AGENCY OF HUMAN SERVICES DEPARTMENT FOR CHILDREN & FAMILIES License to Operate 4 Residential Treatment Program Granted to New England Kurn Hattin Homes, Inc. 708 Kurn Hattin Road Westminster, Vermont in accordance in Title 38, Vermont Statutes Annotated, as amended, Section 2851. TERMS OF THE LICENSE ib “MAXIMIM NUMBER OF CHILDREN: 108 children, male & female, 8 — up to 15 years of age If) This license is granted in consideration of the application thereof and said application and all If) statements, information, answers, promises and agreements. therein contained are hereby % Ip) referred to and made 4 part hereof Commissioner’, Dave Yacovone UNLESS SOONER REVOKED OR SUSPENDED> VERMON State of Vermont Agency of Human Services Department for Children and Families Family Services Division 103 S. Main Street, Waterbury, VT 05671-2401 www.def.state.vtus/fed/ February 7, 2014 Mr. Charles Kelsey, President New England Kum Hattin Homes, Inc. River Woods @ Exeter 5 White Oak Drive Exeter, New Hampshire 03833 Dear Mr. Kelsey, Enclosed is the licensing report for New England Kurn Hatin Homes, Inc., reflecting the September 30, 2013 site visit. ‘The original license has been sent to Co-Executive Director, Thomas Fahner. New England Kurn Hatin Homes, Inc. is in compliance, but with reservations to regulation 202, which reads, “A Residential Treatment Program shall ensure families and custodians the folowing rights: to access written information about the providers policies and procedures that pertain to the care and supervision of children, including @ description of behavior management practices: to receive services with respect for confidentiality, to be involved in assessment and service planning: to give and to withhold informed consent; to be notified immediately or as soon as reasonable of any runaway, attempted suicide, suicide, or medical emergency requiring the services of an Emergency Room or hospitalization, death or any other seminal event in the life of their child/youth; to be notified within 24 hours following the restraint or seclusion of their child/youth; fo fle complaints and grievances without fear of rotafation. “Parental notification within 24 hours...” needs to be added to Community Handbook, page 9 and revised page sent to parents by March 15, 2014. New England Kurn Hattin Homes, Inc. is also in compliance, but with reservations, to regulations 308 and 420, both address the content of personnel evaluations. The intent of the regulations is to ensure employees receive regular and concrete feedback that enhances their professional growth and development. Regulation 306 states, “The Governing Authority is responsible for ensuring the writing of an annual evaluation of the Program Administrator, based on the job description which delineates the responsibilities and authority of the Program Administrator.” While evaluations are written they are very “general and are not based on the job descriptions. Regulation 420 states, “The evaluation willidentfy areas of competence and docurnent targets for growth and development to be reviewed at established intervals.”Generally, evaluations don't target areas for growth, and lack follow up at established intervals. ‘These documents will be reviewed for improvement at the next annual site visit in September 2014. lf you have any questions, please contact me. Sincerely, Ronble Nanaia Croebde Brenda Dawson Crocket, MSW Residential Licensing & Special Investigations fn Forkes Jim Forbes, MSW, MPA, Director Residential Licensing & Special Investigations Enclosure C: Thomas Fahner, Co-Executive Director, N-E. Kurn Hattin Homes, Inc. Connie Sanderson, Co-Exe. Director, N.E. Kur Hatin Homes, Inc. ~via e-mail Gillie Hopkins, Interstate Compact Coordinator, State of Vermont via e-mail fileRESIDENTIAL TREATMENT PROGRAM. Licensing Report L New England Kurn Hatin Homes, Inc. Original faces] Adare PO Box 127, 708 Kum Haitin Road First Reficonse ae [ Westminster, Vermont 05158 Renewal zeae CEA] Telephone: (802) 722-3336 ‘Website: www.kumhattin.org Licensed Capacity: 108 | He - Gender: M&F Daie(S) oF Site Visit | September 30, 2013, Age! B—upto 1S licensor(s) Brenda Dawson and Jennifer Benedict Methodology Review. Review. infeniow: X Application Documents X Program Description X Chikdren/Youth X Fire Safety Inspection documents | X Program Policies & Procedures X Parents X Minutes of Board Meetings X Organizational Chart X Direct Care Staff X Communication logs X Staff Rosterifiles/background Checks X Supervisory Staff X Medication logs X Staff Schedules X Clinicians X Evacuation dri logs X Staff Training Records/Supervision | X Administrators X Secretary of State Website X Glient files X Collateral agencies/depariments fe X_Inspect physical faclifyies) PROGRAM DESCRIPTION: Excerpt from Kum Hatin Website: “The peaceful Vermont hillside overlooking the Connecticut River Valley was a fitting place to launch a dream. In 1894, Charles Albert Dickinson, a clergyman of great stature and influence in Boston, a humanitarian who worked tirelessly to improve the lot of the less privileged, came home to Westminster, the Vermont village where he had been born and raised With the help of colleagues and townspeople Reverend Dickinson founded Kum Hattin Homes, a place where children could find a secure and supportive haven during a troubled period in their