The Agency proposes to amend Rules 59A-13.004, 59A-13.005, and 59A-13.007 through 59A-13.010, 59A-13.013 through 59A-13.015, 59A-13.020 and 59A-13.022, F.A.C., consistent with provisions of Section 400.914, Florida Statutes. Amendments to Section ...  

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    AGENCY FOR HEALTH CARE ADMINISTRATION
    Health Facility and Agency Licensing

    RULE NO: RULE TITLE
    59A-13.004: License Procedure
    59A-13.005: Administration and Management
    59A-13.007: Admission, Transfer, and Discharge Policies
    59A-13.008: Child Care Policies
    59A-13.009: Medical Director
    59A-13.010: Nursing Services
    59A-13.013: In-service Training for Staff and Parents and Guardians
    59A-13.014: Medical Record
    59A-13.015: Quality Assurance Committee
    59A-13.020: Infection Control
    59A-13.022: Emergency Procedures
    PURPOSE AND EFFECT: The Agency proposes to amend Rules 59A-13.004, 59A-13.005, and 59A-13.007 through 59A-13.010, 59A-13.013 through 59A-13.015, 59A-13.020 and 59A-13.022, F.A.C., consistent with provisions of Section 400.914, Florida Statutes. Amendments to Section 59A-13.004, F.A.C., include a revised Application of Licensure dated July 2005, a statement that a license for initial or change in ownership will not be issued until the application fee has been received by the Agency and all associated checks have cleared, and adds language that the facility must notify the Agency 60 days prior to a request to increase the center’s licensed capacity; amendments to Rules 59A-13.005, F.A.C., revises language requiring the centers to develop and maintain a current job description for each employee, revises language that provides employee access to policies and procedures governing conditions of employment, revises language requiring annual written job performance evaluations of PPEC center staff, and revises language for the development and implementation of infection control policies and procedures; amendments to Rule 59A-13.010, F.A.C., deletes the requirement for the Director of Nursing to hold a Baccalaureate degree, deletes annual recertification for Cardiopulmonary Resuscitation (CPR) and adds current CPR certification for the Director of Nursing, registered nurses, licensed practical nurses (LPN), and direct care personnel, adds LPN requirements and experience, adds definition for the term “others” as direct care personnel, and adds standards and requirements the direct care staff must meet, adds LPN’s into the staffing ratio, and adds new language for the staffing pattern if the PPEC center has a census of more than 45 children; amendments to Rule 59A-13.013, F.A.C., include technical clean up of current language, and deletes the requirement for all employees to maintain annual CPR certification and replaces it with all employees must have a current CPR certification; amendments to Rule 59A-13.014, F.A.C., clarifies the medical plan of treatment and the nursing protocol of care; amendments to Rule 59A-13.015, F.A.C., adds language to clarify the selection process of the quarterly assurance review sample and the required members of the quality assurance committee; amendments to Rule 59A-13.020, F.A.C., adds a new statement relating to hand washing procedures for staff after direct contact with each child; amendments to section Rule 59A-13.022, F.A.C., adds language that requires each PPEC center to have documentation of a satisfactory fire safety inspection annually by the local authority having jurisdiction, and adds language that the PPEC center must have an emergency kit available to provide basic first aid and cardiopulmonary resuscitation.
    SUMMARY: Amends rules pertaining to Prescribed Pediatric Extended Care Centers.
    SUMMARY OF ESTIMATED REGULATORY COSTS: No Statement of Estimated Regulatory Cost was prepared.
    Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.
    SPECIFIC AUTHORITY: 400.914 FS.
    LAW IMPLEMENTED: 400.914(1) FS.
    IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE TIME, DATE AND PLACE SHOWN BELOW(IF NOT REQUESTED, THIS HEARING WILL NOT BE HELD):
    TIME AND DATE: April 18, 2006, 9:00 a.m.
    PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building #3, Conference Room C, Tallahassee, Florida 32308.
    THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Kimberly Smoak, Long Term Care Unit, 2727 Mahan Drive, Tallahassee, Florida, or call (850)488-5861

    THE FULL TEXT OF THE PROPOSED RULE IS:

    59A-13.004 License Procedure.

