Library: Policy

340:110-1-47. Case management

Revised 11-1-20

(a) Periodic visits.

(1) Licensing staff conducts monitoring visits documenting compliance with requirements. Required monitoring visits annually include two: • 1

(A) unannounced and one announced, to residential programs; • 2 and

(B) announced, to child-placing agencies. • 2

(2) When caseloads prevent Licensing staff from conducting the required monitoring visits, the programs manager consults with Licensing staff on case management, and the required monitoring visits may be reduced. This adjustment is approved and documented in the case file by the programs manager.

(3) During each monitoring visit, Licensing staff:

(A) observes the entire facility, including outdoor play space and transportation, when available; and

(B) verifies:

(i) compliance with Licensing requirements;

(ii) resident files, when applicable;

(iii) new personnel records including personnel sheets and compliance with background investigations, per Oklahoma Administrative Code (OAC) 340:110-1-8.1; • 3

(iv) the Oklahoma Department of Human Services (DHS) database on applicable individuals, per OAC 340:110-1-8.1;

(v) Form 07LC092E, Insurance Verification, within the previous 12 months;

(vi) fire and health inspections within the previous 12 months, when applicable; and • 4

(vii) other documentation requiring renewal.

(b) Consultation and technical assistance. Licensing staff provides technical assistance to operators to meet and maintain minimum requirements. Consultation is provided to parties interested in licensure and to licensed programs, and includes suggestions for improving the quality of care and for exceeding minimum requirements.

(c) Address change. When a program moves to a new address, Licensing staff follows procedures in this subsection to document the change. • 5

(1) Child-placing agency. When a child-placing agency moves its office, Licensing staff:

(A) obtains an updated Form 07LC040E, Request for License Child-Placing Agency and Residential Child Care; and

(B) requests a permit or license be issued reflecting the address change.

(2) Residential program. When a residential program moves, Licensing staff:

(A) obtains an updated request for license;

(B) conducts a monitoring visit verifying the new location meets Licensing requirements;

(D) obtains Oklahoma Department of Environmental Quality approval, when applicable;

(E) completes an updated physical plant drawing with required calculations; and

(F) requests a permit or license be issued reflecting the address change.

(d) Satellite office. When a child-placing agency adds a satellite office, Licensing staff:

(1) documents each office location; and

(2) requests needed files from satellite locations.

(e) Program or agency name change. When Licensing staff verifies there is a name change but no ownership change, the name change is documented in the case file and the database is updated. A new Form 07LC040E, Request for License Child-Placing Agency and Residential Child Care, reflecting the name change is completed. Licensing staff requests permit or license issuance reflecting the new program or agency name. • 6

(f) Executive or program director change. When there is a director change, Licensing staff:

(1) verifies the new director meets qualifications;

(2) obtains the applicable page of Form 07LC040E, Request for License Child-Placing Agency and Residential Child Care, completed by the new director;

(3) obtains an appropriate, Form 07LC056E, Compliance Review-Residential Child Care Facility; or Form 07LC043E, Child Placing Agency Compliance Review, completed by the executive or program director;

(4) notifies the new director of current personnel granted a waiver; and • 7

(5) documents the information on Form 07LC080E, Licensing Services Supplemental Information.

(g) Capacity increase or decrease. When a program requests a capacity increase or decrease, it is documented on Form 07LC080E, Licensing Services Supplemental Information, and must be approved by the programs manager. When the increase involves new construction, architectural plans approved by the State Fire Marshal are submitted to Licensing for approval prior to construction. When the request to increase capacity is due to additional physical space, the required documentation includes:

(1) the reason for the increase;

(2) fire department approval;

(3) health department approval of additional food preparation space not previously inspected;

(4) a physical plant drawing indicating required calculations; and

(5) the request for additional personnel, when applicable. • 8

(h) Inactive programs. A program is inactive when care or child-placing agency activity was not provided for more than 90-calendar days.

(1) A program remaining open after 90-calendar days submits a request in writing including a statement the owner will notify Licensing prior to resuming care or child-placing agency activity. Licensing staff verifies compliance with requirements prior to resuming care.

(2) The program is contacted by Licensing staff, a minimum of every four months for residential programs; and a minimum of every six months for child-placing agencies by phone, letter, or email to update the program status including changes in personnel, household members, or other program changes.

(3) Voluntary closure is discussed with the owner and an agreement to close is reached, when possible.

