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Library: Policy

340:75-10-8.3. Care and supervision of shelter residents

Issued 7-1-11

Pursuant to OAC 340:110-3-167, the Oklahoma Department of Human Services managed and operated shelters employ an adequate number of staff as child care workers to meet the needs of residents.  All staff members on duty are awake and accessible at all times.  Shelter staff provide direct care and supervision of shelter residents.  • 1


Issued 7-1-11

1.Staff responsibilities in OKDHS managed and operated shelters.

(a) Direct care specialist (DCS) responsibilities.The shelter DCS:

(1) provides direct care and supervision of children residing in the shelter.The DCS supervisor schedules staff to adequately supervise and meet the needs of the children in residence for each shift per OAC 340:110-3-137(a)(3);

(2) records daily observations.A daily log is initiated for each child upon admission.A DCS on each shift records observations of the child in the child's shelter record;

(3) attends a daily shift change meeting.Each DCS supervisor conducts a daily shift change meeting at the end of each shift for the arriving shift of DCS staff coming on duty to allow the outgoing DCS, shelter nurse, shelter child welfare specialist (CWS), and a recreational staff member to attend and inform the arriving DCS of the day's significant events, plans, difficulties, and each child's plan of care including any health problems;

(4) assists in the development and review of the child's comprehensive service plan.DCS staff attend the weekly initial and review staffings of the shelter multidisciplinary treatment team as assigned;

(5) provides intensive care supervision when necessary for the child who exhibits harmful behavior.

(A) When the shelter CWS and the DCS supervisor determine the child is displaying harmful behaviors, an increased level of supervision is ordered by the DCS supervisor on duty.

(B) The shelter CWS documents the assessment of the child's need and the DCS supervisor designates the level of supervision needed.

(C) The level of supervision ordered corresponds to the assessed need of the child.

(D) The shelter multidisciplinary treatment team may recommend intensive care supervision for a resident.

(E) The DCS shift supervisor going off duty communicates the intensive care supervision plan to the oncoming shift supervisor.

(i) Close observation.When close observation is ordered, one DCS staff is assigned to constantly monitor the resident's whereabouts.The staff member responsible for supervising the resident makes face-to-face contact with the child every 15 minutes, except when the child is in school.

(ii) One-on-one.When one-on-one supervision is directed, the DCS assigned to supervise the resident keeps the resident in sight and within arm's reach at all times, except when the resident is using the bathroom, showering, sleeping, or attending school.Heightened supervision is also provided during sleeping hours.During sleeping hours the DCS observes the child every 15 minutes and documents the observations.The DCS staff responsible for supervising the child on one-on-one status is not assigned supervision of other residents.

(iii) Hands-on.When hands-on supervision is directed, the DCS staff assigned to supervise the resident holds the resident's hand, except when the resident is using the bathroom, showering, sleeping, or attending school.DCS staff resumes the hands-on supervision when the resident returns from using the bathroom, showering, sleeping, or attending school.The DCS staff assigned to provide hands-on supervision is not assigned supervision of other residents.

(iv) Suicide watch.Suicide watch is ordered when the shelter CWS assesses a child to be at risk for suicide.

(I) The CW worker is notified by the shelter CWS or the DCS supervisor when a child is placed on suicide watch.Arrangements are made for a behavioral health assessment through the gatekeeping process, by the on-duty shelter CWS in coordination with the CW worker.The assessment is documented in the child's shelter record by the shelter CWS who also notifies the DCS supervisor on-duty of the assessment result.

(II) The DCS supervisor assigns DCS staff to stay within arm's reach of the child at all times.The DCS staff provides ongoing reports to the shelter CWS of the child's behavior.The child sleeps in view of the assigned DCS staff.The assigned DCS staff is not assigned supervision of other residents.

(v) Reassessing the level of supervision.A child's need for any level of intensive care supervision is reassessed by the DCS supervisors and the shelter CWS during each shift change meeting.The intensive care supervision is continued, revoked, or modified.Each plan for intensive care supervision is reviewed by the multidisciplinary treatment team weekly.The team reassess the level of supervision required.

(b) CW worker responsibilities for children in shelter care.Close coordination between the shelter staff and the assigned CW worker is essential for developing and implementing a successful plan of care for the child during the child's shelter residency.The CW worker:

(1) provides information to the shelter including, but not limited to:

(A) demographic information;

(B) family background information;

(C) medical information such as medications, allergies, immunizations, and medical appointments;

(D) behavioral or emotional assessments;

(E) school data;

(F) legal status;

(G) drug usage;

(H) violent, assaultive, or suicidal behaviors;

(I) placement plans; and

(J) any other pertinent information.

(2) provides, obtains, or coordinates with the shelter CWS any services the child receives outside of the facility;

(3) coordinates services for the child with the shelter CWS to ensure the child's needs are addressed;

(4) approves visitation for the child and coordinates visits through the shelter CWS staff;

(5) initiates or ensures the necessary procedures to initiate all applicable benefits and services for the child are obtained including, but not limited to:

(A) foster care IV-E eligibility determination referral;

(B) Title XIX eligibility determination referral;

(C) birth verification;

(D) Social Security number;

(E) Supplemental Security Income (SSI);

(F) enrollment termination from Health Maintenance Organizations (HMOs) for the child who received TANF or medical assistance prior to admission;

(G) SoonerStart, when applicable;

(H) referral for child to Developmental Disabilities Services Division, as applicable; and

(I) placement worksheet;

(5) assists the child in adjusting to the shelter environment.The helping role of the CW worker is critical for the child and the child's family.The CW worker facilitates the child's adjustment at the shelter and aids in the child's understanding of, and adjustment to, the situation.Assisting the child through the trauma of being removed from familiar surroundings is vital to the child's emotional well-being, future growth, and development;

(6) conducts a face-to-face contact with the child during the initial 23 hours of the child's placement in the shelter;

(7) conducts face-to-face contact with the child in the shelter a minimum of one time per week and documents the contact in KIDS.During each visit the CW worker addresses the child's concerns, informs the child of upcoming events such as placements, court hearing dates and outcomes, and visitation plans with family.The CW worker communicates his or her perceptions of the child's adjustment to the shelter CWS;

(8) provides ongoing updates to the shelter CWS regarding the child's needs, legal status, and placement plans;

(9) communicates regularly with the child's family regarding the child's health and welfare, or other concerns as applicable during the child's shelter stay;

(10) initiates the placement process, with the exception of emergency foster care; and

(11) shares information relevant to the child's care with the emergency foster care agency, when applicable.

(c) Travel distance and CW worker responsibilities.When the CW worker must travel more than 60 miles one-way from his or her assigned work location to an OKDHS managed and operated shelter to visit a resident the:

(1) CW supervisor responsible for the child's case requests a CW worker in the shelter's county be temporarily assigned to the child during the child's stay in the shelter;

(2) child's CW worker maintains weekly contact with the shelter CWS and coordinates services with the CW worker temporarily assigned to the child; and

(3) temporarily assigned CW worker conducts weekly face-to-face visits with the child.

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