Subject 290-2-5 RULES AND REGULATIONS FOR CHILD CARING INSTITUTIONS
These rules are adopted and published pursuant to the Official Code of Georgia Annotated (O.C.G.A.) Sec. 49-5-1et seq.
These rules shall be known as the Rules and Regulations for Child Caring Institutions. The purpose of these rules is to provide for the licensing and inspection of child caring institutions within the state of Georgia.
In these rules, unless the context otherwise requires, the words, phrases and symbols set forth herein shall mean the following:
|(a)||"Adult" means a person eighteen (18) years of age or older.|
"Applicant" means the following:
|(c)||"Behavior management" means those principles and techniques used by a facility to assist a resident in facilitating self-control, addressing inappropriate behavior, and achieving positive outcomes in a constructive and safe manner. Behavior management principles and techniques shall be used in accordance with the individual service plan, written policies and procedures governing service expectations, service plan goals, safety, security, and these rules and regulations.|
|(d)||"Chemical restraint" means drugs that are administered to manage a resident's behavior in a way that reduces the safety risk to the resident or others; that have the temporary effect of restricting the resident's freedom of movement; and that are not being used as part of a standard regimen, as specified in the child's service plan, to treat current symptoms of a medical or psychiatric condition.|
|(e)||"Child caring institution" means a child-welfare agency that is any institution, society, agency, or facility, whether incorporated or not, which either primarily or incidentally provides full-time care for children through 18 years of age outside of their own homes, subject to such exceptions as may be provided in rules and regulations of the Board of Human Services. This full-time care is referred to as room, board and watchful oversight. For purposes of these rules, a child caring institution means any institution, society, agency, or facility that provides such care to six or more children.|
|(f)||"Child-placing agency" means a child welfare agency that is any institution, society, agency, or facility, whether incorporated or not, that places children in foster homes for temporary care or in prospective adoptive homes for adoption. For purposes of this definition, agencies that engage in placement activities are required to be licensed as Child-Placing Agencies. This term does not apply to a licensed professional providing only home study preparation services as an evaluator.|
|(g)||"Criminal history background check" means a search as required by law of the criminal records maintained by law enforcement authorities to determine whether the applicant has a criminal record as defined in these rules.|
|(h)||"Commissioner" means the Commissioner of the Department of Human Services.|
|(i)|| "Criminal record" means:
|(j)||"Department" means the Georgia Department of Human Services.|
|(k)||"Director" means the chief administrative or executive officer of the institution.|
|(l)||"Emergency safety interventions" mean those behavioral intervention techniques that are authorized under an approved emergency safety intervention plan and are utilized by properly trained staff in an urgent situation to prevent a child from doing immediate harm to self or others.|
|(m)||"Emergency safety intervention plan" means the plan developed by the facility utilizing a nationally recognized, evidence-based, training program for emergency safety intervention, approved by the Department. The plan shall clearly identify the emergency safety interventions staff may utilize and those that may never be used.|
|(n)|| "Employee" means any person, other than a
director, employed by an institution to perform any duties at any of the
institution's facilities which involve personal contact between that person and
any child being cared for at the institution and also includes any adult person
who resides at the institution or who, with or without compensation, performs
duties for the institution which involve personal contact between that person
and any child cared for by the institution.
For purposes of these rules, an employee does not mean a child that resides at the facility and performs duties for the institution.
