This
rule was filed as 7 NMAC 13.2.
TITLE
7 HEALTH
CHAPTER
13 ADULT DAY CARE
PART
2 REQUIREMENTS FOR ADULT DAY
CARE FACILITIES
7.13.2.1 ISSUING AGENCY: Department of Health, Public Health
Division, Health Facility Licensing and Certification Bureau
[10/31/96;
Recompiled 10/31/01]
7.13.2.2 SCOPE: These regulations apply to public or private
facilities that provide care, services, and supervision for three (3) or more
non-resident adults for less than twenty four hours of any day, and come within
the statutory definition of "health facilities" set out in Section
24-1-2 (D) of the Public Health Act, Section 24-1-1 to 24-1-22 NMSA 1978 as
amended, and are required to be licensed by the licensing authority.
[7/11/88;
Recompiled 10/31/01]
7.13.2.3 STATUTORY AUTHORITY: The regulations set forth herein which
govern the licensing of adult day care facilities have been promulgated by the
secretary of the New Mexico department of health, pursuant to the general
authority granted under Section 9-7-6 (E) of the Department of Health Act, NMSA
1978, as amended; and the authority granted under Sections 24-1-2 (D), 24-1-3
(I) and 24-1-5 of the Public Health Act, NMSA 1978, as amended.
[7/11/88,
10/31/96; Recompiled 10/31/01]
7.13.2.4 DURATION: Permanent.
[10/31/96;
Recompiled 10/31/01]
7.13.2.5 EFFECTIVE DATE: October 31, 1996, unless a different date is
cited at the end of a Section or Paragraph.
[10/31/96;
Recompiled 10/31/01]
[Compiler’s
note: The words or paragraph, above, are no longer applicable. Later dates are now cited only at the end of
sections, in the history notes appearing in brackets.]
7.13.2.6 OBJECTIVE: The purpose of these regulations is to:
A. Establish minimum standards for licensing
facilities providing day care to adults, in order to ensure that participants
receive safe and adequate services and that the health, safety and welfare of
participants and employees are protected.
B. Direct such facilities to provide and
organize program of services in the community group setting for the purpose of
supporting adult's personal independence, and promoting their social, physical,
and emotional well-being.
C. Establish standards for the construction,
maintenance and operation of such facilities.
D. Monitor facility compliance with these
regulations through surveys to identify any areas which could be dangerous or
harmful to the health, safety, and welfare of the participants and staff.
[7/11/88;
Recompiled 10/31/01]
7.13.2.7 DEFINITIONS: For purposes of these regulations the
following shall apply:
A. "Abuse" means any single or
repeated act of force, violence, harassment, deprivation, neglect or mental
pressure which reasonably could cause physical pain or injury, or mental
anguish or fear.
B. "Adult" means an individual
eighteen years of age or older, and or who otherwise qualifies as an adult
under New Mexico law, and who is elderly, disabled or handicapped person having
impairments which prevents the person from living independently without
supportive services.
C. "Adult day care center" means a commercial
building licensed pursuant to these regulations, where care, services, and
supervision are provided to adults.
D. "Adult day care home" means a private
residence licensed pursuant to these regulations where care, services and
supervision are provided to adults.
E. "Ambulatory" means a person who is
fully mobile and does [need] not the continuing help of a person or object for
support (except a walking cane).
F. "Applicant" means the individual
who, or organization which, applies for a license. If the applicant is an
organization, then the individual signing the application on behalf of the
organization, must have authority from the organization. The applicant must be
the owner.
G. "Capacity" means the maximum
number of participants allowed to be cared for at any one time in the facility.
H. "Deficiencies" means violations of, or
failure to comply with, these regulations.
I. "Department" means the New Mexico
department of health.
J. "Director" means the person who is
in charge of the day to day operation and program of an adult day care center.
K. "Dropin" means an adult who
attends the facility on an occasional or unscheduled basis.
L. "Facility" means an private
residence or a commercial building licensed pursuant to these regulations where
care, services, and supervision are provided to adults.
M. "Governing body" means the individual,
agency, group or corporation appointed, elected or otherwise designated in
which the ultimate responsibility and authority for the conduct of the facility
is vested.
N. "Guardian" means one who has the
legal responsibility for the care of a person.
O. "Imminent danger" means a danger which
could reasonably be expected to cause death or serious physical harm or illness
to participants or staff.
P. "License" means the document issued
by the department which constitutes the authority to provide services included
within the scope of this rule.
Q "Licensee" means the person(s)
who, or organization which, has an ownership leasehold, or similar interest in
the adult day care facility and in whose name a license for a home health
agency has been issued and who is legally responsible for compliance with these
regulations.
R. Maintenance" means the care of
building(s) by keeping them in a repaired and safe condition and the grounds in
a safe, sanitary and presentable condition.
S. "Mobile non-ambulatory" means unable to walk
without assistance, but able to move from place to place with the use of
devices such as walkers, crutches, wheelchairs, wheeled platforms, etc.
T. "NMSA" means the New Mexico
Statutes Annotated, 1978 compilation and all the revisions and compilations
thereof.
U. "Participant" means a person enrolled
in an adult day care facility.
V. "Plan of correction" means the plan
submitted by the licensee, applicant, or operator addressing how and when
deficiencies identified at time of a survey will be corrected.
W. "Policy" means a statement of
principle that guides and determines present and future decisions and actions.
X. "Premises" means all parts of the
buildings, grounds, equipment and vehicles of a facility licensed pursuant to
these regulations.
Y. "Private residence" means the dwelling,
where the operator resides on a 24 hour basis, to include provisions for
sleeping, eating, bathing, cooking, etc.
Z. "Relative" means husband, wife,
mother, father, son, daughter, brother, sister, brother-in-law, sister-in-law,
mother-in-law, grandfather, grandmother, half-brothers, includes adoptive,
natural and foster parents, grandparents or adult children.
AA. "Respite care" accommodates the family
or guardian by providing an alternate place for the participant to stay when
the family or guardian needs a rest from the everyday physical and emotional
strain of caring for the participant.
BB. "Staff member" means any person who provides
direct care, services and supervision to the participants in a facility
licensed pursuant to these regulations.
CC. "Supervision" means the direct
observation and guidance of adults at all times and requires being physically
present with them.
DD. "Survey" means an entry into,
and examination of, the facility's premises, records and staff interviews.
EE. "U/L approved" means approved for
safety by the national underwriters laboratory.
FF. "Unattended" means a caregiver is not
physically present with an adult under care.
GG. "Variance" means an act on the
part of the licensing authority to refrain from pressing or enforcing
compliance with a portion or portions of these regulations for an unspecified
period of time for facilities which were in existence at the time these
regulations were promulgated, new facilities in existing construction, or for a
new or innovative service where the granting of a variance will not create a
danger to the health, safety and welfare of adults or staff of a facility, and
is at the sole discretion of the licensing authority.
HH. "Waive/waiver" means to refrain from
pressing or enforcing compliance with a portion or portions of these
regulations for a limited period of time provided the health, safety or welfare
of the adults and staff are not in danger. Waivers are issued at the sole
discretion of the licensing authority.
[7/11/88,
10/31/96; Recompiled 10/31/01]
7.13.2.8 TYPES OF FACILITIES AND SCOPE OF
SERVICES:
A. Adult day care center
is a facility required to be licensed pursuant to these regulations which
provides care, services and supervision to three (3) or more adults, who
because of diminished mental or physical capacity find it difficult to care for
themselves in their own residence during the day. An adult day care center may
be located in any building which meets the applicable state and local building
and safety codes.
B. Adult day care home is private residence required
to be licensed pursuant to these regulations which provides care, services and
supervision to at least three (3) adults but not more than five (5) adults who
because of diminished mental or physical capacity find it difficult to care for
themselves in their own residence during the day.
C. New or innovative programs for
providing adult day care: Professional
organizations which have demonstrated a need for new or innovative services for
day care for three (3) or more adults with special needs which do not fit into
one of the types of facilities outlined in Section 8.1 and 8.2 [now Subsections
A and B of 7.13.2.8 NMAC] above may be licensed at the sole discretion of the
licensing authority, if all requirements outlined in Section 9 [now 7.13.2.9 NMAC]
are met.
D. These facilities must be able to provide
oversight to the participants such as reminding them of medications and
appointments, providing meals and monitoring their activities while on the
premises of the facility. Hours of operation are limited from 6 a.m. to 9 p.m.
E. Participants must be able to ambulate on
their own or in a wheelchair with minimal assistance. They must be ambulatory
or mobile non-ambulatory.
F. In the event federal regulations are
promulgated to govern health-related adult day care ("the medical
model"), these regulations shall continue to apply except to the extent a
provision of these regulations is in conflict with the federal, in which case
the federal regulation shall control.
