AUTHORITY: Implementing and authorized by the Community Living Facilities Act [210 ILCS 35].
SOURCE: Emergency rules adopted at 6 Ill. Reg. 379, effective January 1, 1982, for a maximum of 150 days; adopted at 6 Ill. Reg. 6226, effective May 19, 1982; codified at 8 Ill. Reg. 19476; amended at 8 Ill. Reg. 24706, effective December 7, 1984; emergency amendment at 17 Ill. Reg. 9117, effective June 7, 1993, for a maximum of 150 days; amended at 17 Ill. Reg. 19509, effective November 1, 1993; emergency amendments at 20 Ill. Reg. 456, effective January 1, 1996, for a maximum of 150 days; emergency expired May 29, 1996; amended at 20 Ill. Reg. 9982, effective July 15, 1996; amended at 22 Ill. Reg. 3919, effective February 13, 1998; amended at 23 Ill. Reg. 993, effective January 15, 1999; amended at 24 Ill. Reg. 17182, effective November 1, 2000; amended at 26 Ill. Reg. 11982, effective July 31, 2002; emergency amendment at 27 Ill. Reg. 7953, effective April 30, 2003, for a maximum of 150 days; emergency expired September 26, 2003; amended at 27 Ill. Reg. 18183, effective November 12, 2003; amended at 31 Ill. Reg. 192, effective December 21, 2006 ; emergency amendment at 44 Ill. Reg. 19038, effective November 19, 2020, for a maximum of 150 days; emergency rule expired April 17, 2021; emergency amendment at 45 Ill. Reg. 450, effective December 18, 2020, for a maximum of 150 days; emergency amendment to emergency rule at 45 Ill. Reg. 2123, effective January 27, 2021, for the remainder of the 150 days; emergency rule as amended expired May 16, 2021; emergency amendment at 45 Ill. Reg. 5619, effective April 18, 2021, for a maximum of 150 days; emergency expired September 14, 2021; emergency amendment at 45 Ill. Reg. 6744, effective May 17, 2021, for a maximum of 150 days; emergency expired October 13, 2021; emergency amendment at 45 Ill. Reg. 12041, effective September 15, 2021, for a maximum of 150 days; emergency amendment to emergency rule at 45 Ill. Reg. 14647, effective November 5, 2021, for the remainder of the 150 days; emergency expired February 11, 2022; emergency amendment at 45 Ill. Reg. 13750, effective October 14, 2021, for a maximum of 150 days; emergency expired March 12, 2022; emergency amendment at 46 Ill. Reg. 3347, effective February 12, 2022, for a maximum of 150 days; emergency expired July 11, 2022; emergency amendment at 46 Ill. Reg. 5384, effective March 13, 2022, for a maximum of 150 days; emergency expired August 9, 2022; emergency amendment at 46 Ill. Reg. 13485, effective July 15, 2022, for a maximum of 150 days; emergency expired December 11, 2022; emergency amendment to emergency rule at 46 Ill. Reg. 16488, effective September 19, 2022, for the remainder of the 150 days; emergency expired December 11, 2022; emergency amendment to emergency rule at 46 Ill. Reg. 18305, effective October 31, 2022, for the remainder of the 150 days; emergency expired December 11, 2022; emergency amendment at 46 Ill. Reg. 20341, effective December 12, 2022, for a maximum of 150 days; emergency expired May 10, 2023; amended at 47 Ill. Reg. 17196, effective November 1, 2023; Subchapter c recodified at 49 Ill. Reg. 2553.
SUBPART A: GENERAL PROVISIONS
Section 370.110 General Requirements
a) These Minimum Standards, Rules and Regulations apply to the operator/licensee of facilities licensed and classified to provide community living care.
b) The license issued to each operator/licensee shall designate that the license is for the operation of a Community Living Facility and shall include the following: the licensee's name, facility name, address, the number of beds authorized for that facility, the date the license was issued and the expiration date. Such licenses shall be issued for a period not to exceed one (1) year.
c) The operator shall not admit residents in excess of the licensed capacity of the facility.
d) A community living facility shall not use in its title or description "Hospital," "Sanitarium," "Sanatorium," "Rehabilitation Center," "Skilled Nursing Facility," or any other word or description in its title or advertisements which indicates that a type of service is provided by the facility which the facility is not licensed to provide or in fact, does not provide.
e) The licensee shall give sixty (60) days notice prior to voluntarily closing a facility. Such notice shall be given to the Department, to any residents who must be transferred or discharged, to the resident's representative, and to a member of the resident's family, where practicable. Notice shall state the proposed date of closing and the reason for closing. The licensee shall offer to assist the resident in securing an alternative placement and shall advise the resident on available alternatives. Where the resident is unable to choose an alternate placement and is not under guardianship, the Department shall be notified of the need for relocation assistance. The facility shall comply with all applicable laws and regulations until the date of closing, including those related to transfer or discharge of residents.
Section 370.120 Application for License
a) Any person acting individually or jointly with other persons who proposes to build, own, establish, or operate a community living facility, shall submit pre-application information on forms provided by the Department. The Department shall be furnished a written description of the proposed program to be provided, and other such information as it may require. The pre-application form and other required information shall be submitted and approved prior to surveys of the physical plant or review of building plans and specifications.
b) Application for a license to establish or operate a community living facility, shall be made in writing and submitted, with other such information as the Department may require, on forms provided by the Department.
c) All applications shall be accompanied by an application fee of two hundred ($200) dollars.
d) The license is not transferable. It is issued to a specific licensee and for a specific location. The license and the valid current renewal certificate immediately becomes void and shall be returned to the Department when the facility is sold, or leased; or when operation is discontinued; or when operation is moved to a new location; or when the licensee (if an individual) dies; or when the licensee (if a corporation or partnership) dissolves or terminates; or when the licensee (whatever the entity) ceases to be.
e) A license issued to a corporation shall become null, void and of no further effect upon the dissolution of the corporation or loss of license to conduct business in the State of Illinois issued by Illinois Secretary of State if a foreign corporation.
Section 370.130 Licensee
a) The licensee is responsible for meeting the licensing requirements. The licensee does not have to own the building being used.
b) If the licensee does not own the building, a lease or management agreement between the licensee and the owner of the building is required. A copy of the lease or management agreement shall be furnished to the Department. The Department shall also be provided with copies of all new lease agreements and any changes to existing agreements within thirty (30) days of the effective date of such changes.
c) If the licensee is not a corporation or a political subdivision of the State of Illinois, each person responsible for the operation of the facility and upon whom rests the responsibility for meeting the licensing Minimum Standards, Rules shall be at least eighteen (18) years of age.
d)
1) As a condition of the issuance or renewal of the license of a community living facility the applicant or licensee shall file a statement of ownership, which shall be public information and which shall be available from the Department. The Statement of Ownership shall include: the name, address, telephone number, occupation, or business activity, business address and business telephone number of the person who is the owner of the community living facility and every person who owns the building in which the community living facility is located, if other than the owner of the community living facility; the name of every partner and stockholder of the owner if the owner is a partnership or corporation; and, the address if any facility, wherever located, any financial interest in which is owned by the applicant or licensee, if the facility were required to be licensed if it were located in this State.
2) The applicant shall have on file with the Department for all entities in the chain of ownership of the facility a copy of the Certificate of Incorporation if a domestic corporation, the Certificate of Incorporation and the Certificate of Authority to conduct business in Illinois if a foreign corporation, the signed partnership (if any) if a partnership, the Trust Agreement if a trust and a copy of any lease or management agreement not provided in accordance with Section 370.130(b). The Department shall be provided with copies of any amendments to these documents within thirty (30) days of the effective date of such amendments.
Section 370.140 Issuance of an Initial License for a New Facility
a) Upon receipt and review of an application for a license and inspection of the applicant facility, the Director shall issue a probationary license if the facility is in substantial compliance with the Act and these regulations.
b) A probationary license shall expire six (6) months from date of issuance.
c) The Department shall conduct an investigation of the applicant within thirty (30) days of the termination of the probationary license to determine whether or not the applicant then complies. If in compliance, the probationary license will be replaced with a regular license. If not in compliance, the Department will allow the probationary license to expire.
d) Prior to actual receipt by the operator of the license certificate, the operator may begin operation upon receipt of written approval by the Department.
Section 370.150 Issuance of an Initial License Due to a Change of Ownership
a) Upon receipt and review of an application for a license the Director shall issue a probationary license if the facility is in substantial compliance with the Act and these regulations.
b) Whenever ownership of a facility is transferred from the person named in a license to any other person, the transferee shall obtain a new probationary license. The transferee shall notify the Department of the transfer and apply for a new license at least thirty (30) days prior to final transfer.
c) The license granted to the transferee shall be subject to any plan of correction submitted by the previous owner and approved by the Department.
d) The Department will issue a probationary license for a period of six (6) months from date of issuance if the facility is in substantial compliance with all applicable statutes and rules.
e) The Department shall conduct an investigation of the applicant within thirty (30) days of the termination of the probationary license to determine whether or not the applicant then complies except as otherwise determined in Section 9(3) of the Act. If in compliance, the probationary license will be replaced with a regular license. If not in compliance the Department will allow the probationary license to expire.
f) The issuance date of the probationary license to the new owner will be the date the last licensure requirement is met as determined by the Department. Prior to actual receipt by the operator of the license certificate, the operator may begin operation upon receipt of written approval by the Department.
Section 370.160 Issuance of a Renewal License
At least 120 days, but not more than 150 days, prior to license expiration, the licensee shall submit an application for renewal of the license in such form and containing such information as the Department requires. If the Department determines that the community living facility is in substantial compliance with the Act and this Part, and has provided to the Department an accurate disclosure document in accordance with the Alzeheimer's Special Care Disclosure Act [220 ILCS 4], if applicable (see Section 370.165 of this Part), the Department shall renew the regular license for another one-year period. (Section 9 of the Act)
(Source: Amended at 23 Ill. Reg. 993, effective January 15, 1999)
Section 370.165 Alzheimer's Special Care Disclosure
A facility that offers to provide care for persons with Alzheimer's disease through an Alzheimer's special care unit or center shall disclose to the Department or to a potential or actual client of the facility the following information in writing on request of the Department or client:
a) The form of care or treatment that distinguishes the facility as suitable for persons with Alzheimer's disease;
b) The philosophy of the facility concerning the care or treatment of persons with Alzheimer's disease;
c) The facility's pre-admission, admission, and discharge procedures;
d) The facility's assessment, care planning, and implementation guidelines in the care and treatment of persons with Alzheimer's disease;
e) The facility's minimum and maximum staffing ratios, specifying the general licensed health care provider to client ratio and the trainee health care provider to client ratio;
f) The facility's physical environment;
g) Activities available to clients at the facility;
h) The role of family members in the care of clients at the facility; and
i) The costs of care and treatment under the program or at the center. (Section 15 of the Alzheimer's Special Care Disclosure Act)
(Source: Added at 23 Ill. Reg. 993, effective January 15, 1999)
Section 370.170 Denial or Revocation
a) A license may be denied or revoked for any of the following reasons:
1) Cruelty or indifference to residents.
2) Unlawful appropriation or conversion of the property of a resident.
3) Committing, permitting, aiding, or abetting the commission of any illegal act in the facility.
4) Substantial or repeated failure to operate or conduct the facility in accordance with the Act and the Minimum Standards promulgated pursuant thereto.
5) Submits false information either on Department Licensure Form or during an inspection.
6) Securing the devise or bequest of the property of a resident by undue influence.
7) In the case of an application by an existing licensee for a new or newly-acquired facility, substantial, continuing or repeated failure of the applicant to operate any previously licensed facility or facilities in compliance with the provisions of the Act or of the Minimum Standards promulgated pursuant to it.
8) The inclusion of a person in the ownership or management of the facility who was previously or is currently involved in the ownership or operation of a facility which was/is continually or repeatedly operated in substantial non-compliance with the provisions of the Act or of the Minimum Standards promulgated pursuant to it.
9) Refusing to allow an inspection to occur.
10) Violates the rights of its residents.
11) Fails to submit or implement a plan of correction within the specified time period.
b) Notice under this section shall include a clear and concise statement of the violations on which the nonrenewal or revocation is based, the statute or rule violated and notice of opportunity for a hearing.
c) If a facility desires to contest the denial or revocation of a license, the facility shall, within fifteen (15) days after receipt of notice under Section 370.170(b) of this Section, notify the Department in writing of its request for a hearing. Upon receipt of the request the Department shall send notice to the facility and hold a hearing pursuant to the Department's "Rules of Practice and Procedure in Administrative Hearings" (77 Ill. Adm. Code 100).
d) The effective date of nonrenewal or revocation of a license by the Department shall be any of the following:
1) Until otherwise ordered by the circuit court, revocation is effective on the date set by the Department in the notice of revocation, or upon final decision after hearing.
2) Until otherwise ordered by the circuit court, nonrenewal is effective on the date of expiration of any existing license, or upon final decision after hearing.
3) The Department may extend the effective date of license revocation or expiration in any case in order to permit orderly removal and relocation of residents.
Section 370.180 Experimental Program Conflicting With Requirements
Any facility desiring to conduct an experimental program or do research which is in conflict with these regulations shall submit a written request to the Department and secure prior approval. The Department shall not approve experimental programs which violate residents' rights under the Act.
Section 370.190 Inspections
All facilities to which these regulations apply shall be subject to surveys by properly identified personnel of the Department, or by such other properly identified persons, including local health department staff, as the Department may designate. The licensee, or person representing the licensee in the facility, shall afford the representative of the Department every reasonable opportunity for examining the records, the premises, and obtaining information required in administration of the "Community Living Facilities Licensing Act" (77 Ill. Adm. Code 370).
Section 370.200 Information to Be Made Available to the Public By the Licensee
a) Every facility shall conspicuously post or display in an area of it accessible to residents, employees, and visitors the following:
1) Its current license;
2) A copy of any final order pertaining to the facility issued by the Department or a court; and
b) A facility shall retain the following for public inspection:
1) A complete copy of every inspection report of the facility received from the Department during the past five (5) years;
2) A copy of every order pertaining to the facility issued by the Department or a court during the past five (5) years;
3) A description of the services provided by the facility and the rates charged for those services and items for which a resident may be separately charged;
4) A copy of the Statement of Ownership required by Section 7-(6) of the "Community Living Facilities Licensing Act"; and
5) A list of all personnel employed or retained by the facility who are licensed, certified or registered by the Department of Registration and Education.
Section 370.210 Ownership Disclosure
a) As a condition of the issuance or renewal of the license of any facility, the applicant shall file a statement of ownership.
b) A statement of ownership shall include the following:
1) The name, address, Social Security Number, telephone number, occupation or business activity, business address, business telephone number and the percent of financial interest of the person(s) who is the owner of the legal entity designated as the operator/licensee of the facility which is the subject of the application or license;
2) The name, address, Social Security Number, telephone number, occupation or business activity, business address, business telephone number and the percent of financial interest of the person(s) who is the owner of the legal entity that owns the building in which the operator/licensee is operating the facility which is the subject of the application or license; and
3) The address of any facility, wherever located, owned by the applicant or licensee, if the facility were required to be licensed if it were located in Illinois.
Section 370.220 Variances
a) The Department may, at its discretion, grant a variance to a specific standard set forth in these Regulations when the owner or licensee of a community living facility makes a request for such variance supported by documentation showing that the alternative designs, methods and practices proposed or now in existence will provide equivalent protection of the health, safety, and welfare of the facility's residents to that protection which would prevail under the promulgated standard. Waivers currently in effect will remain in effect until their expiration date.
b) Requests for a variance shall be directed to the Chief of the Division of Health Facilities Surveillance where they will be considered on an individual case basis. The Division shall notify the facility of any additional conditions necessary for the protection of the health, welfare and safety of the facility's residents. The conditions imposed may include mandatory means which will provide the effective equivalent of compliance. Upon occurrence of such additional conditions by the facility, such conditions imposed will be incorporated into and become a part of the variance.
c) In granting or denying any request for a variance, the Division will consider the following:
1) The health, welfare and safety of the residents;
2) The licensee's record of compliance with governing statutes and regulations;
3) The quality of resident care and safety that may be provided if the variance is granted;
4) The efforts exerted by the facility to comply with the standard;
5) Expense; and
6) Precedent.
d) Any variance granted by the Department may be for a specific period of time or for an indefinite period of time.
1) If granted for a specific period of time, the variance shall state when the variance shall expire, and shall also state whether or not a request for a continuation of the variance will be considered by the Department prior to the expiration of the initial variance.
2) If granted for an indefinite period of time, the variance shall so state and shall also describe the procedures under which the Department may revoke the variance and the reasons why such action might be taken by the Department.
3) The Department may revoke any variance at any time upon determination that the continuation of the variance poses a threat to the health, welfare or safety of residents.
Section 370.230 Alcoholism Treatment Programs In Community Living Facilities
Alcoholism treatment programs shall not be established in community living facilities.
Section 370.240 Definitions
Each definition is considered to be a separate rule, but they are not given individual numbers because they are listed alphabetically, and numbers would have to be changed each time a new definition was added or deleted.
"Abuse" – as defined by The Abused and Neglected Long Term Care Facility Residents Reporting Act (Ill. Rev. Stat., ch. 111½, par. 4163).
"Access" – the right to:
Enter any facility;
Communicate privately and without restriction with any resident who consents to the communication;
Seek consent to communicate privately and without restriction with any resident;
Inspect the clinical and other records of a resident with the express written consent of the resident;
Observe all areas of the facility except the living area of any resident who protests the observation.
"Act" – as used in these standards, the "Community Living Facilities Licensing Act."
"Activity Program" – a specific planned program of varied group and individual activities geared to the individual resident's needs and available for a reasonable number of hours each day.
"Adaptive Behavior" – the effectiveness or degree with which the individual meets the standards of personal independence and social responsibility expected of his/her age and cultural group.
"Addition" – any construction attached to the original building which increases the area or cubic content of the building.
"Adequate" – enough in either quantity or quality, as determined by a reasonable person familiar with the professional standards of the subject under review, to meet the needs of the residents of a facility under the particular set of circumstances in existence at the time of review.
"Adult" – A person eighteen (18) years or older.
"Advocate" – a person who represents the rights and interests of an individual as though they were the person's own, in order to realize the rights to which the individual is entitled, obtain needed services, and remove barriers to meeting the individual's needs.
"Aide or Orderly" – any person providing direct personal care, training and/or habilitation services to residents.
"Alteration" – any construction change or modification of an existing building which does not increase the area or cubic content of the building.
"Ambulatory Resident" – a person who is physically and mentally capable of walking without assistance, or is physically able with guidance to do so, including the ascent and descent of stairs.
"Applicant" – Any person, agency, association, corporation, partnership or organization making application for a license.
"Appropriate Programming" – term used to indicate programming which meets each resident's individual needs commensurate with his functioning level.
"Assessment" – the use of an objective system with which to evaluate the physical, social, developmental, behavioral, psychosocial, etc., aspects of an individual.
"Audiologist" – a person who is certified or is eligible for a certificate of clinical competence in audiology granted by the American Speech and Hearing Association under its requirements in effect on the publication of this provision or meets the educational requirements for certification, and is in the process of accumulating the supervised experience required for certification.
"Basement" – when used in these regulations means any story or floor level below the main or street floor. Where due to grade difference, there are two levels each qualifying as a street floor, a basement is any floor below the level of the two street floors. Basements shall not be counted in determining the height of a building in stories.
"Behavior Modification" – treatment to be used to establish or change behavior patterns.
"Community Alternatives" – service programs in the community provided as an alternative to institutionalization.
"Community Living Facility" – see Facility, Community Living.
"Corporal Punishment"-painful stimuli inflicted directly upon the body.
"Cruelty and Indifference to Welfare of the Resident"-failure to provide a resident with the care and supervision he requires; or, the infliction of mental or physical abuse. Examples of physical abuse are restraining a resident, striking, slapping, hitting, or withholding food as punishment. Examples of mental abuse are swearing, threatening and placing the resident in seclusion.
"Department" – as used in these standards means the Illinois Department of Public Health.
"Developmental Disability" – as defined by Ill. Rev. Stat. 1979, ch. 91 1/2, par. 1-106, as amended.
"Developmentally Disabled" – those individuals who have a developmental disability.
"Dietitian" – a person who:
is eligible for registration by the American Dietetic Association; or
has a baccalaureate degree with major studies in food and nutrition, dietetics, and food service management, has one (1) year of supervisory experience in the dietetic service of a health care institution, and participates annually in continuing dietetic education.
"Direct Supervision" – means that work is performed under the guidance and direction of a supervisor who is responsible for the work, who plans work and methods, who is available on short notice to answer questions and deal with problems that are not strictly routine, who regularly reviews the work performed, and who is accountable for the results.
"Director" – the director of public health.
"Discharge" – the full release of any resident from a facility.
"Emergency" – a situation, physical condition or one or more practices, methods or operations which present imminent danger of death or serious physical or mental harm to residents of a facility.
