HomeMy WebLinkAboutMINUTES - 06032014 - C.66RECOMMENDATION(S):
ADOPT a "Support" position on AB 2228, as introduced (Cooley): Crisis nurseries, a bill that makes a number of
changes to existing requirements for crisis nurseries, as recommended by the Legislation Committee.
FISCAL IMPACT:
The California Constitution requires the state to reimburse local agencies and school districts for certain costs
mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would
provide that no reimbursement is required by this act for a specified reason.
No direct impact on Contra Costa County.
BACKGROUND:
At its May 1, 2014 meeting, the Legislation Committee voted unanimously to recommend a position of "Support" on
AB
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
Action of Board On: 06/03/2014 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYE:John Gioia, District I Supervisor
Candace Andersen, District II
Supervisor
Mary N. Piepho, District III
Supervisor
Karen Mitchoff, District IV
Supervisor
Federal D. Glover, District V
Supervisor
Contact: L. DeLaney,
925-335-1097
I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board
of Supervisors on the date shown.
ATTESTED: June 3, 2014
David Twa, County Administrator and Clerk of the Board of Supervisors
By: June McHuen, Deputy
cc:
C. 66
To:Board of Supervisors
From:LEGISLATION COMMITTEE
Date:June 3, 2014
Contra
Costa
County
Subject:Support Position on AB 2228, as introduced, Cooley, Crisis nurseries.
BACKGROUND: (CONT'D)
2228 to the Board of Supervisors.
Current Status: 04/29/2014: From ASSEMBLY Committee on HUMAN SERVICES: Do pass as amended to
Committee on APPROPRIATIONS.
SUMMARY : Makes a number of changes to existing requirements for crisis nurseries. Specifically, this bill:
1) Deletes the authority of a crisis nursery to provide child day care services for children under six years of age
and instead permits a crisis nursery to provide "crisis day respite services."
2) Deletes the prohibition on a crisis nursery providing child day care services to eligible children for more than
30 calendar days within a six-month period, unless otherwise permitted by the Department of Social Services
(DSS).
3) Deletes the requirement that a child receiving child day care services from a crisis nursery are counted towards
its licensed capacity.
4) Permits a crisis nursery's licensed capacity to be based upon 35 square feet of indoor activity space per child, as
specified.
5) Requires at least one crisis nursery caregiver to have certification in cardiopulmonary resuscitation (CPR) and
pediatric first aid, as specified.
6) Requires crisis nursery licensees to develop, maintain and implement a written staff training plan for the
orientation, continuing education, on-the-job training and development, supervision, and evaluation of all lead
caregivers, caregivers, and volunteers, which shall be included in the facility's plan of operation.
7) Requires crisis nursery licensees to designate at least one lead caregiver to be present at the crisis nursery at all
times when children are present.
8) Requires lead caregivers to have one of the following education and experience qualifications:
a) Completion of 12 postsecondary units, as specified, in classes with a focus on early childhood education, child
development, or child health at an accredited college or university, and six months of work experience in a
licensed group home, licensed infant care center, or comparable group child care program or family day care;
b) A current and valid Child Development Associate (CDA) credential, with the appropriate age level
endorsement issued by the CDA National Credentialing Program, and at least six months of on-the-job training or
work experience in a licensed child care center or comparable group child care program; or
c) A current and valid Child Development Associate Teacher Permit issued by the California Commission on
Teacher Credentialing, as specified.
9) Requires lead caregivers to have a minimum of 24 hours of training and orientation before working with
children, permits one year experience in a supervisory position in a child care or group care facility to be
substituted for 16 hours of training and orientation, and requires lead caregivers to undergo at least 20 hours of
ongoing training, as specified.
10) Requires general caregiver staff to complete a minimum of 24 hours of initial training within the first 90 days
of employment, which may include first aid and CPR and shall be included in the written staff training plan, and
requires that at least eight hours of training be completed before the caregiver may be left alone with children or
counted in the staff-to-child ratios, as specified.
11) Reduces the number of hours of training a person must undergo in order to volunteer at a crisis nursery from
eight to five hours in the following ways:
a) Reduces crisis nursery job shadowing from four to two hours; and
b) Reduces from two hours to one hour the amount of training a volunteer must receive on community care
licensing regulations.