[7/11/88;
Recompiled 10/31/01]
7.13.2.9 INITIAL LICENSURE PROCEDURES: To obtain an initial license for an adult
day care facility pursuant to these regulations, the following procedures must
be followed by the applicant:
A. These regulations must be thoroughly understood by the
applicant and used as reference prior to applying for licensure.
B. Application form: Will be provided by the licensing authority.
(1) All information requested
on the application must be provided and complete.
(2) Must be printed or typed.
(3) Must be dated and signed.
(4) Must be notarized.
C. Fees: All applications for license must be
accompanied by the required fee.
(1) Current fee schedules will
be provided by the licensing authority.
(2) Fees must be in the form
of a check or money order made payable to the state of New Mexico.
(3) Fees are not refundable.
D. Floor plans: All applications for initial licensure must
be accompanied by a set of floor plans for the facility.
(1) Floor plans must be of professional
quality, be on substantial paper of at least 18" x 24", and be drawn
to an accurate scale of 1/4" to 1'.
(2) Floor plans must include at least the following information:
(a) Proposed use of each room i.e., staff office, toilets,
activity room(s), kitchen, etc.;
(b) Interior dimensions of all rooms must be included on floor
plans;
(c) Floor plans must include one building or wall section showing
exterior and interior wall construction. Section must include floor, wall, ceiling
and the finishes, i.e., carpet, tile, gyp board with paint, wood paneling,
etc.;
(d) Door types, swing, and sized of all doors, i.e., solid core,
hollow core, 3'0" x 6'8";
(e) If building is air conditioned;
(f) All sinks, tubs, showers, and toilets;
(g) Size, type, sill height, and openable area of windows
indicated;
(h) Any level changes within the building i.e., sunken activity
room, ramps, steps, etc.;
(i) The location of the building on a site/plot plan to determine
surrounding conditions, including all steps, ramps, parking, walks, and any permanent
structures;
(j) If building is new construction, renovated, or an addition,
indicate both the existing and new construction on the floor plans.
(3) Floor plans will be
reviewed by the licensing authority for compliance with current building and
fire codes, and comments will be sent to the applicant specifying any needed
changes or requesting any additional information. Exception: Adult day
care homes are not required to submit floor plans.
E. Zoning and building approvals:
(1) All initial applications must be
accompanied with original written zoning approval from the appropriate
authority, city, county, or municipality.
(2) All initial applications
must be accompanied with written building approval (certificate of occupancy)
from the appropriate authority, city, county, or municipality. Exception: Adult day
care homes are not required to submit building approval.
F. Fire authority approval: All initial applications must be accompanied
by original written approval of the appropriate fire prevention authority
having jurisdiction: i.e., city, county, or state fire marshal's office. Exception:
Adult day care homes are not required to submit fire authority approval.
G. New Mexico environment department
approval: All initial applications must be accompanied
by original written approval of the New Mexico environment department for the
following:
(1) kitchen approval if meals
are prepared or served in the facility;
(2) Private water supply, if
applicable;
(3) Private waste or sewage
disposal, if applicable.
(4) Exception: Adult day care homes are not required to submit
New Mexico environment department approval.
H. Health certificates: Copies of health certificates of the
licensee, caregivers, and staff must accompany all initial application. See
Section 26.1.5 [now Paragraph (5) of Subsection A of 7.13.2.26 NMAC] for requirements
of health certificates.
I. Custodial drug permit: Any facility licensed pursuant to these
regulations which supervises self-administration of medication for the
participants or safeguards medication for participants, must have an
appropriate custodial drug permit as determined by the state board of pharmacy.
J. A list of equipment for adult activities
that the facility will provide on the first day of operation must accompany all
initial applications.
K. A description of the facility's proposed
activities and daily schedule must accompany all initial applications.
L. Initial survey: An initial survey of the proposed facility
will be scheduled by the licensing authority upon receipt of a properly
completed application with all supporting documentation, as outlined in
Sections 8.1 through 8.10 [now 7.13.2.8 NMAC] of these regulations.
M. Issuance of license: A license will be issued by the licensing
authority if the initial survey determines that the facility is in compliance
with these regulations.
[7/11/88,
10/31/96; Recompiled 10/31/01]
7.13.2.10 SPECIAL REQUIREMENTS FOR NEW OR
INNOVATIVE ADULT DAY CARE SERVICES:
A. Applicants for
new or innovative adult day care services which do not fit into any one of the types
of facilities as outlined in Section 8, 8.1 and 8.2 [now Subsections A and B of
7.13.2.8 NMAC] must submit a proposal to the licensing authority for review and
approval. The proposal must include the following:
(1) Statistical data supporting the need for
a special type of adult day care service.
(2) Explanation of the
special problems and needs of the adults who will be receiving these services.
(3) Identify portions of
these regulations which would be in conflict with the proposed facility.
(4) How the proposed facility
would resolve these conflicts with alternative measures which would meet the
intent of these regulations, i.e., increased staffing or fire and safety
precautions.
B. If, at its sole
discretion, the licensing authority approves the proposal a license may be
granted with variances for those portions of the regulations where the program
would be in conflict.
[7/11/88;
Recompiled 10/31/01]
7.13.2.11 LICENSES:
A. Annual license: An annual license is issued for a one (1)
year period to a facility which has met all requirements of these regulations.
B. Temporary license: The licensing authority may, at its sole
discretion, issue a temporary license prior to the initial survey, or when the
licensing authority finds partial compliance with these regulations.
(1) A temporary license shall
cover a period of time, not to exceed one hundred twenty (120) days, during
which the facility must correct all specified deficiencies.
(2) In accordance with
Section 24-1-5 (D), NMSA 1978, no more than two (2) consecutive temporary licenses shall be
issued.
C. Amended license: A licensee must apply to the licensing
authority for an amended license when there is a change of
administrator/director, when there is a change of name of the facility, or if a
change of capacity is sought.
(1) Application must be on a
form provided by the licensing authority.
(2) Application must be
accompanied by the required fee for an amended license.
(3) Application must be
submitted within ten (10) working days of the change.
(4) Application for increase
or decrease of capacity will not be approved nor an amended license issued until an on-site
visit has been made by the licensing authority to determine if the facility
meets all applicable codes and regulations. A facility must not accept additional
participants or change the layout of the facility until the licensing authority
has approved and issued the amended license.
[7/11/88,
10/31/96; Recompiled 10/31/01]
7.13.2.12 LICENSE RENEWAL:
A. Licensee must submit a notarized renewal
application on forms provided by the licensing authority, along with the
required fee, at least thirty (30) days prior to expiration of the current
license.
B. Upon receipt of a notarized renewal
application, required fee, and an on-site survey, the licensing authority will
issue a new license effective the day following the date of expiration of the
current license, if the facility is in compliance with these regulations.
C. If a licensee fails to submit a notarized
renewal application, with the required fee, before the current license expires,
the licensee must submit an initial license application, and the facility shall
cease operations until initial licensure procedures are completed.
[7/11/88;
Recompiled 10/31/01]
7.13.2.13 POSTING OF LICENSE: The facility license shall be posted in a
conspicuous place on the licensed premises, in an area visible to staff and
visitors.
[7/11/88;
Recompiled 10/31/01]
7.13.2.14 NON-TRANSFERABLE RESTRICTIONS OF
LICENSE: A license shall not be transferred by assignment
or otherwise to other persons or location. The license shall be void and must
be returned to the Licensing Authority when any one of the following situations
occur:
A. ownership of the facility changes;
B. th facility changes location;
C. licensee of the facility changes;
D. the facility discontinues operations;
E. a facility wishing to continue operation
as a licensed facility under circumstances 14.1 through 14.4 [now Subsections A
through D of 7.13.2.14 NMAC] above shall submit an application for initial
licensure in accordance with Section 8 [now 7.13.2.8 NMAC] of these regulations
at least thirty (30) days prior to the anticipated change.
[7/11/88,
10/31/96; Recompiled 10/31/01]
7.13.2.15 AUTOMATIC EXPIRATION OF LICENSE: A license shall automatically expire at
midnight on the day indicated on the license as the expiration date, unless
sooner renewed, suspended or revoked, or:
A. on the day a facility discontinues
operation.
B. on the day a facility is sold, leased, or
otherwise changes ownership and/or licensee.
C. on the day a facility changes location.
[7/11/88,
10/31/96; Recompiled 10/31/01]
7.13.2.16 SUSPENSION OF LICENSE WITHOUT
PRIOR HEARING: In accordance with 24-1-5 NMSA 1978, if
immediate action is required to protect human health and safety, the licensing
authority may suspend a license pending a hearing, provided such hearing is
held within five (5) working days of the suspension, unless waived by the
licensee.