|(o)||"Fingerprint records check determination" means a satisfactory or unsatisfactory determination by the department based upon a records check comparison of Georgia Crime Information Center (GCIC) information with fingerprints and other information in a records check application.|
|(p)||"Foster Care" means supervised care in a substitute home on a 24 hour full-time basis for a temporary period of time.|
|(q)||"Foster Home" or "foster care home" means a private home where the foster parent(s) live which has been approved by a child-placing agency to provide 24 hour care, lodging, supervision and maintenance for no more than six children under the age of 19.|
|(r)||"Foster Parent" means an adult person approved by a child-placing agency who has a satisfactory criminal history background check determination and provides care, lodging, supervision, and maintenance on a 24 hour basis for a child who must receive care out of his own home.|
|(s)||"Human Services Professional" means the person(s) employed by the facility who is (are) responsible for providing oversight of services to children and their families in the home setting. The HSP is responsible for monitoring the residents' needs and ensuring that appropriate services are being provided and arranged for in order to meet those needs. Duties include, but are not limited to: the coordination of the facility's admission evaluation; the development of the service and Room, Board, Watchful Oversight plans; case work services as provided in the resident's service plans; and monitoring of the resident's educational and/or vocational needs.|
|(t)||"Living unit" means the physical location where residents live within the institution.|
|(u)||"Manual hold" means the application of physical force, without the use of any device, for the purpose of restricting the free movement of a child's body and is considered a form of restraint. A manual hold does not include briefly holding a child without undue force to calm or comfort the child, holding a child by the hand or by the shoulders or back to walk the child safely from one area to another where the child is not forcefully resisting the assistance, or assisting the child in voluntarily participating in activities of daily living.|
|(v)||"Mechanical restraint" means a device attached or adjacent to the child's body that is not a prescribed and approved medical protection device and that he or she cannot easily remove that restricts freedom of movement or normal access to his or her body. A mechanical restraint does not include devices used to assist a child with appropriate positioning or posture secondary to physical impairments or disabilities.|
|(w)||"Medicaid Rehabilitation Option Provider (MRO)" means that category of behavioral health services designed for the maximum reduction of impairments related to mental illness or addiction and restoration of a Medicaid recipient to his/her best possible functional level.|
"Owner" means any individual or any person affiliated with a corporation,
partnership, or association with 10 percent or greater ownership interest in
the business or agency licensed as a child caring institution and who:
|(y)||"Preliminary records check application" means an application for a preliminary records check determination on forms provided by the department.|
|(z)||"Preliminary records check determination" means a satisfactory or unsatisfactory determination by the department based only upon a comparison of Georgia Crime Information Center (GCIC) information with other than fingerprint information regarding the person upon whom the records check is being performed.|
|(aa)||"Records check application" means two sets of classifiable fingerprints, a records search fee to be established by the department by rule and regulation, payable in such form as the department may direct to cover the cost of a fingerprint records check, and an affidavit by the applicant disclosing the nature and date of any arrest, charge, or conviction of the applicant for the violation of any law; except for motor vehicle parking violations, whether or not the violation occurred in this state, and such additional information as the department may require.|
|(bb)||"Room, Board and Watchful Oversight" means providing a safe, comfortable room, adequately nutritious meals and oversight to ensure a child's basic safety needs are met.|
|(cc)||"Satisfactory criminal history background check determination" means a written determination that a person for whom a records check was performed was found to have no criminal record.|
|(dd)||"Seclusion" means the involuntary confinement of a child away from other children, due to imminent risk of harm to self or others, in a room or an area from which the child is physically prevented from leaving.|
|(ee)||"Supervision" means the continued responsibility of the licensee to take reasonable action to provide for the health, safety, and well-being of a resident while under the supervision of the licensee or the agent or employee of the licensee, including protection from physical, emotional, social, moral, financial harm and personal exploitation while in care. The licensee is responsible for providing the degree of supervision indicated by a child's age, developmental level, physical, emotional, and social needs.|
|(ff)||"Time-out" means a behavior management technique that involves the brief separation of a child from the group, not to exceed twenty (20) minutes, designed to de-escalate the child. During "time-out" a child's freedom of movement is not physically restricted.|
|(gg)||"Unsatisfactory criminal history background check determination" means a written determination that a person for whom a records check was performed has a criminal record.|
|(hh)||"Variance" means a decision by the department to grant a modification to all or part of the literal requirements of a rule.|
|(ii)||"Waiver" means a decision by the department not to apply all or part of a rule.|
Each institution shall have a clearly identified governing body which shall be empowered and responsible for determining all policies and procedures and ensuring compliance with these rules and regulations. The chairperson or chief executive officer of the governing body shall complete a statement of responsibility on behalf of the governing body acknowledging the same in connection with any application for a license on a form provided by the department. If an institution is individually owned, then the owner(s) will complete the statement of responsibility. If an institution is governed by a board, there shall be policies and procedures for periodic rotation of members.
