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Subject 290-2-7 RULES AND REGULATIONS FOR OUTDOOR CHILD CARING PROGRAMS

Rule 290-2-7-.01 Definitions

Unless a different meaning is required by the context, the following terms as used in these rules and regulations shall have the meaning hereafter respectively ascribed to them:

(a) "Administrator" or "Executive Director" means the person responsible for overall administration of the Outdoor Child Caring Program.
(b) "Applicant" means the following:
1. When the outdoor child caring program is owned by a sole proprietorship, the individual proprietor shall be the applicant for the license, complete the statement of responsibility and serve as the licensee;
2. When the outdoor child caring program is owned by a partnership, the general partners shall be the applicant for the license, complete the statement of responsibility and serve as the licensee;
3. When the outdoor child caring program is owned by an association, the governing body of the association shall authorize the application for the license and complete the statement of responsibility and the association shall serve as the licensee; and
4. When the outdoor child caring program is owned by a corporation, the governing body of the corporation shall authorize the application for the license and complete the statement of responsibility and the corporation shall serve as the licensee.
(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) "Board" unless otherwise indicated, shall mean the Georgia Board of Human Resources.
(e) "Camper" means a child who has been admitted to the Outdoor Child Caring Program for care.
(f) "Chemical restraint" means drugs that are administered to manage a child's behavior in a way that reduces the safety risk to the resident or others; that have the temporary effect of restricting the child's freedom of movement; and that are not being used as part of a standard regimen, as specified in the child's treatment plan, to treat current symptoms of a medical or psychiatric condition.
(g) "Child" means a person through 18 years of age.
(h) "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 Resources. 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.
(i) "Commissioner" means the Commissioner of the Georgia Department of Human Resources or his designee.
(j) "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.
(k) "Criminal record" means:
1. Conviction of a crime; or
2. Arrest, charge, and sentencing for a crime where:
(i) A plea of nolo contendere was entered to the charge; or
(ii) First offender treatment without adjudication of guilt pursuant to the charge was granted; or
(iii) Adjudication or sentence was otherwise withheld or not entered on the charge; or
(iv) Arrest and being charged for a crime if the charge is pending, unless the time for prosecuting such crime has expired pursuant to O.C.G.A. Sec. 17-3-1et seq.
(l) "Department" means the Department of Human Resources of the State of Georgia.
(m) "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.
(n) "Emergency safety intervention plan" means the plan developed by the therapeutic camp 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.
(o) "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.
(p) "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.
(q) "Governing Board" means the persons in which the ultimate legal responsibility, authority and accountability for the operation of the Outdoor Child-Caring Camp is vested.
(r) "License" means a written authorization granted by the Department to an applicant for license to operate an Outdoor Child Caring Program as a classification of a Child-caring Institution.
(s) "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.
(t) "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.
(u) "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.
(v) "Outdoor Child-Caring Program" means a child-caring institution, hereinafter also referred to as facility or program or camp that provides room, board and watchful oversight along with a variety of outdoor activities taking place in a wilderness or camp environment that are designed to improve the emotional and behavioral adjustment of the children, through the age of eighteen (18) participating in the activities. The term does not include outdoor camps that operate for a time-limited period, not exceeding 14 weeks per year. These children may also be referred to in these rules as "residents" or "campers."
(w) "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 an outdoor child caring program and who:
1. Purports to or exercises authority of the owner in an outdoor child caring program;
2. Applies to operate or operates an outdoor child caring program;
3. Enters into a contract to acquire ownership of an outdoor child caring program.
(x) "Placement Agency" means any person other than the parent of a child who is legally responsible for placement planning for the child.
(y) "Plan of Correction" means a written plan submitted to the Department by the person or persons responsible for the Outdoor Child Caring Program. The Plan shall identify the existing areas of non-compliance of the Outdoor Child Caring Program, together with the proposed procedures, methods and period of time required to correct the areas of noncompliance.
(z) "Preliminary records check application" means an application for a preliminary records check determination on forms provided by the department.
(aa) "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.
(bb) "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.
(cc) "Room, Board and Watchful Oversight" means providing a safe, appropriate outdoor setting, adequately nutritious meals and oversight to ensure a child's basic safety needs are met.
(dd) "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.
(ee) "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.
(ff) "Social Service Worker (SSW)" means the person(s) employed by the facility who is (are) responsible for providing oversight of services to children and their families in the camp setting. The Social Service Worker 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 their service plan; and monitoring of their educational and/or vocational needs.
(gg) "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.
(hh) "Temporary License" means written authorization granted by the Department to an applicant for license to admit children to the Outdoor Child Caring Program on a conditional basis to allow a newly established Outdoor Child Caring Program a reasonable, but limited period of time to demonstrate that operational procedures are in satisfactory compliance with these rules and regulations, or to allow an established and currently operating Outdoor Child Caring Program a reasonable, but specified, length of time to comply with these rules and regulations, provided said Outdoor Child Caring Program shall first present a Plan of Correction which is acceptable to the Department.
(ii) "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.
(jj) "Unsatisfactory criminal history background check determination" means a written determination that a person for whom a records check was performed has a criminal record.
(kk) "Variance" means written permission by the Department or Board to do some act contrary to the literal rule.
(ll) "Waiver" means the official written relinquishment of a rule in the course of issuance of a license.

Rule 290-2-7-.02 Applicability

(1) No person, institution, agency, society or facility shall operate an Outdoor Child Caring Program unless a license or permit has been obtained from the Department.
(2) The following types of child-caring institutions or activities are exempt from the requirements of these regulations:
(a) Child-caring institutions licensed by the Department pursuant to rules and regulations of the Department, Chapters 290-2-5 and 290-2-6, and which do not provide outdoor child caring camping activities exceeding periods of more than 14-day duration.
(b) facilities licensed by the Department pursuant to rules and regulations for hospitals, Chapter 290-5-6.
(c) facilities licensed by the Department pursuant to rules and regulations for intermediate care homes, Chapter 290-5-9.
(d) facilities licensed by the Department pursuant to rules and regulations for drug abuse treatment programs, Chapter 290-4-2.
(e) facilities owned and operated by the federal government.
(f) summer camps established solely for recreational and educational programs.

Rule 290-2-7-.03 Organization and Administration

(1) The legal basis for operation of an Outdoor Child Caring Program shall be documented through copies of the Articles of Incorporation, partnership agreements, and documents reflecting the creation of an association or a resolution authorizing the operation of the program.
(2) All Outdoor Child Caring Programs shall have a Governing Body that is responsible for and has authority over the policies and activities of the Outdoor Child Caring Program. If an Outdoor Child Caring Program is owned by a partnership, the partners shall be regarded as the Governing Body for the purposes of this subsection. If an Outdoor Child Caring Program is owned by a sole proprietor, the responsibilities imposed on a Governing Body by this subsection shall be borne by that proprietor.
(a) Outdoor Child Caring Programs that are owned corporately shall provide the Department with a list of names, addresses, and titles of the officers and/or executive committee of the Governing Body. Outdoor Child Caring Programs that are owned jointly or individually shall provide the Department with a list of names and addresses of the partners or owner. The Department shall be notified of any changes.
(3) The Governing Body shall be responsible for:
(a) Employing an Administrator or Executive Director;
(b) Developing and complying with written policies and operating procedures concerning organizational structure, personnel practices, admissions, care and services, appropriate behavior management and emergency safety interventions, and discharge of campers in accordance with these rules and regulations;
(c) Ensuring adequate financing;
(d) Ensuring compliance with minimum requirements;
(e) Periodically reviewing the program of care and services;
(f) Approving an annual budget; and
(g) Providing bonding for Board officers and staff who handle substantial operating or capital funds of the Outdoor Child Caring Program.
(4) The Governing Body shall visit the Outdoor Child Caring Program site at least twice a year to observe the operation of the program and the activities of the campers. This shall be documented in the minutes of the meetings of the Governing Body.
(5) The Outdoor Child Caring Program shall operate in accordance with its written policies and procedures. Copies of policies and procedures shall be made available to facility staff.
(6) The Governing Body shall be responsible for obtaining a satisfactory determination on a criminal records check for the Director and all staff whose duties involve personal contact with the campers.
(7) The Outdoor Child Caring Program shall maintain complete financial records. Books shall be audited annually by an independent certified public accountant. A copy of the accountant's statement of income and disbursements and the opinion letter from the audit report shall be submitted annually to the Department.
(8) A new Outdoor Child Caring Program shall have funds sufficient for the first year of operation. It shall have reserve funds or documentation of available credit, equal to the operating costs for the first three months.

