DEPARTMENT OF SOCIAL SERVICES

                   ADULT FOSTER CARE LICENSING DIVISION

                       ADULT FOSTER CARE FACILITIES

(By authority conferred on the department of social services by section  9
of Act No. 380 of the Public Acts of 1965, as amended, and sections 10 and
13 of Act No. 218 of the Public Acts of 1979, as amended, being  SS16.109,
400.710, and 400.713 of the Michigan Compiled Laws)


                       PART 4. CONGREGATE FACILITIES


R  400.2401   Scope.
  Rule 401. This part applies only to congregate facilities.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2402   Licensees and administrators.
  Rule 402. (1) Care provided by a congregate facility shall be based on a
foster care agreement between the congregate facility and the  responsible
agency or person requesting care. The agreement shall specify that  it  is
the responsibility of the agency or person requesting care to provide  all
necessary intake information; to provide other  required  information;  to
provide initial and ongoing and discharge assessment planning; preparation
for discharge; social services assistance in obtaining all necessary  care
which may be needed by the resident. A copy  of  the  agreement  shall  be
maintained in the congregate facility. Where the agreement is not with the
department, a copy shall be filed with the department for its  review  and
approval.
  (2) A licensee or a governing  body  may  appoint  an  administrator  to
operate a congregate facility.
  (3) An administrator, all staff participating in resident care and staff
who are designated as responsible persons or acting in such capacity shall
be at least 18 years of age, be of good moral character and reputation, be
in good health and by training and experience be capable  of  meeting  the
demands of the position.
  (4) A  licensee  or  an  administrator  shall  designate  in  writing  a
responsible person to carry out his responsibilities  and  duties  in  his
absence.
  (5) A licensee or an administrator shall be willing to  cooperate  fully
with the resident, his  own  family  and  responsible  relatives  and  the
supervising agency.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2403   Admission and discharge.
  Rule 403. (1) A congregate  facility  shall  have  a  written  admission
policy which shall be posted in a conspicuous public area of the facility.
The department's assistance in establishing the policy is  available  upon
request of a licensee.
  (2) A prospective resident or his guardian, if the prospective  resident
is legally incompetent, shall exercise free choice in the selection  of  a
foster care congregate facility. The department  shall  determine  if  the
congregate facility is capable of meeting an individual's needs.
  (3) A person shall not be denied  admission  to  or  discharged  from  a
congregate facility because of race, religion, color, or national  origin.
  (4) In administering or managing a congregate facility, an  licensee  or
an administrator shall not accept or keep a person whose behavior requires
isolation or restraint. A person shall not be  admitted  to  a  congregate
facility  whose  present  care  requirements   and   service   needs   are
incompatible with those of other residents in the facility.  This  subrule
shall not be used to circumvent subrule (3).
  (5) An admission prerequisite  for  persons  transferring  from  another
residential setting, nursing home, or medical  institution  is  a  current
written assessment plan outlining the specific service appropriate to  the
resident's  needs  and  the  method  of  providing  the  service.  With  a
resident's consent, an individual not having a  responsible  agency  shall
have an assessment plan completed by department workers and filed  in  the
resident's  record  at  the  congregate  facility  within  30  days  after
admission to the congregate facility.
  (6)  Upon  admission  a  resident's  record  shall  contain  information
obtained from the  resident,  his  next  of  kin  or  legal  guardian,  or
responsible agency indicating persons to  be  notified  of  an  emergency,
including  the  preferred  physician  or  hospital  and  instructions  for
emergency care.
  (7) An individual admitted shall have had a health  appraisal  completed
within the previous 90 days or in emergency admissions  shall  obtain  the
appraisal within 30 days of admission.
  (8) A congregate facility licensee shall report all new  admissions  and
discharges to the department in a manner prescribed by the department.