families’ lives. Surrounded by caring and loving adults, the boys and girls thrived in the bucolic setting. They attended school, milked cows, grew produce, repaired buildings, sewed clothes, played games, put on musical shows, built snowmen, went to church, swam in the swimming hole - typical enterprises of a New England childhood. Over the next century, under the direction of strong leaders and a devoted staff, Kum Hattin grew in size and reputation. Word spread near and far of the remarkable program and total commitment to helping at-risk children grow physically, intellectually, emotionally and socially. Today, some 105 boys and girls, ages five to fifteen, and staff members form the Kum Hattin community. Reverend Dickinson would certainly feel at home at the Kum Hattin of today.” REGULATORY OVERSIGHT ‘Complanée | RecarmendatonaiCommenis TTR Roaidontar Teatro Program shana be ops wit te oral por — approval ofthe Degarimert for Chitron and Femiios, Reson Ucesing Unt rear Licenting Auorty) c {Gz A progr wich was aledy operational Belo Wo need fr @ ease Wit Gelerminos, may be corded to be'm companes fo progam has apple for Sno mating sitsfncon progress toners Soo. c Incorporated August 18, 1894] "103 A Residential Treatment Program shal alow the Lessing Autry to wepectal | aspects ofa programs operation which may impact chikdrenlyouth 106 A Residential Treatment Program shal allow ihe Licensing AUoTiy to FIswvew any emplayee of the program and any chiKiyoutn in the care of the Residential Treatment Program. c 7105 Theso regulations are not meant fupersade State of Federal mandatas € PROCEDURES05 An applicant shal apaly Tor's Teanee on form provided by The Lcencing ‘Aulhorty and provide requested information. 407 Won @ Rosidontel Treatwent Program fas made iney and suticent application for iconsing ronowal, the existing teense does not expire uni the ‘pplication for renewal has been acted upon by the department 4108 A Tcense may be Gaved vith conditions wen roguations hava not Baan met, proviced that the non-compliance does rot const an unsafe sitaon o° a major programmatic weakness and the program acts immediately to address the identified on-complince. VARIANCE HEA Restdenial Treaiment Prosram shall comply wit all applicable regulations unless 2 vatance fora specific ogulation(s) has boen granted tough a prior writen ‘agreement with the Licensing Autor, “Ti3 A variance for spectic rogulaton(s) shal ba Granted envy when be Residential ‘Treatment Program has documenied that the invent of these regultin(s) all be satisfactorily achioved tra maaner othe: than that prosortod bythe regulation), “114 Whon a Residential Treatment Program fais to comply with the varanos ‘2greement the agreement shal be subject lo immediate cancelation. RENEWAL, "175 Asgicaton Tor renewal of a Resienilal Teaiment Program lesise shall be wad in accordance wit the polices and procedures of the oensie suthoiy. ‘Application received 05/08/2013 ‘CHANGES: “116 A Residential Treatment Program shal nobly the Licensing Authoriy atleast 60 days below any of the following: A substantal change in services provided or population eerved, A glanned change in staffing pattem, A planned cnange in the Admigistiation; A planned chango of ownership andlor governance, A planned change of Iocation A planned charge in the rame of the Residential Treatment Progam RLSI was notified of Chris Barry's retirement and the decision to hire ‘Tom Fahner and Connie Sanderson and Co-Executive Directors, 117 A ReaiGental Tresiment Program shal noth Whe Testeing aulhoniy as coon 3S the change & known, # any of the above mentioned changes occur without prior planning REPORTING 118 A Residential Treatment Program shal report any suspected or aleped inant of child abuse 0: neglet within 24 hour, fe the Department for Chgron and Familie, Centralized Intake Unt. (53 S.A. Chapter 49, $4913) 19 A Residential Treaiment Prosfam wil supenise and separate the accused IncveiaKe) and the vieten(e) whose behavior cauted report tothe Department for Children ard Families unless or untlotheruse instructed By The Special investigation Uni angio Reena! Lieoneing Uni. 120 A Residential Treatment Program shallrepor laeats of sexual acy between residents, as defined in these regulations, within 24 nours to the Deparment for CChilaren and Fame, Centralized inlake Unit (800) 840-5285, INVESTIGATIONS “THUR Residential Treatment Program shal cooperate fuiy iv investigations of any complaint of allegation associated withthe program, This may Include, bul = not lined to the Department for Chikren ard Familas Specal Investigations Unk, and {he Lieesing Author NOTIFICATION 422 A Reatential Treatment Program shal immediately, of as soon as reasonable, ropor to the Licensing Aunty incidents that could potently affect the safely, Dhysical or emotional welfare of chirenyouth within the program, Willen report shal foliow verbal report witin 24 hours 428 Incidents of restraint which result W iyury Te a ehiBiyouth or sia mamber, requitng medical attenbon shall be reportad in wring to the Licensing Authorky as soon as possibie, and not ater than within 24 hours, see regulation 65 24 Inedonts af cocusion which result to injury to & chidiyouth or sta amber, requking medical attenion shall be reporiad in wring to the Licensing Authotly as ‘soon as possible, and not later than