12) Adds "child guidance techniques" to existing training requirements for volunteers.
13) Reduces the number of hours of training a volunteer must undergo before being included in staff-to-child ratio
requirements from 20 to eight hours.
14) Deletes existing training requirements that volunteers must undergo 12 hours of CPR training and eight hours
of child health and safety training and instead requires eight hours of training that covers child care health and
safety issues, trauma informed care, the importance of family and sibling relationships, temperaments of children,
self-regulation skills and techniques, and program child guidance techniques.
15) Permits volunteers who have not met specified training requirements necessary to be included in staff-to-child
ratio requirements to supervise napping children without being under the direct supervision of staff.
16) Increases staff-to-child ratio requirements for preschool age children from one-to-three to one-to-six.
17) Increases staff-to-child ratio requirements for infants from one-to-three to one-to-four during the hours of
operation between 7 am and 7 pm.
18) Increases staff-to-child ratio requirements for all children from one-to-four to one-to-six during the hours of
operation between 7 pm and 7 am.
19) Requires licensees and caregivers who provide medication assistance to children to do all of the following:
a) Assist children with the taking of the medication, follow instructions as provided by an appropriate medical
professional, store the medication appropriately, as specified, and administer the medication as directed on the
label or as advised by a physician in writing;
b) Administer nonprescription medication without the consent of the child's physician as long as the medication is
administered in accordance with the product label and the child's parent has consented in writing to the use of the
medication, as specified;
c) Develop and implement a written plan to record the administration of prescription and nonprescription
medications and to inform the child's authorized representative daily, for day care, and upon discharge for
overnight care, when the medications have been given; and
d) Return all medications to the child's authorized representative when the child is withdrawn from the facility, as
specified.
EXISTING LAW
1) Defines a "crisis nursery" as a facility licensed by DSS under the Community Care Facilities Act (CCFA) to
provide short-term, 24 hour residential care and supervision for children under the age of six, who are voluntarily
placed by their parent or guardian due to a family crisis or stressful situation for not more than 30 days. (H&S
Code 1516)
2) Exempts crisis nurseries from having to be licensed as a child day care facility under the California Child Care
and Development Services Act. (H&S Code 1596.792)
3) Permits a crisis nursery to provide child day care services for children under six years of age for no more than
30 days in a six-month period, unless otherwise permitted by DSS. (H&S Code 1516(f))
4) Requires crisis nurseries to collect and maintain information, as specified, indicating the total number of
children placed in the program, the length of stay for each child, the reasons given for the use of the crisis nursery,
and the age of each child, as specified. (H&S Code 1516(e))
5) Requires any person who owns, operates, administers, is employed by, or is a volunteer of a community care
facility, under the CCFA, including a crisis nursery to undergo a criminal background check and receive a
criminal record clearance prior to working with or providing care for clients or residents of a community care
facility. (H&S Code 1522)
6) Requires a crisis nursery licensee to have an administrator who meets one of the following requirements:
a) A Master's Degree in social work or social welfare, marriage, family and child counseling, or counseling
psychology or human services; and have at least three years of experience in the field of child and family services,
as specified; or
b) A Bachelor's Degree in behavioral science and has five years of experience in the field of child and family
services, as specified. (Section 86564(d) of Title 22, CCR)
7) Requires an administrator to "be on the premises for the number of hours necessary to manage and administer
the crisis nursery in compliance with applicable law and regulation." (Section 86564(c) of Title 22, CCR)
8) Requires licensees to designate at least one lead caregiver to be present at the crisis nursery at all times when
children are present. (Section 86565(p) of Title 22, CCR)
9) Provides minimum levels of qualifications, educational experience and ongoing training lead caregivers and
caregiver staff must undergo in order to work with and provide care for children in crisis nurseries, including but
not limited to 24 hours of initial training and 20 hours of annual training, as specified. (Section 86565 of Title 22,
CCR)
10) Requires all lead caregivers, caregivers, and volunteers to have a current and valid pediatric CPR and
pediatric first aid certification, as specified. (Section 86565(n) of Title 22, CCR)
11) Requires all volunteers to undergo eight hours of initial training prior to being allowed to provide staff
supervised care to children in a crisis nursery. (Section 86565(w)(1) of Title 22, CCR)
12) Allows a volunteer who undergoes an additional 20 hours of training within 90 days of becoming a volunteer
to provide unsupervised care to children and to count towards caregiver staff-to-child ratio requirements. (Section
86565(x) of Title 22, CCR)
COMMENTS:
Background on crisis nurseries: Established in 2004 by SB 855 (Machado), Chapter 664, Statutes of 2004, crisis
nurseries were created as a separate licensing category to provide a temporary housing and shelter facility
placement option for parents. The goal of crisis nurseries is to provide an alternative voluntary placement option
for families with young children who are facing difficult or extreme financial, health, or other challenges and to
prevent the need for or the engagement of child welfare services. This limits the role of crisis nurseries to only
serve children under the age of six who are voluntarily placed by their parent or guardian under their temporary
care.
