Part VI. Program Operation
Article 1
Admission, Transfer, and Discharge
6VAC35-41-710. Placement pursuant to a court order.
When a resident is placed in a facility pursuant to a court order, the following requirements shall be met by maintaining a copy of a court order in the resident's case record:
1. 6VAC35-41-730 (application for admission).
2. 6VAC35-41-740 (admission procedures).
3. 6VAC35-41-750 (written placement agreement).
4. 6VAC35-41-780 (emergency admissions).
5. 6VAC35-41-810 (discharge procedures).
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-720. Readmission to a shelter care program.
A. When a resident is readmitted to a shelter care facility within 30 days from discharge, the following requirements shall not apply:
1. 6VAC35-41-730 (application for admission).
2. 6VAC35-41-740 (admission procedures).
B. When a resident is readmitted to a shelter care facility within 30 days from discharge, the facility shall:
1. Review and update all information on the face sheet as provided in 6VAC35-41-340 (face sheet);
2. Complete a health screening in accordance with 6VAC35-41-1200 (health screening at admission);
3. Complete required admission and orientation process as provided in 6VAC35-41-760 (admission); and
4. Update in the case record any other information regarding the resident that has changed since discharge.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-730. Application for admission.
A. Except for placements pursuant to a court order or resulting from a transfer between residential facilities located in Virginia and operated by the same governing authority, all admissions shall be based on evaluation of an application for admission.
B. Providers shall develop and fully complete, prior to acceptance for care, an application for admission that is designed to compile information necessary to determine:
1. The educational needs of the prospective resident;
2. The mental health, emotional, and psychological needs of the prospective resident;
3. The physical health needs, including the immunization needs, of the prospective resident;
4. The protection needs of the prospective resident;
5. The suitability of the prospective resident's admission;
6. The behavior support needs of the prospective resident; and
7. Information necessary to develop a service plan and a behavior support plan.
C. Each facility shall develop and implement written procedures to assess each prospective resident as part of the application process to ensure that:
1. The needs of the prospective resident can be addressed by the facility's services;
2. The facility's staff are trained to meet the prospective resident's needs; and
3. The admission of the prospective resident would not pose any significant risk to (i) the prospective resident or (ii) the facility's residents or staff.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-740. Admission procedures.
A. Except for placements pursuant to a court order, the facility shall admit only those residents who are determined to be compatible with the services provided through the facility.
B. The facility's written criteria for admission shall include the following:
1. A description of the population to be served;
2. A description of the types of services offered;
3. Intake and admission procedures;
4. Exclusion criteria to define those behaviors or problems that the facility does not have the staff with experience or training to manage; and
5. Description of how educational services will be provided to the population being served.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-750. Written placement agreement.
A. Except for placements pursuant to a court order or when a resident admits himself to a shelter care facility, each resident's record shall contain, prior to a routine admission, a completed placement agreement signed by a facility representative and the legal guardian or placing agency. Routine admission means the admittance of a resident following evaluation of an application for admission and execution of a written placement agreement.
B. The written placement agreements shall:
1. Authorize the resident's placement;
2. Address acquisition of and consent for any medical treatment needed by the resident;
3. Address the rights and responsibilities of each party involved;
4. Address financial responsibility for the placement;
5. Address visitation with the resident; and
6. Address the education plan for the resident and the responsibilities of all parties.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-760. Admission.
A. Written procedure governing the admission and orientation of residents to the facility shall provide for:
1. Verification of legal authority for placement;
2. Search of the resident and the resident's possessions, including inventory and storage or disposition of property, as appropriate;
3. Health screening;
4. Notification of parents and legal guardians, as applicable and appropriate, including of (i) admission, (ii) visitation, and (iii) general information, including how the resident's parent or legal guardian may request information and register concerns and complaints with the facility. The facility shall ask the parent or legal guardian regarding whether the resident has any immediate medical concerns or conditions;
5. Interview with resident to answer questions and obtain information;
6. Explanation to resident of program services and schedules;
7. An orientation on the residents' rights, including but not limited to the prohibited actions provided for in 6VAC35-41-560 (prohibited actions); and
8. Assignment of resident to a housing unit or room.
B. When a resident is readmitted to a shelter care facility within 30 days from discharge, the facility shall update the information required in subsection A of this section.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-770. Orientation to facility rules and disciplinary procedures.
A. During the orientation to the facility, residents shall be given written information describing facility rules, the sanctions for rule violations, and the facility's disciplinary process. These shall be explained to the resident and documented by the dated signature of resident and staff.
B. Where a language or literacy problem exists that can lead to a resident misunderstanding the facility rules and regulations, staff or a qualified person under the supervision of staff shall assist the resident.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-780. Emergency admissions.