within 24 hout. (eve regulation 655) c 125 Resentil Treatment Program shall report, verbally and in wring wit’ 2 hou to he Licensing Authority incidents where the program knowinaly or negégentiy c ilatesloensing regulations 200 GENERAL PROVI: SIONS THE RIGHTS OF CHILDREN/YOUTH AND FAMILIES 20 A Residsniial Trostment Progiam shal ensure chiereniyouh te Towing (Gh: to be served unet humane eonaitions wih respect for thelr dgnty and privacy, to receive serves that promotes their arcuth and develooment, to recsive gender specif, cuturaly competent and Ingulsticaly appropriate service; receive services inthe east restive and most eppropriste enviroment, to access writen information about the providers policies and procedures that pertain to te care and supervision of ehilaren, eluding a Gesccpton of behavior management pracics; to be served with respect for contisertialty: to be involved, a5 aporoorate 10 age,‘eielopmant and abiiy, Ir ssseeemant and atice planning: tobe Fee fom Farm By caregivers or others, and from unnecessary or excessive use of restraint and Sseclusionfsolation, to fla complaints and giavances wéout fear of retalan, 202 A Residential Treatment Progam shall ensure families and custodians the following rights: to access witten information about the providers policies. ang procedures that petain fo the care and supenison of ciluren, cluding a description Df behavior managoment practices; to recawe servcos wih respect for confertialiy, to be involvad in assessment and sence planing: to give ard to withheld Informed Consent, to bo noted tnmadiataly or as soon’ as reasonable of any runaway, faticmpted suleke, suckle, or mede=l emergency requiring the senices of an Emergency Room or hospiakzation, death or any other seminal event inthe ie of their chldyouth to, be notified wihin 24 hours following the restraint or ‘seclusion of their chiltyouth; to fle complsinis and grevanoes wihout fear of Fetalation c ‘Add “parental notification” within 24 to Community Handbook, page 8 203 A ResiGoniial Treatment Program shal document prokbifons and Tmniations regarding parental involvement in the chediyouth's Plan of Care and review such prohibitions end imitations st least every 90 days Cc 300 THE GOVERNING AUTHORITY ‘307 A Residential Teaiment Pregiais shall be mosspoatod, W incorporated outeice the Stale of Vermont, shall secure authorization from the Secretary of State to do business in Vermont By laws adopted 1912 and updated September 2003 BO The Govering Athorty 1 wiimaiely responebie for al” aspecis of the Reeidertal Trestmart Program, 303 The Gaveining Authoriy shall make avaliable to the Lessing Autiorly, upon writen request, a ist of ciectors and ofcers of the boar. 308 Tho Governing Auhoriy shalt Review major operational dacsionss ave provisions which precluce both the fact and appearance of confit of interest, Speciy ‘he toms of eppoinment of eloction of members, oftcers, and chatpersonie) of cormmitees; Saeciy the Fequency of meetings and attendance requirements, Prtibt Dard members from being paid members ofthe staf. ‘308 The Governing Authovly of a Residential Treatment Progra shall paint a {qualified acini stator. ‘Tom Fahner & Connie Sanderson ‘305 The Governing AUthorty Te TeSpOnSIBIE for ensuring the wing’ oF an annual evaluation of the Program Adminstrator, based on the jeb descretion which Salineates the esponsibties and authority ofthe Program Administrator c Evaluations are wiltten, but they are very "general’ and are not based on the job descriptions. 307 The Gaverring Auboriy i responsible for assuring the Residential Teaiment Program's continual complance and conformity with the folowing. The program's Stated goals and cbjectves; Relevant laws endior regulations, whether federal, tate, local or municipal, governing the operation of the Rescentl Treatment Program This may include, But iS not fmited to Zoning, Department of Public Safety, Fre Provention; Deparment of Healt, nerstate and Intemational Pacamnt of Chicren; “The Prison Rape Elimination Act of 2003, 308 The Governing Autiorty shall ensure: Development and on-going review of ‘rogram policies and procedures; Development ard reviaw of annual budgets to cary Dut he objectives ofthe Residential Treatment Program: Any fund easing, compmaity ‘adity, Bubcty oF esearch involving childrenlyouth Is conducted in a manner wich respects the dignity and rights of chidron, youth and thoi families and comple with allrelevant state and federal ws regarding confidently, ‘208 Ths Governing Auiioriy shal require and review an annual epor witten By he ‘administrator of the program waich evaluates the program in lation to he program esexption with the goal of consinvous quality provement. ‘310 The annual assessment shall ently indicators tat TOSGUre tho prOSTaATS ablity to Gaver tho services described in the program description. These indicators ‘may consiter (but are not restricted t) the folowing: The nurabor and cumstances of planned discharges; The number and ceumstances of unplanned discharges, Consumer edback: Provision of adequate Superveion a= evidenced by al reports of chiki abuse, sexual contact between childreniyouth; Grievances heard, resolved and Unresolved: Personne! ectlone takon Stat turnover; and Employee satisfaction ‘400 PERSONNEL GENERAL “GOLA Ratidatiial Tieaimstt Progian’ shal nat Bre, oF orinus