501. General (II)

A.Before being employed or contracted as a staff member/direct care volunteer by a licensed community
residential care facility, a person shall undergo a criminal background check pursuant to 1976 Code Section
44-7-2910. Staff members/direct care volunteers/private sitters of the facility shall not have a prior
conviction or pled no contest (nolo contendere) to abuse, neglect, or exploitation of a child or a vulnerable
adult as defined in 1976 Code Section 43-35-10, et seq. (I)

B.Staff members/volunteers shall be provided the necessary training to perform the duties for which they
are responsible in an effective manner. (I)

C.No supervision/care/services shall be provided to individuals who are not residents of the facility other
than children of owners of the facility who are residing in the facility. Minimum staffing requirements shall
be applied in instances where children of owners reside in the facility, i.e., children of owners shall be
considered as residents in the staff/resident ratio. (I)

D.Staff members/direct care volunteers shall have at least the following qualifications: (I)
1. Capable of rendering care/services to residents;
2. Sufficient education to be able to perform their duties, and to speak, read, and write English;
3. Demonstrate a working knowledge of applicable regulations.

E.There shall be accurate and current information maintained regarding all staff members/volunteers of
the facility, to include at least address, phone number, and personal/work/training background.

F. All staff members/direct care volunteers shall be assigned certain duties and responsibilities which
shall be in writing and in accordance with the individual’s capability.
G.When a facility engages a source other than the facility to provide services, normally provided by the
the facility, e.g., staffing, training, recreation, food service, professional consultant, maintenance,
transportation, there shall be a written agreement with the source that describes how and when the services
are to be provided, the exact services to be provided, and that these services are to be provided by qualified
individuals. The source shall comply with this regulation in regard to resident care, services, and rights.

502. Administrator (II).
A.The facility administrator shall be licensed as a CRCF administrator in accordance with 1976 Code Section 44-7-260.

B.The administrator shall exercise judgment that reflects that s/he is capable of meeting the
responsibilities involved in operating a facility to ensure that it is in compliance with these regulations, and
shall demonstrate adequate knowledge of these regulations.

C.A staff member shall be designated in writing to act in the absence of the administrator, e.g., a listing
of the lines of authority by position title, including the names of the persons filling these positions.

503. Staff (I).

A.There shall be a staff member actively on duty and present in the facility at all times that the facility is
occupied by residents and to whom the residents can immediately report injuries, symptoms of illness, or
emergencies. This staff member shall recognize and report significant changes in the physical or mental
condition of each resident and shall ensure that appropriate action is taken.

B.The number and qualifications of staff members/direct care volunteers shall be determined by the
number and condition of the residents. There shall be sufficient staff members/direct care volunteers to
provide supervision, direct care and basic services for all residents. The minimum number of staff
members/direct care volunteers that shall be maintained in all facilities:
1. In each building, there shall be at least one staff member/direct care volunteer for each eight (8)
residents or fraction thereof on duty during all periods of peak hours.
2. In each building, during non-peak hours, there shall be at least one staff member/volunteer on duty
for each thirty (30) residents or fraction thereof. A staff member/volunteer shall be awake and dressed at
all times. Staff member(s)/volunteer(s) shall be able to appropriately respond to resident needs during nonpeak hours.
3. In facilities that are licensed for more than 10 beds, and the facility is of multi-floor design, there
shall be a staff member available on each floor at all times residents are present on that floor.

C.The facility shall maintain documentation to ensure the facility meets Sections 503.B.1 and 503.B.2.

