person receiving care will be named on the license. The license will be limited to the care of the named person only. Stat. Auth.: ORS 410.070 Stats. Implemented: ORS 443.725 Hist.: SSD 14-1985, f. 12-31-85, ef. 1-1-1986; SSD 11-1988, f 10-18-88, cert. ef. 11-1-88; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1996, f. 3-29-96, cert. ef. 4-1-96; SDSD 4-2001, f. & cert. ef. 3-1-01; SPD 31-2006, f 12-27-06, cert. ef. 1-1-07 411-050-0408 Capacity (1) Residents must be limited to five peer s who are unrelated to the licensee aliesident manager by blood or marriage and require care. (2)Respite residents are included in the license capacity of the home. (3)The number of residents permitted to reside in an adult foster home will be determined by the ability of the staff to meet the care needs of the residents, the fire safety standards for evacuation, and compliance with the facility standards of these rules. (4)Determination of maximum capacity must include consideration of total household composition including children and relatives requiring care and supervision. In determining maximum capacity, consideration must be given to whether children over the age of five have a bedroom separate from their parents. (5) When there are family members requiring care in a home in which the licensee is the primary, live-in caregiver, the allowable number of unrelated residents will be a maximum capacity of five if the following criteria are met: (a) The licensee can demonstrate the ability to evacuate all occupants from the adult foster home within three minutes or less; (b)The licensee has adequate staff and has demonstrated the ability to provide appropriate care for all residents (See OAR 411-050-0445(1)(e)); (c)There is an additional 40 square feet of common living space for each person above the five residents; (d)Bedrooms and bathrooms meet the requirements of OAR 411-050-0445(3)and(4); (e) The care needs of day care and respite person(s) are within the classification of the license and any conditions imposed on the license; (f) The well-being of the household including any children or other family members will not be jeopardized; and (g) If there are day care persons in the home licensees must have arrangements for day care persons to sleep in areas other than a resident's bed, a resident's private room, or space designated as common use, in accordance with OAR 411- 050-0445(4)(c). Stat. Auth.: ORS 410.070 Stats. Implemented: ORS 443.705 & 443.775 Hist. SSD 11-1988, f. 10-18-88, cert. ef. 11-1-88; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1996, f. 3-29-96, cert. ef. 4-1-96; SDSD 4-2001, f. & cert. ef.3-1-01; SPD 31-2006, f. 12-27- 06, cert. ef. 1-1-07 411-050-0410 License Application and Fees (1)The Department's application form must be completed and submitted with the non-refundable fee by the licensee applicant. The application is not complete until all of the required application information is submitted to the Division. Incomplete applications are void after 60 days from the date the licensing office receives the application form and nonrefundable fee. Failure to provide accurate information may result in the denial of the application. (2)A separate application is required for each location where an adult foster home is to be operated. (3)An application for a home that has a resident manager must include a Department's completed application form for the resident manager. (4) The license application must include • (a)Verification of attendance at a local office Orientation and succ essfiil completion of the Division's Basic Training examination. (See OAR 411-050-0440(1)(g)(A) and(B)) (b) The maximum resident capacity requested, relatives needing care, room and board occupants, and day care persons. The application must also include the name(s)of any other occupants in the home; (c)The classification being requested with information and supporting documentation regarding qualifications, relevant work experience, and training of staff as required by the Division; (d)A Health History and Physician or Nurse Practitioner's Statement(form SDS 903) regarding the individual's ability to provide care; (e)A completed Financial Information sheet (SDS 448A); a budget for operating the home that includes payroll expenses; and proof of at least two months' liquid resources; (f) The applicant must provide the Division with a list of all unsatisfied judgments, liens and pending lawsuits in which a claim for money or property is made against the applicant; all bankruptcy filings by the applicant; and all unpaid taxes due from the applicant. The Division will require the applicant provide proof of having the amount of resources necessary to pay those claims. The Division may require or permit the applicant to provide a current credit report to satisfy this financial requirement; (g)If the home is leased or rented,the applicant must submit a copy of the lease or rental agreement. The agreement will be a standard lease or rental agreement for residential use and include the following: (A) The owner and landlord's name; (B) Verification that the rent is a flat rate; and. (C) Signatures and date by the landlord and applicant; (h)If the applicant is purchasing or owns the home, verification of purchase or ownership must be submitted with the application. The financial information will not be included in the public file; (i)A signed Criminal History Request form provided by the Department for each person who will have regular contact with the residents, including the licensee(s),the resident manager, shift caregivers, substitute caregivers and any occupants 16 years of age and older, excluding residents; (j) The applicant must submit a current and accurate floor plan that indicates: (A) The size of rooms; (B) Which rooms are to be resident bedrooms and which are to be caregiver bedrooms; (C) The location of all the exits on each level of the home, including emergency exits such as windows; (D)The location of wheelchair ramp(s), if applicable; (E) Where the fire extinguishers and smoke alarms are located; and (F) The planned evacuation routes; - (k) If requesting a license to operate more than one home, a plan covering administrative responsibilities, staffing qualifications, and additional evidence Onancial responsibility; • (1)A$20 per bed non-refundable fee for each non-relative resident; (m) Three personal references who are not family members of the applicant. (See OAR 411-050-0400(30)) Current or potential licensees and co-workers of current or potential licensees are not eligible as personal references; (n)If the applicant or licensee intends to use a resident manager or shift caregiver, a Department's supplemental application completed by the resident manager or shift caregiver must be submitted; and (o)Written information describing the operation plan for the adult foster home, including the use of substitute caregivers, other staff, a back-up licensed provider or approved resident manager,and a plan on coverage for resident manager or shift caregiver absences, if applicable. (5) Shift Caregivers. Shift caregivers maybe used in lieu of a resident manager if granted a written exception by the Division. Use of shift caregivers detracts from the intent of a home-like environment, but will be allowed for specific resident populations. The type of residents served must be a specialized population with intense care needs such as those with Alzheimer's Disease,AIDS, or head injuries. If shift caregivers are used, they must meet or exceed the experience and training qualifications for the license classification requested. (6)After receipt of the completed application materials, including the non-refundable fee the Division must investigate the information submitted including pertinent information received from outside sources, inspect the home, and conduct a personal interview with the applicant. (7)If cited violations from the home inspection are not corrected within the time frames specified by the Division, the issuance of the license must be denied. (8) The applicant may withdraw his or her application at any time during the application process by written notification to the Division. (9)An applicant whose license has been revoked, voluntarily surrendered during a revocation or non-renewal process, or whose application for licensure has been denied shall not be permitted to make a new application for one year from the date the revocation, surrender, or denial was final, or for a longer period if specified in the order revoking or denying the license. [ED.NOTE: Forms referenced are available from the agency.] Stat. Auth.: ORS 410.070 Stats. Implemented: ORS 443.735 Hist.: SSD 14-1985, f. 12-31-85, ef. 1-1-86; SSD 11-1988, f. 10-18-88, cert. ef. 11-1-88; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1996, f. 3-29-96, cert. ef. 4-1-96; SDSD 4-2001, f. & cert. ef. 3-1-01; SPD 31-2006, f. 12-27-06, cert. ef. 1-1-07 411-050-0412 Criminal History Clearance (1)No person may be a licensee, resident manager, shift caregiver, substitute caregiver, or otherwise be in training, employed by a licensee or reside in or on the property of an adult foster home who has not been approved by the Department to work with adults who are elderly or physically disabled in accordance with OAR chapter 407, division 007, Criminal History Check Rules. The approval must be maintained as required. (2) Section(1) of this rule does not apply to: (a) Residents of the adult foster home; • (b) Anyone under the age of 16 years old; or (c) Persons who live or work on the property who do not access the home for meals, or use the appliances or facilities, and do not have unsupervised access to residents or their personal property. (3) In a relative adult foster home,the person receiving payment for providing services to the client is the only person who must be approved by the Department, in accordance with OAR chapter 407, division 007, Criminal History Check Rules. (4) The Department will conduct criminal history checks and obtain information from the Law Enforcement Data System (LEDS) and if necessary, the Federal Bureau of Investigation(FBI), other law enforcement agencies or the courts. (5)A national criminal history check is required for any subject individual who has lived outside the State of Oregon for sixty (60) or more consecutive days during the previous three years or for the reasons described in OAR chapter 407, division 007, Criminal History Check Rules. Resident managers, shift caregivers and substitute caregivers may work in the home pending the outcome of the national criminal history check if the Oregon criminal history check does not reveal any potentially disqualifying crimes and no out-of-state convictions were self-disclosed on the Department's Criminal History Request form. The Department may determine a national criminal history check is not required if the subject individual, according to the Department's Criminal Record Clearance Registry,passed a national check within the previous three years and has not lived outside of Oregon during those three years. (6)An Authorized Designee (AD)will make the fitness determination on all licensee applicants, all licensed providers and all subject individuals. (7)A subject individual must NOT work, receive training or reside in an adult foster home if the subject individual refuses to cooperate with the criminal history check process (e.g.,refuses to be fingerprinted when requested, refuses to complete the Department's Criminal History Request form). (8) The licensee must have written verification from the Division that the required criminal history checks have been completed for all employees,trainees and occupants of the home other than residents. (See OAR 411-050-0444(6)(a) (A)) (9) The Division must provide for the expedited completion of a criminal history check for the State of Oregon when requested by a licensed provider because of an immediate staffing need. Stat. Auth.: ORS 181, 410.070 &443 Stats. Implemented: ORS 181.537 & 443.735 Hist.: SDSD 4-2001, f. &cert. ef. 3-1-01; SPD 31-2006, f. 12-27-06, cert. ef. 1-1-07 411-050-0415 Issuance (1) The Division will issue a license within 60 days after the completed application materials have been received if the home and applicant are in compliance with these rules. The license will state the name of the resident manager, or shift caregivers as applicable, the name(s)of the licensee(s)who have met the requirements to operate the adult foster home, the address of the premises to which the license applies,the license classification, the maximum number of residents and the expiration date..The license must be posted in a prominent place in the home and be available for inspection at all times. (2) The licensee will be given a copy of the Division inspection report forms SDS 517A and 517B, identifying any areas of non-compliance and specifyinme frame for correction, not exceed0 days from date of inspection. The licensee must post the most recent inspOgion reports in the entry or equally pronWent place and must, upon request, provide a copy of the reports to each resident,person applying for admission to the home, or the legal representative, guardian or conservator of a resident. (3)The Division may attach conditions to the license that limit, restrict or specify other criteria for operation of the home. The conditions must be posted with the license (See OAR 411-050-0483). (4)A limited license may be issued to a licensee for the care of a specific person(s). A licensee with this limitation will make no other admissions and at a minimum, must meet the requirements of licensure for a relative adult foster home. A licensee with a limited license may be subject to the requirements specified in the Standards-and Practices for Care and Services. (See OAR 411-050-0447) (5) The Division will not issue an initial license unless: (a) The applicant and adult foster home are in co mpliance with ORS 443.705 to 443.825, and OAR chapter 411, division 050,Adult Foster Homes; (b) The Division has completed an inspection of the adult foster home; (c)The Department has completed a criminal history check in accordance with OAR chapter 407, division 007; (d)The Division has checked the record of sanctions available from its files, including the list of nursing assistants who have been found responsible for abuse and whose names have been added to the registry pursuant to ORS 441.678; and (e)The applicant has demonstrated to the Division the financial ability and resources necessary to operate the adult foster home. (6).A license is valid for one year unless revoked or suspended by the Division. (7)In seeking an initial license,the burden of proof will be upon the applicant of the adult foster home to establish compliance with ORS 443.705 to 443.825, and OAR chapter 411, division 050,Adult Foster Homes. (8)The Division will not issue a license to operate an additional adult foster home to a licensee who has failed to achieve and maintain substantial compliance with the rules and regulations while.operating his or her existing home or homes. (9)Notwithstanding any other provision of this rule or ORS 443.725 or 443.738, the Division may issue a 60-day provisional license to a qualified person if the Division determines that an emergency situation exists after being notified that the licensed provider is no longer overseeing the operation of the adult foster home for purposes of this rule. A person will be considered qualified if they are 21 years of age and meet the requirements of a substitute caregiver. [ED.NOTE: Forms referenced are available from the agency.] Stat. Auth.: ORS 410.070 Stats. Implemented: ORS 443.735 Hist.: SSD 14-1985, f. 12-31-85, ef. 1-1-86; SSD 11-1988, f. 10-18-88,cert. ef. 11-1-88; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1996, f. 3-29-96, cert. ef. 4-1-96; SDSD 4-2001, f. & cert. ef. 3-1-01; SPD 31-2006, f. 12-27-06, cert. ef. 1-1-07 411-050-0420 Renewal • (1)At least 60 days prior to the expirat' of a license, the Division will mail a As}nder notice and renewal application to the licensed provider. The Division Ar investigate any information in the reWGal application and will conduct an unannounced inspection of the adult foster home prior to the license renewal. (2)Renewal Application Requirements. The licensee, resident manager and shift caregivers, as applicable, must submit complete and accurate renewal applications prior to the expiration date to keep the license in effect until the Division takes action. The licensee's renewal application must include: - (a) The Department's license renewal application form; (b)A $20 non-refundable fee for each resident based on the license capacity requested; (c)The Department's Criminal History Request form, completed for each person who will have regular contact with the residents, including the licensee(s),the resident manager, all other caregivers, and any occupants 16 years of age and over, excluding residents; (d)A completed Financial Information sheet(form SDS 903) if the licensee's financial information has changed since the prior application; and (e)A Health History and Physician or Nurse Practitioners' Statement must be updated every third year or sooner if there is reasonable cause for health concerns. (3) Late Renewal Requirements (Unlicensed Adult Foster Home). The home will be treated as an unlicensed facility, subject to Civil Penalties, if the required renewal information and fee are not submitted prior to the expiration date and residents remain in the home. (See OAR 411-050-0487) (4) The licensee will be given a copy of the Division's inspection report forms SDS 517A and 517B citing any violations and a time frame for correction, which will be no longer than 30 days from the date of inspection. (5)The Division will require the licensee to correct violations relating to the health,safety, and welfare of residents prior to issuing the renewal license. If cited violations are not corrected within the time frame specified by the Division, the renewal license may be denied. (6)The Division will not renew a license unless the following requirements are met. (a) The applicant and the adult foster home are in compliance with OAR chapter 411, division 050; (b)The Division has completed an inspection of the adult foster home; (c)The Department has completed a criminal history check in accordance with OAR chapter 407, division 007, Criminal History Check Rules; and (d)The Division has checked the record of sanctions available from its files, including the list of nursing assistants who have been found responsible for abuse and whose names have been added to the registry pursuant to ORS 441.678. (7)In seeking a renewal of a license when an adult foster home has been licensed for less than 24 months, the burden of proof will be upon the licensee to establish compliance with ORS 443.705 to 443.825, and OAR chapter 411, division 050 and chapter 407, division 007. (8)In proceedings for renewal of a license when an adult foster home has been licensed for 24 or more continuous months,the burden of proof will be upon the Division to establish noncompliance with ORS 443.705 to 443.825, and OAR chapter 411, division 050. [ED.NOTE: Forms referenced are available from the agency.] Stat. Auth.: ORS 410.070 • Stats. Implemented: ORS 443.735 fb Hist.: SSD 14-1985, f. 12-31-85, ef. 1-1-86; SSD 11-1988, f. 10-18-88, cert. ef. 11-1-88; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1996, f. 3-29-96, cert. ef. 4-1-96; SDSD 4-2001, f. & cert. ef. 3-1-01; SPD 31-2006, f. 12-27-06, cert. ef. 1-1-07; SPD 9-2007, f. 6-27-07,cert. ef. 7-1-07 411-050-0430 Exceptions (1)An applicant or licensee may request an exception to the provisions of these rules. The request must be in writing and must include clear and convincing evidence that such an exception: (a) Will not jeopardize the care, health, welfare or safety of the residents and all of the residents' needs will be met; and (b)Will assure that all residents, in addition to other occupants in the home, can be evacuated in three minutes or less. (2) Exceptions NOT allowed.Notwithstanding section(1) of this rule,no exception will be granted from a regulation or provision of these rules pertaining to: (a)Resident Capacity(See OAR 411-050-0408); (b) Standards and Practices for Care and Services (See OAR 411-050-0447); or (c) Inspections of the facility (See OAR 411-050-0450). (3)Exceptions may not be granted to any rule that is inconsistent with Oregon Revised Statutes. (4) Exception requests related to fire and life safety will not be granted by the Division without prior consultation with the State Fire Marshal or its designee. (5)In making its determination to grant an exception,the Division will consider the licensee's history of compliance with rules governing adult foster homes or other long-term care facilities for the elderly or physically disabled in this state or any other jurisdiction, if appropriate. The Division must determine that the exception is consistent with the intent and purpose of these rules prior to granting an exception. (See OAR 411-050-0401) (6)An exception is not effective until granted in writing by the Division. Exceptions will be reviewed pursuant to the criteria in OAR 411-050-0430. If applicable,the licensee must reapply for an exception at the time of license renewal or more often if determined necessary by the Division. (7) At all times the burden of proof will be on the applicant or licensee to prove that the requirements of OAR 411-050- 0430 have been met. (8)If an exception to any provision of these rules is denied, the applicant or licensee may request a meeting with the local Division. Stat. Auth.: ORS 410.070 Stats. Implemented: ORS 443.775 Hist.: SSD 14-1985, f. 12-31-85, ef. 1-1-86; SSD 11-1988, f. 10-18-88, cert. ef. 11-1-88; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1996, f. 3-29-96, cert. ef. 4-1-96; SDSD 4-2001, f. & cert. ef. 3-1-01; SPD 31-2006, f. 12-27-06, cert. ef. 1-1-07 411-050-0435 _ Contracts and Refunds • • (1)Medicaid Contractual Agreement: (a)Applicants or licensees who intend to care for Medicaid eligible clients must enter into a contractual agreement with the Department, sign a completed Provider Enrollment form and follow Department rules and contract terms. (b)A valid contractual agreement is not a guarantee that Medicaid eligible individuals will be placed in an adult foster home. (c)No Medicaid eligible clients will be admitted into an adult foster home unless and until: (A) The Division has approved a Provider Enrollment agreement. The Department cannot issue a Medicaid payment to a licensee without a current Provider Enrollment agreement in place; (B) The client has been screened according to OAR 411-050-0447; and (C) The Division has authorized the placement. The authorization must be clearly documented in the resident's record with other required admission materials. (See OAR 411-050-0447(2)) (d) The rate of compensation established by the Division is considered payment in full and licensees must not accept additional funds or in-kind payment; (e) The Department will not make payment for the date of discharge or for any time period thereafter; and (f)A licensee who elects to provide care for a Medicaid recipient is not required to admit more than one Medicaid recipient. However, if the licensee has a valid Medicaid contract for that home, private-pay residents who become eligible for Medicaid assistance cannot be asked to leave solely on the basis of Medicaid eligibility. (g) Either party may terminate a Medicaid contract according to the terms of the contract. (h) Death of Medicaid Resident with No Surviving Spouse. The licensee must forward all personal incidental funds - (PIF)to the Estate Administration Unit, P. O. Box 14021, Salem, Oregon 97309-5024, within 10 business days of the death of a Medicaid resident with no surviving spouse. (See Limits on Estate Claims, OAR 461-135-0835) (2) Private Contract: Licensees who care for private-pay residents must enter into a written contract,which is an admission agreement with the resident or person paying for care. A copy of the contract is subject to review by the Division prior to licensure. The contract must include, but not be limited to: (a) Services to be provided and the rate to be charged. A payment range may not be used unless the contract plainly states when an increase in rate can be expected based on increased care or service needs. (b) Conditions under which the rates can be changed; (c) The home's refund policy in instances of a resident's hospitalization, death, discharge, transfer to a nursing facility or other care facility, or voluntary move. The refund policy must be in compliance with OAR 411-050-0435(3); (d) The home's policies on voluntary moves and whether or not the licensee requires written notification of a resident's intent not to return; (e) Charges for storage of belongings that remain in the adult foster home for more than 15 days after the resident has left the home, if any; and - (f) A statement indicating that residents are not liable for damages considered normal wear and tear on the adult foster home and its contents. • (g)The licensee must not charge or ask for application fees or non-refundable deposits. Fees to hold a bed are permissible. (h)The licensee must give a copy of the signed contract to the resident or his or her representative, which will be documented in the resident's record. (i)The licensee must not include any illegal or unenforceable provision in a contract with a resident and must not ask or require a resident to waive any of the resident's rights or licensee's liability for negligence. (j) Thirty days prior to any general rate increases, additions, or other modifications of the rates, the licensee must give written notice of the proposed changes to private-pay residents and their family or other representatives,unless the change is due to the resident's increased care or service needs, and the agreed upon rate schedule in the resident's contract has specified charges for those changes . (3)Refunds: (a)If a resident dies, the licensee must not retain nor require payment for more than 15 days after the date of the resident's death, or the time specified in the licensee's contract, whichever is less. (b)If a resident leaves an adult foster home for medical reasons and the resident or the resident's representative indicates the intent to not return,the licensee must not charge the resident for more than 15 days or the time specified in the licensee contract, whichever is less,after the date the licensee receives notification from the resident or the resident's representative. (c)The licensee has an obligation to act in good faith to reduce the charge to the resident who has left the home, by seeking a new resident to fill the vacancy. (d)The licensee must refund any unused advance payments to the resident, or the resident's representative as appropriate, within 30 days after the resident dies or leaves the home. (e) If the adult foster home closes or the licensee gives written notice for the resident to leave,the licensee waives the right to collect any fees beyond the date of closure or the resident's departure, whichever is sooner. (f)If a resident dies or leaves an adult foster home due to neglect or abuse at the adult foster home that is substantiated by a Department investigator, or due to conditions of imminent danger of life,health or safety,the licensee must not charge the resident beyond the resident's last day in the home. (g)Refund policies must also apply to the sections in these rules on moves, transfers and discharges. (See OAR 411- 050-0444(9)(10)(11)) [ED.NOTE: Forms referenced are available from the agency.] Stat. Auth.: ORS 410.070 Stats. Implemented: ORS 443.738 Hist.: SSD 14-1985, f. 12-31-85, ef. 1-1-86; SSD 11-1988, f. 10-18-88, cert. ef. 11-1-88; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1996, f. 3-29-96, cert. ef. 4-1-96; SDSD 4-2001, f. & cert. ef. 3-1-01; SPD 31-2006, f. 12-27-06, cert. ef. 1-1-07. 411-050-0440 Qualification and Training Requirements for Licensees,Resident Managers and Other Caregivers (1) Licensee Requirements --Adult foal home licensees must meet and maint ' the requirements specified in this section. Adult foster home applicants licensees must: �. (a)Live in the home that is to be licensed unless there is an approved resident manager, or an exception for shift caregivers has been granted according to OAR 411-050-0440(4); (b)Be at least 21 years of age; (c)Possess physical health, mental health, good judgment and good personal character, including truthfulness, determined necessary by the Division to provide 24-hour care for adults who are physically disabled or elderly. Applicants must have a statement from a physician or other qualified practitioner indicating they are physically, cognitively, and emotionally capable of providing care to residents. Applicants with documented history or substantiated complaints of substance abuse or mental illness must provide evidence satisfactory to the Division of successful treatment, rehabilitation or references regarding current condition; (d)Be approved annually to have contact with adults who are elderly or physically disabled in accordance with OAR chapter 407, division 007, Criminal History Check Rules and maintain that approval as required; (e)Be literate in the English language and demonstrate the ability to communicate in English verbally and in writing with residents and their family members or representatives, emergency personnel (e.g., emergency operator, paramedics and fire fighters),physicians, nurses, case managers, Division staff and other professionals involved in the care of residents; (f)Be able to respond appropriately to emergency situations at all times; and (g)Training Requirements --Applicants and licensees must have the education, experience, and training to meet the requirements of their requested classification. (See OAR 411-050-0443) The following training requirements must be completed prior to obtaining a license: (A)Potential applicants must attend a Division-approved orientation program offered by the local licensing authority. (B)Potential applicants must pass the Division's Basic Training Course examination to meet application requirements for licensure. Potential applicants who fail the first examination may take the examination a second time, however successful completion of the examination must take place within 90 days of the end of the Basic Training Course. Potential applicants who fail a second test must retake the Division's Basic Training Course prior to repeating the examination. (2)Financial Requirements. Applicants and licensees must have the financial ability and maintain sufficient liquid resources to pay the operating costs of the adult foster home for at least two months without solely relying on potential resident income. If an applicant is unable to demonstrate the financial ability and resources required by this section, the Division may require the applicant to furnish a financial guarantee such as a line of credit or guaranteed loan as a condition of initial licensure. (3)Resident Manager Requirements. Applicants for resident manager must meet and maintain the qualification and training requirements specified in OAR 411-050-0440(1)(a)through(1)(g)(B). An applicant will not be approved as a resident manager until the Division has verified that all the requirements have been satisfied. (4) Shift Caregiver Requirements. Applicants for shift caregiver must meet and maintain the qualifications outlined in OAR 411-050-0440(1)(b)through(1)(g)(B). An applicant will not be approved as a shift caregiver until the Division has verified that all the requirements have been satisfied. (See OAR 411-050-0410(4)(n)) (5)Training Within First Year of Licensing: Licensees,resident managers and shift caregivers must complete within the first year of obtaining an initial license a Basic First Aid course, a cardiopulmonary resuscitation (CPR) course, and attend Fire and Life Safety training as available. The Division and the Office of the State Fire Marshal or the local fire • prevention authority may coordinate tllire and Life Safety training program. (6)Annual Training Requirements for Licensees, Resident Managers and Shift Caregivers for License Renewal: • (a) Each year after the first year of licensure, licensees, resident managers and shift caregivers are required to complete at least 12 hours of Division-approved training related to the care of adults who are elderly or physically disabled. Up to four of those hours may be related to the business operation of an adult foster home. (b)Licensees,resident managers and shift caregivers, as applicable, must maintain their CPR certification. (c) Registered nurse delegation or consultation, CPR certification and First Aid training or consultation with an accountant do not count toward the 12 hours of the annual training requirement. (7) Substitute Caregiver Requirements. Substitute Caregivers, or any other person left in charge of residents for any period of time must not be a resident, and must at a minimum, meet the following qualifications: (a) Be at least 18 years of age; (b) Be approved annually to work with adults who are elderly or have physical disabilities in accordance with OAR chapter 407, division 007, Criminal History Check Rules and maintain that approval as required. (c)Be literate in the English language and demonstrate the ability to communicate in English verbally and in writing with residents, residents' representatives and family members, emergency personnel(e.g., emergency operator, paramedics and fire fighters),physicians, case managers, Division staff, and other professionals involved in the care of residents; (d)Be able to respond appropriately to emergency situations at all times; (e)Have a clear understanding of their job responsibilities, have knowledge of the residents' care plans and be able to provide the care specified for each resident including appropriate delegation or consultation by a registered nurse; (f) Possess physical health, mental health, good judgment, and good personal character, including truthfulness, determined necessary by the Division to provide care for adults who are elderly or physically disabled, as determined by reference checks and other sources of information; and (g)Training Requirements for Substitute Caregivers: (A) Substitute caregivers must be oriented to the home and to the residents by the licensee or resident manager including the location of any fire extinguishers; demonstration of evacuation procedures; location of residents'records; location of telephone numbers for the residents'physicians, the licensee and other emergency contacts; location of medications and key for medication cabinet; introduction to residents; instructions for caring for each resident; and delegation by a registered nurse for nursing tasks if applicable. (B) A substitute caregiver must complete the Department's Caregiver Preparatory Training Study Guide (SDS 9030) and Workbook(SDS 9031), and must receive instruction in specific care responsibilities from the licensee or resident manager. The Workbook must be completed by the substitute caregiver without the help of any other person and be considered part of the required orientation to the home and residents. (C) Substitute caregivers left in charge of an adult foster home for any period that exceeds 48 continuous hours, may be required to meet the education, experience and training requirements of a resident manager if the licensing authority determines that such qualifications are necessary based on the resident impairment levels in the home. (D)The Division may grant an exception to the Caregiver Preparatory Training Study Guide and Workbook requirement in paragraph(7)(g)(B)of this rule for a substitute caregiver who holds a current Oregon license as a health care professional such as a physician, rastered nurse, or licensed practical nuraho demonstrates the ability to provide adequate care to residents base n similar training or at least one year experience providing direct care to adults who are elderly or physically disabled. A certified nursing assistant(CNA) must complete the Caregiver Preparatory Training Workbook and have a certificate of completion signed by the licensee. (8) If a licensee is not in compliance with one or more of these rules or the classification for which he or she is licensed, the Division may require,by condition, additional training in the deficient area(s). [ED.NOTE: Forms referenced are available from the agency.] Stat. Auth.: ORS 410.070 Stats. Implemented: ORS 443.735 & 443.738 Hist.: SSD 14-1985, f. 12-31-85, ef. 1-1-86; SSD 11-1988, f. 10-18-88, cert. ef. 11-1-88; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1995, f. & cert. ef. 3-15-95; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1996, f. 3-29-96, cert. ef. 4-1-96; SDSD 4-2001, f. & cert. ef. 3-1-01; SPD 31-2006, f. 12-27-06, cert. ef. 1-1-07 411-050-0443 Classification of Adult Foster Homes (1)A Class 1, Class 2, or Class 3 adult foster home license will be issued by the Division based upon the qualifications of the applicant, resident manager and shift caregivers, as applicable, and compliance with the requirements of OAR chapter 411, division 050. (a)After receipt of the completed application materials, including the nonrefundable fee,the Division must investigate the information submitted including any pertinent information received from outside sources. (b)An applicant may not be issued a license and may not be granted an upgraded license classification if the Division finds unsatisfactory references or a history of noncompliance within the last 24 months. (c)A Class 1 license may be issued if the applicant and resident manager, as applicable, complete the training requirements outlined in OAR 411-050-0440; (d)A Class 2 license may be issued if the applicant and resident manager, as applicable, complete the requirements outlined in OAR 411-050-0440. In addition, each must have the equivalent of two years' full time experience in providing direct care to adults who are elderly or physically disabled; (e)A Class 3 license may be issued if the applicant,resident manager and shift caregivers, as applicable, complete the training requirements outlined in OAR 411-050-0440 and have a current license as a health care professional in the state of Oregon or possess the following qualifications: (A) Have the equivalent of three years' full time experience providing direct care to adults who are elderly or physically disabled and require full assistance in four or more of their activities of daily living.