Prior to SB 855's adoption, crisis nurseries were subject to licensure as a group home under the CCFA. According
to the Assembly Human Services August 26, 2004 analysis of SB 855, the author argued that group home
licensing requirements were "inappropriate for crisis nurseries, since the demands of very young children who are
voluntarily placed by a parent are less serious than those of older children who have been removed from parental
custody by county child protective services workers due to abuse or neglect." Further, operators of crisis nurseries
argued "that the costs of complying with group home regulations are excessive and threaten their viability."
To allow for the monitoring and evaluation of this licensing category, SB 855 was approved with a sunset of
January 1, 2008. That sunset was extended by two subsequent measures to establish the current sunset of January
1, 2014 to provide additional time for DSS to establish licensing regulations. Crisis nurseries were originally
allowed to serve a limited number of foster youth, however, that authority was eliminated effective January 1,
2012 pursuant to SB 1214 (Wolk), Chapter 519, Statutes of 2010. Finally, in 2012, the state adopted SB 1319
(Liu), Chapter 663, Statutes of 2012, which eliminated the sunset and allowed crisis nurseries to exist in
perpetuity. Had the sunset been allowed to take effect, crisis nurseries would have, again, had to comply with
group home licensing requirements under the CCFA.
According to DSS, there are currently five licensed crisis nurseries in California. All five are located in northern
California; Concord, Davis, Nevada City and two in Sacramento. Since 2009, approximately 9,155 children have
been served by these nurseries, except for the Concord facility. On average, the lengths of stay have ranged from
eight hours to just over 24 hours with 44 children staying for the maximum allowable days. No exemptions have
been requested or granted for children to stay beyond the 30-day limit.
Need for the bill: Stating the need for the bill, the author writes:
The current law and regulations governing Crisis Nurseries has not been updated to reflect changes made by SB
1214 (Wolk) Chapter 93, Statutes of 2010, prohibiting the use of Crisis Nurseries for foster children, effective
July 1, 2012. This has resulted in laws and regulations that are unnecessary for Crisis Nurseries. The increased
cost of providing services is preventing Crisis Nurseries from making the most effective use of qualified
volunteers, in support of paid employees, to care for children voluntarily placed by their own parents or legal
guardians.
Staff comments: This bill seeks to modify current operating requirements for crisis nurseries in three ways. First,
it lifts the 30-day limitation on the use of crisis nurseries and aligns facility capacity and operating requirements to
reflect the practical realities that night and day respite care have different needs. Secondly, it modifies training
requirements for lead caregivers, caregivers, volunteers who may be counted as a caregiver, and general
volunteers. Lastly, it eliminates the requirement that staff and certain volunteers be certified in pediatric first aid
and CPR.
Under current statute, no child may utilize a crisis nursery for more than 30-days in a six-month period, but
exemptions can be provided as determined by DSS. However, under current regulations, DSS is required to
respond to an exemption request within 30-days. This is untenable, as it is difficult to determine whether a child's
family, upon the child's entry into a crisis nursery, would still require respite care after 30 days. It is also unclear
whether the 30-day limit should be eliminated, as current data does not demonstrate that the 30-day exemption has
been granted. Rather than delete the 30-day limitation altogether, and in order to maintain the purpose of crisis
nurseries to be a temporary crisis respite service, the bill should reflect reasonable operating standards to allow
that extensions, instead of exemptions, be granted.
