(a) Care and supervision of the children.  The shelters’ Direct Care Specialist (DCS) staff provide direct care and supervision of children residing in the shelter.  The DCS supervisors schedule staff to adequately supervise and meet the needs of the children in residence.  [OAC 340:110-3-137(a)(3)]

• (1) Logging.  A daily log is started for each child at admission.  Each shift of DCS staff record daily observations of the child in the child’s shelter file.
• (2) Shift change.  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.  • 1
• (3) Treatment plans.  DCS staff attend the weekly initial and review staffings of the shelter multidisciplinary treatment team.  They assist in the development and review of the children’s treatment plans.

(b) Intensive care supervision.  The DHS shelters have a plan of care for providing supervision to children who exhibit harmful behavior.  When the shelter social worker and the DCS supervisor determine such behaviors are present, an increased level of supervision is ordered.  When intensive care supervision is required, the shelter social worker documents the assessment of the child’s need and the DCS supervisor designates the level of supervision.  The level of supervision ordered corresponds to the assessed need of the child.  The shelter multidisciplinary treatment team may recommend intensive care supervision for a resident during their weekly staffing.  • 2

• (1) 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.
• (2) One on One.  When One on One supervision is directed, the staff member 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, sleeping, or attending school.  Heightened supervision is provided, even during sleeping hours, and the DCS will observe and document on the child every 15 minutes.  The DCS staff responsible for supervising this child is not assigned to supervise any other resident.
• (3) 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, sleeping, or attending school.  At those times the DCS staff resumes the Hands On supervision when the resident returns.  The DCS staff assigned to provide such supervision is not assigned to supervise any other residents.
• (4) Suicide Watch.  Suicide Watch is ordered if the shelter social worker assesses a child to be at risk for suicide.  The CW worker is notified if a child is on Suicide Watch and arrangements are made for gatekeeping assessment.  The DCS supervisor assigns staff to stay within arm's reach of the child at all times. The DCS staff keeps the shelter social worker apprised of the child’s behavior.  The child sleeps in view of the assigned DCS staff.  The assigned DCS staff is not assigned responsibility for any other residents.   • 3

(c) 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 social worker during each shift change. 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 need for supervision and the level needed.