(ADLs). (B) Have references satisfactory to the Division. The applicant(s)must submit current contact information from at least two licensed health care professionals who have direct knowledge of the individual's ability and past experience as a caregiver. (2)A licensee may be approved to care for ventilator-dependent residents. This approval will be granted by the Seniors and People with Disabilities' Central Office if the licensee,resident manager and shift caregivers, as applicable, meet the criteria for a Class 3 home according to subsection (1)(e) of this rule, and comply with the additional requirements for adult foster homes serving ventilator-dependent residents. (See OAR 411-050-0491) (3) Licensees may only admit or continue to care for residents whose impairment levels are within the classification level of the licensed home. • • (a)A.licensee with a Class 1 license may only admit residents who need assistance in no more than four activities of daily living (ADLs). (b)A licensee with a Class 2 license may provide care for residents who require assistance in all activities of daily living, but require full assistance in no more than three activities of daily living. (c)A licensee with a Class 3 license may provide care for residents who require full assistance in four or more activities of daily living. (4)A licensee may request in writing an exception if: • (a) A new resident wishes to be admitted whose impairment level exceeds the license classification level; or (b)A current resident becomes more impaired, exceeding the license classification level; or (c) There is more than one resident in the home who requires bed-care or full assistance with activities of daily living (ADLs). (5) The Division may grant an exception which allows the resident to be admitted or remain in the adult foster home. The Division will respond in writing within 30 days' receipt of the written request. The licensee must prove the following criteria are met by clear and convincing evidence that: (a)It is the choice of the resident to reside in the home; (b)The licensee is able to give appropriate care and service to the resident in addition to meeting the care and service needs of the other residents; (c)Additional staff is hired to meet the additional care requirements of all residents in the home as,necessary; (d) Outside resources are available and obtained to meet the resident's care needs; (e)The exception will not jeopardize the care, health, safety or welfare of the residents; (f) The licensee can demonstrate how all occupants will be able to evacuate in three minutes or less if the exception is granted. (6)A licensee may submit to the Division a written request for a change in license classification. The Division's determination will be made within 60 days of receipt of the licensee's written request. • Stat. Auth.: ORS 410.070 Stats. Implemented: ORS 443.775 Hist.: SSD 11-1988, f. 10-18-88, cert. ef. 11-1-88; SSD 3-1992,f. 5-26-92, cert. ef. 6-1-92; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1996, f. 3-29-96, cert. ef. 4-1-96; SDSD 4-2001, f. & cert. ef. 3-1-01; SPD 31-2006, f. 12-27- 06, cert. ef. 1-1-07; SPD 9-2007, f. 6-27-07, cert. ef. 7=1-07 411-050-0444 Operational Standards (1) General Practices. (a) Licensees must own, rent or lease the home to be licensed, however the local licensing authority may grant exception to churches, hospitals,non- t associations or similar organizatio a licensee rents or leases the premises where the adult foster home i ocated,the licensee must not enter into contract that requires anything other than a flat rate for the lease or rental. A licensed provider of a building in which an adult foster home is located must not allow the owner to interfere with the admission, discharge or transfer of any resident in the adult foster home unless the owner is a licensee or co-licensee named on the license. (b) The licensee must cooperate with Division personnel in inspections, complaint investigations, planning for resident care, application procedures and other necessary activities. Department personnel have access to all resident and facility records and may conduct private interviews with residents. The State Long-Term Care Ombudsman has access to all resident and facility records. Certified Ombudsman volunteers may have access to resident records w ith written permission from the resident and facility records relevant to caregiving. (c) Information related to resident(s)must be kept confidential, except as may be necessary in the planning or provision of care or medical treatment, or related to an investigation or sanction action under these rules. (d)Licensees must be able to arrange or provide for appropriate transportation for residents when needed. (e) Staffing Standards. A licensee may not employ a resident manager or shift caregiver who does not meet or exceed the experience and training classification standard for the adult foster home. (f)If a resident manager, or shift caregiver, changes during the period the license covers, the licensee must notify the Division immediately and identify who will be providing care. This includes circumstances when the licensee assumes the role as the primary caregiver or shift caregiver when there has been a change in staff, in which case the licensee must submit an updated plan of 24-hour coverage to the Division. Otherwise: (A) The licensee must submit a request for a change of resident manager, or shift caregiver as applicable,to the Division along with the Department's completed resident manager application form, a completed Health History and Physician or Nurse Practitioner's Statement(form SDS 903),the Department's Criminal History Request form and a $10 non-refundable fee. (B)Upon a determination by the Division that the applicant meets the requirements of a resident manager, and the applicant has obtained the required training and passed the test, a revised license will be issued with the name of the new resident manager or shift caregiver(s). The classification of the home will be reevaluated based on the qualifications of the new resident manager or shift caregivers, and changed accordingly. (g)Unexpected and Urgent Staffing Need. If the Division determines an unexpected and urgent staffing need exists, the Division may authorize a person who has not completed the Basic Training or passed the test to act as a resident manager or shift caregiver until training and testing are completed, or for 60 days,whichever period is shorter. The licensee must notify the Division of the situation in writing, satisfactorily demonstrate his or her inability to find a qualified resident manager, or shift caregiver as applicable, that the person is 21 years of age and meets the requirements of a substitute caregiver for the adult foster home. (h)A licensee is responsible for the supervision,training and overall conduct of resident managers, other caregivers, family members and friends when acting within the scope of their employment, duties, or when present in the home. (i) Sexual relations between residents and any employee of the adult foster home,licensee or any member of the licensee's household is prohibited unless a pre-existing relationship existed. (j)A licensee must notify the Division in writing prior to any change of his or her residence or mailing address. (2) Sale or Lease of Existing Adult Foster Homes and Transfer of Licenses: (a)A license is not transferable and does not apply to any location or person(s) other than the location and the person(s) indicated on the license obtained from the Division. (b)The licensee must inform real estatogents, prospective buyers, lessees, andrisferees in all written communication including advertising aWdisclosure statements that the license illgperate an adult foster home is not transferable and must refer them to the Division for information about licensing. (c)When a home is to be sold or otherwise transferred or conveyed to another person who intends to operate the home as.an adult foster home, that person must apply for and obtain a license from the Division prior to the transfer of operation of the home. - (d)The licensed provider must promptly notify the local Division's licensing program in writing about the licensee's intent to close or intent to convey the adult foster home to another individual. The licensee must provide written notice to the residents,their representatives and case managers as applicable, according to OAR 411-050-0444(12)(a). (e)The licensed provider must inform an individual intending to assume operation of an existing adult foster home that residents currently residing in the home must be given at least 30 days' written notice of the licensee's intent to close the adult foster home for the purpose of conveying the home to another person. (f) The licensee must remain licensed and responsible for the operation of the home and care of the residents in accordance with these rules until the home is closed and the residents have been relocated, or the home is conveyed to a new licensee who is licensed by the Division at a level appropriate to the care needs of the residents in the home. (3) Sanitation and Safety Precautions in the Adult Foster Home: (a)Commodes and Incontinence Garments -- If used, commodes must be emptied frequently and cleaned daily, or more frequently if necessary. Incontinence garments must be disposed of in closed containers. (b)Laundry-- Soiled linens and clothing must be stored in closed containers prior to laundering in an area that is separate from food storage, kitchen and dining areas. Pre-wash attention must be given to soiled and wet bed linens. Sheets and pillowcases must be laundered at least weekly and more often if soiled. (c)Pets or Other Animals -- Sanitation for household pets and other domestic animals on the premises must be adequate to prevent health hazards. Proof of rabies vaccinations and any other vaccinations that are required for the pet by a licensed veterinarian must be maintained on the premises. Pets not confined in enclosures must be under control and must not present a danger to residents or guests. (d)Infection Control-- Standard precautions for infection control must be followed in resident care. Hands and other skin surfaces must be washed immediately and thoroughly if contaminated with blood or other body fluids. (e)Disposal of Sharps --Precautions must be taken to prevent injuries caused by needles, scalpels, and other sharp instruments or devices during procedures. After they are used, disposable syringes and needles, scalpel blades, and other sharp items must be placed in a puncture-resistant, red container for disposal. The puncture-resistant container must be located as close as practical to the use area. Disposal must be according to local regulations and resources (ORS 459.386 through 459.405). (f) Water Temperature -- Residents who are unable to safely regulate the water temperature must be supervised. (g)Resident access to or use of swimming or other pools, hot tubs, saunas, or spas on the premises must be supervised. (See also General Conditions, 411-050-0445(1)(f)) (h)There must be current, basic first-aid supplies and a first-aid manual readily available in the home. (4)Meals: (a)Three nutritious meals will be served daily at times consistent with those in the community. Each daily menu will include food from the basic food groups according to the United States Department of Agriculture(USDA's)food pyramid and include fresh fruit and vebles when in season. Consideration be given to residents' cultural and ethnic background in food preparation. (b)A schedule of meal times and menus for the coming week must be prepared and posted weekly in a location accessible to residents and families. Meal substitutions in compliance with subsection(4)(a) of this rule and with resident approval are acceptable. (c) There must be no more than a 14-hour span between the evening and morning meals. (Snacks do not substitute for a meal determining the 14-hour span.)Nutritious snacks and liquids must be offered to fulfill each resident's nutritional requirements. (d)Food must not be used as an inducement to control the behavior of a resident. (e) Home-canned foods must be processed according to the current guidelines of the Oregon State University Extension Service. Freezing is the most acceptable method of food preservation; milk must be pasteurized. (f) Special consideration must be given to residents with chewing difficulties and other eating limitations. Special diets are to be followed as prescribed in writing by the resident's physician or nurse practitioner. (g)Adequate storage must be available to maintain food at a proper temperature, including a properly working refrigerator. (h) The household utensils, dishes, glassware and household food must not be stored in resident bedrooms,bathrooms, or living areas. - (i)Meals must be prepared and served in the home where residents live. Payment for meals eaten away from home for the convenience of the licensee (e.g., restaurants, senior meal sites) is the responsibility of the licensee. Meals and snacks, as part of an individual recreational outing by choice, are the responsibility of the resident. (j)Utensils, dishes and glassware must be washed in hot soapy water,rinsed, and stored to prevent contamination. A dishwasher with a sani-cycle is recommended. (k)Food preparation areas and equipment, including utensils and appliances, must be clean, free of off ensive odors and in good repair. (1) Reasonable precautions must be taken to prevent pests(e.g., ants, cockroaches, other insects and rodents). (5)Telephone: (a)The home must have a working, landline telephone with a listed number that is separate from any other number the home has, such as but not limited to, Internet or fax lines,unless the system includes features that notify the caregiver of an incoming call, or automatically switches to the appropriate mode. If the licensee has a caller identification service on the home number, the blocking feature must be disabled to allow incoming calls to be received unhindered. A licensee may have only one phone line as long as it complies with the requirements of these rules. (b)The licensee must notify the Division, residents,the residents' families, legal representatives and case managers, as applicable, of any change in the adult foster home's telephone number within 24 hours of the change. - (c)Restrictions on the use of the telephone by residents are to be specified in the written house policies and must not violate residents' rights. Individual restrictions must be well documented in the care plan. (d) The licensee must make available and accessible for residents' use a telephone that is in good working order with reasonable accommodation for privacy during telephone conversations. Residents with hearing impairments,to the extent that they cannot hear normal telephone conversation, must be provided with a telephone that is amplified with a volume control or is hearing aid compile. • (6)Facility Records: (a) Facility records must be maintained in the adult foster home and be available for inspection. Facility records include, but are not limited to: (A)Proof that the licensee has the Department's approval as a result of a criminal history check, for each subject individual, who is 16 years of age and older,to have contact with adults who are elderly or physically disabled as a result of a criminal history check. (B) Proof that the licensee and all other caregivers have met and maintained the minimum qualifications as required by OAR 411-050-0440. The following documentation must be available for review upon request: (i) Proof of required continuing education according to OAR 411-050-0440. Documentation must include the date of each training, subject matter, name of agency or organization providing the training and number of classroom hours. (ii) Completed certificates to document caregivers' completion of the Department's Caregiver Preparatory Training Study Guide and Workbook. (iii)Documentation of all substitute caregivers'orientation to the adult foster home as required by OAR 411-050-0440 (8). (iv)The names,addresses, and telephone numbers of the substitute caregivers employed or used by the licensee. (b) Copies of notices to the Division pertaining to changes in the resident manager,shift caregiver(s) or other primary caregiver. (c) Proof of required vaccinations for animals on the premises., (d) Well water tests, if required, according to OAR 411-050-0445(2)(a). Test records must be retained for a minimum of three years. (e) Contracts with the Department including a copy of the adult foster home's private-pay contract. (f) Records of evacuation drills according to OAR 411-050-0445(5)(o), including the date, time for evacuation of all occupants, names of all residents and which residents required assistance. The records must be kept at least three years. (g) Required Posted Items -- The licensee must post the following items in the entryway or other equally prominent place where residents, visitors and others can easily read them: (A)The adult foster home license; (B) Conditions, if any are attached to the license; (C) A copy of a current floor plan meeting the requirements of OAR 411-050-0445(5)(p); (D)The Residents'Bill of Rights; (E) The home's current house policies, which have been reviewed and approved by the Division; (F) The Division's procedure for making complaints; (G) The Long-Term Care Ombudsman poster; (H)The Division's most recent inspecti form; • (I)The Division's notice pertaining to the use of any intercoms, monitoring devices and video cameras that may be used in the adult foster home; and (J)A weekly menu according to section(4) of this rule. (h) Post by Phone -- Emergency telephone numbers including the contact number for at least one licensed provider or approved resident manager who has agreed to respond in person in the event of an emergency and an emergency contact number for the licensee(s), if the licensee(s)does not live in the home. The list must be readily visible and posted by a central telephone in the adult foster home. (7) Resident Records: (a)An individual resident record must be developed, kept current, and readily accessible on the premises for each person admitted to the adult foster home. The record must be legible and kept in an organized manner so as to be utilized by staff. The record must contain the following information: (A)An initial screening assessment; (B) General information according to OAR 411-050-0447(2)(a); and (C)Documentation on Form SDS 913 that the licensee has informed private-pay residents of the availability of a long- term care assessment; (D)Financial Information: (i)Detailed records and receipts if the licensee manages or handles a resident's money. Resident account record form SDS 713 or other expenditure forms may be used if the licensee manages or handles a resident's money. The record must show amounts and sources of funds received and issued to, or on behalf of, the resident and be initialed by the person making the entry. Receipts must document all deposits and purchases of$5 or more made on behalf of a resident. (ii) Contracts signed by residents or their representatives who are paying privately may be kept in a separate file but must be made available for inspection by the Division. - (E) Medical and legal information including, but not limited to: (i) Medical history, if available; (ii) Current physician or nurse practitioner's orders; (iii)Nursing instructions, delegations and assessments as applicable; (iv) Completed medication administration records retained for at least the last six months or from the date of admission, whichever is less(Older records may be stored separately); and (v) Copies of Guardianship, Conservatorship,Advance Directive for Health Care, Health Care Power of Attorney, and Physician's Order for Life Sustaining Treatment(POLST) documents, as applicable. (F) A complete and current care plan; (G) Copies of the current house policies and the current Residents' Bill of Rights,signed and dated by the resident or his or her representative; (H) Significant Events -- A written repikusing form SDS 344 or its equivalent all significant incidents relating to the health or safety of the resident inclu g how and when the incident occurreho w as involved,what action was taken by the licensee and staff, as applicable, and the outcome to the resident; (I)Narrative of Resident's Progress --Narrative entries describing each resident's progress must be documented at least weekly and maintained in each resident's individual record. They must be signed and dated by the person writing them; and (J)Non-confidential information or correspondence pertaining to the care needs of the resident. (b)Access to Resident Records: (A) Resident records must be readily available at the adult foster home to all caregivers working in the home and to representatives of the Department conducting inspections or investigations, as well as to residents, their authorized representatives or other legally authorized persons. (B) The State Long-Term Care Ombudsman has access to all resident and facility records. Certified Ombudsman volunteers have access to facility records relevant to caregiving and resident records with written permission from the resident or the resident's legal representative. (See OAR 114-005-0030) (c) Record Retention--Records, including any financial records for residents must be kept for a period of three years. (d)In all other matters pertaining to confidential records and release of information, licensees must be guided by the principles and definitions described in OAR chapter 410, division 005, Privacy of Protected Information. A copy of these rules will be made available by the Division upon request. (8) House Policies--House policies must be in writing and a copy given to the resident and the resident's family or representative, at the time of admission. House policies established by the licensee must: (a) Include any restrictions the adult foster home may have on the use of alcohol,tobacco, pets', visiting hours, dietary restrictions or religious preferences. (b) Indicate the home's policy regarding the presence and use of legal marijuana on the premises. (c)Not be in conflict with the Residents' Bill of Rights, the family atmosphere of the home or any of these administrative rules. (d) Be reviewed and approved by the Division prior to the issuance of a license and prior to implementing any changes. (e)Be posted where they can easily be seen and read by residents and visitors. (9) Resident Moves, Transfers and Discharges -- The Department encourages licensees to support a resident's choice to remain in his or her living environment while recognizing that some residents may no longer be appropriate for the adult foster care setting due to safety and medical limitations. (a)If a resident moves out of an adult foster home for any reason, at the time of move-out the licensee must submit copies of pertinent information from the resident's record to the resident's new place of residence. Pertinent information must include at a minimum: (A) Copies of current medication sheets and an updated care plan. (B) Documentation of actions taken by the adult foster home staff,resident or the resident's representative pertaining to the move, transfer or discharge. (C) A copy of the Department's currenatice of Resident Move, Transfer or D arge form (SDS 901) must be maintained at least three years for all inv luntary moves. (b) Licensees must immediately document in the resident's record voluntary and involuntary moves;transfers and discharges from the adult foster home, as events take place. (See OAR 411-050-0444(10) and 411-050-0444(11)) (10)Voluntary Moves, Transfers and Discharges (a)If a Department client or a client's representative gives notice of the client's intent to leave the adult foster home, or the client leaves the home abruptly,the licensee will promptly notify the client's case manager. (b)The licensee must obtain prior authorization from the resident,the resident's legal representative, and case manager, as applicable,prior to: (A)Moving voluntarily from one bedroom to another in an adult foster home. (B) Transferring voluntarily from one adult foster home to another that has a license issued to the same person. (C)Moving voluntarily to any other location. (c)Notifications and authorizations must be documented and available in the resident's record. (11)Involuntary Moves, Transfers and Discharges (a)Mandatory Written Notice --A resident may not be moved involuntarily from the adult foster home, or to another room within the adult foster home, or transferred to another adult foster home for a temporary stay without a minimum of 30 days' written notice to the resident and the resident's legal representative, guardian, conservator and case manager, as applicable. The written notice must be on the Department's Notice of Resident Move, Transfer or Discharge form(SDS 901), be completed by the licensee and contain the specific reasons the facility is unable to meet the resident's needs, as determined by the facility's evaluation. (b)Residents may only be moved, transferred or discharged for the following reasons: (A)Medical Reasons -- The resident has a medical or nursing condition that is complex, unstable or unpredictable and exceeds the level of health services the facility provides as specified in the facility's disclosure information. (B) The adult foster home is unable to accomplish evacuation of the adult foster home in accordance with OAR 411- 050-0445(5)(o). (C) Welfare of the Resident or Other Residents. (i)The resident exhibits behavior that poses an imminent danger to self or others including acts that result in the resident's arrest or detention. (ii)The resident engages in behavior or actions that repeatedly and substantially interferes with the rights, health, or safety of residents or others. (iii)The resident engages in illegal drug use, or commits a criminal act that causes potential harm to the resident or others. (D)Failure to make payment for care. (E) The adult foster home has had its license revoked, not renewed, or it was voluntarily surrendered by the licensee. (F) The resident engages in the use of Areal marijuana in violation of the honmwritten policies or contrary to Oregon Law under the Oregon Medical i arijuana Act, ORS 475.300 to 475.348! (c)Less Than 30 Days' Written Notice --A licensee may give less than 30 days' written notice in specific circumstances as identified in paragraphs(A) or(B) below, but must do so as soon as possible using the Department's Notice of Resident Move, Transfer or Discharge form(SDS 901). This notice must be given to the resident, the resident's representative, guardian, conservator and case manager, as applicable. A licensee may give less than 30 days' notice ONLY if: (A)Undue delay in moving the resident would jeopardize the health, safety or well-being of the resident. (i)The resident has a medical emergency that requires the immediate care of a level or type that the adult foster home is unable to provide. (ii) The resident exhibits behavior that poses an immediate danger to self or others. (B) The resident is hospitalized or is temporarily out of the home, and the licensee determines that he or she is no longer able to meet the needs of the resident. (d)Written Notice of Involuntary Moves -- The licensee will complete the Department's Notice of Resident Move, Transfer or Discharge form(SDS 901). The written notice must include the following information: (A) The resident's name; _ (B) The reason for the proposed move,transfer or discharge; (C)The date of the proposed change; (D)The location to which the resident is going, if known; (E)A notice of the right to hold an informal conference and hearing; (F) The name, address and telephone number of the person giving the notice; and (G) The date the notice is issued. (e)Involuntary Moves and Resident Rights -- A person who is to be involuntarily moved or refused the right of return or'readmission, is entitled to an informal conference and hearing prior to an involuntary move, transfer or discharge as follows: (A)Informal Conference -- The Division will hold an informal conference as promptly as possible after the request is received. The Division will send written notice of the time and place of the conference to the licensee and all persons entitled to the notice. Participants may include•the resident, and at the resident's request, a family member, case manager, Ombudsman, legal representative of the resident; the licensee; and a representative from an adult foster home association if the licensee requests it. The purpose of the informal conference is to resolve the matter without an administrative hearing. If a resolution is reached at the informal conference,.the Division will document the outcome in writing and no administrative hearing will be held. (B)Administrative Hearing -- If a resolution is not reached as a result of the informal conference, the resident or resident's representative may request an administrative hearing. If the resident is being moved, transferred or discharged with less than 30 days' notice according to subsection(11)(c) of this rule,the hearing must be held within seven days of the transfer or discharge. The licensee must hold a space available for the resident pending receipt of an administrative order. These administrative rules and ORS 441.605(4) governing transfer notices and hearings for residents of long-term care facilities apply to adult foster homes. (12) Closure of Adult Foster Homes •, (a)Licensees must notify the Division prior to the voluntary closure of a home,proposed sale, or transfer of ownership, and give residents,their families,representatives, and case managers for Department clients,as appropriate, a minimum of 30 days' written notice on the Department's form (SDS 901) according to section (11) of this rule, Involuntary Moves, Transfers and Discharges. (b)In circumstances where undue delay might jeopardize the health, safety or well-being of residents, licensees or staff, written notice, according to section(11) of this rule, Involuntary Moves, Transfers and Discharges,must be given as soon as possible. Stat. Auth.: ORS 410.070 Stats. Implemented: ORS 443.738 Hist.: SPD 31-2006, f. 12-27-06, cert. ef. 1-1-07 411-050-0445 Facility Standards In order to qualify for or maintain a license, an adult foster home must comply with the following provisions: (1) General Conditions: (a)Each adult foster home must meet all applicable local business license, zoning,building and housing codes, and state and local fire and safety regulations for a single family residence. (b)Interior and Exterior Premises. The building and furnishings must be clean and in good repair. The interior and exterior premises must be well maintained and accessible according to the individual needs of the residents. There must be no accumulation of garbage, debris,rubbish or offensive odors. Walls, ceilings, and floors must be of such character to permit washing, cleaning, or painting, as appropriate. (c)Adequate lighting,based on the needs of the individual,must be provided in each room, stairway, and exit way; incandescent light bulbs and florescent tubes must be protected with appropriate covers. (d)Temperature. The heating system must be in working order. Areas of the home used by residents must be maintained at a comfortable temperature. Minimum temperatures during the day will be no less than 68 degrees, no higher than 85 degrees, and no less than 60 degrees during sleeping hours. Variations from the requirements of this rule must be based on resident care needs or preferences and must be addressed in their individual care plan. (A) During times of extreme summer heat,the licensee must make reasonable effort to keep the residents comfortable using ventilation, fans,or air conditioning. Precautions must be taken to prevent resident exposure to stale, non- circulating air. (B)If the facility is air-conditioned,the system must be functional and the filters must be cleaned or changed as needed to ensure proper maintenance. (C)If the licensee is unable to maintain a comfortable temperature for residents during times of extreme summer heat, air conditioning or another cooling system may be required. (e) Common Use Areas. Common use areas for the residents must be accessible to all residents. There must be at least 150 square feet