Regarding the fiscal operating model of crisis nurseries, all five nurseries rely upon philanthropic support and
local funds to operate. As a result, they rely substantially on trained volunteers to serve in the capacity of
caregiving staff in order to meet state staff-to-child ratio requirements. Because of this, the sponsor argues that
current requirements "artificially drive up the cost of providing the services" and that "continuing to operate under
these requirements will force crisis nurseries to close."[1]
In attempting to lessen some of these requirements and to draw upon nearly ten years of experience on how crisis
nurseries have fared, the bill seeks to increase child-to-staff ratios by bringing them into alignment with current
day child care licensing ratio standards. It also increases the content and quality of training for all staff, including
volunteers must undergo, but eliminates the requirement that staff and volunteers who may count in staffing ratios
are certified in pediatric first aid and CPR. If staff, and especially volunteers, are to be recognized for purposes of
meeting facility staff-to-child ratios and allowed to be left alone with children, they should meet a higher level of
training than general volunteers. Eliminating the pediatric first aid and CPR certification requirement is
unnecessary, as it provides a minimum level of health and safety training and experience for caregiver staff and
volunteers who count as staff.
REGISTERED SUPPORT / OPPOSITION:
Support
California Alliance of Child and Family Services
Opposition
None on file.
CHILDREN'S IMPACT STATEMENT:
The goal of crisis nurseries is to provide an alternative voluntary placement option for families with young
children who are facing difficult or extreme financial, health, or other challenges and to prevent the need for or the
engagement of child welfare services. This limits the role of crisis nurseries to only serve children under the age
of six who are voluntarily placed by their parent or guardian under their temporary care.
ATTACHMENTS
AB 2228 bill text
california legislature—2013–14 regular session
ASSEMBLY BILL No. 2228
Introduced by Assembly Member Cooley
February 20, 2014
An act to amend Sections 1516 and 1526.8 of the Health and Safety
Code, relating to crisis nurseries.
legislative counsel’s digest
AB 2228, as introduced, Cooley. Crisis nurseries.
Existing law provides for the licensure and regulation by the State
Department of Social Services of crisis nurseries, as defined. Violation
of these provisions is a misdemeanor. Existing law authorizes crisis
nurseries to provide care and supervision for children under 6 years of
age who are voluntarily placed by a parent or legal guardian due to a
family crisis for no more than 30 days.
Existing law provides that a maximum licensed capacity for a crisis
nursery program is 14 children. Existing law authorizes a crisis nursery
to provide child day care services for children under 6 years of age at
the same site as a crisis nursery, but provides that a child is prohibited
from receiving more than 30 calendar days of child day care services
at the crisis nursery in a 6-month period unless the department issues
an exception. Existing law requires the department to allow the use of
fully trained and qualified volunteers as caregivers in a crisis nursery
subject to specified conditions.
This bill would provide that the maximum licensed capacity of 14
children applies to overnight crisis nursery programs. The bill would
instead provide that a crisis nursery may provide crisis day respite
services and that the maximum licensed capacity for crisis day respite
99
shall be based on 35 square feet of indoor activity space per child, as
prescribed.
This bill would require that the licensee designate at least one lead
caregiver, as described, to be present at the crisis nursery at all times
when children are present, would require the licensee to develop,
maintain, and implement a written staff training plan, as specified, and
would require a crisis nursery to have at least one caregiver at all times
who has completed training pediatric first aid and cardiopulmonary
resuscitation. The bill would modify the requirements relating to the
use of volunteers to be counted in the staff-to-child ratios in a crisis
nursery, as specified, and would prescribe requirements relating to when
a child has a health condition that requires medication.
By expanding the scope of crime, this bill would impose a
state-mandated local program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the state.
Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act
for a specified reason.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
The people of the State of California do enact as follows:
line 1 SECTION 1. Section 1516 of the Health and Safety Code is
line 2 amended to read:
line 3 1516. (a) For purposes of this chapter, “crisis nursery” means
line 4 a facility licensed by the department to provide short-term, 24-hour
line 5 nonmedical residential care and supervision for children under six
line 6 years of age, who are voluntarily placed for temporary care by a
line 7 parent or legal guardian due to a family crisis or stressful situation
line 8 for no more than 30 days.
line 9 (b) A crisis nursery shall be organized and operated on a
line 10 nonprofit basis by either a private nonprofit corporation or a
line 11 nonprofit public benefit corporation.
line 12 (c) “Voluntary placement,” for purposes of this section, means
line 13 a child, who is not receiving Aid to Families with Dependent
line 14 Children-Foster Care, placed by a parent or legal guardian who
line 15 retains physical custody of, and remains responsible for, the care
line 16 of his or her children who are placed for temporary emergency
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line 1 care, as described in subdivision (a). Voluntary placement does
line 2 not include placement of a child who has been removed from the
line 3 care and custody of his or her parent or legal guardian and placed
line 4 in foster care by a child welfare services agency.
line 5 (d) (1) Except as provided in paragraph (2), the maximum
line 6 licensed capacity for a an overnight crisis nursery program shall
line 7 be 14 children.
line 8 (2) A facility licensed on or before January 1, 2004, as a group
line 9 home for children under the age of six years of age with a licensed
line 10 capacity greater than 14 children, but less than 21 children, that
line 11 provides crisis nursery services shall be allowed to retain its
line 12 capacity if issued a crisis nursery license until there is a change in
line 13 the licensee’s program, location, or client population.
line 14 (e) Each crisis nursery shall collect and maintain information,
line 15 in a format specified by the department, indicating the total number
line 16 of children placed in the program, the length of stay for each child,
line 17 the reasons given for the use of the crisis nursery, and the age of
line 18 each child. This information shall be made available to the
line 19 department upon request.
line 20 (f) (1) Notwithstanding Section 1596.80, a crisis nursery may
line 21 provide child day care crisis day respite services for children under
line 22 the age of six years of age at the same site as the crisis nursery. A
line 23 child may not receive child day care services at a crisis nursery
line 24 for more than 30 calendar days in a six-month period unless the
line 25 department issues an exception. A child who is receiving child
line 26 day care services shall be counted in the licensed capacity.
line 27 (2) The maximum licensed capacity for crisis day respite shall
line 28 be based on 35 square feet of indoor activity space per child.
line 29 Bedrooms, bathrooms, halls, offices, isolation areas,
line 30 food-preparation areas, and storage places shall not be included
line 31 in the calculation of indoor activity space. Floor area under tables,
line 32 desks, chairs, and other equipment intended for use as part of
line 33 children’s activities shall be included in the calculation of indoor
line 34 space.
line 35 (g) Exceptions to group home licensing regulations pursuant to
line 36 subdivision (c) of Section 84200 of Title 22 of the California Code
line 37 of Regulations, in effect on August 1, 2004, for county-operated
line 38 or county-contracted emergency shelter care facilities that care for
line 39 children under the age of six years of age for no more than 30 days,
line 40 shall be contained in regulations for crisis nurseries.
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AB 2228— 3 —
line 1 (h) This section shall become operative on July 1, 2012.
line 2 SEC. 2. Section 1526.8 of the Health and Safety Code is
line 3 amended to read:
line 4 1526.8. (a) It is the intent of the Legislature that the department
line 5 develop modified staffing levels and requirements for crisis
line 6 nurseries, provided that the health, safety, and well-being of the
line 7 children in care are protected and maintained.
line 8 (1) At all times, at least one caregiver shall have completed
line 9 training in pediatric cardiopulmonary resuscitation (CPR) and
line 10 pediatric first aid. Completion of training shall be demonstrated
line 11 by current and valid pediatric CPR and pediatric first aid cards
line 12 issued by the American Red Cross, the American Heart
line 13 Association, or by a training program that has been approved by
line 14 the Emergency Medical Services Authority pursuant to Section
line 15 1797.191.