History Background Checks for Owners Required. Prior to approving any license
for a new child caring institution and periodically as established by the
department by rule and regulation, the department shall require an owner to
submit a records check application so as to permit the department to obtain
criminal history background information on the owner.
|(2)|| A child caring institution license shall
not be issued, and any license issued shall be revoked where it has been
determined that the owner has a criminal record involving any of the following
covered crimes, as outlined in O.C.G.A. Sec.
|(3)|| An owner with a valid child caring
institution license issued on or before June 30, 2007 shall be required to
obtain a criminal records check determination no later than December 31, 2008.
|(4)||If at any time the department has reason to believe an owner holding a valid license has a criminal record for any of the crimes listed in Rule .05(2)(a)-(m) above, the department shall require the owner to submit a records check application immediately for determination of whether a revocation action is necessary. Prior to the revocation of the license becoming final, the owner is entitled to an administrative hearing unless the owner has not begun providing services under the license. Where services are not currently being provided under the license, the decision of the administrative hearing officer must precede the initiation of services.|
|(5)|| Criminal History Background Checks for
Director and Employees Required. Prior to serving as a director of a licensed
institution, a person shall submit a records check application and receive a
|(6)||Licenses. No person,
partnership, association, corporation or entity shall operate a child caring
institution in the state without first obtaining a license to operate the
institution by demonstrating compliance with the necessary requirements set
forth in these rules. No licensed child-caring institution first licensed after
the effective date of these rules shall provide room, board and watchful
oversight to more than 16 children on its premises.
|(7)||Temporary License. The
department may in its discretion issue a temporary license if the health and
safety of the children to be served by the institution will not be endangered.
A temporary license will be valid for a specified period not to exceed one (1)
year and may be issued in the following instances:
|(8)||Restricted License. The department may in its discretion issue a restricted license in lieu of a temporary or regular license. The restricted license may be granted either in connection with the initial application process for a license or as a result of a subsequent determination made by the department concerning compliance with these rules. The restriction shall appear on the face of the license and shall restrict an institution from providing care or services which are beyond the capability of the licensee to provide. The restriction may include but is not limited to the number and/or age of the children served by the institution.|
|(9)||Qualifications Requirement. In order to obtain or retain a license, the director of the institution and its employees must be qualified, as defined in these rules, to administer or work in a institution. The department may presume that the director and employees are qualified, subject to satisfactory determinations on the criminal history background checks. However, the department may require additional reasonable verification of the qualifications of the director and employees either at the time of application for a license or at any time during the license period whenever the department has reason to believe that a director or employee is not qualified under these rules to administer or work in an institution.|
|(10)||License is Nontransferable. A license to operate an institution is not transferable in any way. Each license shall be returned to the department immediately upon the suspension, revocation, restriction of the license or termination of the operation.|
|(11)||Renewal of License. A license will be renewed upon a determination by the department that the institution presents satisfactory evidence of meeting the requirements set forth in these rules.|
operating or desiring to provide a service believed to be exempt from licensure
shall apply to the department for exemption. The exemptions granted by the
department are exemptions from licensure, and do not affect the authority of
local, regional or state health department officials, the state fire marshal or
local fire prevention officials to inspect facilities. These rules shall not
apply to the following kinds of programs providing care to children:
|(1)|| An application
for a license to operate an institution shall be submitted to the department on
the forms provided by the department.
The department is authorized and empowered to conduct investigations and inspections of any institution required by these rules to be licensed. The proposed and current licensee and staff shall cooperate with any inspection or investigation by responding truthfully to any legitimate departmental inquiry.
|(a)||Initial Inspection. Following receipt and review of a complete application package, the department may conduct an inspection of the institution to assess compliance with these rules.|
|(b)||Consent to Access. An application for a license or commission to operate an institution or the issuance of a license by the department constitutes consent by the applicant, the proposed holder of the license and the owner of the premises for the department's representative, after displaying picture identification to any institution staff, to enter the premises at any time during operating hours for the purpose of inspecting the facility. This includes both scheduled and unscheduled inspections and includes consent for meaningful access to all staff, parts of the premises, all children present, and all records required by these rules.|
|(c)|| Other Inspections.