[7/11/88;
Recompiled 10/31/01]
7.13.2.17 GROUNDS FOR REVOCATION OR
SUSPENSION OF LICENSE, DENIAL OF INITIAL OR RENEWAL APPLICATION FOR LICENSE, OR
IMPOSITION OF INTERMEDIATE SANCTIONS OR CIVIL MONETARY PENALTIES: A license may be revoked or suspended, an
initial or renewal application may be denied, or intermediate sanctions or
civil monetary penalties may be imposed after notice and opportunity for a
hearing, for any of the following reasons:
A. failure to comply with any provision of
these regulations.
B. failure to allow survey by authorized representatives
of the licensing authority.
C. any person active in the operation of a
facility licensed pursuant to these regulations, to include all adults and
teenaged children living in an adult day care home shall not be under the
influence of alcohol or narcotics or convicted of a felony.
D. misrepresentation or falsification of any
information on application forms or other documents provided by the licensing
authority.
E. discovery of repeat violations of these
regulations during surveys.
F. hiring of or continuing to employ any
person whose health or conduct impairs his/her ability to properly protect the
health, safety, and welfare of the participants.
G. exceeding licensed capacity.
[7/11/88,
10/31/96; Recompiled 10/31/01]
7.13.2.18 HEARING PROCEDURES:
A. Hearing procedures for adverse action
initiated by the licensing authority against a facility license as outlined in
Sections 16 and 17 [now 7.13.2.16 NMAC and 7.13.2.17 NMAC] above will be held
in accordance with Adjudicatory Hearings, New Mexico department of health, 7
NMAC 1.2 (2-1-96) [now 7.1.2 NMAC].
B. A copy of the above regulations will be
furnished to a facility at the time an adverse action is initiated against its
license by the licensing authority, or a copy may be requested at any time by
contacting the licensing authority.
[7/11/88,
10/31/96; Recompiled 10/31/01]
7.13.2.19 NEW FACILITY: A new facility may be located in an existing
building or a newly constructed building:
A. If opened in an existing building a variance
may be granted for those building requirements the facility cannot meet under
the same criteria outlined in Section 18 [now 7.13.2.18 NMAC], if not in
conflict with existing building and fire codes. This is at the sole discretion
of the licensing authority.
B. A new facility opened in a newly
constructed building shall meet all of the requirements of these regulations.
[7/11/88;
Recompiled 10/31/01]
7.13.2.20 FACILITY SURVEYS:
A. Surveys are meant to be constructive and
informative to the licensee and staff of a facility, to insure that the
facility meets the requirements of these regulations, and to identify any area
which could be dangerous or harmful to the health, safety, and welfare of the
participants and staff.
B. A survey will be conducted at least once
annually in each facility licensed pursuant to these regulations by personnel
of the licensing authority using these regulations as criteria. Additional
surveys or visits may be made to assist the facility with technical advice, to
check on progress in correction of violations found on previous survey, or to
investigate complaints.
C. At the completion of a survey, the
findings shall be discussed with the licensee or representative and a plan of
correction will be requested. If a plan of correction is not given at the time
of survey the licensee, director or operator must submit within ten (10)
working days after receiving the official written report of survey, a plan of
correction to the licensing authority for violations found during the survey.
The plan of correction must give specifics as to how the violation will be
corrected and the expected date of completion.
D. The licensing authority may, at its sole
discretion, accept the plan of correction as written or require modifications
of the plan by the licensee.
E. Application for licensure, whether
initial or renewal, shall constitute permission for entry into and survey of a
facility by authorized licensing authority representative during the pendency
of the application and, if licensed, during the licensure period.
F. Surveyors have the right to enter upon
and into the premises of any facility which is licensed or required to be
licensed, whether or not an application for licensure has been made, at any
reasonable time for the purpose of determining the state of compliance with
these regulations.
G. The licensing authority shall perform, as
it deems necessary, unannounced on-site surveys to determine compliance with
these regulations, to investigate complaints, or to investigate the appropriateness
of licensure for any alleged unlicensed facility.
H. At all times, there must be a person
present in the facility who can represent the licensee or director for survey
purposes. This person must be able to provide access to all records and keys to
any locked area.
[7/11/88,
10/31/96; Recompiled 10/31/01]
7.13.2.21 COMPLAINT PROCEDURES:
A. Submission of complaints: Complaints
regarding any facility licensed or required to be licensed pursuant to these
regulations should be submitted to the licensing authority.
(1) Complaints should be
submitted in writing and signed by the complainant.
(2) Complainants telephoning
the licensing futhority should identify themselves and be able to provide necessary information
needed by the licensing futhority in order to document the complaint.
B. Written acknowledgement: The licensing
authority shall, whenever possible acknowledge in writing, within ten (10)
working days, receipt of all complaints.
C. Initiation of investigation: If it is
probable that the health, safety, and welfare of an adult or adults is in
jeopardy, the complaint will be investigated promptly. Otherwise the licensing
authority shall initiate an investigation within twenty (20) working days from
receipt of a compliant.
D. Results of investigation: Both the
licensee of the facility against whom a complaint is lodged, and the
complainant, shall be notified in writing of the results of the investigation.
E. Anonymity may be requested by the complainant
but cannot be assured.
F. Action by the licensing authority:
(1) Complaint
unsubstantiated: A complaint which is unsubstantiated by the licensing
authority is not made part of the facility file and the licensing authority
takes no further action.
(2) Substantiated complaint:
The licensing authority may take the following actions if a complaint is
substantiated:
(a) Require the facility to submit a written plan of correction to
the licensing authority if violations of these regulations are found.
(b) Other administrative sanctions such as the suspension or
revocation of a license, or the filing of criminal charges, or a civil action
may be instituted by the licensing authority if deemed appropriate.
[7/11/88;
Recompiled 10/31/01]
7.13.2.22 CAPACITY OF A FACILITY: The capacity of a facility licensed pursuant
to these regulations is determined by the following:
A. By the type of facility:
(1) an adult day care center
may be licensed for at least three (3) adults but is not limited as to maximum
number of participants. Adult relatives of staff and volunteers receiving care
in the facility must be counted in the licensed capacity.
(2) an adult day care home
may be licensed for at least three (3) adults but not more than five (5) participants. The
licensee's own adult relatives under the care of the facility must be counted
in the licensed capacity when present in the facility.
B. By useable space for activities:
(1) Adult day care centers
and adult day care homes are required to have forty (40) square feet of
activity area for each adult included in the licensed capacity.
(2) The capacity as reflected on the license issued to a
facility licensed pursuant to these regulations must not be exceeded at any
time.
[7/11/88;
Recompiled 10/31/01]
7.13.2.23 REPORTING OF INCIDENTS: All facilities licensed pursuant to these
regulations shall report to the licensing authority any incident or unusual
occurrence which has, or could threaten the health, safety, and welfare of the
participants or staff, such as, but not limited to:
A. lost or missing participant;
B. sexual or physical abuse of a
participant;
C. accidents or injuries requiring medical
care;
D. fire, flood or other natural disaster
which creates structural damages to the facility or poses health hazards.
E. notifiable diseases.
[7/11/88;
Recompiled 10/31/01]
7.13.2.24 GENERAL RECORDS: The following records must be kept on file
in the facility and available for inspection by the licensing authority during
survey:
A. a copy of the report of the latest survey
conducted by the licensing authority and a copy of any variances granted by it.
B. record of fire drills held.
C. a copy of the latest fire prevention
inspection by the authority having jurisdiction. Exception: Adult day care homes
are not required to have fire authority inspections.
D. a copy of the latest environmental
improvement division inspection of the kitchen if meals are served in the
facility. Exception: Adult day care homes are not required to have environmental
improvement division approvals of kitchen.
E. initial and periodic inspection reports
from environmental improvement division for those facilities which have private
water, sewage, or waste disposal systems, when applicable.
F. documentation of staff training as
required by Section 58 [now 7.13.2.58 NMAC] of these regulations.
G. documentation of current first aid
certificates as required by these regulations.
[7/11/88;
Recompiled 10/31/01]
7.13.2.25 PARTICIPANT RECORDS: There must be maintained a complete record
on file for each adult receiving care within a facility licensed pursuant to
these regulations, which must contain at least the following:
A. Personal information:
(1) name of participant;
(2) date of birth;
(3) sex;
(4) home address (mailing
address and location of residence) and telephone number;
(5) name of responsible
party;
(6) current place of employment,
address and work telephone number of responsible party.
B. Emergency information.
(1) record of any allergies
or medical conditions the participant may have;
(2) name and telephone number
of two persons to be called in case of emergency when the responsible party
cannot be reached;
(3) name and telephone number
of physician or emergency medical facility authorized by guardian to be called
in case of illness or emergency;
(4) permission for emergency medical transportation and guardian's
consent for treatment.