of common living space and sufficient furniture in the home to accommodate the recreational and socialization needs of all the occupants at one time. Common space must not be located in an unfinished basement or garage unless such space was constructed for that purpose or has otherwise been legalized under permit. There may be additional space required if wheelchairs are to be accommodated. An additional 40 square feet of common living space will be required for each day care pers room and board occupant, or relative 'riving care for remuneration who exceeds the limit of five. (f) Safety Barriers. Swimming pools,hot tubs, spas, saunas and`stairways, as appropriate, must also be equipped with safety barriers and devices designed to prevent injury. (g)Video Monitors. Use of video monitors detracts from a home-like environment and licensees must not use them in any area of the home that would violate a resident's privacy unless requested by the resident. (2) Sanitation: (a)Non-Municipal Water Source. A public water supply must be utilized if available. If a non-municipal water source is used,the licenser, a sanitarian, or a technician from a certified water-testing laboratory must collect a sample annually. The water sample must be tested at the licensee's expense for coliform bacteria and action taken to ensure potability. Test records must be retained for three years. (b) Septic tanks or other non-municipal sewage disposal system must be in good working order. (c) Garbage and refuse must be suitably stored in readily cleanable,rodent-proof, covered containers,pending weekly removal. (d)Ventilation. All doors and windows that are used for ventilation must have screens in good condition. (3)Bathrooms. Bathrooms must: (a) Provide individual privacy and have a finished interior, with a door which opens to a hall or common-use room; a mirror; have a window that opens or other means of ventilation; and a window covering for privacy. No person must have to walk through another person's bedroom to get to a bathroom; (b) Be clean and free of objectionable odors (See also Commodes and Incontinence Garments, 411-050-0444(3)(a)); (c)Have bathtubs, showers, toilets and sinks in good repair. A sink must be located near each toilet, and a toilet and sink must be available for the resident's use on each floor with resident rooms. There must be at least one toilet, one sink, and one bathtub or shower for each six household occupants (including residents, day care persons, room and board occupants, licensee and licensee's family); (d)Have hot and cold water at each bathtub, shower, and sink in sufficient supply to meet the needs of the residents; (e)Have nonporous surfaces for shower enclosures; glass shower doors, if applicable, must be tempered safety glass, otherwise, shower curtains must be clean and in good condition and non-slip floor surfaces must be provided in bathtubs and showers; (f) Have grab bars for each toilet, bathtubs, and shower to be used by resident's for safety, and have barrier-free access to toilet and bathing facilities; and (g) Have adequate supplies of toilet paper and soap supplied by the licensee. Residents must be provided with individual towels and washcloths, which, are laundered in hot water at least weekly or more often if necessary. Residents must have appropriate racks or hooks for drying bath linens. If individual hand towels are not provided, roller-dispensed hand towels or paper towels in dispenser must be provided for residents' use. (4) Bedrooms: (a) Bedrooms for all household occupants must have been constructed as a bedroom when the home was built, or remodeled under permit; be finished with walls or partitions of standard construction which go from floor to ceiling; have a door which opens directly to a lay or common use room without pae through another bedroom or common bathroom; be adequately vend ted, heated and.lighted with at least on Window that opens which meets fire safety regulations (see subsection (5)(e) of this rule); be at least 70 square feet of usable floor space for one resident or 120 square feet for two residents excluding any area where a sloped ceiling does not allow a person to stand upright; and have no more than two persons per room. (b)Licensees, resident managers, other caregivers or family members must not sleep in areas designated as living areas, nor share bedrooms with residents. (c)There must be an individual bed at least 36 inches wide for each resident consisting of a mattress and springs, or equivalent, in good condition. Cots, rollaways, bunks,trundles, daybeds with restricted access, couches, and folding beds may not be used for residents. Each bed must have clean bedding in good condition consisting of a bedspread, mattress pad,two sheets, a pillow, a pillowcase, and blankets adequate for the weather. Waterproof mattress covers will be used for incontinent residents. Day care persons may use a cot or rollaway bed if bedroom space is available which meets the requirements of subsection(4)(a) of this rule. Resident beds may not be used by day care persons. (d)Each resident's bedroom must have sufficient separate,private dresser and closet space for his or her clothing and personal effects including hygiene and grooming supplies. Residents must be allowed to keep and use reasonable amounts of personal belongings and have private, secure storage space. Drapes or shades for windows must be in good condition and allow privacy for residents. (e)Residents who are non-ambulatory,have impaired mobility, or are cognitively impaired must have bedrooms with a safe, second exit to the ground. Residents with bedrooms above or below the ground floor must demonstrate their capability for self-preservation. (f)Resident bedrooms must be in close enough proximity to the licensee or caregiver in charge to alert him or her to nighttime needs or emergencies, or the bedrooms must be equipped with a call bell or intercom. Intercoms must not violate the resident's right to privacy and must have the capability of being turned off by the resident or at the resident's request. (5) Safety: (a) Buildings must meet all applicable state and local building, mechanical, and housing codes for fire and life safety. The home may be inspected for fire safety by the State Fire Marshal's Office at the request of the licensing authority or Division staff using the standards in these rules, as appropriate. (b)Heat Sources. Heating in accordance with manufacturer's specifications and electrical equipment, including wood stoves and pellet stoves,must be installed in accordance with all applicable fire and life safety codes. Such equipment, including fireplaces, must be in good repair,used properly and be well maintained according to the recommended maintenance schedule of the manufacturer or a qualified inspector. (A)Licensees who do not have a permit verifying proper installation of an existing woodstove or pellet stove must have it inspected by a qualified inspector, Certified Oregon Chimney Sweep Association member, or Oregon Hearth Products Association member and follow their recommended maintenance schedule. (B) The installation of a non-combustible, heat-resistant safety barrier may be required to be installed 36 inches around woodstoves to prevent residents with ambulation or confusion problems from coming in contact with the stove. (C)Unvented,portable oil, gas or kerosene heaters are prohibited. Sealed electric transfer heaters or electric space heaters with tip-over, shut-off capability may be used when approved by the authority having jurisdiction. (c)Extension cord wiring and multi-plug adaptors must not be used in place of permanent wiring. (d)Hardware for all exit doors and interior doors must have simple hardware that cannot be locked against exit and must have an obvious method of oper . Hasps, sliding bolts, hooks and eye d double key deadbolts are not permitted. Homes with one or more rents who have impaired judgment andknown to wander away from their place of residence must-have an activated alarm system to alert a caregiver of an unsupervised exit by a resident. (e) Bedrooms must have at least one window or exterior door that will readily open from the inside without special tools and which provides a clear opening of not less than 821 square inches (5.7 sq. ft.), with the least dimensions not less than 22 inches in height or 20 inches in width. Sill height must not be more than 44 inches from the floor level or there must be approved steps or other aids to the window exit that can be used by residents. Windows with a clear opening of not less than 5.0 square feet or 720 square inches with sill heights of 48 inches may be accepted when approved by the State Fire Marshal or designee. (f) Construction. Interior and exterior doorways used by residents must be wide enough to accommodate wheelchairs and walkers if used by residents. Interior and exterior stairways must be unobstructed, equipped with handrails and appropriate to the condition of the residents. (See also OAR 411-050-0445(5)(r)) (A) Buildings will be of sound construction with wall and ceiling flame spread rates at least substantially comparable to wood lath and plaster or better. The maximum flame spread of finished materials must not exceed Class III (76-200) and smoke density must not be greater than 450. If more than 10 percent of combined wall and ceiling areas in a sleeping room or exit way is composed of readily combustible material such as acoustical tile or wood paneling, such material must be treated with an approved flame retardant coating. Exception: Buildings supplied with an approved automatic sprinkler system. (i)Manufactured Homes. Manufactured homes(formerly mobile homes) units must have been built since 1976 and designed for use as a home rather than a travel trailer. The units must have a manufacturer's label permanently affixed on the unit itself which states it meets the requirements of the Department of Housing and Urban Development(HUD). The required label will read as follows: "As evidenced by this label No. ABC000001, the manufacturer certifies to the best of the manufacturer's knowledge and belief that this mobile home has been inspected in accordance with the requirements of the Department of Housing and Urban Development and is constructed in conformance with the Federal Mobile Home Construction and Safety Standards in effect on the date of manufacture. See date plate." (ii) If such a label is not evident and the licensee believes the unit meets the required specifications, the licensee must take the necessary steps to secure and provide verification of compliance from the manufacturer. (iii) Mobile homes built since 1976 meet the flame spread rate requirements and do not have to have paneling treated with a flame retardant coating. (B) Structural Changes -- The licensee will notify the Division in writing at least 15 days prior to any remodeling, renovations, or structural changes in the facility that require a building permit. Such activity must comply with building and housing codes and fire and safety regulations applicable to a single-family residence. The licensee must forward to the Division within 30 days of completion copies of all required permits and inspections, an evacuation plan and a revised floor plan. (See subsections(m)and(p) of this rule) (g) Fire Extinguishers. At least one fire extinguisher with a minimum classification of 2A-10BC must be in a visible and readily accessible location on each floor, including basements, and be checked at least once a year by a qualified person who is well versed in fire extinguisher maintenance. All recharging and hydrostatic testing must be completed by a qualified agency properly trained and equipped for this purpose. (h) Smoke Alarms. Smoke alarms must be installed in accordance with the manufacturer's instructions in each bedroom; in hallways or access areas that adjoin bedrooms; the family room or main living area where residents congregate; any interior designated smoking area; and in basements. In addition, in multi-level homes, smoke alarms must be installed at the top of stairways. Ceiling placement of smoke alarms is recommended. Alarms must be equipped with a device that warns of low battery when battery operated or with battery back-up if hard wired. Bedrooms used by hearing-impaired oilants who cannot hear the sound of a*lax smoke alarm must be equipped with an additional smoke alarm that has visual or vibrating capacity. (i)All smoke alarms must contain a sounding device or be interconnected to other alarms to provide, when actuated, an alarm that is audible in all sleeping rooms. The alarms must be loud enough to wake occupants when all bedroom doors are closed. Intercoms and room monitors must not be used to amplify alarms. (j)The licensee must maintain smoke alarms and fire extinguishers in functional condition. If there are more than two violations in maintaining battery operated alarms in working condition,the Division may require the licensee to hard - wire the alarms into the electrical system. - (k) Combustibles and Firearms. Flammables, combustible liquids and other combustible materials must be safely and properly stored in their original,properly labeled containers or safety containers and secured in areas to prevent tampering by residents or vandals. Firearms must be stored,unloaded, in a locked cabinet. The firearms cabinet must be located in an area of the home that is not accessible to residents. Ammunition must be secured in a locked area separate from the firearms. (1)Hazardous Materials. Cleaning supplies,medical sharps containers,poisons, insecticides and other hazardous materials must be properly stored in their original,properly labeled containers in a safe area that is not accessible to residents, food preparation and food storage areas, dining areas, and medications. - (m)Evacuation Plan. An emergency evacuation plan must be developed, and revised as necessary to reflect the current condition of the residents in the home. The plan must be rehearsed with all occupants. (n) Orientation to Emergency Procedures. Within 24 hours of arrival, any new resident or caregiver must be shown how to respond to a smoke alarm, shown how to participate in an emergency evacuation drill, and receive an orientation to basic fire safety. New caregivers will also be oriented in how to conduct an evacuation. (o)Evacuation Drill. Evacuation drills will be held at least once every 90 days, with at least one per year conducted while the residents are in bed. Records of drills must be maintained according to OAR 411-050-0444(6)(f). Licensees. and all other caregivers must be able to demonstrate the ability to evacuate all occupants from the facility to the closest point of safety, which is exterior to and away from the structure, and has access to a public sidewalk or street within three minutes or less. If there are problems in demonstrating this evacuation time, conditions may be applied to the license which include, but are not limited to,reduced capacity of residents, additional staffmg, or increased fire protection. Continued problems will be grounds for revocation or non-renewal of the license. (p)Floor Plan. The licensee must develop a current and accurate floor plan that indicates: (A) The size of rooms; (B) Which rooms are to be resident bedrooms and which are to be caregiver bedrooms; (C)The location of all the exits on each level of the home, including emergency exits such as windows; (D)The location of wheelchair ramp(s), if applicable; (E) Where the fire extinguishers and smoke alarms are located; and (F)The planned_evacuation routes.- (q)Providers must not place residents who are unable to walk without assistance or not capable of self-preservation in a bedroom on a floor without a second ground level exit. (r) Stairs must have a riser height of between 6 to 8 inches and tread width of between 8 to 10 1/2 inches. Lifts or elevators are not an acceptable substir resident's capability to ambulate stip(See also OAR 411-050-0445(5) (f))- (s) Exit Ways. All exit ways must be barrier free and the corridors and hallways must be a minimum of 32 inches wide or as approved by the authority having jurisdiction. Interior doorways used by residents must be wide enough to accommodate wheelchairs and walkers if used by residents. Any bedroom window or door identified as an exit must be free of obstacles that would interfere with evacuation. (t) Ramps. There must be at least one wheelchair ramp from a minimum of one exterior door if non-ambulatory persons are in residence. Wheelchair ramps must comply with the Americans with Disabilities Act(ADA), have non-skid surfaces, handrails, and have a maximum slope of one (1) inch rise in each 12 inches of distance. The maximum rise for any run will be 30 inches. Licensees may need to bring existing ramps into revised compliance if necessary to meet the needs of new residents or current residents with increased care needs. (u) Emergency Exits. There must be a second safe means of exit from all sleeping rooms. Providers whose sleeping rooms are above the first floor may be required to demonstrate an evacuation drill from that room, using the secondary exit, at the time of licensure, renewal, or inspection. (v)Adult foster homes located more than five miles distance from the nearest fire station or those of unusual construction characteristics may be required to have a complete fire alarm system meeting the requirements of the National Fire Prevention Association(NFPA) 72 with approved automatic reporting to the local jurisdiction providing fire protection. (w) There must be at least one plug-in, rechargeable flashlight in good functional condition available on each floor for emergency lighting. (x) Smoking regulations must be adopted to allow smoking only in designated areas. Smoking is prohibited in any bedroom including that of residents, licensee resident manager, any other caregiver, occupant or visitor; any room where oxygen is used and anywhere flammable materials are stored. Ashtrays of noncombustible material and safe design must be provided in areas where smoking is permitted. (y) Providers whose homes are located in areas where there is a danger of natural disasters which require rapid evacuation such as forest fires, flash floods, or tsunami waves must be aware of community resources for'evacuation assistance. [Publications: Publications referenced are available from the agency.] Stat. Auth.: ORS 410.070 Stats. Implemented: ORS 443.738 Hist.: SSD 14-1985, f. 12-31-85 ef. 1-1-86; SSD 11-1988, f. 10-18-88, cert. ef. 11-1-88, Sections (8)thru(10) renumbered to 411-050-0447; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1992,f. 5-26-92, cert. ef. 6-1-92; SSD 3- 1996, f. 3-29-96, cert. ef. 4-1-96; SDSD 2-1998(Temp), f. & cert. ef. 2-6-98 thru 8-1-98; SDSD 6-1998, f. 7-31-98, cert. ef. 8-1-98; SDSD 4-2001, f. & cert. ef. 3-1-01; SPD 31-2006, f. 12-27-06, cert.ef. 1-1-07; SPD 9-2007, f. 6-27- 07, cert. ef. 7-1-07 411-050-0447 Standards and Practices for Care and Services (1) Screening and Assessment: (a) Prior to admission of a resident,the licensee must conduct and document a screening to determine that the prospective resident's care needs do not exceed the license classification. The screening must evaluate the ability of the prospective resident to evacuate the home within three minutes along with all occupants of the home. The screening must also determine if the licensee andeegivers can meet the prospective resi is needs in addition to meeting the needs of the other residents of the home. a screening must include medical di noses, medications,personal care needs, nursing care needs, cognitive needs, communication needs, night care needs,nutritional needs, activities, lifestyle preferences, and other information as needed to assure the person's care needs can be met. (b) The screening interview process must include interviews with the prospective resident, the resident's family, prior care providers, and case manager as appropriate. The interview should also include as necessary, any physician, nurse practitioner, registered nurse,pharmacist,therapist or mental health or other health care professional involved in the care of the resident. A copy of the screening document must be given to the prospective resident or the resident's representative. If the prospective resident becomes a resident in the home, a copy of the screening document must be placed in the resident's record. (c) The licensee is required to disclose to a prospective resident any house policies that will limit the resident's activities or preferences while living in the adult foster home. Examples include, but are not limited to: the use of tobacco or alcohol,pets, religious practices, dietary restrictions, and the use of intercoms. Licensed providers must , disclose the home's policy regarding the legal presence and use of medical marijuana. (See OAR 411-050-0444(8)(b)) (2) Prior to Admission: (a) General Information. The licensee must obtain and document general information regarding the resident prior to the resident's admission. The information must include names, addresses, and telephone numbers of relatives, significant persons, case managers, and medical, or mental health providers. The record must also include the date of admission and, if available, the resident's Social Security and medical insurance numbers, birth date, prior living facility and mortuary; (b)The licensee must have made every effort to obtain physician or nurse practitioner's written orders for medications, treatments,therapies and special diets, as applicable,prior to the admission of the resident. Any telephone orders must be followed with written orders. A physician, nurse practitioner, or pharmacist review of the resident's preferences for over-the-counter medications and home remedies must also be obtained at that time. The licensee must also obtain and place in the record any medical information available including history of accidents, illnesses, impairments or mental status that may be pertinent to the resident's care; (c) The licensee must ask for copies of the following documents, if the resident has them: Advance Directive for Health Care,Physician's Order for Life Sustaining Treatment(POLST),proof of court-appointed guardianship and proof of conservatorship,whichever may be applicable. Copies of these documents must be placed in a prominent place in the resident's record and sent with the resident if he or she is transferred for medical care; (d) Prior to admission,the licensee must inform the resident or the resident's representative if the home serves Medicaid clients; (e) The licensee must inform private-pay residents, or their representatives if appropriate, of the availability of long- term care assessment services provided through the Department or a certified assessment program. The licensee must document on the Department's form (SDS 913)that the individual has been advised of their right to receive a long-term care assessment. The facility must maintain a copy of the form in the resident's record and make a copy available to the Division upon request; and (f) The licensee must discuss the Residents' Bill of Rights, and the home's current house policies with the resident and his or her representative as appropriate. The discussion must be documented by having the resident sign and date a copy of the house policies, which have been approved by the Division, and the Residents' Bill of Rights, form SDS 305A. Copies of the signed house policies and Residents'Bill of Rights must be maintained in the resident's record. (3) Care Plan: (a) During the initial 14 days following the resident's admission to the home,the licensee must continue the assessment process which includes documenting sident's preferences and care needs. assessment and care plan must be completed by the licensee and documen eed within the initial 14-day period. There-plan must describe the resident's needs and preferences,the resident's capabilities and what assistance the resident requires for various tasks. The care plan must also include by whom, when and how often care and services will be provided. Specific information must include: (A) The resident's ability to perform activities of daily living (ADLs); (B) Special equipment used by the resident; (C) Communication needs: (Examples may include, but are not limited to,hearing or vision, such as eraser boards or flash cards, or language barriers such as sign language or non-English speaking; (D)Night needs; (E)Medical or physical health problems, including physical disabilities, relevant to care and services; (F) Cognitive, emotional, or impairments relevant to care and services; (G)Treatments,procedures or therapies; (H)Registered nurse consultation,teaching, delegation or assessment; (I)Behavioral interventions; (J) Social, spiritual, and emotional needs including lifestyle preferences, activities,and significant others involved; (K) Emergency exiting ability including assistance and equipment needed; (L) Any use of physical restraints or psychoactive medications; and (M)Dietary needs and preferences; (b)The care plan must be reviewed and updated every six months and as the resident's condition changes. A review note with the date and licensee's signature must be documented in the record at the time of the review. If the care plan contains many changes and becomes less legible, a new care plan must be written. (4)Registered Nurse Consultation: (a)RN Consultation and Assessment--The licensee must obtain a medical professional consultation and assessment to meet the care needs of the resident as required in these rules. A registered nurse consultation must be obtained when a skilled nursing care task, as defined by the Oregon State Board of Nursing,has been ordered by a physician or other qualified practitioner. (b)The licensee must also request a registered nurse consultation under the following conditions: (A) When the resident has a health concern or behavioral symptoms that may benefit from a nursing assessment and provider education. (B) When written parameters are needed to clarify the physician or nurse practitioner's p.r.n. order for medication and - treatment. (See subsection(5)(g)of this rule) (C) Prior to the use of physical restraints when not assessed, taught and reassessed, according to subsection (5)(m) of this rule, by the physician, nurse practitioner, Christian Science practitioner, mental health clinician, physical therapist or occupational therapist. (D) Prior to the use of new psychoactive medications when not assessed,taught and reassessed according to subsection (5)(h) of this rule, by the physician, nurse practitioner or mental health practitioner, and prior to requesting psychoactive medications to treat behavioral symptoms. (E) When care procedures have been ordered,which are new for a specific resident,the licensee, or other caregivers. (c)RN Delegation-- The registered nurse may determine that a nursing care task is to be taught utilizing the delegation process. Delegations are not transferable to other residents or caregivers. (Refer to OAR chapter 851, division 047) (d) Documentation of nurse consultations, delegations, assessments and reassessments must be maintained in the resident's record and made available to the Division upon request. (5) Standards for Medications, Treatments and Therapies: (a)The licensee and caregivers must demonstrate an understanding of each resident's medication administration regimen. The reason the medication is used, medication actions, any specific instructions and common side effects must be referenced by medication resource material readily available at the facility; (b) Written Orders. The licensee must obtain and place a signed order in the resident's record for any medications, dietary supplements,treatments, or therapies which have been prescribed by the physician or nurse practitioner. Orders must be carried out as prescribed unless the resident or the resident's legal representative refuses to consent: (A) Changed Orders. Changes may not be made without a physician or nurse practitioner's order and the physician or nurse practitioner must be notified if a resident refuses to consent to an order. Order changes obtained by telephone must be followed-up with signed orders. Changes in the dosage or frequency of an existing medication require a new pharmacy label. If a new pharmacy label cannot be obtained,the change must be written on the existing pharmacy label and match the new medication order..(See paragraph (5)(e)(D) of this rule) (B) Documentation. Attempts to obtain the written changes must be documented and readily available for review in the resident's record. Over-the-counter medications or home remedies requested by the resident must be reviewed by the resident's physician, nurse practitioner or pharmacist as part of developing the initial care plan and at time of care plan review. (c) Health Care Professional Orders (Implemented by AFH Staff). The licensee who implements a hospice, home health or other physician-generated order must: (A)Have a copy of the hospice or home health document that communicates the written order; (B) Transcribe the order onto the medication administration record(MAR); (C)Implement the order as written; and (D)Include the order on subsequent medical visit report(s) for the physician or nurse practitioner to review. (d) Hospice and Home Health Orders (Implemented by Non AFH Staff). The licensee who provides adult foster home services to a recipient of hospice or home health services, but who does not implement a hospice or home health- generated order must: (A)Have a copy of the hospice or home health document that communicates the order; and (B) Include the order on subsequent medical visit report(s) for the physician or nurse practitioner to review. (e)Medication Administration Record OAR). A current, written medication adetistration record must be kept for each resident and must: (A)List the name of all medications administered by the caregiver, including over-the-counter medications and prescribed dietary supplements. The record must identify the dosage,route (if other than oral) and the date and time each medication or supplement is to be given; (B) Identify any treatments and therapies given by the caregiver. The record must indicate the type of treatment or therapy and the time the procedure is to be performed; (C) Be immediately initialed by the person administering the medication, treatment or therapy as it is completed. Each medication administration record must contain a legible signature that identifies each set of initials; (D) Document changed and discontinued orders on the medication administration record immediately showing the date of the change or discontinued order. Changed orders must be written on a new line with a line drawn to the start date and time; and (E) Document missed or refused medications, treatment's or therapies. If a medication, treatment, or therapy is missed or refused by the resident,the initials of the person administering the medication must be circled, and a brief but complete explanation must be recorded on the back of the medication record. (f)Disposal of Medication. Licensees must dispose of all unused, discontinued, outdated, recalled and contaminated medications according to the requirements of the adult foster home's local DEQ waste management company. A record of the disposal must be readily available in the resident's record.Documentation regarding the disposal must include: (A) The date of disposal; (B)Description of medication, (i.e., name, dosage, and amount being disposed); (C)Name of resident for whom the medication was prescribed; (D) Reason for disposal; (E)Method of disposal; (F) Signature of person disposing of the medication; and (G) For Controlled Medications. Signature of witness to the disposal according to paragraph(5)(i)(E) of this rule. (g)P.R.N. Medications. Prescription medications ordered to be given "as needed" or"p.r.n." must have specific parameters indicating what the medication is for and specifically when,how much and how often the medication may be administered. Any additional instructions must be available for the caregiver to review before the medication is administered to the resident. (A) P.R.N. Documentation. As needed (p.r.n)medication must be documented on the resident's medication administration record with the time,dose, the reason the medication was given,and the outcome. (B)P.R.N. Advance Set-Up. As needed(p.r.n.) medications must not be included in any advance set-up of medication. (h)Psychoactive Medications: (A)A licensee may use psychoactive medications to treat.a resident's behavioral symptoms only after a consultation with the physician, nurse practitioner, registered nurse or mental health professional has been obtained. The consultation must identify a probable cause of the behavior and include behavioral and environmental interventions to be used instead of or in addition to mecltion. It is expected that the alternativigierventions will be tried and the resident's response to them will be documented prior to the use of medication.(irescriptions or orders for psychoactive medication must specify the dose, frequency of administration and the circumstance for use, (i.e., specific symptoms). The licensee and all caregivers must be aware of these parameters.