504. Inservice Training (I).

A.Documentation of all in-service training shall be signed and dated by both the individual providing the
training and the individual receiving the training. The following training shall be provided by appropriate
resources, e.g., licensed/registered/certified persons, books, electronic media, etc., to all staff
members/direct care volunteers and private sitters in the context of their job duties and responsibilities,
prior to resident contact and at a frequency determined by the facility, but at least annually unless otherwise
specified by certificate, e.g., cardiopulmonary resuscitation (CPR):
1. Basic first-aid to include emergency procedures as well as procedures to manage/care for minor
accidents or injuries;
2. Procedures for checking and recording vital signs (for designated staff members only);
3. Management/care of persons with contagious and/or communicable disease, e.g., hepatitis,
tuberculosis, HIV infection;
4. Medication management including storage, administration, receiving orders, securing medications,
interactions, and adverse reactions;
5. Depending on the type of residents, care of persons specific to the physical/mental condition being
cared for in the facility, e.g., dementia; cognitive disability; mental illness; or aggressive, violent, and/or
inappropriate behavioral symptoms etc., to include communication techniques (cueing and mirroring),
understanding and coping with behaviors, safety, activities, etc.
6. Use of restraint techniques;
7. OSHA standards regarding bloodborne pathogens;
8. Cardiopulmonary resuscitation for designated staff members/direct care volunteers to ensure that
there is a certified staff member/direct care volunteer present whenever residents are in the facility;
9. Confidentiality of resident information and records;
10. Bill of Rights for Long-Term Care Facilities per 1976 Code Section 44-81-10, et seq.;
11. Fire response training within twenty-four (24) hours of their first day on the job in the facility
(See Section 1503);
12. Emergency procedures/disaster preparedness within twenty-four (24) hours of their first day on
the job in the facility (See Section 1400); and
13. Activity training (for the designated staff only).

B.Job Orientation.
All new staff members/direct care volunteers shall have documented orientation to the organization and
environment of the facility, specific duties and responsibilities of staff members/direct care volunteers, and
residents’ needs within twenty-four (24) hours of their first day on the job in the facility.

505. Health Status (I).

A.All staff members/direct care volunteers who have contact with residents, including food service staff
members/direct care volunteers, shall have a health assessment within 12 months prior to initial resident
contact. The health assessment shall include tuberculin skin testing as described in Section 1702.

B.If a staff member/direct care volunteer is working at multiple facilities operated by the same licensee,
copies of records for tuberculin skin testing and the pre-employment health assessment shall be accessible
at each facility. For any other staff member/direct care volunteer, a copy of the tuberculin skin testing shall
be acceptable provided the test had been completed within three months prior to resident contact.

506. Private Sitters (II).

A.Unless the written agreement (See Section 901.A) between a resident and the facility prohibits the use
of private sitters, the facility shall establish a formalized private sitter program directed by a facility staff
the member so that residents or their responsible party may contract for sitter services.
1. The facility shall assure that private sitters have been chosen in accordance with the Residents Bill
of Rights.
2. Facilities allowing the use of private sitters shall establish written policies and procedures for private
3. Prior to resident contact, the private sitter shall have documented orientation to the organization and
environment of the facility. Orientation to the facility shall consist, at least, of the following:
a. Residents’ rights;
b. Confidentiality;
c. Disaster preparedness;
d. Emergency response procedures;
e. Safety procedures and precautions; and
16 | Regulation 61-84
f. Infection control.
4. There shall be accurate current information maintained regarding private sitters including:
a. Name, address, and telephone number;
b. Documentation of orientation to the facility, including residents’ rights, regulation compliance,
policies and procedures, training, and duties;
c. Date of initial resident contact may be maintained by the facility, if applicable.
B.The facility shall maintain the following documentation regarding private sitters:
1. A health assessment (in accordance with Section 505.A) within twelve (12) months prior to initial
resident contact or his or her first day working as a private sitter;
2. A criminal record check (See Section 501.B.) completed prior to working as a private sitter;
3. Determination of TB status (See Section 1702.D.) prior to initial resident contact or his or her first
day working as a private sitter.

C.Private sitters shall not be included in the minimum staffing requirements of Section 503.B.

D.Private sitters shall sign in and sign out with facility staff upon entering or leaving the facility. Private
sitters shall display identification in accordance with facility policies and procedures that is visible at all
times while on duty.