OKDHS - OAC 340:110-1-47. Case management

340:110-1-47. Case management

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Revised 7-1-11

(a) Periodic visits.

(1) Licensing staff annually conducts monitoring visits to document compliance with the requirements: • 1

(A) two unannounced and one announced, to residential facilities; • 2 and
(B) two announced, to child-placing agencies. • 3

(2) If caseloads prevent licensing staff from conducting all visits, the programs manager consults with licensing staff on case management, and the number of required visits may be reduced. This adjustment is approved and documented in the case record by the programs manager.
(3) During each monitoring visit, licensing staff:

(A) observes the entire facility, including outdoor play space and vehicles used for transportation, if available; and
(B) checks:

(i) resident files, if applicable;
(ii) records for new staff including staff sheets and compliance with background investigations per OAC 340:110-1-51 and copies of Form 07LC041E, Staff Information – Child Care Facility, obtained for the case record; • 4
(iii) Oklahoma Department of Human Services (OKDHS) computer checks on applicable persons per OAC 340:110-1-51; • 5
(iv) Form 07LC092E, Insurance Verification, within the last 12 months;
(v) fire and health inspections within the last 12 months, if applicable; and • 6
(vi) other documentation that requires renewal.

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

(c) Change of address. When a facility moves to a new location, licensing staff follows specific procedures to document the move. • 7

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

(A) obtains an updated application; and
(B) files a narrative in the case file stating the new address and finding directions.

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

(A) obtains an updated application;
(B) conducts a monitoring visit and completes a monitoring report to verify the new location meets licensing requirements;
(C) obtains new fire and health approvals;
(D) obtains Department of Environmental Quality approval, if applicable; and
(E) files a narrative in the case file stating the new address and finding directions.

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

(1) documents the location of each office; and
(2) requests files as needed from satellite locations.

(e) Change in facility or agency name. If the licensing staff verifies there is a change in name but no change in ownership, the name change is documented in the case record and the database is updated. A new application reflecting the name change is completed. • 8

(f) Change in executive or program director. When there is a change in director, licensing staff:

(1) verifies the new director meets qualifications;
(2) obtains the applicable page of Form 07LC040E, Request for License – Child Placing Agency or Residential Child Care Facility, completed by the new director;
(3) notifies the new director of current employees that have been granted a waiver; and • 9
(4) documents the information on Form 07LC080E, Licensing Services Supplemental Information.

(g) Increase or decrease in licensed capacity. When a facility requests an increase or decrease in licensed capacity, 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. If the request to increase capacity is due to additional physical space, the required documentation includes:

(1) reason for the increase;
(2) fire department approval;
(3) health department approval of any additional food preparation space not previously inspected;
(4) physical plant drawing indicating the measurements, total square footage, and number of additional children that can be accommodated; and
(5) additional staff, if applicable. • 10

(h) Inactive cases. A facility is determined to be in inactive status when care has not been provided for more than 90 days.

(1) A facility wanting to remain open after 90 days submits a request in writing including a statement that the owner will notify licensing when care is resumed. Licensing staff verify compliance with requirements prior to resuming care.
(2) The facility is contacted by licensing staff every four months by telephone or letter to update the facility status including changes in personnel, household members, or other facility changes.
(3) The closure is discussed with the owner and an agreement to close is reached if possible.
(4) If care has not been provided for more than 12 consecutive months, licensing staff sends a letter to notify the owner of case closure unless Oklahoma Child Care Services is notified within 10 days of receipt of letter.
(5) Licensing staff visits the inactive facility at least once a year to verify compliance with licensing requirements until closure is final. • 11
(6) If a change of address occurs during the time a facility is in inactive status, a full visit is required to verify compliance and follow change of address per (c) of this Section.

