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Virginia Administrative Code (Last Updated: January 10, 2017) |
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Title 22. Social Services |
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Agency 40. Department of Social Services |
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Chapter 60. Standards and Regulations for Licensed Adult Day Care Centers |
Section 699. Assistance with activities of daily living
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If the center serves participants who need assistance with activities of daily living (ADLs), the following standards shall apply:
1. Assistance with eating/feeding.
a. Dining areas shall be supervised by staff whenever meals or snacks are served. There shall be at least one staff member who is trained in the procedures of "abdominal thrusts" in each area when participants are eating.
b. Additional staff shall be present in the dining areas to assist participants who cannot eat independently. These staff members shall be trained in eating assistance techniques.
c. Self-feeding skills of participants shall be continuously observed and evaluated so that meals and snacks are not missed because of a participant's inability to feed himself.
d. Appropriate adapted utensils, including adapted plates/bowls and cups with straws and handles, shall be provided for those participants who need them. Information about effective eating adaptations shall be shared with appropriate family care givers of those participants. Assistance shall be provided to those participants who need it with such activities as opening containers and cutting food.
e. Low-stimulus dining areas shall be provided for participants with head injuries or other conditions that impair concentration.
f. Changes in food and liquid intake shall be documented and changes made in the care plan to ensure adequate intake. Families shall be notified of such changes.
2. Assistance with ambulation/transfer.
a. The ability of the participant to safely transfer and ambulate shall be continually monitored, changes documented, and the plan of care changed to maximize the participant's safety.
b. There shall be adequate staff to provide individualized assistance to get to activities, meals and the restroom if the center serves participants with transfer/ambulation deficits.
c. The center shall have at least one wheelchair available for emergency use, even if all participants are ambulatory or have their own wheelchairs.
d. All staff shall be trained in providing assistance with ambulation and transfer, safe use of ambulation/transfer equipment, and procedures for monitoring and reporting malfunctioning equipment.
e. Staff shall identify unmet needs equipment and repairs, document their recommendations and refer families to appropriate resources, even when participants or families are responsible for purchasing and maintaining equipment.
f. Participants who use wheelchairs shall be offered other seating options throughout the day, if appropriate.
g. There shall be a plan for ambulating those participants who cannot walk independently to maintain maximum mobility.
3. Assistance with toileting.
a. Participants shall be assessed to determine their individual toileting needs. These needs shall be reflected in the plan of care and shared with family care givers. Staff shall follow toileting procedures for each participant, such as transferring techniques.
b. Equipment to aid in toileting such as gait belts, elevated toilet seats, and grab bars shall be available and within easy reach of participants and staff.
c. Participants who are at risk of falling, or who have other safety risks, shall not be left alone while toileting.
d. All supplies, such as incontinence products, extra clothing, and latex gloves, shall be available and prepared prior to toileting a participant so that the participant is not left unattended while necessary items are being retrieved.
e. Staff and participants shall wash their hands after each toileting procedure.
f. Privacy, confidentiality and dignity shall be maintained for participants during toileting, including closing doors and not discussing needs in front of others.
g. Staff shall arrange for coverage of program responsibilities when they must leave the group to assist with toileting a participant.
4. Assistance with bathing.
a. The center shall ensure the privacy and dignity of a participant who is assisted with bathing/showering.
b. A shower chair, bench or other seating, safety equipment such as grab bars, and nonslip surfaces shall be provided.
c. Adequate supplies to complete the bathing process shall be provided such as, but not limited to, towels, soap, wash cloths and shampoo, unless the participant brings these items from home.
d. The participant shall never be left unattended in the shower or bath. If the bathing area is not in sight or sound of other occupied parts of the building, there shall be an emergency call system to summon additional assistance.
5. Assistance with dressing.
a. Extra clothing shall be available for participants who need to change during the day. Each participant can keep a change of clothing at the center or the center can keep a supply to use as needed.
b. Participants' clothing, equipment and supplies kept at the center shall be properly labeled and stored to prevent loss.
c. If the center serves participants who cannot dress themselves, there shall be staff available to assist with coats, hats, and gloves as participants arrive and depart. Assistance with dressing shall be available for those who need it for rest periods and toileting.
d. Special attention shall be given to footwear of participants who are at risk of falling. Staff shall encourage family members to provide appropriate shoes and shall document those recommendations.
Historical Notes
Derived from Volume 16, Issue 12, eff. July 1, 2000.