Existing Community Living Facility – any facility initially licensed as a health care facility or approved for construction by the Department or any facility initially licensed or operated by any other agency of the State of Illinois prior to January 1, 1982. Existing facilities shall meet the design and construction standards for existing Community Living Facilities.
"Facility, Community Living" – a transitional residential setting which provides guidance, supervision, training and other assistance to ambulatory, mildly and moderately developmentally disabled adults with the goal of eventually moving these persons to more independent living arrangements. Residents are required to participate in day activities, such as vocational training, sheltered workshops or regulate employment. A community living facility shall not be a nursing or medical facility and shall house no more than 20 residents, excluding staff, except as provided for in Section 18 of the "Community Living Facilities Licensing Act," approved September 23, 1981, as amended by Public Act 82-745.
"Financial Responsibility" – sufficient assets to provide adequate services such as: staff, heat, laundry, foods, supplies, and utilities for at least a two (2) month period of time.
"Food Service Sanitation Rules and Regulations" – The following definitions are to be used with the "Rules and Regulations for Food Service Sanitation" (77 Ill. Adm. Code 750) as contained in Section 370.1460 of this Part.
"Closed" means without openings large enough for the entrance of insects. An opening of 1/32 inch or less is closed.
"Corrosion-resistant materials" means those materials that maintain their original surface characteristics under prolonged influence of the food to be contacted, the normal use of cleaning compounds and bactericidal solutions, and other conditions of the use environment.
"Easily cleanable" means that surfaces are readily accessible and made of such material and finish and so fabricated that residue may be effectively removed by normal cleaning methods.
"Equipment" means stoves, ranges, hoods, slicers, mixers, meatblocks, tables, counters, refrigerators, sinks, dishwashing machines, steam tables, and similar items other than utensils, used in the operation of a food service establishment.
"Food" means any raw, cooked, or processed edible substance, beverage or ingredients including ice used or intended for use or for sale in whole or in part for human consumption.
"Food contact surfaces" means those surfaces or equipment and utensils with which food normally comes in contact and those surfaces with which food may come in contact and drain back into food or onto surfaces normally in contact with food.
"Kitchenware" means all multi-use utensils other than tableware.
"Packaged" means bottled, canned, cartoned, or securely wrapped.
"Potentially hazardous food" means any food that consists in whole or in part of milk or milk products, eggs, meat, poultry, fish, shellfish, edible crustacea, or other ingredients, including synthetic ingredients, and which is capable of supporting rapid progressive growth of infectious or toxigenic microorganisms. This term does not include clean, whole, uncracked, odor-free shell eggs.
"Safe" means materials manufactured from or composed of materials that are not food additives or color additives as defined in Section 201(s) or (t) of the "Federal Food, Drug and Cosmetic Act" (21 U.S.C. 352 et seq.) as used, or are food additives or color additives so defined and are used in conformity with regulations established pursuant to Section 409 or Section 706 of that Act.
"Sealed" means free of cracks or other openings that permit the entry or passage of moisture.
"Single service articles" means cups, containers, lids, closures, plates, knives, forks, spoons, stirrers, paddles, straws, napkins, wrapping materials, toothpicks, and similar articles designed for one-time, one-person use and then discarded.
"Tableware" means multi-use eating and drinking utensils used or designed for direct use by the food consumer.
"Utensil" means any implement (knives, forks, spoons, tongs, spatulas, scoops, pots and pans, etc.) used in the storage, preparation, transportation, or service of food.
"Goal" – an expected result or condition that involves a relatively long period of time to achieve, that is specified in behavioral terms in a statement of relatively broad scope, and that provides guidance in establishing specific, short-term objectives directed toward its attainment.
"Habilitation" – an effort directed toward the alleviation of a disability or toward increasing a person's level of physical, mental, social or economic functioning. Habilitation may include, but is not limited to, diagnosis, evaluation, medical services, residential care, day care, special living arrangements, training, education, sheltered employment, protective services, counseling and other services.
"Habilitation Plan" – a written plan directed toward the alleviation of a disability or toward increasing a person's level of physical, mental, social or economic functioning.
"House Manager" – a qualified person on duty forty (40) hours a week managing the Community Living Facility and responsible for its operation and its inhabitants.
"Individual Educational Program (IEP)" – a written statement for each resident that provides for specific education and related services. The Individual Educational Program may be incorporated into the Individual Habilitation Plan (IHP).
"Individual Habilitation Plan (IHP)" – a total plan of care that is developed by the interdisciplinary team for each resident, and that is developed on the basis of all assessment results.
"Institutional Occupancy" – when used in these regulations means Health Care Facilities, Group (a), as defined in Chapter 10, paragraph 10-0001 of the Life Safety Code, National Fire Protection Association (1967 Edition).
"License" – either probationary or regular as defined in the "Community Living Facilities Licensing Act."
"Licensed Practical Nurse" – a person who is licensed to practice practical nursing under the "Illinois Nursing Act," as now or hereafter amended.
"Licensee" – A person, agency, association, corporation, partnership, or organization which has been issued a license to operate a community living facility.
"Maladaptive Behavior" – impairment in adaptive behavior as determined by a clinical psychologist or by a physician. Impaired adaptive behavior may be reflected in delayed maturation, reduced learning ability or inadequate social adjustment.
"Mental Retardation" – as defined by Ill. Rev. Stat. 1979, ch. 91½, par. 1-116.
"Misappropriation of Property" – using a resident's cash, clothing, or other possessions without authorization by the resident or the resident's authorized representative; failure to return valuables after a resident's discharge; or failure to refund money after death or discharge when there is an unused balance in the resident's personal account.
"Neglect" – as defined by Ill. Rev. Stat., ch. 111½, par. 4163.
"New Community Living Facility" – any facility initially licensed as a health care facility by the Department on or after January 1, 1982. New facilities shall meet the design and construction standards for new Community Living Facilities.
"Normalization" – the principle of helping individuals to obtain an existence as close to normal as possible, by making available to them patterns and conditions of everyday life that are as close as possible to the norms and patterns of the mainstream of society.
"Nurse" – see Registered Nurse or Licensed Practical Nurse.
"Objective" – an expected result or condition that involves a relatively short period of time to achieve, that is specified in behavioral terms, and that is related to the achievement of a goal.
"Occupational Therapist, Registered (OTR)" – a person who: is a graduate of an occupational therapy curriculum accredited jointly by the Council on Medical Education of the American Medical Association and the American Occupational Therapy Association; or is eligible for certification by the American Occupational Therapy Association.
"Occupational Therapy Assistant" – a person who is eligible for certification as a certified occupational therapy assistant (COTA) by the American Occupational Therapy Association.
"Operator" – the person responsible for the control, maintenance and governance of the facility, its personnel and physical plant.
"Oversight" – general watchfulness and appropriate action to meet the total needs of the residents, exclusive of nursing or personal care. Oversight shall include, but is not limited to, social, recreational and employment opportunities for residents who, by reason of mental disability, or in the opinion of a licensed physician, are in need of residential care.
"Owner" – the individual, partnership, corporation, association or other person who owns a facility. In the event a facility is operated by a person who leases the physical plant, which is owned by another person, "Owner" means the person who operates the facility, except that if the person who owns the physical plant is an affiliate of the person who operates the facility and has significant control over the day-to-day operations of the facility, the person who owns the physical plant shall incur jointly and severally with the owner all liabilities imposed on an owner under the Act.
"Person" – any individual, partnership, corporation, association, municipality, political subdivision, trust, estate or other legal entity whatsoever.
"Person in Need of Mental Treatment" – any person who is mentally ill and who, because of his or her illness, is reasonably expected to inflict serious physical harm upon him or herself or another in the near future or is unable to provide for his or her basic physical needs so as to guard him or herself from serious harm.
"Personal Care" – assistance with meals, dressing, movement, bathing, or other personal needs, or general supervision and oversight of the physical and mental well-being of an individual, exclusive of nursing.
"Pharmacist, Registered" – a person who is registered to practice pharmacy under the "Pharmacy Practice Act" (Ill. Rev. Stat. 1979 ch. 111, par. 4001 et seq.) as now or hereafter amended.
"Physician" – any person licensed by the State of Illinois to practice medicine in all its branches as provided in the "Medical Practice Act" (Ill. Rev. Stat. 1979, ch. 111, pars. 4401 et seq.).
"Probationary License" – an initial license issued for a period not to exceed six (6) months.
"Program Coordinator" – a qualified person directly responsible for the overall program, operation and management of a Community Living Facility.
"Psychiatrist" – a physician who has had at least three (3) years of formal training or primary experience in the diagnosis and treatment of mental illness.
"Psychologist" – a person who is registered with the Illinois Department of Registration and Education to practice clinical psychology.
"Qualified Mental Retardation Professional" – a person who is:
• an educator with a degree in education from an accredited program and with specialized training or one (1) year of experience in working with the mentally retarded; or
• a physical or occupational therapist who has specialized training or one (1) year of experience in treating the mentally retarded; or
• a physician licensed by the State of Illinois to practice medicine or osteopathy and with specialized training or one (1) year of experience in treating the mentally retarded; or . a psychologist registered with the State of Illinois Department of Registration and Education in accordance with the "Psychologist's Registration Act" (Ill. Rev. Stat. 1979, ch. 111, pars. 5301 et seq.) and with specialized training or one (1) year of experience in treating the mentally retarded; or
• a registered nurse with a valid current Illinois registration to practice as a registered professional nurse who has specialized training or one (1) year of experience in treating the mentally retarded; or
• a speech pathologist or audiologist who has specialized training or one (1) year of experience in treating the mentally retarded; or
• a registered social worker with a Bachelor's Degree in social work from an accredited program, or a Bachelor's Degree in a field other than social work and at least three (3) years social work experience under the supervision of a qualified social worker, and with specialized training or with one (1) year of experience in working with the mentally retarded; or
• a therapeutic recreation specialist who is a graduate of an accredited program and eligible for registration in the National Therapeutic Recreation Society, and who has specialized training or one (1) year experience in working with the mentally retarded; or
• a rehabilitation counselor who is certified by the Commission on Rehabilitation Counselor Certification and who has specialized training or one (1) year of experience in treating the mentally retarded.
"Registered Nurse" – a person who is licensed to practice nursing under the "Illinois Nursing Act" (Ill. Rev. Stat. 1979, ch. 111, pars. 3401 et seq.) as now or hereafter amended.
"Reputable Moral Character" – having no history of a conviction of the applicant, or if the applicant is a firm, partnership, or association, of any of its members, or of a corporation, of any of its officers, or directors, or of the person designated to manage or supervise the facility, of a felony, or of two (2) or more misdemeanors involving moral turpitude, as shown by a certified copy of the record of the court of conviction, or in the case of the conviction of a misdemeanor by a court not of record, as shown by other evidence; or other satisfactory evidence that the moral character of the applicant, or manager, or supervisor of the facility is not reputable.
"Resident" – a person residing in a community living facility.
"Resident's Representative" – a person other than the owner, or an agent or employee of a facility not related to the resident, designated in writing by a resident to be his representative, or the resident's guardian, or the parent of a minor resident for whom no guardian has been appointed.
"Restraint of a Resident" – the application of a device to limit movements.
"Room" – a part of the inside of a facility that is partitioned continuously from floor to ceiling with openings closed with glass or hinged doors.
"Satisfactory" – same as Adequate.
"Seclusion" – the retention of a resident in a room which he cannot open.
"Self Preservation" – the ability to follow directions and/or recognize impending danger or emergency situations and react by avoiding or leaving the unsafe area.
"Sheltered care" – maintenance and personal care.
"Social Worker, Qualified" – a person who:
is licensed by the State of Illinois (registered or certified by the Illinois Department of Registration and Education); and
is a graduate of a school of social work which has been approved by the Council on Social Work Education (some schools are approved for Bachelor's Degree programs and others for Master's Degree programs); and has one (1) year of social work experience in a health care setting.
"State Fire Marshal" – the Fire Marshal of the Office of the State Fire Marshal, Division of Fire Prevention.
"Story" – when used in these regulations means that portion of a building between the upper surface of any floor and the upper surface of the floor above except that the topmost story shall be the portion of a building between the upper surface of the topmost floor and the upper surface of the roof above.
"Sufficient" – same as Adequate
"Supervision" – authoritative procedural guidance by a qualified person for the accomplishment of a function or activity within his/her sphere of competence, with initial direction and periodic inspection of the actual act of accomplishing the function or activity. Unless otherwise stated in regulations, the supervisor must be on the premises if the person does not meet assistant level (two (2) year training program) qualifications specified in these definitions.
"Support Services" – those services provided to residents in order to facilitate their integration into the community and to improve their level of functioning, independence, and self-respect.
"Therapeutic Recreation Specialist" – a person who is registered with the National Therapeutic Recreation Society and who meets the minimum standards it has established for classification as a Therapeutic Recreation Specialist.
"Time Out" – removing an individual from a situation that results in undesirable behavior. It is a behavior modification procedure which is developed and implemented under the supervision of a qualified professional.
"Transfer" – a change in status of a resident's living arrangements from one facility to another facility.
"Valid License" – a license which is unsuspended, unrevoked and unexpired.
(Source: Amended at 8 Ill. Reg. 24268, effective November 29, 1984)
SUBPART B: ADMINISTRATION
Section 370.400 Administration
a) There shall be a qualified program coordinator directly responsible for the overall operation, program and management of a Community Living Facility. This person shall be a college graduate, at least twenty-one (21) years of age with training and experience as determined appropriate by the Department, in consultation with the Illinois Department of Mental Health and Developmental Disabilities. Appropriate experience is one year's experience working with the developmentally disabled. This person may also be the house manager.
b) There shall be a qualified house manager on duty forty (40) hours a week who shall be responsible for the operation of the facility and its inhabitants. This house manager must delegate this reponsibility to another staff person, in his or her absence, as supervisory responsibility must extend throughout each 24-hour period. This person(s) shall be a high school graduate or equivalent, at least twenty-one (21) years of age, with training and experience as determined appropriate by the Department, in consultation with the Illinois Department of Mental Health and Developmental Disabilities.
c) The program coordinator and house manager shall be of reputable and moral character, in good physical and mental health, have an understanding of the needs of the residents, have the ability to establish a program to meet their needs, and be capable of directing and supervising persons working and residing in the facility.
d) The program coordinator shall delegate adequate authority to the house manager. Such administrative assignment shall not interfere with the supervision of the program for the residents.
e) The licensee, program coordinator and house manager shall be familiar with all applicable statutes and regulations. They shall be responsible for seeing that the applicable regulations are met in the facility and that employees are familiar with those regulations according to the level of their responsibilities.
SUBPART C: POLICIES
Section 370.510 Social and Vocational Training Program Policies
a) The facility shall adopt and function in conformity with written policies which shall be formulated with the involvement of the program coordinator and appropriate staff, and which shall be reviewed at least annually. These written policies shall include at a minimum the following provisions:
1) Admission, transfer and discharge of residents including persons accepted and not accepted.
2) Resident services including social and vocational services and programs, and health maintenance and emergency services available to residents from community sources.
b) All the policies and information required in them shall be available for review by the Department and/or Department of Mental Health and Developmental Disabilities personnel.
Section 370.520 Admission and Discharge Policies
a) These written policies shall include at a minimum the following provisions:
1) No person shall be admitted to a community living facility until and unless he/she has been determined, by an appropriate evaluation, to have a reasonable potential for returning to his/her own home or leading an independent life.
2) No person requiring prenatal or maternity care may be admitted to, nor shall reside in, a facility unless adequate prenatal and other medical services from community sources are available to her.
3) No person shall be denied admission solely on the basis of mobility limitations.
4) No person shall be admitted to, nor reside in a facility:
A) Who requires mental treatment as defined in Section 370.240 of this Part. (See definition of "Person in Need of Mental Treatment" in Section 370.240.)
B) Who is destructive of property or himself/herself.
C) Who has serious mental or emotional problems based on a diagnosis by a physician or clinical psychologist.
D) Who is less than eighteen (18) years of age.
E) Who is in need of nursing care or more personal care than oversight and supervision.
5) A facility shall not admit more residents than the number authorized by the license issued to it.
6) A facility shall not refuse to discharge or transfer a resident when requested to do so by the resident or by the resident's guardian.
7) No person shall be admitted with a communicable disease, including active tuberculosis.
b) Nothing in this Part shall excuse compliance with accessibility or reasonable accommodation requirements of State or federal law.
(Source: Amended at 17 Ill. Reg. 19509, effective November 1, 1993)
Section 370.530 Agreement Between Resident and Facility
A written agreement shall be established annually between each resident or legal guardian, and the facility briefly stating the programs and services to be provided, facility house rules, and mutual financial responsibilities.
Section 370.540 General Policies
a) The facility shall permit daily visiting at reasonable times during the day and evening.
b) Residents occupying any bedroom shall be of the same sex except in the case of a room occupied by husband and wife.
c) There shall be no resident traffic through a resident's bedroom by residents of another bedroom to reach any other area of the facility.
Section 370.550 Personnel Policies
The facility shall have written personnel policies that shall include, but are not limited to, the following:
a) Employment
1) Employment application forms shall be completed on each employee, kept on file in the facility, and shall be available to Department personnel for review. Application forms shall also be available to Department of Human Services personnel for program evaluation purposes. These forms shall contain date of employment, age or birthdate, home address, educational background, experience including types of employment, where previously employed, type of position to be filled in this facility, last date employed and reasons for leaving.
2) In addition to the application form, the individual personnel file shall contain other pertinent personnel data such as health records and evaluation of performance.
3) Each employee shall have a physical examination which has been conducted within a period of 10 days before or after employment and annually thereafter. Additional physical examinations may be requested according to the Control of Communicable Diseases Code (77 Ill. Adm. Code 690).
4) This initial physical exam shall include tuberculin testing in accordance with the Department's Control of Tuberculosis Code (77 Ill. Adm. Code 696).
5) An employee disgnosed or suspected of having a contagious or infectious disease shall not be on duty until such time as a written statement is obtained from a physician that the disease is no longer contagious or is found to be noninfectious.
b) General
1) All employees shall be at least 16 years of age or have a work permit.
2) An ongoing, planned in-service program embracing orientation, skill training and ongoing education shall be carried out to enable all personnel to perform their duties effectively.
3) The facility shall have a plan to provide personnel coverage for regular staff when they are absent.
4) Every facility shall have a dated weekly employee time schedule posted in a convenient place where employees may refer to it. These shall be kept on file at the facility for one year.
c) Prior to employing any individual in a position that requires a State license, the facility shall contact the Illinois Department of Professional Regulation to verify that the individual's license is active. A copy of the license shall be placed in the individual's personnel file.
d) The facility shall check the status of all applicants with the Nurse Aide Registry prior to hiring.
(Source: Amended at 26 Ill. Reg. 11982, effective July 31, 2002)
SUBPART D: PERSONNEL
Section 370.710 Personnel
a) Sufficient staff in numbers and qualifications shall be on duty all hours of each day to provide services that meet the total needs of the residents. As a minimum, there shall be at least one (1) staff member awake dressed and on duty at all times on the day and evening shifts.
1) There shall be at least one staff member on duty in the facility at all times on the night shift. This person need not be awake or dressed, but must be quickly available if a resident has need of his/her services.
2) Provision shall be made for personnel coverage when regular staff is absent.
b) The number and classification of personnel to be provided, including staff for the social and vocational training programs of the facility, shall be based on the following, developed in consultation with the Illinois Department of Mental Health and Developmental Disabilities:
1) number of residents living within the facility,
2) type of social and vocational programs in current operation to meet resident needs,
3) consultants and part-time professional staff available,
4) guidelines specified in Appendix A.
The Department of Mental Health and Developmental Disabilities as it evaluates social and vocational programs will examine staffing patterns and accomplishments and will report its findings to the Department.
c) If arrangements are made to share professional staff and/or consultants, a written agreement must be prepared specifying terms of the arrangement, updated annually and kept on file.
Section 370.715 Health Care Worker Background Check
A facility shall comply with the Health Care Worker Background Check Act [225 ILCS 46] and the Health Care Worker Background Check Code (77 Ill. Adm. Code 955).
(Source: Amended at 31 Ill. Reg. 192, effective December 21, 2006)
Section 370.720 Personnel Policies
Personnel policies shall be provided as covered in Section 370.550.
SUBPART E: HEALTH MAINTENANCE SERVICES
Section 370.810 Medical Care Policies
a) Each facility shall have a written program updated annually regarding the provision of health maintenance services and the procedures for their implementation.
b) The resident (or his or her guardian), shall have a physician of his or her own choosing to care for his or her medical needs. The resident shall be encouraged to see his or her physician as often as necessary as determined by his or her physician to assure adequate medical care.
c) Each applicant accepted for admission shall have a complete physical examination either within one (1) month prior to admission or within seventy-two (72) hours after admission to the facility. This examination shall include an evaluation of the resident's condition and recommendations for his or her care.