  (9) A resident shall  not  be  discharged  from  a  congregate  facility
without adequate preparation, including a determination that a move is  in
a resident's best interest. At  the  time  of  discharge  the  responsible
agency or the department of social services shall  update  the  assessment
plan to provide for  continuity  in  achieving  objectives.  A  congregate
facility shall record the date of discharge, the reason for discharge, the
disposition of money and valuables held for safekeeping, and a  forwarding
address of the resident, or a  relative,  guardian  or  other  adult.  The
foregoing does not restrict the resident's ability to make his own  living
arrangements.
  (10) The express wishes of the  resident  shall  be  considered  in  all
movements to and from a congregate facility.
  (11)  A  bedfast  person  or  one  requiring  continuous  and   constant
professional nursing care  shall  not  be  accommodated  in  a  congregate
facility. This does not preclude the accommodation of a  resident  who  is
temporarily ill and bedfast but who does not require professional nursing.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2404   Illnesses and accidents.
  Rule 404. (1) In case of an accident  or  sudden  adverse  change  in  a
resident's physical condition or adjustment, a congregate  facility  shall
obtain needed care immediately and notify the responsible relative and the
person or agency responsible for placing and maintaining the  resident  in
the congregate facility.
  (2) An occurrence of a reportable communicable disease as defined by the
laws of this state or the rules implementing such laws shall  be  reported
immediately to the local health department and the department.
  (3) Immediate investigation of the cause  of  an  accident  or  incident
involving a resident,  employee,  or  visitor  shall  be  initiated  by  a
congregate facility licensee or administrator and an appropriate  accident
record or incident report  completed  and  maintained.  Within  72  hours,
serious accidents requiring medical attention shall  be  reported  to  the
department for remedial review.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2405   Deaths of residents.
  Rule 405. When a  resident  dies,  a  congregate  facility  licensee  or
administrator shall notify immediately the resident's physician, the  next
of kin or legal guardian and the person or agency responsible for  placing
and  maintaining  the  resident  in  the  congregate  facility.   Statutes
applicable to the  reporting  of  sudden  or  unexpected  death  shall  be
observed. The death shall be reported to the department within  72  hours.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2406   Personnel policies and health supervision.
  Rule 406. (1) Written personnel policies, practices,  job  descriptions,
and procedures shall be made available to all  employees  and  volunteers.
Work assignments shall be consistent with job descriptions and  the  level
of training and experience of the employee or volunteers.
  (2)  An  employee  involved  in  food  preparation  or  kitchen  cleanup
activities or who comes in contact  with  residents,  as  a  preemployment
requirement,  shall  be  certified  by  a  physician  to  be   free   from
communicable diseases required to be reported by the laws of this state or
by the rules promulgated under such laws. Periodically,  the  licensee  or
administrator shall review with each employee his present state of health.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2407   Staffing.
  Rule 407. (1) The ratio of staff to residents shall be adequate to carry
out responsibilities defined in the act  and  in  these  rules  and  staff
ratios shall conform with requirements set  by  the  department  following
study by the department and advice from the council.
  (2) Congregate facilities operating other than  a  general  habilitative
and  activities  program  shall  employ  a  program  director  and   other
personnel, as necessary, with special  and  appropriate  skills;  or  have
formal agreements with other agencies or persons whereby services are made
available to the congregate facility according to resident need.
  (3)  A  responsible  person,  capable  of  immediately   responding   to
emergencies, shall be on the premises of each living unit of a  congregate
facility during sleeping hours although the person need not be  awake  and
dressed.
  (4) Personnel shall wear clean  garments,  maintain  a  high  degree  of
personal cleanliness, and conform to acceptable hygienic  practices  while
on duty.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2411   Services for residents.
  Rule  411.  A  congregate  facility  shall  provide  services  for   the
habilitation of its residents. In addition  to  transportation  and  basic
self-care and habilitation training, congregate facilities  shall  provide
or cause to be provided all of the following program  elements  which  are
essential for the habilitation  of  their  residents.  Without  department
approval a program element other than  basic  self-care  and  habilitation
training shall not be provided on the premises when it is available in the
community:
  (a) Basic self-care and habilitation training means a service  to  teach
and reinforce skills in dressing, grooming,  eating,  bathing,  toileting,
and following of simple directions.