Rule 290-2-7-.04 Criminal History Background Checks, Pesonnel

(1) Criminal History Background Checks for Owners Required. Prior to approving any license for a new outdoor child caring program 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.
(a) An owner may not be required to submit a records check application if it is determined that the owner does not do at least one of the following:
1. Maintains an office at the location where services are provided to children;
2. Resides at a location where services are provided to children;
3. Has direct access to children receiving care; or
4. Provides direct personal supervision of personnel by being immediately available to provide assistance and direction during the time services are being provided.
(b) In lieu of a records check application, an owner may submit evidence, satisfactory to the department, that within the immediately preceding 12 months the owner has received a satisfactory criminal history background check determination.
(2) An outdoor child caring program 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. 49-2-14.1et seq.:
(a) A violation of Code Section 16-5-1, relating to murder and felony murder;
(b) A violation of Code Section 16-5-21, relating to aggravated assault;
(c) A violation of Code Section 16-5-24, relating to aggravated battery;
(d) A violation of Code Section 16-5-70, relating to cruelty to children;
(e) A violation of Code Section 16-5-100, relating to cruelty to a person 65 years of age or older;
(f) A violation of Code Section 16-6-1, relating to rape;
(g) A violation of Code Section 16-6-2, relating to aggravated sodomy;
(h) A violation of Code Section 16-6-4, relating to child molestation;
(i) A violation of Code Section 16-6-5, relating to enticing a child for indecent purposes;
(j) A violation of Code Section 16-6-5.1, relating to sexual assault against persons in custody, detained persons, or patients in hospitals or other institutions;
(k) A violation of Code Section 16-6-22.2, relating to aggravated sexual battery;
(l) A violation of Code Section 16-8-41, relating to armed robbery;
(m) A violation of Code Section 30-5-8, relating to abuse, neglect, or exploitation of a disabled adult or elder person; or
(n) Any other offense committed in another jurisdiction that, if committed in this state, would be deemed to be a crime listed in this paragraph without regard to its designation elsewhere.
(3) An owner with a valid outdoor child placing agency license issued on or before June 30, 2007 shall be required to obtain a criminal records check determination no later than December 31, 2008.
(a) An owner with a valid outdoor child caring program license issued on or before June 30, 2007 who is determined to have a criminal record for any of the crimes listed in Rule .04(2)(a)-(n) above, shall not have the license revoked prior to a hearing being held before a hearing officer pursuant to Chapter 13 of Title 50, the "Georgia Administrative Procedure Act."
(b) An owner with a valid outdoor child caring program license who acquires a criminal record as defined in Rule .04(2)(a)-(n) above subsequent to the effective date of these rules shall disclose the criminal record to the department.
(c) 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 .04(2)(a)-(n) 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.
(4) Criminal History Background Checks for Director and Employees Required. Prior to serving as a director of a licensed outdoor child caring program, a person shall submit a records check application and receive a satisfactory determination or be determined eligible to serve as a director as a result of an administrative hearing.
(a) A person with an unsatisfactory criminal history background check determination may not serve as a director of a licensed outdoor child caring program if it is determined that such person has a criminal record involving any of the following covered crimes:
1. Any felony under Georgia law;
2. A violation of Code Section O.C.G.A. Sec. 16-4-1, relating to criminal attempt when the crime attempted is any of the crimes specified by this paragraph;
3. A violation of Code Section O.C.G.A. Sec. 16-5-23, relating to simple battery; where the victim is a minor;
4. A violation of Code Section O.C.G.A. Sec. 16-6-1et seq., relating to sexual offenses, excluding the offenses of bigamy or marrying a bigamist;
5. A violation of Code Section O.C.G.A. Sec. 16-21-1, relating to contributing to the delinquency of a minor;
6. Any other offense committed in another jurisdiction that, if committed in this state, would be deemed to be a crime listed in this paragraph without regard to its designation elsewhere.
(b) Prior to serving as an employee other than a director of a licensed outdoor child caring program, a person must submit a preliminary record check application and receive a satisfactory determination. Provided however, should there be an unsatisfactory determination, the person must submit to a fingerprint record check and get a satisfactory determination or be determined eligible to serve as an employee as a result of an administrative hearing.
(c) A person with an unsatisfactory background check determination may not serve as an employee of a licensed outdoor child caring program if it is determined that such person has a criminal record involving any of the covered crimes outlined in O.C.G.A. Secs. 16-4-1, 16-5-23, 16-6-1 and 16-21-1 and in Rule .04(2)(a)1. -6. above.
(d) In lieu of a records check application, a director or employee may submit evidence, satisfactory to the department, that within the immediately preceding 12 months the above personnel have received a satisfactory records check determination or a satisfactory preliminary records check determination, whichever is applicable.
(5) Personnel. In accordance with these rules and regulations, the outdoor child caring program shall employ and provide training and supervision for an adequate number of staff necessary to ensure the health and safety of the campers in its care.
(6) Outdoor Child Caring Programs shall have written job descriptions which specify what duties employees are expected to perform. A copy of the job descriptions shall be available to the employees and to the Department.
(7) The Administrator or Executive Director shall have a masters degree from an accredited college or university and a minimum of three years of increasingly responsible experience in the human service, mental health or health care field, or a Bachelors Degree plus five years experience in the field of child care, human services, mental health, at least two of which includes supervisory and/or administrative responsibility.
(8) The Administrator shall be responsible for implementing the policies adopted by the Governing Body, the on-going operation of the Outdoor Child Caring Program, and compliance with the "Rules and Regulations for Outdoor Child Caring Programs."
(9) The Administrator or his/her designee shall be present and responsible for the operation of the camp at all times. Staff on duty shall be made aware of the designated person.
(10) There shall be an effective written plan for staff supervision of the group sessions. The plan shall include the line of supervision, support staff, their location and accessibility.
(11) The staff member with primary responsibility for planning, developing, implementing service and Room Board and Watchful Oversight plans, supervising staff who deliver the services, and developing in-service training shall have a master's degree in psychology, social work, education or other related fields and experience and/or training in working with children in an outdoor Child Caring Program environment.
(12) Each Outdoor Child Caring Program shall have a social service worker on staff.
(13) The social service worker shall have at least a Bachelor's Degree from an accredited college or university.
(14) Each Outdoor Child Caring Program shall employ or contract with an adequate number of qualified and trained staff who provide room, board and watchful oversight appropriate to the types of children being served.
(15) The Outdoor Child Caring Program s shall arrange for the provision of professional services e.g., physicians, dentists, psychiatrists, psychologists, teachers, nurses, recreational therapists and other specialists according to the requirements of the Medicaid Rehabilitation Option Network.
(16) The Outdoor Child Caring Program shall have staff coverage throughout the 24-hour period.
(a) The Outdoor Child Caring Program 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.
(b) Supervisory staff shall be accessible to campers and to child care staff 24 hours per day. 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 campers in care.
(c) If volunteers are used as a supplement to child care staff, they shall meet the same requirements as the regular child care staff.
(d) Teachers who supervise campers' activities may be included in the provision of watchful oversight during the time they are responsible for a group.
(17) Child care staff or supervisory staff shall be available at all times so that no group will be without appropriate supervision.
(18) Tasks which conflict or interfere with their child care responsibilities shall not be assigned to child care staff. Job descriptions and staff assignments shall show no conflicts in assignments to child care staff.
(19) The personal qualifications of employees shall be verified including a satisfactory criminal history background check completed in accordance with O.C.G.A. Sec. 49-5-60et seq. and a ten-year employment history. Verification of educational qualifications shall include documentation of a high school diploma or official transcripts from an accredited institution of higher learning.
(a) At least three references shall be obtained for each potential employee prior to employment. Information obtained from the references shall be written and filed whether the interview is conducted in person or by telephone. References should attest to the person's capabilities of performing the duties for which they are employed and to the person's suitability of working with the types of children served by the camp.
(b) Each employee shall submit an oral or written statement to the facility at the time of application that they have never been shown by credible evidence (such as a decision of a court or jury, or a department investigation or other reliable evidence) to have abused, neglected, sexually exploited, or deprived a child or adult or to have subjected any person to serious injury as a result of intentional or grossly serious injury as a result of intentional or grossly negligent misconduct.
(20) Child care staff shall be at least four years older than the oldest child in their group, have a high school education or an equivalency and experience in working with children in a group setting. Former campers employed as staff shall be at least 21 years of age.
(21) In addition to the initial orientation, including training on the facility's policies and procedures pertaining to behavior management techniques and emergency safety interventions, all staff working with campers shall receive annually at least 40 hours of in-service training related to children's service needs in a primitive environment. In-service training for staff working with campers shall be documented. This shall include the date, the subject, and name of the person who conducted the training.
(22) Training in first aid and C.P.R. shall be required within 90 days of employment for all child care staff who are not licensed/certified health professionals.
(a) Training shall be certified by a Red Cross instructor or a licensed/certified health professional.
(b) First aid training shall be updated at least every three years. Certificates or statements of training shall document that training has been updated.
(23) All child care staff shall have training by certified staff in water safety and lifesaving techniques.
(24) A specialist trained in the particular activity shall supervise the participation of the campers in high risk activities such as rock climbing, canoeing, caving, etc.
(25) Personnel records shall be maintained for each employee of the outdoor child caring program. These records shall contain as a minimum the following information:
(a) Identifying information such as name, address, telephone number, and emergency contact person(s);
(b) Qualifications for the position;
(c) Date, name of contact, and information received from pre-employment references;
(d) Date of employment;
(e) Verification of training, including dates of all such training;
(f) Annual reports of performance, including all records of employee discipline arising from the inappropriate use of behavior management techniques and emergency safety interventions;
(g) Criminal history background check determination;
(h) Date and reason for separation; and
(i) Forwarding address of separated employees.