The department may conduct scheduled and unscheduled inspections of an
institution in the following instances:
|(d)||Failure to Allow Access. Failure to allow access of the department's representative to the institution, its staff, or the children receiving care at the institution or the books, records, papers, or other information related to initial or continued licensing, or failure to cooperate with a departmental inspection or investigation shall constitute good cause for the denial, restriction, revocation or suspension of a license, or other penalty as provided by law.|
|(e)||False or Misleading Statements. No licensee shall make or condone any employee making false or misleading statements to the department in connection with any authorized investigation or inspection being conducted by the department.|
|(1)||Program Purpose. In accordance with these rules and regulations, a licensed child caring institution shall develop, implement and comply with written policies and procedures that specify its philosophy, purpose, and program orientation. Such policies and procedures shall identify the characteristics and ages of the children it serves, including the referral sources.|
|(2)||Program Description and Implementation. In accordance with these rules and regulations, a licensed child caring institution shall develop, implement and comply with written policies and procedures that describe the range of services including room, board and watchful oversight and the manner in which such services will be provided by the facility. Such policies and procedures shall describe how identified services will be provided, the specific emergency safety intervention plan, including the emergency safety interventions, that will be used, and how such services will be assessed and evaluated. A program description must show what services are provided directly by the facility and how it will coordinate its services with those provided by any Medicaid rehabilitation option provider or other available community or contract resources.|
|(3)|| Director. The governing body of the
institution shall designate a director who shall be authorized to manage the
|(4)|| Finances. The
governing body shall provide for the preparation of an annual budget and
approve such budget. Copies of the current year's budget and expenditure
records shall be maintained for examination and review by the department.
|(6)|| Staffing. The institution
shall have sufficient numbers of qualified and trained staff as required by
these rules to provide for the needs, care, protection, supervision and room,
board and watchful oversight of children. All staff and volunteers shall be
supervised to ensure that assigned duties are performed adequately and to
protect the health, safety and well-being of the children in care.
|(7)|| Reporting. Detailed written summary
reports shall be made to the Department of Human Services Residential Child
Care Licensing Unit electronically or by fax on the required incident intake
information form (IIIF) within 24 hours of a serious occurrence involving
children in care, including but not limited to:
|(8)||Child Abuse Reports. Whenever the child caring institution has reason to believe that a child in care has been subjected to child abuse it shall cause a report of such abuse to be made to the child welfare agency of the county of occurrence providing protective services as designated by the Department of Human Services (Division of Family and Children Services) or in the absence of such an agency to an appropriate police authority or district attorney in accordance with the requirements of O.C.G.A. Sec. 19-7-5. A copy of such report shall also be filed with the Department of Human Services Residential child care Licensing Unit.|
|(1)||Referrals. An institution
shall only accept referrals for children whose known needs can be met by the
institution in accordance with its program purpose and program description.
institution shall only admit children whose known needs can be met by the
institution based on preplacement assessment, planning and room, board and
watchful oversight capacity.
|(1)|| An institution shall complete a full
written assessment of each child admitted for care and of each child's family
within thirty days of admission and develop an individual written service plan
for each child based on the assessments within thirty days of admission. If an
assessment is not completed within thirty days, the reasons for the delay shall
be documented in the child's case record and such documentation shall include
statements indicating when the assessment is expected to be completed.
|(1)||During a child's placement in an institution, the preliminary plans for discharge required by Rule .10(b)5. shall be adjusted according to the child's circumstances. At least three months prior to planned discharge, except in cases of emergency discharges, an institution shall formulate an aftercare plan that identifies the supports, room, board and watchful oversight summary and resources that the child and child's family are expected to need following discharge. When a child is being discharged for placement in another institution or similar program, the receiving institution or program, except in cases of emergency discharges, shall be given at least thirty days notice of the proposed date of placement.|
|(2)||Emergency discharges are authorized when the health, safety and room, board and watchful oversight needs of the child or other children in residence might be endangered by the child's further placement in the institution. At least 72 hours of prior notice of discharge shall be provided to the parent(s) or guardian(s), or placement agency. If such notice is not possible, the reasons shall be documented in the child's case record.|
|(3)|| When a child is
discharged, an institution shall compile a complete written discharge summary
within thirty days of the discharge. Such summary shall include:
|(4)||A copy of the completed discharge summary shall be made available to the child's parent(s) or guardian(s), or placement agency representative when it is completed.|
|(1)||Casework Services. All children in care and families of children in care shall receive case work services as provided in their service plan from their assigned Human Services Professional or other appropriate professionals (internal and external of facility) who shall meet with and counsel with the children. The results of such counseling shall be recorded in the children's case records. The purposes of such services are to identify and monitor the children's and families' progress relative to the needs, goals and objectives identified in child care assessments and service plans and to discuss any problems being encountered by or with the children in care.|
Educational and Vocational Services. An institution shall not admit a child
unless an educational program commensurate with the specific educational and
vocational needs of the child can be provided.