  (b) Social education training means a  service  which  covers  areas  of
training inclusive of recreational participation such as  group  programs,
community entertainment and recreational  facilities  utilization.  Social
graces and acceptable public behavior are covered  in  this  area  as  are
leisure time use and skills.
  (c)  Tutorial  and  special  skills  training  is  a  service  typically
providing 1-to-1 training in an area.  Services  include  basic  self-care
training, mobility training, or advanced skills.
  (d) Adult activity, day  care  or  day  training,  is  an  activity  and
training service including basic self-care  skills,  activities  of  daily
living, utilization of community resources,  hazard  training,  individual
and group programs of therapy and education, recreational programs,  field
trips, skills maintenance, and special training. Objectives range from the
maintenance of a participant  in  the  community  to  the  development  of
prevocational skills to permit placement in a sheltered workshop  setting.
  (e) Work activity is a work activity service provided  in  a  protective
setting in a day program to  serve  a  retarded  or  mentally  ill  adult.
Activities are divided between  development  of  prevocational  skills  by
producing a product in a  structured  work  setting  and  providing  basic
social activities of daily living training. The major focus  shall  be  on
work skills for which reimbursement from products sold or  from  contracts
may be provided.
  (f) Sheltered workshop is a service in a certified  protective  workshop
setting which includes special vocational training,  job  evaluation,  and
rehabilitation planning with a definite objective of placement in  gainful
employment, sheltered or independent. Certification includes  proper  wage
deviation  permits  from  the  department  of  labor  and   approvals   as
appropriate from the division of vocational rehabilitation.
  (g) Personal adjustment is a service  for  a  person  with  psychiatric,
emotional, behavioral, or developmental problems and  includes  counseling
and individual or group therapy as well as diagnostic evaluation. It  also
includes utilization of appropriate  batteries  of  psychological  testing
material  and  related  counseling  to  assist   in   classification   and
determination of readiness for movement or maintenance in  the  community.
  (h) Transportation means vehicle travel by public or private carrier and
related cost to and from program  resources  in  the  community  including
consultation, medical, and other services. This  includes  escort  between
screening and entry programs.
  (i) Health services include pharmaceutical, medical, or dental  services
provided directly or through contractual agreement.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2412   Care of residents.
  Rule 412. (1) A staff member or a responsible  person  shall  always  be
present when a resident is in the congregate facility or a living unit.
  (2) Residents shall  be  assured  privacy  and  protection  from  moral,
social, and financial exploitation.
  (3) All work performed by a resident shall be  in  accordance  with  the
assessment plan.
  (4) A resident shall be treated with dignity, and  his  personal  needs,
including protection and safety, shall be attended to at all times.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2413   Residents; personal care.
  Rule 413. (1) A congregate facility shall provide care  and  maintenance
to its residents including either or both personal care and supervision as
appropriate. Supervision means guidance of an individual as he carries out
activities of daily living, including reminding a resident to maintain his
medication schedule  as  directed  by  his  physician,  reminding  him  of
important  activities  to  be  carried  out,  assisting  him  in   keeping
appointments and being aware of his general whereabouts even though he may
travel independently about the community. Personal care  means  continuous
attendance by a responsible person  to  render  personal  assistance  with
dressing,  personal  hygiene,  grooming,  and  maintenance  of  medication
schedule as directed and supervised  by  the  individual's  physician  and
being aware  of  the  individual's  specific  whereabouts  at  all  times,
including his presence in outside activities. Specifically, personal  care
shall include, as required, care of the skin, mouth, teeth,  hands,  feet,
eyes, and hair.
  (2) A resident shall receive a bath or shower weekly and be afforded the
opportunity for daily bathing.
  (3) A resident shall be offered facilities for shaving daily.
  (4) A resident shall  be  afforded  opportunities  to  obtain  haircuts,
hairsets, or other hair grooming processes.
  (5) A resident  shall  be  afforded  the  opportunity,  encouraged,  and
instructed to dress as fashion, cleanliness, and the season warrants.