Rule 290-2-7-.05 Admission and Intake Policies

(1) The Outdoor Child Caring Program shall admit only those campers for whom it has a program designed to meet the particular needs of the camper and who meet the admission policies.
(a) The Outdoor Child Caring Program shall provide information to the custodian about the services, environment, age ranges and behavioral characteristics of the other children in placement prior to admission.
(b) The Outdoor Child Caring Program shall maintain signed documentation from the custodian that they have received and considered the information provided in Rule .05(1)(a) above and have determined that the placement environment is appropriate and does not represent an undue risk to the health and safety of the child or children being placed.
(c) The Outdoor Child Caring Program shall have written admission policies which specify the age, sex, and types of needs of campers for which the camp is qualified by staff, program and equipment to meet.
(d) The Outdoor Child Caring Program shall apply to the Department for a new license prior to a change in the admission policies which would require a change in the conditions of the license.
(2) An Outdoor Child Caring Program shall not accept more campers than is specified on the license, or campers whose age and sex are inconsistent with the conditions of the license.
(3) Children under 8 years of age shall not be accepted for care in an Outdoor Child Caring Program.
(4) The Outdoor Child Caring Program shall not admit a camper who has not had a medical examination by a licensed physician within 30 days prior to admission. The report of the examination shall include an explanation of any known problem or potential problem, the prescribed medical treatment and any recommendations for future care and examinations and a statement to the effect that the conditions are not incompatible with the rigors of the Outdoor Child Caring Program environment. The prescribed medical treatment and recommendations for future care shall be incorporated into the camper's service plan.
(5) Campers shall have had a dental examination by a licensed dentist within the six months prior to admission. Dental treatment shall be provided as recommended by the examining dentist.
(6) The Outdoor Child Caring Program shall not accept a camper for care until a psychological or psychiatric evaluation and an intake study has been made and based on an analysis and recommendation of the social service worker with approval of the Administrator has determined that the placement meets the needs and best interests of the camper.
(7) The intake study shall be prepared by the social service worker and shall be maintained in the Camper's record. The study shall include a summary of at least the following information:
(a) Current (within 1 year) evaluation by a licensed psychiatrist or psychologist authorized as a Medicaid Rehabilitation Option Provider, Community Resources provider, or other privately licensed psychiatrist or psychologist;
(b) A description of family relationships and the circumstances that make the placement necessary;
(c) The camper's developmental history;
(d) The parents' or placement agency's expectation of placement;
(e) The camper's understanding of placement;
(f) A description of the camper's personality, behavior, and interests;
(g) The camper's school history;
(h) History of previous placements;
(i) A statement about the camper's legal status;
(j) A statement of the camper's room, board and watchful oversight needs;
(k) The immediate and long-range goals of placement;
(l) The name of the family member or the placement agency who will be responsible for the relationship with the Outdoor Child Caring Program and the camper;
(m) Medical/dental history;
(n) Religious preference; and
(o) List of friends or others that may be permitted to visit with the camper if approved by the facility;
(8) The intake process shall include a discussion about placement with the camper and his or her parents or Placement Agency. It shall include a visit to the Camp.
(9) At the time of placement a written agreement shall be made between the Outdoor Child Caring Program, the camper and the camper's parents or placement agency. A copy of this agreement shall be in the camper's record. The agreement shall as a minimum include:
(a) Authorization to care for the camper;
(b) A medical consent form signed by a person authorized to give consent;
(c) Consent for camper to participate in trips or special activities;
(d) General goals and expectations for the camper's individual service plan;
(e) Written financial agreement including responsibility for medical, dental, clothing and other special needs; and
(f) Provision for notification of parents or placement agency in the event of unauthorized absences, medical or dental problems and any other significant event regarding the child, including the use of emergency safety interventions.
(10) Before admission, or at the time of admission, the Outdoor Child Caring Program shall provide written material to the camper's parents or placement agency which specifies:
(a) Rules regarding visits, mail, gifts, and telephone calls;
(b) Information on the nature and frequency of reports to the camper's parents or the Supervisory staff shall be accessible to campers and to child care staff 24 hours per day. All placement agency 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 campers in care.
(c) The facility's policy concerning behavior management and emergency safety interventions;
(d) The facility's policy or program concerning religious training;
(e) The name of the person or office that parents or the placement agency can contact if they feel their child's rights have been violated;
(f) Information regarding trips or special activities; and
(g) If the Outdoor Child Caring Program has a school program, information concerning its accreditation, approval or lack thereof.
(11) The Outdoor Child Caring Program shall provide orientation for new campers.
(12) The Outdoor Child Caring Program shall comply with the Interstate Compact on the Placement of Children, O.C.G.A. Chapter 39-4, when admitting children from another state.

Rule 290-2-7-.06 Support Services

(1) Within 30 days of admission, an individual service plan shall be developed by camp staff, the camper and his parents or placement agency. The plan shall be filed in the camper's case record with copies or a summary being made available to the camper's parents or placement agency.
(2) The service plan shall:
(a) specify the camper's needs and the way these needs shall be met;
(b) include the objectives of placement and the estimated length of stay, daily individual and group activities to achieve the objectives;
(c) be utilized by staff members working with the camper;
(d) provide for the social and educational needs of the camper;
(e) provide for the coordination of specialized services that will be delivered by the Medicaid Rehabilitation Option Provider and measures for insuring their integration with the child's ongoing service plan;
(f) provide for meeting the medical needs of the camper;
(g) specify the degree of the family's involvement.
(3) There shall be a staffing conference at least every three months for the purpose of reviewing and assessing progress toward meeting the goals of the service and room, board and watchful oversight plan. The camper shall be included in the conference. Results of the conference shall be filed in the camper's record.
(4) A case review conference with the camper, parents and/or placement agency shall be conducted at least every 6 months.
(5) Counseling and/or other social services are an integral part of the camper's service plan. Implementation of these services shall be in accordance to the camper's individual service plan and shall be provided by the Medicaid Rehabilitation Option Network.
(6) The Outdoor Child Caring Program shall obtain professional consultation and treatment for campers with special needs. When these services are obtained, they shall be documented in the camper's case record.
(7) Information and statements from mental health professionals (psychiatrists, psychologists, social workers, etc.) shall be utilized in the assessment, service planning, and implementation of the plan and monitoring of the progress of the camper.
(8) Discharge Planning.

At least one month prior to planned discharge, except in cases of emergency discharges, an Outdoor Child Caring Program shall formulate an aftercare plan that identifies the supports and resources that the camper and camper's family are expected to need following discharge. When a camper 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. A copy of the completed discharge summary shall be sent to the camper's parent (s) or guardian(s), or placement agency representative via e-mail, fax or mail. (Documentation should be kept in camper's file, to show summary was sent.)

Rule 290-2-7-.07 Daily Care

(1) A daily schedule shall be developed to meet Campers' needs.
(2) All staff having witnessed or having knowledge of a significant event for a Camper shall report such to the supervisor orally as soon as possible and in writing within 24 hours.
(3) The Outdoor Child Caring Program shall see that each Camper is supplied with personal clothing suitable to the camper's age and size and the season.
(4) Campers shall be given training in habits of personal care, hygiene, and grooming. Each camper shall be supplied with personal care, hygiene, and grooming equipment.
(5) Money earned by a camper or received as a gift or allowance shall be the Camper's personal property. A camper's money may be deposited with the Camp office but shall be accounted for separately from the Camp's funds.
(6) A camper shall not be required to use earned money to pay for room and board unless it is part of the service plan and is approved by the parent or placement agency and the director of the program.
(7) Campers shall be provided food of adequate quality and in sufficient quantity to supply the nutrients needed for growth and development.
(a) "Food for Fitness - A Daily Food Guide," developed by the United States Department of Agriculture, shall be used as a basis for meeting these requirements.
(b) Campers shall have a minimum of three meals available daily and snacks.
(c) Menus, as served, shall be retained on file for one month after use.
(d) No more than 14 hours shall pass between the last meal or snack of one day and the serving of the first meal of the following day.

