| (a) This applies to all three-person and four-person
residences and host home/companion care settings, unless otherwise
specified.
(b) A program provider must ensure that:
(1) the residence, neighborhood, and community meet
the needs of the individual and provide an environment that ensures
the health, safety, and welfare of the individual;
(2) the home is modified to meet the specific adaptive
needs of the individual;
(3) adaptive equipment is functional for the individual
or, if the equipment is not functional, the provider has documented:
(A) the broken equipment;
(B) the order date of new or replacement equipment;
(C) the date of the new or replacement equipment installment;
and
(D) alternative strategies used during the interim;
(4) mattresses are off the floor and a mattress cover
is utilized unless contraindicated and documented by the service planning
team;
(5) home furnishings are safe and fit for use;
(6) the home is clean and sanitary;
(7) the home is free of infestations including bugs,
rodents, and other pests;
(8) the walls, ceilings, floors, and windows are in
good condition and not hazardous to the individual;
(9) the bathrooms are functional and safe to use;
(10) there is hot water available at sinks and in bathing
facilities;
(11) the temperature of the hot water at sinks and
bathing facilities does not exceed 120 degrees Fahrenheit unless the
program provider, in accordance with subsection (c) of this section,
conducts a competency-based skills assessment showing that all individuals
in the residence can independently regulate the temperature of the
hot water from the sinks and bathing facilities;
(12) the major home appliances are in working order,
including kitchen appliances and heating and cooling systems;
(13) the individual's bedroom door has a lock that:
(A) is operable by the individual;
(B) only the individual, a roommate of the individual
if applicable, and staff designated by the program provider have keys
to the individual's bedroom door; and
(C) is not purchased and installed at the individual's
or LAR's expense;
(14) the individual does not require a lock if:
(A) the individual lives in a host home/companion care
setting and the service provider is the LAR; or
(B) there is a documented modification in the individual's
person-directed plan;
(15) household cleaners and chemicals are stored securely;
(16) perishable foods are refrigerated or stored safely;
(17) animals and pets are kept free of disease and
vaccinated as required by Texas Health and Safety Code, Chapter 826;
and
(18) the interior and exterior of the home:
(A) is free of accumulation of waste and trash;
(B) is accessible and free of hazards to an individual;
and
(C) does not compromise the health or safety of an
individual.
(c) If the program provider conducts the competency-based
skills assessment described in subsection (b)(11) of this section:
(1) the assessment must:
(A) be conducted by a staff member who is not a service
provider of residential support, supervised living, or host home/companion
care who works or lives in the residence;
(B) be conducted for each individual;
(C) evaluate the individual's cognitive and physical
ability to independently mix or regulate the hot water temperature
without assistance or guidance from each sink and bathing facility
in the residence; and
(D) be based on a face-to-face demonstration by the
individual; and
(2) the program provider must:
(A) complete the assessment at least annually;
(B) document the results of the assessment; and
(C) keep a copy of the results in the residence.
(d) The program provider must ensure that each residence
has:
(1) exterior doors that are unobstructed and accessible
to all individuals living in the residence;
(2) two means of escape from the residence;
(3) two means of escape from an individual's bedroom,
unless the program provider has a fire sprinkler system that is checked
and maintained according to Texas Insurance Code, Chapter 6003, at
which point there can be one means of escape from an individual's
bedroom;
(4) working smoke alarms in each bedroom and immediately
outside the bedrooms; and
(5) fire extinguishers that are:
(A) accessible and unobstructed to the service provider;
(B) on each level of the home;
(C) serviced or replaced after each use; and
(D) if unused, serviced according to the manufacturer's
instructions, or as required by the state or local fire marshal.
(e) The program provider, as it relates to fire drills,
must:
(1) conduct at each residence at least:
(A) one fire drill every 90 days;
(B) four fire drills every 365 days; and
(C) two of the fire drills listed in subparagraph (B)
of this paragraph must be conducted during sleeping hours;
(2) ensure that each staff member participates in a
fire drill within 90 days of hire and at least annually thereafter;
(3) ensure that the staff member can explain the emergency
plans for the residence;
(4) provide training for a staff member who does not
follow the emergency plan during the fire drill; and
(5) revise the emergency plan to ensure the individual
can exit the residence safely if the individual is unable to exit
the home according to the emergency plan.
(f) The program provider, as it relates to emergency
plans, must:
(1) ensure that a staff member reviews the emergency
plans for each individual at a residence before providing services;
(2) instruct staff members on where to locate the emergency
plans at the residence; and
(3) maintain documentation related to emergency preparedness
accessible to staff members at the residence, including:
(A) emergency plans that address:
(i) the relevant emergencies given the geographic location;
(ii) the needs of the individuals living in the residence;
and
(iii) fire drill responses; and
(B) emergency numbers publicly posted in an area of
the residence that is easily accessible to staff members.
(g) A program provider must implement and maintain
personnel practices that safeguard individuals against infectious
and communicable diseases, which includes:
(1) using standard precautions in the care of all individuals,
including hand hygiene and maintaining a sanitary environment to avoid
sources and transmission of infections;
(2) creating written policies for the prevention and
control of communicable diseases among employees and individuals,
including the appropriate use of transmission-based precautions and
protective measures the program provider must take if an employee
contracts a communicable disease; and
(3) revising a policy or practice if a shortcoming
is identified.
(h) A program provider must implement and maintain
medication administration and storage practices that safeguard an
individual's medication, which includes:
(1) creating written policies for preventing unauthorized
access to medications;
(2) using a procedure that ensures safe medication
administration to the individual;
(3) ensuring staff are trained and knowledgeable about
the individuals' medications;
(4) ensuring staff who are administering medications
have been trained and delegated by a registered nurse (RN);
(5) maintaining accurate, current, and accessible documentation
of medication administration; and
(6) revising a policy or practice if a shortcoming
is identified.
(i) A program provider must comply with the requirements
in this subsection regarding a four-person residence.
(1) Before providing residential support in a four-person
residence, the program provider must:
Cont'd... |