Section 370.820 Communicable Disease Policies
a) The program coordinator shall be responsible for meeting all the "Communicable Disease Rules of the State of Illinois", Department of Public Health.
b) No resident with a communicable, contagious, or infectious disease shall be admitted knowingly. An individual, when suspected or diagnosed as having any such disease, shall be given immediate medical attention.
c) No resident may be admitted knowingly who has had a history of tuberculosis until the patient is classified as inactive, as defined by the latest classification of the American Thoracic Society, "Diagnostic Standards."
d) All illnesses required to be reported under Section 370.820(a) above, shall be reported immediately to the local health department and/or to this Department. The program coordinator shall furnish all pertinent information relating to such occurrences and document the notification.
Section 370.830 Behavior Emergencies
a) The resident's personal physician shall be contacted in the event of a behavior emergency. If treatment away from the Community Living Facility is indicated, the facility shall be responsible for taking the resident to the nearest appropriate mental health facility (public or private). Upon request, the Department of Mental Health and Developmental Disabilities will supply information to the facility as to what services are available in the community.
b) No form of seclusion, nor use of restraints, shall be permitted except as specified in Section 370.3030(a).
Section 370.840 Medication Policies
a) Every facility shall adopt and function in conformity with written policies and procedures, for assisting residents in obtaining individually prescribed medication for self-administration and for disposing of medications prescribed by the attending physicians.
1) These policies and procedures shall be developed with consultation from an Illinois registered professional nurse and a registered pharmacist. These policies and procedures shall be part of the written program of care and services.
2) All medications taken by residents in this type of facility must be ordered by the attending physician directly from a pharmacy. Facility staff may not order medication from a pharmacy.
3) If the policies of the facility permit residents to be totally responsible for their own medication, when the attending physician gives written permission for such action, the policies of the facility shall provide that the resident and attending physician shall be given written statements concerning the relative responsibilities of each of the three parties, (facility, resident and physician), in cases where the resident, or any other person suffers harm due to the resident's actions in handling his/her own medications.
b)
1) This type of facility shall not stock drugs.
2) No pharmacy shall be operated in this type of facility.
c)
1) All medications on individual prescription or from the physician's personal supply shall be properly labeled as set forth in Section 370.840(m).
2) All other medications shall be authorized by a physician for individual resident use, and shall be clearly identified with the resident's name.
d)
1) All medications used by residents shall be properly recorded by facility staff at time of use.
2) A medication record need not be kept for those residents for whom the attending physician has given permission to keep their medication in their room and to be fully responsible for taking the medications in the correct dosage and at the proper times themselves.
e) Medications administered by hypodermic shall not be given in a facility unless administered by a physician, registered nurse, or licensed practical nurse. A resident who has been trained in self-administration of a drug by hypodermic may be permitted to do so upon the written order of the physician.
f) Bottled oxygen may not be administered in this type of facility, except in an emergency. Not more than one 12 pound portable size tank of oxygen for such an emergency use shall be kept in the facility. However, the use of an oxygen concentrator is permitted when prescribed by a physician for a resident. The facility must be in compliance with directions for use of such equipment as established by the manufacturer.
g) All discontinued legend or controlled drugs, all medications having an expiration date that has passed, and all medications of residents who have expired, shall be disposed of in accordance with the rules and regulations of the Federal Drug Enforcement Administration by the prescribing physician or the consultant pharmacist. A notation of their disposition shall be made in the resident's record.
h)
1) All medications shall be stored in a locked area at all times. Areas shall be well lighted and of sufficient size to permit storage without crowding. This area may be a drawer, cabinet, closet, or room.
2) This area may be a locked drawer or cabinet in the resident's room for those residents whom the attending physician has given written permission to be totally responsible for their own medication, including the obtaining, storage and self-administration of the medication.
i) The key to the medicine area shall be the responsibility of, and in the possession of, the staff persons responsible for overseeing the self-administration of medications by residents.
1) The general medicine area shall not be used for any other purpose. It shall not be located in residents' rooms, bathrooms, or the kitchen. However, for those persons whom the attending physician has given written permission to handle their own medications, medications may be stored in a locked drawer or cabinet in the resident's room along with other possessions of that resident.
2) Residents for whom the attending physician has given permission to be totally responsible for their own medication shall maintain possession of the key to their own medication storage area. A duplicate key shall be kept by the facility in its safe, or some other secure place, for emergency use, such as if the resident should lose or misplace his/her key.
j) Medications for external use shall be kept in a separate area in the medicine cabinet area or in a separate locked area.
k) All poisonous substances and other hazardous compounds shall be kept in a separate locked area away from medications.
l) Biologicals or medications requiring refrigeration shall be stored in a properly covered locked container in a refrigerator.
m) The label of each individual medication container filled by a pharmacist shall clearly indicate the resident's full name, physician's name, prescription number, name and strength of drug, amount of drug, date of issue, expiration date of all time-dated drugs; name, address, and telephone number of pharmacy issuing the drug; and the initials of the pharmacist filling the prescription. If the individual medication container is filled by a physician from his/her own supply, the label shall clearly indicate all the proceeding information except that pertaining to the identification of the pharmacy, pharmacist, and prescription number.
n) Medication containers having soiled, damaged, incomplete, illegible, or makeshift labels shall be returned to the issuing pharmacist, pharmacy, or dispensing physician for relabeling or disposal. Containers having no labels shall be destroyed in accordance with Federal and State laws.
o) The medications of each resident shall be kept and stored in their originally received containers. Medications shall not be transferred between containers.
(Source: Amended at 8 Ill. Reg. 24706, effective December 7, 1984)
SUBPART F: PROGRAM SERVICES
Section 370.1010 Program Evaluation
The Illinois Department of Mental Health and Developmental Disabilities will evaluate the social and vocational programs provided by the Community Living Facility in terms of compliance with program standards as specified in Appendix A, and will report its findings in writing to the Department.
Section 370.1020 Program and Services
a) Each facility shall establish and provide to each resident a supervised home environment for the residents who, without such services, might require institutionalization.
b) Each facility shall:
1) Establish and provide to each resident a community living program which will lead to independent or increased independent living in the community. The program shall:
A) Assist each individual resident in developing realistic goals and acceptable attitudes.
B) Provide each individual resident with practical experiences in community living.
C) Assist each individual resident in adjusting to a variety of situations which will result in the development of acceptable behavior.
D) Provide evening and weekend training programs emphasizing those areas which will lead to independent living, e.g., personal grooming, socialization skills, communication skills, clothing, finances, food, transportation, and leisure-time activities.
E) Provide and/or arrange a vocational training program to meet the individual needs of each resident.
2) Provide accommodations related to services and program by a unit concept. Each such unit shall consist of not less than five (5) nor more than twenty (20) residents.
3) Provide that the residents will be responsible for assisting and planning household activities, participating in various household tasks such as maintaining the grounds, cleaning their own rooms, and assisting in the care of other areas in the facility.
4) Provide that the residents are encouraged and taught to plan, prepare and serve meals; and that equipment and utensils in the kitchen are available for use by the residents.
5) Provide that residents shall assist in shopping for food for the facility, and in purchasing their own clothes, toiletries and other incidentals.
6) Provide that residents be required to assume personal responsibility for the housekeeping standards of their bedrooms. Such housekeeping shall include, but not be limited to, cleaning of floors, making beds, changing linen, and keeping personal clothing in drawers and closets.
7) Provide that residents are taught how to use home and/or commercial-type laundry equipment.
8) Provide that residents shall not be used to replace employed staff.
9) Encourage a planned volunteer program to assist with the facility's program for its residents. It shall be under the direction of a staff member in a supervisory capacity.
10) Arrange for the placement of qualified residents in an independent living situation, or if otherwise indicated, in another group living facility at an appropriate level of care.
SUBPART G: RECORDS
Section 370.1210 General
a) An active record shall be kept for each resident. This record shall be kept current, dated, signed, complete, legible, and available at all times to the appropriate personnel of the facility and to the representatives of the Department and the Illinois Department of Mental Health and Developmental Disabilities. Each resident shall be evaluated by the facility's staff and an individual habilitation plan developed within fifteen (15) days of admission to the facility. Such evaluation shall include a written entry in the resident's permanent record regarding present work or training assignment outside the facility, social and vocational training program goals within the facility and probable length of stay needed in the facility to accomplish independent living goals.
b) Each resident's record shall be written in ink or typed, and each entry shall be dated and signed. The record shall include the following:
1) Identification sheet(s) and/or admission form(s) including resident's name, social security number, marital status, birthdate, age, birthplace, sex, home address, and religion; name, address and telephone number of referral agency, personal physician; next of kin or other responsible person.
2)
A) A statement that the resident is free of communicable diseases, including active tuberculosis. It shall be signed and dated by the physician. This shall be completed within one (1) month prior to, or within seventy-two (72) hours after admission.
B) Any additional information pertaining to the resident's medical and personal history that may be helpful in the management of the resident shall be included.
3) Results of an examination by a psychologist determining mental and functional level completed within the last year. If a current psychological evaluation is unavailable, the staff psychologist shall make such an evaluation within fifteen (15) days of the resident's admission.
4) Progress record towards goals documented a minimum of at least once monthly.
5) A full written report on any serious incident or accident involving a resident while on the premises. This report shall include the date and time of each incident or accident and the action taken concerning it. These incidents and accidents shall include medication errors and drug reactions and all situations requiring the emergency services of a physician, a hospital, the police, the fire department, the coroner, etc. The Department shall be notified by a phone call to the Regional Office of all such incidents or accidents. Such notification shall be made within twenty-four (24) hours of their occurrence. A written copy of this report shall be sent to the Department within seven (7) days of such incident or accident.
6) Consultants shall make written reports of their findings and recommendations at the time of each visit. These shall be included in the resident's progress record if concerned with an individual resident.
7) Discharge information shall be recorded within seventy-two (72) hours after the resident leaves the facility. This shall indicate the date, time, condition of the resident, to whom released and where going (home, another facility, etc.). This information may be part of the admission record form.
Section 370.1220 Other Records
a) The facility shall maintain a record of any personal money, regardless of source, or valuables kept for a resident. If purchases are made for a resident from these personal monies, proper receipts shall be kept and notations made in a separate bookkeeping system.
b) The facility shall keep a record of each resident's valuable belongings. This shall be initiated at the time of admission. It shall be kept current and should be part of the resident's ongoing record.
c) The facility shall maintain a record of recommendations from consultants regarding the overall program and its development.
d) Each facility shall maintain a permanent chronological resident registry book showing date of admission, name of resident, and date of discharge.
e) Records and daily time schedules shall be kept on each employee as set forth in Section 370.550(a) and 370.550(b).
Section 370.1230 Confidentiality
The facility shall comply with all of the provisions of the "Mental Health and Developmental Disabilities Confidentiality Code" (Ill. Rev. Stat. 1981, ch. 91½, pars. 801 et seq.) as amended.
SUBPART H: FOOD SERVICE
Section 370.1410 Food Service
a) The food service in each facility shall be under the operational supervision of a manager or supervisor who has been certified in food service sanitation in accordance with Subpart C of the rules for Food Service Sanitation (77 Ill. Adm. Code 750: Subpart C) of the Illinois Department of Public Health. This person shall be on the premises sufficient time each week to determine that the food service is satisfactory.
b) Food shall be prepared and served family style to approximate, as nearly as possible, a family living situation. Residents shall be allowed and encouraged to serve themselves the appropriate amount of food for a properly balanced diet. Normally, seating arrangements should not exceed six (6) residents per table. Residents should be allowed and encouraged to choose their own seating arrangements. There shall be no segregation between the sexes by table or seating arrangements.
Section 370.1420 Adequacy of Diet
The daily food allowance for each resident shall meet the basic food pattern for a general diet for an adult following the recommendations of the Food and Nutrition Board, National Research Council, and shall include:
a) Milk: Two (2) eight (8) ounce servings of milk. A portion of this amount may be served in a cooked form such as creamed dishes, desserts, etc.
b) Meat Group: Two (2) or more servings of protein food of good quality. The following are samples of one (1) serving:
1) One (1) egg equals one-third (⅓) serving.
2) Three (3) ounces of cheese two (2) one-and-one-half (1½) ounce, or three (3) one (1) ounce slices), or three-fourths (¾) cup cottage cheese.
3) Three (3) ounces fresh cooked fish or shellfish, or one-half (½) cup canned fish.
4) Three (3) ounces of any cooked meat (without fat, bone) such as ground beef, steak, roast beef, lamb or pork, pork chops, veal chops, lamb chops, chicken, turkey, liver, etc.
5) Three (3) ounces prepared luncheon meat (two (2) one and one-half (1½) ounce slices.)
6) Occasionally dry beans or dry peas may be served as an alternate.
c) Vegetable and Fruit Group: Four (4) or more servings. One serving of vegetable equals one-half (½) cup.
1) A citrus fruit each day or other fruit or vegetable important for Vitamin C.
2) A dark green or deep yellow vegetable for Vitamin A at least every other day.
3) Other fruits and vegetables including potatoes.
4) Any vegetable repeated for the day shall not again be counted as one (1) of the four (4) servings required in this group.
d) Bread and Cereal Group: Four (4) or more servings of whole grain, enriched or restored. One (1) slice bread equals one (1) serving. One-half (½) cup cereal equals one (1) serving.
e) Butter or Margarine: Some of either each day as a seasoning and as a spread.
f) Other Foods: Serve other foods as necessary to round out meals, satisfy individual appetites, improve flavor and meet the individual's nutritional and caloric needs. Snacks may also be used for this purpose.
Section 370.1430 Therapeutic Diets
The facility shall prepare appropriate menus for any resident admitted to the facility for whom the physician has prescribed a therapeutic diet, using diet manuals acceptable to the Department. Such menus shall be approved by either an attending physician or a dietitian.
Section 370.1440 Scheduling of Meals
a) A minimum of three (3) meals or their equivalent shall be provided daily.
b) Snacks of nourishing quality shall be made available.
Section 370.1450 Food Preparation and Service
Foods shall be prepared by appropriate methods that will conserve their nutritive value, enhance their flavor and appearance.
Section 370.1460 Food Handling Sanitation
a) Every facility that serves more than twenty (20) residents per meal shall comply with the latest edition of the Department's "Food Service Sanitation Rules (77 Ill. Adm. Code 750). Facilities serving twenty (20) or less residents per meal shall comply with the following food sanitation standards:
1) Food shall be wholesome and free from spoilage, filth, and other contamination and shall be safe for human consumption. Food shall be obtained from sources that comply with all laws relating to food wholesomeness and identification. Use of home prepared potentially hazardous foods and hermetically sealed, non-acid and low-acid food which has been processed in a place other than a commercial food processing establishment is prohibited.
2) Fluid milk and fluid-milk products used or served shall be pasteurized and shall meet the Grade A quality standards as established by law. Dry milk and dry-milk products shall be pasteurized.
3) Each container of unshucked shell stock (shellfish, oysters, clams, mussels) shall be identified by an attached tag that states the name of the original shell stock shipper, the kind and quantity of shell stock, and an official certificate number issued according to the law of the jurisdiction of its origin. Fresh and frozen shucked shellfish shall be packed in nonreturnable packages identified with the name and address of the original shell stock shipped, shucker, packer, or repacker, and the official certificate number issued according to the law of the jurisdiction of its origin of the shipper. Shell stock and shucked shellfish shall be kept in the container in which they were received until they are used.
4) Only clean whole eggs, with shell intact and without cracks or checks, or pasteurized liquid or pasteurized dry eggs or egg products shall be obtained.
b) Food Storage. Food shall be protected at all times, including while being stored, prepared, displayed, served, or transported, from contamination by all agents, including dust, insects, rodents, unclean equipment and utensils, unnecessary handling, coughs and sneezes, flooding, drainage, and overhead leakage or condensation. The temperature of potentially hazardous foods shall be 45 degrees F. or below or 140 degrees F. or above at all times, except as otherwise provided in this Part.
1) Stored food, whether raw or prepared, shall be enclosed in a clean, covered container if removed from the immediate container or package in which it was obtained except during necessary periods of preparation or service. Use of a cloth towel as a container cover is prohibited.
2) Food shall be stored above the floor on clean surfaces in a way that permits cleaning of the storage area without contamination of the food by splash, dust, or other means. A minimum, unobstructed storage height of six inches above the floor is recommended.
3) Food shall not be stored under exposed sewer or leaking water lines.
4) Food not subject to further washing or cooking before being served shall be stored in a way that protects it against contamination.
5) Packaged food shall not be stored in contact with water or undrained ice except as provided for Section 370.1460(c)(8).
6) Unless its identity is unmistakable, bulk food not stored in the labeled container or package in which it was obtained shall be stored in a container labeled to identify the food by common name.
7)
A) Enough conveniently located refrigeration facilities or effectively insulated facilities shall be provided to assure the maintenance of food at required temperatures during storage. The recommended maximum operating ambient air temperature of cold food storage equipment should be as follows:
B) Refrigerator – 40 degrees F. Refrigerated (short-term) display case – 45 degrees F.
8) All cold food storage equipment shall be provided with a numerical indicating thermometer scaled to at least 5 degrees F. increments and accurate to plus or minus 3 degrees F. and so located to measure the air temperature in the warmest part of the facility and located to be easily readable.
9) The temperature of potentially hazardous foods requiring refrigeration shall be 45 degrees F. or below except during necessary periods of preparation and service.
10) Frozen foods shall be kept frozen and should be stored at a temperature of 0 degrees F. or below until removed from storage for preparation and use.
11) Stored ice intended for human consumption shall not be used as a medium for cooling stored food, food containers or food utensils.
12) Hot food holding equipment, if used, shall be provided with a numerical indicating thermometer scaled to at least 5 degrees F. increments and accurate to plus or minus 3 degrees F. located in the coolest part of the facility and located to be easily readable.
c) Food Preparation and Service. Food shall be prepared with the least possible manual contact, with suitable utensils and on surfaces that prior to use have been cleaned.
1) Raw Fruits and Raw Vegetables. Raw fruits and raw vegetables shall be washed thoroughly before being cooked or served.
2) Cooking Potentially Hazardous Foods. Potentially hazardous foods requiring cooking shall be rapidly cooked to heat all parts of the food to a temperature of at least 140 degrees F., except that:
A) Poultry, poultry stuffings and stuffed meats shall be cooked to heat all parts of the food to at least 165 degrees F. with no interruption of the cooking process.
B) Pork and pork products shall be cooked to heat all parts of the food to at least 150 degrees F.
C) Rare roast beef shall be cooked to an internal temperature of at least 130 degrees F., and rare beef steaks shall be cooked to a temperature of 130 degrees F. unless otherwise ordered by the immediate consumer.
3) Dry Milk and Milk Products. If reconstituted, dry milk and dry milk products may be used in instant desserts and whipped products; for cooking, baking purposes; and for an individually prepared portion of a beverage.
4) Liquid, Frozen, Dry Eggs and Egg Products. Liquid, frozen, and dry eggs and egg products shall be used only for cooking and baking purposes.
5) Reheating. Potentially hazardous foods that were cooked and then refrigerated shall be heated rapidly to 165 degrees F. or higher throughout before being placed in a hot food storage facility. Steam tables, bainmaries, warmers, and other hot food holding facilities are prohibited for the rapid heating of potentially hazardous foods.
6) Reconstitution. Nondairy creaming agents shall not be reconstituted for consumption on the premises in quantities exceeding one pint.
7) Product Thermometers. Metal stem-type numerically scaled indicating thermometers accurate to +3 degrees F. shall be provided and used to assure attainment of proper internal cooking temperatures of all potentially hazardous foods.
8) Thawing Potentially Hazardous Foods. Potentially hazardous foods shall be thawed:
A) In refrigerated units in a way that the temperature of the food does not exceed 45 degrees F.; or
B) Under potable running water at a temperature of 70 degrees F. or below, not to exceed two hours with sufficient water velocity to agitate and float off loose food particles into the over-flow; or
C) In a microwave oven only when the food will be immediately transferred to conventional cooking facilities as part of a continuous cooking process or when the entire, uninterrupted cooking process takes place in the microwave oven; or
D) As part of the conventional cooking process.
9) Reuse of Tableware. Reuse of soiled tableware by self-service resident, when returning for additional servings of food is prohibited.
10) Ice Dispensing. Ice for residents' use, if approved, shall be dispensed only with scoops, tongs, or other ice-dispensing utensils or through automatic self-service ice-dispensing equipment. Ice-dispensing utensils and ice receptacles shall be stored in a way that protects them and the ice from contamination.
11) Milk Dispensing. Milk and milk products for drinking purposes shall be provided to the resident in commercially-filled packages or served from a bulk milk dispenser.
12) Re-Serving. Any food once served to a resident shall not be re-served.
d) Employee Hygiene and Practice. Employees and residents shall thoroughly wash their hands and the exposed portions of their arms with soap and warm water before starting work, during work as often as is necessary to keep them clean, and after smoking, eating, drinking, or using the toilet. Employees and residents shall keep their fingernails clean and trimmed.
