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DELAWARE |
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Standard or
Definition
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Chapter 3, Paragraphs 341-344
Delaware Requirements for Residential Child
Care Facilities and Day Treatment Programs
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Restraint
Definition
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“Mechanical Restraint” means the involuntary,
time-limited and reasonable use of any device in order to restrict a child’s
movement or functions or the ability to use his or her hands, arms, or legs,
for the purpose of behavior management.
“Restrictive Procedure” means the involuntary,
non-punitive, age-appropriate, time-limited and reasonable use of any action, device, drug or
technique that is designed to restrain or restrict a child’s movement, function or
mobility for the purpose of:
- Reducing serious maladaptive behavior of a child;
- Preventing a child from harming either himself or herself, or
others;
- Preventing the destruction of property; or
- Controlling maladaptive behavior when the child has failed to
respond to less restrictive means of behavior management.
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Restraint
Exclusions
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Non-violent physical intervention strategies and
time-out techniques are not restrictive procedures.
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Chemical Restraint
Definition
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“Chemical Restraint” means the involuntary, unplanned and emergency
application of a psychotropic drug to restrict the function or movement
of a child the purpose of behavior management. The planned and
routine application of prescribed psychotropic drug is not a chemical
restraint.
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Seclusion
Definition
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“Exclusion” means the involuntary, time-limited removal of a child six
years of age or older from his or her environment through the use of non-violent
physical intervention and restricting that child in an unlocked room under
continuous monitoring and preventing his or her egress, for the purpose of
behavior management.
“Locked Isolation” means the involuntary and time-limited confinement
of a child in a locked room for the purpose of behavior management.
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Seclusion
Exclusions
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None.
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Criteria for
Restraint and Seclusion
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A licensee shall develop, adopt, follow and maintain on file written
policies and procedures governing the appropriate use of non-violent physical
intervention strategies. These policies and procedures shall require that
non-violent physical intervention strategies may be used only:
- When a child is out of control and could physically harm himself or
herself or others;
- To prevent the destruction of property when the child fails to
respond to nonphysical behavior management interventions;
- For a duration of time that shall not exceed 15 consecutive minutes,
without written documentation on attempts made to release the child from the
hold if more than 15 minutes is required. A licensee shall ensure
that a child is released from a physical intervention strategy as soon as he or she
gains control, or before 15 consecutive minutes have elapsed, whichever
occurs first; and
- By employees or volunteers who have been specifically trained in its
use and authorized to apply such strategies.
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Monitoring
Requirements
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A licensee shall ensure that an employee who is assigned to monitor a
child placed in locked isolation shall have no other immediate responsibility
and shall:
- Be in visual and auditory contact with the child at all times;
- Ensure that all personal needs of the child are met;
- Ensure that a child has access to toilet facilities, as needed; and
- Ensure that the child receives the same number and frequency of
meals and snacks provided to other children in the facility or
program.
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Ordering and
Initiation
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A licensee shall not authorize or permit restrictive procedures to be
used in a punitive, retributive, harsh or abusive manner, nor for the convenience
of staff or as a substitute for other less restrictive, appropriate means of social
treatment or intervention.
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In-person
Assessment
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None.
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Debriefing
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None.
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Family &
Guardian Notification
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None specified.
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Notification of
Rights and Restraint and Seclusion Policies and Procedures at admission
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A licensee shall disseminate copies of the behavior management policies
and procedures to all employees and children within 10 consecutive calendar
days of employment or admission, respectively, and shall make copies available
to the parent(s), legal guardian or the referring agency.
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Training
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A licensee shall ensure that each employee and volunteer whose primary
role or function requires interaction with children and who works 24 or more
hours a week receives at least 40 hours of training annually.
This training shall cover subject matters designed to maintain, improve or enhance the employee’s knowledge of or
skills in carrying out his or her job responsibilities, including:
- Instruction in administering cardiopulmonary resuscitation (CPR) and
first aid, including the location of first aid kits. A licensee providing
care to children below six years of age shall include training in pediatric
first aid and pediatric CPR;
- Cultural sensitivity; and
- Behavior management policies and procedures.
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Documentation
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A licensee shall develop, adopt, follow and maintain on written file
policies and procedures governing the accurate and timely recording of each incident
in which a time-out technique or a non-violent physical intervention strategy is
used. Such policies and procedures shall ensure that the identity of the child,
the date, time, place, and circumstances of, and the name of the employee or volunteer
who administered the time-out technique or the non-violent physical
intervention strategy is recorded. The nature of the technique or strategy and the
elapsed time used shall also be recorded.
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Reporting
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A licensee shall ensure that any allegation(s) of an
inappropriate or abusive application of a restrictive procedure is brought to the attention of
the Human Rights Committee promptly.
A licensee shall ensure that the Human Rights
Committee initiates an investigation of any allegation(s) of an inappropriate or abusive
application of a restrictive procedure within two consecutive business days of having
received the allegation(s).
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Quality Improvement
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None specified.
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