    (1) Except as provided in sections 400. 903 and 400.905, F.S., 391.203 and 391.205, F.S., no person, firm, association, partnership, or corporation shall either directly or indirectly operate a PPEC center in this state without first applying for and receiving a license from the Agency AHCA to operate such facility.

    (2) Application for a license to operate a PPEC center must be made on AHCA Form 3110-8002, July 2005, – “Application for Licensure, Prescribed Pediatric Extended Care Center,” hereby incorporated by reference, which must be submitted by the owner or administrator to the Agency. This form is available from the Agency for Health Care Administration, 2727 Mahan Drive, MS-33, Tallahassee, Florida 32308, or at the web address at: http:// ahca.myflorida.com/.   In addition to a completed application,

    applicants for initial, renewal and change of ownership must submit the following: Any person operating a facility in this state is subject to the requirements of Sections  391.203 and 391.205, F.S., and these rules.

    (a) Licensure fees in the amount of $650.00 payable to the Agency for Health Care Administration.  A license for an initial or change of ownership application will not be issued until the application fee has been received by the Agency and all associated checks have cleared.  If a check for the renewal licensure fee is dishonored and returned to the Agency, the license holder will have ten (10) calendar days to pay the full amount plus any applicable fees as provided by law.  Such payment must be made by cash, cashier’s check, or money order.  Failure to pay the licensure and processing fee will result in suspension of the license until all fees are paid in full.

    (b) Documentation of compliance with subsection 59A-13.022(1), F.A.C., regarding fire safety conducted within the previous three months.

    (3) Separate licenses are applications for operation of a facility shall be required for whenever the buildings are located on separate premises.

    (4) Licensees must shall not operate a PPEC center facilities with a census capacity greater than the number of children clients indicated on the face of the license.

    (5) Licenses issued for the operation of a PPEC center are shall  be limited as provided in Section 400.905, F.S., 391.205, and unless revoked, will shall expire one year from the date of issuance whichever occurs first. Applicants for license renewal shall comply with the provisions of Section 391.205, F.S., and these rules.

    (6) No other licensed, or certified health care or business entity may be located within a PPEC center entities and PPEC centers shall not collocate.

    (7) Application for a license to operate a PPEC center shall be made on AHCA Form 3110-8002 (April 1998), “Application for Licensure, Prescribed Pediatric Extended Care Center”, hereby incorporated by reference, which shall be submitted by the owner or administrator to the AHCA . This form may be attained by writing to the Agency for Health Care Administration, 2727 Mahan Drive, Tallahassee, Florida 32308.

    (8) Except counties and municipalities, every applicant shall  submit the license fee required by Section 391.205,, F.S., by check or money order payable to the Agency for Health Care Administration along with the application for licensure.

    (9) The annual license fee is $650.00.

    (7)(10) Whenever the licensee of a PPEC center a facility seeks to increase the licensed capacity number of children for which he/ is licensed, the licensee must shall submit an application to the Agency 60 days prior to the requested date of the change. Upon successful completion of a health and life safety survey, the license will be modified accordingly modify his  license accordingly.

    (11) Single copies of AHCA forms incorporated by reference within this section may be obtained without cost from the AHCA, 2727 Mahan Drive,, Tallahassee, Florida 32308.

    Specific Authority 400.914(1) 391.214 FS. Law Implemented 400.914  391.203, 391.205, 391.206, 391.207, 391.210, 391.214 FS. History–New 3-8-89, Formerly 10D-102.004, Amended 2-27-94, 5-24-98,_________.

     

    59A-13.005 Administration and Management.

    (1) The licensee of each PPEC center shall have full legal authority and responsibility for the operation of the center facility.

    (2) Each PPEC center must shall be organized in accordance with a written table of organization, which describes the lines of authority and communication down to the child care level. The organizational structure must shall be designed to ensure an integrated continuum of services to the children clients.