to empley, any person whose health, behavior, afions or judgment might endanger the physial or ‘emotional wed-being of ho chilen/youth served “402 A Residential Trealient Program Shall not Wi pfson substantiate for child sbuse or noaloct ‘oF continue t employ, any “403 Thre shall be a sufclent number of personnel qualified by education, Walnng and experience with sufficient authority to adequalaly perform the following functions ‘Administrative; Financial, Supervisory, nial, Case Management; Direct childcare, Housekeeping: Maintenance; Food se-vce; Maintenance of records ‘404 A Residential Trestment Program shall have writen job dseoipions Tor al Positions within the program, including tines of authriy, which are accessible to all “Job descriptions have been updated within the last two yearser 405 A Resident Treatriont Program shall Gneuro that GPO Chia Gare emplOvwOS hve requlaly senaculed how's of work 405A Reskdental Treatment Program shall cHlabIGh pOkGES goverTing employes ‘onde Those poles shall be designed to promote: Good role modeling, Adequita ‘supenision of childrenyouth; The development of heathy relationships between Found in the Employee Handbook under ‘professionalism® ul, elgrenyouth QUALIFICATIONS WOT The Gedeitals of the program adwinisbater, died responsible Tor The ‘herapoutte mlleu within the reséenial restmentpragram,regareless of job tle wil inolude at minirum: Mastors degree in a valovant field ard, Four years direct care, ‘nouding eupentsory experience In a rosdortial Yeatment program of therapeutic Seting for children andlor youth. ot Bachelor's degree in a felevant fed and. Five yore direct care, including two years euperusory experiance in a residential ireatment program or therapeutic seing ox chien and you Karen Lansberry Director of Residential Care Servicos has 28S in Education land has been employed by Kum Hattin ‘aS a "House Parent" since 2000. 406 Tho credentials of tose providing suporision of cect care ssf, regardless oF Job tie vil Include at minirusr: Masters dogroe in a relevant feld and, One year femerience providing drect eave residential eatment programs for chidrenIyout (oF Bachelors degree and, Two years experience proving cect care in cesiental freatment programs for chldrenjouth. of, High Schoe! Oplome or GED and, Four Yyoars experiance working with enirendyoith in resent testmant programs. Carol Bazin & Mary Jo Dansereau are, Assistant Directors of Residential Care: ‘Services. Carol has a H.S. Diploma and hhas been a ‘House Parent” since, 1987. Mary Jo has an Associates degree in Human Services, “408 The credentals oF ose providing vec care for chistenyouth, egandiess Ofjob ‘te wil include at minimum: Bachelo's degree and, 21 years of age anc, Fxperience working with chilérenfyouth. of, High Scheol Diploma of GED and, 21 years of age land, Two years exparence inferactin with chidren'youth, This may Incluce, but I hol festicted to camp counselor, coach, babysting. KH requires all direct care staff to have child care experience regardless of ‘education level. Job descriptions have been updated to inciude the expectation that staf be al least 21 years of age “FiO Tnaividusle providing civic Sewioes or crisrenivouth and families shall have ‘omperence working with chldronyouth end famiies shall mest current Vormont Teensing and ceriicationrequiramonts and professional standards ‘Jennifer Jacobs, MS in Ciinical Psych, Director of Counseling, supervises 6 Masters level Case Coordinators, FIRING “FTA Reaidenital Treatment Program shall Rave writen personnel poIGSE apa Proosdures forthe hiting, ofertatin, trahing, supervision, evalalion, recognition, ‘Sscipine and termination of emoyees, “#12 Rasidental Teatment Program shal conduct BaSkgiSind GREG, ypon hire and ‘every three years thereafter, on ll employees, board memberitustoes, voluntees, Student terns, and others who may have unsupervised cone! wth ehlcentyouth i the program. Misimaly, the backpfound checks shal include the Verrant Grininal Inermaton Center, Vert Chit Protacton Regitly and te Adut Abuse Registry Kum Haitin submits staff releases to RLS! to run background checks every three years, Everyone is also “fingerprinted” as KH is a school 413 The resulls OF background checks must be recetved and evaluated by the program adminnirator prior to the individual being hired and pier to having any Unsupervised contact wth cildrenyourh, Documentation of completed background checks and adminetrathe review mus be maintained and avaliable o bcensing Upon request Received and reviewed by Director ‘of Human Recourses and Executive Directors. EMPLOYEE ORIENTATION AND TRAINING “FEA Reatlental Treaiment Program shal have witten poses and prcosdures Tor the orlentaton of ew staff to Une program. This ofetation must occur within the rst 430 days of employment and include, but is not imted f: Program description and Population served; A tour of the fait, Overall program tealment philosophy and ‘approach; Program phlosophy of behavior management; Chidiyeuth_atevance process; Basi Information about behavior chitdenlyouth may exhib entiation of tary waming signs that indicate chid/yeuth may become dstuptive or aggressive and how these ‘observations are to be reported: Professenalism in dealing wit chikrentyouth, families, and others; Confidentiality, Progrem policies and procedure fesating 10 