1) The outer garments of all persons, including dishwashers, engaged in handling of food or food contact services shall be reasonably clean.
2) Employees and residents may consume food only in designated dining areas. Areas shall not be designated as dining areas if consuming food there might result in contamination of other food, equipment, utensils, or other items needing protection.
3) Employees and residents shall not use tobacco or other smoking products in any form while engaged in food preparation or service, nor while in any equipment or utensil washing or food preparation areas. Employees shall use tobacco in any form only in designated areas. Areas shall not be designated for that purpose if the use of tobacco might result in the contamination of food, equipment, utensils or other items needing protection.
4) Employees and residents shall handle soiled tableware in a way that avoids contamination of their hands.
5) Employees and residents shall maintain a high degree of personal cleanliness and shall conform to good hygienic practices.
e) Equipment and Utensils. Multi-use equipment and utensils shall be made and repaired with safe, non-toxic materials, including finishing materials, shall be corrosion resistant, non-absorbent, smooth, easily cleanable, and durable under conditions of normal use. Single-service articles shall be made from clean, sanitary, safe, and non-toxic materials, equipment, utensils, and single-service articles shall not impart odors, color, or taste, nor contribute to the contamination of food.
1) Solder. If soft solder or hard solder (silver solder) is used, it shall be composed of safe materials and be corrosion resistant.
2) Wood. Hard maple or equivalently non-absorbent material that meets the general requirements set forth in the introductory text of this section may be used for cutting blocks, cutting boards, and baker's tables. The use of wood as a food-contact surface under other circumstances is prohibited.
3) Plastics. Safe plastic or safe rubber or safe rubber-like materials that, under normal conditions of use, are resistant to scratching, scoring, decomposition, crazing, chipping and distortion, that are of sufficient weight and thickness to permit cleaning and sanitizing by normal dishwashing methods, and which meet the general requirements set forth in the introductory text of this section are permitted for repeated use. The repeated use of equipment and utensils made of materials not meeting the requirements of this section is prohibited.
4) Mollusk Shells. The reuse of mollusk and crustacea shells as food containers is prohibited.
5) Design and Fabrication. All equipment and utensils, including plasticware, shall be designed and fabricated for durability under conditions of normal use and shall be resistant to denting, buckling, pitting, chipping, and crazing. Food-contact surfaces shall be easily cleanable, smooth, and free of breaks, open seams, cracks, chips, pits, and similar imperfections, and free of difficult-to-clean internal corners and crevices. Cast iron may be used as a food-contact surface only if the surface is heated, such as in grills and skillets. Threads shall be designed to facilitate cleaning; ordinary "V" type threads are prohibited, as food-contact surfaces.
6) Lubrication. Equipment containing bearings and gears requiring unsafe lubricants shall be designed and constructed so that the lubricant cannot leak, drip, or be forced onto food-contact surfaces. Only safe lubricants shall be used on equipment designed to receive lubrication of bearings and gears on or within food-contact surfaces.
7) Sinks, dish tables, and drain boards shall be self-draining.
8) Accessibility. Unless designed for in-place cleaning, food-contact surfaces shall be accessible for cleaning and inspection:
A) Without being disassembled; or
B) By disassembling without the use of tools; or
C) By easy disassembling with the use of only simple tools kept available near the equipment, such as a mallet, a screwdriver, or an open-end wrench.
9) In-Place Cleaning. Pipes, tubes, valves, and lines contacting food and intended for in-place cleaning shall be so designed and fabricated that:
A) Cleaning solutions can be circulated throughout a fixed system using an effective cleaning regimen; and
B) Cleaning solutions will contact all interior food-contact surfaces; and
C) The system is self-draining or capable of being completely evacuated.
10) Non-Food-Contact Surfaces. Surfaces of equipment not intended for contact with food, but which are exposed to splash or food debris or which otherwise require frequent cleaning, shall be designed and fabricated so as to be smooth, washable, free of unnecessary ledges, projections, or crevices, and readily accessible for cleaning, and shall be of such material and in such repair as to be easily maintained in a clean and sanitary condition.
11) Ventilation Hoods. Ventilation hoods and devices shall be designed to prevent grease or condensate from dripping into food or onto food-contact surfaces. Filters or baffles, where used, shall be readily removable for cleaning and reinstallation, or replacement.
12) General. Equipment, including ice makers and ice storage equipment, shall not be located under exposed sewer lines, leaking water lines, stairwells, or other sources of contamination.
13) Aisles and Working Spaces. Aisles and working spaces between units of equipment and between equipment and walls shall be unobstructed and of sufficient width to permit employees and residents to perform their duties readily without contamination of food or food-contact surfaces by clothing or personal contact.
f) Cleaning Frequency. Equipment and utensils shall be cleaned as described below.
1) Tableware shall be cleaned after each use.
2) Kitchenware and food-contact surfaces of equipment shall be washed and rinsed after each use and following any interruption of operations during which time contamination may have occurred.
3) Where equipment and utensils are used for the preparation of potentially hazardous foods on a continuous or production-line basis, utensils and the food-contact surfaces of equipment shall be washed and rinsed at intervals throughout the day on a schedule subject to the approval of the regulatory authority. This schedule shall be based on food temperature, type of food, and amount of food particle accumulation.
4) The food-contact surfaces of grills, griddles, and similar cooking devices and the cavities of microwave ovens shall be cleaned and shall be kept free of encrusted grease deposits and other accumulated soil.
5) Non-food-contact surfaces of equipment shall be cleaned as often as is necessary to keep the equipment free of accumulation of dust, dirt, food particles, and other debris.
g) Wiping Cloths.
1) Cloths used during service for wiping food spills on food-contact surfaces shall be clean and used for no other purpose.
2) Cloths used for wiping non-food-contact surfaces shall be clean and used for no other purpose. These cloths shall be rinsed frequently.
h) Manual Cleaning
Sinks shall be cleaned prior to use. Equipment and utensils shall be pre-flushed or pre-scraped and, when necessary, pre-soaked to remove gross food particles and soil. Equipment and utensils shall be thoroughly washed in a hot detergent solution that is kept clean and then shall be rinsed free of detergent and abrasives.
i) Chemical Sanitization. If chemicals are used for sanitizing, they shall not have concentrations higher than the maximum permitted in Appendix B, and a test kit or other device that accurately measures the parts per million concentration of the solution shall be provided and used.
j) Dish tables or drain boards of adequate size shall be provided for proper handling of soiled utensils prior to washing and for cleaned utensils and shall be located so as not to interfere with the proper use of the dishwashing facilities.
k) Mechanical Cleaning. Cleaning may be done by spray-type or immersion dishwashing machines or by any other type of machine or device if it is demonstrated that it thoroughly cleans equipment and utensils.
Such machines and devices shall be properly installed and maintained in good repair. Automatic detergent dispensers and wetting agent dispensers, if any, shall be properly installed and maintained.
l) Equipment and utensils shall be flushed or scraped and, when necessary, soaked to remove gross food particles and soil prior to their being cleaned in a dishwashing machine. After flushing, scraping, or soaking, equipment and utensils shall be placed in racks, trays, or baskets, or on conveyors, in a way that food-contact surfaces are subject to the unobstructed application of detergent wash and clean rinse waters and that permits free draining. Clean rinse water shall remove particulate matter and detergent residues. All dishwashing machines shall be thoroughly cleaned at least daily.
m) Drying. All equipment, tableware and utensils shall be air-dried.
n) Equipment Storage. Equipment, utensils and tableware shall be stored in the following manner.
1) Cleaned equipment and utensils shall be handled in a way that protects them from contamination. Spoons, knives and forks shall be touched only by their handles. Cups, glasses and bowls shall be handled without contact with inside surfaces or with surfaces that contact the user's mouth.
2) Cleaned utensils, tableware and movable equipment shall be stored above the floor in a clean, dry location in a way that protects them from contamination by splash, dust and other potential contaminates. The food-contact surfaces of fixed equipment shall also be protected from contamination. Equipment and utensils shall not be placed under exposed sewer or leaking water lines.
3) Utensils shall be air-dried before being stored or shall be stored in a self-draining position on smooth, non-absorbent, easily cleanable surfaces and/or from suitably constructed hooks or racks.
4) Wherever practical, stored utensils shall be covered or inverted. Facilities for the storage of spoons, knives and forks shall be provided and shall be designed to present the handle to the employee or resident.
o) Tableware may be set prior to serving a meal when glasses and cups are inverted, and knives, forks and spoons are wrapped or otherwise covered.
p)
1) Single-service Articles. Single-service articles shall be stored above the floor on clean shelves and in closed containers that protect them from contamination.
2) Single-service articles shall be commercially packaged for individual use or shall be available to the resident from a dispenser in a way that prevents contamination of surfaces that may contact food or the user's mouth. Handling of single-service articles in bulk shall be conducted in a way that protects them from contamination. Single-service articles shall be used only once.
q) Garbage and Refuse. Garbage and refuse shall be kept in durable fly-proof and rodent-proof containers that do not leak and do not absorb liquids. Plastic bags and high wet strength paper bags may be used to line these containers and may be used for storage inside the food service establishment when protected from insects and rodents.
1) Containers. Containers, compactors, and compactor systems shall be easily cleanable, shall be provided with tight-fitting lids, doors, or covers, and shall be kept covered when not in actual use. Drain plugs, where required, shall be in place at all times, except during cleaning.
2) There shall be a sufficient number of containers to hold all the garbage and refuse that accumulates.
3) All garbage and refuse containers shall be maintained in a sanitary condition and shall be thoroughly cleaned on the inside and outside in a way that does not contaminate food, equipment, utensils, or food preparation areas. Liquid waste from compacting or cleaning of garbage or refuse containers shall be disposed of as sewage.
4) Garbage and Refuse Storage. Garbage and refuse on the premises shall be stored in a manner inaccessible to insects and rodents. When stored outside, plastic bags or high wet strength paper bags or bale units containing garbage and refuse must be stored in approved containers.
5) Garbage or refuse storage rooms, if used, shall be constructed of easily cleanable, non-absorbent, washable materials, shall be kept clean, shall be insect and rodent proof, and shall be large enough to store the garbage and refuse containers that accumulate.
6) Outside storage areas or enclosures shall be large enough to store the garbage and refuse containers that accumulate and shall be kept clean. Garbage and refuse containers and compactor systems located outside shall be stored on or above a smooth surface of non-absorbent material, such as concrete or machine-laid asphalt, that is kept clean, graded to prevent accumulation of liquid waste, and maintained in good repair.
7) All garbage and rubbish shall be disposed of daily or at such other frequencies as may be approved by the regulatory authority and in such a manner as to prevent a nuisance.
8) Where garbage or combustible rubbish is burned on the premises, an approved incinerator shall be provided, and shall be operated in such a manner as to comply with State and local regulations and so that it does not create a nuisance. Areas around such incinerators shall be kept in a clean and orderly condition.
r) Protective Shielding.
Shielding to protect against broken glass falling into food shall be provided for all artificial light fixtures located over or within food storage, preparation, service and display facilities and facilities where utensils are cleaned and stored. Infra-red or other heat lamps shall be protected against breakage by a shield surrounding and extending beyond the bulb, leaving only the face of the bulb exposed.
s) Poisons and Toxic Materials. Only those poisonous or toxic materials required to maintain the establishment in a sanitary condition or required for sanitizing of equipment or utensils shall be present in food service establishments.
1) Containers of poisonous and/or toxic materials, including insecticides and rodenticides, shall be prominently and distinctly labeled for easy identification of contents and stored in the original container as received from the manufacturer or distributor.
2) Poisonous and/or toxic materials shall be stored in cabinets that are used for no other purpose or in a place other than an area where food is stored, prepared, displayed or served and other than an area where clean equipment or utensils are stored. Bactericides and cleaning compounds shall not be stored in the same cabinet or area of a room with insecticides, rodenticides or other poisonous or toxic materials. They may be stored in an area separated from food within the food storage room but shall not be intermingled with food products.
3) Bactericides, cleaning compounds or other compounds intended for use on food-contact surfaces shall not be used in a way that leaves a toxic residue on such surfaces, nor in a way that constitutes a hazard to employees.
4) Poisonous and/or toxic materials shall not be used in a way that contaminates food, equipment or utensils, nor in a way that constitutes a hazard to employees or other persons, nor in a way other than in full compliance with their labeling.
5) Premises (General). Personal medications shall not be stored in food storage, preparation or service areas.
6) First-aid supplies shall be stored in a way that prevents them from contaminating food and food-contact surfaces.
t) A door shall separate food service operations from any laundry area, except that laundry operations may be conducted in a storage room containing only packaged foods.
1) Linen Storage. Clean cloths and napkins shall be stored in a clean place and protected from contamination until used.
2) Non-absorbent containers or washable laundry bags shall be provided and damp or soiled linens and clothes shall be kept in them until removed for laundering.
3) Cleaning and Equipment Storage. Maintenance and cleaning equipment shall be used and stored in a way that does not contaminate food, utensils, equipment or linen.
u) Animals. Live animals, including cats, dogs, birds and turtles, shall be excluded from all food preparation and dining areas. This exclusion does not apply to edible crustacea, shellfish or fish, nor to fish in an aquarium. Police patrol dogs or guide dogs accompanying blind persons shall be permitted in dining areas.
Section 370.1470 Kitchen Equipment, Utensils and Supplies
a) The kitchen or dietary area shall be adequate to meet the food service needs. It shall have adequate equipment, utensils and supplies to properly store, prepare, and serve the required number of meals. This shall include, but is not limited to, the following:
b) There shall be an adequate supply of food preparation equipment such as pots, pans, spoons, knives, mixers, etc., of the proper type to satisfactorily prepare the meals.
c) Each facility shall provide an adequate number of dishes, glassware, and silverware of a satisfactory type to serve all the residents in the facility at each meal.
SUBPART I: MAINTENANCE, HOUSEKEEPING AND LAUNDRY
Section 370.1610 Maintenance
a) Every facility shall have an effective plan for maintenance including sufficient staff, appropriate equipment and adequate supplies. Each facility shall:
1) Maintain the building in good repair and free of the following: cracks in floors, walls or ceilings; peeling wallpaper or paint; warped or loose boards; warped, broken, loose or cracked floor covering, such as tile or linoleum; loose handrails or railings; loose or broken window panes; and any other similar hazards.
2) Maintain all electrical, signaling, mechanical, water supply, heating, fire protection and sewage disposal systems in a safe and functioning condition. This shall include regular inspections of these systems.
3) Maintain all electrical cords and appliances in a safe and functioning condition.
4) Maintain the interior and exterior finishes of the building as needed to keep it attractive, clean, and safe. (Painting, washing, etc.)
5) Maintain all furniture and furnishings in a clean, attractive, and safely repaired condition.
6) Maintain the grounds and other buildings on the grounds in a safe, sanitary and presentable condition.
7) The building and grounds shall be kept free of any possible infestations of insects and rodents by: eliminating sites of breeding and harborage inside and outside the building; eliminating sites of entry into the building with screens of not less than 16 mesh to the inch and repair of any breaks in construction.
b)
1) Maintain all plumbing fixtures and piping in good repair and properly functioning.
2) Protect the potable water supply from contamination by providing and properly installing adequate, backflow protection devices or providing adequate air gaps on all fixtures that may be subject to backflow or back siphonage.
Section 370.1620 Housekeeping
a) Every facility shall have an effective plan for housekeeping including sufficient staff, appropriate equipment and adequate supplies. Each facility shall:
1) Keep the building in a clean, safe and orderly condition. This includes all rooms, corridors, attics, basements and storage areas.
2) Keep floors clean, as non-slip as possible, free from tripping hazards.
3) Control odors within the housekeeping staff's area of responsibility by effective cleaning procedures and by the proper use of ventilation systems. Deodorants shall not be used to cover up persistent odors caused by unsanitary conditions or poor housekeeping practices.
b) Attics, basements, stairways and similar areas shall be kept free of accumulations of refuse, discarded furniture, old newspapers, boxes, discarded equipment and other items.
c) Bathtubs, shower stalls and/or lavatories shall not be used for laundering, janitorial or storage purposes.
d) Potentially hazardous compounds and/or solutions, such as cleaning compounds and insecticides, shall be kept in a segregated space outside of food preparation or storage areas and bathrooms.
Section 370.1630 Laundry Services
a) Every facility shall have an effective means of supplying an adequate amount of clean linen for operation, either through an in-house laundry, a contract with an outside service, or each resident doing his or her own laundry as a part of a training program.
b) An adequate supply of clean linen shall be defined as the three sets of sheets, pillow cases and other linens needed to meet the needs of the residents. Additional changes of linen may be required in consideration of laundering and transporting soiled linens.
c) If an in-house laundry service is provided, then the following conditions shall exist:
1) Whether the laundry is done by each resident on his or her own or a staff member, the laundry area shall be maintained and operated in a clean, safe and sanitary manner.
2) Written operating procedures shall be developed, posted and implemented which provide for the handling, transport and storage of clean and soiled linens.
3) If the facility provides staff to do the laundry, then such laundry personnel must be in good health and practice good personal grooming. Employees must thoroughly wash their hands and exposed portions of their arms with soap and warm water before starting work, during work as often as necessary to keep them clean and after smoking, eating, drinking, using the toilet and handling soiled linens.
4) Clean linen shall be protected from contamination during handling, transport and storage.
5) Soiled linen shall be handled, transported and stored in a manner that protects facility residents and personnel.
6) The laundry and its accessary storage and handling areas shall not be used as a storage area for supplies not directly connected with the operation of the laundry.
d) If an outside laundry service is used, it shall provide for protection of clean linens during transport back to the facility.
e) If the facility provides laundry service for residents' personal clothing, it must be handled, transported and stored in a manner that will not allow contamination of clean linen or allow contamination by soiled linen.
SUBPART J: FURNISHINGS, EQUIPMENT AND SUPPLIES
Section 370.1810 Furnishings
a) Each resident shall be provided with a bed that is at least thirty-six (36) inches wide, be of sturdy construction and in good repair. Cots, roll-away or folding beds shall not be used. Double beds shall be used for married couples if they desire this arrangement. Single beds shall be provided for single residents, unless the resident and the facility are agreeable to the use of a double bed.
b) Each bed shall be provided with satisfactory type springs in good repair and a clean, firm, comfortable mattress of appropriate size for the bed.
c) Each bed shall be provided with a minimum of one (1) clean, comfortable pillow.
d) Each bedroom shall be furnished with enclosed space within the resident's room for hanging the resident's clothes. This space shall be at least two (2) feet by two (2) feet per resident and of sufficient height for hanging clothes.
e) Each resident shall be provided with a minimum of two (2) adequately sized drawers located in the resident's bedroom.
f) Each bedroom shall be provided with a mirror. Each lavatory shall be provided with a mirror.
g) Each bedroom shall have window shades, or equivalent, in good repair.
h) A bedside table, chair and satisfactory reading lamp, or equivalent, shall be provided for each bed.
i) Each living and multi-purpose room for residents' use shall be provided with an adequate number of reading lamps, tables and chairs or settees. These furnishings shall be well constructed and of satisfactory design for the residents.
j) Dining room furnishings that are well constructed, comfortable, in good repair and of satisfactory design shall be provided for each resident. A sufficient number of tables, of a type that can be used by wheelchair residents, shall be available to accommodate all wheelchair residents in the facility.
k) Office spaces and other areas shall be satisfactorily furnished with desks, chairs, tables, lamps, cabinets, counters and other furnishings essential to the proper use of the area.
l) A facility shall make reasonable efforts to have activated at all times the closed captioning feature on a television in a common area provided for use by the general public or in a resident's room, or enable the closed captioning feature when requested to do so by a member of the general public or a resident, if the television includes a closed captioning feature. As used in this subsection (l), "closed captioning" means a text display of spoken words presented on a television that allows a deaf or hard of hearing viewer to follow the dialogue and the action of a program simultaneously.
1) It is not a violation of this subsection if the closed captioning feature is deactivated by a member of the facility's staff after the feature is enabled in a common area or in a resident's room unless the deactivation of the closed captioning feature is knowing or intentional. It is not a violation of this subsection if the closed captioning feature is deactivated by a member of the general public, a resident, or a member of the facility’s staff at the request of a resident of the facility. Facilities shall ensure that staff are trained on the requirements of this subsection (l) and that staff, prior to deactivating a television's closed captioning feature, confirm with others within the television viewing area of the intention to deactivate the closed captioning feature. If residents are not in agreement on deactivating the closed captioning feature, then the closed captioning feature shall not be deactivated.