(4) Licensing staff monitors the inactive program, at least once during the 12-month timeframe verifying compliance with Licensing requirements until closure is final or the program resumes care. • 9

(5) When an address change occurs during the time a program is in inactive status, a monitoring visit is required and address change is followed per (c) of this Section.

(i) Inactive program closure. Procedures in (1) through (4) of this subsection are followed when closing an inactive residential program or child-placing agency.

(1) To verify program status, Licensing staff contacts the program or agency owner during the 12th month of inactive status.

(2) Licensing documents program status on Form 07LC080E, Licensing Services Supplemental Information, and notifies the owner the case will be closed when care or child-placing activity does not resume prior to the end of the 12th month.

(3) When care was not provided for 12-consecutive months or longer, Licensing staff provides a letter notifying the owner of case closure within 10-calendar days of letter receipt, unless Licensing is notified care or child-placing activity resumed.

(4) The case is closed and the owner must reapply and be approved for a new license prior to resuming care, per OAC 340:11-1-45.

(j) Change in ownership. When there is a change in ownership or a change in the business organization of a residential program or child-placing agency, the case is closed, and the program must apply for a new license. Prior to permit or license issuance, the program must comply with background investigations, per OAC 340:110-1-8.1. A permit may be issued when a monitoring visit without numerous, repeated, or serious non-compliances was conducted within the past 60-calendar days. A full-monitoring visit is conducted within 14-calendar days of ownership change, verifying the new owner is able to meet minimum Licensing requirements. • 10

(k) Transitional change of ownership. When a residential program or child-placing agency requests a transitional change of ownership (1) through (5) of this subsection are followed.

(1) Licensing staff conducts a monitoring visit within five DHS-business days, verifying compliance with Licensing requirements and, obtains: • 11

(A) Form 07LC015E, Transitional Change of Ownership, completed by the current and prospective owners;

(B) Form 07LC040E, Request for License Child-Placing Agency and Residential Child Care, completed by the prospective owner; and

(C) a current personnel list, verifying the prospective owner employs the same personnel as the current owner, at the time of transitional change of ownership.

(2) Periodic and ongoing monitoring is maintained, per (a) of this Section.

(3) All Licensing monitoring and correspondence are provided to both the current and prospective owners.

(4) Change of ownership procedures are followed, by the end of 90-calendar days, when applicable, per (j) of this Section.

(5) When programs notify Licensing the transitional change of ownership is no longer proceeding, Licensing staff verifies program operation or child-placing activity status and consults with the programs manager for appropriate action.

(l) Response to a child death. When notified of a child death while in care, Licensing staff:

(1) completes Form 07LC079E, Child Death Report, and forwards it to the statewide licensing coordinator or designee; and

(2) visits the residential program as soon as possible, and contacts the child-placing agency unless advised otherwise by local law enforcement officials. • 12

(m) Serious incident reports. Licensing staff submits a serious incident report to the programs manager. Serious incidents include at least, incidents: • 13

(1) resulting in the serious injury or child death, such as a:

(A) shaken baby;

(B) drowning or near drowning; or

(2) placing a child at a high risk for death or injury, such as when a child is left:

(A) at a location away from the facility;

(B) unattended in a vehicle; or

(3) resulting in significant facility damage, such as:

(A) fire;

(B) flood; or

(n) Coordination with state agencies. Licensing staff works cooperatively with the DHS Office of Client Advocacy and Child Welfare Services, the Oklahoma Commission on Children and Youth, the Oklahoma Health Care Authority, and local law enforcement. • 14

INSTRUCTIONS TO STAFF 340:110-1-47

Revised 11-1-20

1. (a) Residential program monitoring visits are documented on the monitoring checklist.

(b) The programs manager is consulted for appropriate action regarding program monitoring safety concerns. Appropriate action may include the utilization of a witness and/or coordination with local law enforcement officials.

(c) During the announced monitoring visit, Licensing staff:

(1) verifies personnel professional development records; and

(2) discusses the monitoring checklist with the program's or the child-placing agency's director or personnel in charge. The director or personnel in charge signs the monitoring summary and Licensing staff provides the program's owner/operator or the child-placing agency's director with a copy.

(d) When documents are received from a program, other agencies and outside sources, Licensing notations are made on a copy of the received document.

(e) Weapons and ammunition are monitored per (1) through (4) of this Instruction.

(1) During the initial program monitoring or when Licensing staff has not previously monitored the program, Licensing observes weapon and ammunition storage, per applicable Licensing requirements.