C. Date of enrollment.
D. Date of disenrollment.
E. The following must be recorded in each
participant's file when applicable:
(1) accidents and illnesses which require first aid or medical
attention;
(2) observation of recent
bruises, injuries or signs of abuse or neglect;
(3) use of physical
restraints.
F. Medications prescribed for the resident,
including time and dosage.
G. Written authorization from the
participant, responsible party or guardian, must be in the participants record
for the removal of the participant's from the grounds of the facility to participate
in field trips, nature walks, or other activities whether or not the activity
includes transportation by vehicle.
H. Daily attendance of the participant.
I. Enrollment agreement signed by the
participant, responsible party or guardian which clearly outlines the
following:
(1) services to be provided
by the facility and costs for the same;
(2) acknowledgement by the
participant, responsible party or guardian that they clearly understand the policies of the
facility and agree to them.
J. General:
(1) each participant's record
must be kept on file in the facility at least six (6) months after
disenrollment.
(2) participant's records
must be made available to those persons authorized by law or regulation to
review or inspect such records, such as guardians, staff, or representatives of
the licensing authority.
(3) participant's records
must be complete with all documentation at the time of admission, to include drop ins.
[7/11/88;
Recompiled 10/31/01]
7.13.2.26 STAFF RECORDS:
A. There must be maintained a complete
record on file for each staff member or volunteer working more than eight (8)
hours of any week and having direct contact with the participants which must
contain at least the following:
(1) name.
(2) address and telephone
number.
(3) position for which
employed.
(4) date of employment and
termination, when applicable.
(5) certificate signed by a
physician or recognized health facility stating that the staff member, or volunteer is free from
tuberculosis in a transmissible form as required by the New Mexico department
of health regulations, Control of Communicable Disease in Health Facility
Personnel, 7 NMAC 4.4 [now 7.4.4 NMAC].
B. A daily attendance record of all employed
staff must be kept by the facility.
C. The facility must maintain weekly work schedules
of all employed staff and caregivers. These schedules must be kept on file for
at least six (6) months.
D. Staff records must be available for
review by representatives of the licensing authority at all times.
[7/11/88;
Recompiled 10/31/01]
7.13.2.27 FACILITY RULES: Each facility must have written rules
pertaining to the following:
A. admission and disenrollment of
participants.
B. duties and responsibilities of all
employed staff and volunteers regarding the care, services, and supervision of the
participants, which must be updated when staff duties change.
[7/11/88;
Recompiled 10/31/01]
7.13.2.28 POLICIES AND PROCEDURES: All facilities licensed pursuant to these
regulations must have written policies and procedures covering the following areas:
A. actions to be taken in case of accidents
or emergencies involving a participant;
B. policies and procedures on reporting
suspected adult abuse or neglect;
C. policies and procedures for admission and
disenrollment of participants;
D. policies and procedures for action to be
taken in the event a participant is found missing from the facility;
E. policies and procedures for handling of
medications;
F. policies and procedures for handling of
complaints received from guardians or any other person;
G. the facility must have policies and
procedures prohibiting the following:
(1) abusing or neglecting a
participant (e.g., slapping, hitting, striking, withholding food as a
punishment, verbally threatening, or failing to provide a participant with the
level of services and degree of supervision;
(2) retaliation against a
participant because of complaints or suggestions regarding the management of
the facility;
(3) social isolation;
(4) the use of chemical
restraint.
H. If at any time a participant's rights are
restricted in order to protect the health, safety, and welfare of the
participant the reasons for the restriction of the rights must be clearly documented
in the participant's record.
I. Policies and procedures for the use of
restraints.
J. These policies and procedures may be
adopted from other sources.
[7/11/88;
Recompiled 10/31/01]
7.13.2.29 GENERAL BUILDING(S), GROUNDS, AND
SAFETY REQUIREMENTS:
A. New construction, additions and
alternation: When construction of building, additions, or
alterations to existing building are contemplated, plans and specifications
covering all portions of the work must be submitted to the licensing authority
for plan review and approval prior to beginning actual construction. When an
addition or alteration is contemplated, plans for the entire facility must be
submitted.
B. Number of stories: All building requirements contained in these
regulations are based on building of one (1) story in which care for adults is
not being provided above or below ground level. Facilities housed in
multi-storied buildings and wishing to provide services to adults above or
below ground level will have additional requirements due to the complexities of
the building and fire codes. These additional requirements will be outlined by
the appropriate building and fire authorities and by the licensing authority
through plan review and on site surveys during the licensing process.
C. Energy conservation: New buildings for a facility must be
constructed to provide energy conservation as required by applicable building
codes.
D. Access to the handicapped: All facilities must provide access to the
handicapped as required in current building codes and other state and federal
regulations. Exception: Adult day care homes are not required to comply with 29.1
through 29.4 [Subsections A through D of 7.13.2.29 NMAC] above.
E. Prohibition on mobile homes: Trailers and mobile homes shall not be used
for adult day care.
F. Extent of a facility: All buildings on the premises used for the
care of adults will be considered part of the facility and must meet all
requirements of these regulations. Adults being cared for in any building on
the premises will be counted in the capacity of the facility.
[7/11/88;
Recompiled 10/31/01]
7.13.2.30 SPACE REQUIREMENTS: Facilities licensed pursuant to these
regulations must meet the following space requirements for capacity and
service:
A. Adult day care centers and adult day care
homes are required to have forty (40) square feet of activity area for each
adult for which the facility is licensed to provide care.
B. Indoor activity area is computed by measuring
the activity areas used for the participants, excluding kitchens, corridors,
bathrooms, storage areas and closets. Measurements are taken from wall to wall
in each room, deducting offsets and built in fixtures.
C. An outside activity area must be provided.
[7/11/88;
Recompiled 10/31/01]
7.13.2.31 MAINTENANCE OF BUILDING(S) AND
GROUNDS:
A. All electrical, signaling, mechanical,
water supply, heating, fire protection and sewage systems must be maintained in
a safe and functioning condition, including regular inspections of these
systems.
B. All furniture and furnishing must be kept
clean and in good repair. Furnishings or decorations of an explosive or highly
flammable character shall not be used.
C. The buildings and grounds of the facility
must be maintained in a safe, sanitary, and presentable condition at all times.
[7/11/88;
Recompiled 10/31/01]
7.13.2.32 HOUSEKEEPING:
A. The facility must be kept free from
offensive odors and accumulations of dirt, rubbish, dust and safety hazards.
B. Activity areas for participants must be
cleaned and tidied daily.
C. Floors and walls must be constructed of a
finish that can be easily cleaned. Floor polishes shall provide a non-slip
finish.
D. Bathrooms and lavatories shall be cleaned
as often as necessary to maintain a clean and sanitary condition.
E. Deodorizers must not be used to mask
odors caused by unsanitary conditions or poor housekeeping practices.
F. Storage areas must be kept free from
accumulations of refuse, discarded furniture, old newspapers, and the like.
G. Combustibles, such as cleaning rags and
compounds, must be kept in closed metal containers in areas providing adequate
ventilation and away from participant activity and sleeping areas.
H. Poisonous or flammable substances must
not be stored in participant's activity areas, or food storage areas.
[7/11/88;
Recompiled 10/31/01]
7.13.2.33 HEATING, VENTILATION, AND
AIR-CONDITIONING:
A. Heating, air-conditioning, piping,
boilers, and ventilation equipment must be furnished, installed and maintained
to meet all requirements of current state and local mechanical, electrical and
construction codes.
B. The heating method used by the facility
must provide a minimum temperature of sixty-eight (68) degrees F in all rooms
used by the participants.
C. The use of unvented heaters, open flame
heaters or portable heaters, is prohibited.
D. An ample supply of outside air must be
provided in all spaces where fuel fired boilers or heaters are located to
assure proper combustion.
E. All gas-fired heating equipment must be
provided with a 100 percent automatic cutoff control valve in event of pilot
failure.
F. Each building where gas is used must have
the outside gas shutoff valve conspicuously painted red. The facility must have
a tool readily available which will operate the shut-off valve. The tool will
also be painted red. All staff of the facility must be instructed as to
location of the gas shut-off valve and must know how to shut off the gas supply
in case of fire or gas leakage. Exception: Adult day care homes are not
required to comply with 33.6 [now Subsection F of 7.13.2.33 NMAC] above.
G. All boiler, furnace or heater rooms shall
be protected from other parts of the building by construction having a fire resistance
rating of not less than one hour. Doors to these rooms shall be at least 1
3/4" solid core. Exception: Adult day care homes are
permitted to have the normal residential type heating system.