Providers accepting emergency admissions, which are the unplanned or unexpected admission of a resident in need of immediate care excluding self-admittance to a shelter care facility or a court ordered placement, shall:
1. Develop and implement written procedures governing such admissions that shall include procedures to make and document prompt efforts to obtain (i) a written placement agreement signed by the legal guardian or (ii) the order of a court;
2. Place in each resident's record the order of a court, a written request for care or documentation of an oral request for care, and justification of why the resident is to be admitted on an emergency basis; and
3. Except placements pursuant to court orders, clearly document in written assessment information gathered for the emergency admission that the individual meets the facility's criteria for admission.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-790. Resident transfer between residential facilities located in Virginia and operated by the same governing authority.
A. Except for transfers pursuant to a court order, when a resident is transferred from one to another facility operated by the same provider or governing authority the sending facility shall provide the receiving facility, at the time of transfer, a written summary of (i) the resident's progress while at the facility; (ii) the justification for the transfer; (iii) the resident's current strengths and needs; and (iv) any medical needs, medications, and restrictions and, if necessary, instructions for meeting these needs.
B. Except for transfers pursuant to a court order, when a resident is transferred from one to another facility operated by the same provider or governing authority the receiving facility shall document at the time of transfer:
1. Preparation through sharing information with the resident, the family and the placing agency about the facility, the staff, the population served, activities, and criteria for admission;
2. Notification to the family, if appropriate; the resident, the placement agency, and the legal guardian; and
3. Receipt of the written summary from the sending facility required by subsection A of this section.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-800. Placement of residents outside the facility.
A resident shall not be placed outside the facility prior to the facility obtaining a placing agency license from the Department of Social Services, except as permitted by statute or by order of a court of competent jurisdiction.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-810. Discharge procedures.
A. The provider shall have written criteria for discharge that shall include:
1. Criteria for a resident's completing the program that are consistent with the facility's programs and services;
2. Conditions under which a resident may be discharged before completing the program; and
3. Procedures for assisting placing agencies in placing the residents should the facility cease operation.
B. The provider's criteria for discharge shall be accessible to prospective residents, legal guardians, and placing agencies.
C. Residents shall be discharged only to the legal guardian, legally authorized representative, or foster parent with the written authorization of a representative of the legal guardian. Residents over the age of 17 or who have been emancipated may assume responsibility for their own discharge.
D. As appropriate and applicable, information concerning current medications, need for continuing therapeutic interventions, educational status, and other items important to the resident's continuing care shall be provided to the legal guardian or legally authorized representative, as appropriate.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-820. Discharge documentation.
A. Except for residents discharged pursuant to a court order, the case record shall contain the following:
1. Documentation that discharge planning occurred prior to the planned discharge date;
2. Documentation that discussions with the parent or legal guardian, placing agency, and resident regarding discharge planning occurred prior to the planned discharge date;
3. A written discharge plan developed prior to the planned discharge date; and
4. As soon as possible, but no later than 30 days after discharge, a comprehensive discharge summary placed in the resident's record and sent to the placing agency. The discharge summary shall review the following:
a. Services provided to the resident;
b. The resident's progress toward meeting service plan objectives;
c. The resident's continuing needs and recommendations, if any, for further services and care;
d. Reasons for discharge and names of persons to whom resident was discharged;
e. Dates of admission and discharge; and
f. Date the discharge summary was prepared and the signature of the person preparing it.
B. When a resident is discharged pursuant to a court order, the case record shall contain a copy of the court order.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
Article 2
Programs and Services
6VAC35-41-830. [Reserved].
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-840. Structured programming.
A. Each facility shall implement a comprehensive, planned, and structured daily routine, including appropriate supervision designed to:
1. Meet the residents' physical and emotional needs;
2. Provide protection, guidance, and supervision;
3. Ensure the delivery of program services; and
4. Meet the objectives of any individual service plan.
B. Each facility shall have goals, objectives, and strategies consistent with the facility's mission and program objectives utilized when working with all residents until the residents' individualized service plans are developed. These goals, objectives, and strategies shall be provided to the residents in writing during orientation to the facility.
C. Residents shall be allowed to participate in the facility's programs, as applicable, upon admission.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-850. Daily log.
A. A daily communication log shall be, in accordance with facility procedures, maintained to inform staff of significant happenings or problems experienced by residents.
B. The date and time of the entry and the identity of the individual making each entry shall be recorded.
C. If the facility records log book-type information on a computer, all entries shall post the date, time, and identity of the person making an entry. The computer shall prevent previous entries from being overwritten.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-860. Individual service plan.
A. An individual service plan shall be developed and placed in the resident's record within 30 days following admission and implemented immediately thereafter. The initial individual service plan shall be distributed to the resident; the resident's family, legal guardian, or legally authorized representative; the placing agency; and appropriate facility staff.
B. Individual service plans shall describe in measurable terms the:
1. Strengths and needs of the resident;
2. Resident's current level of functioning;
3. Goals, objectives, and strategies established for the resident including a behavior support plan, if appropriate;
4. Projected family involvement;
5. Projected date for accomplishing each objective; and
6. Status of the projected discharge plan and estimated length of stay except that this requirement shall not apply to a facility that discharges only upon receipt of the order of a court of competent jurisdiction.