  (6) A resident shall be given  assistance  or  trained  in  the  use  of
prosthesis as appropriate.
  (7) A resident's dignity and privacy shall be respected  in  all  areas.
Female residents requiring assistance  in  activities  such  as  dressing,
bathing, and personal hygiene shall be assisted by or in the  presence  of
another female.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2414   Complaints.
  Rule 414. A resident shall be afforded a means of presenting  grievances
to the congregate facility licensee  or  administrator.  If  the  area  of
concern is with the responsible agency, refer to R 400.2119.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2415   Health care of residents.
  Rule 415. (1) A resident shall have a health appraisal at least annually
which contains specific recommendations for care, maintenance,  treatment,
or special programs and shall reflect the resident's progress  in  meeting
scheduled objectives.
  (2) A resident who  in  the  recent  past  has  been  a  patient  in  an
institution shall have on file in his individual record a statement of his
medical history and his medical and health needs.
  (3) The weight of each resident shall be recorded upon admission  and  a
monthly record of the weight of each resident shall be maintained.
  (4) All prescription  medication  shall  be  prescribed  by  a  licensed
physician. Medication shall be administered and safeguarded in  accordance
with the instructions of a resident's physician.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2416   Prohibited practices.
  Rule 416. Licensees or administrators shall not  establish  or  practice
policies of physical restraint, isolation, corporal  punishment,  personal
humiliation, or withholding of food, water, or clothing.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2417   Assessment plan.
  Rule 417. Care, maintenance, and services shall be provided according to
an assessment plan. Components of a plan shall include at least:
  (a)  Specific  objectives  of   maximum   self-care   and   independence
appropriate for each resident.
  (b) Health appraisal, including medical-dental and,  where  appropriate,
other evaluations by health professionals and prescribed treatment.
  (c) Care and maintenance requirements.
  (d) Specific services and planning needed to obtain objectives.
  (e) Work activities.
  (f) Religious activities.
  (g) Restrictions or exceptions to  the  requirements  of  resident  care
which are individually set and allowable under licensing rule.
  (h) Payment planning related to the care and services to be obtained  by
the resident.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2418   Resident activities.
  Rule 418. (1) A resident shall have access to  the  use  of  the  United
States mails; he may write and  send  mail  at  his  own  expense  without
censorship and receive mail addressed to him unopened.
  (2) A resident shall  have  daily,  private  access  to  and  use  of  a
telephone for local calls. Similar  access  is  to  be  granted  for  long
distance calls which are made collect or for which charges  are  otherwise
met by the resident.  When  pay  telephones  are  provided  in  congregate
facilities, a reasonable amount  of  change  shall  be  available  in  the
congregate facility to enable residents to  make  change  for  telephoning
purposes.
  (3) A resident shall have immediate access to and use  of  his  personal
clothing and personal belongings which he usually or habitually carries on
his person or uses  as  a  matter  of  identification,  grooming,  toilet,
prosthesis,  hygiene,  communication,   religious   observance,   personal
adornment, personal entertainment, study, or personal enhancement.
  (4) A resident shall be provided with storage space  for  his  immediate
and private use.
  (5) A congregate facility shall facilitate family relationships  by  its
routine and personnel attitude. Restrictive visiting hours  shall  not  be
maintained and residents shall be allowed to receive reasonable numbers of
visitors at any reasonable  time.  Exceptions  shall  be  covered  in  the
assessment plan. Special consideration shall be given to  visitors  coming
from out of town or whose hours of employment warrant deviation from usual
visiting hours.
  (6) A resident who is capable shall have the opportunity  of  doing  his
own shopping for his personal needs in the nearest community.
  (7) A resident shall be afforded  appropriate  recreational  experiences
and opportunities within and outside the congregate facility.
  (8) A resident shall be permitted to practice the  religious  belief  of
his choice free of any coercion, and be allowed religious ministration  at
reasonable  hours.  Religious  practice  shall  not  be  required  of  any
resident.
  (9) An adult shall not be denied admission to, or be discharged from,  a
congregate facility because of race, religion, color, or national  origin.