H. A facility must be adequately ventilated
at all times by either mechanical or natural means to provide fresh air and the
control of unpleasant odors.
I. All gas burning heating and cooking
equipment must be connected to an approved venting system to take the products
of combustion directly to the outside air.
Exception: Adult day care homes
are not required to vent cooking stoves.
J. All openings to the outer air used for
ventilation must be screened with screening material of not less than sixteen
(16) meshes per lineal inch.
K. The facility must be provided with a
system for maintaining participant's comfort during periods of hot weather.
[7/11/88;
Recompiled 10/31/01]
7.13.2.34 WATER:
A. A facility must be provided with an
adequate supply of water which is of a safe and sanitary quality suitable for
domestic use.
B. If the water supply is not obtained from
an approved public system, the private water system must be inspected, tested
and approved by the New Mexico environment department prior to licensure. It is
the facility's responsibility to ensure that subsequent periodic testing or
inspection of such private water systems be made at intervals prescribed by the
New Mexico environment department.
C. Hot and cold running water, under
pressure, must be distributed to all food preparation areas, lavatories,
washrooms, laundries and bathrooms.
[7/11/88,
10/31/96; Recompiled 10/31/01]
7.13.2.35 WATER HEATERS:
A. All fuel-fired water heaters must be
separated from other parts of the facility by partitions having a
fire-resistive rating of one hour. Doors to the enclosure must be 1 3/4"
solid core. Exception: Adult day care homes.
B. All water heaters must be equipped with a
pressure relief valve (pop-off-valve) complete with relief drain line to the
outside of the facility.
C. Water heaters must not be located in
participant areas used for activity or sleeping.
D. Temperature of hot water for lavatories
must not be above one-hundred and ten (110) degrees F.
[7/11/88;
Recompiled 10/31/01]
7.13.2.36 SEWAGE AND WASTE DISPOSAL:
A. All sewage and liquid wastes must be
disposed of into a municipal sewage system where such facilities are available.
B. Where a municipal sewage system is not
available, the systems used must be inspected and approved by the New Mexico
environment department, and the construction industries division. Exception:
Adult day care homes.
C. Where municipal or community garbage
collection and disposal service are not available, the method of collection and
disposal of garbage used by the facility must be inspected and approved by the
New Mexico environment department. Exception: Adult day care homes.
D. All garbage and refuse receptacles must
be durable, have tight fitting lids, must be insect and rodent proof, washable,
leak proof, and constructed of materials which will not absorb liquids.
Receptacles must be kept clean.
[7/11/88,
10/31/96; Recompiled 10/31/01]
7.13.2.37 LIGHTING AND LIGHTING FIXTURES:
A. All areas of the facility, including storerooms,
stairways, hallways, and entrances must be lighted sufficiently to make all
parts of the area clearly visible.
B. All lighting fixtures must be shielded in
participant activity areas and food preparation areas.
C. Adult day care centers must be provided
with emergency lighting which will activate automatically upon disruption of
electrical service.
D. Adult day care homes must have at least a
flashlight readily available and in operable condition for use as emergency
lighting.
[7/11/88;
Recompiled 10/31/01]
7.13.2.38 ELEMENTS OF FACILITY ELECTRICAL
SYSTEM:
A. Electrical installations and electrical
equipment must comply with all current state and local codes.
B. All fuse and breaker boxes must be
labeled to indicate the area of the facility to which each fuse or circuit
breaker provides services.
C. The main electrical service line must
have a readily available disconnect switch. All staff and caregivers must know
the location of the electrical disconnect switch and how to operate it in case
of emergency.
D. The use of jumpers or devices to bypass
circuit breakers or fuses is prohibited.
[7/11/88;
Recompiled 10/31/01]
7.13.2.39 ELECTRICAL CORDS, APPLIANCES, AND
OUTLETS:
A. Electrical cords and appliances must be
U/L approved.
(1) Electrical cords shall be replaced as soon as they show wear.
(2) Under no circumstances
shall extension cords be used as a general wiring method.
(3) Extension cords must be
plugged into an electrical outlet within the room where used and must not be connected in one room
and extended to another room.
B. The use of multiple sockets (gang plugs)
in electrical outlets is strictly prohibited.
[7/11/88;
Recompiled 10/31/01]
7.13.2.40 WINDOWS: All activity areas for participants must
have a least one (1) window and/or skylight area of at least 1/20 of the floor
area.
[7/11/88;
Recompiled 10/31/01]
7.13.2.41 EXITS:
A. There must be at least two (2) exits
remote from each other from each floor of the facility.
B. Exit ways must be kept free from
obstructions at all times.
C. All exits must be marked by signs having
letters at least six (6") high whose principal strokes are at least
three-fourths (3/4") of an inch wide.
D. Exit signs, when applicable, must be
visible at all times. Exception: Adult day care homes are not
required to have exit signs.
[7/11/88;
Recompiled 10/31/01]
7.13.2.42 DOORS:
A. Required exit doors must be openable from
the inside at all times the facility is in operation.
B. All required exit doors must have a
minimum width of thirty six (36") inches.
Exception: Adult day care homes.
C. Required exit doors in facilities having
a capacity of fifty (50) or more must open outward.
D. Locks and latches on closets and
bathrooms must be of the type that the lock can be released from the outside.
[7/11/88;
Recompiled 10/31/01]
7.13.2.43 OUTDOOR AREAS:
A. Outdoor area must be located on the
premises of the facility.
B. If required by the agency, the outdoor
area must be fenced and have at least one (1) latched gate available for
emergency exit.
C. Outdoor areas must be kept free of sharp
objects, trash, weeds, or other hazardous items.
D. Outdoor areas must be designed to permit
direct supervision of the participants at all times.
[7/11/88;
Recompiled 10/31/01]
7.13.2.44 TOILET AND BATHING FACILITIES:
A. Bathrooms must be completely enclosed. A
window or mechanical system for ventilation must be provided.
B. Toilets and lavatories (hand washing
sinks) must be provided for each sex in the following ratios in adult day care
centers:
(1) (1) toilet for one (1) to
fifteen (15) participants.
(2) One (1) toilet for each
additional fifteen (15) participants or fraction thereof.
(3) Lavatories must be
provided within each toilet room at a ratio of one to (40) forty participants.
(4) Toilet paper, soap, and
disposable towels must be provided in all toilet rooms.
(5) The use of a common towel or wash cloth is prohibited.
(6) Bathrooms and lavatories
must be cleaned as often as necessary to maintain a clean and sanitary condition.
C. Adult day care homes are required to have
at least one (1) toilet and one (1) lavatory.
D. Facilities accepting participants with
special bathing needs, or provide bathing as a service, will provide approved
bathing facilities.
[7/11/88;
Recompiled 10/31/01]
7.13.2.45 FIRE SAFETY COMPLIANCE: All current applicable requirements of state
and local codes for fire prevention and safety must be met by the facility.
[7/11/88;
Recompiled 10/31/01]
7.13.2.46 FIRE CLEARANCE AND INSPECTIONS:
A. Written documentation from the state fire
marshal's office or fire authority having jurisdiction evidencing a facility's
compliance with applicable fire prevention codes must be submitted to the
licensing authority prior to issuance of an initial license. Exception:
Adult day care homes are not required to have fire authority inspections.
B. Each facility shall request from the fire
authority having jurisdiction an annual fire inspection. If the policy of the
fire authority having jurisdiction does not provide for annual inspection of
the facility, the facility must document the date the request was made and to
whom. If the fire authority having jurisdiction does make annual inspections, a
copy of the latest inspection must be kept on file in the facility. Exception:
Adult day care homes are not required to have annual fire inspections.
[7/11/88;
Recompiled 10/31/01]
7.13.2.47 FIRE ALARMS, SMOKE DETECTORS AND
OTHER EQUIPMENT:
A. The facility must be equipped with an
approved, manually operated alarm system or other continuously sounding alarm
approved in writing by the fire authority having jurisdiction. Exception:
Adult day care homes are not required to have manually operated alarm systems.
B. The facility must be equipped with smoke
detectors approved in writing by the fire authority having jurisdiction as to
number, type, and placement. Exception: Adult day care homes are only
required to have one smoke detector in the participants activity rooms which
may be battery operated.
C. Fire extinguishers as approved by the
state fire marshal or fire authority having jurisdiction must be located in the
facility. Facilities must as a minimum have two (2) 2A10BC fire extinguishers,
one (1) centrally located in the facility activity areas. Exception:
Adult day care homes are only required to have one (1) 2A10BC fire extinguisher
located in the kitchen or food preparation area.
D. Fire extinguishers, alarm systems,
automatic detection equipment, and other fire fighting equipment must be
properly maintained and inspected at least yearly, and more often if recommended
by the manufacturer, state fire marshal, or fire authority having jurisdiction.