    (3) Center supervision:

    (a) The licensee of each center must shall designate one person as administrator who is shall be responsible and accountable for the overall management of the center.

    (b) The center administrator must shall designate in writing a person to be responsible for the center when the administrator is to be absent from the center for more than a period of 24 hours.

    (c) The center administrator must Responsibilities of the center administrator shall include the following:

    1. Maintain the following written records and any Maintaining or causing to be maintained the following written records other records required by Section 400.914, F.S., Chapter 391, F.S., and these rules. The records must shall be kept in a place, form, and system in accordance with ordinarily employed in acceptable medical and business practices and available in the center for inspection by the Agency department during normal business hours:

    a. A daily census record, which must shall indicate the number of children currently receiving services in the center;

    b. A record of all accidents or unusual incidents involving any child or staff member that caused, or had the potential to cause, injury or harm to any person or property within the center. Such records must shall contain a clear description of each accident or incident, the names of the persons involved, a description of all medical or other services provided to these persons specifying who provided such services, and the steps taken, if any, to prevent recurrence of such accident or incidents in the future.

    c. A copy of current agreements entered into with third party providers;

    d. A copy of current agreements with each consultant employed by the center and documentation of each consultant's visits and required written, dated reports, and

    e. A personnel record for each employee, which must shall include: a current copy of a Florida certificate and/or number and current license number, as applicable; the original employment application, and references, furnished from the most recent health care employer and employment history for the preceding five (5) years if applicable; and a copy of all job performance evaluations;

    2. Develop and maintain a current job description for each employee. Ensuring the development and maintenance of a current job description for each employee;

    3. Provide each employee access to written personnel policies governing conditions of employment. Ensureing that each employee is furnished with a copy of written personnel policies governing conditions of employment including the job description for his own position;

    4.  Conduct annual written job performance evaluations that note strengths and weaknesses and include plans to correct any job performance weakness.  Performance evaluations must be reviewed with the employee. Ensureing that each employee receives at least a yearly written job performance evaluation which is discussed with the employee, notes job performance strengths and weaknesses, and discusses plans to correct any job performance weaknesses;

    5.  Assign duties to employees that are consistent with their job descriptions and with their levels of education, preparation and experience. Ensureing that such qualified personnel and ancillary services as are necessary  to assure  the health, safety, and proper care of children; are provided;

    6. Provide necessary qualified personnel and ancillary services to ensure the health, safety, and proper care of each child. Ensureing that each employee is assigned duties which are consistent with his job description and with his level of education, preparation, and experience; and

    7. Develop and implement infection control policies and procedures.  These policies and procedures must be included in the PPEC center’s policy manual. Ensureing that the Infection control policies and procedures are included in the center’s policy manual.

    Specific Authority 400.914(1) 391.214 FS. Law Implemented 400.914(1)(h) 391.214(1) FS. History–New 3-8-89, Formerly 10D-102.005, Amended  5-24-98,_________.

     

    59A-13.007 Admission, Transfer, and Discharge Policies.

    (1) Each PPEC center must shall have written policies and procedures governing the admission, transfer, and discharge of children.

    (2) The admission of each child to a PPEC center must shall be under the supervision of the center administrator or his designee, and must shall be in accordance with the center’s child care policies and procedures.

    (3) Each child admitted to a PPEC center must shall be admitted upon prescription by a licensed prescribing physician and must shall remain under the care of the licensed primary physician for the duration of the child’s his stay in the center.

    (4) Each child admitted for service to a PPEC center must shall meet at least the following criteria:

    (a) Infants and children considered for admission to the PPEC center will be those who are medically or technologically dependent.

    (b) The infants and children must not, prior to admission, present significant risk of infection to other children or personnel. The medical and nursing directors must shall review, on a case-by-case basis, any child with a suspected infectious disease to determine appropriateness of admission.

    (c) The child must be medically stabilized, require skilled nursing care, or other interventions, and be appropriate for outpatient care.

    (d) If the child meets the preceding criteria, the medical or nursing director of the PPEC center must will implement a preadmission plan which delineates services to be provided and appropriate sources for such services.