The individual, or in the case of the legally  incompetent  his  guardian,
shall exercise free choice in the selection of a congregate facility if it
is capable of meeting the individual's needs.
  (10) Any  exception  to  resident  activities  shall  be  noted  in  the
assessment plan.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2421   Residents' funds; access; safekeeping.
  Rule 421. (1) A resident shall have access to and use of personal  funds
belonging to him in reasonable amounts, including immediate access  to  at
least $5.00  of  his  personal  funds.  Exceptions  shall  be  subject  to
provisions of the assessment plan.
  (2) The maximum value of money and valuables a congregate facility shall
accept for  safekeeping  shall  not  exceed  the  amount  of  $400.00  per
resident.
  (3) Residents' funds shall be kept separate and apart from all funds and
monies of the licensee and treated as a trust obligation of the  licensee.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2422   Accounting of residents' funds.
  Rule 422. (1) A resident's funds are subject at all times to a full  and
prompt accounting to the resident.  Funds  shall  be  considered  promptly
accounted for when the following conditions have been observed:
  (a) A resident receives on request an itemized monthly statement of  all
charges against funds held in  trust  which  shall  be  in  such  form  as
reasonably to inform the resident of the nature of the charge for goods or
services and the amount thereof. A copy of the itemized statement shall be
filed in the resident's record.
  (b) A resident receives up to his full amount of  personal  funds  at  a
time designated by the  resident  but  in  no  event  later  than  5  days
following the request subject to limitations in the resident's  assessment
plan.
  (c) The charges against the resident's fund account  bear  a  reasonable
relationship to value or agreed price for the services rendered and  goods
furnished or made available to the resident.
  (2) A resident who  is  discharged  from  a  congregate  facility  shall
receive an itemized  statement  of  his  personal  funds  and  prompt  and
reasonable payment of funds remaining  in  his  account  at  the  time  of
discharge, but no later than 5 banking days after discharge.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2423   Charges against residents' funds.
  Rule 423. A resident, or in the case of a mentally handicapped resident,
the responsible agency, legal guardian, person,  or  relative  responsible
for maintaining him, shall be given  prior  written  notice  and  approval
obtained before charges are made  against  his  account.  A  copy  of  the
authorization shall be maintained in the resident's record.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2424   Transactions prohibited; review.
  Rule 424. (1) A congregate facility licensee or a member of his  family,
or congregate facility staff shall not borrow money or  valuables  from  a
resident with or without his consent.
  (2) Transactions between a resident and a congregate facility  shall  be
subject to review by the department where it is alleged by a  resident  or
his representative that the congregate facility did not  comply  with  any
rule pertaining to trust funds. Department review does  not  preclude  any
other legal remedy a resident or his representative may have.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2431   Home environment.
  Rule 431. (1) A congregate facility shall be so  constructed,  arranged,
and maintained as to  provide  adequately  for  the  health,  safety,  and
well-being of occupants.
  (2)  Furnishings  and  housekeeping  standards  shall  be  such  that  a
congregate facility presents a comfortable, clean, and orderly appearance.
  (3)  All  occupied  rooms  shall  be  of  standard  lath   and   plaster
construction or equivalent.
  (4) The atmosphere and routine of the congregate facility shall be  such
that a resident may spend the majority of his nonsleeping hours out of the
bedroom.
  (5) Dining,  bath,  sitting,  living,  and  recreation  rooms  shall  be
maintained by an adequate central heating system or its  equivalent  at  a
temperature range of 68-72 degrees Fahrenheit during nonsleeping hours.
  (6) A congregate facility shall make adequate provision  for  laundering
personal laundry.
  (7) A congregate facility shall  be  equipped  to  provide  an  adequate
amount of hot water for a resident's use between the temperature range  of
110-120 degrees Fahrenheit at the fixture.
  (8) A toilet, lavatory, and  bathing  or  showering  facility  shall  be
provided for each 8 adults in  a  congregate  facility  including  live-in
staff and residents. At least 1 toilet and lavatory shall be  provided  on
each floor having resident bedrooms.