(i) Change in ownership. If a residential program or child-placing agency assumes new ownership, the case file is closed, and the program must apply for new license under the new owner. Prior to the issuance of a permit or license, the facility must be in compliance with background investigations per OAC 340:110-1-51. A permit may be issued if a monitoring visit without numerous, repeated, or serious non-compliances was conducted at the facility within the past 60 days. A full monitoring visit is conducted within two weeks of change of ownership to verify the new owner is able to meet minimum licensing requirements. • 12

(j) Response to a child death. When notified of the death of a child while in child care, licensing staff:

(1) completes Form 07LC079E, Child Death Report, and forwards it to the statewide licensing coordinator or designee; and
(2) visits the facility as soon as possible, unless advised otherwise by law enforcement. • 13

(k) Serious incident reports. The licensing staff submits to the programs manager a report of any serious incident. A serious incident includes, but is not limited to, an incident: • 14

(1) that results in the serious injury or death of a child, such as:

(A) shaken baby;
(B) drowning or near drowning; or
(C) traffic accident resulting in serious injury;

(2) that places a child at a high risk for death or injury, such as a child:

(A) leaves a facility without the staff's knowledge;
(B) is left at a location away from the facility;
(C) is left unattended in a vehicle; or
(D) is left alone in a facility;

(3) that causes significant damage to a facility, such as:

(A) fire;
(B) flood; or
(C) tornado; and

(4) where media involvement is anticipated.

(l) Coordination with state agencies. Residential licensing staff works cooperatively with the OKDHS Office of Client Advocacy, the Oklahoma Commission on Children and Youth, Oklahoma Health Care Authority, law enforcement, and OKDHS Children and Family Services Division. • 15

INSTRUCTIONS TO STAFF 340:110-1-47

Revised 7-1-11

1.  (a) Monitoring visits to residential facilities are documented on Form 07LC058E, Residential Child Care Facility Visit Sheet.

(b) Staff safety concerns regarding facility monitoring are staffed with a supervisor for appropriate action. Appropriate action may include the utilization of a witness and/or coordination with law enforcement officials.

(c) During the annual records check, licensing staff:

(1) verifies documentation of non-registration on Child Care Restricted Registry on applicable persons per OAC 340:110-1-10.1;

(2) checks employee training records;

(3) conducts Oklahoma Department of Human Services (OKDHS) computer checks on applicable persons; and

(4) searches dockets on the Oklahoma State Courts Network (OSCN).

(d) The monitoring report is discussed with the facility's or agency's director or staff in charge. The director or staff in charge signs the report, and provides a copy of the monitoring report within five working days to the facility's owner/operator or agency.

(e) The monitoring report is submitted to the programs manager for review. The original is filed in the facility record.

2.  When monitoring residential programs, Form 07LC058E is used to document compliance with requirements. Also, Form 07LC059E, Residential Child Care Facility – Resident File Review, and Form 07LC050E, Personnel File Review – Agency and Residential Programs, are used if applicable. After each monitoring visit, the licensing staff enters the monitoring frequency plan that reflects the required number of visits per year on the licensing database. Any changes in the monitoring frequency plan must be reviewed with the programs manager. Examples of the required number of visits includes:

(1) one visit per year for inactive facilities;

(2) three visits per year for facilities with a history of compliance;

(3) six visits per year for applications, six-month permits; and

(4) twelve visits per year for seriously non-compliant facilities.

3.   When monitoring child placing agencies, Form 07LC022E, Child-Placing Agency – Foster Care File Review, Form 07LC044E, Adoption Services File Review, Form 07LC050E, Personnel File Review – Agency and Residential Program, and/or 07LC065E, Resident Monitoring Report, are completed as applicable. After each monitoring visit, the licensing staff enters the monitoring frequency plan that reflects the required number of visits per year on the licensing database. Any changes in the monitoring frequency plan must be reviewed with the programs manager. Examples of the required number of visits includes:

(1) one visit per year for inactive facilities;

(2) two visits per year for facilities with a history of compliance;

(3) six visits per year for applications, six-month permits; and

(4) twelve visits per year for seriously non-compliant facilities.

4.  Licensing maintains facility staff sheets in the case file for one year after their employment has ended. Staff sheets must be purged for public viewing.

5.  Computer checks.

(1) Annual computer checks to identify prior involvement with OKDHS are completed on all adults who sign Form 07LC040E, Request for License – Child-Placing Agency, Residential Child Care, and Children's Shelter. These are checked on the computer by date of birth and Social Security number.

(2) Annual docket searches of the OSCN include Oklahoma Court Information System (OCIS), non-OCIS counties, and the court clerk in non-reporting counties are completed on all adults who sign the application. These are checked by all known names. The court clerk in counties where a person resides or is employed is contacted if they are non-reporting counties.