    1. If the child is hospitalized at the time of referral, pre-admission planning will include the parents or guardians, relevant hospital medical, nursing, social services and developmental staff to assure that the hospital discharge plans will be implemented upon admission to the following placement in the PPEC center.

    2. A consent form outlining the purpose of a PPEC center, family responsibilities, authorized treatment and appropriate liability release, and emergency disposition plans must shall be signed by the parents or guardians and witnessed prior to admission to the PPEC center. The parents or guardians and the PPEC center must shall be provided a copy of the consent form.  A copy of the signed consent form must be maintained in the child’s medical record. Confidentiality of PPEC records must shall be maintained in accordance with applicable state and federal laws section 455.241.

    Specific Authority 400.914(1) 391.214 FS. Law Implemented 400.914(1)(a),(h)  391.214(1) FS. History–New 3-8-89, Formerly 10D-102.007, Amended________.

     

    59A-13.008 Child Care Policies.

    (1) Each PPEC center must shall develop, implement, and maintain written policies and procedures governing all child care and related medical or other services provided.

    (2) Child care policies and procedures must shall be developed, and maintained and implemented by a group of professional PPEC center staff personnel comprised of at least the medical director or medical consultant, the center’s administrator, and the director of nursing services. All child care policies and procedures must shall be reviewed at least no less often than annually and shall be revised as needed.

    (3) The child care policies and procedures developed must, shall at a minimum, ensure client care in compliance with the provisions of Section 400.914, F.S., Chapter 391, F.S., and the standards contained in these rules.

    Specific Authority 400.914(1) 391.214 FS. Law Implemented 400.914(1)(a)  391.214(1) FS. History–New 3-8-89, Formerly 10D-102.008, Amended________.

     

    59A-13.009 Medical Director.

    A board certified pediatrician must will serve as the medical director for the PPEC center. Responsibilities of the medical director include shall include:

    (1) Periodic review of services to assure acceptable levels of quality of care and services.

    (2) Maintenance of a liaison role with the medical community.

    (3) Advisement on the development of new programs and modifications of existing programs.

    (4) Assurance that medical consultation will be available in the event of the medical director’s absence.

    (5) Serving on committees as defined and required by these rules and by the center’s policies.

    (6) Consulting with the center’s administrator on the health status of the center’s facility personnel.

    (7) Reviewing reports of all accidents or unusual incidents occurring on the premises and identifying to the center’s administrator hazards to health and safety.

    (8) Development and implementation Ensuring the of a policy and procedure for the delivery of emergency services and the delivery of regular physician’s services when the child’s attending physician or his designated alternative is not available.

    Specific Authority 400.914(1) 391.214 FS. Law Implemented 400.914(1)(f)  391.214(1)(d),(f) FS. History–New 3-8-89, Formerly 10D-102.009, Amended________.

     

    59A-13.010 Nursing Services.

    (1) A registered nurse will serve full-time as the Director of Nursing. The Director of Nursing must have at least the following qualifications:

    (a) Minimum of a Baccalaureate degree in nursing; 

    (a)(b) Hold a current Current Florida registered nurse license licensure.

    (b) Hold a current certification in Cardiopulmonary Resuscitation (CPR). Completion of a course in pediatric CPR, with annual recertification; and

    (c) (d) Have a minimum of two (2)  years general pediatric nursing experience of which at least  six (6) months must have been spent caring for medically fragile infants or children in a pediatric intensive care, or neonatal intensive care, PPEC or similar care setting during the previous five (5) years. Minimum of 2 years experience in general pediatrics experience of which at least 6 months shall have been spent in a pediatric intensive care or neonatal intensive care settings during the previous 5 years.

    (2) The Director of Nursing is shall be responsible for the daily operation of the PPEC center.