  (9) Bathrooms and toilet facilities without windows  shall  have  forced
ventilation to the outside. Bathroom windows used  for  ventilation  shall
open easily.
  (10)  Toilets,  bathtubs,  and  showers  shall  provide  for  individual
privacy.
  (11) Floors, walls, and ceilings shall be finished so as  to  be  easily
cleanable, and shall be kept clean and in good repair.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2432   Living and sleeping areas.
  Rule 432. (1) A congregate facility shall provide  distinct  living  and
sleeping areas. All areas shall be well lighted, heated,  and  ventilated.
  (2) A congregate facility shall provide 1 or more attractively furnished
multipurpose  areas  of  adequate   size   for   training,   recreational,
family-style dining and other diversional and social activities.
  (3) The living and sleeping areas for a given resident shall not  be  in
noncontiguous wings, units, or buildings.
  (4) A living room, dining room, or other room not  ordinarily  used  for
sleeping shall not be used for sleeping by residents or  family  or  staff
members.
  (5) Traffic to and from any room  shall  not  be  through  a  resident's
bedroom.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2433   Bedrooms.
  Rule 433. (1) A room shall not be used as a bedroom where more than  1/2
the room height is below grade, except where the ceiling of  such  portion
of a building is located 5 feet or more above grade for more than  25%  of
the perimeter measurement of the building.
  (2) Bedrooms for residents shall be separated from halls, corridors, and
other rooms  by  floor-to-ceiling  walls  containing  no  openings  except
doorways.
  (3) Interior  doorways  of  bedrooms  occupied  by  residents  shall  be
equipped with  a  side-hinged,  permanently  mounted  door  equipped  with
positively latching hardware which will insure opening of the  door  by  a
single motion, such as turning a knob or by pressing with normal  strength
on a latch.
  (4) Residents of opposite sex shall not occupy the same  bedroom  unless
they are husband and wife.
  (5) Residents having impaired mobility shall not sleep in or be assigned
bedrooms located above the first or main floor.
  (6) Bedrooms shall have at  least  1  window.  Bedrooms  shall  be  well
ventilated and maintained at a comfortable temperature.
  (7) A single occupancy bedroom shall have at least  80  square  feet  of
usable floor space (70 square feet for existing facilities). Usable  floor
space is defined as that floor space under a ceiling at  least  6  feet  6
inches in height.
  (8) A multi-occupancy bedroom shall have at  least  70  square  feet  of
usable floor space per bed (65 square feet for existing facilities) with a
maximum of 4 beds per bedroom. Usable floor space is defined as that floor
space under a ceiling at least 6 feet 6 inches in height.
  (9) There shall be at  least  a  3-foot  clearance  between  beds  in  a
multiresident bedroom.
  (10) Rollaways, cots, double deck, stacked bunks, hide-a-beds,  daybeds,
and studio couches are prohibited.
  (11) Provision shall be made for a resident to mount or hang pictures on
bedroom walls.
  (12) A resident bedroom shall be equipped with a mirror appropriate  for
grooming.
  (13) Bedroom furnishings shall include an adequate closet  or  wardrobe,
lighting sufficient for reading and other resident activities,  bureau  or
dresser or equivalent, and at least 1 chair with arms in each bedroom  for
every 2 residents.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2434   Bedding and linen.
  Rule 434. (1) A congregate facility shall provide an individual  bed  at
least 36 inches wide and 72 inches long with comfortable springs  in  good
condition, a clean protected mattress not less than 5 inches  thick  or  4
inches if of a synthetic construction, and a pillow.
  (2) A congregate facility shall provide bedding which includes 2 sheets,
a pillow case, a minimum of 1  blanket,  and  a  bedspread.  A  congregate
facility shall maintain a linen supply for twice the number of beds in it.
A congregate facility shall provide towels and washcloths which  shall  be
changed at least twice weekly and more often if soiled. Bed linen shall be
changed at least weekly and more often if soiled.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2447   Safety generally.
  Rule 447. (1) Scatter or throw rugs on hard finished floors shall have a
nonskid backing.