Rule 290-2-7-.08 Campers' Rights and Privileges

(1) The staff of the Outdoor Child Caring Program shall allow privacy as needs indicate for each camper.
(2) Campers shall have access to a quiet, private area where they can withdraw from the group when appropriate.
(3) Termination of contacts between the camper and his or her family shall not be allowed while the camper is in care unless the rights of the parents have been terminated by court order or it has been determined by the placement agency that family contact is not in the camper's best interest. The frequency and nature of contact shall be based on the needs of the camper, and shall be determined with the participation of the camper, his or her family or placement agency and Outdoor Child Caring Program staff. Any limitations shall be filed in the camper's case record. Restriction of a contact shall be based on a determination by the staff along with any additional information from the Medicaid Rehabilitation Option Provider that due to the nature of the circumstances at that time that particular contact is not in the best interest of the camper. Reasons for the restrictions shall be shared with the Camper and the family and documented in the camper's record.
(4) The Outdoor Child Caring Program shall have clearly written policies regarding visits, gifts, mail, and telephone calls between the camper and his or her family or placement agency.
(5) A camper shall be allowed to bring personal possessions to the Outdoor Child Caring Program and to acquire possessions. Limits put on the kind of possessions a camper may or may not bring or receive shall be applied equally to all Campers, shall be discussed with the camper and his or her parents or placement agency and shall be documented in the camper's record.
(6) The Outdoor Child Caring Program shall not place a camper in a position of having to acknowledge his or her dependency, destitution, or neglect. The Outdoor Child Caring Program shall not require the camper to make public statements about his or her background or dependence on the Camp, to publicly acknowledge gratitude to the Camp or to perform at public gatherings.
(7) Pictures, reports, or identification that humiliate, exploit, or invade the privacy of a camper or his or her family or Placement Agency shall not be made public. The Outdoor Child Caring Program shall not use reports or pictures from which campers can be identified without written consent from the camper and the parents or placement agency.
(8) The opinions and recommendations of the campers shall be considered in the development and evaluation of the camping program and activities.
(9) The Outdoor Child Caring Program shall have clearly written policies for the behavior management of campers. Copies shall be available to staff and campers.
(10) Discipline shall be consistent with the policies of the Outdoor Child Caring Program and shall not be physically or emotionally damaging.
(11) Staff members shall be responsible for all behavior management of campers.

Rule 290-2-7-.09 Behavior and Management and Emergency Safety Interventions

(1) Behavior Management.
(a) The Outdoor Child Caring Program shall develop and implement policies and procedures on behavior management. Such policies and procedures shall set forth the types of children served in accordance with its program purpose, the anticipated behavioral problems of the children, and acceptable methods of managing such problems.
(b) Such Behavior management policies and procedures shall incorporate the following minimum requirements:
1. Behavior management principles and techniques shall be used in accordance with the individual service plan and written policies and procedures governing service expectations, service plan goals, safety, security, and these rules and regulations.
2. Behavior management shall be limited to the least restrictive appropriate method, as described in the camper's service plan and in accordance with the prohibitions as specified in these rules and regulations.
(c) The following forms of behavior management shall not be used:
1. Assignment of excessive or unreasonable work tasks;
2. Denial of meals and hydration;
3. Denial of sleep;
4. Denial of shelter, clothing, or essential personal needs;
5. Denial of essential program services;
6. Verbal abuse, ridicule, or humiliation;
7. Restraint, manual holds, and seclusion used as a means of coercion, discipline, convenience, or retaliation;
8. Denial of communication and visits unless restricted in accordance with Rule .08(3);
9. Corporal punishment; and
10. Seclusion not used appropriately as an emergency safety intervention.
(d) Campers shall not be permitted to participate in the behavior management of other campers or to discipline other campers.
(e) Outdoor Child Caring Programs shall submit to the Department electronically or by facsimile a report within 24 hours whenever an unusual incident occurs regarding behavior management, including any injury requiring medical treatment beyond first aid that is received by a camper as a result of any behavior management.
(f) All forms of behavior management used by direct care staff shall also be documented in case records in order to ensure that such records reflect behavior management problems.
(2) Emergency Safety Interventions.
(a) Emergency safety interventions may be used only by staff trained in the proper use of such interventions when a camper exhibits a dangerous behavior reasonably expected to lead to immediate physical harm to the camper or others and less restrictive means of dealing with the injurious behavior have not proven successful or may subject the camper or others to greater risk of injury.
(b) Emergency safety interventions shall not include the use of any restraint or manual hold that would potentially impair the camper's ability to breathe or has been determined to be inappropriate for use on a particular camper due to a documented medical or psychological condition.
(c) The institution shall have written policies and procedures for the use of emergency safety interventions, a copy of which shall be provided to and discussed with each camper and the camper's parents and/or legal guardians prior to or at the time of admission. Emergency safety interventions policies and procedures shall include:
1. Provisions for the documentation of an assessment at admission and at each annual exam by the camper's physician, a physician's assistant, or a registered nurse with advanced training working under the direction of a physician, or a public health department that states there are no medical issues that would be incompatible with the appropriate use of emergency safety interventions on that camper. Such assessment and documentation must be re-evaluated following any significant change in the camper's medical condition; and
2. Provisions for the documentation of each use of an emergency safety intervention including:
(i) Date and description of the precipitating incident;
(ii) Description of the de-escalation techniques used prior to the emergency safety intervention, if applicable;
(iii) Environmental considerations;
(iv) Names of staff participating in the emergency safety intervention;
(v) Any witnesses to the precipitating incident and subsequent intervention;
(vi) Exact emergency safety intervention used;
(vii) Documentation of the 15 minute interval visual monitoring of a child in seclusion;
(viii) Beginning and ending time of the intervention;
(ix) Outcome of the intervention;
(x) Detailed description of any injury arising from the incident or intervention; and
(xi) Summary of any medical care provided.
3. Provisions for prohibiting manual hold use by any employee not trained in prevention and use of emergency safety interventions.
(d) Emergency safety interventions or the use of physical restraint may be used to prevent runaways only when the child presents an imminent threat of physical harm to self or others, or as specified in the individual service and room, board and watchful oversight plan.
(e) Facility staff shall be aware of each camper's medical and psychological conditions, as evidenced by written acknowledgement of such awareness, to ensure that the emergency safety intervention that is utilized does not pose any undue danger to the physical or mental health of the camper.
(f) Campers shall not be allowed to participate in the emergency safety intervention of another camper.
(g) Immediately following the conclusion of the emergency safety intervention and hourly thereafter for a period of at least four hours where the camper is with a staff member, the camper's behavior will be assessed, monitored, and documented to ensure that the camper does not appear to be exhibiting symptoms that would be associated with an injury. Authority O.C.G.A. Secs. 49-5-8 and 49-5-12.
(h) At a minimum, the emergency safety intervention program that is utilized shall include the following:
1. Techniques for de-escalating problem behavior including camper and staff debriefings;
2. Appropriate use of emergency safety interventions;
3. Recognizing aggressive behavior that may be related to a medical condition;
4. Awareness of physiological impact of a restraint on the camper;
5. Recognizing signs and symptoms of positional and compression asphyxia and restraint associated cardiac arrest;
6. Instructions as to how to monitor the breathing, verbal responsiveness, and motor control of a camper who is the subject of an emergency safety intervention;
7. Appropriate self-protection techniques;
8. Policies and procedures relating to using manual holds, including the prohibition of any technique that would potentially impair a camper's ability to breathe;
9. Camp policies and reporting requirements;
10. Alternatives to restraint;
11. Avoiding power struggles;
12. Escape and evasion techniques;
13. Time limits for the use of restraint and seclusion;
14. Process for obtaining approval for continual restraints and seclusion;
15. Procedures to address problematic restraints;
16. Documentation;
17. Investigation of injuries and complaints;
18. Monitoring physical signs of distress and obtaining medical assistance; and
19. Legal issues.
(i) Emergency safety intervention training shall be in addition to the annual training required in Rule .04(16) and shall be documented in the staff member's personnel record.
(j) All actions taken that involve utilizing an emergency safety intervention shall be recorded in the camper's case record showing the cause for the emergency safety intervention, the emergency safety intervention used, and, if needed, approval by the director, the staff member in charge of casework services, and the physician who has responsibility for the diagnosis and treatment of the camper's behavior.
(k) Outdoor Child Caring Program shall submit to the Department electronically or by facsimile a report in a format acceptable to the Department within 24 hours whenever an unusual incident occurs regarding emergency safety interventions, including:
1. Any injury requiring medical treatment beyond first aid that is received by a camper as a result of any e mergency safety intervention;
2. For any Outdoor Child Caring Program with a licensed capacity of 20 residents or more, any 30-day period in which three or more instances of emergency safety interventions of a specific camper occurred and/or whenever the Outdoor Child Caring Program has had a total of 10 emergency safety interventions for all campers in care within the 30-day period; and
3. For any Outdoor Child Caring Program with a licensed capacity of less than 20 residents, any 30-day period in which three or more instances of emergency safety interventions of a specific camper occurred and/or whenever the Outdoor Child Caring Program has had a total of five instances for all campers in care within the 30-day period.
(l) Outdoor Child Caring Program shall submit a written report to the program's director on the use of any emergency safety intervention immediately after the conclusion of the intervention and shall further notify the camper's parents or legal guardians regarding the use of the intervention. A copy of such report shall be maintained in the camper's file.
(m) At least once per quarter, the institution, utilizing a master agency restraint log and the camper's case record, shall review the use of all emergency safety interventions for each camper and staff member, including the type of intervention used and the length of time of each use, to determine whether there was a clinical basis for the intervention, whether the use of the emergency safety intervention was warranted, whether any alternatives were considered or employed, the effectiveness of the intervention or alternative, and the need for additional training. Written documentation of all such reviews shall be maintained. Where the Outdoor Child Caring Program identifies opportunities for improvement as a result of such reviews or otherwise, the Outdoor Child Caring Program shall implement these changes through an effective quality improvement plan.
(n) No later than January 1, 2007 and ongoing thereafter, all direct care staff who may be involved in the use of emergency safety interventions, shall have evidence of having satisfactorily completed a nationally recognized training program for emergency safety interventions to protect residents and others from injury, which has been approved by the Department and taught by an appropriately certified trainer in such program.
(o) Manual Holds.
1. Emergency safety interventions utilizing manual holds require at least one trained staff member to carry out the hold. Emergency safety interventions utilizing prone restraints require at least two trained staff members to carry out the hold.
2. Emergency safety interventions shall not include the use of any restraint or manual hold that would potentially impair the camper's ability to breathe or has been determined to be inappropriate for use on a particular camper due to a documented medical or psychological condition.
3. When a manual hold is used upon any camper whose primary mode of communication is sign language, the camper shall be permitted to have his or her hands free from restraint for brief periods during the intervention, except when such freedom may result in physical harm to the camper or others.
4. If the use of a manual hold exceeds 15 consecutive minutes, the facility director or his or her designee, who possesses at least the qualifications of the director and has been fully trained in the facility's emergency safety intervention plan, shall be contacted by a two-way communications device or in person and determine that the continuation of the manual hold is appropriate under the circumstances. Documentation of any consultations and outcomes shall be maintained for each application of a manual hold that exceeds 15 minutes. Manual holds shall not be permitted to continue if the restraint is determined to pose an undue risk to the camper's health given the camper's physical or mental condition.
5. A manual hold may not continue for more than 30 minutes at any one time without the consultation as specified in subparagraph (2) of this subparagraph, and under no circumstances may a manual hold be used for more than one hour total within a 24-hour period.
6. If the use of a manual hold on a camper reaches a total of one hour within a 24-hour period, the staff shall reconsider alternative strategies, document same, and consider notifying the authorities or transporting the camper to a hospital or mental health facility for evaluation.
7. The camper's breathing, verbal responsiveness, and motor control shall be continuously monitored during any manual hold. Written summaries of the monitoring by a trained staff member not currently directly involved in the manual hold shall be recorded every 15 minutes during the duration of the restraint. If only one trained staff member is involved in the restraint and no other staff member is available, written summaries of the monitoring of the manual hold shall be recorded as soon as is practicable, but no later than one hour after the conclusion of the restraint.
(p) Seclusion.
1. If used, seclusion procedures in excess of thirty (30) minutes must be approved by the director or designee. No child shall be placed in a seclusion room or area in excess of one (1) hour within any twenty-four (24) hour period without obtaining authorization for continuing such seclusion from the child's physician, psychiatrist, or licensed psychologist and documenting such authorization in the child's record.
2. A seclusion room or area shall only be used if a camper is in danger of harming himself or herself or others.
3. A camper placed in a seclusion room or area shall be visually monitored at least every 15 minutes.
4. A room or area used for the purposes of seclusion must meet the following criteria:
(i) The room or area shall be constructed and used in such ways that the risk of harm to the camper is minimized;
(ii) The room or area shall be equipped with a viewing window on the door so that staff can monitor the child;
(iii) The room or area shall be lighted and well-ventilated;
(iv) The room or area shall be a minimum fifty (50) square feet in area; and
(v) The room or area must be free of any item that may be used by the camper to cause physical harm to himself/herself or others.
5. No more than one camper shall be placed in the seclusion room or area at a time.
6. A seclusion room or area monitoring log shall be maintained and used to record the following information:
(i) Name of the secluded camper;
(ii) Reason for camper's seclusion;
(iii) Time of camper's placement in the seclusion room or area;
(iv) Name and signature of the staff member that conducted visual monitoring; and
(v) Time of the camper's removal from the seclusion room or area.

