§ 3800.274. Additional requirements.
The following additional requirements apply to facilities in which secure care is provided:
(1) The facility shall have a valid fire safety occupancy approval appropriate for locked facilities from the appropriate authority, listing the type of occupancy, prior to receiving a certificate of compliance under this chapter.
(2) A reportable incident as specified in § 3800.16(a) (relating to reportable incidents) includes a child’s absence from the premises for any period of time, an assault on a staff person by a child that requires medical treatment for the staff person, the use of handcuffs or leg restraints beyond 2 hours, and the use of seclusion beyond 4 hours.
(3) Children shall be directly supervised at all times during awake hours.
(4) A minimum of two child care workers shall be present in the facility at all times.
(5) There shall be one child care worker present with the children for every six children during awake hours.
(6) There shall be one child care worker present with the children for every 12 children during sleeping hours.
(7) Children shall be supervised by conducting observational checks of each child within 15 minute intervals during sleeping hours.
(8) Observational checks of children during sleeping hours shall include actual viewing of each child.
(9) Observational checks of children during sleeping hours shall be recorded in writing noting the date, time, person making the check and any unusual circumstances observed.
(10) The driver and at least one additional staff person shall be present in the vehicle at all times one or more children are being transported. There shall be one child care worker present with the children for every three children during transportation of children either by the facility or another transportation source. The driver of the vehicle may not be counted in the staffing ratio.
(11) No more than two children may share a bedroom.
(12) Glass windows, windows in doors, shower doors and light fixtures and other glass surfaces shall be protected with a secure, nonbreakable covering or composed of shatterproof glass.
(13) Glass mirrors are not permitted.
(14) Furnishings or other items such as drapery cords, electrical outlets, shower curtains, shoe strings, razors and noncollapsing clothing hooks, that may create a risk for self-injury or suicide may not be accessible to a child whose health and safety assessment specified in § 3800.141 (relating to child health and safety assessment) indicates known or suspected suicide or self-injury attempts or gestures or an emotional history which may indicate a predisposition to self-injury or suicide, except during specific activities while these items are in use and the child is under direct supervision by staff persons.
(15) Items such as knives, razors, matches and tools, that may create an opportunity for use as a weapon or tool in an assault or other violent behavior may not be accessible to a child whose health and safety assessment specified in § 3800.141 indicates known incidents of aggressive or violent behavior, except during specific activities while these items are in use and the child is under direct supervision by staff persons.
(16) The following requirements apply to the use of mechanical restraints:
(i) Handcuffs behind the back, leg restraints and locking transportation waist belts with handcuffs in front of the child used during transportation, are the only types of mechanical restraints that are permitted.
(ii) A child may not be handcuffed to an object or another person.
(iii) Oral or written authorization by supervisory staff is required prior to each use of a mechanical restraint, except for those restraints used during transportation.
(iv) The use of handcuffs or leg restraints, except for those used during transportation, may not exceed 2 hours, unless a licensed physician, a licensed physician’s assistant or registered nurse examines the child and gives written orders to continue the use of the restraint. Reexamination and new written orders are required for each 2-hour period the restraint is continued. If a restraint is removed for any purpose other than for movement and reused within 24 hours after the initial use of the restraint, it is considered continuation of the initial restraint.
(v) The restraint shall be checked for proper fit by a staff person at least every 15 minutes, except for those used during transportation.
(vi) The physical needs of the child shall be met promptly.
(vii) Handcuffs and leg restraints, except for those used during transportation, shall be removed completely for at least 10 minutes during every 2 hours the restraint is used.
(viii) Handcuffs and leg restraints, except those used during transportation, shall be checked and observed by a supervisory staff person who is not administering the restraint, at least every 1 hour the restraint is used.
(ix) The use of handcuffs and leg restraints for any child, except those used during transportation, may not exceed 4 hours in any 48-hour period without a written court order.
(17) The following requirements apply to the use of seclusion:
(i) Oral or written authorization by supervisory staff is required prior to each use of seclusion.
(ii) The use of seclusion may not exceed 4 hours, unless a licensed physician, a licensed physician’s assistant or registered nurse examines the child and gives written orders to continue the use of seclusion. Reexamination and new written orders are required for each 4-hour period the seclusion is continued. If seclusion is interrupted for any purpose and reused within 24 hours after the initial use of seclusion, it is considered continuation of the initial seclusion period.
(iii) A staff person shall observe a child in seclusion at least every 5 minutes.
(iv) The physical needs of the child shall be met promptly.
(v) A child in seclusion shall be checked and observed by a supervisory staff person who is not continually observing the child as required in subparagraph (iii), at least every 2 hours the seclusion is used.
(vi) The use of seclusion for any child may not exceed 8 hours in any 48-hour period without a written court order.
(vii) A room used for seclusion shall meet the conditions as specified in § 3800.212(e) (relating to exclusion).
(18) Mechanical restraints and seclusion may not be used simultaneously for any child.
(19) The use of any combination of mechanical restraints and seclusion for any child may not exceed 6 hours in any 48-hour period without a written court order.
Cross References This section cited in 55 Pa. Code § 3800.6 (relating to applicability to specific facility types).
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