Fire extinguishers must be tagged noting the date of inspection.
E. All fire extinguishers must be inspected
yearly and recharged as specified by the manufacturer, state fire marshal or
local fire prevention authorities. All fire extinguishers must be tagged noting
the date of inspection.
[7/11/88;
Recompiled 10/31/01]
7.13.2.48 STAFF FIRE AND SAFETY TRAINING:
A. All staff of a facility must know the
location of and be instructed in proper use of fire extinguishers and other
procedures to be observed in case of fire or other emergencies. The facility
should request the local fire prevention authority to give periodic instruction
in fire prevention and techniques of evacuation.
B. The staff of a facility must be
instructed as part of their duties to constantly strive to detect and eliminate
potential safety hazards, such as loose handrails, frayed electrical cords,
blocked exits or exit ways, and any other condition which could cause burns,
falls, or other personal injury to the participants or staff.
C. Fire drills: The facility must conduct at
least one (1) fire drill each month:
(1) Fire drills must be held
at different times of the day.
(2) The fire alarm system or detector system
in the facility shall be used in the conduct of fire drills.
(3) In the conduct of fire
drills, emphasis must be placed upon orderly evacuation under proper discipline
rather than upon speed.
(4) A record of fire drills
held must be maintained on file in the facility. Such record must show date and
time of the drill, number of personnel participating in the drill, and any
problem noted during the drill.
(5) The local fire department
should be requested to supervise and participate in fire drills.
D. Each facility must have a fire evacuation
plan conspicuously posted in the facility, and all staff must be familiar with
the evacuation plan. Exception: Adult day care homes are not
required to have evacuation.
[7/11/88;
Recompiled 10/31/01]
7.13.2.49 PROVISIONS FOR EMERGENCY CALLS:
A. An easily accessible telephone for summoning
help in case of emergency must be available in each facility. A pay telephone
will not fulfill this requirement.
B. A list of emergency numbers including,
but not limited to, fire department, police department, ambulance services, and
poison control center shall be posted by each telephone in the facility.
[7/11/88;
Recompiled 10/31/01]
7.13.2.50 SMOKING:
A. Smoking in the kitchen or food
preparation areas is strictly prohibited.
B. Separate smoking areas must be designated
and provided with suitable ashtrays.
C. Smoking must never be permitted in any
area where oxygen is in use.
[7/11/88;
Recompiled 10/31/01]
7.13.2.51 CARPETS:
A. Carpeting, if used in new facilities,
must be of at least class II rating. Existing facilities, as they replace
carpeting, must replace with carpet having at least a class II rating.
B. Carpets must be of a stable and regular
surface to prevent tripping and/or slipping hazards and allow wheelchair
mobility.
[7/11/88;
Recompiled 10/31/01]
7.13.2.52 ACCESS REQUIREMENTS FOR THE
HANDICAPPED:
A. Accessibility to the handicapped must be
provided in all facilities and shall include the following: Exception:
Adult day care homes are not required to have access for the handicapped.
(1) Main entry into the
facility must be ground level or ramped to allow wheelchair access.
(2) Building must allow
access to participant's activity areas.
(3) Access to at least one
toilet is required to have a minimum door clearance of thirty-two (32")
inches, thirty-six (36") inches is recommended. Toilet room must also
provide a sixty inch (60") diameter clear space (turning radius for a
wheelchair).
(4) If ramps are provided to
the building, the slope must be at least twelve inches (12") horizontal
run for each one (1") inch of vertical rise.
(5) Ramps leading to doorways
must have a five foot by five foot (5' x 5") level area at the doorway.
(6) Ramps exceeding a six
(6") inch rise shall be provided with handrails.
B. Requirements contained herein are minimum
and additional handicap requirements may apply depending on size and complexity
of the facility.
C. Consultation will be given to new facilities
on handicap requirements upon submission of floor plans during the initial
licensing process.
[7/11/88;
Recompiled 10/31/01]
7.13.2.53 ADULT DAY CARE CENTERS IN
MULTI-USE FACILITIES:
A. An adult day care program must be self-contained
with its own staff and separate area.
B. Depending on the nature of other
activities in the building, it may or may not be appropriate for day care
participants to share in them on a planned basis. Such involvement must be as
part of the day care program plan and must be supervised by a day care staff
member, i.e., senior center crafts and social events and lunch at a congregate
meal site.
C. It is not appropriate for persons from
other activity groups in the building to move through the day care area at will
or to attend day care activities on an informal basis. The day care program is
in a sense a "closed" program in that participation is open only to
persons enrolled in the program and to visitors on a planned basis.
[7/11/88;
Recompiled 10/31/01]
7.13.2.54 GENERAL PERSONNEL AND STAFFING
REQUIREMENTS:
A. All persons involved with the care of
participants shall be of good character and physically, mentally and
emotionally equipped to provide good care and maintain responsible supervision for
the participants.
B. All involved with the care of
participants must be screened by the licensee. Their qualifications, references
and employment history must be verified prior to employment.
C. A person who has been convicted of a
felony or of a misdemeanor involving moral turpitude shall not be allowed to
work as an administrator/director/operator, direct service staff, or support
staff member in a facility licensed pursuant to these regulations. This
includes family members who work or reside in an adult day care home.
D. All persons volunteering with the
facility, are deemed to be staff and are subject to these regulations.
E. Staff members who work directly with
participants and who are counted in the staff/participant ratio must be
eighteen (18) years of age or older.
F. Persons under the age of eighteen (18)
shall at all times work directly under the supervision of a staff member who is
physically present.
G. Persons employed solely for clerical,
cooking and maintenance shall not be included in the staff/participant ratio.
H. Substitutes and part-time staff members,
who are counted in the staff/participant ratios, shall meet the same
requirement as regular staff.
[7/11/88;
Recompiled 10/31/01]
7.13.2.55 QUALIFICATIONS FOR DIRECTORS OF
CENTERS:
A. The adult day care center shall have a
full-time program director.
B. The program director shall have the
authority and responsibility for the management of activities and direction of
staff to insure that activities and services are provided appropriately and in
accordance with established policies.
C. The program director shall meet all of
the minimum qualifications and personal characteristics stated below.
(1) eighteen (18) years of
age or older;
(2) shall have completed at
least a baccalaureate degree from a nationally accredited institution of
education in the field of geriatrics, or a health related course of study which
includes the care of the elderly, or be a registered nurse;
(3) shall have a minimum of two (2) years
experience and training in services to elderly and/or handicapped adults;
(4) shall have demonstrated
ability in supervision and administration.
D. Meet the requirements of Section 53 [now
7.13.2.53 NMAC].
[7/11/88;
Recompiled 10/31/01]
7.13.2.56 QUALIFICATIONS OF OPERATORS OF
ADULT DAY CARE HOMES: Licensees of adult day care homes must have
the following minimum qualifications:
A. eighteen (18) years of age or older;
B. be competent and have a demonstrated
ability to manage all aspects of a day care program;
C. have a minimum of a high school education
or the equivalent;
D. have at least two (2) years of full-time
work experience in services to elderly and/or handicapped adults;
E. provide a written statement from a
physician or a recognized health facility stating that the operator is free
from communicable disease;
F. have the ability to work with people;
G. provide references, including former
employer(s);
H. meet the requirements of Section 53 [now
7.13.2.53 NMAC].
[7/11/88;
Recompiled 10/31/01]
7.13.2.57 VOLUNTEERS:
A. When volunteers are used in an adult day
care program, adequate planning prior to the placement of the volunteers will
take place in order to provide the volunteer with a written description of his
duties and responsibilities. This written description shall outline in detail
the tasks to be performed, qualifications for performing the tasks, and
specifics about hours, days and length of commitment needed from the volunteer.
B. The volunteer shall take part in a formal
or informal orientation and training session to inform him/her of the goals of
the program, the operation and daily schedule of the program, specific needs of
the adults being served and any necessary , specialized approaches the
volunteer will be expected to use.
C. Employees of the program shall be
properly informed of the use of a volunteer prior to his working in the
program, staff's responsibility and role and the volunteer's responsibility and
role. Employees shall be involved in planning for the volunteer and shall
assist in writing the duties the volunteer will perform.
D. Volunteers working more than half-time
and having direct contact with participants shall have a certificate from a
physician or medical facility stating that they are free from tuberculosis in a
transmissible form.
[7/11/88;
Recompiled 10/31/01]
7.13.2.58 STAFF TRAINING:
A. All facilities shall provide training for
each staff member.
B. Documentation for training shall be kept
on file at each facility and available for inspection by representatives of the
licensing authority.
C. Documentation may take the form of
certificates or a training log with the date, name of staff member or
caregiver, hours spent in training, subject and source of training.