|(3)|| Health Services. The facility shall
provide for a comprehensive program of preventive, routine, and emergency
medical and dental care for all children.
|(4)||Recreation and Leisure. The institution shall provide for a program of indoor and outdoor recreational and leisure activities. When providing these activities, it shall utilize the community's cultural, social, and recreational resources whenever possible and appropriate. Children's activities as stated in their service plans shall provide for leisure and recreational time. An institution shall procure and maintain a variety of recreational and leisure equipment and supplies such as games, sporting equipment, reading materials, and art supplies.|
|(5)|| Other Services.
|(2)|| Emergency Safety Interventions.
|(1)||The institution shall develop and implement policies and procedures for children to voice grievances and to submit written grievances without fear of retaliation.|
|(2)||All written grievances submitted by a child shall be recorded in the case record showing the grievance, description or method of explanation or resolution, and involved staff.|
|(1)||The institution shall develop and implement policies and procedures that prohibit child abuse and sexual exploitation of children in care. Such policies and procedures shall incorporate requirements for the reporting of child abuse and sexual exploitation in accordance with state law.|
|(2)|| All reports of alleged child abuse and
sexual exploitation of children in care shall also be reported immediately to
the Child Care Licensing Section of the department.
|(1)|| An institution
shall provide each child with meals and snacks of serving sizes dependent upon
the age of the child based upon nutrition guidelines as established by the
United States Department of Agriculture Child Care Food Program.
|(2)|| An institution licensed to care for
thirteen or more children must obtain a valid food service permit and remain in
compliance with Department of Public Health food service requirements.
Institutions licensed to care for twelve or less children are not required to
obtain a food service permit but shall meet the following requirements:
|(1)|| Required Approvals.
|(3)|| Lavatory and Bathing Facilities.
|(4)||Living Room. For institutions licensed on or after the effective date of these rules, the institution shall maintain a living room or den for the children residing in a living unit. Such space shall be equipped with comfortable furnishings suitable for relaxation and social interaction.|
|(5)||Dining Area. The institution shall maintain a dining area that is furnished to permit children, staff, and guests to eat together in a small group or groups.|
|(6)||Climate Control. The institution shall be maintained at a temperature range of sixty-five (65) degrees Fahrenheit to eighty-two (82) degrees Fahrenheit, depending upon the season of the year.|
|(7)||Ceilings and Walls. All ceilings shall be at least seven (7) feet in height. Ceiling and walls shall be of good repair.|
|(8)||Windows. All windows that can be opened and that are used for ventilation shall have insect window screens. Windows and screens must be in good repair.|
|(9)|| The institution shall be kept clean and
free of hazards to health and safety and of debris and pests.
Grounds. Exterior grounds of the institution shall be free of hazards to health
|(12)|| Accessibility. Where children are
dependent upon a wheelchair or other mechanical device for mobility, the
child-caring institution shall have:
|(13)||Children shall not be required to sleep in areas of the premises that are not routinely used as or specifically designated as bedrooms such as doorways, hallways, bathrooms, closets, crawl spaces, fire escapes, kitchens, communal living areas, etc.|
|(1)|| Plans of Correction. If the
Department determines that either a child-caring institution or a facility
applying to become licensed as a child-caring institution does not comply with
the rules, the Department shall provide written notice specifying the rule(s)
violated and setting a time for the institution not to exceed ten (10) working
days within which to file an acceptable written plan of correction where the
Department has determined that an opportunity to correct is permissible. If
such plan of correction is determined not acceptable to the Department because
it does not adequately correct the identified violation, the Department will
advise the child-caring institution or facility applying to become licensed
that the plan of correction is not acceptable. The Department may permit the
institution to submit a revised plan of correction.