Rule 290-2-7-.10 Medical and Dental Care

(1) The Outdoor Child Caring Program shall have written policies and procedures for obtaining diagnosis and treatment of medical and dental problems.
(a) The Outdoor Child Caring Program shall have a written agreement with external physicians, dentists and other health care providers for medical emergencies and routine medical care.
(b) The Outdoor Child Caring Program shall instruct all staff members in the policies and procedures to be followed in an emergency.
(2) All campers shall be examined annually by a licensed physicianwith an initial physical examination documented at least 30 days before being admitted to the camp.
(3) Facilities for medical isolation shall be available on the premises of the Outdoor Child Caring Program or at a facility recommended by a physician. No person with a contagious disease shall remain in the group during the contagious period.
(4) All campers shall have a dental examination by a licensed dentist or a dental hygienist working under the supervision of a licensed dentist at least once every 6 months.
(5) The Outdoor Child Caring Program shall comply with laws, rules, and regulations regarding immunization.
(6) The Outdoor Child Caring Program shall comply with laws, rules, and regulations for acquiring, storing, and administering medication.
(a) Medicines shall be contained in a locked cabinet or metal box at the Outdoor Child Caring Program.
(b) The medicine cabinet or box shall have a separate compartment for storing poisons and drugs for external use only.
(c) The Outdoor Child Caring Program shall develop and implement policies and procedures for the appropriate use and management of all types of medications. All direct care Outdoor Child Caring Program staff shall receive orientation on the policies and procedures. Such policies and procedures shall include the following
(d) Non-prescription medications. No camper shall be given a nonprescription medication by staff members of the Outdoor Child Caring Program unless the child exhibits symptoms that the medication is designed to relieve.
(e) Prescription medications. No camper shall be given a prescription medication unless the medication is prescribed for the camper by an authorized health care professional.
(f) Prescription medications shall only be given to a camper as ordered in the camper's prescription. An institution shall not permit medications prescribed for one camper to be given to any other camper.
(g) A camper's attending physician shall be notified in cases of dosage errors, drug reactions, or if the prescription medication does not appear to be effective. This information will be documented on the back of the Medication Administrative Record.
(h) Psychotropic medications. No camper shall be given psychotropic medications unless use is in accordance with the goals and objectives of the camper's service plan. Psychotropic medications must be prescribed by a physician who has responsibility for the diagnosis and treatment of the camper's conditions that necessitate such medication. Continued use of psychotropic medications shall be reviewed by the prescribing physician every sixty days.
(i) An Outdoor Child Caring Program shall designate and authorize classes of staff, such as Outdoor Child Caring Program Staff, to handout medications and supervise the taking of medications. Only designated and authorized staff shall handout and supervise the taking of medication. Staff will ensure medication has been taken and campers are not sharing medication. If designated and/or authorized staff makes 3 medicine errors in 1 month's time, staff will need to repeat the course before being able to hand out medications. Course curriculum shall be available to the Department and copy of the test kept in the employee's file.
(j) An Outdoor Child Caring Program shall maintain a record of all medications handed out by authorized staff and taken by camper to include: name of camper taking medication, name of prescribing physician and date of prescription (if the medication is prescription or psychotropic), required dosage, date and time taken, dosage taken, and name and signature of staff member that handed out and supervised the taking of medication. No blanks shall be left on the Medication Administrative Record, if the camper is away this absence is to be documented on the MAR.
(k) All expired medications shall be discarded and not handed out for use.
(7) First aid supplies shall be available and administered by a trained staff member. If campers are away from the camp during the time they need to take their medication or over twenty-hours, Camp staff shall keep medicines locked in the daypack and kept on the staff person who is responsible and trained to give medication.
(8) Persons administering medication shall have received appropriate training from a licensed/certified health professional. Documentation of training shall be filed in the individual's personnel record. Medication records shall include the medication given, the time, the dosage, and the name of the person administering the medication.
(9) Policies and procedures for dealing with medical emergencies such as bee stings, multiple insect bites, snake bites, hypothermia, etc. shall be developed. Staff shall be instructed as to their individual responsibilities and action to be taken.
(10) Staff shall inquire of each camper on a daily basis as to signs of illness, fever, rashes, bruises and injuries and shall provide or make arrangements for follow-up care as the camper's condition may require and document such actions until the condition is resolved.

