A. The licensee shall employ or contract with sufficient numbers of staff to ensure that the program is capable of meeting the requirements of this chapter, and all other applicable laws and regulations, in a manner consistent with the philosophy of assisted living and in compliance with generally accepted standards of care for the specific conditions of the residents the program intends to serve.

B. Relief personnel shall be available at all times in the event that the regularly scheduled staff members are unavailable. Relief personnel shall meet the requirements of §C and §D of this regulation.

  1. Age Requirements. At a minimum:

(1) The manager and alternate manager shall be 21 years old or older; and

(2) All other staff shall be 18 years old or older.

  1. The manager, alternate manager, and all other staff shall at a minimum:

(1) Be free from tuberculosis in a communicable form in accordance with Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in Health-Care Facilities (that is, tuberculin skin testing (TST) or chest x-ray, if indicated, within one year before employment or annual sign/symptom screen for those individuals with previous positive TST);

(2) Be immune to measles, mumps, rubella, and varicella (chickenpox) as evidenced by antibody serology or vaccine history;

(3) Be offered the influenza vaccine annually as evidenced by a documented acceptance or refusal of the vaccine during the recognized influenza season;

(4) Have a criminal background check or criminal history records check completed in accordance with Health-General Article, Title 19, Subtitle 19, Annotated Code of Maryland, within 30 days before employment, which includes a written evaluation, by the manager, of any criminal history and its relationship to assigned job duties, for any staff with a documented criminal history;

(5) Have sufficient skills, training, and experience to serve the residents in a manner that is consistent with the philosophy of assisted living;

(6) Receive initial training, prior to assuming responsibility for resident care, in:

(a) The health and psychosocial needs of the population being served;

(b) The resident assessment process;

(c) The use of service plans;

(d) Cuing, coaching, and monitoring residents who self-administer medications, with or without assistance;

(e) Providing assistance with ambulation, personal hygiene, dressing, toileting, and feeding; and

(f) Resident rights;

(7) Receive initial training, prior to assuming responsibility for resident care, and annual training in:

(a) Fire and life safety, including the use of fire extinguishers;

(b) Infection control, including standard precautions, contact precautions, and hand hygiene, based on criteria published by the Centers for Disease Control;

(c) Emergency disaster plans;

(d) Basic food safety;

(e) Environmental safety;

(f) Cognitive impairment and mental illness, as described in §I of this regulation; and

(g) Responding to choking and cardiopulmonary arrests, including hands-on exercises.

(8) Have current certification, including documented expiration dates, if involved in direct resident care, in:

(a) Basic first aid by a first aid instructor certified by a national organization; and

(b) Basic cardiopulmonary resuscitation (CPR), including a hands-on component, by a CPR instructor certified by a national organization;

(9) Hold appropriate licensure or certification as required by law; and

(10) Have additional Alzheimer’s/dementia training initially and annually, beyond the requirements of this regulation, as specified in Regulation .27 of this chapter, for all staff who work in Alzheimer’s/dementia special care units, including the designated unit manager.

E. A staff member who completes an approved 80-hour manager training course shall be exempt from the required annual trainings set forth in §D(7) of this regulation for a period of 4 years.

F. Proof of training shall include:

(1) Date of class;

(2) Course content;

(3) Documentation of successful completion of the training content;

(4) Signatures of the trainer and attendees; and

(5) Qualifications and contact information for the trainer.

G. Training may be provided through various means including:

(1) Classroom instruction;

(2) In-service training;

(3) Internet courses;

(4) Correspondence courses;

(5) Pre Recorded training; or

(6) Other training methods.

H. When the training method does not involve direct interaction between faculty and participant, the program shall make available to the participant during the training a trained individual to answer questions and respond to issues raised by the training.

I. Training in Cognitive Impairment and Mental Illness.

(1) When job duties involve the provision of personal care services as defined in Regulation .02B of this chapter, staff shall receive a minimum of 5 hours of initial training on cognitive impairment and mental illness. The training shall be designed to meet the specific needs of the program’s population, as determined by the manager, including the content set forth in Regulation .16A(8) and (9)(a)-(c).

(2) When job duties do not involve the provision of personal care services, staff shall receive a minimum of 2 hours of initial training on cognitive impairment and mental illness. The training shall include the content set forth in Regulation .16A(8)(a), (b), and (c)(iii).

(3) Ongoing training in cognitive impairment and mental illness shall be provided annually consisting of, at a minimum:

(a) 2 hours for staff whose job duties involve the provision of personal care services; and

(b) 1 hour for staff whose job duties do not involve the provision of personal care services.

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