  (2) Handrails and nonskid surfacing or  strips  shall  be  installed  in
showers and bath areas.
  (3) Sidewalks, fire escape routes and entrances shall be  kept  free  of
any hazards such as ice, snow, and debris.
  (4) A yard area shall be kept free from all hazards,  nuisances,  refuse
and litter.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2448   Water and sanitation.
  Rule 448. (1) Private water systems shall meet the department of  public
health rules,  "Regulations  for  Certain  Water  Supplies  in  Michigan,"
available from the Department of Public Health, 3500 North  Martin  Luther
King, Jr. Blvd., Lansing, MI 48915. A  bacteriological  report  confirming
water quality shall be required during  initial  inspection  and  every  2
years thereafter. Congregate facilities using a  community-approved  water
system need not comply with this requirement.
  (2) Sewage disposal systems shall meet the  requirements  of  the  state
department of public health.
  (3) Kitchen and bathroom areas shall be maintained to insure cleanliness
and sanitation so as to protect health.
  (4) Waste which is not disposed of by mechanical means shall be kept  in
a leakproof, nonabsorbent container with close-fitting covers for garbage,
refuse, and other solid waste. Waste shall be  removed  from  the  kitchen
daily and from the premises at least weekly.
  (5) Hand-washing facilities provided in both kitchen and bathroom  areas
shall include hot and cold water, soap and individual  towels,  preferably
of paper.
  (6) An insect, rodent or pest-control program  shall  be  maintained  as
necessary, and carried out in a  manner  which  continually  protects  the
health of residents. Poisons,  caustics,  and  other  dangerous  materials
shall be stored and  safeguarded  in  nonresident  areas  and  in  nonfood
preparation and storage areas.
  (7) Open windows shall be screened May through October.
  (8) When a resident is discharged, his room and its  contents  shall  be
thoroughly cleaned. Blankets and spreads shall be sanitized.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2451   Records generally.
  Rule 451. Resident records, a resident register,  accident  records  and
incident reports, residents' grievances and complaints, employee  records,
employee work schedules and record of resident funds and  valuables  shall
be kept in the congregate facility and shall be available to the  director
or his authorized representative.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2452   Resident records.
  Rule 452. (1) An individual resident record shall be provided  for  each
resident in the congregate facility.
  (2) It shall be the shared responsibility  of  the  congregate  facility
licensee and the responsible agency to  assure  that  a  current  resident
record is maintained and that all entries are dated and signed.
  (3) The resident record shall include all of the following  information:
  (a) Identifying information including all of the following  information:
  (i) Name.
  (ii) Social security number.
  (iii) Agency case number.
  (iv) Veteran status and number.
  (v) Marital status.
  (vi) Age.
  (vii) Sex.
  (viii) Home address.
  (ix) Religious preference.
  (x) Insurance information.
  (xi) Burial provisions.
  (b) Assessment plan.
  (c) Name, address,  and  telephone  number  of  next  of  kin  or  legal
guardian.
  (d) Name, address, and telephone number  of  person  or  placing  agency
responsible  for  resident's  maintenance  and  care  in  the   congregate
facility.
  (e) Date of admission.
  (f) Date of discharge and place to which resident was discharged.
  (g) Health information including all health  appraisals  and  statements
and instructions for administering prescribed medication.
  (h) The name and address of the preferred  physician  and  hospital  and
instructions for emergency care.
  (i) Information available from the resident about insurance policies and
prearranged funeral arrangements.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2453   Resident register.
  Rule 453. A chronological register of residents shall be maintained  and
include the following information for each resident:  date  of  admission,
date of discharge, and place to which resident was  discharged,  including
date and location for temporary absences.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2454   Accident records and incident reports.
  Rule 454. An accident record or incident report shall  be  prepared  for
each accident or incident involving a resident, staff member, or  visitor.
Incident means seizures or  highly  unusual  behavior  episodes  including
periods of absence without prior notice. An accident  record  or  incident
report shall include the following information:
  (a) Name of person involved in accident or incident.