Rule 290-2-7-.11 Education

(1) The Outdoor Child Caring Program shall ensure that each child attends an appropriate educational program (regular, special education or vocational education) designed to meet his/her educational need.
(2) Prior to or upon admission an Individual Education Plan shall be developed by the Camp staff, Camper, parent or Placement Agency and a certified teacher. The I.E.P. shall be incorporated in the Camper's individual service plan.
(3) The I.E.P. shall conform with the State Standards and shall be updated annually.
(4) Certified teachers shall be used for on-site schools.

Rule 290-2-7-.12 Campers' Records

(1) Each Camp shall maintain a permanent register with identifying information of all children accepted for service. In addition to other required documentation, each camper's record shall include:
(a) Name.
(b) Date of birth.
(c) Sex.
(d) Religion.
(e) Race.
(f) Names, addresses and phone numbers of parents, brothers, and sisters.
(g) Names, addresses and phone numbers of other persons who have a significant relationship with the child.
(h) Name, address and phone number of an emergency contact.
(i) Date of admission.
(j) Birth Certificate or other document which establishes identity, if required for enrollment in public school.
(k) A copy of the intake study.
(l) Placement Agreement.
(m) Service plan.
(n) Documentation of case reviews and updates of service plan.
(o) Health records of immunizations, examinations, treatments recommended and received.
(p) Reports of significant events occurring during time camper was receiving care.
(q) Discharge data including date and to whom discharged.
(2) The Camp shall ensure that case records are kept confidential and inaccessible to unauthorized persons, safe from fire, damage or theft.

Rule 290-2-7-.13 Discharge

(1) The following persons shall be involved in planning the discharge of a camper from the Outdoor Child Caring Program:
(a) The camper,
(b) The camper's parents or placement agency,
(c) Outdoor Child Caring Program staff.
(2) The name, address, and relationship of the person to whom the camper is discharged shall be recorded.
(3) If, in the event of an emergency discharge, the Outdoor Child Caring Program is unable to plan for the discharge with the persons listed in these rules, the Outdoor Child Caring Program shall document circumstances surrounding the emergency discharge in the camper's record. Parents and placement agencies shall be advised of the policies related to emergency discharge prior to admission of a camper.
(4) The Outdoor Child Caring Program shall not discharge a camper to any one other than the parent or placement agency or an order from a court of competent jurisdiction.