2) If a facility does not have a television in a common area that includes a closed captioning feature, then the facility shall ensure that all televisions subsequently obtained for common areas include a closed captioning feature. This subsection does not affect any other provision of law relating to disability discrimination or providing reasonable accommodations or diminish the rights of a person with a disability under any other law. Nothing in this subsection shall apply to televisions that are privately owned by a resident or third party and not owned by the facility. (Section 5.5 of the Act)
3) A facility shall post information regarding the availability of closed captioning on televisions in the facility and shall provide residents with information on how to activate the closed caption feature.
(Source: Amended at 47 Ill. Reg. 17196, effective November 1, 2023)
Section 370.1820 Equipment and Supplies
a) There shall be a sufficient supply of linen and bedding in good condition to provide proper cleanliness and comfort to the residents.
b) There shall be a first aid kit in each living unit. This shall contain bandages, sterile gauze dressings, bandage scissors, tape, sling, burn ointment, and any other first aid supplies and equipment.
c) Program supplies shall be provided to maintain an ongoing program and meet the varied interests and needs of the residents. These shall include, but are not limited to, games, craft supplies, current magazines,books, radio, and television.
d) Dishes and kitchen equipment shall be provided as set forth in Section 370.1470.
e) Cleaning equipment and supplies shall be provided as set forth in Section 370.1610 and 370.1620.
SUBPART K: WATER SUPPLY AND SEWAGE DISPOSAL
Section 370.2010 Codes
Water supply, sewage disposal and plumbing systems shall comply with all applicable State and local codes and ordinances.
Section 370.2020 Water Supply
a) Each facility shall be served by water from a municipal public water supply when available.
b) When a municipal public water supply is not available, the water supply shall comply with the Department's rules for "Drinking Water Systems" (77 Ill. Adm. Code 900), as amended promulgated pursuant to "An Act in Relation to Public Health (Ill. Rev. Stat. 1979, ch. 111½, pars. 22 et seq.), as amended.
c)
1) If water is supplied by a well that is not part of a municipal system, the well shall be constructed and maintained in accordance with the "Illinois Water Well Construction Code" (77 Ill. Adm. Code 920) and "Water Well Pump Installation Code" (77 Ill. Adm. Code 925).
2) Each facility shall have a written agreement with a water company, dairy, or other water purveyor to provide an emergency supply of potable water for drinking and culinary purposes.
Section 370.2030 Sewage Disposal
a) All sewage and liquid wastes shall be discharged into a public sewage system when available.
b) When a public sewage system is not available, sewage and liquid wastes shall be collected, treated, and disposed of in a private sewage disposal system. The design, construction, maintenance, and operation of the system shall comply with the "Private Sewage Disposal Licensing Code" (77 Ill. Adm. Code 905), as amended.
Section 370.2040 Plumbing
Each plumbing system shall comply with the "Illinois State Plumbing Code" (77 Ill. Adm. Code 890) and the rules promulgated thereunder effective at the time of construction and/or approved acceptance by the Department.
SUBPART L: DESIGN AND CONSTRUCTION STANDARDS FOR NEW COMMUNITY LIVING FACILITIES
Section 370.2210 Applicability of Standards
a)
1) These standards shall apply to all new community living facilities and major alterations and additions to existing community living facilities. (Major alterations are those that are not defined as minor alterations in Section 370.2210(f) herein.) A permit from the Illinois Health Facilities Planning Board is not required for Community Living Facilities.
2) Projects for which working drawings and specifications have received final approval by the Department prior to the promulgation of these Standards are subject only to those standards that were in effect at the time that final approval was given.
b) When construction is contemplated, either for new buildings or additions or major alterations to existing buildings coming within the scope of these standards, design development drawings and outline specifications shall be submitted to the Department for review. Approval of design development drawings and specifications shall be obtained from the Department prior to starting final working drawings and specifications. Comments or approval will be provided within thirty (30) days of receipt by the Department.
c) The final working drawings and specifications shall be submitted to the Department for review and approval prior to beginning of construction. For final approval to remain valid, contracts must be signed within one (1) year of the date of final approval. Alternate methods of design development and construction, such as fast track may be acceptable, subject to the approval of the Department. Comments or approval will be provided within thirty (30) days of receipt by the Department.
d) Any contract modifications which affect or change the function, design, or purpose of a facility shall be submitted to the Department for approval prior to authorizing the modifications. Comments or approval will be provided within thirty (30) days of receipt by the Department.
e) The Department shall be notified at least thirty (30) days before construction has been completed. The Department will then complete a final inspection. Deficiencies noted during the final inspection must be completed before occupancy will be allowed.
f) Minor alterations or remodeling changes which do not affect the structural integrity of the building, which do not change functional operation, which do not affect fire safety, and which do not add beds or facilities over those for which the community living facility is licensed need not be submitted for drawing approval.
g) No system of water supply, plumbing, sewage, garbage or refuse disposal shall be installed, nor any such existing system materially altered or extended until complete plans and specifications for the installation, alteration or extension have been submitted to the Department and have been reviewed and approved.
Section 370.2220 Codes and Standards
a) Each facility shall comply with the applicable provisions of the following codes and standards:
1) State of Illinois Codes and Standards
|
Code or Standard |
Agency |
A) |
Ill. State Plumbing Code (1976) (77 Ill. Adm. Code 890) |
Department of Public Health |
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B) |
Accessibility Standards (June 1978) (77 Ill. Adm. Code 400) |
Capital Development Board |
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C) |
Rules for Food Service Sanitation (1975) (77 Ill. Adm. Code 750) |
Department of Public Health |
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D) |
State of Illinois Safety Glazing Materials Act, 1971 (Ill. Rev. Stat. 1981, ch. 111½, pars. 3101 et seq.) |
State of Illinois Department of Labor |
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E) |
Rules for Fire Prevention and Safety (41 Ill. Adm. Code 100) September 1983 |
Office of State Fire Marshal Division of Fire Prevention |
2) Other Codes and References
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Codes or Standards |
Agency |
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A) |
National Fire Protection Association |
National Fire Protection Association |
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NFPA l0 – 1978 edition, Standard for Portable Extinguishers |
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ii) |
NFPA 70 – 1981 edition National Electric Code |
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iii) |
NFPA 72 – 1975 edition, Local Protective Systems |
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iv) |
NFPA 90A – 1978 edition, Air Conditioning and Ventilating Systems |
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v) |
NFPA 220 – 1979 edition, Standard Types of Building Construction |
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vi) |
NFPA 255 – 1979 edition, Test of Surface Burning Characteristics of Building Materials |
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B) |
Underwriters' Laboratory, Inc. (UL) |
Underwriters' Laboratories, Inc. |
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i) |
Fire Resistance Index (All Editions) |
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ii) |
Building Material Directory (All Editions) |
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C) |
America Society for Testing and Materials (ASTM) Standard No. E-84-1977A Method of Test for Surface Burning Characteristics of Building Materials (as currently revised in NFPA 225-1979) |
America Society for Testing and Materials |
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D) |
Uniform Building Code (1976 Edition) |
International Conference of Building Officials |
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b) In addition to compliance with the Standards set forth herein, all building codes, ordinances and regulations which are enforced by City, County or other local jurisdictions in which the facility is, or will be located must be observed.
c) Where no local building code exists, the recommendations of the 1976 Edition of the "Uniform Building Code" shall apply.
Section 370.2230 Preparation of Drawings and Specifications
a) The preparation of drawings and specifications shall be executed by or be under the immediate supervision of an architect registered in the State of Illinois.
b) All drawings and specifications shall contain the architect's name and address.
c) The first submission shall be the design development drawings indicating in detail the assignment of all spaces, size of areas and rooms, and indicating in outline, the fixed and movable equipment and furniture, and the outline specifications.
d) The plans shall be drawn at a scale sufficiently large to clearly present the proposed design.
e) Plans showing the proposed location must be submitted to the Illinois Department of Transportation, Division of Water Resources to determine compliance with the State Flood Plain Regulations and Executive Order IV, 1979.
f) The drawings shall include:
1) a plan of each floor including the basement or ground floor,
2) roof plan,
3) plot plan showing roads, parking areas, sidewalks, etc.,
4) elevations of all facades,
5) sections through the building,
6) identification of all fire and smoke compartmentation.
g) Outline specifications shall provide a general description of the construction including finishes; acoustical material, floor covering; heating and ventilating systems; description of the electrical system including the emergency electrical system.
h) The total gross floor area and bed count shall be shown on the drawings.
i) A brief narrative of the proposed program shall be submitted with the design development drawings and outline specifications.
j) Following approval of the design development drawings and the outline specifications, working drawings and specifications shall be submitted. All working drawings shall be well prepared and clear and distinct prints submitted. Drawings shall be accurately dimensioned and shall include all necessary explanatory notes, schedules and legends. Working drawings shall be complete and adequate for contract purposes. Drawings shall be prepared for each of the following branches of work: Architectural, Structural, Mechanical, Electrical and Plumbing.
1) The architectural drawings shall show:
A) Site plan showing all topography, newly established levels and grades, existing structures on the site (if any), new buildings and structures, roadways, walks, and the extent of the areas to be landscaped. All structures which are to be removed under the construction contract shall be shown.
B) Plan of each floor and roof.
C) Elevation of each facade.
D) Sections through building.
E) Scale Details as necessary at a scale sufficiently large to properly indicate details of the work.
F) Schedule of finishes.
2) The structural drawings shall show:
A) Plans of foundations, floors, roofs and all intermediate levels shall show the complete design with sizes, sections, and the relative location of the various members including:
B) Schedule of beams, girders and columns.
C) Notes on design data shall include the name of the governing building code, values of allowable unit stresses, assumed live loads, wind loads, earthquake load, and soil bearing pressures.
D) Details of special connections, openings, pipe sleeves and expansion joints.
E) Special structures shall include calculations defining load assumption, shear and moment diagrams and horizontal and vertical reactions.
3) Mechanical drawings with specifications shall show the complete heating, cooling and ventilation systems plumbing and drainage systems, and shall include the following:
A) Heating, Cooling and Ventilation.
i) Air conditioning systems with required equipment, water and refrigerant piping, and ducts.
ii) Supply and exhaust ventilating systems with connections and piping.
B) Plumbing and Drainage Systems.
i) Size and elevation of: street sewer, house sewer, house drains, street water main, and water service into the building.
ii) Location and size of soil, waste, and vent stacks with connections to house drains, cleanouts, fixtures and equipment.
iii) Size and location of hot, cold and circulating mains, branches, and risers from the service entrance, and tanks.
iv) Riser diagram of all plumbing stacks with vents, water risers and fixture connections.
v) All fixtures and equipment that require water and drain connections.
4) Electrical drawings shall show all electrical wiring, outlets, and equipment which require electrical connections, and shall include the following:
A) Electrical service entrance with switches and feeders to the public service feeders, characteristics of the light and power current, transformers and their connections.
B) Location of main switchboard, power panels, light panels and equipment. Feeder and conduit sizes shall be shown with schedule of feeder breakers or switches.
C) Light outlets, receptacles, switches, power outlets, and circuits.
D) Telephone layout showing service entrance, telephone switchboard, strip boxes, telephone outlets and branch conduits as approved by the telephone company. Where public telephones are used for intercommunication, provide separate room and conduits for racks and automatic switching equipment as required by the telephone company.
E) Fire alarm system with stations, signal devices, control board and wiring diagrams.
F) Emergency electrical system with outlets, transfer switch, source of supply, feeders, and circuits.
G) All other electrically operated systems and equipment.
5) When the project is an addition, the preceding requirements apply and details and information on the existing building also shall be provided as follows:
A) Type of activities within the existing building and distribution of existing beds, etc.
B) Type of construction of existing building and number of stories in height.
C) Plans and details showing attachment of new construction to the existing structure.
D) Mechanical and Electrical systems showing connections to the existing system.
6) The Department may require submission of drawings of all or any part of the existing structure.
7) Specifications shall supplement the drawings and shall: Describe, except where fully indicated and described on the drawings, the materials, workmanship, kind, sizes, capacities, finishes, and other characteristics of all materials, products, articles and devices.
Section 370.2240 Site
a) The facility shall be located on a reasonably flat or rolling, well drained site that is not subject to flooding and reasonably free from sources of excessive noise, noxious or hazardous smoke or fumes. The facility shall not be located in deteriorated, unpleasant, or potentially hazardous area; nor near uncontrolled sources of insect and rodent breeding.
b) The facility shall be located so that the building or buildings can comply with all applicable local zoning ordinances, building restrictions and fire safety requirements. The Department may impose requirements if the proposed locations of the building or buildings on the site would result in a hazard to, or be detrimental to the health, welfare, or safety of the residents in the facility.
c) The facility shall be located in a community which can provide the necessary supportive services for the home such as physicians' services, medical facilities, public utilities, or other acceptable substitutes; and be located on a well-maintained, all-weather road.
d) The facility shall be located in a section of the community conveniently accessible to reach public transportation, parks, churches, shopping and other community resources, which will be beneficial in the residents' training program toward independent living.
e) The facility shall be served by a potable water supply with water pressure and volume that is acceptable to this Department and the Office of the State Fire Marshal.
f) The distance from the fire station, the accessibility of the facility, and capability of the fire department must be approved in writing by the Office of the State Fire Marshal.
g) The facility shall have at least one (1) municipal or private fire hydrant, located within three hundred (300) feet of every point on the perimeter of the building and satisfactory for use by the equipment of the fire department serving the building, or have an acceptable equivalent. Additional hydrants may be required, if needed, to properly protect the residents from fire hazards. Evaluation and written approval must be obtained from the Office of the State Fire Marshal.
Section 370.2250 Administration
a) Facilities for the physically handicapped (public, staff) shall be provided in administration and public areas if these areas are located within the facility.
b) Each facility shall provide sufficient space for clerical, financial and managerial functions.
c) Each facility shall provide a toilet room with a water closet and a lavatory for staff and visitors.
Section 370.2260 Bedrooms
a) Each single bedroom used for a resident shall have at least one hundred (100) square feet of usable net floor area, not including any space taken up for closets, wardrobes, bathrooms, and clearly definable entryway areas.
b) Each multiple bedroom used for residents shall have for each resident housed in the room at least seventy-five (75) square feet of usable floor area. Usable area does not include any space utilized for closets, wardrobes, bathrooms, and clearly definable entryway areas. Maximum room capacity shall be two (2) residents. There shall be a three (3) foot minimum distance between beds.
c) Resident bedrooms shall have an entrance directly off an exit corridor or may be part of an apartment suite (bedrooms, toilet, living/dining room and residential kitchen) having an entrance to an exit corridor.
1) Entrance door to an apartment suite or resident bedroom shall swing into the room.
2) No room that opens into a central kitchen or necessitates passing through a central kitchen shall be used as a resident bedroom.
d) Each room used as a resident bedroom shall have at least one (1) outside window, and a total window area to the outside equal to at least one-tenth (1/10) the floor area of the room. The total window area may be reduced to 7.5% of the floor area of the room if wood or other non-cold conducting sash such as metal sash with a thermal break and double or triple insulating glass is used, except that at least nine (9) square feet of window area is required in single bedrooms.
e) Each bedroom shall have adequate and satisfactory artificial light.
f) Each resident shall have access to a toilet room.
g) Each facility shall provide a closet or wardrobe of at least six (6) square feet for each resident.
h)
1) Each bedroom floor shall be no more than three (3) feet below the adjacent ground level.
2) Each below grade bedroom shall be designed to maintain a dry and comfortable environment.
i) The furniture in the room shall be so arranged, even if it reduces the bed capacity of the room, so that the bed, bedside stand and chair for each resident will be reasonably well arranged.
Section 370.2270 Nurses' Station
A nurses' station is not a requirement, but provision for twenty-four (24) hour staff supervision shall be provided within each unit (See Subpart D).
Section 370.2280 Bath and Toilet Rooms
a) Each facility shall provide a minimum of one (1) water closet, one (1) lavatory and one (1) bathtub or shower for each sex on each floor occupied by residents.
1) Each facility shall provide bathroom fixtures in the following minimum numbers. The number of resident beds shall be used in determining the number of bathroom fixtures required, irrespective of the fact that some of the beds may not be occupied.
2) Each facility shall provide one (1) lavatory and one (1) water closet for each six (6) resident beds on each floor.
3) Each facility shall provide one (1) bathtub or shower for each eight (8) resident beds on each floor, which is not otherwise served by bathing facilities adjacent to the resident room.
b)
1) Each tub or shower shall be in an individual room or enclosure which provides space for the private use of the bathing fixture, and for drying and dressing.
2) Showers shall be at least 3'-0" square.
Section 370.2290 Living, Dining Room, and Activity Room(s)
a) These rooms shall be so located that the room is not an entrance vestibule from the out-of-doors, nor an obstruction to traffic in and out of the facility.
b)
1) Each facility shall provide at least one (1) comfortably furnished living room.
2) The minimum floor space for a living room shall be one hundred twenty (120) square feet. The living room shall have a total window area equal to at least one-tenth (1/10) the floor area.
c) Provide a dining room with sufficient area to properly and comfortably seat the residents it serves.
d) The combined area of the living, dining, and activity rooms shall be not less than thirty (30) square feet per resident bed.
Section 370.2300 Kitchen
a) Provide a central kitchen or residential kitchen properly located for efficient food service, and large enough to accommodate the equipment and personnel needed to prepare and serve properly the number of meals required as determined by the Department. The size of kitchen shall be approximately ten (10) square feet per resident bed.
b) Provide kitchen equipment in an arrangement for convenient operation, good sanitation, healthful working conditions and control of heat, noise, and odors.
c) Provide appropriate equipment for the preparation and serving of meals.
d) Provide refrigeration of perishable foods.
e) Provide a two (2) compartment sink equipped with drain boards. One (1) compartment is for washing dishes and the other is for rinsing and sanitizing them. The compartment for sanitizing shall be sufficiently deep to allow complete submersion of all items washed. A domestic type dishwashing machine equipped with sanitizing features is required for kitchens serving more than ten (10) residents.
f) The central kitchen shall be provided with a handwashing lavatory. The 2-bowl sink may be used for handwashing.
g) The walls and ceilings of all food handling rooms shall be finished with smooth, washable, light-colored surfaces.
h) All openings to the outside shall be effectively screened during fly seasons, and screen doors shall be equipped with self-closing devices, or a satisfactory alternative method.
i) The central kitchen shall be located so that no resident must pass through it to reach a bathroom, resident's bedroom, the living room, dining room, or the out-of-doors.
Section 370.2310 Laundry Room
a) Provide a laundry room equipped with appropriate and satisfactory type equipment of a design to meet the needs of the facility unless a commercial laundry is used.
b) Laundry facilities shall not be located in rooms used for food storage, preparation, or serving.
Section 370.2320 Housekeeping and Storage
a) Sufficient janitor's closets shall be provided throughout the facility as required to maintain a clean and sanitary environment. Each shall contain a floor receptor or service sink and storage space for housekeeping equipment and supplies. Space(s) for large housekeeping equipment and for back-up supplies may be centrally located.
b) Provide a total area of approximately ten (10) square feet per resident bed for the storage of excess personal possessions of residents and staff, linens, supplies, activity materials and other items. This does not include closets or wardrobes in residents' rooms. Separate storage space with provisions for locking and security control shall be provided for residents' personal effects which are not kept in residents' bedrooms.
c) Provide storage rooms for maintenance supplies, yard equipment, etc.
Section 370.2330 Building General
a) General
1) Building shall not be a structural part of a long-term care facility or other institutional buildings.
2) Provide a room arrangement that will permit the facility to be divided functionally into living units for not more than twenty (20) residents. Each living unit shall contain its own living room and dining room.
3) Each facility shall have a maximum capacity of twenty (20) beds.
4) Buildings of one (1) story in height shall be constructed of fire resistive, protected noncombustible, protected ordinary, protected wood frame, heavy timber, or unprotected noncombustible construction. Buildings of fire resistive construction are not limited in height or number of stories. Buildings of two (2) stories or more in height may be of any approved construction type and must be equipped throughout with an approved automatic extinguishing system, except for fire-resistive construction.
5) All corridors shall be four (4) feet in clear and unobstructed width.
b) Doors and Windows
1) Main entrance and all exit doors shall be thirty six (36) inches in width and shall swing outward and be provided with door closers.
2) Exit access doors and all doors used by the residents (except toilets) shall be thirty-two (32) inches in width, side-hinged, swingingtype.
3) The doors for the toilet rooms used by residents shall have a minimum door width of thirty (30) inches.
4) Resident toilet rooms shall open directly into a corridor or into a resident bedroom.
5) No toilet or bathroom door shall be provided with hardware which could allow a resident to become locked in the room. All toilet and bathroom doors and hardware shall be designed to permit emergency ingress to the room.
6) Locks installed on residents' bedroom and apartment suite doors shall be so arranged that they can be quickly and easily unlocked from the corridor side. All such locks shall be arranged to permit exit from the room by a simple operation without the use of a key. The door may be lockable by the occupant if the door can be locked from the corridor side and keys are carried by the attendants at all times.
