10A NCAC 70I .0604. HEALTH SERVICES

(a)  No child shall be accepted into a residential child-care facility without having had a medical examination by a licensed medical provider  within 12 months prior to admission, or a medical examination by a licensed medical provider within two weeks after admission or sooner if indicated by the child's health status.  The medical examination shall include a signed statement by the licensed medical provider specifying the child's medical condition and medications prescribed and indicating the presence of any communicable disease which may pose a risk of transmission in the facility. If a child is in the custody of a department of social services, is already scheduled to have and is having a medical examination report completed annually, and is entering a facility, the schedule of annual medical examination reports shall not be changed.  A copy of the most recent medical examination report shall be obtained from the responsible county department of social services by the facility.

(b)  A child admitted to a residential child-care facility shall be immunized against diphtheria, tetanus, whooping cough, poliomyelitis, red measles (rubeola), rubella, mumps, and any other disease as required by 10A NCAC 41A .0400, as age appropriate, prior to admission.  The facility shall obtain documentation of immunization.  A copy of 10A NCAC 41A .0400 may be accessed at the following website (http://www.oah.state.nc.us/rules/) at the time of adoption of this Rule.

(c)  A residential child-care facility shall make arrangements with one or more licensed medical providers or medical clinics and with at least one dentist for the care of the children.

(d)  Each child shall have a medical examination at least once a year and more often as needed.  A child shall not be allowed to participate in activities that pose risks to his or her health.  Any illness, disease or medical condition of a child shall be identified and treated promptly through proper medical care.  Children shall have a psychiatric or psychological examination or both when indicated and treatment when indicated.

(e)  Children shall have had a dental examination, by a licensed dentist, within one year prior to admission or arrangements shall be made for an exam within six weeks after admission and annually thereafter.  The facility shall document dental services in the child's record.

(f)  The facility shall instruct direct child-care staff on medical care which may be given by them without specific orders from a licensed medical provider.  The facility shall instruct direct child-care staff in the procedures for obtaining medical care beyond home health care and handling medical emergencies.

(g)    The residential child-care facility shall arrange with a hospital for the admission of children from the facility in the event of serious illness or emergency.

(h)  The residential child-care facility shall obtain a mouthpiece, utilize universal precautions and other precautionary equipment for administering CPR for the children in residence.

(i)  The residential child-care facility shall ensure that first aid kits are available for immediate use in each living unit, recreation area and in vehicles used to transport children.

(j)  The residential child-care facility shall not engage in any home health care practices that conflict with the control measures for communicable diseases in 10A NCAC 41A .0200.  A copy of 10A NCAC 41A .0200 may be accessed at the following website (http://www.oah.state.nc.us/rules/) at the time of adoption of this Rule.

(k)  Direct child-care staff shall be able to recognize common symptoms of illnesses in children and be alert to any infectious condition and take proper precautions to prevent the spread of such a condition.

(l)  Direct child-care staff shall be able to provide home health care.  A thermometer shall be kept available for use.  When there is risk of transmission, arrangements shall be made for isolation and attendant care of a child with a communicable disease.

(m)  Prescription medications shall be administered only when approved by a licensed medical provider.

(n)  Non-prescription medication shall be administered only when approved by the parents, guardian, legal custodian or a licensed medical provider.

(o)  All medicines, prescription and non prescription, shall be stored in a locked cabinet, closet or box not accessible to children.

(p)  Each child shall have a medical record which contains written consent from the legal custodian or parent authorizing routine medical and dental treatment and emergency treatment.

(q)  Each child shall have a medical record which contains the preadmission medical examination report, or a medical examination report within two weeks after admission (or sooner if indicated by the child's health status), immunization records, and records of ongoing medical and dental care and examinations received, including hospitalizations, illnesses or accidents and treatment provided.

(r)  A residential child-care facility shall have written policies and procedures regarding the administration of medications to children placed in the residential child-care facility.  The executive director of a residential child-care facility, or his or her designee, shall discuss and provide these policies and procedures to the parents, guardian or legal custodian, and the child (if 12 years of age or older), upon admission.

(s)  The residential child-care facility shall maintain a Medication Administration Record (MAR) for each child that documents all medications administered.

(t)  The residential child-care facility shall document medication errors, adverse drug reactions and medication orders in the child's Medication Administration Record (MAR).

(u)  Upon discharge of a child, the residential child-care facility shall return prescription medications to the person or agency legally authorized to remove the child from residential child-care.  The residential child-care facility shall provide oral or written education to the person or agency legally authorized to remove the child from residential child-care regarding the medications.  Unwanted, out-dated, improperly labeled, damaged, adulterated or discontinued prescription medications shall be returned to a pharmacy for disposal.

 

History Note:        Authority G.S. 131D-10.5; 143B-153;

Eff. July 1, 1999 (See S.L. 1999, c.237, s. 11.30);

Amended Eff. October 1, 2008.