|(2)||All adverse actions to enforce the Rules and Regulations for Child-Caring Institutions shall be initiated in accordance with the Rules and Regulations for Enforcement of Licensing Requirements, Chapter 290-1-6, and O.C.G.A. §§ 49-5-12 and 49-5-12.1, Penalties for Violation of Child Welfare Agency Laws and Regulations and § 49-5-60et seq. and the requirements set forth herein.|
|(3)|| Required Notifications for
Revocations and Suspensions. The institution shall notify each child's
parents and/or legal guardians of the Department's actions to revoke the
license or seek an emergency suspension of the institution's license to
|(1)|| In accordance
49-5-90et seq., notwithstanding other remedies available to the
department which may be pursued at the same time, the commissioner or his/her
designee may issue emergency orders. Such orders may include the following:
|(2)|| An emergency
order shall contain the following:
|(3)||Unless otherwise provided in the order, an emergency order shall become effective upon its service to the owner, the director, or any other agent, employee, or person in charge of the institution at the time of the service of the order.|
|(4)||Prior to issuing an emergency order, the commissioner or his/her designee may consult with persons knowledgeable in the field of child care and a representative of the institution to determine if there is a potential for greater adverse effects on children in care as a result of the emergency order.|
The facility shall prepare for potential emergency situations that may affect the care of children by developing and complying with an effective disaster preparedness plan that identifies emergency situations and outlines an appropriate course of action. The plan must be reviewed annually and revised, as appropriate, including any related written agreements.
|(a)|| The disaster preparedness plan shall
include at a minimum plans for the following emergency situations:
|(b)||There shall be plans to ensure sufficient staffing and supplies to provide room, board and watchful oversight during the emergency situation.|
|(c)||There shall be plans for the emergency transport or relocation of all the facility children, should it be necessary, in vehicles appropriate to the children's needs. Additionally there shall be written agreements with any facilities which have agreed to receive the facility's children in these situations.|
|(d)||The facility shall document participation of all areas of the facility in quarterly fire drills.|
|(e)||In addition to fire drills, the facility shall have its staff rehearse portions of the disaster preparedness plan, with a minimum of two rehearsals each calendar year either in response to an emergency or through planned drills, with coordination of the drills with the local Emergency Management Agency (EMA) whenever possible.|
|(f)||The plan shall include the notification to the department of the emergency situation as required by these rules and notification of the lawful custodians of the children's whereabouts and condition.|
|(g)||The facility shall provide a copy of the internal disaster preparedness plan to the local Emergency Management Agency (EMA) and shall include the local EMA in development of the facility's plan for the management of external disasters.|
|(h)|| The facility's
disaster preparedness plan shall also include the following additional items in
efforts to limit and contain health hazards to children, staff, and the general
public due to pandemic or infectious disease outbreaks:
|(i)||The facility's disaster preparedness plan shall be made available to the department for inspection upon request.|
|(j)||The department may suspend any requirements of these rules and the enforcement of any rules where the Governor of the State of Georgia has declared a public health emergency.|
|(1)||The department may, in its discretion, grant waivers and variances of specific rules upon application or petition being filed by an institution.|
|(2)||The department may grant a variance or waiver to a rule when an institution demonstrates that the purpose of the underlying statute upon which the rule is based can be or has been achieved by other specific means and that strict application of the rule would create a substantial hardship. For purposes of this rule, a substantial hardship means a significant, unique, and demonstrable economic, technological, legal, or other type hardship which impairs the ability to continue to function as a child caring institution.|
and waiver applications submitted to the department shall include, but are not
limited to the following:
|(4)||The institution must implement and comply with any terms and conditions established by the department in order to operate under any waiver or variance granted.|
|(5)||Variances or waivers shall not be sought or authorized when the granting of a waiver or variance would be harmful to public health, safety, or welfare or contrary to state law provisions.|
In the event that any rule, sentence, clause or phrase of any of these rules and regulations may be construed by any court of competent jurisdiction to be invalid, illegal, unconstitutional, or otherwise unenforceable, such determination or adjudication shall in no manner affect the remaining rules or portions thereof. The remaining rules or portions thereof shall remain in full force and effect, as if such rule or portions thereof so determined, declared or adjudged invalid or unconstitutional were not originally a part of these rules.