7) All doors to bedrooms and exit corridors shall be a minimum of one and three-fourth (1¾) inches thick solid core wood or equivalent, with positive latching, and without louvers.
8) Doors that are part of a 2-hour fire rated wall separating sections of the building, or an abutting building, must be at least one and one-half (1½) hour, "B" label and self-closing.
9) Doors in stairways shall have a fire protection rating of twenty (20) minutes, be self-closing and self-latching. Provide a wire glass vision panel in a steel frame.
10) Doors and windows shall fit snugly and be weather tight, yet open and close easily.
11) Outside doors, other than required exits, and operable windows shall be equipped with tight-fitting, 16-mesh screens. Screen doors shall be equipped with self-closing devices.
c) Floors
1) Floors shall be smooth, free from cracks and finished so that they can be easily and properly cleaned. Floors shall be covered wall to wall with water resistant material in wet areas including but not limited to bathrooms, kitchens, utility rooms.
2) Thresholds and expansion joints shall be flush with the floor to facilitate use of wheelchairs and carts.
d) Walls and Ceiling
1) All rooms occupied or used by residents shall have ceilings not less than eight (8) feet in height.
2) Corridors, storage rooms, toilet rooms and other minor rooms shall have ceilings not less than seven (7) feet eight (8) inches in height.
3) Projections located in the path of traffic shall be not less than six (6) feet eight (8) inches above the floor.
4) Materials used for wall construction shall be highly resistant to impact damage.
e) Mirrors shall be installed above all lavatories except handwashing lavatories in food preparation areas.
f) Provide paper towel dispensers and waste receptacles at all lavatories except those located within, or directly off of a resident's room.
g) Interior finish materials (floors, walls and ceilings) shall be either Class A (flame spread 0-25 smoke development 0-450) or Class B (flame spread 26-75 smoke development 0-450).
h) There shall be at least one (1) approved fire extinguisher in all basements, furnace rooms, kitchens, and laundry rooms. In addition, there shall be at least one fire extinguisher on each floor of the building, located so a person will not have to travel more than fifty (50) feet from any point to reach one. They shall be inspected annually and recharged when necessary. The date of checking and recharging shall be recorded on a tag attached to the extinguisher.
i)
1) Approved containers with proper covers shall be provided for storage of rubbish and waste.
2) Housekeeping throughout the building, including basements, attics and unoccupied rooms shall be adequately performed to minimize fire hazards.
Section 370.2340 Exit Facilities and Subdivision of Floor Areas
a) At least two (2) exits, remote from each other, shall be provided for each floor or fire section of the building used by residents. At the upper floor level, at least one of the means of egress shall consist of an enclosed interior stairway, an exterior stairway, or a horizontal exit.
b) Exits shall be so located that the entrance door of every resident's bedroom and of every living, dining, and activity room is not more than one hundred (100) feet along the line of travel to the nearest exit. This distance may be increased up to one hundred fifty (150) feet if the entire building is protected by a complete automatic sprinkler system.
c) Basements used by residents for such purposes as recreation, group meetings, dining, or laundry shall be provided with two (2) means of exit. At least one of the exits shall have direct access to the outside of the building.
d) Fire escape stairs shall not be accepted as constituting any part of the required means of egress for new buildings.
e) All corridors and passages to be used as a means of exit, or part of means of exit, shall not lead through any room or space used for a purpose that may obstruct free passage.
f) Means of egress shall be so arranged that there are no dead end pockets, hallways, corridors, passageways, or courts whose depth exceeds twenty (20) feet.
g) Corridor walls shall have a fire-resistive rating of at least one (1) hour. Corridor walls may terminate at the underside of the ceiling.
Section 370.2350 Stairways and Vertical Openings
a) Interior stairways shall be enclosed with construction having a 1-hour fire resistance rating, exit directly to outside grade and have a door at all floors.
b) Light or ventilation shaft, chute and other vertical openings between stories shall be enclosed with construction having a 1-hour fire resistance rating.
c) Every multi-level facility shall have stairways with a minimum headroom of six (6) feet, eight (8) inches and a maximum height of twelve (12) feet between landings; a minimum clear width of three (3) feet, except handrails which may project not more than three and one-half (3½) inches on each side, a handrail is required only on one side of the stair. The width of treads exclusive of nosing or projection shall be not less than nine (9) inches and risers shall be not more than eight (8) inches. Stairways with triangular or winding treads or single risers are not acceptable.
d) Every stairway shall have a landing that is at least as deep as the width of the stairway door.
e) Usable space under stairs shall not be used for storage.
f) Means of egress such as stairs, stair landings, balconies, ramps and aisles, located along the edge of open-sided floors and mezzanines, shall have guardrails to prevent falls over the open side. Each new stair shall have handrails on at least one side.
Section 370.2360 Hazardous Areas
Walls at enclosure of hazardous areas shall have a one (1) hour fire resistive rating. Doors at enclosure of hazardous areas shall be a minimum three-fourth (¾) hour "C" label, with automatic closer. Hazardous areas include the following:
a) Kitchens
b) Furnace and heater rooms
c) Laundries
d) Rooms or spaces, including repair shops, used for the storage of combustible supplies and equipment in quantities deemed hazardous by the authority having jurisdiction.
Section 370.2370 Structural
a) The buildings and all parts thereof shall be of sufficient strength to support all dead, live, and lateral loads without exceeding the working stresses permitted for the materials of their construction in generally accepted good engineering practice.
b) Special Provisions
1) Special provision shall be made for loads which have a greater load than the specified minimum live load, including partitions which are subject to change of location.
2) Consideration shall be given to structural members and connections of structures which may be subject to earthquakes or tornadoes.
c) Foundations shall rest on natural solid ground and shall be carried to a depth of not less than one foot below the frost line.
d) Assumed live loads shall be in accordance with the ICBO Uniform Building Code.
Section 370.2380 Mechanical Systems
a) Mechanical systems shall be tested, balanced, and operated to demonstrate that the installation and performance of these systems conform to the requirements of these standards.
b) Upon the completion of the contract, the owner shall be furnished with a complete set of manufacturer's operating and preventative maintenance instructions, parts list with numbers and descriptions for each piece of equipment and a copy of the air-balance report. A complete set of these documents shall be kept on the premises.
c) The owner shall be provided with instructions in the operational use of the systems and equipment as required.
d) A design temperature of 75º F for both summer and winter design conditions shall be provided for all patient use areas including corridors.
e) All ventilation supply, return and exhaust systems shall be mechanically operated.
f) Air conditioning and ventilation systems shall be designed, installed and maintained as required by National Fire Protection Association Standard 90A or 90B, depending on the size of the facility.
Section 370.2390 Plumbing Systems
a) All plumbing systems shall be designed and installed in accordance with the requirements of the "Illinois State Plumbing Code" except that the number of water closets, lavatories, bathtubs, showers, and other fixtures shall be as required by these Standards and the Facility's program.
b) Plumbing fixtures shall be of nonabsorptive acid-resistant materials.
c) Shower bases and tub bottoms shall be provided with nonslip surfaces.
d) Water supply systems shall be designed to supply water at sufficient pressure and volume to operate all fixtures and equipment during maximum demand periods.
e) Hot water distribution systems shall be arranged to provide hot water at each hot water outlet at all times. Hot water at shower, bathing and handwashing facilities shall not exceed 110º F.
f) Water storage tanks shall be fabricated of corrosion resistant metal or lined with noncorrosive material.
g) Insofar as possible, drainage piping shall not be installed above the ceiling nor installed in an exposed location in food preparation centers, food serving facilities, food storage areas, and other critical areas. Special precautions shall be taken to protect these areas from possible leakage or condensation from necessary overhead piping systems.
Section 370.2400 Electrical Systems
a) All material including equipment, conductors, controls, and signaling devices shall be installed to provide a complete electrical system with the necessary characteristics and capacity to supply the electrical facilities required by these Standards. All materials shall be listed as complying with available standards of Underwriters' Laboratories, Inc. or other similarly established standards.
b) All spaces occupied by people, machinery, and equipment within buildings, approaches to and exits from buildings, and parking lots shall have lighting.
c) Residents' rooms shall have general lighting. At least one light fixture shall be switched at the entrance to each resident room. All switches for control of lighting in residents' sleeping areas shall be of the quiet operating type.
d) Receptacles (Convenience Outlets)
1) Each resident bed room shall have duplex grounding type receptacles as follows: At least one located at the head of each bed; one for television if used; and one on another wall. Receptacles are to be located between twelve (12) to thirty (30) inches above the finished floor.
2) Resident bathrooms shall have at least one duplex receptacle.
3) At least one duplex receptacle shall be installed in each corridor.
Section 370.2410 Fire Alarm and Detection System
a) Provide an approved supervised fire alarm system.
b) An approved automatic smoke detection system shall be installed on each floor level. Such system shall be installed in accordance with National Fire Protection Association Standard 101, Section 6-3 of the 1976 Edition of the Life Safety Code, and with National Fire Protection Association Standard 72, 1975 Edition. In no case shall smoke detectors be spaced further apart than thirty (30) feet on center, or more than fifteen (15) feet from any wall. The automatic smoke detection system shall be electrically interconnected to the fire alarm system.
c) The fire alarm system shall automatically transmit the alarm to any available municipal fire department by direct private line or through any approved central station.
Section 370.2420 Emergency Electrical System
An emergency electrical service, which may be battery operated if effective for four (4) or more hours, shall provide services as follows:
a) Illumination of means of egress
b) Fire detection and alarm system
c) Telephone service
d) Exit sign fixtures.
Section 370.2430 Fire Protection
The Department, or upon request the Fire Prevention Division of the Office of the State Fire Marshal, will make inspections for fire safety and compliance with these Standards. The Fire Prevention Division shall call to the attention of the Department of Public Health any violations of these standards pertaining to fire protection found during a requested inspection. The Department, or upon request, the Fire Prevention Division, shall be privileged to make as many subsequent visits as deemed necessary by the Department for assurance of compliance.
SUBPART M: DESIGN AND CONSTRUCTION STANDARDS FOR EXISTING COMMUNITY LIVING FACILITIES
Section 370.2610 Applicability of Standards
a) These standards shall apply to all existing Community Living Facilities and all minor alterations or remodeling changes to existing structures that are in conformance with construction type and height. See Subpart L for New Construction and Major Additions and Alterations.
b) Minor alterations or remodeling changes which do not affect the structural integrity of the building, which do not change functional operations, which do not affect fire safety, and which do not add beds or facilities over those for which the Community Living Facility is licensed need not be submitted for drawing approval. A permit from the Illinois Health Facilities Planning Board is not required for Community Living Facilities.
Section 370.2620 Codes and Standards
a) Nothing stated herein shall relieve the sponsor from compliance with building codes, ordinances and regulations which are enforced by City, County or other local jurisdictions.
b) The following codes which were effective at the date of approval by the Department of the final drawings and specifications or the final inspection of the building apply:
1) Illinois State Plumbing Code (77 Ill. Adm. Code 690) Department of Public Health
2) Accessibility Standards for the Handicapped (77 Ill. Adm. Code 400) Capitol Development Board
3) Rules for Fire Prevention and Safety (41 Ill. Adm. Code 100) Office of State Fire Marshal Division of Fire Prevention
4) Rules for Food Service Sanitation (77 Ill. Adm. Code 750) Department of Public Health
5) State of Illinois Safety Glazing Materials Act (Ill. Rev. Stat. 1981 ch. 111 1/2, par. 3101), l97l Department of Labor
Section 370.2630 Preparation of Drawings and Specifications
Drawings and specifications which are prepared for work which is required by these Standards shall be prepared in accordance with Section 370.2230 of the Construction Standards for New Community Living Facilities.
Section 370.2640 Site
a) Each facility shall comply with all applicable zoning ordinance and be located on a reasonably flat or rolling, well-drained site that is: not subject to flooding; reasonably free from sources of excessive noise, noxious or hazardous smoke or fumes. The facility shall not be located in a deteriorated, unpleasant, or potentially hazardous area; nor near uncontrolled sources of insect and rodent breeding.
b) Each facility shall be located in or near a community which can provide the necessary supportive services for the facility such as physicians' services, medical facilities, public utilities, or other acceptable substitutes; and be located on a well-maintained, all-weather road.
c) Each facility shall be located in a section of the community conveniently accessible to reach public transportation, parks, churches, shopping and other community resources which will be beneficial in the residents' training program toward independent living.
d) Each facility shall be served by a potable water supply with water pressure and volume that is acceptable to this Department.
e) The distance from the fire station, the accessibility of the facility, and capability of the fire department must be approved in writing by the Office of the State Fire Marshal.
f) Each facility shall have at least one (1) municipal or private fire hydrant, located within three hundred (300) feet of the building and satisfactory for use by the equipment of the fire department serving the building, or have an acceptable equivalent. Additional hydrants may be required if needed to properly protect the residents from fire hazards.
Section 370.2650 Administration and Public Areas
a) Facilities for the physically handicapped (public, staff) shall be provided in administration and public areas if these are located within the facility.
b) Each facility shall be provided with sufficient space for clerical, financial and managerial functions.
c) Each facility shall be provided with a toilet room with a water closet and lavatory for staff and visitors.
Section 370.2660 Bedrooms
a) Each single bedroom used for a resident shall have at least seventy (70) square feet of usable net floor area, not including any space taken up for closets, wardrobes, bathrooms, and clearly definable entryway areas.
b) Each multiple bedroom used for residents shall have for each resident housed in the room at least sixty (60) square feet of usable floor area. Usable area does not include any space utilized for closets, wardrobes, bathrooms, and clearly definable entryway areas. Maximum room capacity shall be two (2) residents. There shall be a three (3) foot minimum distance between beds.
c) Resident bedrooms shall have an entrance directly off an exit corridor or may be part of an apartment suite (bedrooms, toilet, living/dining room and residential kitchen) having an entrance to an exit corridor.
1) Entrance door to an apartment suite or a resident bedroom shall swing into the room.
2) No room that opens into a central kitchen or necessitates passing through a central kitchen shall be used as a resident bedroom.
d) Each room used as a resident bedroom shall have at least one (1) outside window, and a total window area to the outside equal to at least one-tenth (1/10) the floor area of the room.
e) Each bedroom shall have adequate and satisfactory artificial light.
f) Each resident shall have access to a toilet room.
g) A closet or wardrobe of at least four (4) square feet shall be provided for each resident.
h)
1) Each bedroom floor shall be no more than three (3) feet below the adjacent ground level.
2) Each below grade bedroom shall be designed to maintain a dry and comfortable environment.
i) The furniture in the room shall be so arranged, even if it reduces the bed capacity of the room, so that the bed, bedside stand and chair for each resident will be reasonably well arranged.
Section 370.2670 Nurses' Station
A nurses' station is not a requirement, but provision for twenty-four (24) hour staff supervision shall be provided within each unit. (See Subpart D)
Section 370.2680 Bath and Toilet Rooms
a) Provide a minimum of one (1) water closet, one (1) lavatory and one (1) bathtub or shower for each sex on each floor occupied by residents.
1) Provide bathroom fixtures in the following minimum numbers. The number of resident beds shall be used in determining the number of bathroom fixtures required, irrespective of the fact that some of the beds may not be occupied.
2) Provide one (1) lavatory and one (1) water closet for each six (6) resident beds on each floor.
3) Provide one (1) bathtub or shower for each eight (8) resident beds on each floor, which is not otherwise served by bathing facilities adjacent to the resident room.
b)
1) Each tub or shower shall be in an individual room or enclosure which provides space for the private use of the bathing fixture, and for drying and dressing.
2) Showers shall be at least 3'-0" square.
Section 370.2690 Living, Dining Room, and Activity Room(s)
a) These rooms shall be so located that the room is not an entrance vestibule from the out-of-doors, nor an obstruction to traffic in and out of the facility.
b) Living Room
1) Provide at least one (1) comfortably furnished living room on each floor.
2) The minimum floor space for a living room shall be eighty (80) square feet. The living room shall have a total window area of at least one-tenth (1/10) the floor area.
c) Provide a dining room with sufficient area to properly and comfortably seat the residents it serves.
d) The combined area of the living, dining, and activity rooms shall be not less than fifteen (15) square feet per resident bed.
Section 370.2700 Kitchen
a) Provide a central kitchen or residential kitchen properly located for efficient food service, and large enough to accommodate the equipment and personnel needed to prepare and serve properly the number of meals required as determined by the Department. The size of kitchens shall be approximately ten (10) square feet per resident bed.
b) Provide kitchen equipment in an arrangement for convenient operation, good sanitation, healthful working conditions and control of heat, noise, and odors.
c) Provide appropriate equipment for the preparation and serving of meals.
d) Provide refrigeration of perishable foods.
e) Provide a two (2) compartment sink equipped with drain boards. One (1) compartment is for washing dishes and the other is for rinsing and sanitizing them. The compartment for sanitizing shall be sufficiently deep to allow complete submersion of all items washed. A domestic type dishwashing machine equipped with sanitizing features is required for kitchens serving more than ten (10) residents.
f) The central kitchen shall be provided with a handwashing lavatory. The 2-bowl kitchen sink may be used for handwashing.
g) The walls and ceilings of all food handling rooms shall be finished with smooth, washable, light-colored surfaces.
h) All openings to the outside shall be effectively screened during fly seasons, and screen doors shall be equipped with self-closing devices; or a satisfactory alternative method.
i) The central kitchen shall be located so that no resident must pass through it to reach a bathroom, resident's bedroom, the living room, dining room, or the out-of-doors.
Section 370.2710 Laundry Room
a) Provide a laundry room equipped with appropriate and satisfactory type equipment of a design to meet the needs of the facility unless a commercial laundry is used.
b) Laundry facilities shall not be located in rooms used for food storage, preparation, or serving.
Section 370.2720 Housekeeping and Storage
a) Sufficient janitor's closets shall be provided throughout the facility as required to maintain a clean and sanitary environment. Each shall contain a floor receptor or service sink and storage space for housekeeping equipment and supplies. Space(s) for large housekeeping equipment and for back-up supplies may be centrally located.
b) Provide a total area of approximately ten (10) square feet per resident bed for the storage of excess personal possessions of residents and staff, linens, supplies, activity materials and other items. This does not include closets or wardrobes in residents' rooms. Separate storage space with provisions for locking and security control shall be provided for residents' personal effects which are not kept in residents' bedrooms.
c) Provide storage rooms for maintenance supplies, yard equipment, etc.
Section 370.2730 Building General
a) General
1) Building shall not be a structural part of a long-term care facility or other institutional buildings.
2) Provide a room arrangement that will permit the facility to be divided functionally into living units for not more than twenty (20) residents. Each living unit shall contain its own living room and dining room.
3) Each facility shall have a maximum capacity of twenty (20) beds, except as provided for in Section 18 of the Community Living Facilities Licensing Act (Ill. Rev. Stat. 1981 ch. 111½ par. 4197 et seq.) approved September 23, 1981, as amended by Public Act 82-745.
4) Buildings of one (1) story in height shall be constructed of fire resistive, protected noncombustible, protected ordinary, protected wood frame, heavy timber, or unprotected noncombustible construction. Buildings of fire resistive construction are not limited in height or number of stories. Buildings of two (2) stories or more in height may be of any approvable construction type and must be equipped throughout with an approved automatic extinguishing system, except for fire-resistive construction.
5) All corridors shall be three (3) feet in clear and unobstructed width.
b) Doors and Windows
1) Main entrance and exit doors shall be thirty-six (36) inches in width and shall swing outward and be provided with door closers.
2) Exit access doors and all doors used by the residents (except toilets) shall be thirty-two (32) inches in width, side-hinged, swinging type.
3) The doors for the toilet rooms used by residents shall have a minimum door width of thirty (30) inches.
4) Resident toilet rooms shall open directly into a corridor or into a resident's bedroom.
5) No toilet or bathroom door shall be provided with hardware which could allow a resident to become locked in the room. All toilet and bathroom doors and hardware shall be designed to permit emergency ingress to the room.
6) Locks installed on resident bedroom and apartment suite doors shall be so arranged that they can be quickly and easily unlocked from the corridor side. All such locks shall be arranged to permit exit from the room by a simple operation without the use of a key. The door may be lockable by the occupant if the door can be unlocked from the corridor side and the keys are carried by the attendants at all times.
7) All doors to bedrooms and exit corridors shall be at least one and three-eights (1 3/8) inches thick solid core wood or equivalent, with positive latching, and without louvers.
8) Doors that are part of a 2 hour rated fire wall separating sections of a building, or an abutting building, must be at least one and one half (1½) hour, 'B' label and self-closing.
9) Doors in stairways shall be at least one and three-eights (1⅜) inches thick solid core wood or equivalent with a wire glass vision panel in a steel frame. The door shall be self-closing and self-latching.
10) Doors and windows shall fit snugly and be weather tight, and shall open and close easily.
11) Outside doors, other than required exits, and operable windows shall be equipped with tight-fitting, l6-mesh screens. Screen doors shall be equipped with self-closing devices.
c) Floors
1) Floors shall be smooth, free from cracks and finished so that they can be easily and properly cleaned.