D. Before beginning work all facilities
shall provide for each staff member an orientation which includes the following
as a minimum:
(1) scope of services,
activities, and program offered by the facility;
(2) emergency first aid
procedures, recognition of illness and indicators of abuse;
(3) fire prevention measures
and emergency evacuation plans;
(4) review of licensing
regulations;
(5) special problems of the
elderly and disabled;
(6) participant rights;
(7) sanitation procedures.
E. Emergency staff and substitutes are not
required to participate in training.
F. Adult day care centers:
(1) All staff members,
including the director, shall participate in at least forty (40) documented
clock hours of training during each year of employment.
(2) Of the forty (40) hours of required training, twenty (20)
hours shall be in areas covering the physical, emotional, intellectual, and
social needs of adults.
(3) Other training may
include, but is not limited to the following: nutrition, sanitation procedures,
first aid,
and cardiovascular resuscitation techniques.
G. Adult day care homes:
(1) All staff members shall
participate in at least twenty four (24) documented clock hours of training
during each year of licensure.
(2) The required twenty four
(24) hours of training shall be in the subjects specified in Sections 58.6.2
and 58.6.3 [now Paragraphs (2) and (3) or Subsection F of 7.13.2.58 NMAC] of
these regulations.
H. Training may be obtained from, but not
limited to, the following resources:
(1) public health division,
department of health.
(2) social services division,
department of human services.
(3) adult day care
associations and information and referral services.
(4) university related
programs.
(5) vocational/technical
schools.
(6) county extension offices.
(7) local fire department.
(8) red cross.
(9) self-study as approved by
the licensing authority.
(10) In service training by a
qualified staff member whose qualifications are approved by the licensing
authority.
[7/11/88;
Recompiled 10/31/01]
7.13.2.59 STAFFING REQUIREMENTS:
A. General:
(1) Staff/participant ratios
must be maintained at all times.
(2) The responsibility of staff
members included in the staff/participant ratio shall be direct care of the
participants.
(3) Each facility must keep a
list on file of two (2) readily available persons who can be called to the facility to substitute
for any staff member in case of an emergency or illness. These persons names
telephone numbers, and health certificates must be on file.
B. Staff/participant ratios:
(1) Adult day care centers -
One full time equivalent staff position with responsibility for direct
participant care for each five (5) participants.
(2) Adult day care homes -
One full time equivalent staff position with responsibility for direct care for no more than five
(5) participants.
[7/11/88;
Recompiled 10/31/01]
7.13.2.60 GENERAL:
A. The health, safety, and welfare of the
participants must be the primary concern in all activities and services
provided by facilities licensed pursuant to these regulations.
B. Participants must never be left unattended.
Staff members must be physically present with the participants at all times.
[7/11/88;
Recompiled 10/31/01]
7.13.2.61 CARE AND SERVICES FOR ADULTS WITH
SPECIAL NEEDS: In addition to all other requirements
contained in these regulations, facilities providing care and services to
adults with special needs including respite care, must comply with the
following:
A. Facilities which are able to
appropriately mainstream special needs adults may do so at their own
discretion.
B. An adult with a severe diagnosed mental
or physical handicap may be admitted to a facility upon the written
recommendation of a licensed physician or therapist.
C. The facility must make appropriate
provisions to meet the needs of adults who require special services such as additional
space, wide doors, halls, ramps and specially equipped toilet rooms.
D. The licensing authority may require
higher staff/adult ratios and staff qualifications to properly care for the
adults with special needs, if deemed necessary.
[7/11/88;
Recompiled 10/31/01]
7.13.2.62 ACTIVITIES:
A. Adult day care activities shall be
designed to meet the specific needs and interests of the participants, as
determined by individual plans of care, and shall be consistent with the
program's goals.
B. Activities shall be planned by staff,
participants, family/caregivers, volunteers and other interested individuals
and groups.
C. The day care center shall assure safe and
healthy conditions for activities in and outside the facility.
D. The plan for, and conduct of, activities
must be an ongoing process and shall be reviewed, revised and evaluated as
necessary.
E. The adult day care program shall provide
for a balance of activities to meet the interrelated needs and interest
(social, intellectual, cultural, economic, emotional and physical) of
participants.
F. Activities shall be designed to promote
personal growth and improve the self-image of participants by providing
opportunities to:
(1) learn new skills and gain
knowledge;
(2) challenge and tap the potential of participants;
(3) participate in activities
of interest;
(4) improve capacity for
independent functioning;
(5) develop satisfying and
interpersonal relationships;
(6) be exposed to, and
involved in, activities and events within the greater community;
(7) develop cultural
enrichment;
(8) have fun and enjoyment.
G. Activities shall respond to individual
differences in health status, lifestyle, ethnicity, values, experiences, needs,
interests, abilities, skills and age by providing opportunities for a variety
of types and levels of involvement, including:
(1) small and large group
activities;
(2) individualized
activities;
(3) active and spectator
participation;
(4) inter-generational
experience;
(5) involvement in the greater community;
(6) services to individuals
and to the program
H. Activities shall be flexible and
responsive to changes in:
(1) the needs and interests
of individual participants;
(2) functional capacities of
participants;
(3) the characteristics of
the adult population in the service area.
I. Activities shall emphasize individual
participant's strengths and abilities rather than impairments, and shall
contribute to participant's feeling of competence and accomplishment.
J. All program activities shall be
supervised by program staff.
K. Participants shall have the choice of
refusing to participate in any given activity, and time shall be allowed for
rest and relaxation.
[7/11/88;
Recompiled 10/31/01]
7.13.2.63 SCHEDULE:
A. A monthly calendar of activities shall be
prepared and distributed to participants and family/caregivers.
B. Daily activities (and services) shall be
posted in a visible location within the center.
C. The participant and family caregivers
shall be encouraged to evaluate activities and plan future activities on a six
(6) month basis.
[7/11/88;
Recompiled 10/31/01]
7.13.2.64 EQUIPMENT:
A. Each facility shall have a living and/or
multi-purpose room for the use of participants. Such rooms shall be provided
with reading lamps, tables, chairs, and couches. These furnishings shall be well
constructed, comfortable, and in good repair.
B. The living room and/or multi-purpose
rooms shall be provided with supplies to meet the varied interests and needs of
the participants, including, but not limited to games, current magazines,
books, radio and television.
C. The interest areas shall be arranged so
that quiet and noisy activities can occur concurrently without disturbing each
other.
D. Equipment, furniture and materials shall
be kept in good condition and present no safety hazards.
[7/11/88;
Recompiled 10/31/01]
7.13.2.65 LINENS: Linens and bedding shall be kept clean at
all times.
A. There shall be separate handling and
storage of clean and soiled linens.
B. Clean linen shall be stored in clean
storage area.
C. Linens shall be laundered and disinfected
prior to re-use by another participant.
D. Any linen which has been used by a sick
participant, or which has been dirtied by urine or defecation shall be
collected, laundered and disinfected separately from other items.
E. New linens must be laundered before use.
[7/11/88;
Recompiled 10/31/01]
7.13.2.66 FIRST AID REQUIREMENTS: At all times there shall be one staff member
on duty who holds current first aid certificate and has completed an approved
cardiopulmonary resuscitation course.
A. A first-aid, accessible to all personnel,
shall be kept in the facility.
B. The first aid kit shall contain as a
minimum: band aids, gauze pads, adhesive tape, scissors, soap, and syrup of
ipecac.
C. In case of accidental poisoning, the
facility shall immediately contact the poison control center and their
directions shall be followed.
D. Syrup of Ipecac must not be given to any
participant without first contacting the poison control center.
E. All facilities are strongly encouraged to
send all of their personnel to an approved cardiopulmonary resuscitation
course.
F. All facilities shall have a first aid
manual available to the staff or caregivers.
[7/11/88;
Recompiled 10/31/01]
7.13.2.67 PETS: The facility shall inform participants and
guardians of the presence of pets in the facility.
A. There shall be no pets in the kitchen or
food serving areas.
B. Pets shall be inoculated as prescribed by
a veterinarian.
C. Proof of inoculation shall be kept on
file in the facility.
D. Pets must be kept well groomed and
healthy.
[7/11/88;
Recompiled 10/31/01]
7.13.2.68 FOOD SERVICE AND PREPARATION: Each facility that serves meals shall meet
all state and local regulations governing food services establishments. Exception: Adult day care homes.
A. There shall be no smoking in food service
and food preparation areas.
B. Refrigerators, work tables, cupboards,
and stoves shall be maintained in clean condition.
C. All food and drink shall be protected
from spoiling by proper storage and by putting it in air-tight containers or
wrapping it.
D. All raw fruits and vegetables shall be
washed thoroughly before being cooked or served.