    (a) All PPEC centers shall have a minimum full-time equivalent of 2 registered nurses.(3) Registered nurse staffing standards:

    (a) (b) The registered nurse must shall have at least the following qualifications and experience:

    1. Licensed Licenseure as a registered nurse in Florida, pursuant to under Chapter 464, F.S, and a baccalaureate degree in nursing or two (2) or more years of pediatric speciality care experience, with at least six (6) months experience caring for medically or technologically dependent children. 

    2.  Current Annual pediatric certification in CPR.; and

    3. Minimum of 2 years experience in general pediatrics with at least 6 months experience caring for medically or  technologically dependent children.

    3.4. Pediatric nursing experience, defined as being responsible for the care of acutely ill or chronically ill children, within the previous 24 months.

    (b)(c) The registered nurse staff must provide: shall be responsible for at least the following:

    1. Nursing Provision of interventions; educational services to increase the parent’s or guardian’s family’s confidence and competence in caring for the child with special needs; assistance to facilitate coping with the effects of chronic illness on the child and family and support effective relationships among siblings and the ill child; interventions to foster normal development and psychosocial adaptation.;

    2.  Information regarding Knowledge of availability and access requirements to community resources.; and

    3. Fostering and maintaining A collaborative relationship with the interdisciplinary health team.

    (4) Licensed practical nurse staffing standards:

    Licensed practical nurses working in a PPEC center must be supervised by a registered nurse and have the following qualifications and experience;  If nursing assistants are utilized to augment registered nurse staffing, the nursing assistant shall have as a minimum the following qualifications:

    (a) Hold a Current Florida licensed practical nurse license pursuant to Chapter 464, F.S. Two years experience in the care of infants and toddlers;

    1. References documenting skill in care of infants and children;

    2. Basic cardiac life support annual certification.

    (b) Have two (2) year’s experience in pediatrics; and The nursing assistant shall work under the supervision of the registered nurse and be responsible for providing direct care to PPEC center children.

    (c) Hold a current certification in CPR.

    (5) Direct care personnel staffing standards. For the purposes of this subsection, other direct care personnel include: nursing assistants, nursing assistants certified pursuant to Chapter 464, patient care technicians, medical assistants, Emergency Medical Technicians (EMT) licensed pursuant to Chapter 401, and individuals with training and experience in education, social services or child care related fields.

    (a) Direct care personnel must meet the following requirements:

    1. Have one (1) year experience in the care of infants and toddlers,

    2. Employment references documenting skill in the care of infants and children, and

    3. Hold a current certification in CPR.

    (b)  Direct care personnel must work under the supervision of the registered nurse and be responsible for providing direct care to PPEC center children

    (6)(5) Total staffing for nursing services and direct care must, shall at a minimum, meet the following ratios: but at no time shall be less than 1 staff member on duty per 3 children. If only one staff member is on duty, that member must be a registered nurse:

    Children

    Total Staff

    RN

    RN or LPN

    Direct Care, or Licensed Nurse (RN or LPN)

    1

    1

    1

     

     

    2-6

    2

    1

     

    1

    7-9

    3

    1

    1

    1

    10-12

    4

    1

    1

    2

    13-15

    5

    2

    1

    2

    16-18

    6

    2

    1

    3

    19-21

    7

    2

    2

    3

    22-24

    8

    2

    2

    4

    25-27

    9

    3

    2

    4

    28-30

    10

    3

    2

    5

    31-33

    11

    3

    3

    5

    34-36

    12

    3

    3

    6

    37-39

    13

    4

    3

    6

    40-42

    14

    4

    3

    7

    43-45

    15

    4

    4

    7

    1-3 children 1 RN

    4-6 children 2 RNs

    7-9 children 2 RNs plus 1 other 

    10-12 children 2 RNs plus 2 others

    13-15 children  3 RNs plus 2 others

    16-18 children 3 RNs plus 3 others

    19-21 children 4 RNs plus 3 others

    22-24 children 4 RNs plus 4 others

    If the PPEC center has a census of more than 45 children, the staffing must increase by one staff for every three (3) children alternating between a direct care staff and licensed nurse.

    Specific Authority 400.914(1) 391.214 FS. Law Implemented 400.914(1)(a),(h)  391.214(1) FS. History–New 3-8-89, Formerly 10D-102.007, Amended________.

