Adult Day Care Centers shall assure that written special care services policies and procedures are established, implemented by staff and available for review within the center.† In addition to all applicable policies and procedures for adult day care centers, there should be policies and procedures that address:

(1)†††††††††† The philosophy of the special care service which includes a statement of mission and objectives regarding the specific population to be served by the center which shall address, but not be limited to, the following:

(a)†††††††††† a safe, secure, familiar and consistent environment that maintains and encourages the use of skills for daily living;

(b)†††††††††† a structured program of daily activities that allows for flexibility to respond to the needs, abilities, and preferences of participants;

(c)†††††††††† individualized service plans that stress the maintenance of participantís abilities and promote the highest possible level of physical and mental functioning; and

(d)†††††††††† methods of behavior management which preserve dignity through design of the physical environment, physical exercise, social activity, appropriate medication administration, proper nutrition and health maintenance.

(2)†††††††††† The process and criteria for enrollment in and discharge from the service.

(3)†††††††††† A description of the special care services offered by the center.

(4)†††††††††† Participant assessment and service planning, including opportunity for family involvement in the service planning and the implementation of the service plan, including responding to changes in the participantís condition.

(5)†††††††††† Safety measures addressing specific dangers such as wandering, ingestion, falls, smoking, and aggressive behavior.

(6)†††††††††† Lost or missing participants.

(7)†††††††††† Staff to participant ratios in the special care service to meet the needs of participants.

(8)†††††††††† Amount and content areas of staff training both at orientation and annually based on the special care needs of the participants.

(9)†††††††††† Physical environment and design features that address the needs of the participants.† These features can encompass an entire center if the center promotes itself as providing special care or any section separated by closed doors from the rest of the center and advertised especially for special care of participants.

(a)†††††††††† Center or section exit doors may be locked only if the locking devices meet the requirements outlined in the N.C. State Building Code for special locking devices;

(b)†††††††††† Where exit doors are not locked, a system of security monitoring shall be provided.

(10)†††††††† Activities based on personal preferences and needs of the participants that focus on the individualís interests and abilities.

(11)†††††††† Opportunity for involvement of families in participant care, if applicable.

(12)†††††††† The availability of or information on family support groups and other community services.

(13)†††††††† Additional costs and fees to the participant for the special services provided.


History Note:††††††† Authority G.S. 131D-6; 143B-153; S.L. 1999-334;

Temporary Adoption Eff. September 28, 1999;

Eff. July 17, 2000.