intorentons employed by staf Io prevent. deescalata, safely manage hielyouth acting out behaviers: Roles and expectation of varus personnel in preventing and responding to cis sfustions; Documentation requirements, Working 2 par of@ fear, Policies regarding zero telerance for sanual abuse; Procedures for feponing euspecied inedents of chi abuse and neglect Policies and procedures regarding runaway chilrer/youth Policies and procedures regarting the acavistion, ‘Storage, adminisvation, documentation and disposal of medicalon; Emergency Fesponse procedures; Emergency evacuation procedures; Residential Treatment Program requiatons. “418 During oreniation, each employee should be mace aware of tha plan for Nis or hor particular on-going training and professionsl development. Plans should be developed betwen tha ermployee and supervisor and should be based on thelr roles ‘and respansilites In the program. 41 Sta who may work win colciealyeuth shall wecaive baling tie prevention ‘and use of restraint pros to paricipting in tho use of restraint. Sta wil be competent in (but not lime to) the folowing: Relationship buling, group processes, restraint prevention, de-escalation methoss, avoidance of power ctugales, and teshold for Use of restraint The physiological etfect of rstvain mantaring physical dstress signs nd oblaining’ medical assistance, and postonal asphyxia: Legal issues and Primarily found in the “Community Handbook” Karen Lansberry, Director of Residential Care Services is responsible for providing or ensuring the initial and on-going training of Direct Care Staff meets these standards. Karen Lansberry is the certified trainer of the Crisis Prevention5 Toayneras condlions tat may alee the way chidrenivouth and sal tay weapond ‘0 restrsint (e9., cultural sensitivity, age, gander, developmental delays, NSiory of twauma, syiptoms related to substance abuse, heath risks, etc), and; Escape and evasion techniques, time tts, the process for obialnng’ sporoval for canned fester, the procedure to address problematic restraints, documentation, debcoing 1h chidren’youth, fotow-up with staf and investigations of iuries and complains Institute (CPI) Nonviolent Crisis, Intervention. 417A. Resident Treatment Program shall ensute supervisors and those who provide dzect cafe receive on-going training and develop competencies relevant to the population served including (bul not limied to) Relationship Busding. Ustening ‘and ‘cormunicaton, Family Engagement; Understanding and analyzing probiom behaviors; Trauma inforned pracices, Posiive behavior support, Designing and Implementing routmes; Seng cloar limes; Praising and reinforing behavior. Early Sitecons of confict siuations; Intervenions fo minimize potential confits, Designing and implementing actly programs; Teaching socal and anger management skiis, Managing. transitons; Managing personal boundaries: Harascment; Confict resolution; Fist Add and omergency medical procedures: Adrinstaion of mediation and the documestation herent Karen Lansberry is responsible for providing or ensuring the training and supervision of Supervisory staff specifically, the Assistant Directors and House Parents, 418 A Resdeniil Treaiment Program shall ensure annual aihing for every emalaves responsi for direct chid care effecive de-escalation techniques, appropriate use of restraint, seclusion and expectations reganting the documentaion of the use of restraint and secusion Nonviolent Crisis Intervention, (CPI) ‘waining occurs before each new ‘school year commences. EVALUATION HA Residential Treatment Proaram shal’ conduct_at mimi, an annual portermance evaluation based on performance expectations inthe context of each employee's job desorption and plan for ongoing profession development. 420 The evaluation wil dently areas of competence and docuent targets for growth ‘and development fo bo revewed at ecablishod intervai. Generally, evaluations don't target areas for growth, and lack follow up. at established intervals. “21 The evawation wil be Signed by the employee and hisher enmnedaie supenisor. ‘There mest be an opportuny for the employes to express hisiher agreement of isageeement withthe evaluaton In witing. The employee shall be gion a copy of hismer evaluation PERSONNEL FILES “@22K Resiashal Talnent Program shall malian @ pewonne! fie Tor each ‘employee containing: The application ‘or employment andicr resume; Documentation of ‘reference checks; Employee's starting and termination datos; Appicabio professional credentiaiscetfications; A stoned [ob description, acknowiedging Tecelpt Employee's plan for on-going training ané professional development, Documentation of irinin: Alf annual performance evaluations; Commendations and discpiinar actions relating to the indiadua's ob peresmance. ‘STAFF COMMUNICATIONS “HBB A Resideniial Treatment Program shal esabish procedures To assure adequate ‘communicaton and suppor among staf to provide safety, coninuty and integration Sf services to the chidreniyouth. This may include logs, shit notes, minutes. of meetings, ec VOLUNTEER SERVICES AND STUDENT INTERNS “FER Resideital Treatment Program may ville volunteers and siodent infers 1 work directly wih a paricular chiaiyouth or group of chiseniyouth under tho supecvision of an employee ofthe progr. a ‘The Department Head that utlizes volunteers are responsible for “hiring” and supervision. “WIS Vaintears wi nek proWeIS esseribaT Services whieh would oihenwse Bo naval 8 A Resontal Tioatrent Progiam shal ensue that Ba coeds and Tearing experiences of veluntows and student intems do not interoro with the care of shildronyout “427 Volnieers and eine ave Sad To Whe Same background, Guaradier and reference checks as empl 428 Vourisers shal receus taining levark to te work they wil bo doing and Issues of confidentiality a} a} a} a 429 Student Intems shall receive Wang Evan T The Work thoy wil be doing, Including but rot tinted to} se traning provided employees wihin tho fist 30 days of hie. See regulation 415, 500 TREATMENT AND CASE MANAGEMENT SERVICES PROGRAM DESCRIPTION GOT A Residential Treatment Progam shall Fave 8 writen pregram dascipton, accessible 10 prospecive residents, parents, custosans, placing agencies and tha ‘general pubic upon request. c Found on the Website and in brochures 502 The program descpion shall elude: Description of Whe population soved, Criteria for admission; Excusionary citera; Descrition ofthe mifeu; Description of the treaiment modalties; Description ofthe clinical sevces provided; Descripion of the edueatonal services provided,ASE RECORDS 503A Residential Tieainent Program shal have wiileh polices and procedures for eolation ofthe confientinlty of al chidrerdysut’s recor, ‘508 A Residenial Treatment Program shall maintain ‘en7(S) Tor Gach GhIdiyoat, ‘The content and format ef theea records shall be unferm within the program and ‘minimally inciuds: The name of the chilyouth, Gender, Dato of brik, Date of Admission; Legal custody and. custodonship status; Infomed corsent signed by the Patenl(s) 2nd custodian fo provide ameryancy medical teatmant and for te ‘administration of medication; Contsct information for the parents), carelakers. Documented acknowindgement trom the ehidiyouth, parent(s) and custcian that they have been informed ofthe program's pokois and procedures regarcing tho use fof tesraint and seclusion; Inormes consent signed by parents) and custodian regarding the polies and procedures guiing the use of restraint and seclusion ‘hat may occur whe the chidivouth i in the program; De-escalaton intervention pian; Referal and Inteke information; Treatmenilinical records; Education. recores: Cumulative medical records including date and resut of last physical and dental cxaminations; Plan of Care, amendments and reviews; InSdont Reperts; Discharge Plan, Date of Discharge; and Contact nfermation ofthe porson or program to whieh the chidyouth was discharged. 505 When information 1s in (He possession of another person oF agency and Uunavalabie to the progeam, the program shall docurnert atoms t2 acquire that information, 505 A Residenlial Treatment Progam shall ES@bIah polices and procedures regarding tha retention, storage and cleposal of rcarés Varies depending on Deparment REFERRALIADMISSION PROCESS: “SOT K Reval Treatment Program shall accegt a chidiyauth info ca7@ ony when @ Ccurent intake evaluation has been completed. The evalution shall include Infomation and assessments regarding tne family, the chid’youtn's devoiopmanta, socal, behavioral, psychological, and medical histories, allergies and any. special needs. 305 A Residenfal Treatment Program shall accepk and sexo only those hlarentyauth whose needs can be mat by the services provided by the rogram, 805 A Residential Tiealment Program shall have writen roferal and admission potcies and procedues. Found in the Admissions Packet 510 A Residential Treat Program shal ensure tal the chihyouh, neler parent(s) and custodian ate provided reasonable opportunity to parispate in the mission process and decsions, and that due consgeration is ghen {© any ‘questonsiconoems. 511 A Rosidenial Tioaiment Program shat provide chien, youth, falas ad ‘custodians upon placement a clear and simp witen slatement thal Includes: The rocoduro used fo report complaints or grievances, incudg timoines and accessible repoting formats; Assurance thatthe complaint may be submited to somwone other than the individual named in tha compiant, Assurance that relation will not be tolerated, An opportunty for the child, youth, famiy member, custoan or stat ‘member ta present his of her varson of events and fo presont vitesse A process {or informing the complainant of ths resus; A procass for appeal: Contac! information for the licensing authorty, and Contec information for the Sate designated protection anv advocacy system, “12 A Residential Treatment Progam shall ensure that upon plasement, each ‘chdyouth i asked f helshe has ary physical complains ands checked fer obvious sions of ilness. fver, rashes, bruises and injury. Te resus of hs interview shall be ‘ocumentea an Kept in the enidiyoutN's 62213 ‘513 Depending on the age, gender and neads ofthe Ghldlyouth an inventory andlor ‘search ofa chilyouth’s balongings as pat ofthe scission process activity wil bo Conducted by a sare gender siaff person asthe chidiyouh boing admited are nthe ‘hisiouth’s presence, ‘514 A Residential Treatment Program shail obiain the willen Womed consant of @ Chior youth, thei parent(s) and custodian before the chid or youth is photographed ‘andor ecard for research andor program publely purposes, 515 A Resienial Treatment Program shall assign a slat manber to orient he Chiaiyouth and hismer parent(s) and