     

    59A-13.013 In-service Training for Staff , and Parents and Guardians.

    Each PPEC center must shall develop a staff, parent and guardian training programs. which will be available to staff, parents and guardians and includes at least the following:

    (1) Staff training must include:

    (a)(1) Quarterly staff development programs appropriate to the category of personnel. will be conducted to maintain quality patient care.

    (b)(2) Documentation of all staff development programs, and required participation. will be documented.

    (c)(3) Current CPR certification All employees shall  maintain annual pediatric  cardiopulmonary resuscitation certification for all staff.

    (2)(4) Each new employee will participate in orientation to acquaint the employee with the philosophy, organization, program, practices, and goals of the PPEC center.

    (3)(5) A comprehensive orientation to acquaint the parent or guardian with the philosophy and services will be provided at the time of the child’s admission to placement in the PPEC center.

    Specific Authority 400.914(1) 391.214 FS. Law Implemented 400.914(1)(a),(h)  391.214(1) FS. History–New 3-8-89, Formerly 10D-102.007, Amended________.

     

    59A-13.014 Medical Record.

    A medical record must shall be developed at the time of admission, must be maintained for each child, signed by authorized personnel and The records shall contain at least contain at least the following:

    (a) A medical plan of treatment and a nursing protocol of care.

    (b)(1)  All details of the referral, admission, correspondence and papers concerning the child.

    (2 ) Entries in the Medical records, shall be in ink and signed by authorized personnel, include at least the following:

    (c)(a)  Physician orders.

    (d)(b) Flow chart of medications and treatments administered.

    (e)(c) Concise, accurate information and initialed case notes reflecting progress toward protocol of care goals achievement of care goals or reasons for lack of progress.

    (f)(d)  Documentation of nutritional management and special diets, as appropriate.

    (g)(e) Documentation of physical, occupational, speech and other special therapies.

    (2)(3) The An individualized nursing care protocol of care must be developed within ten (10) working days of admission. The protocol must be reviewed monthly and revised quarterly, and include any recommendations and revisions to the plan based on consultation with other professionals involved in the child’s care. and revised to include recommended changes  in the therapeutic plans. The disposition to be followed in the event of emergency situations will be specified in the plan of

    care;

    (4) Medical history, including include allergies and special precautions.

    (5) Immunization record.

    (6) Quarterly review of Protocol of Care to updated the plan in consultation with other professionals involved in the child’s care;

    (6)(7) A discharge order written by the primary physician will be documented and entered in the child’s record. A discharge summary, which includes the reason for discharge, will also be included.

    Specific Authority 400.914(1) 391.214 FS. Law Implemented 400.914(1)(a),(h)  391.214(1) FS. History–New 3-8-89, Formerly 10D-102.007, Amended________.

     

    59A-13.015 Quality Assurance Committee.

    All PPEC centers must shall have a quality assurance program and must and will conduct quarterly reviews of the PPEC center’s medical records for at least half of the children served by the PPEC center at the time of the quality assurance review. The quarterly review sample must be randomly selected so each child served at the center has an equal opportunity to be included in the review.

    (1) The quality assurance committee must include the following: the medical director, administrator, director of nursing, and three (3) other committee members as determined by each PPEC center.

    (2)(1)  The quality assurance review will be conducted by two (2) 2 members of the quality assurance committee. The quality assurance review responsibilities shall rotate among the quality assurance committee members at least on an annual basis. Within 15 calendar working

    days of its review, the quality assurance committee must shall furnish copies of its report to the PPEC center medical and nursing directors.

    (3)(2) Each quarterly quality assurance review must shall include:

    (a) A review of the goals in each child’s nursing protocol.

    (b) A review of the steps, process, and success in achieving the goals.

    (c) Identification of goals not being achieved as expected, reasons for lack of achievement and plans to promote goal achievement.

    (d) Evidence that the protocol of care has been revised to accommodate the findings of the quality assurance report will be forwarded to the quality assurance committee within ten (10) calendar working days of receipt of the quality assurance committee report.

