(1) Each new staff member employed by the facility to provide direct services to clients must have a medical examination at the time of employment and prior to contact with clients. Annually thereafter, staff must submit a physician’s statement that, based on test results, the employee does not constitute a threat of communicating diseases to clients. If any staff is found to have or is suspected of having a communicable disease, then he or she must be removed from all duties that require contact with clients until certification is received from a physician that such risk no longer exists.
    (2) Background screening shall be performed as required by Chapters 400, Part VIII, and 435, Florida Statutes § 408.809, and Fl. Admin. Code R. 59A-35.090
    (3) Regardless of the organization or design of client living units, the minimum overall direct care staff-client ratios must comply with those specified in 42 C.F.R. § 483.430(d)(3), dated October 1, 2014, as incorporated by reference and available at http://www.gpo.gov/fdsys/pkg/CFR-2014-title42-vol5/xml/CFR-2014-title42-vol5-sec483-430.xml and http://www.flrules.org/Gateway/reference.asp?No=Ref-06402.
    (4) The licensee must have an administrator, licensed nurses to care for each client’s health care needs, and QIDPs to ensure each client’s active treatment program is integrated, coordinated and monitored.
    (5) All staff must receive training within 30 days of employment and annually thereafter on the licensee’s emergency disaster procedures that include the staff’s role before, during, and after the emergency.
    (6) The licensee must ensure that 50% of its staff on duty at all times are certified in cardio-pulmonary resuscitation (CPR) and have received basic first aid training.
    (7) All staff must receive training and demonstrate competency in the prevention and minimal use of restraint and seclusion within 30 days of employment. Competency in these methods must be demonstrated and documented annually thereafter. Training must include:
    (a) The emotional and physical effects of restraint and seclusion on clients and staff;
    (b) History of trauma, impact on clients and the potential for retraumatization;
    (c) Crisis prevention and intervention approaches including de-escalation strategies;
    (d) Applicable legal and clinical requirements governing behavioral services, restraints and seclusion;
    (e) Safe and appropriate initiation of physical contact and application and monitoring of restraints and seclusion; and,
    (f) Approaches to facilitate the earliest possible release from restraints or seclusion.
Rulemaking Authority 400.962, 400.967 FS. Law Implemented 400.964, 400.967(2)(b), 400.967(2)(h), 408.809, FS. History-New 12-21-15.