line 16 (2) The licensee shall develop, maintain, and implement a
line 17 written staff training plan for the orientation, continuing education,
line 18 on-the-job training and development, supervision, and evaluation
line 19 of all lead caregivers, caregivers, and volunteers. The licensee
line 20 shall incorporate the training plan in the crisis nursery plan of
line 21 operation.
line 22 (3) The licensee shall designate at least one lead caregiver to
line 23 be present at the crisis nursery at all times when children are
line 24 present. The lead caregiver shall have one of the following
line 25 education and experience qualifications:
line 26 (A) Completion of 12 postsecondary semester units or equivalent
line 27 quarter units, with a passing grade, as determined by the
line 28 institution, in classes with a focus on early childhood education,
line 29 child development, or child health at an accredited college or
line 30 university, as determined by the department, and six months of
line 31 work experience in a licensed group home, licensed infant care
line 32 center, or comparable group child care program or family day
line 33 care. At least three semester units, or equivalent quarter units, or
line 34 equivalent experience shall include coursework or experience in
line 35 the care of infants.
line 36 (B) A current and valid Child Development Associate (CDA)
line 37 credential, with the appropriate age level endorsement issued by
line 38 the CDA National Credentialing Program, and at least six months
line 39 of on-the-job training or work experience in a licensed child care
line 40 center or comparable group child care program.
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line 1 (C) A current and valid Child Development Associate Teacher
line 2 Permit issued by the California Commission on Teacher
line 3 Credentialing pursuant to Sections 80105 to 80116, inclusive, of
line 4 Title 5 of the California Code of Regulations.
line 5 (4) Lead caregivers shall have a minimum of 24 hours of
line 6 training and orientation before working with children. One year
line 7 experience in a supervisory position in a child care or group care
line 8 facility may substitute for 16 hours of training and orientation.
line 9 The written staff training plan shall require the lead caregiver to
line 10 receive and document a minimum of 20 hours of annual training
line 11 directly related to the functions of his or her position.
line 12 (5) Caregiver staff shall complete a minimum of 24 hours of
line 13 initial training within the first 90 days of employment, which may
line 14 include first aid and CPR and shall be included in the written staff
line 15 training plan. Eight hours of training shall be completed before
line 16 the caregiver staff are responsible for children, left alone with
line 17 children, and counted in the staff-to-child ratios described in
line 18 subdivision (c). A maximum of four hours of training may be
line 19 satisfied by job shadowing.
line 20 (b) The department shall allow the use of fully trained and
line 21 qualified volunteers as caregivers in a crisis nursery, subject to the
line 22 following conditions:
line 23 (1) Volunteers shall be fingerprinted for the purpose of
line 24 conducting a criminal record review as specified in subdivision
line 25 (b) of Section 1522.
line 26 (2) Volunteers shall complete a child abuse central index check
line 27 as specified in Section 1522.1.
line 28 (3) Volunteers shall be in good physical health and be tested
line 29 for tuberculosis not more than one year prior to, or seven days
line 30 after, initial presence in the facility.
line 31 (4) Prior to assuming the duties and responsibilities of a crisis
line 32 caregiver or being counted in the staff-to-child ratio, volunteers
line 33 shall complete at least eight five hours of initial training divided
line 34 as follows:
line 35 (A) Four Two hours of crisis nursery job shadowing.
line 36 (B) Two hours One hour of review of community care licensing
line 37 regulations.
line 38 (C) Two hours of review of the crisis nursery program, including
line 39 the facility mission statement, goals and objectives, child guidance
line 40 techniques, and special needs of the client population they serve.