(C)The licensee and all caregivers must know the intended effect of a medication for a particular resident, the common side effects as well as the circumstances for reporting to the physiciain or nurse practitioner. (D)The care plan must identify and describe the behavioral symptoms for which psychoactive medications are being used and list all interventions, including behavioral, environmental and medication. (E)A plan for reassessment of psychoactive medication usage must be individually determined for each resident. The reassessment will be completed by the physician or nurse practitioner. (F) Psychoactive medications must never be given to discipline a resident or for the convenience of the caregivers. (i) Medication Containers, Storage and Disposal: (A)Each of the resident's medication containers,,including bubble packs, must be clearly labeled by the pharmacy. Over-the-counter medication purchased for a specific resident's use must be in the original labeled container and marked with the resident's name. (B) Over-the-counter medications in stock bottles (with original labels) may be used for multiple residents in the home. (C)All medications must be kept in a locked, central location, separate from medications of the caregiver or caregiver's family. (D) Residents must not have access to medications of the licensee, caregivers or other household members. (E)Unused, outdated or discontinued medications must not be kept in the home and must be disposed of Licensees should contact the local DEQ waste management company in their area for instructions on proper disposal of unused or expired medications. Disposal of all medications may be documented on the medication administration record but must be readily available in the resident's record. Disposal of all controlled substances must be documented and witnessed by at least one other individual who is 18 years of age or older. (j)Advanced Set-Up. The licensee may set up each resident's medications for up to seven days in advance (excluding p.r.n.. medications) by using a closed container manufactured for that purpose. If used, each resident must have his or her own container with divisions for the days and times of the day the medications are to be given. The container must be clearly labeled with the resident's name, name of each medication, time to be given, dosage, amount,route (if other than oral) and description of the medications. The container must be stored in the locked area with the medications; (k) Self-Administration of Medication. Residents must have a physician or nurse practitioner's written order of approval to self-medicate. Residents able to handle their own medical regimen may keep medications in their own room in a small storage area that can be locked. The licensee must notify the physician or nurse practitioner if the resident show signs of no longer being able to self-medicate safely; (1)Injections. Subcutaneous, intramuscular, and intravenous injections may be self-administered by the resident or administered by a relative of the resident, or an Oregon licensed Registered Nurse (RN). An, Oregon Licensed Practical Nurse (LPN) can also give subcutaneous and intramuscular injections. A caregiver who has been delegated and trained by a registered nurse under provision of the Oregon State Board of Nursing (Standards for Registered Nurse Delegation of Nursing Tasks to Unlicensed Persons)may give subcutaneous injections. Intramuscular and intravenous injections cannot be delegated; (m)Physical Restraints(See Definitions, OAR 411-050-0400(46)) Physical restraints may only be used when required to treat a resident's medical symptoms, or to maximize a resident's physical functioning. Licensees and caregivers may • use physical restraints in adult foster has only in compliance with these ruledicluding the Residents' Bill of Rights. (See section(7)of this rule) Prior to the se of any type of physical restraint,th llowing must be completed:: (A)Assessment. A physician,nurse practitioner, registered nurse, Christian Science practitioner, mental health clinician,physical therapist or occupational therapist will complete an assessment,which includes consideration of all other alternatives. If, following the assessment and trial of other measures, it is determined that a restraint is necessary, the least restrictive restraint must be used and as infrequently as possible and the licensee must obtain a written order from the resident's physician, nurse practitioner or Christian Science practitioner; (B) Consent. Physical restraints may not be used without first obtaining written consent of the resident or the resident's legal representative; (C)Reassessment. The frequency for reassessment of the physical restraint's use must be determined based on the recommendations made in the initial assessment. A physician,nurse practitioner, registered nurse, Christian Science practitioner, mental health clinician, physical therapist or occupational therapist may perform the reassessment; (D) Documentation. The following must be kept in the resident's record pertaining to physical restraints: (i)The assessment completed by a medical professional according to paragraph(5)(m)(A) above. The assessment must include documentation of all other alternatives and less restrictive measures which were considered; identify alternative, less restrictive measures that must be used in place of the restraint whenever possible; a written procedural guidance for correct use of the restraint; the frequency and procedures for nighttime use (if applicable); and dangers and precautions related to the use of the restraint; (ii)A written order authorizing the use of the physical restraint from the resident's physician, nurse practitioner or Christian Science practitioner. The order must include specific parameters including type, circumstances and duration of the use of the restraint. (P.R.N. orders for restraints are not allowed.); (iii) Written consent of the resident or the resident's legal representative to use the specific type of physical restraint; (iv) The use of any type of physical restraint must be recorded on the resident's care plan showing why and when the restraint is to be used, along with instructions for periodic release. Any less restrictive, alternative measures planned during the assessment and cautions for maintaining safety while restrained must also be recorded on the care plan; and (v)The reassessments completed by a medical professional according to paragraph(5)(m)(C) above. (E)Daytime Use. Residents physically restrained during waking hours must have the restraints released at least every two hours for a minimum of 10 minutes and be repositioned, offered toileting,exercised or provided range-of-motion exercises during this period; (F)Nighttime Use. The use of physical restraints at night is discouraged and must be limited to unusual circumstances. If used,the restraint shall be of the design to allow freedom of movement with safety. The frequency of night monitoring to address resident safety and care needs must be determined in the assessment. Tie restraints of any kind must not be used to keep a resident in bed; (G)If any physical restraints are used in an adult foster home, they must allow for quick release at all times.Use of restraints must not impede the three-minute evacuation of all household members; and (H)Physical restraints may not be used for the discipline of a resident or for the convenience of the adult foster home. (6)Resident Care: (a) Care and supervision of residents must be in a home-like atmosphere and must be appropriate to the needs, preferences, age and condition of the individual resident. The training of the licensee and staff will be appropriate to the • age, care needs and condition of the rests. (See OAR 4.11-050-0440(1)(g))letional staff may be required if day care or respite residents are in the home; (b)If a resident has a medical regimen or personal care plan prescribed by a licensed health care professional, the provider must cooperate with the plan and ensure that it is implemented as instructed; (c)Notification. The licensee must notify emergency personnel, the resident's physician, registered nurse, family representative, and case manager, as applicable, under the following circumstances: (A)Emergencies (Medical, Fire, Police). In the event of an emergency, the licensee or other caregiver with the resident at the time of the event, must first call 911 or the appropriate emergency number for their community. This does not apply to residents with medical emergencies who practice Christian Science. Caregivers must follow written instructions from the hospice nurse, if applicable. If the resident has a completed Physician's Orders for Life Sustaining Treatment(POLST) form, or other legal documents such as an Advance Directive for Health Care and Do Not Resuscitate (DNR) orders, copies must be available to the emergency personnel when they arrive; (B) Hospitalization. In the event the resident is hospitalized. (C) Health Status Change. When the resident's health status or physical condition changes. (D)Death. Upon the death of the resident. (d)Licensees must not inflict, or tolerate to be inflicted, abuse or punishment; financial exploitation; or neglect of resident(s); (e) Licensees must exercise reasonable precautions against any conditions that could threaten the health, safety or welfare of residents; (f) A qualified caregiver must always be present and available at the home when residents are in the home. A resident must not be left in charge in lieu of a caregiver; (g)Activities. Licensees must make available at least six hours of activities per week which are of interest to the residents,not including television and movies. (Information regarding activity resources is available from the Division). Activities must be oriented to individual preferences as indicated in the resident's care plan(See paragraph (3)(a)(J) of this rule). Documentation of each resident's activity participation must be recorded in the resident's records; (h) Direct Involvement of Caregivers. Licensees or caregivers must be directly involved with residents on a daily basis. If the physical characteristics of the adult foster home do not encourage contact between caregivers and residents and among residents,the licensee must demonstrate how regular positive contact will occur; (i) Resident Money. If the licensee manages or handles a resident's money, a separate account record must be maintained in the resident's name. The licensee must not under any circumstances commingle, borrow from, or pledge any funds of a resident. (A) Personal Incidental Funds (PIF) for Department clients are to be used at the discretion of the client for such things as clothing,tobacco and snacks (not part of daily diet). (B)Licensees and other caregivers must not accept gifts from residents through undue influence or accept gifts of substantial value. Caregivers and family members of caregivers must not accept gifts of substantial value or loans from the resident or the resident's family. Licensees or other caregivers must not influence, solicit from, or suggest to any of the residents or their representatives that the residents or their representatives give the caregiver or the caregiver's family money or property for any purpose. (C) The licensee must not subject the resident or the resident's representative to unreasonable rate increases. (j)Licensees and other caregivers must loan money to residents. • (7) Residents' Bill of Rights: Licensees, their families and employees of the home must guarantee not to violate these rights and to help the residents exercise them. The Residents' Bill of Rights provided by the Division must be explained and a copy given to residents at admission. The Resident's Bill of Rights states each resident has the right to: (a)Be treated as an adult with respect and dignity; (b)Be informed of all resident rights and all house policies; (c)Be encouraged and assisted to exercise constitutional and legal rights including the right to vote; (d) Be informed of their medical condition and the right to consent to or refuse treatment; (e) Receive appropriate care and services and prompt medical care as needed; (f) Be free from mental and physical abuse; (g) Complete privacy when receiving treatment or personal care; (h)Associate and communicate privately with any person of choice and send and receive personal mail unopened; (i)Have access to and participate in activities of social, religious, and community groups; (j)Have medical and personal information kept confidential; (k)Keep and use a reasonable amount of personal clothing and belongings, and to have a reasonable amount of private, secure storage space; (1)Be free from chemical and physical restraints except as ordered by a physician or other qualified practitioner. Restraints are used only for medical reasons, to maximize a resident's physical functioning, and after other alternatives have been tried. Restraints are not used for discipline or convenience; (m)Manage their own financial affairs unless legally restricted; (n)Be free from financial exploitation. The licensee must not charge or ask for application fees or non-refundable deposits or solicit, accept or receive money or property from a resident other than the amount agreed to for services; (o)A written agreement regarding services to be provided and the rates to be charged. The licensee must give 30 days' written notice before any change in the rates or the ownership of the home; (p)Not be transferred or moved out of the adult foster home without 30 days' written notice and an opportunity for a hearing.A licensee may transfer a resident only for medical reasons or for the welfare of the resident or other residents, or for nonpayment; (q)A safe and secure environment; (r)Be free of discrimination in regard to race, color, national origin, sex, or religion; and (s) Make suggestions or complaints without fear of retaliation. [ED.NOTE: Forms referenced are available from the agency.] • Stat. Auth.: ORS 410.070 _ Stats. Implemented: ORS 443.738, 4439&443.775 • Hist.: SSD 14-1985, f. 12-31-85, ef. 1-1-86; SSD 11-1988, f. 10-18-88, cert. ef. 11-1-88, Renumbered from 411-050- 0445(8)thru(10); SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1992, f. 5-26-92,cert. ef. 6-1-92; SSD 3-1996, f. 3- 29-96, cert. ef. 4-1-96; SDSD 4-2001, f. & cert. ef. 3-1-01; SPD 31-2006, f. 12-27-06,cert. ef. 1-1-07 411-050-0450 Inspections (1)The Division must conduct an inspection of an adult foster home: (a)Prior to issuance of a license; (b)Prior to the annual renewal of a license. The Division will conduct this inspection unannounced; (c)Upon receipt of an oral or written complaint of violations that threaten the health, safety, or welfare of residents; or (d)Anytime the Division has probable cause to believe a home has violated a regulation or provision of these Administrative Rules or is operating without a license. (2) The Division may conduct inspections: (a)Any time such inspections are authorized by these Administrative Rules and any other time the Division considers it necessary to determine if a home is in compliance with these Administrative Rules or with conditions placed upon the license; (b)To determine if cited violations have been corrected; and (c)For the purpose of routine monitoring of the residents' care. (3) State or local fire inspectors must be permitted access to enter and inspect adult foster homes regarding fire safety upon the Division's request. (4) The Division staff must have full access and authority to examine and copy facility and resident records, including but not limited to, admission agreements, private pay resident contracts, and resident account records, as applicable. (5) Private Interview. Division staff has authority to interview the licensee, resident manager, other caregivers and residents. Interviews must be confidential and conducted privately. (6)Licensees must authorize resident managers and other caregivers to permit entrance and access to resident and facility records by Division staff for the purpose of inspection, investigation, and other duties within the scope of Division authority. • (7)The Division has authority to conduct inspections with or without advance notice to the licensee, staff, or a resident of the home. The Division will not give advance notice of any inspection if the Division believes that notice might obstruct or seriously diminish the effectiveness of the inspection or enforcement of these Administrative Rules. (8)If Division staff are not permitted access or inspection, a search warrant may be obtained. (9) The inspector will respect the private possessions of residents, licensees and staff while conducting an inspection. (10)Public File. The Division will maintain current information on all licensed adult foster homes and must make all non-confidential information available to prospective residents and other interested members of the public at local Division offices or Area A gencies on Ad kg licensing offices throughout the silos authorized by law. The information includes: (a)The location of the adult foster home and the name and mailing address of the licensee if different; (b)A brief description of the physical characteristics of the home; (c)A copy of the current license which indicates the current classification of the home; (d)The date the licensee was first licensed to operate that home; (e) The date of the last licensing inspection including any fire inspection, the name and telephone number of the office that performed the inspection and a summary of the findings; (f) Copies of all non-confidential portions of complaint investigations involving the home,together with the findings, actions taken by the Division and responses from the licensee and complainant, as appropriate. All complaint terminology must be clearly defined and the final disposition clearly designated; (g)Any license conditions, suspensions, denials, revocations, civil penalties, exceptions or other actions taken by the Division involving the home; and (h) Whether care is provided primarily by the licensed provider, a resident manager or shift caregivers. Stat. Auth.: ORS 410.070 Stats. Implemented: ORS 443.740 & 443.755 Hist.: SSD 14-1985, f. 12-31-85, ef. 1-1-86; SSD 11-1988, f. 10-18-88, cert. ef. 11-1-88; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1996, f. 3-29-96, cert. ef. 4-1-96; SDSD 4-2001, f. & cert. ef. 3-1-01; SPD 31-2006, f. 12-27-06, cert. ef. 1-1-07 . 411-050-0455 Complaints (1) The Division will furnish each adult foster home with a Complaint Notice which states the telephone number of the Division, the Long-Term Care Ombudsman and the procedure for making complaints. (2)Any person who believes these Administrative Rules have been violated may file a complaint with the Division. (3) The Division will investigate complaints as quickly as possible. The primary purpose of the prompt response is to protect the residents and correct the situation. Investigations of complaints alleging injury, abuse or neglect must be completed as soon as possible and all investigations will be completed within 60 days unless there is a concurrent criminal investigation that requires additional time. (4)The adult foster home licensee must not retaliate against any resident after the resident or someone acting on the resident's behalf has filed a complaint in any manner, including but not limited to, increasing charges; decreasing services; rights or privileges; threatening to increase charges or; threatening to deny or decrease services, rights or privileges; taking or threatening to take any action to coerce or compel the resident to leave the facility or by abusing or threatening to harass or abuse a resident in any manner(See OAR 411-050-0400(2)). (5) Licensees must ensure that any complainant,witness or employee of a facility must not be subject to retaliation by any adult foster home caregiver, (including their family and friends who may live in or frequent the adult foster home) for making a report,being interviewed about a complaint or being a witness, including but riot limited to, restriction of access to the home or a resident or, if an employee, dismissal or harassment. (6)As approved by law, the complainll have immunity from any civil or giglinal liability with respect to the making or content of a complaint madellg good faith. Immunity under this subs on does not protect self-reporting licensees from liability for the underlying conduct that is alleged in the complaint. (7) Standards will be followed for investigations related to abuse, neglect, or injury. (a)The Division will cause an investigation within two hours if a complaint alleges that a resident has been injured, abused or neglected and that any resident's health or safety is in imminent danger or that the resident has died or been hospitalized due to abuse or neglect; (b)The Division will cause an investigation to begin by the end of the next working day if circumstances exist which could result in the injury, abuse, or neglect and that the circumstances could place the resident's health or safety in imminent danger; (c)An unannounced on-site visit will be conducted; (d)The investigator will interview the licensee and will advise the licensee of the nature of the complaint; the licensee will have an opportunity to submit relevant information to the investigator. All available witnesses identified by any sources as having personal knowledge relevant to the complaint will be interviewed. Interviews are confidential and conducted in private; (e)All evidence and physical circumstances that are relevant and material to the complaint will be considered; (f)Immediate protection must be provided for the residents by the Division, as necessary. The licensee must correct any substantiated problem immediately; (g)A report will be written within 60 days of receipt of a complaint which includes the investigator's personal observations, a review of documents and records, a summary of all witness statements, and a conclusion; and (h)Reports indicating the need for a sanction by either the local licensing authority or the Division will be referred to the appropriate office for corrective action immediately upon completion of the investigation. (8)The Division,through its local offices, will mail a copy of the investigation report to the following people within seven days of the completion of the investigation: (a)The complainant(unless the complainant requests anonymity); (b)The resident(s) involved and any persons designated by the resident(s)to receive the information; (c) The licensee; and (d)The Long-Term Care Ombudsman; (e)The report must protect as confidential the identity of the resident, the complainant, and any witnesses; and (f) The report must be accompanied by a notice informing such persons of the right to give additional information about the content of the report to the Division's local office within seven days of receipt. - (9)The Division's local office must review the responses and reopen the investigation if additional evidence of a violation is received. A copy of the entire report must be sent to the Division upon completion of the investigation report, whether or not the investigation report concludes the complaint is substantiated. (10)The Division must take appropriate corrective action within 60 days from completion of the investigation report. (11) Licensees who acquire substantiatilkomplaints pertaining to the health, sail& or welfare of residents may be assessed civil penalties, may have cond ns placed on their licenses, or may haheir licenses suspended, revoked or not renewed. (12) Complaint Reports. Copies of all completed complaint reports must be maintained and available to the public at the local Division. Individuals may purchase a photocopy upon requesting an appointment to do so. Completed reports placed in the public file must: (a) Protect the privacy of the complainant and the resident; (b) Treat the names of the witnesses as confidential information; (c) Clearly designate the final disposition of the complaint. (A)Pending Complaint Reports. Any information regarding the investigation of the complaint will not be filed in the public file until the investigation has been completed. (B) Complaint Reports and Responses. The investigation reports, including copies of the responses, with confidential information deleted, must be available to the public at the local Division office along with other public information regarding the adult foster home. Stat. Auth.: ORS 410.070 Stats. Implemented: ORS 443.765 Hist.: SSD 14-1985, f. 12-31-85, ef. 1-1-86; SSD 11-1988, f. 10-18-88, cert. ef. 11-1-88; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1996, f. 3-29-96, cert. ef. 4-1-96; SDSD 4-2001, f. & cert. ef. 3-1-01; SDSD 11-2001, f. 12-21-01, cert. ef. 1-1-02; SPD 31-2006, f. 12-27-06,cert. ef. 1-1-07 411-050-0460 Procedures for Correction of Violations (1)If, as a result of an inspection or investigation,the Division determines that abuse has occurred, the licensee will be notified verbally to immediately cease the abusive act. The Division will follow-up with a written confirmation of the warning to cease the abusive act and will include notification that further sanctioning may be imposed. (2) If an inspection or investigation indicates a violation(s) of these rules other than abuse,the Division will notify the licensee of the violation(s) in writing. (3) The notice of violation must state the following: (a)A description of each condition that constitutes a violation; (b)Each rule that has been violated; (c)A specific time frame for correction,not to exceed 30 days after receipt of the notice, except in cases of imminent danger; (d) The Division may approve a reasonable time in excess of 30 days if correction of the violation(s).within 30 days is determined to be impossible; (e) Sanctions that may be imposed against the home for failure to correct the violation(s); (f) The right of the licensee to contest the violation(s) if an administrative sanction is imposed; and (g)The right of the licensee to request xception as provided in OAR 411-054430. (4)At any time after receipt of a notice of violation or an inspection report,the applicant, the licensee or the Division may request a meeting. The meeting will be scheduled within ten(10) days of a request by either party. (a)The purpose of the meeting is to discuss the violation(s) stated in the notice of violation,provide information and to assist the applicant or licensee in achieving compliance with the requirements of these Administrative Rules. (b)The request for a meeting by an applicant or licensee or the Division will not extend any previously established time frame for correction. (5)The applicant or licensee must notify the Division of correction of the violation(s)no later than the date specified in the notice of violation. (6)The Division may conduct a reinspection of the home after the date the Division receives the report of compliance, or after the date by which the violation(s) must be corrected as specified in the notice of violation. (7)For violation(s)that present an imminent danger to the health, safety or welfare of residents,the licensee must correct the violation(s) and abate the conditions no later than 24 hours after receipt of the notice of violation. The Division may inspect the home after the 24-hour period to determine if the violation(s)has been corrected as specified in the notice of violation. (8)If residents are in immediate danger, the license may be immediately suspended and arrangements made to move the residents. (9)If, after inspection of a home, the violations have not been corrected by the date specified in the notice of violation or if the Division has not received a report of compliance,the Division may institute one or more administrative sanctions. Stat. Auth.: ORS 410.070 Stats. Implemented: ORS 443.765 Hist.: SSD 14-1985, f. 12-31-85, ef. 1=1-86; SSD 11-1988, f. 10-18-88, cert. ef. 11-1-88; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1996, f 3-29-96, cert. ef. 4-1-96; SDSD 4-2001, f. & cert. ef. 3-1-01; SPD 31-2006, f 12-27-06, cert. ef. 1-1-07 411-050-0465 Administrative Sanctions (1)An administrative sanction may be imposed for non-compliance with these rules.An administrative sanction includes one or more of the following actions: (a)Attachment of conditions to a license; (b) Civil penalties; (c) Denial, suspension,revocation, or non-renewal of license; and/or (d) Reclassification of a license. (2) If the Division imposes an administrative sanction, it will serve a notice of administrative sanction upon the licensee personally, by certified mail, or by registered mail. (3) The notice of administrative sanction will state: (a) Each sanction imposed; •• • (b)A short and plain statement of each condition or act that constitutes a violation; (c) Each statute or rule allegedly violated; (d)A statement of the licensee's right to a contested case hearing; (e) A statement of the authority and jurisdiction under which the hearing is to be held; (f)A statement that the Division's files on the subject of the contested case automatically become part of the contested case record upon default for the purpose of proving a prima facie case; and (g)A statement that the Division will issue a final order of default if the licensee fails to request a hearing within the specified time. Stat. Auth.: ORS 410.070 Stats. Implemented: ORS 443.765 Hist.: SSD 14-1985, f. 12-31-85, ef. 1-1-86; SSD 11-1988, f. 10-18-88, cert. ef. 11-1-88; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1996, f. 3-29-96, cert. ef. 4-1-96; SDSD 4-2001, f. & cert. ef. 3-1-01; SPD 31-2006, f. 12-27-06, cert. ef. 1-1-07 411-050-0480 Denial, Revocation or Non-Renewal of License (1)The Division may deny, revoke, or refuse to renew a license where it finds: ,(a)There has been substantial non-compliance with,these rules or where there is substantial non-compliance with local codes and ordinances or any other state or federal law or rule applicable to the health and safety of caring for residents in an adult foster home; (b)The Department has conducted a criminal history check and determined the applicant or licensee is not approved in accordance with OAR chapter 407, division 007, Criminal History Check Rules; (c)The licensee allows a caregiver, or any other person, excluding the residents, to reside or work in the adult foster home, who has been convicted of potentially disqualifying crimes, and has been denied, or refused to cooperate with the Division in accordance with OAR chapter 407, division 007, Criminal History Check Rules; (d)The applicant or licensee falsely represents that he or she has not been convicted of a crime. (2)The Division may deny, revoke, or refuse to renew an adult foster home license if the applicant or licensee: (a) Submits incomplete or untrue information to the Division; (b)Has a history of, or demonstrates financial insolvency, such as foreclosure,eviction due to failure to pay rent, termination of utility services due to failure to pay bill(s); (c)Has a prior denial, suspension,revocation or refusal to renew a certificate or license to operate a foster home or residential care facility in this or any other state or county; (d)Is associated with a person whose license for a foster home or residential care facility was denied, suspended, revoked or refused to be renewed due to abuse or neglect of the residents, or creating a threat to the residents or failure to possess physical health, mental health or good personal character within three years preceding the present action, unless the applicant or licensee can de strate to the Division by clear and co cing evidence that the person does not pose a threat to the residents. For poses of this subsection, an applicant oensee is "associated with" a person if the applicant or licensee: (A) Resides with the person; (B) Employs the person in the foster home; (C) Receives financial backing from the person for the benefit of the foster home; (D) Receives managerial assistance from the person for the benefit of the foster home; (E) Allows the person to have access to the foster home; or (F) Rents or leases the adult foster home from the person. (e) Has threatened the health, safety, or welfare of any resident; (f)Has abused, neglected, or exploited any resident; (g)Has a medical or psychiatric problem that interferes with the ability to provide foster care; (h) Has previously been cited for the operation of an unlicensed adult foster home; (i)Does not possess the good judgment or character deemed necessary by the Division; (j)Fails to correct a violation within the specified time frame allowed; (k) Refuses to allow access and inspection; (1)Fails to comply with a final order of the Division to correct a violation of the Administrative Rules for which an administrative sanction has been imposed such as a License Condition; (m)Fails to comply with a final order of the Division imposing an administrative sanction, including the imposition of a civil penalty; (n)Fails to take or pass the Basic Training Course examination; (o) Has failed to submit a current, completed Criminal History Request form to the Division on more than one occasion before allowing persons 16 years or older to live,receive training or work in the adult foster home, or have unsupervised access to residents or their personal property; or (p) Has previously surrendered a license while under investigation or administrative sanction during the last three years. (3) If the license is revoked for the reason of abuse, neglect or exploitation of a resident,the licensee may request a review in writing within 10 days after receipt of the notice of the revocation. If a request is made,the Division administrator or designee will review all material relating to the allegation of abuse,neglect or exploitation and the revocation within 10 days. The administrator or designee will determine, based on a review of the material, whether to. sustain the decision. If the administrator or designee does not sustain the decision,the license will be restored immediately. The decision of the administrator or designee is subject to a contested case hearing under ORS 183.310 to 183.550. (4) If a license is revoked or not renewed, the licensee must be entitled to a contested case hearing preceding the effective date of the revocation or nonakewal if the licensee requests a hearin writing within 21 days after receipt of the notice. If no written request for a ely hearing is received, the Division issue the final order by default. The Division may designate its file as the record for purposes of default. (5)A license subject to revocation will remain valid during an administrative hearings process even if the hearing and final order are not issued until after the expiration date of the license. (6)If an initial license is denied for any reason other than the results of a test or inspection, the applicant is entitled to a hearing if the applicant requests a hearing in writing within 60 days after receipt of the denial notice. If no written request for a hearing is timely received, the Division will issue a final order by default. The Division may designate its file as the record for purposes of default. (7) If a license is revoked or not renewed,the Division may arrange for residents to move for their protection. Stat. Auth.: ORS 410.070 Stats. Implemented: ORS 443.745 Hist.: SSD 14-1985, f. 12-31-85, ef. 1-1-86; SSD 2-1987(Temp), f. & ef. 5-5-87; SSD 10-1987, f. 10-29-87, ef. 11-1- 87; SSD 11-1988, f. 10-18-88, cert. ef. 11-1-88; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1996, f. 3-29-96, cert. ef. 4-1-96; SDSD 4-2001, f. & cert. ef. 3-1-01; SPD 31-2006, f. 12-27-06, cert. ef. 1-1-07 411-050-0481 Suspension of License (1) The Division may immediately suspend a license for reason of abuse, neglect, or exploitation of a resident if the Division finds that the abuse, neglect or exploitation causes an immediate threat to any of the residents. (2) The licensee may request a review of the decision to immediately suspend a license by submitting a request, in writing, within 10 days after receipt of the notice and order of suspension. Within 10 days after receipt of the licensee's request for a review,the Division administrator or designee will review all material relating to the allegation of abuse, neglect, or exploitation and to the suspension, including any written documentation submitted by the licensee within that time frame. The administrator or designee will determine, based on a review of the material, whether to sustain the decision. If the administrator or designee does not sustain the decision,the suspension will be rescinded immediately. The decision of the administrator or designee is subject to a contested case hearing under ORS 183.310 to 183.550 if requested within 90 days. (3)If a license is suspended, the Division may arrange for residents to move for their protection. Stat. Auth.: ORS 410.070 Stats. Implemented: ORS 443.745 Hist.: SSD 3-1996, f. 3-29-96, cert. ef. 4-1-96; SDSD 4-2001, f. & cert. ef. 3-1-01; SPD 31-2006, f. 12-27-06, cert. ef. 1-1-07 411-050-0483 Conditions (1) Conditions may be attached to a license and take effect immediately upon notification by the Division or the delivery date of the notice,whichever is sooner. The type of condition attached to a license must directly relate to a risk of harm or potential risk of harm to residents. Conditions may be attached upon a finding that: (a) Information on the application or initial inspection requires a condition to protect the health, safety or welfare of residents; (b) There exists a threat to the health, s , or welfare of a resident; • (c) There is reliable evidence of