custodian, to Me et the program; Including a verbal review of emergency evacuation procedures, the chidiyoull’s rights nd program expeditions, ‘516 A Resiential Tiealment Progiam shall make avaible tw each chlalyouty Dareni(s), and custodian, a simply wrtten list of rules and eppectations governing ‘hiarenyyout’s behavior ‘S47 The program wil info the EhIGjoUth, pareal[s) and caslodan ofthe pales 2d procedures regarding the use of restraint and sectuson, Whie this entation wil Include the foliaving content, the mode of delvery ie dependent on the population served. Explanation of de-escalaton techniques staff members may omploy to detues the situation in an aftemt fo avoid the use of restraint or seclusion; Description of tustons and efeia for the use of rosvalnt or soctsion, Who Is authored to ‘approve and intiate the uso of restaint or seclusion: A description of the restrat techniques authorized for use: A viewing of rooms used for secusion, The prtcel for New England Kum Hattin Homes, Inc. does not use seclusion.The monitoring of te ahiayouts heath and wolrboing dung te recat, ncuding tine fames; The protocol for supervision and montoiag ofthe chiliyouth’s heath and wel-being wale secluded, inclding time frames; The decsion-making process Used by staff forthe ciscondnuation of the use of restralr or seclusion; The intemat ‘fevance procedute to report inaporopriate use restraint or seclusion” and Contact informaion forthe Licensing Authonty 516 A Residential Treatment Program wil obtain wilten scknowagameal Fam The Chikiyout, parent(s) and custodian thal thay hava been informed of the program's Dolicies and procedures regarding the use of restraint and secusion, ‘519 A Residental Treatment Program that uses restraint or seclusion shall fer the child/youth, paten{s) and custodian the oppoctunity to provide information about te {chlayuth that may help prevent the use of restraint and seclusion. 520 A Residantal Treaiment Program shall gatier and assess the Taoning Information to. davelop an indivcualized de-escalaion plan for each chidivouth to ‘avoid the use of resrait and seclusion. The chillyouth’s hstory of violence, The chil’yout's histary of suicidat ideation or attempts; Events that may tigger ‘aggressive or suicdal behavior, Techniques to regain cont, sl egulto,seltsooth that have been successfl in the past; Preexisting medical condtions or physical sabes tat place the chou at increased risk of harm, aed History of aur: that places the chikifyouth at increased risk of psychological harm If he/she Is restrained or soctodes, PLAN OF CARE BATA Resident Teatient Program shall develop a Plan of Care based oa the review ofthe referral information and input from the referal source, the chidiyouth, parents) and custodian within soven The “Student “Support Pian” is completed within one day, ‘822 The Plan of Care shall fclude: Reason for Admission, Promminary Coals and Objectives, Servicasiinterventions 1b be provided, by whom, and ‘fequency: How progress will be measured; Family contsct and level of Inclement; Mental Heath ‘talus, Physical “Health stats, Sodal Skis, Famly "relationships; RocrostoActiviesinteresie; Education; Aaivtiee of dally vinndependent ving hile, e-escataton erection Plan, Plan for discharge: Atercare planing. The Treatment team focuses on four goals across. disciplines (School, Residence, Counseling and tedical) '523 Plans of Care shal be signed by the administrator ofthe program (o: designee) ‘SRE A Residential Treatnost Progiam shall domonsvate cAVivouth, parental and “custodial participa in the development ofthe Plan of Caro 25 A Residential Teeabnent Program shall wview and revise the Plan of Care at least once avery 80 days and shal evaluate tre degree to which te goals havo boon achieved, identify success‘ interventions, progress toward discharge planning and ‘recommendations al alal 526 A Residential Weabnent Program shall ensure that the Plan of Gare and ‘subsaquont revisions are explained fo the cidyout,hisiher paren.) and custodian {i language understandabie o everyone q| 'B2T The current Pian of Care shall be avalabie upon request al he tne oF asa 600 RESIDENTIAL LIFE _ SUPERVISION ‘661A Residontial Treatrint Program chal provide adsquate cupareion appropriate fo the iresiment and deveioonental nests of chikven/youth, 602 A Rosidontal Treatment Prearam shall onsure thal each GNRIyouln has ready ‘Scc9ss lo 2 responsibie staf! member thoughout the night Sieep-in staff are readily available 603 A Rosidental Treatment Pregram shall provide adequate ovemight supenislon Consistent with the needs ofthe chilervyouth ‘Alarms on doors and windows in Lewis Cottage on} FAMILY INVOLVEMENT G04 A Residenilal Treatment Progian shall make every possbla efor to facials ‘ppertunites for chidrenlyouth to communicate wth parent), siblings, and custodian to foster permanent relaionshis wih ly, fr accordance wit to Plan of Care. 605 Afsinative visting houts shal be provided for families who are unable fo visi a tha preserbed tines, consistent with te Plan of Care ° 106 A Residential Treatment Program shill ot use faitly contact as at Wowntve to clic desired benavior, Ixowee famaly contact shall not be withheld as @ consequence formisboravir. GOT A Residential Treatment Progiar shall have Willan PrOOBSurSS Tor ovemight ists cuside the program which includes; The chiliyouts