(2) During subsequent monitoring visits, Licensing staff asks about weapons and ammunition storage and verify it is locked.

(3) Weapons and ammunition are not removed from locked containers for Licensing observation.

(4) Storage locations are not viewed in children's presence and for confidentiality are documented on Form 07LC080E, Licensing Services Supplemental Information.

(f) When photographs are needed for non-compliance determination, procedures in (1) through (3) of this Instruction are followed.

(1) Licensing documents discussion of the photographs with the operator.

(A) Photographs are:

(i) not enhanced or altered; and

(ii) printed, attached to Form 07LC080E, Licensing Services Supplemental Information, documenting discussion with the supervisor and placed in the case file.

(2) Photographs are deleted from cell phone devices.

(3) When the program is uncooperative, Licensing does not proceed with taking photographs, discussing the alternatives, and consults with the supervisor for appropriate action.

(g) Licensing requirements not reviewed during partial- or full-monitoring visits are documented on the monitoring checklist.

(h) Partial-monitoring visits include documentation regarding:

(1) first page completion including staff-child ratios;

(2) weapons; and

(3) criminal history and new household members.

(i) A full-monitoring visit is conducted when numerous, repeated, or serious non-compliance with requirements, per Oklahoma Administrative Code (OAC) 340:110-1-47.2 are observed during a partial-monitoring visit.

(j) When Licensing staff visits a program between monitoring visits for purposes, such as picking up paperwork, consulting on a specific issue, or verifying a repair was made, a full-monitoring visit is not required.

(k) Case files are maintained in the Oklahoma Department of Human Services (DHS) office where Licensing staff is located. Files are complete and information is filed in the appropriate manner.

(l) Confidential information, such as identifying child information, including initials, is documented on Form 07LC080E, Licensing Services Supplemental Information, and placed in the confidential case file section.

(m) Licensing staff conducts searches on the DHS database and the Oklahoma State Courts Network (OSCN) on applicable individuals, per OAC 340:110-1-8.1(g).

2. When monitoring residential programs and child-placing agencies, applicable file reviews and monitoring checklists are completed. After each monitoring visit, Licensing staff enters the monitoring-frequency plan reflecting the required number of monitoring visits annually on the Licensing database. Changes in the monitoring-frequency plan are reviewed with the programs manager. Examples of the required number of monitoring visits annually include:

(1) one for inactive programs;

(2) two for programs with a compliant history;

(3) six for request for license and six-month permits; and

(4) twelve for programs with a pattern of serious non-compliances.

3. Personnel sheets are maintained in the case file for 12 months after employment ends. Personnel sheets are purged for public viewing. Licensing staff documents personnel Social Security Administration name changes on Form 07LC080E, Licensing Services Supplemental Information, attaches it to the personnel sheet, and notifies the Office of Background Investigations (OBI) to update the database. A new personnel information sheet is not required.

4. Procedures for monitoring fire and health inspections in (1) and (2) of this Instruction are followed.

(1) Licensing reviews on-going fire and health inspections and copies are not required for the case file.

(2) When the inspection has Licensing violations, it is documented as a non-compliance and a copy is maintained in the case file. However, when health inspections are not conducted timely, Licensing staff notifies an appropriate Child Care Services (CCS) designee and it is not documented as a non-compliance.

5. The database is updated with the new address. The statewide licensing coordinator or designee issues a new license reflecting the initial license date. Current personnel do not acquire a new employment date or require a new background check.

6. Licensing staff notifies the programs manager. The statewide licensing coordinator or designee issues a new license reflecting the initial license date and Licensing staff is provided a copy.

7. When requested, directors are provided a waiver notice copy.

8. The programs manager reviews the recommendation and approves or denies the increase. The licensee is notified in writing when the increase was approved. When a capacity increase is requested for reasons other than an increase in space, the recommendation to the programs manager is made in narrative form with the increase reason. The procedure for increasing or decreasing program capacity is in (1) through (4) of this Instruction.

(1) Increase. Programs must provide a written request for capacity increase. Licensing staff:

(A) verifies current fire and health inspections and notifies the Office of State Fire Marshal to determine when another inspection or further evaluation is required and documents the contact on Form 07LC080E; Licensing Services Supplemental Information, and

(B) does not recommend a capacity increase when the program has numerous, repeated, or serious non-compliances with requirements. When the only serious non-compliance was the program exceeded capacity, the programs manager is consulted for appropriate action.

