Section 411.135  Precautions for High Risk Behavior

a)         The secure child care facility shall develop special precautions and procedures that shall be ordered by the medical director or registered nurse and implemented by staff when children or youth present high risk behaviors that could result in death or injury to the child or youth and/or other persons.  Specifications for precautions shall be set out in the standardized Secure Child Care Facility Program Plan and shall address the following high risk situations/circumstances: suicide attempts, gestures, or ideation; self-hurtful (e.g., mutilation) behavior; assaultive behavior; elopement behavior; and sexual acting out.

b)         Precautions for high risk behavior shall also specify:

1)         criteria for implementing special precautions;

2)         responsibilities of staff;

3)         communication from shift to shift and documentation requirements;

4)         criteria for discontinuation of the precautions for high risk behavior;

5)         levels of precaution intensity (e.g., close observation vs. suicide precautions); and

6)         criteria for determining if acute psychiatric hospitalization is indicated.

c)         All secure child care facility staff shall be fully trained and knowledgeable about the facility's precautions for high risk behavior.