E. All foods shall be protected from
insects, rodents and other vermin.
F. Foods shall be served promptly and
refrigerated immediately after use.
G. Utensils that can be re-used shall be
washed and sanitized.
[7/11/88;
Recompiled 10/31/01]
7.13.2.69 KITCHENS:
A. There shall be no through traffic in the
kitchen during food preparation or service.
Exception: Adult day care homes.
B. Facilities may allow participants to
prepare food as a program activity under careful supervision. [7/11/88;
Recompiled 10/31/01]
7.13.2.70 FOOD PREPARATION:
A. Outer clothing of persons preparing or
serving food shall be maintained with the highest degree of cleanliness.
B. When staff members are involved in food
preparation or service, these persons shall thoroughly scrub their hands and
wear clean fresh outer clothing before preparing or serving formula or food.
C. In facilities not under the jurisdiction
of the New Mexico environment department, only snacks which require no cooking
shall be served. Exception: Adult day care homes.
[7/11/88,
10/31/96; Recompiled 10/31/01]
7.13.2.71 FOOD TEMPERATURE REQUIREMENTS:
A. All perishable food shall, except when
being prepared, be kept at forty-five (45) degrees F. or below, or
one-hundred-forty (140) degrees F. or above.
B. Foods requiring refrigeration shall be
kept at forty-five (45) degrees F. or below. Frozen foods shall be kept at zero
(0) degrees F. or below.
C. Refrigerators and separate freezers shall
have thermometers. Metal stem thermometers shall be available to measure proper
internal cooking and holding temperatures.
[7/11/88;
Recompiled 10/31/01]
7.13.2.72 MENUS:
A. The same menu must not be served twice in
one (1) week.
B. A copy of the current week's menu,
including snacks, shall be posted in the kitchen and the entrance of the
facility where it can be readily seen.
C. Posted menus shall be followed.
Substitutions shall be of equivalent nutritional value and shall be recorded on
the posted menu.
D. The weekly menu plans must be dated and
kept on file for thirty (30) days.
[7/11/88;
Recompiled 10/31/01]
7.13.2.73 MEAL TIMES AND NUTRITION:
A. Staff/participant ratios must be
maintained at meal times.
B. Time allowed for meals shall enable the
participants to eat at a leisurely rate.
C. Meals may be served in areas of main
activity.
D. Dining areas shall be equipped with
tables, chairs, eating utensils and dishes.
E. Nutrition:
(1) A meal shall be provided to each
participant in attendance at the program during standard mealtimes. Each meal
shall provide at lease one-third (1/3) of an adult's daily nutritional
requirement.
(2) A nutritious
mid-morning and mid-afternoon snack shall be offered daily to participants.
Snacks shall be planned to keep sugar, salt and cholesterol intake to a minimum.
(3) Participants shall not go for more than
(3) hours without being offered a meal or a snack.
(4) A therapeutic diet shall be provided, if
prescribed in writing by a physician, for any participant. If therapeutic diets
are prepared by program staff, such staff shall have training in planning and
preparing therapeutic diets or shall provide documentation of previous training
and education sufficient to assure ability to prepare meals in accordance with
a physician's prescription.
(5) A registered dietitian/nutritionist must
be consulted by the staff on basic and special nutritional needs and proper
food handling techniques. Instruction in nutrition, weight control and safe
food handling techniques may be provided as an ongoing part of program
activities.
[7/11/88;
Recompiled 10/31/01]
7.13.2.74 NOTIFIABLE DISEASES: Facilities shall report any notifiable
disease occurring to the participants to the local public health field office:
A. Each facility shall secure the current
list of notifiable diseases published by the New Mexico department of health
and post it conspicuously in the facility.
B. Facilities shall not admit or allow the
continued attendance of participants who are ill or who are known or suspected
of having notifiable diseases.
C. After a participant has had a notifiable
communicable disease, he or she shall be re-admitted to the facility only upon
written approval of the attending physician.
[7/11/88;
Recompiled 10/31/01]
7.13.2.75 ISOLATION:
A. A participant who becomes sick at the facility
must be separated from the rest of the participants until leaving the facility.
The guardian or responsible party must be promptly notified of the
participant's illness and arrangements must be made for the participant to be
removed from the facility.
B. The facility must have a bed available
for a sick participant which must be thoroughly cleaned after use.
C. The sick participant must be kept in an
area where he/she can be under constant observation.
D. Staff must wash their hands thoroughly after
caring for sick participants.
[7/11/88;
Recompiled 10/31/01]
7.13.2.76 MEDICATIONS: Any facility licensed pursuant to these
regulations who supervises self-administration of medication for the
participants or safeguards medication for residents must have an appropriate
custodial drug permit as determined by the state board of pharmacy.
A. To apply for a custodial drug permit, or
to obtain information concerning management of drugs and pharmaceutical, the
facility should contact the state board of pharmacy.
B. Only medications which can be
self-administered by the participant, unless they will be administered by a
licensed physician, dentist, or nurse, can be kept by a facility.
C. Medications prescribed for one
participant must not be given to any other participant.
D. Drugs and medications shall neither be
supplied nor given to participants, unless ordered or prescribed by a licensed
physician, dentist, or other practitioner licensed to do so.
E. Over the counter medications may be given
to a participant by the facility, if the facility has a written procedure
reviewed and approved by a licensed physician for giving such medications.
F. Medications must be kept in a locked
cabinet or other suitable container approved by the state board of pharmacy.
Medications must be separated, by individual, in the storage area.
G. The key for the medication storage area
must be made available only to personnel duly authorized by the director of the
facility.
H. Medication which requires refrigeration
must be kept in a separate locked box within a refrigerator, a locked
refrigerator, or a refrigerator in a locked room.
I. All medications must be kept in their
original containers.
J. Poisonous substances and medications
labeled for "external use only" must not be accessible to
participants and must be kept separate from other medications.
K. All outdated medications shall be
disposed of in a manner approved by the state board of pharmacy.
L. No facility will prepare dosages of
medications, in advance, to be given to participants for self-administration
with assistance. The medications must be in the original container, the staff
member assisting may hold the container, assist the participant in opening the
container, and assist the participant in administering the medication. Exception:
If a facility has on [sic] the staff nurses registered in the state of New
Mexico who prepare dosage and administer to the resident.
[7/11/88;
Recompiled 10/31/01]
7.13.2.77 USE OF PHYSICAL RESTRAINTS:
A. Physical restraints may only be used when
authorized by a physician in writing for a specified period of time or in
emergencies.
B. The use of physical restraints may only
be applied by a licensed nurse.
C. Physical restraints must be applied in
accordance with the written policies and procedures of the facility.
D. Supervision of participants in restraints
shall be on a one to one basis for the duration of the time the restraints are
in place.
[7/11/88;
Recompiled 10/31/01]
7.13.2.78 TRANSPORTATION:
A. If a facility licensed pursuant to these
regulations provides transportation to participants it is responsible for the
participant from the time picked up until delivered.
B. All vehicles used for transportation of
participants must be licensed and meet all applicable laws of the state of New
Mexico.
C. All vehicles used for transportation of
participants must be equipped with a fire extinguisher and first aid kit.
D. Participants must be loaded and unloaded
at the curb side of the vehicle.
E. Drivers may leave the vehicle only to
assist participants in boarding and leaving the vehicle, and must remain in
sight of the vehicle at all times.
F. Drivers of vehicles used to transport
participants must be licensed and abide by state and local laws.
G. Participants shall be transported no more
than thirty minutes without being offered the opportunity to have a rest stop.
H. Vehicles used to transport participants
shall be equipped with seatbelts. Drivers shall insure participants use seatbelts
while being transported.
[7/11/88;
Recompiled 10/31/01]
7.13.2.79 RELATED REGULATIONS AND CODES: Adult day care facilities subject to these
regulations are also subject to other regulations, codes and standards as the
same may, from time to time, be amended as follows:
A. Health Facility Licensure Fees and
Procedures, New Mexico department of health, 7 NMAC 1.7 (10/31/96) [now 7.1.7
NMAC].
B. Health Facility Sanctions and Civil
Monetary Penalties, New Mexico department of health, 7 NMAC 1.8 (10/31/96) [now
7.1.8 NMAC].
C. Adjudicatory Hearings, New Mexico
department of health, 7 NMAC 1.2 (2-1-96) [now 7.1.2 NMAC].
[7/11/88,
10/31/96; Recompiled 10/31/01]
HISTORY
OF 7.13.2 NMAC:
Pre-NMAC
History: The material in this Part was
derived from that previously filed with the State Records Center and Archives:
HED
88-1 (PHD/HSD), Regulations Governing Facilities Providing Adult Day Care,
7/11/88.
History
of Repealed Material: [Reserved]