2) Floors in bathrooms, kitchens, and utility rooms shall be completely covered with water resistant material.
d) Walls and Ceilings
1) All rooms occupied or used by residents shall have ceilings not less than seven (7) feet eight (8) inches in height.
2) Corridors, storage rooms, toilet rooms and other minor rooms shall have ceilings not less than seven (7) feet six (6) inches in height.
3) Projections located in the path of traffic shall be not less than six (6) feet eight (8) inches above the floor.
4) Materials used for wall construction shall be highly resistant to impact damage.
e) Mirrors shall be installed above all lavatories except handwashing lavatories in food preparation areas.
f) Paper towel dispensers and waste receptacles shall be provided at all lavatories, except those located within, or directly off of a resident's room.
g) Interior finish materials (floors, walls and ceilings) shall be either:
1) Class A – (Flame spread 0-25 Smoke development 0-450)
2) Class B – (Flame spread 26-75 Smoke development 0-450)
h) There shall be at least one (1) approved fire extinguisher in all basements, furnace rooms, kitchens, and laundry rooms. In addition, there shall be at least one fire extinguisher on each floor of the building, located so a person will not have to travel more than fifty (50) feet from any point to reach one. They shall be inspected annually and recharged when necessary. The date of checking and recharging shall be recorded on a tag attached to the extinguisher.
i) Approved containers with proper covers shall be provided for storage of rubbish and waste.
j) Housekeeping throughout the building, including basements, attics, and unoccupied rooms shall be adequately performed to minimize all fire hazards.
Section 370.2740 Exit Facilities and Subdivision of Floor Areas
a) At least two (2) exits, remote from each other, shall be provided for each floor or fire section of the building used by residents. At the upper floor level, at least one of the means of egress shall consist of an enclosed interior stairway, an exterior stairway, or a horizontal exit.
b) Exits shall be so located that the entrance door of every resident's bedroom or apartment suite and of every living, dining, and activity room is not more than one hundred (100) feet along the line of travel to the nearest exit. This distance may be increased up to one hundred fifty (150) feet if the entire building is protected by a complete automatic sprinkler system.
c) Basements used by residents for such purposes as recreation, group meetings, dining, or laundry shall be provided with two (2) means of exit. At least one of the exits shall have direct access to the outside of the building.
d) Fire escape stairs may be accepted as being part of the required means of egress, subject to the approval of the authority having jurisdiction.
e) All passages to be used as a means of exit, or part of a means of exit, shall not pass through any room or space used for any purpose that may obstruct free passage.
f) Means of egress shall be so arranged that there are no dead end pockets, hallways, corridors, passageways, or courts whose depth exceeds twenty (20) feet.
g) Corridor walls shall have a fire-resistive rating of at least one-third (⅓) hour. Corridor walls may terminate at the underside of the ceiling.
Section 370.2750 Stairways and Vertical Openings
a) Interior stairways shall be enclosed with construction having one-third (⅓) hour fire resistance rating. It shall exit directly to the outside grade, and have a door at all floors.
b) Light or ventilation shaft, chute and other vertical openings between stories shall be enclosed with construction having a fire resistance rating at least one-third (⅓) hour.
c) Every multi-level facility shall have stairways with a minimum headroom of six (6) feet, eight (8) inches and a maximum height of twelve (12) feet between landings; a minimum clear width of three (3) feet, except handrails which may project not more than three and one-half (3½) inches on each side, handrail is required only on one side of stair; width of treads exclusive of nosing or projection not less than nine (9) inches and risers of not more than eight (8) inches. Stairways with triangular or winding treads or single risers are not acceptable.
d) Every stairway shall have a landing that is at least as deep as the width of the stairway door.
e) Usable space under stairs shall not be used for storage.
f) Means of egress such as stairs, stair landings, balconies, ramps and aisles, located along the edge of open-sided floors and mezzanines, shall have guardrails to prevent falls over the open side.
Section 370.2760 Hazardous Areas
a) Walls at enclosure of hazardous areas shall have a one-hour fire resistive rating. Doors at enclosure of hazardous areas shall be a minimum of one and three-eights (1⅜) inch thick solid core wood or equivalent and be self closing.
b) Hazardous areas include the following:
1) Kitchens
2) Furnace and heater rooms
3) Laundries
4) Rooms or spaces, including repair shops, used for the storage of combustible supplies and equipment in quantities deemed hazardous by the authority having jurisdiction.
Section 370.2770 Structural
a) Buildings and all parts thereof shall be maintained structurally to support all dead, live and lateral loads.
b) Buildings shall be maintained in good repair. Buildings that show signs of distress shall be repaired immediately.
Section 370.2780 Mechanical Systems
a) Mechanical systems shall be tested, balanced, and operated to demonstrate that the installation and performance of these systems conform to the requirements of these standards.
b) Upon the completion of the contract, the owner shall be furnished with a complete set of manufacturers operating and preventative maintenance instructions, parts list with numbers and descriptions for each piece of equipment, and a copy of the air-balance report. A complete set of these documents shall be kept on the premises.
c) The owner shall be provided with instructions in the operational use of the systems and equipment as required.
d) A design temperature of 75 degrees fahrenheit for both summer and winter design conditions shall be provided for all patient use areas including corridors.
e) All ventilation supply, return and exhaust systems shall be mechanically operated.
f) Air conditioning and ventilation systems shall be designed, installed and maintained as required by National Fire Protection Association Standard 90A or 90B, depending on the size of the facility.
Section 370.2790 Plumbing Systems
a) All plumbing systems shall be designed and installed in accordance with the requirements of the "Illinois State Plumbing Code" except that the number of water closets, lavatories, bathtubs, showers, and other fixtures shall be as required by these Standards and the Facility program.
b) Plumbing fixtures shall be of non-absorptive acid-resistant materials.
c) Shower bases and tub bottoms shall be provided with nonslip surfaces.
d) Water supply systems shall be designed to supply water at sufficient pressure and volume to operate all fixtures and equipment during maximum demand periods.
e) Hot water distribution systems shall be arranged to provide hot water at each hot water outlet at all times. Hot water at shower, bathing and handwashing facilities shall not exceed 110 degrees fahrenheit.
f) Water storage tanks shall be fabricated of corrosion resistant metal or lined with noncorrosive material.
g) Insofar as possible, drainage piping shall not be installed above the ceiling nor installed in an exposed location in food preparation centers, food serving facilities, food storage areas, and other critical areas. Special precautions shall be taken to protect these areas from possible leakage of condensation from necessary overhead piping systems.
Section 370.2800 Electrical Systems
a) All material including equipment, conductors, controls, and signaling devices shall be installed to provide a complete electrical system with the necessary characteristics and capacity to supply the electrical facilities required by these Standards. All materials shall be listed as complying with available standards of Underwriters' Laboratories, Inc. or other similarly established standards.
b) All spaces occupied by people, machinery, and equipment within buildings, approaches to and exits from buildings, and parking lots shall have lighting.
c) Residents' rooms shall have general lighting. At least one light fixture shall be switched at the entrance to each resident room. All switches for control of lighting in residents' sleeping areas shall be of the quiet operating type.
d) Receptacles (Convenience Outlets)
1) Each resident bed room shall have duplex grounding type receptacles as follows: At least one located at the head of each bed; one for television if used; and one on another wall. Receptacles are to be located between twelve (12) to thirty (30) inches above the finished floor.
2) Resident bathrooms shall have at least one duplex receptacle.
3) At least one duplex receptacle shall be installed in each corridor.
Section 370.2810 Fire Alarm and Detection System
a) Provide an approved supervised fire alarm system.
b) An approved automatic smoke detection system shall be installed on each floor level. Such system shall be installed in accordance with National Fire Protection Association Standard 101, Section 6-3 of the l976 Life Safety Code, and with National Fire Protection Association Standard 72, l975. In no case shall smoke detectors be spaced further apart than thirty (30) feet on center, or more than fifteen (15) feet from any wall.
c) The automatic smoke detection system shall be electrically interconnected to the fire alarm system.
d) The fire alarm system shall automatically transmit the alarm to any available municipal fire department by direct private line, or through any approved central station.
Section 370.2820 Emergency Electrical System
An emergency electrical service, which may be battery operated if effective for four (4) or more hours, shall provide services as follows:
a) Illumination of means of egress
b) Fire detection and alarm system
c) Telephone service
d) Exit sign fixtures
Section 370.2830 Fire Protection
The Department, or upon request the Fire Prevention Division of the Office of the State Fire Marshal, will make inspections for fire safety and compliance with these standards. The Fire Prevention Division shall call to the attention of the Department of Public Health any violations of these standards pertaining to fire protection found during a requested inspection. The Department, or upon request the Fire Prevention Division, shall be privileged to make as many subsequent visits as deemed necessary by the Department for assurance of compliance.
SUBPART N: RESIDENT'S RIGHTS
Section 370.3010 General
a)
1) No resident shall be deprived of any rights, benefits, or privileges guaranteed by law, the Constitution of the State of Illinois or the Constitution of the United States solely on account of his or her status as a resident of a facility.
2) In addition, every resident shall be provided with all rights guaranteed by the Mental Health and Developmental Disabilities Code (Ill. Rev. Stat. 1981, ch. 91½, pars. 1-100 et seq.), as amended.
b) A resident shall be permitted to retain and use or wear his or her personal property in his or her immediate living quarters, unless deemed inappropriate by a Qualified Mental Retardation Professional, when necessary to protect the resident or others from harm, and so documented in the resident's clinical record.
c) If clothing is provided to the resident by the facility it shall be of a proper fit.
d) The facility shall provide adequate and convenient storage space for the personal property of the resident.
e) The facility shall provide a means of safeguarding small items of value for its residents in their rooms or in any other part of the facility so long as the residents have daily access to such valuables.
f) The facility shall develop procedures for investigating complaints concerning theft of resident's property and shall promptly investigate all such complaints.
g) The facility administrator shall ensure that married residents residing in the same facility be allowed to reside in the same room within the facility unless there is no room available in the facility or it is deemed medically inadvisable by the resident's attending physician and so documented in the resident's records.
h) Residents occupying any bedroom shall be of the same sex except in the case of a room occupied by husband and wife.
i) There shall be no traffic through a resident's room to reach any other area of the building.
j) Children under sixteen (16) years of age who are related to employees or owners of a facility, and who are not themselves employees of the facility, shall be restricted to quarters reserved for family or employee use except during times when such children are part of a group visiting the facility as part of a planned program, or similar activity.
k) A resident may refuse to perform labor for a facility. Performing household chores is not considered to be performing labor for a facility, unless such chores go beyond what would normally be expected from an individual living in his or her own home.
l) A resident shall be permitted the free exercise of religion. Upon a resident's request, and if necessary at the resident's expense, the facility administrator shall make arrangements for a resident's attendance at religious services of the resident's choice. However, no religious beliefs or practices, or attendance at religious services, may be imposed upon any resident.
m) All facilities shall comply with the "Illinois Election Code" (Ill. Rev. Stat. ch. 111½, pars. 3101 et seq.) as it pertains to absentee voting for residents of licensed long-term care facilities.
n) The facility shall immediately notify the resident's next of kin, representative and physician of the resident's death or when the resident's death appears to be imminent.
o) The facility shall also immediately notify the resident's family, guardian, representative, conservator and any private or public agency financially responsible for the resident's care whenever emergency situations occur such as accidents, sudden illness, disease, unexplained absences, and other circumstances arise, such as extraordinary resident charges, billings, or related administrative matters.
p) Where a resident, a resident's representative or a resident's next of kin believes that an emergency exists each of them, collectively or separately, may file a verified petition to the circuit court for the county in which the facility is located for an order placing the facility under the control of a receiver.
Section 370.3020 Medical and Personal Care Program
a) A resident shall be permitted to retain the services of his or her own personal physician at his or her own expense under an individual or group plan of health insurance, or under any public or private assistance program providing such coverage.
b) The Department shall not prescribe the course of medical treatment provided to an individual resident by the resident's physician in a facility.
c) Every resident shall be permitted to obtain from his or her own physician or the physician attached to the facility complete and current information concerning his or her medical diagnosis, treatment and prognosis in terms and language the resident can reasonably be expected to understand.
d) Every resident shall be permitted to participate in the planning of his or her total care and medical treatment to the extent that his or her condition permits.
e) No resident shall be subjected to experimental research or treatment without first obtaining his or her informed, written consent. The conduct of any experimental research or treatment shall be authorized and monitored by an institutional review committee appointed by the administrator of the facility where such research and treatment is conducted. The membership, operating procedures and review criteria for institutional review committees shall be prescribed under rules and regulations of the Department.
f)
1) Every resident shall be permitted to refuse medical treatment and to know the consequences of such action, unless such refusal would be harmful to the health and safety of the resident or others and such harm is documented by a physician or nurse in the resident's clinical record.
2) The resident, or guardian, shall be given the opportunity to refuse generally accepted mental health or developmental disability services, including but not limited to medication, unless such services are necessary to prevent the recipient from causing serious harm to him or herself or others. If such services are refused, they shall not be given. The Qualified Mental Retardation Professional shall inform a resident or guardian who refuses such services of alternate services available and the risks of such alternate services, as well as the possible consequences to the resident of refusal of such services.
g) Every resident, resident's guardian, or parent if the resident is a minor shall be permitted to inspect and copy all his or her clinical and other records concerning his or her care and maintenance kept by the facility or by his or her physician.
h) A resident shall be permitted respect and privacy in his or her medical and personal care program. Every resident's case discussion, consultation, examination and treatment shall be confidential and shall be conducted discreetly, and those persons not directly involved in the resident's care must have his or her permission to be present.
Section 370.3030 Restraints
a) Neither physical restraints nor confinements shall be employed for the purpose of punishment or for the convenience of any facility personnel. No physical restraints or confinements shall be employed except as authorized in writing by a physician, clinical psychologist, or a registered nurse with supervisory responsibilities, who documents the need for such restraints or confinements in the resident's clinical record.
b) Safety devices and time-out periods may be employed only when necessary to prevent a resident from injuring oneself or others. The written authorization shall specify the precise time periods and conditions in which any restraints and confinements shall be employed.
c) No chemical, medication, or tranquilizer shall be employed by a facility as a restraint or confinement in lieu of or in addition to any physical restraint or confinement. Such chemicals, medications, or tranquilizers may only be employed as part of a duly prescribed therapeutic medical treatment program authorized by the resident's physician and documented in the resident's clinical record.
d) No resident shall be subjected to any behavior modification program which utilizes restraints, confinements, or aversive stimuli of any nature unless and until the informed consent of such resident, resident's guardian, or parent of a minor resident has been obtained.
Section 370.3040 Abuse and Neglect
a) An owner, licensee, program coordinator, house manager, employee or agent of a facility shall not abuse or neglect a resident.
b) A facility employee or agent who becomes aware of abuse or neglect of a resident shall immediately report the matter to the facility program coordinator or house manager.
c) A facility program coordinator or house manager who becomes aware of abuse or neglect of a resident shall immediately report the matter by telephone and in writing to the resident's representative, or if he or she is not available then to the Department.
Section 370.3050 Communication and Visitation
a) Every resident shall be permitted unimpeded, private and uncensored communication of his or her choice by mail, public telephone or visitation.
b) The facility program coordinator or house manager shall ensure that correspondence is conveniently received and mailed, and that telephones are reasonably accessible.
c) The facility program coordinator or house manager shall ensure that residents may have private visits at any reasonable hour unless such visits are restricted by a physician, clinical psychologist, or a Qualified Mental Retardation Professional in order to protect the resident or others from harm, harassment or intimidation, and such restriction is documented in the resident's clinical record.
d) The facility shall allow daily visiting at all reasonable times.
e) The facility program coordinator or house manager shall ensure that space for visits is available and that facility personnel knock, except in an emergency, before entering any resident's room.
f) All residents shall be permitted unimpeded, private and uncensored communication by telephone and visitation. Such communication may only be restricted by a physician, clinical psychologist or Qualified Mental Retardation Professional, in order to reasonably protect the resident or others from harm, harassment or intimidation. The reason for any restriction shall be placed in the resident's clinical record by the person making the restriction.
g) All mail addressed to anyone shall be forwarded at once to the persons to whom they are addressed without examination by facility personnel. All mail addressed to a resident shall be delivered to the resident without examination by facility personnel.
h) Any employee or agent of a public agency, any representative of a community legal services program or any member of a community organization shall be permitted access at reasonable hours to any individual resident of any facility, if the purpose of such agency, program or organization includes rendering assistance to residents without charge, but only if there is neither a commercial purpose nor affect to such access and if the purpose is to do any of the following:
1) Visit, talk with and make personal, social, and legal services available to all residents;
2) Inform residents of their rights and entitlements and their corresponding obligations, under federal and State laws, by means of educational materials and discussions in groups and with individual residents;
3) Assist residents in asserting their legal rights regarding claims for public assistance, medical assistance and social security benefits as well as in all other matters in which residents are aggrieved. Assistance may include counseling and litigation; or
4) Engage in other methods of asserting, advising and representing residents so as to extend to them full enjoyment of their rights.
i) No visitor shall enter the immediate living area of any resident without first identifying him or herself and then receiving permission from the resident to enter. The rights of other residents present in the room shall be respected.
j) A resident may terminate at any time a visit by a person having access to the resident's living area.
Section 370.3060 Resident's Funds
a) A resident shall be permitted to manage his or her own financial affairs unless he/she or his or her guardian or if the resident is a minor, his or her parent, authorizes the program coordinator or house manager of the facility in writing to manage such resident's financial affairs under Sections 370.3060(c) through (n).
b) The facility shall at the time of admission, provide each resident, or his or her representative, with a written statement explaining the resident's rights regarding personal funds and listing the services for which the resident will be charged, and obtain a signed acknowledgement from each resident or his or her representative that he has received the statement.
c) The facility may accept funds from a resident for safekeeping and managing, if it receives written authorization from the resident or his or her guardian; such authorization shall be attested to by a witness who has no pecuniary interest in the facility or its operations, and who is not connected in any way to facility personnel in any manner whatsoever.
d) If the facility maintains resident funds, it shall maintain and allow each resident access to a written record of all financial arrangements and transactions involving the individual resident's funds.
e) If the facility maintains resident funds, it shall provide each resident, or his or her representative with a written itemized statement at least quarterly, of all financial transactions involving the resident's funds.
f) If the facility maintains resident funds, it shall purchase a surety bond to guarantee the security of resident's funds.
g) The facility shall keep any funds received from a resident for safekeeping in an account separate from the facility's funds.
h) The facility shall deposit any funds received from a resident in excess of $100 in an interest bearing account insured by agencies of, or corporations chartered by, the State or federal government. The account shall be in a form which clearly indicates that the facility has only a fiduciary interest in the funds and any interest from the account shall accrue to the resident.
i) The facility may keep up to $l00 of a resident's money in a non-interest bearing account or petty cash fund, to be readily available for the resident's current expenditures.
j) The facility shall return to the resident, upon written request, all or any part of the resident's funds given the facility for safekeeping, including the interest accrued from deposits.
k) The facility shall place any monthly allowance to which a resident is entitled in that resident's personal account, or give it to the resident, unless the facility has written authorization from the resident or the resident's guardian to handle it differently.
l) Unless otherwise provided by State law, the facility shall upon the death of a resident provide the executor or administrator of the resident's estate with a complete accounting of all the resident's personal property, including any funds of the resident being held by the facility.
m) If a resident is incapable of managing his or her funds and does not have a representative or guardian, the facility shall notify the Office of the State Guardian of the Guardianship and Advocacy Commission.
n) If the facility is sold, the seller shall provide the buyer with a written verification by a public accountant of all residents' monies and properties being transferred, and obtain a signed receipt from the new owner.
Section 370.3070 Private Right of Action
a) Each resident shall have the right to maintain a private right of action against a facility as described in Section 370.3070(b) through (f)
b) The owner and licensee of a facility are liable to a resident for any intentional or negligent act or omission of their agents or employees which injures the resident.
c) The licensee shall pay the actual damages, or $500, whichever is greater, and costs and attorney's fees to a facility resident whose rights as specified in the Act or this Part are violated.
d) A resident may maintain an action under this Act and this Part for any other type of relief, including injunctive and declaratory relief, permitted by law.
e) Any waiver by a resident or his or her legal representative of the right to commence an action under Sections 370.3070(b) through (f) , whether oral or in writing, shall be null and void, and without legal force or effect.
f) A licensee or its agents or employees shall not transfer, discharge, evict, harass, dismiss, or retaliate against a resident, a resident's representative, or an employee or agent who makes a report of resident abuse or neglect, brings or testifies in a private right of action, or files a complaint, because of such action or testimony.
Section 370.3080 Transfer and/or Discharge
The facility shall comply with all of the provisions of "The Mental Health and Developmental Disabilities Code," as amended pertaining to the transfer and/or discharge of residents.