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AB 2228— 5 —
line 1 (5) Within 90 days, volunteers who are included in the
line 2 staff-to-child ratios shall complete at least 20 hours of training
line 3 divided as follows:
line 4 (A) Twelve hours of pediatric first aid and pediatric
line 5 cardiopulmonary resuscitation.
line 6 (B) Eight hours of child care health and safety issues.
line 7 (5) Within 90 days, volunteers who are included in the
line 8 staff-to-child ratios shall complete at least eight hours of training
line 9 covering child care health and safety issues, trauma informed
line 10 care, the importance of family and sibling relationships,
line 11 temperaments of children, self-regulation skills and techniques,
line 12 and program child guidance techniques.
line 13 (6) Volunteers who meet the requirements of paragraphs (1),
line 14 (2), and (3), but who have not completed the training specified in
line 15 paragraph (4) or (5) may assist a fully trained and qualified staff
line 16 person in performing child care duties. However, these volunteers
line 17 shall not be left alone with children, shall always be under the
line 18 direct supervision and observation of a fully trained and qualified
line 19 staff person, and shall not be counted in meeting the minimum
line 20 staff-to-child ratio requirements, except that volunteers may
line 21 supervise napping children without being under the direct
line 22 supervision of staff.
line 23 (c) The department shall allow the use of fully trained and
line 24 qualified volunteers to be counted in the staff-to-child ratio in a
line 25 crisis nursery subject to the following conditions:
line 26 (1) The volunteers have fulfilled the requirements in paragraphs
line 27 (1) to (4), inclusive, of subdivision (b).
line 28 (2) There shall be at least one fully qualified and employed staff
line 29 person on site at all times.
line 30 (3) (A) There shall be at least one employed staff or volunteer
line 31 caregiver for each group of three children, or fraction thereof, six
line 32 preschool age children, or fraction thereof, and one employed staff
line 33 or volunteer caregiver for each group of four infants, or fraction
line 34 thereof, from 7 a.m. to 7 p.m.
line 35 (B) There shall be at least one paid caregiver or volunteer
line 36 caregiver for each group of four six children, or fraction thereof,
line 37 from 7 p.m. to 7 a.m.
line 38 (C) There shall be at least one employed staff person present
line 39 for every volunteer caregiver used by the crisis nursery for the
line 40 purpose of meeting the minimum caregiver staffing requirements.
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— 6 —AB 2228
line 1 (d) There shall be at least one staff person or volunteer caregiver
line 2 awake at all times from 7 p.m. to 7 a.m.
line 3 (e) (1) When a child has a health condition that requires
line 4 prescription medication, the licensee shall ensure that the caregiver
line 5 does all of the following:
line 6 (A) Assists children with the taking of the medication as needed.
line 7 (B) Ensures that instructions are followed as outlined by the
line 8 appropriate medical professional.
line 9 (C) Stores the medication as instructed in the original container
line 10 with the original unaltered label in a locked and safe area that is
line 11 not accessible to children.
line 12 (D) Administers the medication as directed on the label or as
line 13 advised by the physician in writing.
line 14 (2) Nonprescription medications may be administered without
line 15 approval or instructions from the child’s physician if all of the
line 16 following conditions are met:
line 17 (A) Nonprescription medications are administered in accordance
line 18 with the product label directions on the nonprescription medication
line 19 containers.
line 20 (B) For each nonprescription medication, the licensee obtains,
line 21 in writing, approval and instructions from the child’s authorized
line 22 representative for the administration of the medication to the child.
line 23 This documentation shall be kept in the child’s record. The
line 24 instructions from the child’s authorized representative shall not
line 25 conflict with the product label directions on the nonprescription
line 26 medication container.
line 27 (3) The licensee shall develop and implement a written plan to
line 28 record the administration of the prescription and nonprescription
line 29 medications and to inform the child’s authorized representative
line 30 daily, for day care, and upon discharge for overnight care, when
line 31 the medications have been given.
line 32 (4) When no longer needed by the child, or when the child
line 33 withdraws from the center, all medications shall be returned to
line 34 the child’s authorized representative or disposed of after an attempt
line 35 to reach the authorized representative.
line 36 SEC. 3. No reimbursement is required by this act pursuant to
line 37 Section 6 of Article XIII B of the California Constitution because
line 38 the only costs that may be incurred by a local agency or school
line 39 district will be incurred because this act creates a new crime or
line 40 infraction, eliminates a crime or infraction, or changes the penalty
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AB 2228— 7 —
line 1 for a crime or infraction, within the meaning of Section 17556 of
line 2 the Government Code, or changes the definition of a crime within
line 3 the meaning of Section 6 of Article XIII B of the California
line 4 Constitution.
O
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— 8 —AB 2228