Rule 290-2-7-.14 Buildings, Grounds, and Equipment

(1) Camps shall have access to a minimum of 10 acres per camper for the first 50 campers with an additional 5 acres per camper for each additional camper. Housing sites shall be located so as to provide visual separation of the groups.
(2) Housing sites shall not be subject to or in proximity to conditions that create or are likely to create offensive odors, flies, noise, traffic or any similar hazards.
(3) All camp sites shall be well drained and free from depressions in which water may stand. Natural sinkholes, pools, swamps or other surface collectors of water within 200 feet of the periphery of the camp shall be either drained or filled to remove the still surface water. Mosquito breeding shall be prevented in such areas containing water not subject to such drainage or filling.
(4) Grounds within the housing site shall be free from debris, noxious plants (poison ivy, etc.) and uncontrolled weeds or brush.
(5) The housing site shall provide a space for recreation reasonably related to the size of the program and the type of occupancy.
(6) Water shall be supplied from an approved public supply if available; if not available, the private system shall comply with Rules and Regulations for Water Supply Quality Control of the Georgia Department of Natural Resources.
(7) The use of a common drinking cup shall not be permitted.
(8) No tile or concrete sanitary sewers or septic tanks shall be allowed within a distance of fifty (50) feet, and no cesspool or septic tank open-jointed drain fields shall be allowed within a distance of one-hundred fifty (150) feet of the private water supply.
(9) Adequate and safe sewerage facilities with flush toilets shall be provided if water supply is available. Public sewers, subsurface septic tank-seepage system or other type of liquid waste treatment and disposal system shall be provided. Raw or treated liquid waste shall not be discharged or allowed to accumulate on the ground surface.
(10) Where water supply is not available, sanitary type privies or portable toilets shall be provided. All such facilities shall be constructed as required by the Department. Privies, if provided, shall be maintained so as to prevent access of flies and animals to the contents therein, to prevent fly breeding and to prevent contamination of water supply.
(11) All facilities provided for excreta and liquid waste disposal shall be maintained and operated in a sanitary manner to eliminate possible health or pollution hazards.
(12) Water closets or privy seats for each sex shall be in the ratio of not less than one such unit for each fifteen (15) occupants, with a minimum of one (1) unit for each sex in common use facilities.
(13) Separate toilet accommodations for males and females shall be provided in common use areas. Toilets shall be distinctly marked "Male" and "Female."
(14) Housing shall be structurally sound, in good repair, maintained in a sanitary condition and shall provide protection to the occupants against the elements.
(15) Housing shall have flooring constructed of rigid materials, smooth finished, readily cleanable and so located as to prevent the entrance of ground and surface water.
(16) A balcony, upper story, attic or loft shall not be used for sleeping or group assembly.
(17) All outside openings in kitchen and dining rooms shall be protected with screening of 16 mesh or less.
(18) All screen doors shall be tight, in good repair and equipped with self-closing devices.
(19) All living quarters and service rooms shall be provided with properly installed, operable heating equipment capable of maintaining a temperature of at least 50° Fahrenheit if during the period of normal occupancy the temperature in such quarters falls below 50° Fahrenheit.
(20) Any stoves or other sources of heat utilizing combustible fuel shall be installed and vented in such a manner as to prevent fire hazards and a dangerous concentration of gases. No portable heaters other than those operated by electricity shall be provided in sleeping areas. If a solid or liquid fuel stove is used in a room with wooden or other combustible flooring, there shall be a concrete slab, insulated metal sheet or other fire-proof materials on the floor under each stove, extending at least eighteen (18) inches beyond the perimeter of the base of the stove.
(21) Any wall or ceiling within eighteen (18) inches of a solid or liquid fuel stove or a stovepipe shall be of fireproof material. A vented metal collar shall be installed around a stovepipe or vent passing through a wall, ceiling, floor or roof. Such vent or chimney shall extend above the peak of the roof.
(22) When a heating system has automatic controls, the controls shall be of the type which cut off the fuel supply upon the failure or interruption of the flame or ignition, or whenever a predetermined safe temperature or pressure is exceeded. All steam and hot water systems shall be provided with safety devices arranged to prevent hazardous pressures and excessive temperatures.
(23) All heating equipment shall be maintained and operated in a safe manner to eliminate possibilities of fire.
(24) Electrical wiring and lighting fixtures shall be installed and maintained in a safe condition.
(25) Bathing and hand washing facilities, supplied with hot and cold water shall be provided for the use of all occupants. These facilities shall be clean and sanitary and maintained in good repair.
(26) There shall be a minimum of one (1) showerhead per fifteen (15) persons. Showerheads shall be spaced at least three (3) feet apart, with a minimum of nine (9) square feet of floor space per unit. Adequate dry dressing space shall be provided in common use facilities. Shower floors shall be constructed of non-absorbent, properly constructed floor drains. Separate shower facilities shall be provided for each sex. When common use shower facilities for both sexes are in the same building, they shall be separated by a solid nonabsorbent wall extending from the floor to ceiling or roof, and shall be plainly designated "Male" or "Female."
(27) If laundry service is not otherwise provided, laundry facilities supplied with hot and cold water under pressure shall be provided for the use of all occupants.
(28) Bedding provided by the Outdoor Child Caring Program shall be clean and sanitary. All bedding shall be laundered or otherwise sanitized between assignment to different campers.
(29) Linens shall be changed as often as required for cleanliness and sanitation, but not less frequently than once a week.
(30) Bedwetters shall have their linens changed as often as they are wet.
(31) Adequate personal storage area shall be available for each child to separate his or her clothing from other children's personal belongings.
(32) Boys and girls shall not share the same sleeping unit.
(33) A separate bed, bunk or cot shall be available for each person. Tripledeck beds are prohibited. Beds shall be spaced in a manner which will provide a walk space on at least one side and at least one end of each bed.
(34) Food service facilities and program shall meet Chapter 290-5-14 Rules and Regulations for Food Service, Georgia Department of Human Resources.
(35) Poisonous and toxic materials shall be properly identified, stored separately from food and properly used. Poisonous polishes shall not be used on eating and cooking utensils.
(36) Persons with wounds or communicable diseases shall be prohibited from handling food.
(37) Food handlers shall practice good hygienic practices.
(38) Floors, walls and ceilings shall be kept clean and in good repair.
(39) Adequate lighting shall be provided and shall be properly protected from breakage.
(40) The kitchen area and cooking equipment shall be properly vented.
(41) Pets shall not be allowed in the food storage, preparation or dining area.
(42) Durable, clean containers of adequate size and tight fitting lids shall be conveniently located to each housing unit for storage of garbage and other refuse.
(43) Provisions shall be made for collection of refuse at least once a week, or more often if necessary. The disposal of refuse, which includes garbage, shall be in accordance with requirements of Chapter 290-5-14 Rules and Regulations for Food Service, Georgia Department of Human Resources.
(44) Storage facilities and areas shall be maintained in a sanitary condition.
(45) A vector control program shall be maintained to insure effective control of all insects and rodents in buildings and on the premises.
(46) If chemical control is needed to supplement good sanitation practices, proper pesticides shall be used in strict accordance with label instructions.
(47) Swimming pools shall be constructed in accordance with Department design standards and all pools shall be maintained and operated as required by local regulations and standards of the Department. Other swimming areas (lake, creeks, etc.) shall be kept clean of hazardous trash and debris.
(48) Documentation of current and approved fire, health, and safety inspections shall be kept on file at the Outdoor Child Caring Program. Copies of the inspection reports shall be submitted to the Department when the signed application for licensure is submitted and annually thereafter.
(49) Fire drills shall be held at least 8 times a year. Written records of the drills shall be maintained.
(50) There shall be a disaster preparedness plan for staff and residents to follow for meeting disasters and emergencies such as fires or severe weather. The plan shall include procedures and action to be taken in case of adverse weather conditions such as extremely low temperatures, storms, tornadoes, etc. All staff members shall know the procedures and action to be taken for meeting disasters and emergencies.
(51) Horses and other animals maintained in any camp shall be quartered at a reasonable distance from any sleeping, living, eating or food preparation area.
(a) Stables and corrals shall be located as to prevent contamination of any water supply. Manure shall be removed from stalls and corrals as often as necessary to control flies.
(b) Horses, dogs or other domestic animals or pets shall not be permitted on a bathing beach or in water in the area used for waterfront activities.
(52) All dogs, cats and other warm-blooded pets owned or under the supervision of an occupant of any Camp shall be currently vaccinated against rabies in compliance with the law.
(a) Written records shall be kept on the type of vaccinations and the date of vaccinations.
(b) The premises shall be kept free of stray animals.
(53) Primitive campsites shall be maintained and operated in a safe and healthful manner.
(a) Drinking water used at primitive camps and on hikes and trips away from permanent campsites shall be from a source known to be safe (free of coliform organisms) or shall be rendered safe before used in a manner approved by the Department of Human Resources.
(b) Primitive campsites which are not provided with approved toilet facilities shall have a separate toilet area designated for each sex at a minimum ratio of one (1) toilet seat per 15 persons. Slit trenches or cat holes with a readily available supply of clean earth backfill or other disposal methods approved in writing by the Department of Health shall be utilized for the disposal of human excreta in these areas. Toilet areas shall be located at least one hundred and fifty (150) feet from a stream, lake or well and at least seventy-five (75) feet from a campsite, tent or other sleeping or housing facility.
(c) Solid wastes which are generated in primitive camps should be disposed of at an approved sanitary landfill or similar disposal facility. Where such facilities are not available, solid wastes shall be disposed of daily by burial under at least two (2) feet of compacted earth cover in a location which is not subject to inundation by flooding. Burying is not recommended.
(d) Hot water and detergent shall be used to wash all food utensils after each meal at primitive campsites. Where group dishwashing is practiced, all utensils shall be immersed for at least two (2) minutes in a lukewarm chlorine bath containing at least 50 ppm of available chlorine at all times. Where chlorine is used, a three compartment vat or three containers are required for washing, rinsing and immersion.
(e) No dish, receptacle or utensil used in handling food for human consumption shall be used or kept for use if chipped, cracked, broken, damaged or constructed in such a manner as to prevent proper cleaning sanitizing.
(f) Disposable or single use dishes, receptacles or utensils used in handling food shall be discarded after one use.
(g) Eating utensils shall not be stored with foods or other materials and substances and shall be stored in clean dry containers.
(h) Persons who handle food and/or eating utensils for the group shall maintain personal cleanliness, shall keep hands clean at all times and shall thoroughly wash the hands with soap and water after each visit to the toilet. They shall be free of local infection commonly transmitted through the handling of food or drink and free of communicable disease.
(i) Food shall be stored in clean and dry containers that provide protection from insects, rodents and wildlife. Hazardous substances, medicines, etc., shall not be stored in containers with food.

Rule 290-2-7-.15 Reports

(1) The governing board shall submit on a timely basis such financial, statistical reports, and board minutes and other information as may be required by the Department.
(2) Reporting. Detailed written summary reports shall be made to the Department of Human Resources, Office of Regulatory Services, Residential Child Care Unit via email or fax on the required incident intake information form (IIIF) within 24 hours. This report shall be made regarding serious occurrences involving children in care, including but not limited to:
(a) Death or serious injury (requiring extensive medical care and/or hospitalization of any camper in care);
(b) Suicide attempts;
(c) Abuse;
(d) Any federal, state or private legal action by or against the Camp which affects any child, the conduct of the Camp or any person affiliated with the Camp;
(e) Closure of a living unit due to disaster or emergency situations such as fires or severe weather; and
(f) Any injury requiring medical treatment beyond first aid that is received by a camper as a result of any e mergency safety intervention.
(3) Child Abuse Reports. Whenever the outdoor child caring program 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 Resources (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 Office of Regulatory Services.
(4) The governing board of the Outdoor Child Caring Program shall report to the Department:
(a) Any change in administrator; and
(b) Any impending change that would necessitate a change in the conditions of the license, i.e., capacity, age range, sex, location or name.

