Section 411.140  Supervision of Children and Youth

a)         Primary supervision of children and youth shall be provided by trained secure child care staff who shall work under the supervision of a registered nurse or a secure child care supervisor.

b)         The secure child care facility shall provide the following minimum shift coverage for children and youth residing in the facility:

1)         One child care staff must be present and on duty for every three children and youth (i.e., 1:3 ratio) while children and youth are awake and on the premises. This would include the day (7:00 a.m. to 3:00 p.m.) and evening (3:00 p.m. to 11:00 p.m.) shifts.

2)         For the night shift (11:00 p.m. to 7:00 a.m.), there shall be at least one child care staff for every five children and youth (i.e., 1:5 ratio). At no time shall there be less than two staff awake and on duty.

3)         At least one shift supervisor must be on duty during each shift.

4)         Unless the assigned shift supervisor is a Registered Nurse, a Registered Nurse must also be on duty during the shift.

5)         When both males and females are housed in the facility, at least one male and one female staff member shall be on duty at all times.

6)         Minimum shift coverage applies 7 days per week, including holidays.

c)         A verbal report shall be given concerning the status of all children and youth at shift change.  A written shift note documenting the child or youth's progress shall be entered into each child's or youth's client file. All staff shall be made aware of special precautions and treatment programming that is to be implemented during their shift.

d)         Secure child care staff shall provide continuous supervision and monitoring of all children and youth at all times.  Staff shall have continuous line of sight supervision whenever 2 or more children or youth are congregated. Special precaution orders for high risk behaviors shall supersede or supplement the requirement of this subsection.

e)         Written shift assignments and position descriptions that state the duties and responsibilities for each assigned secure care staff position in the facility shall be maintained. Shift assignments shall specify the basic monitoring and supervision requirements to assure safety and a therapeutic milieu.  Special precaution assignments are always supplemental to the minimum requirement for supervision and monitoring provided in the secure child care facility.

f)         Secure child care staff shall be required to read and document their review of the appropriate shift assignment each time they assume a new position.

g)         The sleeping arrangements for children and youth shall be determined by the medical director or designated psychiatrist.  All children and youth shall be placed in single occupancy bedrooms.