Section 370.3090 Complaint Procedures
a) Any person, agency, association or governmental body may file a complaint with the Department alleging that a Community Living Facility is in violation of the Act or of the rules promulgated pursuant to the Act.
b) The Department may conduct an investigation in order to determine if the Community Living Facility is in compliance. If, based on the results of its investigation, the Department determines that the Community Living Facility is not in compliance, it shall promptly serve a notice of violation upon the licensee. Such notice of violation shall comply with the requirements described in Section 8(3) of the Act. The Department shall notify the complainant of its findings upon written request.
c) The complaint, a copy of the complaint, or a record published, released or otherwise disclosed to the Community Living Facility shall not disclose the name of the complainant unless the complainant consents in writing to the disclosure or the investigation results in a judicial proceeding, or unless disclosure is essential.
d) A licensee or its agents shall not transfer, discharge, evict, harass, dismiss, or retaliate against a resident or an employee or agent who files a complaint under this Section, or who testifies under Section 12 of the Act because of the complaint or testimony.
e) Any person participating in good faith in the making of a complaint, or in the investigation of such a complaint shall not be deemed to have violated any privileged communication and shall have immunity from any liability, civil, criminal or that otherwise might result as a consequence of making such a complaint. The good faith of any persons making a complaint or participating in the investigation of such a complaint shall be presumed.
Section 370.3100 Confidentiality
The facility shall comply with all of the provisions of the Mental Health and Developmental Disabilities Confidentiality Act, (Ill. Rev. Stat. 1981, ch. 91½, pars. 801 et seq.) as amended.
Section 370.3110 Facility Implementation
a) The facility shall establish and function in conformity with written policies and procedures to implement the responsibilities and rights provided in the Act and these rules and regulations. The policies shall include the procedure for the investigation and resolution of resident complaints under the Act. The policies shall be clear and unambiguous and shall be available for inspection by any person.
b) Upon admission to a community living facility, residents shall be provided with a copy of their rights and related rules, regulations and policies and the name, address and telephone number of the Guardianship and Advocacy Commission. These rights shall include but need not be limited to the Mental Health and Developmental Disabilities Code.
c) The facility shall provide copies of material listed in Section 370.3110(b) upon request to next of kin, sponsoring agencies, representative payees and the public.
d) The resident, resident's representative, guardian, or parent of a minor resident shall acknowledge in writing the receipt from the facility of a copy of all resident rights and a copy of all facility policies implementing such rights.
e) The facility shall ensure that its staff is familiar with and observes the rights and responsibilities enumerated in the Act and these regulations.
Section 370.APPENDIX A PROGRAM STANDARDS
The Department of Mental Health and Developmental Disabilities considers the following programs to be appropriate and necessary to assist the developmentally disabled resident in a Community Living Facility program toward more independent living.
Social Service shall be provided under the direction and supervision of a registered or a certified social worker. The service must foster maximum personal and social development of the resident and also must foster and facilitate family functioning and effective and satisfactory social and community relationships within the ability of the developmentally disabled individual.
Vocational Training shall be provided under the direction and supervision of a qualified vocational counselor or instructor. Qualifications shall be in accordance with the State Department of Personnel job classifications. The program should assist each developmentally disabled person to progress as far as he or she can along the continuum from vocational function to competitive employment and entrance into society.
Activity Therapy should function under the direction of a qualified activity therapist or occupational therapist. Qualifications shall be in accordance with the State Department of Personnel job classifications. Programs should provide for physical and mental health, promote optimal sensorimotor, cognitive, affective and social development. They also should encourage movement from dependent to independent and interdependent functioning and provide for enjoyable use of leisure time.
Psychology should be directed and supervised by a registered psychologist. The service should facilitate, through the application of psychology principles, the optimal development of each developmentally disabled individual. The service should provide evaluation and assessment with individual and group therapy and program services related to resident habilitation, staff training, and communication participation.
Behavior Modification must be under the direction and supervision of a trained professional with a background in behavior modification, if the facility maintains this type of program. Support staff must also have had adequate training and receive appropriate supervision as they conduct and maintain this program. Monies budgeted for the maintenance of token economies or reward systems shall not be used for staff or consultant salaries and/or expenses, nor for the rental or maintenance of facilities.
Training Staff are designated as program support personnel who function in appropriate program areas. They are not meant to provide routine care which is assumed under the basic community living program. These individuals will be assigned to program areas or tasks as the needs of individuals or small groups of residents are considered.
Training services should provide a planned and systematic sequence of instruction in formal and informal activities, based on appropriate evaluation and objectives designed to:
a. develop skills in performing activities of daily living including self-help, motor skills, and communication;
b. enhance emotional, personal, and social development;
c. provide experiences conducive to the acquisition of a positive self-concept and desire to learn; and
d. provide experiences for gaining useful occupational and prevocational skills.
Transportation is given program consideration because it involves the resident's ability to participate in community work, recreation, and other activities. This is a desirable program activity which should lead to independence and possible return to the community.
STAFFING
Staffing shall include at least the following: a program coordinator, a full-time house manager, and the following full or part-time professional staff; social worker, psychologist, activity staff. In a small facility one person may function as the program coordinator and full-time house manager.
Program Coordinator: The program coordinator may be the executive director of a host agency who would serve in lieu of a full-time program coordinator if the size and type of program does not warrant a full-time person.
1. The duties and responsibilities of the program coordinator include: planning, coordinating and participating in the activities of the Community Living Facility; assisting in establishing and implementing procedures for admitting residents and providing related services; recruiting, supervising, and coordinating activities of staff; arranging for treatment and special diagnostic services when necessary; conducting conferences with staff to develop programs; resolving administrative services when necessary; and keeping staff informed of changes in responsibilities or procedures; interpreting the Community Living Facility program to parents and visitors; establishing liason with generic community services to facilitate use of such services by project participants; preparing records, recommendations, and reports reflecting Community Living Facility programs and operations.
2. Education and Experience: An appropriate college degree and at least one year of full-time professional experience with the developmentally disabled or other handicapped persons. The individual should be experienced in the dynamics of individual and group behavior.
House Manager
1. The duties and responsibilities of the house manager include: Day to day supervision of the residents living in the Community Living Facility; in cooperation with the Program Coordinator, assists in planning, coordinating and participating in the activities of the Community Living Facility; being immediately responsible for the residents' health, welfare and safety, as well as for the provision of an appropriate social and vocational program which will lead to a greater degree of independence in living or to independent living status.
2. Education and training: Includes working knowledge of household management, food service, and sanitation with experience in home management and housekeeping; basic knowledge of principles and practices of guiding and training the developmentally disabled; basic knowledge of health and safety precautions and first aid methods; ability to keep records; ability to become aware of the specific needs and interests of the developmentally disabled and to cope with their social, emotional and intellectual needs; and ability to profit from in-service training.
Social Services: The facility shall designate a staff member to provide social services to residents. If the staff member designated to provide social services is not a qualified social worker the facility shall have an effective arrangement with a qualified social worker to provide social service consultation.
The social worker shall make prompt use of information available on health and welfare resources in the community to deal with social problems. The social worker shall review social service data in the resident's permanent record and shall insure that a current social history is on file. This shall be a written part of the resident's permanent record and shall be updated by the social worker as needed.
The social worker shall, on request of the program coordinator, maintain active contacts with the resident's family and shall assist in community placement when the resident is deemed ready for more independent living. Such placement is to be made in consultation with the facility's psychologist.
Psychological Services: A registered psychologist shall be provided for staff consultation. The consultant shall also provide services to the residents as needed.
A current psychological evaluation (completed within the last year), including an evaluation of the resident's intellectual capacity, should be submitted to the Community Living Facility upon a resident's admission. If such an evaluation has not been completed, the staff psychologist of the Community Living Facility shall make such an evaluation within fifteen (15) days of the resident's admission.
The psychologist shall also be available to staff for consultation regarding the resident's adjustment and behavior within the Community Living Facility. The results of any psychological evaluation and consultation with staff shall become a permanent part of the resident's written record.
Activity Staff: The facility shall designate a staff member to be director of the activities program. If the facility does not have a qualified recreational therapist, occupational therapist or group social worker on its staff, arrangements shall be made with a person from one (1) or more of the above disciplines to provide consultation to the activities director regarding programming to meet the assessed needs of the residents. This consultant shall assist facility staff in developing an individualized activity program for each resident within fifteen (15) days after the resident's admission to the facility.
ACTIVITY PROGRAM
1. There shall be a specified planned program of group and individual activities geared to the individual resident's needs. Activities shall be available daily and for a reasonable amount of time. Residents shall be given an opportunity to contribute to planning, preparation, conducting, cleanup, and critique of the program.
2. There shall be a trained staff person responsible for planning and directing the activities program. This person, though not necessarily a full-time employee, shall provide a program that adequately meets the resident's needs and interests. Additional activity personnel shall be provided as necessary to meet the needs of the residents and the program.
3. There shall be written permission given by the resident's physician for the resident to participate in the activity program. Standing orders will be acceptable with individual contraindications noted.
4. The activity program should include, but is not limited to, the following program areas:
Recreational activities (examples: games, both quiet and active; parties; outside entertainment, etc.)
Crafts (applicable to both men and women)
Community activities (examples: resident participation in community activities such as plays; church events; band concerts; tours, etc.)
5. A planned volunteer and/or auxiliary program that supports the activities program shall be encouraged. It shall be under the direction of a staff member in a supervisory capacity.
Vocational Training Staff: Appropriate to the nature and size of the facility, a clearly designated person or team shall be responsible for the implementation, evaluation, and revision of the facility's vocational program. Vocational program personnel shall be vocational instructors qualified by the appropriate state agency or tradesmen who have attained at least journeyman status.
The ultimate objectives of the vocational program should be to assist every resident to move as far as he can along the continuum from nonvocational status to remunerative employment, and entry into the mainstream of society as an independent citizen and worker.
The vocational program shall be rendered as follows:
1. Directly, through personal contact between vocational personnel and residents, and
2. Indirectly, through contact between vocational personnel and other persons working with the residents, designed to enhance and facilitate the development and maintenance of a rehabilitative environment.
The vocational program which is made available to the residents in accordance with their needs shall include the following:
1. Vocational adjustment,
2. The formulation of a written vocational objective for each resident,
3. The formulation of a written plan to achieve the stated objective,
4. Implementation of the vocational plan.
Prevocational services shall be established when needed and should contribute to the development of work readiness. This program should provide for:
1. Vocationally relevant academic instruction,
2. Instruction in the self-help and social skills necessary for vocational success,
3. Instruction and practice in the social skills necessary for maximal independent functioning in the community, such as travel, handling of money, and use of community resources,
4. Orientation into the world of work,
5. Development of work attitudes needed for vocational success,
6. Rotated exploration and tryout of job tasks,
7. Continuation of evaluation of vocational potential.
Vocational training programs shall meet all applicable legal requirements and shall be provided through means such as:
1. Work training stations,
2. Work activity centers,
3. Transitional sheltered workshops,
4. Work-study programs,
5. On-the-job training,
6. Training in the classroom or on the job.
Appropriate to the nature and size of the facility, provision shall be made for vocational training staff development, through such means as:
1. In-service training,
2. Short-term workshops,
3. Seminars,
4. Attendance at conferences,
5. Visits to other facilities.
Section 370.APPENDIX B SANITIZING SOLUTIONS
Sanitizing solutions may be safely used on food-processing equipment and utensils and on other food-contact articles as specified in this section, within the following prescribed conditions:
(a) Such sanitizing solutions are used, followed by adequate draining, before contact with food.
(b) The solutions consist of one of the following, to which may be added components generally recognized as safe and components which are permitted by prior sanction or approval.
(1) An aqueous solution containing potassium, sodium or calcium hypochlorite, with or without the bromides of potassium, sodium or calcium.
(2) An aqueous solution containing dichloroisocyanuric acid, trichloroisocyanuric acid or the sodium or potassium salts of these acids, with or without the bromides of potassium, sodium or calcium.
(3) An aqueous solution containing potassium iodide, sodium p-toluenesulfonchloramide and sodium lauryl sulfate.
(4) An aqueous solution containing iodine, butoxy monoether of mixed (ethylene-propylene) polyalkylene glycol having a cloudpoint of 90º -100º C in 0.5 percent aqueous solution and an average molecular weight of 3,300, and ethylene glycol monobutyl ether. Additionally, the aqueous solution may contain diethylene glycol monoethyl ether as an optional ingredient.
(5) An aqueous solution containing elemental iodine, hydriodic acid, a-(p-nonylphenyl) -omega-hydroxypoly (oxy-ethylene) (complying with the identity prescribed in Section 178.3400(c) and having a maximum average molecular weight of 748) and/or polyoxyethylene-polyoxypropylene block polymers (having a minimum average molecular weight of 1,900). Additionally, the aqueous solution may contain isopropyl alcohol as an optional ingredient.
(6) An aqueous solution containing elemental iodine, sodium iodide, sodium dioctylsulfosuccinate, and polyoxyethylene-polyoxypropylene block polymers (having a minimum average molecular weight of 1,900).
(7) An aqueous solution containing dodecylbenzenesulfonic acid, polyoxyethylene-polyoxypropylene block polymers (having a minimum average molecular weight of 2,800). In addition to use on food-processing equipment and utensils, this solution may be used on glass bottles and other glass containers intended for holding milk.
(8) An aqueous solution containing elemental iodine, butoxy monoether of mixed (ethylene-propylene) polyalkylene glycol having a minimum average molecular weight of 2,400, and a-lauroyl-omega-hydroxypoly (oxyethylene) with an average 8-9 moles of ethylene oxide and an average molecular weight of 400. In addition to use on food-processing equipment and utensils, this solution may be used on beverage containers, including milk containers or equipment. Rinse water treated with this solution can be recirculated as a preliminary rinse. It is not to be used as final rinse.
(9) An aqueous solution containing n-alkyl (C12-C18) benzyldimethylammonium chloride compounds having average molecular weights of 351-380 and consisting principally of alkyl groups with 12-16 carbon atoms with or without not over 1 percent each of groups with 8 and 10 carbon atoms. Additionally, the aqueous solution may contain isopropyl alcohol as an optional ingredient.
(10) An aqueous solution containing trichloromelamine and either sodium lauryl sulfate or dodecylbenzenesulfonic acid. In addition to use on food-processing equipment and utensils and other food-contact articles, this solution may be used on beverage containers except milk containers or equipment.
(11) An aqueous solution containing equal amounts of n-alkyl (C12C18) benzyl dimethyl ammonium chloride and n-alkyl (C12C18) dimethyl ethylbenzyl ammonium chloride (having an average molecular weight of 384). In addition to use on food-processing equipment and utensils, this solution may be used on food-contact surfaces in public eating places.
(12) An aqueous solution containing the sodium salt of sulfonated oleic acid, polyoxyethylene-polyoxypropylene block polymers (having an average molecular weight of 2,000 and 27 to 31 moles of polyoxypropylene). In addition to use on food-processing equipment and utensils, this solution may be used on glass bottles and other glass containers intended for holding milk. All equipment, utensils, glass bottles and other glass containers treated with this sanitizing solution shall have a drainage period of 15 minutes prior to use in contact with food.
(13) An aqueous solution containing elemental iodine and alkyl (C12C15) monoether of mixed (ethylene-propylene) polyalkylene glycol, having a cloud-point of 70 degrees C. - 77 degrees C. in 1 percent aqueous solution and an average molecular weight of 807.
(14) An aqueous solution containing iodine, butoxy monoether of mixed (ethylene-propylene) polyalkylene glycol, having a cloud-point of 90 degrees C. to 100 degrees C. in 0.5 percent aqueous solution and an average molecular weight of 3,300 and polyoxyethylene-polyoxypropylene block polymers (having a minimum average molecular weight of 2,000).
(15) An aqueous solution containing lithium hypochlorite.
(16) An aqueous solution containing equal amounts of n-alkyl (C12-C18) benzyl dimethyl ammonium chloride and n-alkyl (C12-C14) dimethyl ethylbenzyl ammonium chloride (having average molecular weights of 377-384), with the optional adjuvant substances tetrasodium ethylenediaminetetraacetate and/or alpha-(p-nonylphenol) -omega-hydroxypoly (oxyethylene) having an average poly (oxyethylene) content of 11 moles. In addition to use of food-processing equipment and utensils, this solution may be used on food-contact surfaces in public eating places.
(17) An aqueous solution containing di-n-alkyl (C8-C10) dimethyl ammonium chlorides and isopropyl alcohol, having average molecular weights of 332-361. In addition to use on food-processing equipment and utensils, this solution may be used on food-contact surfaces in public eating places.
(18) An aqueous solution containing n-alkyl (C12-C18) benzyldimethylammonium chloride, sodium metaborate, alpha-terpineol and alpha [p-(1,1,3,3-tetramethylbutyl) phenyl] -omega-hydroxypoly (oxyethylene) produced with one mole of the phenol and 4 to 14 moles ethylene oxide.
(19) An aqueous solution containing sodium dichloroisocyanurate and tetrasodium ethylenediaminetetraacetate. In addition to use on food-processing equipment and utensils, this solution may be used on food-contact surfaces in public eating places.
(20) An aqueous solution containing ortho-phenylphenol, ortho-benzyl-para-chlorophenol, para-tertiaryamylphenol, sodium – alpha – alkyl (C12-C15) – omega-hydroxypoly (oxyethylene) sulfate with the poly (oxyethylene) content averaging one mole, potassium salts of coconut oil fatty acids, and isopropyl alcohol or hexylene glycol.
(21) An aqueous solution containing sodium dodecylbenzenesulfonate. In addition to use on food-processing equipment and utensils, this solution may be used on glass bottles and other glass containers intended for holding milk.
(c) The solutions identified in paragraph (b) of this section will not exceed the following concentrations:
(1) Solutions identified in paragraph (b)(1) of this section will provide not more than 200 parts per million of available halogen determined as available chlorine.
(2) Solutions identified in paragraph (b)(2) of this section will provide not more than 100 parts per million of available halogen determined as available chlorine.
(3) Solution identified in paragraph (b)(3) of this section will provide not more than 25 parts per million of titratable iodine. The solutions will contain the components potassium iodide, sodium p-toluenesulfonchloramide, and sodium lauryl sulfate at a level not in excess of the minimum required to produce their intended functional effect.
(4) Solutions identified in paragraph (b) (4), (5), (6), (8), (13), and (14) of this section will contain iodine to provide not more than 25 parts per million of titratable iodine. The adjuvants used with the iodine will not be in excess of the minimum amounts required to accomplish the intended technical effect.
(5) Solutions identified in paragraph (b)(7) of this section will provide not more than 400 parts per million of dodecylbenzenesulfonic acid and not more than 80 parts per million of polyoxyethylene-polyoxypropylene block polymers (having a minimum average molecular weight of 2,800).
(6) Solutions identified in paragraph (b)(9) of this section shall provide when ready to use no more than 200 parts per million of the active quaternary compound.
(7) Solutions identified in paragraph (b)(10) of this section shall provide not more than sufficient trichloromelamine to produce 200 parts per million of available chlorine and either sodium lauryl sulfate at a level not in excess of the minimum required to produce its intended functional effect or not more than 400 parts per millions of dodecylbenzenesulfonic acid.
(8) Solutions identified in paragraph (b)(11) of this section shall provide, when ready to use, no more than 200 parts per million of active quaternary compound.
(9) The solution identified in paragraph (b)(12) of this section shall provide not more than 200 parts per million of sulfonated oleic acid, sodium salt.
(10) Solutions identified in paragraph (b)(15) of this section will provide not more than 200 parts per million of available chlorine and not more than 30 ppm lithium.
(11) Solutions identified in paragraph (b)(16) of this section shall provide not more than 200 parts per million of active quatenary compound.
(12) Solutions identified in paragraph (b)(17) of this section shall provide when ready to use, a level of 150 parts per million of the active quaternary compound.
(13) Solution identified in paragraph (b)(18) of this section shall provide not more than 200 parts per million of active quaternary compound and not more than 66 parts per million of alpha [p-(1,1,3,3-tetramethylbutyl) phenyl]-omega – hydroxypoly (oxyethylene).
(14) Solutions identified in paragraph (b)(19) of this section shall provide, when ready to use, a level of 100 parts per million of available chlorine.
(15) Solutions identified in paragraph (b)(20) of this section are for single use applications only and shall provide, when ready to use, a level of 800 parts per million of total active phenols consisting of 400 parts per million ortho-phenylphenol, 320 parts per million ortho-benzyl-para-chlorophenol and 80 parts per million para-tertiaryamylphenol.
(16) Solution identified in paragraph (b)(21) of this section shall provide not more than 430 parts per million and not less than 25 parts per million of sodium dodecylbenzenesulfonate.
(d) Sanitizing agents for use in accordance with this section will bear labeling meeting the requirements of the Federal Insecticide, Fungicide, and Rodenticide Act.