location, Length of stay Pian for transposition; Pian for conveying medication; Discussion of medication regime; Recommendations for superision; Name, address ana contact infomation for person responsible fr the chiliyouth wile they are away from the program: Relationship to the person responsible for the chisiyouth; Plan forthe unforesoen relurn ofthe cilayouth, and Documentation of above activites, The parents of students in the program receive a monthly e-mail, newsletters, school calendar and athletic schedules. There is a monthly “family” day", parenting classes and an open ‘invitation to Visit the campus at any time, Kurn Hatin can provide overnight accommodation in apartments on- site, gas cards, food cards to families in need to assist with visitation, GOB A Restontl Treeimont Program shall not plaoe a chidyouah Wa foster HO unless the Residential Treatment Program is also a licensed Chi Placing Ago EDUCATION L 809 A Residential Treatinere Program shal eicure Wat every GuaIyouT is provided fn epproniste educational program in accordance wil sete law and approved ty the ‘Approved “Independent Schoo byVernont Departnant of Education the VT Department of Education, DAILY ROUTINE “SHO-A Restenlial Treatment Proacam shal folow a wren daly routine, coding weekends and vacations {614 Daily joutines shal not conficl wi The Implementation ofa cNVayGu’s Pian of Care, COMMUNICATION AND PRIVACY ‘42 A Residential Treatment Program shal pent Ghlcreniyouth fo Send and Teche mail, make tslephone cals and e ail, consistent win tha Plan of Cae, ‘513 Program staff shal read a chidyoulhs mal and emai or listen iv on Tlephors conversations enly with the chitiyouth's fll knowledge and understanding of the Feasons forts action, consistent wri the Pian of Car {14 A Residential Treaiment Program shall nol bar coniael Baween a cnlaTyouth and thoir parents), custodian, attorney, guardian ad Item, clorgy end Stato-lesignatod protection and advocacy system. ‘616 Wihen the night ofa chidiyouth fs communtale fr ary hannar wih any parson futsice the orogram must he curtaise, or mentored resin program shal Document the decison, incuding whe was invoved in the decision making process, reasons for imitations of hisher ight to communicate with the spectiod indus) Inform the childbyouh of the decision making process; Review tis decision minimal at each review of the Pian of Cav, ‘Access to e-mail is Supervised by clinicians. Otherwise, contact with parents is generally twice a week. MONEYIFINES a ‘awn money consistent with his/her Pian of Care, oO 6817 Fines shu not be levied except in accordance witha witisn Pragiam Descion lich includes @ desertion of how revenues fom fines ar used forthe boneft ofthe Chilrentyoath residing i the program. oO No financial consequences, possible restitution built into SSP. CHORES 18 The Reskiortal Treatment Progiam may assign chores That prowde for the evelopment of fe skis and not used as punishment 1619 Chidreniyouth paricipation in chores shall not be a subsite Tor WoLeReRING land maintenance af, RELIGION 20 A Residential Teatment Program wih reigious affations) or expectations for partlcation shall Inula euch informaton in the program Seseripton, 9 Religious Education class 821 A Residential Tesiment Program shall make every effort io accommadsis & chiidiyouths desire to attend andlor participate in religious actives and services in _sccardance wih hisher own fh a PERSONAL BELONGINGS ‘GHD A Residential Treatment Program shall ersure thet cldenivouh have Finer ‘own alequate,claan, and apprograte dating 623A Residential Treatment Program shall alow chidrenlyouth to bang Wiser ersonal belongings to the program eg. conor tems, memoria £624 Limitations on tbe quantity of personal tems shail be discussed dung Whe referallagmission process. {825 Provisions shall be mada forthe prclecon of chidrenlyout's paisonal propeRY. al al a] B26 Aiy Séarch of @ ChidWOUINS personal belongings Tor contraband deemed necessary for tho safoty of the chidiyouth or atnere wit tho program wil be ‘conduct in the presence of the chilyauth by same gender staff asthe chidiyouth Unloescontraindiestod and documented ° PERSONAL CARE AND HYGIENE {627 A Residential Treatment Program shall ensure chikren/youthrecaive guidance healthy personal core and hygiene habs a FOOD SERVICES ‘828 A Reckential Teatment Program shall eraure that a Chilyouth are prowded at leas three nuistional meals, avaiable daly at regular tes. 1629 There shal be no more than 14 hours belveen the evening meal and breawaa, tunlossnuttional snacks are offered during the evening 1630 No chiniyouth Ina Residential Treatment Program shallbe detieda meal foray reason, except by a documented doctor's order. 1631 No chiyouth shall be required to eat anything they do nol WanETD eat, nor There bbe consequerioss for food preferences 832 Special dielary nesds shall be discussed curio the weferaliviake process and the Residential Treatment Program shall make Neathy accommodations for chigreniyauth with special dietary needs, 9} a} of a} a} MEDICAL CARE ‘635 A Resential Tieaimiont Program shal ensure a route physical @amination by ‘8 medical practioner for each chidyouth within 30 days of admission uniess the {lleyouth Feceived such an examination within 12 month porto admission 9 Kur Hatin has Tis own infimmary, overseen by Eliot Hall, MD.