  (b) Date, hour, place, and cause of accident or incident.
  (c) Effect of accident or incident on person involved and care given.
  (d) Name of physician notified and time of notification.
  (e)  Physician's  statement  regarding  extent  of  injuries,  treatment
ordered, and disposition of person involved.
  (f) Corrective  measures  taken  to  avoid  repetition  of  accident  or
incident.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2455   Employee records and schedules.
  Rule 455. (1) A record shall be maintained for permanent  full-time  and
permanent part-time employees only and shall include the following:
  (a) Name, address, telephone number, and social security number.
  (b) License or registration number, if applicable.
  (c) Date of birth.
  (d) Summary of experience and education (resume).
  (e) References.
  (f) Beginning date of employment and position for which employed.
  (g) Performance evaluation.
  (h) Results of annual health certifications.
  (i) Periodic health review information.
  (j) Date employment ceased and reasons therefor.
  (2) A daily work schedule shall be maintained to include the number  and
type of personnel on duty in the congregate facility. Work schedules shall
be kept for 90 days.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2456   Resident's grievances and complaints record.
  Rule 456. A resident grievances and complaint record shall be maintained
which shall include copies of all resident grievances or complaints  filed
in chronological order.  The  report  shall  include  the  nature  of  the
complaint, the date of the complaint, and a statement indicating  how  the
issue was resolved.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2457   Resident funds and valuables.
  Rule 457. The resident funds and valuables  record  shall  indicate  the
date and receipt number of all deposits and dispersals, and the amount and
description of monies or valuables or both given for safekeeping for  each
resident. It shall also include any written authorization by the  resident
for charges made by the congregate facility to the fund.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2461   Emergency preparedness.
  Rule 461. (1) A congregate facility shall have a telephone. A congregate
facility shall have a written procedure to be  followed  in  the  case  of
fire, or medical emergency. Responsible employees and  residents,  to  the
best of their ability, shall be familiar with emergency planning  and  his
or her responsibilities.
  (2) An emergency plan shall specify persons to be notified, locations of
alarm signals and fire extinguishers, evacuation  routes,  procedures  for
evacuating residents of limited mobility and visitors, and provide for  at
least 4 fire drills per year.
  (3) The emergency plan, including appropriate telephone  numbers,  shall
be prominently posted and made fully known to all  residents,  staff,  and
responsible persons and be reviewed annually.
  (4) Staff shall be trained to perform assigned  tasks  and  be  familiar
with all fire fighting equipment.
  (5) Fire drills shall be conducted  quarterly  and  a  record  of  their
performance shall be maintained. Evacuation  planning  shall  include  the
possibility of nighttime movements of residents.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2471   Quality of meals.
  Rule 471. (1) A minimum of 3 regular, nutritious, attractively  prepared
meals shall be provided daily. No more than 15 hours shall elapse  between
the evening and morning meal. Meals shall be of proper form,  consistency,
and temperature. Meals shall meet the general requirements  for  nutrition
published by the department or currently found in  the  recommended  daily
dietary allowances, food and nutrition board, national academy of science.
  (2) Special diets shall be prescribed only by a physician.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2472   Food service.
  Rule 472. (1) All perishable foods shall be stored at such  temperatures
as will protect against spoilage.
  (2) All foods while being stored, prepared, or served shall be protected
against contamination and be safe for human consumption.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2473   Equipment.
  Rule 473. A congregate facility shall be equipped  properly  to  prepare
and serve adequate meals.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2474   Meal planning.
  Rule 474. (1) Menus shall be written 3 days prior to the serving of  the
meal. Any change or substitution shall be noted and considered as  a  part
of the original menu.
  (2) Records of menus as served shall be provided  upon  request  by  the
department.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.


R  400.2475   Staff.
  Rule 475. A minimum of 1 individual qualified by  training,  experience,
and performance shall be responsible for food preparation. Such additional
food service  assistance,  including  relief  persons,  as  necessary  for
regular and timely meals, shall be employed.

  History:  1954 ACS 82, Eff. Feb. 1, 1975; 1979 AC.