C. Each service plan shall include the date it was developed and the signature of the person who developed it.
D. The service plan shall be reviewed within 60 days of the development of the plan and within each 90-day period thereafter. The individual service plan shall be revised as necessary. Any changes to the plan shall be made in writing. All participants shall receive copies of the revised plan.
E. The resident and facility staff shall participate in the development of the individual service plan.
F. The (i) supervising agency and (ii) resident's parents, legal guardian, or legally authorized representative, if appropriate and applicable, shall be given the opportunity to participate in the development of the resident's individual service plan.
G. Copies of the individual service plan shall be provided to the (i) resident; (ii) parents or legal guardians, as appropriate and applicable, and (iii) the placing agency.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-870. Quarterly reports.
A. Except when a resident is placed in a shelter care program, the resident's progress toward meeting his individual service plan goals shall be reviewed and a progress report shall be prepared within 60 days of the development of the plan and within each 90-day period thereafter and shall review the status of the following:
1. Resident's progress toward meeting the plan's objectives;
2. Family's involvement;
3. Continuing needs of the resident;
4. Resident's progress towards discharge; and
5. Status of discharge planning.
B. Each quarterly progress report shall include the date it was developed and the signature of the person who developed it.
C. All quarterly progress reports shall be distributed to the resident; the resident's family, legal guardian, or legally authorized representative; the placing agency; and appropriate facility staff.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-880. Therapy.
Therapy, if provided, shall be provided by an individual (i) licensed as a therapist by the Department of Health Professions or (ii) who is licensure eligible and working under the supervision of a licensed therapist unless exempted from these requirements under the Code of Virginia.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-890. Community relationships.
A. Opportunities shall be provided for the residents to participate in activities and to utilize resources in the community.
B. In addition to the requirements of 6VAC35-41-290 (background checks for volunteers or interns), written procedures shall govern how the facility will determine if participation in such community activities or programs would be in the residents' best interest.
C. Each facility shall have a staff community liaison who shall be responsible for facilitating cooperative relationships with neighbors, the school system, local law enforcement, local government officials, and the community at large.
D. Each provider shall develop and implement written procedures for promoting positive relationships with the neighbors that shall be approved by the department.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-900. Resident visitation at the homes of staff.
Resident visitation at the homes of staff is prohibited unless written permission from the (i) resident's parent or legal guardian, as applicable and appropriate, (ii) the facility administrator, and (iii) the placing agency is obtained before the visitation occurs. The written permission shall be kept in the resident's record.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
Article 3
Supervision
6VAC35-41-910. Additional assignments of direct care staff.
If direct care staff assume nondirect care responsibilities, such responsibilities shall not interfere with the staff's direct care duties.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-920. Staff supervision of residents.
A. No member of the direct care staff shall be on duty and responsible for the direct care of residents more than six consecutive days without a rest day, except in an emergency. For the purpose of this section, a rest day shall mean a period of not less than 24 consecutive hours during which a staff person has no responsibility to perform duties related to the operation of the facility.
B. Direct care staff shall have an average of at least two rest days per week in any four-week period.
C. Direct care staff shall not be on duty more than 16 consecutive hours, except in an emergency.
D. There shall be at least one trained direct care staff member on duty and actively supervising residents at all times that one or more residents are present.
E. Whenever residents are being supervised by staff there shall be at least one staff person present with a current basic certification in standard first aid and a current certificate in cardiopulmonary resuscitation issued by a recognized authority.
F. The provider shall develop and implement written procedures that address staff supervision of residents including contingency plans for resident illnesses, emergencies, off-campus activities, and resident preferences. These procedures shall be based on the:
1. Needs of the population served;
2. Types of services offered;
3. Qualifications of staff on duty; and
4. Number of residents served.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-930. Staffing pattern.
A. During the hours that residents are scheduled to be awake, there shall be at least one direct care staff member awake, on duty, and responsible for supervision of every 10 residents, or portion thereof, on the premises or participating in off-campus, facility sponsored activities, except that independent living programs shall have at least one direct care staff member awake, on duty, and responsible for supervision of every 15 residents on the premises or participating in off-campus, facility sponsored activities.
B. During the hours that residents are scheduled to sleep there shall be no less than one direct care staff member on duty and responsible for supervision of every 16 residents, or portion thereof, on the premises.
C. There shall be at least one direct care staff member on duty and responsible for the supervision of residents in each building where residents are sleeping. This requirement does not apply to approved independent living programs.
D. On each floor where residents are sleeping, there shall be at least one direct care staff member awake and on duty for every 30 residents or portion thereof.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-940. Outside personnel working in the facility.
A. Facility staff shall monitor all situations in which outside personnel perform any kind of work in the immediate presence of residents in the facility.
B. Adult inmates shall not work in the immediate presence of any resident and shall be monitored in a way that there shall be no direct contact between or interaction among adult inmates and residents.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.