(2) Decrease. When decreasing capacity, Licensing staff updates the floor plan indicating rooms available for children's use.

(3) Capacity increase or decrease. A capacity increase or decrease recommendation may be made by submitting a narrative report to the programs manager.

(4) Approval. When capacity change is approved, the programs manager or designee issues the program a license reflecting the capacity and the original license issuance date. A license copy is provided to Licensing staff.

9. A full-monitoring visit is conducted 12 months from the last full-monitoring visit and not from the time the program or agency was considered inactive. This visit may be announced to ensure someone is present.

10. (a) Ownership types include, a:

(1) sole proprietor;

(2) corporation;

(3) partnership;

(4) limited liability company; or

(5) school, faith-based, or government entity.

(b) When a change of ownership results in six-month permit issuance, fire and health inspections conducted within the previous 12 months are accepted.

(c) When a change of business entity results in a license issuance, fire and health inspections conducted within the previous 12 months are accepted.

(d) New program construction, additional square footage not previously included in licensed capacity, or kitchen alterations affecting food service require new fire and health inspections.

(e) For circumstances in (b) and (c) of this Instruction, previous inspection copies are maintained in the new program file.

11. Transitional change of ownership.

(1) Monitoring visits are conducted under the current owner's program.

(2) All copies of Licensing monitoring and correspondence are filed in both the current and prospective owners' case files.

(3) All of the current owner's Licensing history is available to the prospective owner on request, including revocation or denial of license information.

(4) Licensing staff follows-up with the program or child-placing agency when the 90-calendar day timeframe is approaching to verify program operation status in efforts to avoid disruption of care or providing of services.

12. When notified of the death of a child in care, Licensing staff:

(1) determines and documents what occurred. Documentation includes:

(A) the child(ren)'s names, ages, and number present, and personnel present at the incident time;

(B) what supervision was provided during this time;

(C) when the caregiver last checked on the child;

(D) the caregiver's response on finding the child; and

(E) the names of the personnel involved, when possible;

(2) obtains pertinent program records, including attendance records for children and personnel present at time of death;

(3) notifies the licensing programs manager and CCS director; and

(4) considers whether the death is possibly related to Sudden Infant Death Syndrome (SIDS) or other sleep related causes, and when so, refers to OAC 340:110-1-9(q).

13. A serious incident report includes:

(1) the name and age of child(ren) seriously injured or killed;

(2) the incident date and time;

(3) a description of child(ren)'s injuries or facility damage;

(4) the caregiver's account of the incident;

(5) a summary of other contacts made with agencies involved in the investigation, such as Child Welfare Services (CWS) or local law enforcement officials;

(6) pertinent information regarding the caregiver's history, such as prior involvement with CWS or a history of numerous, repeated, or serious non-compliance with Licensing requirements; and

(7) the names of personnel involved.

14. Reports from the Office of Client Advocacy (OCA), CWS, the Oklahoma Commission on Children and Youth (OCCY), the Oklahoma Health Care Authority (OHCA), and local law enforcement.

(1) The programs manager reviews all reports received from OCA, CWS, OCCY, OHCA, and local law enforcement.

(2) All reports received from OCA, CWS, OCCY, OHCA, and local law enforcement are reviewed for possible non-compliances with Licensing requirements. When the review of information indicates non-compliances residential Licensing staff investigates, per OAC 340:110-1-47.2 or investigates a complaint investigation, per OAC 340:110-1-47.1.

(3) When a referral is received from the Child Abuse and Neglect Hotline, Licensing staff reviews the information to determine if the referral was screened-out or accepted by OCA for investigation.

(A) When a referral is screened-out, Licensing staff determines if the:

(i) report was made by an outside entity. Allegations of non-compliance with Licensing requirements are treated as a Licensing complaint, per OAC 340:110-1-47.1; or

(ii) information was self-reported. Licensing staff follows up with the program to address possible areas of non-compliance using case management responses to non-compliant programs, per OAC 340:110-1-47.2.(c). This contact is documented for the case file.

(B) When OCA accepts a referral for investigation, Licensing staff assists with the investigation, when requested, by the OCA investigator. The final report is reviewed for substantiated findings, personnel misconduct, and areas of concern violating Licensing requirements. Licensing staff follows up with the program using case management responses to non-compliant programs, per OAC 340:110-1-47.2(c).

(4) The statewide licensing coordinator is consulted regarding release of confidential information.