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TITLE 26HEALTH AND HUMAN SERVICES
PART 1HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 550LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS
SUBCHAPTER CGENERAL PROVISIONS
DIVISION 1OPERATIONS AND SAFETY PROVISIONS
RULE §550.205Safety Provisions

(a) A center must ensure that the local fire marshal's office inspects the center annually. The center must keep a copy of the annual fire inspection report on file at the center for two years after the date of inspection.

(b) A center must prepare a fire drill plan and conduct a fire drill at least once every month.

  (1) The center's administrator and nursing director must participate in the monthly fire drill.

  (2) The center must conduct fire drills at various times of the day.

  (3) The center must document a drill on a DADS Fire Drill Report Form.

(c) The center's administrator and nursing director must:

  (1) review the center's fire drill plan;

  (2) evaluate the effectiveness of the plan after each fire drill;

  (3) review any problems that occurred during each drill and take corrective action, if necessary; and

  (4) maintain documentation to support the requirements of this subsection.

(d) A center must have a working telephone available at all times at the center. Coin operated telephones or cellular telephones are not acceptable for this purpose. If the center has multiple buildings, a working telephone must be located in each of the buildings.

(e) A center must post at or near the immediate vicinity of all telephones:

  (1) emergency telephone numbers including:

    (A) the DADS abuse, neglect, and exploitation hotline;

    (B) poison control;

    (C) 911 or the local fire department, ambulance, and police in communities where a 911 management system is unavailable; and

    (D) an emergency medical facility; and

  (2) the center's address.

(f) A center must adopt and enforce written policies and procedures for a minor's medical emergency. The policy must include:

  (1) a requirement that each minor has an emergency plan, developed in collaboration with a minor's parent, that:

    (A) includes instructions from a minor's prescribing physician, as applicable;

    (B) includes coordination with other health care providers, including hospice; and

    (C) is updated and reviewed at least yearly or more often as necessary to meet the needs of a minor;

  (2) a requirement that staff receive training for medical emergencies;

  (3) a requirement that staff receive training in the use of emergency equipment; and

  (4) procedures that staff follow when a minor's parent cannot be contacted in an emergency.

(g) If a minor must be transported to an emergency medical facility while at the center, the staff must immediately notify a minor's parent and hospice provider, if applicable. If a parent cannot be contacted, the center must ensure that an individual authorized by the parent or center staff meets a minor at the emergency facility.

(h) The center must prepare a medical emergency transfer form to give to the emergency transportation provider when transporting a minor to an emergency medical facility. The transfer form must include:

  (1) the minor's name and age;

  (2) the minor's diagnoses, allergies, and medication;

  (3) the minor's parent name and contact information;

  (4) the minor's prescribing physician name and contact information;

  (5) the center's name and contact information; and

  (6) the name of the administrator or nursing director.

(i) A center must maintain a first aid kit with unexpired supplies and an automated external defibrillator for minors served at the center that is easily accessible but not within reach of minors.

(j) A center must adopt and enforce written policies and procedures for the verification and monitoring of visitors, including service providers at a center. The policies and procedures must include:

  (1) verification of a visitor's identity;

  (2) verification of a visitor's authorization to enter a center;

  (3) the recording of a visitor's name, organization, purpose of the visit, and the date and time a visitor entered and exited a center;

  (4) the center's awareness of a visitor while in a center; and

  (5) documentation of the requirements in this subsection.

(k) A center must adopt and enforce written policies and procedures for the release of a minor. The policy must include:

  (1) procedures to verify the identity of a person authorized to pick up a minor from the center; and

  (2) procedures for the release of a minor when transported by the center in accordance with Subchapter D of this chapter (relating to Transportation).

(l) A center must adopt and enforce written policies and procedures to ensure that no minor is left unattended at the center. The policy must include procedures for:

  (1) a minor who arrives at the center;

  (2) a minor who remains at the center during operating hours;

  (3) a minor who leaves the center; and

  (4) staff to conduct daily visual checks at the center at the close of business.

(m) A center must maintain daily records and documentation of the visual check at the end of each day to ensure no minor is left at the center. The documentation must include:

  (1) the date and time; and

  (2) the signature of the staff member conducting the daily visual checks at the center at the close of business.

(n) Except as otherwise provided in this section, a center must meet the provisions applicable to the health care occupancy chapters of the 2000 edition of the LSC of the National Fire Protection Association (NFPA) and the requirements in Subchapter E of this chapter (relating to Building Requirements). Roller latches are prohibited on corridor doors.

(o) Notwithstanding any provisions of the 2000 edition of the Life Safety Code, NFPA 101, to the contrary, a center may place alcohol-based hand-rub dispensers at the center if:

  (1) use of alcohol-based hand-rub dispensers does not conflict with any state or local codes that prohibit or otherwise restrict the placement of such dispensers in health care facilities;

  (2) the dispensers are installed in a manner that minimizes leaks and spills that could lead to falls;

  (3) the dispensers are installed in a manner or location out of reach of a minor; and

  (4) the dispensers are installed in accordance with Chapter 18.3.2.7 or Chapter 19.3.2.7 of the 2000 edition of the LSC, as amended by NFPA Temporary Interim Amendment 00-1(101), issued by the Standards Council of the National Fire Protection Association on April 15, 2004.

(p) A center's environment must be free of health and safety hazards to reduce risks to minors. The center must:

  (1) use childproof electrical outlets or childproof covers on unused electrical outlets in all rooms to which minors have access at the center;

  (2) use safety precautions for strings and cords, including those used on window coverings, and keep them out of the reach of minors;

  (3) use safety precautions for all furnishings including cabinets, shelves, and other furniture items that are not permanently attached to the center; and

  (4) use play material and equipment that is safe and free from sharp or rough edges and toxic paints.

(q) A center must adopt and enforce a written policy describing whether a center is a weapons-free location. A center must:

  (1) provide a copy of the policy to staff, individuals providing services on behalf of a center, an adult minor, and a minor's parent; and

  (2) provide a copy of the policy to any person who requests it.

(r) If a center is weapons-free, a center must post a visible and readable sign at the entrance of the center indicating the center is a weapons-free location.

(s) A center must adopt and enforce a written policy prohibiting the use of tobacco in any form, the use of alcohol, and the possession of illegal substances and potentially toxic substances at a center.


Source Note: The provisions of this §550.205 adopted to be effective September 1, 2014, 39 TexReg 6569; transferred effective May 1, 2019, as published in the Texas Register April 12, 2019, 44 TexReg 1875

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