Rule 290-2-7-.16 Application for License

(1) Application for licensure of an Outdoor Child Caring Program shall be made on forms provided by the Department. The application shall be verified by both the Executive Director and Chairman of the Governing Body.
(2) The following material shall be filed with the application:
(a) Certified copy of the current Articles of Incorporation (if incorporated).
(b) Certified copy of the current Bylaws (if applicable).
(c) A list of the name and address of the current members of the Governing Body and a notarized letter of acceptance from each.
(d) A list of the professional staff including their education and experience.
(e) Plan for financing including an itemized annual budget, base for any schedule of fees, letter from C.P.A. stating that the bookkeeping system will be set up so that an audit can be made at the end of each fiscal year.
(f) Copy of personnel policies and practices.
(g) Outline of the Outdoor Child Caring Program's proposed program.
(h) Copy of admission policies and procedures.
(i) Documentation of need:
(I) Written communications from community leaders in the field of child welfare indicating a need for the services proposed by the applicant; or
(II) Recent research data establishing a need for the services being proposed; or
(III) Evidence that the services will be used by referral sources.
(j) Manual of operating procedures as referred to in Section 290-2-7-.03.
(k) Written disclosure concerning the status of all applications previously made (whether granted, denied, or pending) and licenses previously obtained (whether currently in force, revoked or suspended) for outdoor camping activities in other jurisdictions by agencies in common control with or under common control of the applicant Agency or Outdoor Child Caring Program or with which the applicant Agency or Outdoor Child Caring Program intends to cooperate in the care and service of children. The aforementioned requirement of disclosure will also apply to all applications and licenses for agencies with whom the Administrator or individual board members of the applicant Agency or Outdoor Child Caring Program are affiliated in any capacity. The purpose of this provision is to disclose to the Department full and complete information concerning the prior and continuing efforts of the applicant Agency or Outdoor Child Caring Program, its Executive Director and individual members of the governing body in child care activities in other jurisdictions.
(3) False or Misleading Information. The application for a license including the application for a criminal history background check must be truthfully and fully completed. In the event that the department has reason to believe that any required application has not been completed truthfully, the department may require additional verification of the facts alleged. The department may refuse to issue a license where false statements have been made in connection with the application or any other documents required by the department.
(4) A license to operate an Outdoor Child Caring Program is not transferable. A new application shall be filed when there is a substantial change in membership (50%) of the governing body.
(5) The Department shall consider each application filed and in its discretion, either deny said application, suspend consideration of said application until additional requested information is received, or issue a temporary license, based on a determination that the Outdoor Child Caring Program has made adequate provision to meet these Rules. An Outdoor Child Caring Program's initial license shall be a temporary license, valid for a specified period not to exceed one year.
(6) If the department finds that any outdoor child caring program applicant does not meet rules and regulations prescribed by the department but is attempting to meet such rules and regulations, the department may, in its discretion, issue a temporary license or commission to such outdoor child caring program, but such temporary license or commission shall not be issued for more than a one-year period.
(a) Upon presentation of satisfactory evidence that such institution is making progress toward meeting prescribed rules and regulations of the department, the department may, in its discretion, reissue such temporary license or commission for one additional period not to exceed one year.
(b) As an alternative to a temporary license or commission, the department, in its discretion, may issue a restricted license or commission which states the restrictions on its face.
(c) Upon consideration of an application for renewal of the initial temporary license granted to an Outdoor Child Caring Program the Department may, in its sole discretion, based on the Outdoor Child Caring Program's performance during the initial licensing period, either deny said renewal, issue a full one-year license, or issue an additional temporary license for a specified period not to exceed six months.
(7) An application for renewal of license shall be made no later than 60 days prior to the expiration of a Outdoor Child Caring Program's current license on forms provided by the Department. The application for renewal shall be verified by both the Administrator and Chairman of the Governing Body and shall certify, unless noted otherwise therein, that all of these Rules have been and continue to be complied with and that all information previously filed with the Department is true and correct. All changes in membership of the Governing Body and personnel since the date of last application (whether for initial license or renewal) shall be fully documented, as to names, dates and circumstances.
(8) If an application for licensure is denied, or a license revoked, an application for a new license may not be filed within one year of such denial or revocation.
(9) Information required for relicensing shall be submitted on forms provided by the Department.
(10) The license shall be posted at some point near the entrance or part of the office that is open to view by the public.

Rule 290-2-7-.17 Variances and Waivers

The Department may grant a variance to a rule when the variance is necessary because the rule is not applicable, or to allow experimentation and demonstration of new and innovative approaches to the delivery of services or the Outdoor Child Caring Program has met the intended purpose of the rule through equivalent rules. The Department may establish conditions which must be met by the Outdoor Child Caring Program in order to operate under the variance.

Rule 290-2-7-.18 Disaster Preparedness

The Outdoor Child Caring Program shall prepare for potential emergency situations that may affect the care of children by the development of an effective disaster preparedness plan that identifies emergency situations and outlines an appropriate course of action. The plan must be reviewed and revised annually, as appropriate, including any related written agreements.

(a) The disaster preparedness plan shall include at a minimum plans for the following emergency situations:
1. Local and widespread weather emergencies or natural disasters, such as tornadoes, hurricanes, earthquakes, ice or snow storms, or floods;
2. Manmade disasters such as acts of terrorism and hazardous materials spills;
3. Unanticipated interruption of service of utilities, including water, gas, or electricity, involving any placement homes within a local or widespread area;
4. Loss of heat or air conditioning in facilities, outdoor temporary structures or primitive natural environments where campers may be housed;
5. Fire, explosion, or other physical damage to facilities, outdoor temporary structures or primitive environments where campers may be housed; and
6. Pandemics or other situations where the campers' need for services exceeds the capacity and availability of services regularly offered by the Outdoor Child Caring Program.
(b) There shall be plans to ensure sufficient camp staff and supplies for campers to provide room, board and watchful oversight during the emergency situation.
(c) There shall be plans for the emergency transport or relocation of all campers, should it be necessary, in vehicles appropriate to the camper's needs. Additionally there shall be written agreements with any agencies which have agreed to receive the program's campers in these situations.
(d) The Outdoor Child Caring Program shall document quarterly disaster drills.
(e) The disaster preparedness plan shall include a requirement that the program notify the Department of the emergency situation as required by these rules and notify the parents, placement agency or lawful custodians of the camper's whereabouts and condition.
(f) The Outdoor Child Caring Program 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 Outdoor Child Caring Program's plan for the management of external disasters.
(g) The Outdoor Child Caring Program's disaster preparedness plan shall be made available to the Department for inspection upon request.
(h) 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.

Rule 290-2-7-.19 Inspections: Access by Department Staff

An application for license to operate an Outdoor Child Caring Program shall constitute consent by the Outdoor Child Caring Program for the staff of the Department to enter the premises or wherever campers are being cared for at any time during normal business hours, with or without prior notice for the purpose of reviewing records, obtaining pertinent information and determining compliance with these Rules.

Rule 290-2-7-.20 Emergency Orders

(1) In accordance with O.C.G.A. 49-5-90et seq., notwithstanding other remedies available to the department which may be pursued at the same time, the commissioner or his designee may issue emergency orders. Such orders may include the following:
(a) Emergency relocation of children when it is determined that the children are subject to an imminent and substantial danger.
(b) Emergency placement of a monitor or monitors in an outdoor child caring program upon a finding that the department's rules and regulations are being violated which threaten the health, safety, or welfare of children in care and when one or more of the following conditions are present:
1. The outdoor child caring program is operating without a license; or
2. The department has denied the application for the license or has initiated action to revoke the existing license; or
3. Children are suspected of being subjected to injury or life-threatening situations or the health or safety of a child or children is in danger.
(c) Emergency prohibition of admissions to an outdoor child caring program when children are in imminent and substantial danger and the outdoor child caring program has failed to correct a violation of rules and regulations within a reasonable time, as specified by the department. Such violation giving rise to the prohibition could jeopardize the health and safety of the children if allowed to remain uncorrected or is a repeat violation over a twelve month period.
(2) An emergency order shall contain the following:
(a) The scope of the order;
(b) The reasons for the issuance of the order;
(c) The effective date of the order if other than the date the order is issued;
(d) The person to whom questions regarding the order are to be addressed; and
(e) Notice of the right to a preliminary hearing.
(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 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.

Rule 290-2-7-.21 Enforcement and Penalties

(1) Plans of Correction. If the Department determines that either an Outdoor Child Caring Program or a facility applying to become licensed as an Outdoor Child Caring Program does not comply with the rules, the Department shall provide written notice specifying the rule(s) violated and setting a time for the agency not to exceed ten (10) working days with in 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 Outdoor Child Caring Program or facility applying to become licensed that the plan of correction is not acceptable. The Department may permit the camp to submit a revised plan of correction.
(a) The camp shall comply with an accepted plan of correction.
(b) Where the Department determines that either the Outdoor Child Caring Program or the facility applying to become licensed as an Outdoor Child Caring Program has not filed an acceptable plan of correction or has not complied with the accepted plan of correction, the Department may initiate an adverse action to enforce these rules.
(2) All adverse actions to enforce the Rules and Regulations for an Outdoor Child Caring Program shall be initiated in accordance with the Rules and Regulations for Enforcement of Licensing Requirements, Chapter 290-1-6, and O.C.G.A. Secs. 49-5-12 and 49-5-12.1, Penalties for Violation of Child Welfare Agency Laws and Regulations and Sec. 49-5-60et seq. and the requirements set forth herein.
(3) Required Notifications for Revocations and Suspensions. The camp 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 camp's license to operate.
(a) The official notice of the revocation or emergency suspension action and any final resolution, together with the Department's complaint intake phone number and website address, shall be provided by the camp to each current and prospective child's parents and/or legal guardians.
(b) The camp shall ensure the posting of the official notice at the camp in an area that is visible to each child's parents and/or legal guardians.
(c) The camp shall ensure that the official notice continues to be visible to each child's parents and/or legal guardians throughout the pendency of the revocation and emergency suspension actions, including any appeals.
(d) The camp shall have posted in an area that is readily visible to each child's parents and/or legal guardians any inspection reports that are prepared by the Department during the pendency of any revocation or emergency suspension action.
(e) It shall be a violation of these rules for the camp to permit the removal or obliteration of any posted notices of revocation, emergency suspension action, resolution, or inspection survey during the pendency of any revocation or emergency suspension action.
(f) The Department may post an official notice of the revocation or emergency suspension action on its website or share the notice of the revocation or emergency suspension action and any information pertaining thereto with any other agencies that may have an interest in the welfare of the children in care of the camp.
(g) 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.