abuse, neglect, or exploitation; or (d) The home is not being operated in compliance with these rules. (2) Examples of conditions that may be imposed on a licensee include, but are not limited to: (a)Restricting the total number of residents based upon the ability of the licensee to meet the health and safety needs of the residents; (b) Restricting the number of residents a provider may admit or retain within a specific classification level based upon the ability of the licensee and staff to meet the health and safety needs of all the residents; (c) Changing the classification of the license based on the licensee's ability to meet the specific care needs of the residents; (d) Requiring additional staff to meet the resident's care needs; (e)Requiring additional qualifications or training of licensee and staff to meet specific resident care needs; (f) Restricting admissions when there is a threat to the current residents of the home and admitting new residents would compound that threat; and (g)Restricting a licensee from allowing persons on the premises who may be a threat to resident's health, safety or welfare. (3) In accordance with OAR 411-050-0465, the licensee will be notified in writing of any conditions imposed, the reason for the conditions, and be given an opportunity to request a hearing under ORS.183.310 to 183.550. A licensee must request a hearing in writing within 21 days after the receipt of the notice. Conditions will take effect immediately and are a final order of the Division unless later rescinded through the hearings process. (4) In addition to, or in-lieu of, a contested case hearing, a licensee may request an informal conference with the Division of conditions imposed. The informal conference does not diminish the licensee's right to a hearing. (5) Conditions may be imposed for the extent of the licensure period (one year) or limited to some other shorter period of time. If the condition corresponds to the licensing period, the reasons for the condition will be considered at the time of renewal to determine if the conditions are still appropriate. The effective date and expiration date of the condition must be indicated on the attachment to the license. If the licensee believes the situation that warranted the condition has been remedied, the licensee may request in writing that the condition be removed. Stat. Auth.: ORS 410.070 Stats. Implemented: ORS 443.745 Hist.: SSD 11-1988, f. 10-18-88, cert. ef. 11-1-88; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1996, f. 3-29-96, cert. ef. 4-1-96; SDSD 4-2001, f. & cert. ef. 3-1-01; SPD 31-2006, f. 12-27- 06, cert. ef. 1-1-07 411-050-0485 Criminal Penalties (1) Operating an adult foster home without a license is punishable as a Class C misdemeanor ORS 443.991(3). (2)Refusing to allow access and inspection of a home by Division staff or state or local fire inspection is a Class B misdemeanor ORS 443.991(2). •. • • (3)The Division may commence an action to enjoin operation of an adult foster home: (a) When an adult foster home is operated without a valid license; or (b)After a notice of revocation or suspension has been given and a reasonable time for placement of individuals in other facilities has been allowed. Stat. Auth.: ORS 410.070 Stats. Implemented: ORS 443.991 Hist.: SSD 14-1985, f. 12-31-85, ef. 1-1-86; SSD 2-1987(Temp), f. &ef. 5-5-87; SSD 11-1988, f. 10-18-88, cert. ef. 11-1-88; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1996, f. 3-29-96, cert. ef. 4-1-96; SDSD 4-2001, f. & cert. ef. 3-1-01; SPD 31-2006, f. 12-27-06, cert. ef. 1-1-07 411-050-0487 Civil Penalties - (1) Civil penalties, not to exceed $100 per violation to a maximum of$250 may be assessed for a general violation of these rules. (2)Mandatory penalties up to $500 will be assessed for falsifying resident or facility records or causing another to do so. (3) A mandatory penalty of$250 will be imposed for failure to have either the licensee, qualified resident manager, qualified shift caregiver, or qualified substitute caregiver on duty 24 hours per day in the adult foster home. (4)A mandatory penalty of$250 will,be imposed for dismantling or removing the battery, from any required smoke, alarm or failing to install any required smoke alarm. (5) The Division will impose a civil penalty of not less than $250 nor more than$500 on a licensee who admits a resident knowing that the resident's care needs exceed the license classification of the licensee if the admission places the resident or other residents at risk of harm. (6) Civil penalties up to a maximum of$1,000 per occurrence may be assessed for substantiated abuse. (7)In addition to any other liability or penalty provided by law,the Division may impose a penalty for any of the following: (a) Operating the home without a license; (b)The number of residents exceeds the licensed capacity; (c) The licensee fails to achieve satisfactory compliance with the requirements of these Administrative Rules within the time specified, or fails to maintain such compliance; (d)The home is unable to provide adequate level of care to residents; (e) There is retaliation or discrimination against a resident, family, employee, or any other person for making a complaint against the home; (f) The licensee fails to cooperate with the Division,physician,registered nurse, or other health care professional in carrying out a resident's care plan; or (g)The licensee fails to obtain an apprl criminal history check from the Deent prior to employing that individual as a caregiver in the home. (8)A civil penalty may be imposed for violations other than those involving health, safety, or welfare of a resident if the licensee fails to correct the violation as stated in subsections(8)(a) and(8)(b) of this rule; and (a)A reasonable time frame for correction was given, not exceeding 30 days after the first notice of violation was received. (b)Where more than 30 days are required to correct the violation, such time is specified in a plan of correction and found acceptable by the Division; (c) The following rules relate to the health, safety or welfare of residents and protection from retaliation for making a complaint: 411-050-0440(1)(d) and (e); 411-050-0440(7)(b) and (c); 411-050-0443(3)and (4); 411-050-0444 (1)(e); 411-050-0445; and 411-050-0447. (9)Any civil penalty imposed under this section becomes due and payable ten days after the order imposing the civil penalty becomes final by operation of law or on appeal. The notice must be delivered in person, or sent by registered or certified mail and must include: (a)A reference to the particular sections of the statute, rule, standard, or order involved; (b) A short and plain statement of the matters asserted or charged; (c)A statement of the amount of the penalty or penalties imposed; and (d)A statement of the right to request a hearing. (10)The person to whom the notice is addressed will have 10 days after receipt of the notice in which to make written application for a hearing. If a written request for a hearing is not timely received, the Division will issue a final order by default. (11)All hearings will be conducted according to the applicable provisions of ORS 183.310 to 183.550. (12)When imposing a civil penalty the Division will consider the following factors: (a) The past history of the person incurring the penalty in taking all feasible steps or procedures to correct the violation; (b) Any prior violations of statutes, rules or orders pertaining to the facility; (c)The economic and financial conditions of the person incurring the penalty; (d)The immediacy and extent to which the violation threatens or threatened the health, safety, or welfare of one or more residents; and (e) The degree of harm to resident(s). (13)If the person notified fails to request a hearing within the time specified, or if after a hearing the person is found to be in violation of a license,rule, or order, an order may be entered assessing a civil penalty. (14)Unless the penalty is paid within 10 days after the order becomes final, the order constitutes a judgment and may be recorded by the County Clerk which becomes a lien upon the title to any interest in real property owned by that person. The Division may also initiate a Notice of Revocation for failure to comply with a final order. (15) Civil penalties are subject to judiceview under ORS 183.480, except thipe court may, at its discretion, reduce the amount of the penalty. (16)All penalties recovered under ORS 443.790 to 443.815 will be paid into the State Treasury and credited to the General Fund. Stat. Auth.: ORS 410.070 Stats. Implemented: ORS 443.775, 443.790&443.795 Hist.: SSD 11-1988, f. 10-18-88, cert. ef. 11-1-88; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92; SSD 3-1996, f. 3-29-96, cert. ef. 4-1-96; SDSD 4-2001, f. &cert. ef. 3-1-01; SPD 31-2006, f. 12-27-06, cert. ef. 1-1-07 411-050-0490 Zoning for Adult Foster Homes Adult foster homes are subject to applicable sections of ORS 197.660 to 197.670. Stat. Auth.: ORS 410, 411 & 443.705 -443.795 Stats. Implemented: ORS 197.660, 196.670& 443.760 Hist.: SSD 14-1985, f. 12-31-85, ef. 1-1-86; SSD 11-1988, f. 10-18-88, cert. ef. 11-1-88; SSD 3-1992, f. 5-26-92, cert. ef. 6-1-92 411-050-0491 Adult Foster Homes for Ventilator-Dependent Residents (1) Qualifications: Licensees must meet and maintain compliance with OAR 411-050-0440, Qualifications. In addition: (a) The applicant or licensee, as applicable, has demonstrated competency in providing care for ventilator-dependent residents; (b)The applicant or licensee, as applicable, has operated his or her class 3 home in substantial compliance with the administrative rules for at least one year; (c)The applicant or licensee, as applicable, has completed Division-approved training pertaining to ventilator- dependent residents and other training as may be required. (2) Operational Standards: Licensees must meet and maintain compliance with OAR 411-050-0444, Operational Standards. In addition: (a) Qualified staff must be awake and available to meet the routine and emergency care and service needs of residents 24 hours a day. (b)All caregivers have demonstrated competency in providing care for a ventilator-dependent population. (c)All caregivers are able to evacuate the residents and any other occupants of the home within three minutes or less. (d) The applicant and licensee must have a satisfactory system in place to ensure caregivers are alert to the 24-hour needs of residents who may be unable to independently call for assistance. (e)All caregivers must know how to operate the generator without assistance and be able to demonstrate its operation upon request by the Division. (3) Facility Standards: Licensees must meet and maintain compliance with OAR 411-050-0445. In addition: (a)The residents'bedrooms must be a*mum of 100 square feet, or larger if viltssary, to accommodate the standard fequirements of OAR 411-050-0445(4) m addition to equipment and supplies ne sary for the care and services needed by individuals with ventilator equipment. (b) Homes with ventilator-dependent residents must have a functional, emergency back-up generator that is installed by a licensed electrician. The generator must be adequate to maintain electrical service for resident needs until regular service is restored. (c) The home must have a functional, interconnected smoke alarm system with back-up batteries. (d) The home must have a functional sprinkler system, and maintenance must be completed as recommended by the manufacturer. (e) Each resident's bedroom must have a mechanism in place that will enable residents to summon a caregiver's assistance when needed. The summons must be audible in all areas of the adult foster home. (4) Standards and Practices for Care and Services: Licensees must meet and maintain compliance with OAR 411-050- 0447. In addition: (a) The licensee must conduct and document a thorough screening on the Department's form. (b)Prior to admitting a ventilator-dependent resident to his or her adult foster home, the licensee must obtain preauthorization from the Division's Salem Central.Office. (c)The licensee must have a primary care physician identified for each resident being considered for admission. (d)The licensee must retain the services of registered nurses to work in the home who are trained in the care of ventilator-dependent persons. RN services include, but are not limited to, the provision of medical consultation for and supervision of resident care, skilled nursing care as needed and delegation of nursing care to caregivers. When the licensed provider is an RN, a back-up RN must be identified and available to provide nursing services in the absence of the licensee. (e) The licensee must develop individual care plans with RN consultants that address the expected frequency of nursing supervision, consultation and direct service intervention. (f) The licensee will have physician, and RN and respiratory therapist consultation services available on a 24-hour basis and for in-home visits as appropriate. The licensee must call the appropriate medical professional to attend emergent care needs of the resident. Stat. Auth.: ORS 410.070 Stats. Implemented: ORS 410.070 Hist.: SPD 31-2006, f. 12-27-06, cert. ef. 1-1-07 Hist.: SPD 31-2006, f. 12-27-06, cert..ef. 1-1-07 The official copy of an Oregon Administrative Rule is contained in the Administrative Order filed at the Archives Division,800 Summer St. NE,Salem,Oregon 97310.Any discrepancies with the published version are satisfied in favor of the Administrative Order.The Oregon Administrative Rules and the Oregon Bulletin are copyrighted by the Oregon Secretary of State.Terms and Conditions of Use Alphabetical Index by Agency Name Numerical Index by OAR Chapter Number Search the Text of the OARs Ouestions about Administrative Rules? REGON SECRETARY OF STATE - - atar��, Oregon State Archly . , ;� _ CONTACT US I N :w._U__ r... oars,. _ leg_ ta" ive.__w a records mgmt'w I geneaiiigy..._ .gov rnors ET: . ._ ,i.holdings state.agenicy, .i.-.tacat,gvvt E web„exhibits.___tour` 1 zl, ! ` The Oregon Administrative Rules contain OARs filed through May 15, 2008 DEPARTMENT OF HUMAN SERVICES, SENIORS AND PEOPLE WITH DISABILITIES DIVISION DIVISION 325 4 24 HOUR RESIDENTIAL SERVICES FOR CHILDREN AND ADULTS WITH DEVELOPMENTAL DISABILITIES 411-325-0010 Statement of Purpose These rules prescribe standards,responsibilities, and procedures for 24-Hour Residential Programs providing services to individuals with developmental disabilities. These rules also prescribe the standards and procedures by which the Department of Human Services licenses programs to provide residential care and training to individuals with \developmental disabilities. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 -443.455 Hist.: SPD 25-2003, f 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0020 Defmitions (1) "24-Hour Program" means a comprehensive residential program licensed by the Department of Human Services under ORS 443.400(7) and (8),to provide residential care and training to individuals with developmental disabilities. (2) "Abuse" means: (a) "Abuse of a child" is defined in ORS 418.005, 419B.005, 418.015,418.748, and 418.749. This includes but is not limited to: (A)Any death caused by other than accidental or natural means, or occurring in unusual circumstances; (B)Any physical injury including, but not limited to, bruises, welts, burns, cuts, broken bones, sprains, bites, which are deliberately inflicted; (C)Neglect including,but not limited to, failure to provide food, shelter, medicine,to such a degree that a child's health and safety are endangered; (D) Sexual abuse and sexual exploitation including, but not limited to, any sex contact in which a child is used to sexually stimulate another person. Thi•ay include anything from rape to fon to involving a child in pornography; (E) Threat of harm including, but not limited to, any action, statement, written or non-verbal message which is serious enough to make a child believe he or she is in danger of being abused; (F) Mental injury including,but not limited to, a continuing pattern of rejecting, terrorizing, ignoring, isolating, or corrupting a child,resulting in serious damage to the child; or (G) Child selling including, but not limited to, buying, selling or trading for legal or physical custody of a child; (b)Abuse of an Adult. Except for those additional circumstances listed in OAR 411-325-0020(2)(c)(A-F) abuse of an adult means one or more of the following: .(A)Any death caused by other than accidental or natural means, or occurring in unusual circumstances; (B) Any physical injury caused by other than accidental means, or that appears to be at variance with the explanation given of the injury; (C) Willful infliction of physical pain or injury; or (D) Sexual harassment or exploitation, including but not limited to, any sexual contact between an employee of a community facility or community program and an adult. (E)Neglect that leads to physical harm through withholding of services necessary to maintain health and wellbeing. (c)Abuse in other circumstances. When the Department directly operates any licensed 24 Hour Residential Program; or the CDDP or a Support Services Brokerage purchases or contracts for services from a program licensed or certified as a 24-Hour residential program, an adult foster home, an employment or community inclusion program; a supported living program; or a semi-independent living program abuse also means: (A) A failure to act or neglect that results in the imminent danger of physical injury or harm through negligent omission, treatment, or maltreatment. This includes, but is not limited to,the failure by a service provider or staff to provide adequate food, clothing, shelter, medical care, supervision, or tolerating or permitting abuse of an adult or child by any other person. However, no adult will be deemed neglected or abused for the sole reason that he or she voluntarily relies on treatment through prayer alone in lieu of medical treatment; (B) Verbal mistreatment by subjecting an individual to the use of derogatory names,phrases,profanity, ridicule, harassment, coercion or intimidation of such a nature as,to threaten significant physical or emotional harm or the withholding of services or supports, including implied or direct threat of termination of services; (C) Placing restrictions on an individual's freedom of movement by restriction to an area of the residence or program or from access to ordinarily accessible areas of the residence or program, unless agreed to by the ISP team and included in an approved behavior support plan. (D) An inappropriate or unauthorized restraint that results in injury. (i)A restraint is inappropriate if: (1) It is applied without a functional assessment of the behavior justifying the need for the restraint; or (11) It is used for behaviors not addressed in a behavior support plan; or (111) It uses procedures outside the parameters described in a behavior support p or (1V) It does not use procedures consisteenwith the Oregon Intervention System. (ii) A restraint is not authorized if: (1)There is not a written physician's order when the restraint is used as a heath related protection; or (11) It is applied without ISP Team approval as identified on the ISP and is described in a formal written behavior support plan. (iii)It is not abuse if it is used as an emergency measure, if absolutely necessary to protect the individual or others from immediate injury and only used for the least amount of time necessary. (E)Financial exploitation which may include, but is not limited to, an unauthorized rate increase; staff borrowing from or loaning money to an individual; witnessing a will in which the program or a staff is a beneficiary; adding the program's name to an individual's bank account(s) or other titles for personal property without approval of the individual or his/her legal representative and notification of the ISP team. (F) Inappropriately expending an individual's personal funds,theft of an individual's personal funds, using an individual's personal funds for the program's or staff's own benefit, commingling an individual's funds with program or another individual's funds, or the program becoming guardian or conservator. (G)The definitions of abuse described in OAR 411-325-0020 (2)(b)(A-E) also apply to homes or facilities licensed to provide 24-Hour Residential Services for children with developmental disabilities or to agencies licensed or certified to provide Proctor Foster Care for children with developmental disabilities. • (H)The definitions of abuse described in OAR 411-325-0020 (2)(c)(A-F) also apply to staff of the CMHDDP or a Support Services Brokerage. (3) "Abuse investigation and protective services" means reporting and investigation activities as required by OAR 407- 045-0300 and any subsequent services or supports necessary to prevent further abuse. (4) "Administration of medication" means the act of placing a medication in or on an individual's body by a staff member who is responsible for the individual's care. (5) "Administrator" means the Assistant, Department of Human Services and Administrator of Seniors and People with Disabilities or that person's designee. • (6) "Adult" means an individual 18 years or older with developmental disabilities. (7) "Advocate" means a person other than paid staff who has been selected by the individual or by the individual's legal representative to help the individual understand and make choices in matters relating to identification of needs and choices of services, especially when rights are at risk or have been violated. (8) "Aid to physical functioning" means any special equipment prescribed for an individual by a physician, therapist, or dietician which maintains or enhances the individual's physical functioning. (9) "Appeal" is the process by which a licensed provider may petition the suspension, denial or revocation of their license or application under Chapter 183, Oregon Revised Statutes, by making a written request to the Department. (10) "Applicant(s)" means a person, agency, corporation or governmental unit, who applies for a license to operate a residential home or facility providing 24-hour comprehensive services to individuals with developmental disabilities. (11) "Assessment" means an evaluation of an individual's needs. The evaluatio performed by a Services Coordinator or other designated Indiv. 1 Support Plan team members who w se the evaluation to develop the individual's Individual Support Plan(IS )). At a minimum this includes the completion of the Personal Focus Worksheet and Risk Tracking Record. • (12) "Baseline Level of Behavior" means the frequency, duration or intensity of a behavior, objectively measured, described and documented prior to the implementation of an initial or revised behavior support plan. This baseline measure serves as the reference point by which the ongoing efficacy of the support plan is to be assessed. A baseline level of behavior should be reviewed and reestablished at minimum yearly, at the time of the individual's support plan team meeting. (13) "Behavior Data Collection System" is the methodology specified within the individual's behavior support plan that directs the process for recording observation, intervention and other support provision information critical to the analysis of the efficacy of the behavior support plan. (14) "Behavior Data Summary" is a document composed by the provider agency to summarize episodes of physical intervention. This document serves as a substitution for the requirement of individual incident reports for each episode of physical intervention. (15) "Board of Directors" means a group of individuals formed to set policy and give directions to a program designed to provide residential services to individuals with developmental disabilities. This includes local advisory boards used by multi-state organizations. (16) "Care" means supportive services, including but,not limited to, provision of room and board, supervision, protection;, and assistance in bathing, dressing, grooming, eating, management of money,transportation or recreation. Care also includes being aware of the individual's general whereabouts at all times,and monitoring the activities of the individuals while on the premises of the residence to ensure their health, safety and welfare. (17) "Chemical restraint" means the use of a psychotropic drug or other drugs for punishment, or to modify behavior in place of a meaningful behavior/treatment plan. (18) "Child" means an individual under the age of 18 that has a provisional determination of developmental disability. (19) "Choice" means the individual's expression of preference, opportunity for, and active role in decision-making related to: the selection of assessments, services, service providers, goals and activities, and verification of satisfaction with these services. Choice may be communicated verbally, through sign language,or other communication method. (20) "Community Developmental Disability Program" or"CDDP" means an entity that is responsible for planning and delivery of services for persons with mental retardation or other developmental disabilities in a specific geographic area of the state under a contract with the Department or a local mental health authority. (21) "Community Developmental Disability Program Director" means the director of a community mental health and developmental disability program which operates or contracts for all services for persons with mental or emotional disturbances, drug abuse problems, mental retardation or other developmental disabilities, and alcoholism and alcohol abuse problems under the County Financial Assistance Contract with the Department of Human Services. (22) "Competency Based Training Plan" means a written description of a provider's process for providing training to newly hired program staff. At a minimum the plan must address health, safety, rights, values and personal regard, and the provider's mission. The plan will describe competencies, training methods, timelines, how competencies of staff are determined and documented, including steps for remediation, and when a competency(ies)may be waived by a provider to accommodate a staff person's specific circumstances. (23) "Complaint investigation" means an investigation of any allegation which has been made to a proper authority that the program has taken an action which is alleged to be contrary to law, rule or policy that is not covered by an abuse investigation or a grievance procedure. • (24) "Condition" means a provision attached to a new or existing license, which limits or restricts the scope of the license or imposes additional requirements_on the licensee. • (25) "Crisis" means a situation, as determined by a qualified Services Coordinator,that could result in civil court commitment under ORS. 427.215 through 427.300, an imminent risk of loss of the community support system for an adult or the imminent risk of loss of home for a child with no alternative resources available. (26) "Denial." is the refusal of the Department of Human Services to issue a license to operate a 24-hour residential home/facility for children or adults because the Department has determined that the home/facility is not in compliance with one or more of these administrative rules. (27) "Department" means Department of Human Services, Seniors and People with Disabilities, an organizational unit within the Department that focuses on the planning of services,policy development and regulation of programs for persons that have developmental disabilities. (28) "Developmental Disability for adults" means a disability attributable to mental retardation, autism, cerebral palsy, epilepsy, or other neurological handicapping condition that requires training or support similar to that required by individuals with mental retardation, and the disability: (a) Originates before the individual attains the age of 22 years, except that in the case of mental retardation the condition must be manifested before the age of 18; and (b) Has continued, or can be expected to continue, indefinitely; and (c) Constitutes a substantial handicap to the ability of the individual to function in society; and (d) The condition or impairment must not be otherwise primarily attributed to mental illness, substance abuse, an emotional disorder,Attention Deficit and Hyperactivity Disorder(ADHD), a learning disability, or sensory impairment; or (e) Results in significant subaverage general intellectual functioning with concurrent deficits in adaptive behavior that are manifested during the developmental period. Individuals of borderline intelligence may be considered to have mental retardation if there is also serious impairment of adaptive behavior. Definitions and classifications must be consistent with the "Manual of Terminology and Classification in Mental Retardation" by the American Association on Mental Deficiency, 1977 Revision. Mental retardation is synonymous with mental deficiency. (29) "Developmental Disability for children five years and younger" means the condition or impairment must not be otherwise primarily attributed to mental illness, substance abuse, an emotional disorder, Attention Deficit and Hyperactivity Disorder (ADHD), a learning disability, or sensory impairment; and be expected to last indefinitely, and is always provisional; AND (a) There is a standardized test demonstrating significant adaptive impairment (more than two standard deviations below the norm) in at least two of the following areas of functioning: self care; receptive and expressive language; learning; mobility and self-direction; OR . (b) There is a statement by a licensed medical practitioner that the child has a condition or syndrome that will likely cause significant adaptive impairment in at least two of the areas listed in(28). (30) "Developmental Disability for children six years and older" is always provisional and means: (a) There is a diagnosis of mental retardation; OR (b)There is a diagnosis of developmental disability; AND (A)There is a significant adaptive impairment(more than two standard deviations below the norm) in at least two of the following areas: self-care; receptive and expressive language; learning; mobility; self-direction; AND (B)The condition or impairment must be expected to last indefinitely and must not be otherwise primarily attributed to mental illness, substance abuse, an emotional disorder, Attention Deficit and Hyperactivity.Disorder(ADHD), a_ learning disability, or sensory impairment; AND (C) The individual is expected to need multiple, specialized supports indefinitely. (31) "Direct Nursing Services" means the provision of individual-specific advice,plans or interventions, based on nursing process as outlined by the Oregon State Board of Nursing, by a nurse at the home/facility. Direct nursing service differs from administrative nursing services. Administrative nursing services include non-individual-specific services, such as quality assurance reviews, authoring health related agency policies and procedures, or providing general training for staff. (32) "Domestic Animals" are any of various animals domesticated so as to live and breed in a tame condition. Examples of domestic animals are dogs, cats, and domesticated farm stock. (33) "Educational Surrogate" means an individual who acts in place of a parent in safeguarding a child's rights in the special education decision-making process when the parent cannot be identified or located after reasonable efforts, when there is reasonable cause to believe that the child has a disability and is a ward of the state, or at the request of a parent or adult student. (34) "Entry" means admission to a Department funded developmental disability service provider. For purposes of this rule "entry" means admission to-a 24-hour licensed home/facility. (35) " Executive Director" means the individual designated by a board of directors or corporate owner responsible for the administration of the program's services for individuals. (36) "Exit" means termination from a Department funded developmental disability service provider. Exit does not mean transfer within a service provider's program within a county. (37) "Grievance" means a formal complaint by the individual or a person acting on his/her behalf about any aspect of the program or an employee of the program. (38) "Guardian" means a parent for individuals under 18 years of age or a person or agency appointed by the courts who is authorized by the court to make decisions about services for the individual. (39) "Health Care Provider" means a person licensed, certified or otherwise authorized or permitted by law of this state to administer health care in the ordinary course of business or practice of a profession, and includes a health care facility. • (40) "Health Care Representative" means: (a)A health care representative as defined in ORS 127.505(12); or (b)A person who has authority to make health care decisions for an individual under the provisions of OAR 411-365- 0100 through 411-365-0320. (41) "Incident report" means a written report of any injury, accident, acts of physical aggression or unusual incident involving an individual. _. (42) "Independence" means the extent to which persons with mental retardation developmental disabilities exert control and choice over their own live. (43) "Individual" means an adult or a child with developmental disabilities for whom services are planned, provided arid authorized by a qualified Services Coordinator. (44) "Individual Support Plan" or "ISP" means the written details of the supports,activities and resources required for an individual to achieve personal goals. The Individual Support Plan is developed to articulate decisions and agreements made during a person-centered process of planning and information gathering.The ISP is the individual's Plan of Care for Medicaid purposes. (45) "Individualized Education Plan" (IEP)means a written plan of instructional goals and objectives in conference with the teacher,parent/guardian, student, and a representative of the school district. (46) "Individual Support Plan Team" or "ISP team" in comprehensive services means a team composed of the individual served, agency representatives who provide service to the individual if appropriate for in-home supports, the guardian, if any,relatives of the individual, and the Services Coordinator and other persons who are well liked by the individual. (47) "Integration" means the use by persons with mental retardation or other developmental disabilities of the same community resources that are used by and available to other persons in the community and participation in the same community activities in which persons without a disability participate, together with regular contact with persons without a disability. It further means that persons with developmental disabilities live in homes, that are in proximity to community resources and foster contact with persons in their community. (See ORS 427.005.) (48) "Legal representative" means the parent if the individual is under age 18,unless the court appoints another individual or agency to act as.guardian. For those individuals over the age of 18, a legal representative means an attorney at law who has been retained by or for the adult, or a person, or agency who is authorized by the court to make decisions about services for the individual. (49) "Licensee",means a person or organization to whom a license is granted. (50) "Majority Agreement" means for purposes