22 VAC 40-61-40. Quality Assurance.

5. Assessment of the relationship of the program to the rest of the community service network. Clarification: Define what you mean by community service network.

22VAC40-61-120 Reports of abuse, neglect and exploitation

Proposed Language: B. The center shall notify the participants contact person or legal representative when a report is made as referenced in subsection A of this section, without identifying any confidential information.

Recommendation:

• Delete B.  In situations where the person suspected of alleged abuse is the contact person informing that person, prior to APS intervention, could put the participant at risk of retaliation or further abuse. It is best to allow the center to use the best judgment about notification of the contact person after speaking with the local department and/or APS hotline.

22VAC40-61-180 Staff records and health requirements

Proposed language: E. The following required health information shall be maintained at the center and be included in the staff record for each staff member and each volunteer who comes in contact with participants.

Recommendation:

• Remove requirement for volunteer having TB testing. Rather, except the volunteer that is included in the staff ratio that would be required TB screening annually.

22VAC 40-61-240 Participant agreement with the center.

Recommendation: 

• In the applicable sections of the regulation, add “authorized representative” as an option in the event a legal representative or family member is not available; consider including a definition for “authorized representative.”

22VAC 40-61-260. Physical examinations and report.

Proposed language: B. The report of the required physical examination shall be on file at the center and shall include…….:

Recommendation:

• B.1. Change address and telephone number to “Date of birth” because this is how the person is identified.
• B.5. Delete this requirement, and consider replacing it with “other health care conditions that may impact the need for care and supervision in the Adult Day Health Care environment.”
• B10. Add the statement: “The individual is physically and mentally capable or not capable of exiting a building in an emergency without the assistance of another person.”

22VAC 40-61-320 Assistance with activities of daily living.

Proposed language: C. Assistance with eating and feeding.

Recommendation:

• C.4. Change the second sentence to read, “Information about the need for eating adaptations shall be shared with the participant or the participant’s representative, and center staff shall assist the participant with utilization of the adaptive equipment or supplies that are provided by the participant or participant’s representative.”

22VAC 40-61-330 Activities.

Proposed language:

F. Schedule of activities:

b. The name, type, date, and hour of the activity.

K. In addition to the required scheduled activities, there shall be unscheduled staff and participant interaction throughout the day that fosters an environment that promotes socialization opportunities for participants.

Recommendation:

• F.1. b. Delete “Type” because there is not enough room on the calendar to include this information; furthermore, the activity implies the type of activity. 
• K. Delete the statement about staff to participant interactions. Instead say, “In addition to the required scheduled activities, center staff will foster an environment that promotes socialization opportunities for participants.”

22VAC 40-61-370. Observance of religious dietary practices.

Recommendation:

• Add the statement: In the event a participant has complex or cost prohibitive dietary needs or preferences that the facility is not able to accommodate, the participant may be expected to provide food items of their choice.

22VAC40-61-380. Transportation services.

Proposed Language: B. 1. The driver has a valid Virginia driver's license to operate the type of vehicle being used.

Recommendation:

• B1. The driver has a valid driver's license to operate the type of vehicle being used.