    (e) Implementation of the revisions to the protocol must be of care as documented in on the child’s record.

    (4)(3) The quality assurance review will also ascertain and assure the presence of the following documents in each child’s medical record:

    (a) A properly executed consent form.  ;and

    (b) A medical history for the child, including notations from visits to health care providers’. ;and

    (c) An immunization record with documentation of allergies and special precautions.

    Specific Authority 400.914(1) 391.214 FS. Law Implemented 400.914(1)(a),(h)  391.214(1) FS. History–New 3-8-89, Formerly 10D-102.007, Amended________.

     

    59A-13.020 Infection Control.

    Infection control requirements procedures must shall include at least the following:

    (1) The PPEC center must have shall contain  an isolation room with one (1) large glass area for observation of the child.

    (2) Isolation procedures must shall be used to prevent cross-infections.

    (3) All cribs and beds must shall be labeled with the individual child’s name.  Linens must shall be removed from the crib for laundering purposes only.

    (4) Bed linens must shall be changed when soiled and as necessary, but not less than twice weekly. at least twice weekly

    (5) Antimicrobial soap and disposable paper towels must shall be at each sink.

    (6) Staff must wash their hands after direct contact with each child, using appropriate hand washing techniques to prevent the spread of infection from one child to another.

    (7)(6) Children suspected of having a communicable disease, which may be transmitted through casual contact, as determined by the center’s facility’s medical director, must shall  be isolated; the parents or guardians must shall be notified of the condition; and the child must  shall  be removed from the PPEC center as soon as possible. When the communicable disease is no longer present, as evidenced by a written physician’s statement, the child may return to the PPEC center. ; and

    (8)(7) PPEC center staff members suspected of having a communicable disease must shall not return to the PPEC center until the signs and symptoms which related to the communicable disease are no longer present, as evidenced by a written physician’s statement.

    Specific Authority 400.914 (1), F.S391.214 F.S., Law Implemented 400.914 (1) (e), F.S.  391.214(1)(f) F.S., History–New 3-8-89, Formerly 10D-102.020, Amended________.

     

    59A-13.022 Fire Safety and Emergency Procedures.

    (1) All PPEC centers must shall conform to state standards prepared by the State Fire Marshal: Chapter 69A-36 4A-36, F.A.C., Uniform Fire Safety Standards for Child Care Facilities, and  must shall be inspected annually. A copy of the current annual fire inspection report, prepared by a certified fire inspector, conducted by the local authority having jurisdiction over fire safety or the State Fire Marshal, must shall be on file at the PPEC center. Documentation of a satisfactory fire safety inspection shall be provided at the time of the licensee’s annual survey.

    (2) There must shall be a working telephone, which is neither locked nor a pay station, in the PPEC center.  child care facility.

    (3) Emergency telephone numbers must shall be posted on or in the immediate vicinity of all telephones.

    (4) An emergency generator power source must shall exist, with sufficient generating power to continue function of medical equipment in the event of a power failure. The emergency generator  must shall be tested every 30 days and satisfactory mechanical operation must will be documented on a log designed for that purpose and signed by the person conducting the test.

    (5) Emergency transportation must shall be performed by a licensed E.M.S. provider, with a PPEC center staff member accompanying each the child.

    (6) The PPEC center must have an emergency kit available to provide basic first aid and cardiopulmonary resuscitation.

    Specific Authority  400.914 (1), F.S.  391.214 F.S., Law Implemented  400.914 (1) (f), F.S.  391.214(1)(f) F.S. History–New 3-8-89, Formerly 10D-102.022, Amended________.

     

     


    NAME OF PERSON ORIGINATING PROPOSED RULE: Kimberly Smoak
    NAME OF SUPERVISOR OR PERSON WHO APPROVED THE PROPOSED RULE: Alan Levine, Secretary
    DATE PROPOSED RULE APPROVED BY AGENCY HEAD: 2/16/2006
    DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: November 10, 2005