of entry, exit,transfer and annual ISP team meetings that no one member of the ISP team will have the authority to make decisions for the team. Representatives from service provider (s), families, the CDDP, or advocacy agencies will be considered as one member of the ISP team for the purpose of reaching majority agreement. (51) "Mandatory Reporter" means any public or private official who, while acting in an official capacity, comes in contact with and has reasonable cause to believe that an individual with disabilities has suffered abuse, or that any person with whom the official comes in contact while acting in an official capacity, has abused the individual with disabilities. Pursuant to ORS 430.765(2)psychiatrists, psychologists, clergy and attorneys are not mandatory reporters with regard to information received through communications that are privileged under ORS 40.225 to 40.295. (52) "Mechanical restraint" means any mechanical device, material, object or equipment that is attached or adjacent to an individual's body that the individual cannot easily remove or easily negotiate around, and that restricts freedom of movement or access to the individual's body. (53) "Medication" means any drug, chemical, compound, suspension or preparation in suitable form for use as a curative or remedial substance taken either internally or externally by any person. (54) "Modified diet" means the texture or consistency of food or drink is altered or limited. Examples include, but are not limited to, no nuts or raw vegetables,thickened fluids, mechanical soft, finely chopped,pureed, bread only soaked in milk. (55) "Nurse" means a person who holds a valid, current license as a Registered irse (RN) or Licensed Practical Nurse (LPN) from the Oregon Board of Nurs (56) "Nursing Care Plan" means a plan of care developed by a Registered Nurse (RN)that describes the medical, nu'rsing,psychosocial, and other needs of the individual and how those needs will be met. It includes which tasks will be taught or delegated to the provider and staff. (57) "Oregon Core Competencies" is: (a)A list of skills and knowledge for newly hired staff in the areas of health, safety,rights, values and personal regard, and the service provider's mission; and (b)The associated timelines in which newly hired staff must demonstrate competencies. (58) "Oregon Intervention System" or "OIS" means a system of providing training to people who work with designated individuals with developmental disabilities,to provide elements of positive behavior support and nonaversive behavior intervention. The system uses principles of pro-active support and describes approved physical intervention techniques that are used to maintain health and safety. (59) "Physical intervention" means the use of any physical action or any response to maintain the health and safety of an individual or others during a potentially dangerous situation or event. (60) "Physical restraint" means any manual physical holding of or contact with an individual that restricts the individual's freedom of movement. (61) "Prescription medication" means any medication that requires a physician prescription before it can be obtained from a pharmacist. (62) "Productivity" means engagement in income-producing work by a person with mental retardation or other developmental disabilities which is measured through improvements in income level, employment status or job. advancement or engagement by a person with mental retardation or other developmental disabilities in work contributing to a household or community. (63) "Protection" means necessary actions taken to prevent subsequent abuse or exploitation of the individual, to prevent self-destructive acts, and to safeguard an individual's person,property and funds. (64) "Protective services" means necessary actions taken to prevent subsequent abuse or exploitation of the individual, to prevent self-destructive acts, and safeguard an individual's person,property, and funds as soon as possible. (65) "Psychotropic medication" means a medication whose prescribed intent is to affect or alter thought processes, mood, or behavior. This includes, but is not limited to, anti-psychotic, antidepressant, anxiolytic (anti-anxiety), and behavior medications. Because a medication may have many different effects, its classification depends upon its stated, intended effect when prescribed. (66) "Respite care" means short-term services for a period of up to 14 days. Respite care may include both day and overnight care. . (67) "Revocation" is the action taken to rescind a 24-hour home/facility license after the Department has determined that the program is not in compliance with one or more of these administrative rules. (68) "Self-administration of medication" means without supervision,the individual manages and takes his/her own medication. It includes identifying his/her medication and the times and methods of administration, placing the medication internally in or externally on his or her own body without staff assistance,and safely maintaining the medication(s). (69) "Services Coordinator" means an employee of the community developmedisability program or other agency which contracts with the County or Deitment, who is selected to plan,proc oordinate, monitor individual support plan services and to act as a proponent for persons with developmental disabilities. (70) "Service provider" means a public or private community agency or organization that provides recognized mental health or developmental disability,services and is approved by the Department or other appropriate agency to provide these services. For the purpose of this rule "provider", "program", "applicant" or "licensee" is synonymous with "service provider." (71) "Significant other" means a person selected by the individual to be his/her friend. (72) "Specialized diet" means that the amount, type of ingredients or selection of food or drink items is limited, restricted, or otherwise specified by a physician's order. Examples include, but are not limited to, low calorie, high fiber, diabetic, low salt, lactose free, low fat diets. This does not include diets where extra or additional food is offered, without physician's orders but may not be eaten, for example, offer prunes each morning at breakfast or include fresh. fruit with each meal. (73) "Staff' means a paid employee responsible for providing services to individuals and whose wages are paid in part or in full with funds sub-contracted with the CDDP or contracted directly through the Department. (74) "Support" means those services that assist an individual maintaining or increasing his or her functional independence, achieving community presence and participation, enhancing productivity, and enjoying a satisfying lifestyle. Support services can include training, the systematic, planned maintenance, development or enhancement of self-care, social or independent living skills, or the planned sequence of systematic interactions, activities, structured learning situations, or educational experiences designed to meet each individual's specified needs in the areas of integration and independence. (75) "Suspension of License" is a temporary withdrawal of the approval to operate a 24-hour home or facility after the Department determines that the 24-hour home or facility is not in compliance with one or more of these administrative rules. (76) "Transfer" means movement of an individual from one home/facility to another within the same county, administered by the same service provider. (77) "Transition plan" means a written plan for the period of time between an individual's entry into a particular service and when the individual's ISP is developed and approved by the ISP team. The plan must include a summary of the services necessary to facilitate adjustment to the services offered, the supports necessary to ensure health and safety, and the assessments and consultations necessary for the ISP development. (78) "Unusual Incident" means those incidents involving serious illness or accidents, death of an individual, injury or illness of an individual requiring inpatient or emergency hospitalization, suicide attempts, a fire requiring the services of a fire department, or any incident requiring abuse investigation. (79) "Variance" means an exception from a regulation or provision of these rules,which may be granted by the Department,upon written application by the provider. (80) "Volunteer" is any individual assisting in a 24-hour home or facility without pay to support the care provided to individuals residing in the home or facility. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 -443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0030 Issuance of License (1) License required.No person, agency or governmental unit acting individually or jointly with any other person, agency or governmental unit will establish, conduct, maintain, manage or operate a residential home or facility providing 24-hour support services without being licensed for each home or facility. (2)Not transferable.No license is transferable or applicable to any location, home or facility, agency,management agent or ownership other than that indicated on the application and license. (3) Terms of license. The Department will issue a license to an applicant found to be in compliance with these rules. The license will be in effect for two years from the date issued unless revoked or suspended. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0040 Application for Initial License (1) Application. At least 30 days prior to anticipated licensure the applicant must submit an application and required non-refundable fee. The application will be provided by the Department and must include all information requested by the Department. (2)Number of beds. The application must identify the number of beds the residential home or facility is presently capable of operating at the time of application, considering existing equipment, ancillary service capability and the physical requirements as specified by these rules. For purposes of license renewal, the number of beds to be licensed must not exceed the number identified on the license to be renewed unless approved by the Department. (3) Contracts. The initial application must include a copy of any lease agreements or contracts, management agreements or contracts, and sales agreements or contracts, relative to the operation and ownership of the home or facility. (4) Floor Plan. The initial application must include a floor plan of the home or facility showing the location and size of rooms, exits, smoke alarms and extinguishers. (5) Scheduled onsite-licensing inspection. Should the scheduled, onsite licensing inspection reveal that the applicant is not in compliance with these rules, as attested to on the Licensing Onsite Inspection Checklist, the onsite licensing inspection may be rescheduled at the Department's convenience. (6) License required prior to providing services. Applicants must not admit any individual to the home or facility prior to receiving a written confirmation of licensure from the Department. (7) Demonstrated Capability and Performance History. (a) If an applicant fails to provide complete, accurate, and truthful information during the application and licensing process, the Department may cause initial licensure to be delayed, or may deny or revoke the license. (b) Any applicant or person with a controlling interest in an agency will be considered responsible for acts occurring during, and relating to,the operation of such home/facility or agency for purpose of licensing. (c) The Department may consider the background and operating history of the applicant(s) and each person with a controlling ownership interest when determining whether to issue a license. (d)When an application for initial licensure is made by an applicant(s)who or operates other licensed homes or facilities in Oregon,the Department mleny the license if the applicant's exiset home(s) or facility(ies) are not, or have not been, in substantial compliance with the Oregon Administrative Rules. (8) Separate buildings. Separate licenses are not required for separate buildings located contiguously and operated as an integrated unit by the same management. (9)Admittance of individuals.No residential home or facility will admit individuals whose care needs exceed the classification on its license without prior written consent of the Department. Stat. Auth. ORS 410.070,409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04 411-325-0050 License Expiration,Termination of Operations, License Return (1)Expiration. Unless revoked, suspended or terminated earlier, each license to operate a residential home or facility will expire two years following the date of issuance. (2)Termination of operation. (a)If the home.or facility operation is discontinued for any reason, the license will be considered to have been terminated. (b)Each license will be considered void immediately if the,operation is discontinued by voluntary action of the licensee • or if there is a change in ownership. (3)Return of license. The license must be returned to the Department immediately upon suspension or revocation of the license or when the operation is discontinued. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04 411-325-0060 Conditions on License Attaching conditions to a license. The Department may attach conditions to the license which limit, restrict or specify other criteria for operation of the home or facility. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f..12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0070 Renewal of License (1) Renewal application required. A license is renewable upon submission of an application to the Department and the payment of the required non-refundable fee, except that no fee will be required of a governmental owned home or facility. (2) Filing of application extends date of expiration. Filing of an application and quired fee for renewal before the date of.expiration extends the effective date expiration until the Department takeWtion upon such application. If the renewal application and fee are not submitted prior to the expiration date, the home or facility will be treated as an unlicensed home or facility subject to Civil Penalties (OAR 411-325-0460). (3) Licensing review. The Department will conduct a licensing review of the service prior to the renewal of the license. The review will be unannounced, be conducted 30 - 120 days prior to expiration of the license, and will review compliance with OAR 411-325-0010 through 411-325-0480. (4) Refusal to renew a license. The Department will not renew a license if the home or facility is not in substantial compliance with these rules, or if the State Fire Marshal or the authorized representative has given notice of noncompliance pursuant to ORS 479.220. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04 411-325-0080 Mid-Cycle Review (1) Mid-Cycle Review Process. The Department may conduct a mid-cycle monitoring review of the home or facility nine to fifteen months after renewal of the provider's license under the following circumstances: (a) Failure by the provider to successfully complete licensing renewal as evidenced by two or more follow-up reviews; or (b) Failure by the provider to successfully complete plans of correction for protective service investigations; or (c)Upon the request of the CDDP or other Department designee, or provider: (2) Self-Assessment Required. As part of the mid-cycle process the provider must conduct a self-assessment based upon the requirements of this rule. (a)The provider must document the findings of the self-assessment on forms provided by the Department; (b)The provider must develop and implement a plan of correction based upon the findings of the self-assessment; and (c) The provider must submit the self-assessment to the local CDDP with a copy to the Department 30 days prior to the mid-cycle review. (3) Compliance with OAR 411-325-0010 through 411-325-0480. The review will be conducted for compliance with OAR 411-325-0010 through 411-325-0480, and at the discretion of the Department the review may be announced or unannounced. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0090 Change of Ownership, Legal Entity,Legal Status, Management Corporation (1)Notice of pending change in ownership, legal entity, legal status, or management corporation. The home or facility • must notify the Department in writing of a ny pending change in the program's oership or legal entity, legal status, or management corporation. (2)New license required. A new license will be required upon change in a program's ownership, legal entity or legal status. The program must submit a license application and required fee at least 30 days prior to change in ownership, legal entity or legal status. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 -443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04 411-325-0100 Inspections and Investigations (1) Inspections and investigations required. All services covered by this rule must allow the following types of investigations and inspections: (a) Quality assurance, license renewal and onsite inspections; (b) Complaint investigations; and (c)Abuse investigations. (2) Inspections and investigations by the Department, its designee or proper authority. All inspections and investigations must be performed by the Department, its designee, or proper authority. (3)Unannounced. Any inspection or investigation may be unannounced. (4)Required documentation. All documentation and written reports required by this rule must be: (a) Open to inspection and investigation by the Department, its designee or proper authority; and (b) Submitted to or be made available for review by the Department within the time allotted. (5)Priority of investigation under (1)(c). When abuse is alleged or death of an individual has occurred and a law enforcement agency, or the Department or its designee has determined to initiate an investigation, the provider must not conduct an internal investigation. For the purposes of this section, an internal investigation is defined as conducting interviews of the alleged victim, witness, the alleged perpetrator or any other person who may have knowledge of the facts of the abuse allegation or related circumstances; reviewing evidence relevant to the abuse allegation, other than the initial report; or any other actions beyond the initial actions of determining: (a) If there is reasonable cause to believe that abuse has occurred; or (b) If the alleged victim is in danger or in need of immediate protective services; or (c) If there is reason to believe that a crime has been committed; or (d) What, if any, immediate personnel actions must be taken to assure individual safety. (6) The Department or its designee must conduct investigations prescribed in OAR 407-045-0250 through 407-045- 0360 and must complete an Abuse Investigation and Protective Services Report according to.OAR 407-045-0330. The report must include the findings based upon the abuse investigation. "Inconclusive" means that the matter is not resolved, and the available evidence does not support a final decision that there was reasonable cause to believe that abuse occurred or did not occur. "Not substantiated" means that based on the ev. ence, it was determined that there is reasonable cause to believe that the allad incident was not in violation of the initions of abuse or attributable to the person(s) alleged to have engaged in such conduct. "Substantiated" means that based on the evidence there is reasonable cause to believe that conduct in violation of the abuse definitions occurred and such conduct is attributable to.the person(s) alleged to have engaged in the conduct. (7)Upon completion of the abuse investigation. Upon completion of the abuse investigation by the Department, its designee, or a law.enforcement agency, a provider may conduct an investigation to determine if any personnel actions are necessary. (8)Abuse Investigation and Protective Services Report. Upon completion of the investigation report according to OAR 407-045-0330,the sections of the report that are public,records and not exempt from disclosure under the public records law will be provided to the appropriate provider(s). The provider must implement the actions necessary within the deadlines listed, to prevent further abuse as stated in the report. (9)Plan of correction. A plan of correction must be submitted to the CDDP and the Department for any noncompliance found during an inspection under this rule. Stat.Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 -443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0110 Variances (1) Criteria for a variance. The Department may grant a variance to these rules based upon a demonstration by the provider that an alternative method or different approach provides equal or greater program effectiveness and does not adversely impact the welfare, health, safety or rights of individuals. (2)Variance application. The provider requesting a variance must submit, in writing, an application to the CDDP that contains the following: (a)The section of the rule from which the variance is sought; (b)The reason for the proposed variance; (c)The alternative practice, service, method, concept or procedure proposed; and (d) If the variance applies to an individual's services, evidence that the variance is consistent with a currently approved ISP according to OAR 411-325-0430. (3) Community Developmental Disability Program review. The CDDP shall forward the signed variance request form to the Department within 30 days of receipt of the request indicating its position on the proposed variance. (4)Department review. The Administrator or designee may approve or deny the request for a variance. (5)Notification. The Department must notify the provider and the CDDP of the decision. This notice will be sent within 30 calendar days of receipt of the request by the Department with a copy to other relevant Department programs or offices. (6)Appeal. Appeal of the denial of a variance request will be made in writing to the Administrator with a copy sent to the CDDP. The Administrator's decision will be final. (7)Duration of variance. The Department will determine the duration of the varrce. • (8) Written approval. The provider may implement a variance only after written approval from the Department. Stat. Auth. ORS 410.070,409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04 411-325-0120 Health: Medical (1) Written policies and procedures. The program must have and implement policies and procedures that maintain and protect the physical health of individuals. Policies and procedures must address the following: (a)Individual health care; (b)Medication administration; (c)Medication storage; (d)Response to emergency medical situations; (e)Nursing service provision, if provided ; (f)Disposal of medications; and (g) Early detection and prevention of infectious disease. (2) Individual health care. The individual must receive care that promotes their health and well being as follows: (a) The program must ensure each individual has a primary physician or primary health care provider whom he or she, the parent, guardian or legal representative has chosen from among qualified providers; (b) The program must ensure each individual receives a medical evaluation by a qualified health care provider no less than every two years or as recommended by a physician; (c) The program must monitor the health status and physical conditions of each individual and take action in a timely manner in response to identified changes or conditions that could lead to deterioration or harm; (d)A physician's or qualified health care provider's written, signed order is required prior to the usage or implementation of all of the following: (A) Prescription medications; (B)Non prescription medications except over the counter topical; (C) Treatments other than basic first aid; (D)Modified or special diets; • (E)Adaptive equipment; and (F)Aids to physical functioning. • (e)The program must implement a phyian's or qualified health care provider's order. (3)Required documentation. The program must maintain records on each individual to aid physicians, licensed health professionals and the program in understanding the individual's medical history. Such documentation must include: (a)A list of known health conditions, medical diagnoses; known allergies and immunizations; (b)A record of visits to licensed health professionals that include documentation of the consultation and any therapy provided; and (c)A record of known hospitalizations and surgeries. (4) Medication procurement and storage. All medications must be: (a)Kept in their original containers; (b)Labeled by the dispensing pharmacy,product manufacturer or physician, as specified per the physician's or licensed health care practitioner's written order; and (c)Kept in a secured locked container and stored as indicated by the product manufacturer. (5)Medication administration. All medications and treatments must be recorded on an individualized medication administration record(MAR). The MAR must include: (a) The name of the individual; (b)A transcription of the written physician's or licensed health practitioner's order, including the brand or generic name of the medication, prescribed dosage, frequency and method of administration; (c) For topical medications and treatments without a physician's order, a transcription of the printed instructions from the package; (d) Times and dates of administration or self administration of the medication; (e) Signature of the person administering the medication or the person monitoring the self administration of the medication; (f)Method of administration; (g)An explanation of why a PRN (i.e., as needed) medication was administered; (h)Documented effectiveness of any PRN (i.e., as needed)medication administration; (i)An explanation of any medication administration irregularity; and (j)Documentation of any known allergy or adverse drug reaction. (6) Self-administration of medication. For individuals who independently self-administer medications, there must be a plan as determined by the ISP team for the periodic monitoring and review of the self-administration of medications. (7) Self-administration medications unavailable to other.individuals. The`program must ensure that individuals able to self-administer medications keep them in a secure locked container unavailable exher individuals residing in the same residence and store them as recoll,nded by the product manufacturer. (8) PRN/Psychotropic medication prohibited. PRN (i.e., as needed), orders will not be allowed for psychotropic medication. (9) Adverse medication effects safe guards. Safeguards to prevent adverse effects or medication reactions must be utilized and include: (a) Obtaining, whenever possible, all prescription medication except samples provided by the health care provider, for an individual from a single pharmacy which maintains a medication profile for him or her; (b) Maintaining information about each medication's desired effects and side effects; (c) Ensuring that medications prescribed for one individual are not administered to,or self-administered by, another individual or staff member; and (d)Documentation in the individual's record of reason why all medications should not be provided through a single pharmacy. (10)Unused, discontinued, outdated, recalled and contaminated medications. All unused, discontinued, outdated, recalled and contaminated medications must be disposed of in a manner designed to prevent the illegal diversion of these substances. A written record of their disposal must be maintained that includes documentation of: (a) Date of disposal; (b) Description of the medication, including dosage strength and amount being disposed; (c) Individual for whom the medication was prescribed; (d) Reason for disposal; (e) Method of disposal; (f) Signature of the person disposing of the medication; and (g) For controlled medications, the signature of a witness to the disposal. (11)Direct nursing services. When direct nursing services are provided to an individual the program must: (a) Coordinate with the nurse or nursing service and the ISP team to ensure that the services being provided are sufficient to meet the individual's health needs; and (b) Implement the Nursing Care Plan, or appropriate portions therein, as agreed upon by the ISP team and the registered nurse. (12)Notification. When the individual's medical,behavioral or physical needs change to a point that they cannot be met by the program, the Services Coordinator must be notified immediately and that notification documented. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0130 Health: Food and Nutrition • (1) Well balanced diet. The provider m•provide access to a well balanced diet in accordance with the U.S. Department of Agriculture. (2)Modified or special diets. For individuals with physician or health care provider ordered modified or special diets the program must: (a)Have menus for the current week that provide food and beverages which consider the individual's preferences and are appropriate to the modified or special diet; and (b)Maintain documentation that identifies how modified texture or special diets are prepared and served for individuals. (3)Number of meals. At least three meals must be made available or arranged for daily. (4)Need and preference of individual. Foods must be served in a form consistent with the individual's need and provide opportunities for choice in food selection. (5)Prohibited food items. Unpasteurized milk and juice or home canned meats and fish must not be served or stored in the residence. (6) Supply of food. Adequate supplies of staple foods for a minimum of one week and perishable foods for a minimum of two days must be maintained on the premises. (7) Sanitation. Food must be stored, prepared and served in a sanitary manner. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0140 Health: Physical Environment (1) Clean and in good repair. All floors, walls, ceilings, windows, furniture and fixtures must be kept in good repair, clean and free from odors. Walls, ceilings, and floors must be of such character to permit frequent washing, cleaning, or painting. (2) Water and sewage. The water supply and sewage disposal must meet the requirements of the current rules of the Department of Human Services governing domestic water supply. (3) Public water supply. A public water supply must be utilized if available. If a non-municipal water source is used, a sample must be collected yearly by the provider, sanitarian, or a technician from a certified water-testing laboratory. The water sample must be tested for coliform bacteria and action taken to ensure potability. Test records must be retained for three years. (4) Septic tanks or other non-municipal sewage disposal systems. Septic tanks or other non-municipal sewage disposal systems must be in good working order. Incontinence garments must be disposed of in closed containers. (5)Room temperature. The temperature within the residence must be maintained within a normal comfort range. During times of extreme summer heat,the provider must make reasonable effort to keep individuals comfortable using ventilation, fans, or air conditioning. (6) Heat source screens. Screening for workable fireplaces and open-faced heatemust be provided. (7) Heating and cooling devices. All heating and cooling devices must be installed in accordance with current Building Codes and maintained in good working order. (8) Handrails. Handrails must be provided on all stairways. (9) Swimming pools, hot tubs, saunas or spas. Swimming pools, hot tubs, saunas, or spas must be equipped with safety barriers and devices designed to prevent injury and unsupervised access. (10) Sanitation for household pets and other domestic animals. Sanitation for household pets and other domestic animals must be adequate to prevent health hazards. Proof of current rabies vaccinations and any other vaccinations that are required for the pet by a licensed veterinarian must be maintained on the premises. Pets not confined in enclosures must be under control and must not present a danger or health risk to individuals residing at the residence or • their guests. (11) Insects and rodents. All measures necessary must be taken to prevent the entry of rodents, flies, mosquito's and other insects. (12) Garbage. The interior and exterior of the residence must be kept free of litter, garbage and refuse. (13) State and local codes. Any work undertaken at a residence, including but not limited to, demolition, construction, remodeling, maintenance, repair, or replacement must comply with all applicable State and local building, electrical, plumbing and zoning codes appropriate to the individuals served. (14)Zoning. Programs must comply with all applicable, legal zoning ordinances pertaining to the number of individuals receiving services at the residence. . Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 -443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04 411-325-0150 Safety: General (1)Toxic materials. All toxic materials including,but not limited to,poisons, chemicals, rodenticides and insecticides must be: - (a) Properly labeled; (b) Stored in original container separate from all foods, food preparation utensils, linens and medications; and (c) Stored in a locked_area unless the Risk Tracking records for all individuals residing in the home document that there is no risk present. (2) Flammable and combustible materials. All flammable and combustible materials must be properly labeled, stored and locked in accordance with State Fire Code. - (3) Knives and sharp objects. For children, knives and sharp kitchen utensils must be locked unless otherwise determined by a documented ISP team decision. (4) Window coverings for privacy. Window shades, curtains, or other covering devices must be provided for all bedroom and bathroom windows to assure privacy. • (5) Hot water supply and temperature. Hot water in bathtubs and showers must e exceed 120 °F. Other water sources, except the dishwasher, must not exceelp10 °F. -. (6) Window openings. Sleeping rooms on ground level must have at least one window readily openable from the inside without special tools that provides a clear opening of not less than 821 square inches, with the least dimension not less than 22 inches in height or 20 inches in width. Sill height must not be more than 44 inches from the floor level. Exterior sill heights must not be greater than 72 inches from the ground,platform, deck or landing. There must be stairs or a ramp to ground level. Those homes/facilities previously licensed having a minimum window opening of not less than 720 square inches are acceptable unless through inspection it is deemed that the window opening dimensions present a life safety hazard. (7) Square footage requirement for sleeping rooms. Sleeping rooms must have 60 square feet per individual with beds located at least three feet apart. (8)Flashlights. Operative flashlights, at least one per floor, must be readily available to staff in case of emergency. (9) First-aid kit and manual. First-aid kits and first-aid manuals must be available to staff within each residence in a designated location. First aid kits containing any items other than band-aids, tape, bandages must be locked. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0160 Program Management and Personnel Practices (1)Non-discrimination. The program must comply with all applicable state and federal statutes, rules and regulations in regard to non-discrimination in employment practices. (2)Basic personnel policies and procedures. The program must have in place and implement personnel policies and procedures that address suspension, increased supervision, or other appropriate disciplinary employment procedures when a staff member has been identified as an alleged perpetrator in an abuse investigation or when the allegation of abuse has been substantiated. (3) Prohibition against retaliation. A community program or service provider must not retaliate against any staff who reports in good faith suspected abuse or retaliate against the child or adult with respect to any report. An alleged perpetrator cannot self-report solely for the purpose of claiming retaliation. (a) Subject to penalty. Any community facility, community program or person that retaliates against any person because of a report of suspected abuse or neglect will be liable according to ORS 430.755, in a private action to that person for actual damages and, in addition, will be subject to a penalty up to $1000,notwithstanding any other remedy provided by law. (b)Adverse action defined. Any adverse action is evidence of retaliation if taken within 90 days of a report of abuse. For purposes of this subsection, "adverse action" means any action taken by a community facility, community program or person involved in a report against the person making the report or against the child or adult because of the report and includes, but is not limited to: (A)Discharge or transfer from the program, except for clinical reasons; (B)Discharge from or termination of employment; (C) Demotion or reduction in remuneration for services; or (e) Written documentation kept current that the staff person has demonstrated c• ., s etency in areas identified by the provider's competency based training asrequired by OAR 411-325-0160(4 d which is appropriate to their job description; (f)'Written documentation of 12 hours job-related inservice training annually; including documentation of training in CPR and first aid certification: (9) Program documentation requirements. All entries required by this rule OAR 411-325-0010 to 411-325-0480 must: (a) Be prepared at the time, or immediately following the event being recorded; (b) Be accurate and contain no willful falsifications; _ (c)Be legible, dated and signed by the person(s) making the entry; and (d) Be maintained for no less than three years. (10) Dissolution of program. Prior to the dissolution of a program, a representative of the governing body or owner must notify the Department 30 days in advance in writing and make appropriate arrangements for the transfer of individual's records. Stat. Auth. ORS 410.070,409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0170 Safety: Staffing Requirements _ (1) General staffing requirements. Each residence must provide staff appropriate to the number of individuals served as follows: (a) Each home or facility serving five or fewer individuals must provide at a minimum one staff on the premises when individuals are present; and (b)Each program serving five or fewer individuals in apartments must provide at a minimum one staff on the premises of the apartment complex when individuals are present; and (c) Each home or facility serving six or more individuals must provide a minimum of one staff on the premises for every 15 individuals during awake hours and one staff on the premises for every 15 individuals during sleeping hours, except residences licensed prior to January 1, 1990; and (d) Each home or facility serving children, for any number of individuals, must provide at a minimum one awake night staff on the premises when individuals are present. (2) Exceptions to minimum staffing requirements in OAR 411-325-0170(1)(a), (b) and (c) for homes or facilities serving adults. A home or facility is granted an exception to staffing requirements in OAR 411-325-0170(1)(a), (b) and (c) for adults to be home alone when the following conditions have been met: (a)No more than two adults will be left alone in the home at any time without on staff supervision; (b) The amount of time any adult can be left alone will not exceed five hours within a twenty-four hour period and no adult will be responsible for any other adult or child in the home or community; (c)No individual will be left home alone without staff supervision between the Ors of 11:00 P.M. and 6:00 A.M.; (d) The adult has a documented history being able to do the following safety measures or there is a documented ISP team decision agreeing to an equivalent alternative practice: (A) Independently call 911 in an emergency and give relevant information after calling 911; (B) Evacuate the premises during emergencies or fire drills without assistance in three minutes or less; (C) Knows when, where and how to contact the provider in an Emergency; (D)Before opening door, checks who is there; (E)Does not invite strangers to the home/facility; (F)Answers door appropriately; (G)Use small appliances, sharp knives, kitchen stove and microwave safely; (H) Self-administers medications, if applicable; (I) Safely adjusts water temperature at all faucets; and (J) Safely takes shower/bathes without falling. (e)There is a documented ISP team decision annually noting team agreement that the adult meets the requirements of OAR 411-325-0170(2)(d)(A)-(J). (3) Changes in an adult's ability to remain home alone without supervision. If at any time the adult is unable to meet the requirements in OAR 411-325-0170(2)(d)(A)-(J), the provider must not leave the adult alone without supervision. In addition, the provider must notify the adult's Services Coordinator within one working day and request that the ISP team meet to address the adult's ability to be left alone without supervision. t(4) Contract requirements for staff ratios. Each residence must meet all requirements for staff ratios as specified by contract requirements. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 =443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0180 Safety: Individual Summary Sheets Current one to two page summary sheet:A current one to two page summary sheet must be maintained for each individual receiving services from the program. The record must include: (1)The individual's name, current and previous address, date of entry into the program, date of birth, sex, marital status (for individuals 18 or older), religious preference, preferred hospital, medical prime number and private insurance number where applicable, guardianship status; and - (2) The name, address and telephone number of: (a) The individual's legal representative, family, advocate or other significant person,and for children, the child's parent (D) Restriction or prohibition of access to the program or the individuals served the program. (4) Competency-based staff training plan. The program must have and implement a competency-based staff-training plan, which meets, at a minimum,the competencies and timelines set forth in the Department's Oregon Core Competencies. (5)Mandatory abuse reporting personnel policies and procedures. Any employee of a public or private community agency is required to report incidents of abuse when the employee comes in contact with and has reasonable cause to believe that an individual has suffered abuse or that any person with whom the employee comes in contact, while acting in an official capacity,has abused the individual.Notification of mandatory reporting status must be made at least annually to all employees on forms provided by the Department. All employees shall be provided with a Department produced card regarding abuse reporting status and abuse reporting. For reporting purposes the following will apply: (a)Agencies providing services to adults must report to the CDDP where the adult resides and if there is reason to believe a crime has been committed a report must also be made to law enforcement. (b)Agencies providing services to children must report to DHS Child Welfare or law enforcement in the county where the child resides. (6)Director qualifications. The program must be operated under the supervision of a Director who has a minimum of a bachelor's degree and two years of experience, including supervision, in developmental disabilities, mental health, rehabilitation, social services or a related field. Six years of experience in the identified fields may be substituted for a degree. (7) General staff qualifications. Any employee providing direct assistance to individuals must meet the following criteria: (a)Be at least 18 years of age; (b) Have approval to work based on current Oregon Department of Human Services policy and procedures for review of criminal history; (c)Be literate and capable of understanding written and oral orders; be able to communicate with individuals, physicians, Services Coordinators and appropriate others; and be able to respond to emergency situations at all times; (d)Have clear job responsibilities as described in a current signed and dated job description; (e) Have knowledge of individuals' ISP's and all medical, behavioral and additional supports required for the individual; and (f) Have met the basic qualifications in the program's competency based training plan. (8) Personnel files and qualifications records. The program must maintain up-to-date written job descriptions for all employees as well as a file available to the Department or CDDP for inspection that includes written documentation of the following for each employee: (a) Written documentation of references and qualifications being checked; (b) Written documentation of an approved criminal record clearance by the Oregon Department of Human Services; (c) Written documentation of employee notification of mandatory abuse training and reporter status prior to supervising individuals and annually thereafter; (d) Written documentation of any substantiated abuse allegations; or guardian, education surrogate, if applicable; • (b) The individual's preferred physician, secondary physician or clinic; (c)'The individual's preferred dentist; (d) The individual's identified pharmacy; (e) The individual's school, day program, or employer, if applicable; (f) The individual's Services Coordinator, and for Department direct contracts, Department representative; and (g) Other agency representatives providing services to the individual. (3) For children under the age 18, any court ordered or guardian authorized contacts or limitations must also be included on the individual summary sheet. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0190 Safety: Incident Reports and Emergency Notifications (1)Incident reports. A written report that describes any incident as defined in OAR 411-325-0020(41) involving an individual must be placed in the individual's record. Such description must include: (a) Conditions prior to or leading to the incident; (b)A description of the incident; (c) Staff response at the time; and (d)Administrative review to include the follow-up to be taken to prevent a recurrence of the incident. (2) Sent to guardian and Services Coordinator. Copies of all unusual incident reports must be sent to the individual's Services Coordinator within five working days of the incident. Upon request of the guardian, copies of unusual incident reports will be sent to the guardian within five working days of the incident. Such copies must have any confidential information about other individuals removed or redacted as required by federal and state privacy laws. Copies of unusual incident reports will not be provided to a guardian when the report is part of an abuse or neglect investigation. (3) Immediate notification of allegations of abuse and abuse investigations. The program must notify the CDDP immediately of an incident or allegation of abuse falling within the scope of OAR 411-325-0020(2)(a)(A)-(G), (b)(A)- (E), and(c)(A)-(H). When an abuse investigation has been initiated,the CDDP will assure that either the Services Coordinator or the program will also immediately notify the individual's legal guardian or conservator. The parent who is not the guardian, next of kin or other significant person may also be notified unless the adult requests the parent, next of kin or other significant person not be notified about the abuse investigation or protective services, or notification has been specifically prohibited by law. (4)Immediate notification for serious illness, injury or death. In the case of a serious illness, injury or death of an individual, the program must immediately notify: (a)The individual's guardian or conservator, parent, next of kin or other significant person; (b)The Community Developmental Disability Program; and • (c)Any agency responsible for or providmg • services to the individual. (5)Emergency notification. In the case of an individual who is away from the residence, without support beyond the time frames established by the ISP team,the program must immediately notify: (a)The individual's guardian, if any, or nearest responsible relative; (b) The individual's designated contact person; (c) The local police department; and (d) The Community Developmental Disability Program. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 -443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0200 Safety: Transportation (1)Vehicles operated to transport individuals. Providers, including employees and volunteers who own or operate vehicles that transport individuals, must: (a) Maintain the vehicles in safe operating condition; - (b) Comply with Department of Motor Vehicles laws; (c) Maintain or assure insurance coverage including liability, on all vehicles and all authorized drivers; and (d) Carry in vehicles a first aid kit. (2) Seat belts and appropriate safety devices. When transporting, the driver must ensure that all individuals use seat belts. Individual car or booster seats will be used for transporting all children as required by law. When transporting individuals in wheel chairs,the driver must ensure that wheel chairs are secured with tie downs and that individuals wear seat belts. (3) Drivers. Drivers operating vehicles that transport individuals must meet applicable Department of Motor Vehicles requirements as evidenced by a driver's license. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 -443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0210 Individual/Family Involvement Policy (1) Individual/family involvement policy needed. The program must have and implement a written policy that addresses: • • (a) Opportunities for the individual to participate in decisions regarding the operations of the program; (b) Opportunities for families, guardians, legal representatives and significant others of the individuals served by the program to interact; (c) Opportunities for individuals, families, guardians, legal representatives and significant others to participate on the Board or on committees or to review policies of the program that directly affect the individuals served by the program. Stat. Auth. ORS 410.070,409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f 12-29-03, cert. ef. 1-1-04 411-325-0220 Individual Furnishings (1)Bedroom furniture. Bedroom furniture must be provided or arranged for each individual and include: (a)A bed, including a frame unless otherwise documented by an ISP team decision,a clean comfortable mattress, a waterproof mattress cover, if the individual is incontinent, and a pillow; (b)A private dresser or similar storage area for personal belongings which is readily accessible to the individual; and (c)A closet or similar storage area for clothing which is readily accessible to the individual. (2) Linens. Two sets of linens must be provided, or arranged for each individual and include: (a) Sheets and pillowcases; (b) Blankets, appropriate in number and type for the season and the individual's comfort; and (c) Towels and washcloths. (3) Personal hygiene items. Each person must be assisted in obtaining personal hygiene items in accordance with individual needs and items must be stored in a sanitary and safe manner. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04 411-325-0230 Emergency Plan and Safety Review (1) Written emergency plan. A written emergency plan must be developed and implemented and must include instructions for staff in the event of a fire, explosion, earthquake, accident, or other emergency including evacuation of individuals served at the residence. (2) Emergency telephone numbers. Emergency telephone numbers must be read' available in each residence in close proximity to phone(s)used by staff as .ws: (a) The telephone numbers of the local fire,police department and ambulance service, if not served by a 911 emergency service; and (b)The telephone number of the Executive Director, emergency physician and other persons to be contacted in the case of an emergency. (3) Quarterly safety review. A documented safety review that is site specific must be conducted quarterly to ensure that the residence is free of hazards. The provider must keep these reports for three years and make them available upon request by the CDDP or Department. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04 411-325-0240 Safety: Assessment of Fire Evacuation Assistance Required (1)Assessment of level of evacuation assistance required. The program must assess within 24 hours of entry to the residence the individual's ability to evacuate the residence in response to an alarm or simulated emergency. (2) Documentation of level of assistance required. The program must document the level of assistance needed by each individual to safely evacuate the residence and such documentation must be maintained in the individual's entry records. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04 411-325-0250 Safety: Fire Drill Requirements and Fire Safety (1) General fire drill requirements. The program must conduct unannounced evacuation drills when individuals are present, one per quarter each year with at least one drill per year occurring during the hours of sleep. Drills must occur at different times of the day, evening and night shifts with exit routes being varied based on the location of a simulated fire. (2) Written fire drill documentation required. Written documentation must be made at the time of the fire drill and kept by the program for at least two years following the drill. Fire drill documentation must include: (a) The date and time of the drill or simulated drill; (b) The location of the simulated fire and exit route; (c) The last names of all individuals and staff present on the premises at the time of the drill; (d) The type of evacuation assistance provided by staff to individuals' as specified in each individual's safety plan; (e) The amount of time required by each individual to evacuate or staff simulating the evacuation; and (f) The signature of the staff conducting the drill. • (3) Smoke alarms or detectors and protection equipment. Smoke alarms or detectors and protection equipment must be inspected and documentation of inspections maintained as recommended by the local fire authority or State Fire Marshal. (4)Adaptations required for sensory or physically impaired. The program must provide necessary adaptations to ensure fire safety for sensory and physically impaired individuals. Stat. Auth. ORS 410.070,409.050 Stats. Implemented: ORS 443.400 -443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04,cert. ef. 8-1-04 , 411-325-0260 Safety: Individual Fire Evacuation Safety Plans (1) Written fire safety evacuation plan for five or fewer individuals residing in homes, duplexes, or apartments who are . unable to evacuate residence in three minutes or less, or who request not to participate in fire drills. For individuals who are unable to evacuate the residence within the required evacuation time, or who, with concurrence of the ISP team,request not to participate in fire drills,the program must develop a written fire safety and evacuation plan that includes the following: (a)Documentation of the risk to the individual's medical, physical condition and behavioral status; (b)Identification of how the individual will evacuate his/her residence including level of support needed; (c)The routes to be used to evacuate the residence to a point of safety; (d)Identification of assistive devices required for evacuation; (e) The frequency the plan will be practiced and reviewed by the individual and staff; (f) The alternative practices; (g)Approval of the plan by the individual's guardian, case manager and the program director; and (h)A plan to encourage future participation. (2) Required documentation of practice and review of fire safety and evacuation plans. The program must maintain documentation of the practice and review of the safety plan by the individual and the staff. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 -443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0270 • Specific Standards: Safety-Fire Safety Requirements for Homes(s) on a Single Property or on Contiguous Property Serving Six or More Individuals (1) State of Oregon Building Codes and Fire Code. The home must provide safety equipment appropriate to the number and level of individuals served and meet the requirements of the State of Oregon Structural Specialty and the Fire Code as adopted by the State: (a)Each residence housing six or more, but fewer than l l individuals, or each r ence that houses five or fewer individuals, but is licensed as single fa y due to the total number of individu erved per the license or meets the contiguous property provision, must meet the requirements of an SR 3.3 occupancy; and must: (A) Provide and maintain permanent wired smoke alarms from a commercial source with battery back-up in each bedroom and at a point centrally located in the corridor or area giving access to each separate sleeping area and on each floor; and (B) Provide and maintain a 13D residential sprinkler system as defined in the most recent edition of the National,Fire Protection Association standard. (b) Each residence housing 11 or more but fewer than 17 individuals must meet the requirements of an SR-3.2 occupancy. (c)Each residence housing 17 or more individuals must meet the requirements of an SR 3.1 occupancy. (2)Licensed capacity plus respite bed for homes on a single property or on a contiguous property serving six or more individuals. At no time will the number of individuals served exceed the licensed capacity, except that one a dditional individual may receive respite care services not to exceed two weeks. Respite supports must not violate the safety and health sections of this rule. (3)No admittance of person unable to appropriately respond. The program must not admit individuals functioning below the level indicated on the license for the residence. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 -443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef.•1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 . 411-325-0280 Specific Standards: Safety-Fire Safety Requirements for Homes or Duplexes Serving Five or Fewer Individuals (1) Fire safety requirements. The home or duplex must be made fire safe by: (a) Providing a second means of egress. (b) Providing a class 2A10BC fire extinguisher easily accessible on each floor in the home or duplex. (c) Providing and maintaining permanent wired smoke alarms from a commercial source with battery back up in each bedroom and at a point centrally located in the corridor or area giving access to each separate sleeping area and on each floor. (d) Providing and maintaining a 13D residential sprinkler system in accordance with the most recent edition of the National Fire Protection Association Code. Homes or duplexes rated as "Prompt" facilities per Chapter 3 of the 2000 edition NFPA 101 Life Safety Code are granted an exception from the residential sprinkler system requirement. (2) Exception for permanent wired smoke alarms and 13D residential sprinkler systems. A home or duplex is granted an exception to requirements in OAR 411-325-0280(1)(c) and(d) under the following circumstances: (a)All individuals residing in the home or duplex have demonstrated the ability to respond to an emergency alarm with or without physical assistance from staff,to the exterior and away from the home, in 3 minutes or less, as evidenced by 3 or more consecutive documented fire drills; (b) Battery operated smoke alarms with a 10 year battery life and hush feature have been installed in accordance with the manufacturer's listing, in each bedroom, adjacent hallways, common living s, basements, and in two-story homes, at the top of each stairway. Cele placement of smoke alarms is recorded. If wall mounted, smoke alarms must be between 6" and 12" from the ceiling and not within 12" of a corner. Alarms must be equipped with a device that warns of low battery condition when battery operated. All smoke alarms are to be maintained in functional condition; and (c)A written fire safety evacuation plan is implemented that assures that staff assist all individuals in evacuating the premises safely during an emergency or fire as documented by fire drill records. (3)Respite care. At no time will the number of individuals served at the residence exceed the maximum capacity of five including respite services. An individual may receive respite services not to exceed two weeks. Respite services must not violate the safety and health sections of this rule. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04 411-325-0290 Specific Standards: Safety-Fire Safety Requirements for Apartments Serving Five or Fewer Individuals (1)Fire safety requirements. The apartment must be made fire safe by: (a)Providing and maintaining in each apartment battery-operated smoke alarms with a 10-year life in each bedroom and in a central location on each floor; (b)Providing first floor occupancy apartments. Individuals who can exit in three minutes or less without assistance may be granted a variance from the first floor occupancy requirement; (c)Providing a class 2A10BC portable fire extinguisher easily accessible in each apartment; (d) Providing access to telephone equipment or intercom in each apartment, usable by the individual served; and (e) Providing constantly usable unblocked exits from the apartment and apartment building. (2) Respite care. At no time will the number of individuals served at the residence exceed the maximum capacity of five including respite services. An individual may receive respite services not to exceed two weeks. Respite services must not violate the safety and health sections of this rule. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 -443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0300 Rights: General (1)Abuse prohibited for adults and children. Adults as defined at 411-325-0020(6) must not be abused nor will abuse be tolerated by any employee, staff or volunteer of the program. Children as defined at 411-325-0020(18) or as defined in these rules must not be abused nor will abuse be tolerated by any employee, staff or volunteer of the program. (2) Protection and wellbeing. The program must ensure the health and safety of individuals from abuse including the protection of individual rights, as well as, encourage and assist individuals through the ISP process to understand and exercise these rights. Except for children under the age of 18, where reasonable limitations have been placed by a parent or guardian, these rights must at a minimum provide for: • • (a)Assurance that each individual has the same civil and human rights accorded to other citizens of the same age except when limited by a court order: (b) Adequate food,housing, clothing, medical and health care, supportive services and training; (c) Visits with family members, guardians, friends, advocates and others of the individual's choosing,'and legal and medical professionals; (d) Confidential communication including personal mail and telephone; (e) Personal property and fostering of personal control and freedom regarding that property; (f) Privacy in all matters that do not constitute a documented health and safety risk to the individual; (g) Protection from abuse and neglect, including freedom from unauthorized training, treatment and chemical/mechanical/physical restraints; (h) Freedom to choose whether or not to participate in religious activity; (i) The opportunity to vote for individuals over the age of 18 and training in the voting process; (j) Expression of sexuality within the framework of State and Federal Laws, and for adults over the age of 18, freedom to many and to have children; (k)Access to community resources,including recreation, agency services, employment`and community inclusion' services, school, educational opportunities and health care resources; (1) Individual choice for children and adults that allows for decision making and control of personal affairs appropriate to age; (m) Services which promote independence, dignity and self-esteem and reflect the age and preferences of the individual child or adult; (n) Individual choice for adults to consent to or refuse treatment, unless incapable, and then an alternative decision maker is allowed to consent or refuse. For children consent to or refusal of treatment by the child's parent or guardian except as defined in statute (ORS 109.610) or limited by court order; (o) Individual choice to participate in community activities; (p)Access to a free and appropriate education for children and individuals under the age of 21 including a procedure for school attendance or refusal to attend. (3) Policies and procedures. The program must have and implement written policies and procedures that protect an individual's rights as listed in OAR 411-325-0300(2)(a-p). (4)Notification of policies and procedures. The program must inform each individual and parent or guardian orally and in writing of their rights and a description of how to exercise those rights. This must be completed at entry to the program and in a timely manner, thereafter, as changes occur. Information must be presented using language, format, and methods of communication appropriate to the individual's needs and abilities. Stat. Auth. ORS 410.070, 409.050 • Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f 7-30-04, cert. ef. 8-1-04 • • 411-325-0310 Rights: Confidentiality of Records Confidentiality. All individuals'records are confidential except as otherwise provided by applicable State and Federal rule or laws. (1)For the purpose of disclosure from individual medical records under these rules, service providers under these rules are considered "providers" as defined in ORS 179.505(1). (2)For the purposes of disclosure from non-medical individual records, all or portions of the information contained in these records may be exempt from public inspection under the personal privacy information exemption to the public records law set forth in ORS 192.502(2). Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f 7-30-04, cert. ef. 8-1-04 411-325-0320 Rights: Informal Complaints and Formal Grievances (1) Grievances. The program must develop and implement written policies and procedures regarding individual informal complaints and formal grievances. These policies and procedures must at minimum address: (a) Informal complaint resolution. Opportunity for an individual or someone acting on behalf of the individual to informally discuss and resolve any allegation that a program has taken action which is contrary to law,rule, or policy and that does not meet the criteria for an abuse investigation. Choosing this opportunity will not preclude the individual or someone acting on behalf of the individual to pursue resolution through formal grievance processes. (b) Formal grievances and grievance log. A description of how the program receives and documents grievances from individual(s) and others acting on the behalf of individuals. If a grievance is associated in any way with abuse, the recipient of the grievance must immediately report the issue to the appropriate authority, the CDDP, Department for direct contracted services and notify the Executive Director or designee. The formal grievance policies and procedures must require: (A)Investigation of the facts supporting or disproving the grievance; (B) That the Executive Director or designee provide a formal written response to the grievant within 15 days of receipt of the grievance, unless the grievance is informally resolve to the grievant's satisfaction prior to that time. The formal written response of the Executive Director or designee must clearly inform the grievant: - (i) Of the right to appeal an adverse decision to the CDDP and how to do so, including the name, address, and phone number of the person at the CDDP to whom the appeal should be submitted; (ii) Of the availability of assistance in,appealing the grievance and how to access that assistance. (C) That the Executive Director or designee will submit to the CDDP for review grievances that have not been resolved to the satisfaction of the grievant, where the Executive Director or designee believes that the grievant may not have the capability to appeal an adverse decision to the CDDP. (D) The CDDP will address the appeal as provided in the Community Developmental Disability Programs Administrative Rule, OAR 411-320-0170. • • (E)Documentation of each grievance and its resolution must be filed or noted in the grievant's record. In addition,the program must maintain a grievance log, which will, at a minimum, identify the person making the grievance, the date ofthe grievance,the nature of the grievance, the resolution, and the date of the resolution. (2)Notification of policies and procedures. The program must inform each individual, parent or guardian orally and in writing, of its grievance policy and procedures. This must be done at entry to the program and in a timely manner thereafter as changes occur. Information must be presented using language, format and methods of communication appropriate to the individual's needs and abilities. Stat. Auth. ORS 410.070,409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0330 Rights: Medicaid Fair Hearings Medicaid service recipients policy and procedure. The program must have a policy and procedure that provides for immediate referral to the CDDP when a Medicaid recipient, parent or guardian requests a fair hearing. The policy and procedure must include immediate notice to the individual, parent or guardian of the right to a Medicaid fair hearing each time a program takes action to deny, terminate, suspend or reduce an individual's access to services covered under Medicaid. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04 411-325-0340 Rights: Behavior Support (1) Written policy required. The program must have and implement a written policy for behavior support that utilizes individualized positive behavior support techniques and prohibits abusive practices. (2) Development of an individualized plan to alter a person's behavior. A decision to develop a plan to alter a person's behavior must be made by the ISP team. Documentation of the ISP team decision must be maintained by the program. (3)Functional behavioral assessment required. The program must conduct a functional behavioral assessment of the behavior, which must be based upon information provided by one or more persons who know the individual. The functional behavioral assessment must include: (a)A clear,measurable description of the behavior which includes (as applicable) frequency, duration and intensity of the behavior; (b)A clear description and justification of the need to alter the behavior; (c)An assessment of the meaning of the behavior, which includes the possibility that the behavior is one or more of the following: (A)An effort to communicate; (B) The result of medical conditions; (C) The result of psychiatric conditions::and • - (D) The result of environmental causes or other factors. (d)A description of the context in which the behavior occurs; and (e)A description of what currently maintains the behavior. (4) Behavior support plan requirements. The behavior support plan must include: (a)An individualized summary of the person's needs,preferences and relationships; (b)A summary of the function(s) of the behavior, (as derived from the functional behavioral assessment); (c) Strategies that are related to the function(s) of the behavior and are expected to be effective in reducing problem behaviors; (d) Prevention strategies including environmental modifications and arrangement(s); (e) Early warning signals or predictors that may indicate a potential behavioral episode and a clearly defined plan of response; (f)A general crisis response plan that is consistent with the Oregon Intervention System (OIS); (g)A plan to address post crisis issues; (h)A procedure for evaluating the effectiveness of the plan which includes a method of collecting and reviewing data on frequency, duration and intensity of the behavior; (i) Specific instructions for staff who provide support to follow regarding the implementation of the plan; and (j) Positive behavior supports that includes the least intrusive intervention possible. (5)Additional documentation requirements for implementation of behavioral support plans. Providers must maintain the following additional documentation for implementation of behavioral support plans: (a) Written evidence that the individual,parent(s) (if applicable), guardian or legal representative (if applicable) and the ISP team are aware of the development of the plan and any objections or concerns have been documented; (b) Written evidence of the ISP team decision for approval of the implementation of the behavior support plan; and (c) Written evidence of all informal and positive strategies used to develop an alternative behavior. (6)Notification of policies and procedures. The program must inform each individual and the parent(s), guardian, legal representative of the behavior support policy and procedures at the time of entry to the program and as changes occur. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0350 Rights: Physical Intervention (1) Circumstances allowing the use of ph sical intervention. The program must only employ physical intervention techniques that are included in the curr pproved OIS c urriculum or as appro.by the OIS Steering Committee. Physical intervention techniques must o y be applied: .(a)'When the health and safety of the individual and others are at risk, and the ISP team has authorized the procedures in a documented ISP team decision that is included in the ISP and uses procedures that are intended to lead to less restrictive intervention strategies; or (b)As an emergency measure, if absolutely necessary to protect the individual or others from immediate injury; or (c)As a health related protection ordered by a physician, if absolutely necessary during the conduct of a specific medical or surgical procedure, or for the individual's protection during the time that a medical condition exists. (2) Staff training. Staff supporting an individual must be trained by an instructor certified in the Oregon Intervention System(OIS) when the individual has a history of behavior requiring physical intervention and the ISP team has determined there is probable cause for future application of physical intervention. Documentation verifying such training must be maintained in the staffs personnel file. (3)Modification of OIS physical intervention procedures. The program must obtain the approval of the OIS Steering Committee for any modification of standard OIS physical intervention technique(s). The request for modification of physical intervention technique(s)must be submitted to the OIS Steering Committee and must be approved in writing by the OIS Steering Committee prior to the implementation of the modification. Documentation of the approval must be maintained in the individual's record. (4) Physical intervention techniques in emergency situations. Use of physical intervention techniques that are not part of an approved plan of behavior support in emergency situations must: (a) Be reviewed by the program's executive director or designee within one hour of application; (b) Be used only until the individual is no longer an immediate threat to self or others; (c) Submit an incident report to the CDDP Services Coordinator, or other Department designee (if applicable), personal agent(if applicable), and the person's legal guardian(if applicable), no later than one working day after the incident has occurred; and (d)Prompt an ISP team meeting if an emergency intervention is used more than three times in a six-month period. (5)Incident report. Any use of physical intervention(s)must be documented in an incident report excluding circumstances defined in OAR 411-325-0350(7)(a-h). The report must include: (a)The name of the individual to whom the physical intervention was applied; (b) The date,type, and length of time the physical intervention was applied; (c)A description of the incident precipitating the need for the use of the physical intervention; (d) Documentation of any injury; (e)The name and position of the staff member(s)applying the physical intervention; (f) The name(s) and position(s) of the staff witnessing the physical intervention; (g)The name and position of the person providing the initial review of the use of the physical intervention; and (h) Documentation of an administrative review that includes the follow-up to be taken to prevent a recurrence of the incident by the director or his/her desig4)who is knowledgeable in OIS, as evi•t by a job description that reflects this responsibility. (6)'Copies submitted. A copy of the incident report must be forwarded within five working days of the incident, to the CDDP Services Coordinator and when applicable to the legal guardian and the personal agent. - (a) The Services Coordinator or when applicable the Department designee will receive complete copies of incident reports. (b) Copies of incident reports will not be provided to a legal guardian,personal agent or other service providers, when the report is part of an abuse or neglect investigation. (c) Copies provided to a legal guardian,personal agent, or other service provider must have confidential information about other individuals removed or redacted as required by federal and state privacy laws. (d)All interventions resulting in injuries must be documented in an incident report and forwarded to the CDDP Services Coordinator or other Department designee (if applicable) within one working day of the incident. (7) Behavior data summary. The program may substitute a behavior data summary in lieu of individual incident reports when: (a) There is no injury to the individual or others; (b) The intervention utilized is not a physical restraint; (c)There is a formal written functional assessment and a written behavioral support plan; (d) The individual's behavior support plan defines and documents the parameters of the baseline level of behavior; (e) The physical intervention technique(s), and the behavior(s) for which they are applied remain within the parameters outlined in the individual's behavior support plan and the OIS curriculum; (f) The behavior data collection system for recording observation, intervention and other support information critical to the analysis of the efficacy of the behavior support plan, is also designed to record items as required in support in OAR 411-325-0350(5)(a)-(c) and (e)-(h); and (g) There is written documentation of an ISP team decision that a behavior data summary had been authorized for substitution in lieu of incident reports. (8) Copy to CDDP. A copy of the behavior data summary must be forwarded every thirty days to the CDDP Services Coordinator or other Department designee (if applicable), or personal agent(if applicable) and the person's legal guardian(if applicable). Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 -443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0360 Rights: Psychotropic Medications and Medications for Behavior (1)Requirements. Psychotropic medications and medications for behavior must be: (a) Prescribed by physician or health care provider through a written order; and (b) Monitored by the prescribing physician, ISP team and program for desired responses and adverse consequences. (2)Balancing test. When medication is first prescribed and annually thereafter, the provider must obtain a signed balancing test from the prescribing health care provider using the DHS Balancing Test Form or by inserting the required form content into the provider's agency forms. Providers must present the physician or health care provider with a full and clear description of the behavior and symptoms to be addressed, as well as any side effects observed. (3) Documentation requirements. The provider must keep signed copies of these forms in the individual's medical record for seven years. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f 7-30-04, cert.ef. 8-1-04 411-325-0370 Rights: Individuals' Personal Property (1) Record of personal property. The program must prepare and maintain an accurate individual written record of personal property that has significant or monetary value to each individual as determined by a documented ISP team or guardian decision. The record must include: (a) The description and identifying number, if any; (b)Date of inclusion in the record; (c)Date and reason for removal from the record; (d) Signature of staff making each entry; and (e)A signed and dated annual review of the record for accuracy. Stat. Auth. ORS 410.070,409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 1.2-29-03, cert. ef. 1-1-04 411-325-0380 Rights: Handling and Managing Individuals' Money (1) Policies and procedures. The program must have and implement written policies and procedures for the handling and management of individuals' money. Such policies and procedures must provide for: (a) The individual to manage his/her own funds unless the ISP documents and justifies limitations to self-management; (b) Safeguarding of an individual's funds; (c) Individuals receiving and spending their money; and (d) Taking into account the individual's interests and preferences. (2) Individual written record. For those individuals not yet capable of managing their own money, as determined by the ISP Risk Tracking Record or guardian,the program must prepare and maintain an accurate written record for each individual of all money received or dised on behalf of or by the individual. •record must include: (a)The date, amount and source of income.received; (b) The date, amount and purpose of funds disbursed; and (c) Signature of the staff making each entry. (3) Reimbursement to individual. The program must reimburse the individual any funds that are missing due to theft, or mismanagement on the part of any staff member of the program or for any funds within the custody of the program that are missing. Such reimbursement must be made within 10 working days of the verification that funds are missing. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 -443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04 411-325-0390 Entry,Exit and Transfer: General (1) Qualifications for Department funding. All individuals considered for Department funded services must: (a) Be referred by the Community Developmental Disability Program; (b) Be determined to have a developmental disability by the Department or its designee; and (c)Not be discriminated against because of race, color, creed, age, disability, national origin, duration of Oregon residence, method of payment, or other forms of discrimination under applicable state or federal law. (2)Authorization of entry into 24-Hour Residential Programs. The CDDP Services Coordinator, except in the cases of children's residential services and state operated community programs, must make authorization of entry into 24-Hour residential program. The Department must authorize admission into children's residential services and state operated community programs. (3)Information required for entry meeting. The program must acquire the following information prior to or upon an entry ISP team meeting: (a) A copy of the individual's eligibility determination document; (b)A statement indicating the individual's safety skills including ability to evacuate from a building when warned by a signal device, and adjusting water temperature for bathing and washing; (c)A brief written history of any behavioral challenges including supervision and support needs; (d)A medical history and information on health care supports that includes, where available: (A) The results of a physical exam made within 90 days prior to entry; (B) Results of any dental evaluation; (C) A record of immunizations; (D)A record of known communicable diseases and allergies; and (E) A record of major illnesses and hospitalizations. • (e) A written record of any current or recommended medications, treatments, diets d aids to physical functioning; (f)'Copies of documents relating to guardianship or conservatorship or health care representative or any other legal restrictions on the rights of the individual, if applicable; - (g) Written documentation that the individual is participating in out of residence activities including school enrollment for individuals under the age of 21; and (h)A copy of the most recent Functional Behavioral Assessment, Behavior Support Plan, Individual Support Plan, and Individual Education Plan if applicable. (4) Crisis entries from family homes. If the individual is being admitted from his or her family home and the information required in OAR 411-325-0390(3)(a)-(h) is not available, the program will ensure that they assess the individual upon entry for issues of immediate health or safety and document a plan to secure the remaining information no later than thirty days after entry. This must include a written justification as to why the information is not available. (5)Entry meeting. An entry ISP team meeting must be conducted prior to the onset of services to the individual. The findings of the meeting must be recorded in the individual's file and include, at a minimum: (a)The name of the individual proposed for services; (b)The date of the meeting and the date determined to be the date of entry; (c) The names and role of the participants at the meeting; (d) Documentation of the pre-entry information required by OAR 411-325-0390(3)(a)-(h); (e) Documentation of the decision to serve or not serve the individual requesting service, with reasons; and (f) A written transition plan to include all medical, behavior and safety supports needed by the individual, to be provided to the individual for no longer than 60 days, if the decision was made to serve. (6) Exit meeting. Each individual considered for exit must have a meeting by the ISP team before any decision to exit is made. Findings of such a meeting must be recorded in the individual's file and include, at a minimum: (a)The name of the individual considered for exit; (b)The date of the meeting; (c)Documentation of the participants included in the meeting; (d)Documentation of the circumstances leading to the proposed exit; (e) Documentation of the discussion of strategies to prevent an exit from service (unless the individual, individual's guardian, or for a child the parent or guardian is requesting exit); (f) Documentation of the decision regarding exit including verification of a majority agreement of the meeting participants regarding the decision; and (g) Documentation of the proposed plan for services to the individual after the exit. (7) Requirements for waiver of exit meeting. Requirements for an exit meeting may be waived if an individual is immediately removed from the home under the following conditions: • (a) The individual and his/her guardian or representative requests an immediate move from the home; or (b)'The individual is removed by a legal authority acting pursuant to civil or criminal proceedings other than detention for a child. (8) Transfer meeting. A meeting of the ISP Team to discuss any proposed transfer of an individual must precede the decision to transfer. Findings of such a meeting must be recorded in the individual's file and include, at a minimum: (a) The name of the individual considered for transfer; (b) The date of the meeting or telephone call(s); (c)Documentation of the participants included in the meeting or telephone call(s) including for a child, a parent or guardian who is participating to sign documents; (d) Documentation of the circumstances leading to the proposed transfer; (e) Documentation of the alternatives considered instead of transfer; (f) Documentation of the reasons any preferences of the individual, guardian, legal representative, parent or family members cannot be honored; (g) Documentation of a majority agreement of the participants with the decision; and (h) The written plan for services to the individual after transfer: Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0400 Grievance of Entry,Exit and Transfer (1) Grievances. In cases where the individual,parent or guardian objects to, or the ISP team cannot reach majority agreement regarding an entry refusal, a request to exit the program or a transfer within a program, a grievance may be filed by any member of the ISP team. (a)In the case of a refusal to serve, the program vacancy may not be permanently filled until the grievance is resolved. (b)In the case of a request to exit or transfer, the individual must continue to receive the same services until the grievance is resolved. (2) Grievance to the CDDP. All grievances must be made to the CDDP Director or designee in writing, in accordance with the CDDP's dispute resolution policy. The CDDP will provide written response to the individual making the appeal within the timelines specified in the CDDP's dispute resolution policy. (3) Grievance to the Department. In cases where the CDDP's decision is in dispute a written grievance must be made to the Department within ten days of receipt of the CDDP's decision. (4) Department Grievance process. The Administrator or designee will review all unresolved appeals. Such review will be completed and a written response provided within 45 days of receipt of written request for Department review. The decision of the Administrator or designee will be final. • (5) Documentation required. Documentation of each grievance and its resolution must be filed or noted in the individual's record. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0410 Respite Care Services (1) Qualifications for respite care services. All individuals considered for respite care services funded through 24-hour residential services must: (a)Be referred by the Community Developmental Disability Program or Department; - (b) Be determined to have a developmental disability by the Department or its designee; and (c)Not be discriminated against because of race, color, creed, age, disability, national origin, duration of Oregon residence, method of payment, or other forms of discrimination under applicable state or federal law. (2) Respite care plan. The individual,provider, and the guardian, legal representative, advocate, parent and family or other ISP team members (as available)must participate in an entry meeting prior to the initiation of respite care services. This meeting may occur by phone and the CDDP or Department will ensure that any critical information relevant to the individual's health and safety, including physicians' orders, will be made immediately available. The outcome of this meeting will be a written respite care plan that must take effect upon entry and be available on site, and must: (a)Address the individual's health, safety and behavioral support needs; (b) Indicate who is responsible for providing the supports described in the plan; and (c) Specify the anticipated length of stay at the residence up to 14 days. (3) Waiver of exit meeting requirement. Exit meetings are waived for individuals receiving respite care services. (4) Waiver of appeal rights for entry, exit and transfer. Individuals receiving respite care services do not have appeal rights regarding entry, exit or transfer. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04; cert. ef. 8-1-04 411-325-0420 Crisis Services (1)-Qualifications for crisis services. All individuals considered for crisis services funded through 24-hour residential services must: (a)Be referred by the Community Developmental Disability Program or Department; (b) Be determined to have a developmental disability by the Department or its lime; • (c) Be determined to be eligible for DD Services as defined in OAR 411-325-0020(28), (29), or(30), or any subsequent revision thereof; and (d)Not be discriminated against because of race,color, creed, age, disability,national origin, duration of Oregon residence, method of payment, or other forms of discrimination under applicable state or federal law. (2) Support Services Plan of Care and Crisis Addendum required. Persons receiving support services under chapter 411 division 340, and receiving crisis services must have a Support Services Plan of Care and a Crisis Addendum upon entry to the program. (3) Plan of Care required for persons not enrolled in support services. Persons,not enrolled in support services, receiving crisis services for less than 90 consecutive days must have a plan of care on entry that addresses any critical information relevant to the individual's health and safety including current physicians' orders. (4) Risk Tracking Record required. Persons not enrolled in support services, receiving crisis services for 90 days or more must have a completed Risk Tracking Record and a Plan of Care that addresses all identified health and safety supports as noted in the Risk Tracking Record. (5)Entry meeting required. Entry meetings are required for individuals receiving crisis services. (6)Exit meeting required. Exit meetings are required for individuals receiving crisis services. (7) Waiver of appeal rights for entry, exit and transfers. Individuals receiving crisis services do not have appeal rights regarding entry, exit or transfers. Stat. Auth. ORS 410.070,409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0430 Individual Support Plan (1) Department Individual Support Plan implementation schedule. Providers must participate as scheduled in the Department ISP training and must implement the required Department ISP process after completion of training. (2) Individual Support Plan required. A copy of each individual's ISP and supporting documentation on the required Department forms must be available at the residence within 60 days of entry and annually thereafter, unless the provider has not been trained to implement the Department ISP process. In situations where the provider has not been trained, the individual must have a completed ISP with supporting documents as required by OAR 309-041-1300 through 309-041-1370. (3)Preparation for ISP. The following information must be collected and summarized within 45 days prior to the ISP meeting: (a) Personal Focus Worksheet; (b)Risk Tracking Record; (c)Necessary protocols or plans that address health, behavioral, safety and financial supports as identified on the Risk Tracking Record; (d)A Nursing Care Plan, if applicable, including but not limited to those tasks re wired by the Risk Tracking Record; and • (e) Other documents required by the ISP team. (4) Content of Individual Support Plan. A completed ISP must be documented on the Department required form that includes the following: (a) What's most important to the individual; (b) Risk summary; (c) Professional services the individual uses or needs; (d) Action plan(s); (e) Discussion Record; (f) Service supports; and (g) Signature sheet. (5) Documentation required. The provider must maintain documentation of implementation of each support specified in OAR 411-325-0430(3)(c-e) and services noted in the individual's ISP. This documentation must be kept current and be available for review by the individual, guardian, CDDP and Department representatives. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 -443.455 Hist.: SPD 25-2003, f 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0440 Children's Direct Contracted Services For purposes of this rule chapter 411 division 325, any documentation or information required to be submitted to the CDDP Services Coordinator must also be submitted to the Department Residential Services Coordinator assigned to the home or facility. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 -443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0450 Conditions (1) Circumstances under which conditions may be applied to a license. Conditions may be attached to a license upon a finding that: (a) Information on the application or initial inspection requires a condition to protect the health and safety of individuals; (b) There exists a threat to the health, safety, and welfare of an individual; (c) There is reliable evidence of abuse, neglect, or exploitation; • (d) The home/facility is not being operated in compliance with these rules; or • (e)'The provider is licensed to care for a specific person(s) only and further placements must not be made into that home or facility. (2)Imposing conditions. Conditions that may be imposed on a licensee include: (a)Restricting the total number of individuals that can be served; (b) Restricting the number and support level of individuals allowed within a licensed classification level based upon the capacity of the provider and staff to meet the health and safety needs of all individuals; (c)Reclassifying the level of individuals that can be served; (d)Requiring additional staff or staff qualifications; (e) Requiring additional training of provider/staff; (f)Requiring additional documentation; or (g) Restriction of admissions. (3)Written notification. The provider will be notified in writing of any conditions imposed, the reason for the conditions, and be given an opportunity to request a hearing under ORS Chapter 183.310 to 183.550. (4)Administrative review. In addition to, or in lieu of, a contested case hearing, a provider may request a review by the Administrator or designee of conditions imposed by the Department. The review does not diminish the provider's right to a hearing. (5)Length of conditions. Conditions may be imposed for the extent of the licensure period(two years) or limited to some other shorter period of time. If the condition corresponds to the licensing period, the reasons for the condition will be considered at the time of renewal to determine if the conditions are still appropriate. The effective date and expiration date of the condition will be indicated on an attachment to the license. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0460 Civil Penalties (1) Long-term care facility statute applicable. For purposes of imposing civil penalties,24-Hour residential homes and facilities licensed under ORS 443.440 to 443.455 and subsection(2) of 443.991 are considered to be long-term care facilities subject to ORS 441.705 to 441.745. (2) Schedule and sections of rule subject to civil penalties. The Department will exercise the powers under ORS 441.705 to 441.745 and thereby issues the following schedule of penalties applicable to 24-hour residential homes and facilities: (a)Violations of any requirement within any part of the following sections of the rule may result in a civil penalty up to $500 per day for each violation not to exceed $6,000 for all violations for any licensed 24-hour residential home or facility within a 90-day period: • (A) 411-325-0120(2), (11); • (B)411-325-0130; (C)411-325-0140; (D)411-325-0150; (E)411-325-0160; (F) 411-325-0170; (G)411-325-0190; (H)411-325-0200; (I) 411-325-0220(1), (2); (J) 411-325-0230; (K) 411-325-0240, 0250, 0260, 0270, 0280 and 0290; (L) 411-325-0300, 0310, 0320, 0330, 0340, and 0350; (M) 411-325-0360; (N)411-325-0380; (0)411-325-0430(3), (4); and(5); (P) 411-325-0440. (b) Civil penalties of up to $300 per day per violation may be imposed for violations of any section of this rule not listed in(2)(a) (A)-(N) of this section if a violation has been cited on two consecutive inspections or surveys of a 24- hour residential home or facility where such surveys are conducted by an employee of the Department. Penalties assessed under this section will not exceed $6,000 within a 90-day period. (3) Monitoring defined. For purposes of this rule, a monitoring occurs when a 24-hour residential home or facility is surveyed, inspected or investigated by an employee or designee of the Department or an employee or designee of the Office of State Fire Marshal. (4) Consideration of factors when imposing civil penalties. In imposing a civil penalty pursuant to the schedule published in section(2) of this rule, the Department will consider the following factors: (a) The past history of the program incurring a penalty in taking all feasible steps or procedures necessary or appropriate to correct any violation; (b)Any prior violations of statutes or rules pertaining to 24-hour residential homes or facilities; (c)The economic and financial conditions of the program incurring the penalty; and (d)The immediacy and extent to which the violation threatens or threatened the health, safety and well-being of individuals. • (5)Due and payable..Any civil penalty imposed under ORS 443.455 and 441.710 will become due and payable when the program incurring the penalty receives a notice in writing from the Administrator or designee. The notice referred to in this section will be sent by registered or certified mail and will include: (a)A reference to the particular sections of the statute, rule, standard, or order involved; (b)A short and plain statement of the matters asserted or charged; (c)A statement of the amount of the penalty or penalties imposed; and (d)A statement of the program's right to request a hearing. (6)Timeline to make written application for a hearing. The person representing the program, to whom the notice is addressed, will have 20 days from the date of mailing of the notice in which to make a written application for a hearing before the Department. (7) Conduct of hearing. All hearings will be conducted pursuant to the applicable provisions of ORS Chapter 183. (8) Failure to request a hearing within 20 days. If the program notified fails to request a hearing within 20 days, an order may be entered by the Department assessing a civil penalty. (9) Program is found to be in violation of a license, rule, or order listed in ORS 441.701(1). If, after a hearing,the program is found to be in violation of a license,rule, or order listed in ORS 441.710(1), an order may be entered by the Department assessing a civil penalty. (10) Remittance or reduction of a civil penalty. A civil penalty imposed under ORS 443.455 or 441.710 may re remitted or reduced upon such terms and conditions as the Administrator considers proper and consistent with individual health and safety. (11) Civil penalty payable within 10 days after order is entered. If the order is not appealed, the amount of the penalty is payable within 10 days after the order is entered. If the order is appealed and is sustained, the amount of the penalty is payable within 10 days after the court decision. The order, if not appealed or sustained on appeal, will constitute a judgment and may be filed in accordance with the provisions of ORS 18.320 to 18.370. Execution may be issued upon the order in the same manner as execution upon a judgment of a court of record. (12) Violation of any general order or final order. A violation of any general order or fmal order pertaining to a 24-hour residential home or facility issued by the Department is subject to a civil penalty in the amount of not less than$5 and not more than $500 for each and every violation. (13)Judicial review of civil penalties. Judicial review of civil penalties imposed under ORS 441.710 will be provided under ORS 183.480, except that the court may, in its discretion, reduce the amount of the penalty. (14)Penalties recovered. All penalties recovered under ORS 443.455 and 441.710 to 441.740 will be paid into the State Treasury and credited to the General Fund. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 -443.455 Hist.: SPD 25-2003, f 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0470 License Denial, Suspension, Revocation, Refusal to Renew (1) Substantial failure to comply with rules. The Department will deny, suspend,revoke or refuse to renew a license where it fords there has been substantial failure to comply with these rules; or where the State Fire Marshal or his or her representative certifies there is failure to comply with all applicable ordinances and rules relating to safety from fire. (2) Imminent danger to individuals. The Department will suspend the home or facility license where imminent danger to health or safety of individuals exists. (3) Provider agency on list for Centers for Medicare and Medicaid Services excluded or debarred providers. The Department will deny, suspend, revoke or refuse to renew a license where it finds that a provider is on the current Centers for Medicare and Medicaid Services list of excluded or debarred providers. (4) Revocation, suspension or denial done in accordance with ORS Chapter 183. Such revocation, suspension or denial will be done in accordance with rules of the Department and ORS Chapter 183. (5) Failure to disclose requested information. Failure to disclose requested information on the application or provision of incomplete or incorrect information on the application will constitute grounds for denial or revocation of the license. (6) Failure to implement a plan of correction or comply with a final order. The Department will deny, suspend, revoke or refuse to renew a license if the licensee fails to implement a plan of correction or comply with a final order of the Department imposing an administrative sanction, including the imposition of a civil penalty. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 -443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04 411-325-0480 Criminal Penalties (1)Violation of ORS 443.400 to 443.455. Violation of any provision of 443.400 to 443.455 is a Class B misdemeanor. (2)Violation of ORS 443.881. Violation of any provision of 443.881 is a Class C misdemeanor. Stat. Auth. ORS 410.070, 409.050 Stats. Implemented: ORS 443.400 - 443.455 Hist.: SPD 25-2003, f. 12-29-03, cert. ef. 1-1-04 The official copy of an Oregon Administrative Rule is contained in the Administrative Order filed at the Archives Division, 800 Summer St. NE,Salem,Oregon 97310.Any discrepancies with the published version are satisfied in favor of the Administrative Order.The Oregon Administrative Rules and the Oregon Bulletin are copyrighted by the Oregon Secretary of State.Terms and Conditions of Use Alphabetical Index by Agency Name Numerical Index by OAR Chapter Number Search the Text of the OARs Questions about Administrative Rules? Link to the Oregon Revised Statutes(ORS) Return to Oregon State Archives Home Page