(3) Review of annual OKDHS computer and OSCN searches are required only from the last date of annual review.

(4) While documentation of the OKDHS computer check and OSCN is filed in the confidential section of the facility's case, copies of the searches are not required unless new information is found. All other searches are filed in public viewing and meet public inspection requirements in accordance with OAC 340:110-1-55.

6.   Licensing views on-going fire and health inspections and copies are not required for the case file. If the inspection has licensing violations, document this as a non-compliance. A copy is only needed if problematic.

7.   The database is updated with the new address. The statewide licensing coordinator or designee issues a new license to the facility. Current employees do not acquire a new employment date or a new background check.

8.   The licensing staff notifies the programs manager of the change. The statewide licensing coordinator or designee issues a new license to the facility and a copy is sent to the licensing staff.

9.   When requested, directors are provided a copy of the waiver letter.

10. The programs manager reviews the recommendation and approves the increase. The licensee is notified in writing that the increase has been approved. If an increase in capacity is requested for other reasons than the increase in space, then the recommendation to the programs manager is made in narrative form giving the reason for the increase. The procedure for increasing or decreasing capacity of a facility is outlined in (1) through (4) of this Instruction.

(1) Increase. When a facility requests an increase in capacity, the licensing staff:

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

(B) does not recommend to increase capacity when the facility has numerous, repeated, or serious non-compliance with requirements. When the only serious non-compliance was that the facility exceeded capacity, the request for increase is staffed with programs manager for appropriate action.

(2) Decrease. When decreasing capacity the licensing staff updates the floor plan on Form 07LC057E, Physical Plant, indicating which rooms are available for use by children.

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

(4) Approval. If change in capacity is approved, the programs manager or designee issues a new license to the facility that reflects the new capacity. A copy of the license is sent to the licensing staff.

11. A full visit is conducted 12 months from the last full visit not from the time the facility was considered inactive.

12. Types of ownership include:

(1) sole proprietor;

(2) corporation;

(3) partnership;

(4) limited liability company; or

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

13. When notified of the death of a child in child care, licensing staff:

(1) determines and documents what occurred and whether the facility was in compliance at the time of death, documenting:

(A) number of children and staff present at the time of incident;

(B) what supervision was provided during this time;

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

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

(E) the names of staff involved;

(2) notifies the licensing programs manager and director of Oklahoma Child Care Services (OCCS); and

(3) considers whether the death is possibly related to sudden infant death syndrome (SIDS). If SIDS is possible, licensing staff:

(A) documents:

(i) where the child was sleeping and sleep position;

(ii) the condition of the crib or playpen; and

(iii) observations regarding the bedding, pillows, and other items in the sleeping area;

(B) provides the caregiver the pamphlet, SIDS – What Child Care Providers and Other Caregivers Should Know, OKDHS Publication no. 94-01;

(C) notifies the licensing programs manager and director of OCCS;

(D) contacts the licensing training coordinator to request that additional information be sent to the caregiver;

(E) obtains verbal or written verification confirming the cause of death as SIDS; and

(F) notifies the Oklahoma State Department of Health SIDS coordinator, who is available to offer support to the caregiver and family.

14. A serious incident report includes:

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

(2) the date and time of the incident;

(3) a description of the injuries to the child(ren) or damage to the facility;

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

(5) a summary of contacts made with other agencies involved in the investigation of the incident, such as CW or the police;

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

(7) the names of staff involved.

15.  Reports from Office of Client Advocacy (OCA), Oklahoma Commission on Children and Youth (OCCY), Oklahoma Health Care Authority (OHCA), law enforcement, and Children and Family Services Division (CFSD).

(1) The programs manager reviews all reports received from OCA, OCCY, and OHCA. Reports are registered by appropriate division support staff.

(A) Documentation of reports received from OCA includes:

(i) date report was received;

(ii) facility name and case number;

(iii) date of investigation;

(iv) investigator assigned to the investigation;

(v) accused caregiver;

(vi) findings;

(vii) date corrective action plan is due;

(viii) date corrective action plan was submitted;

(ix) date licensing staff was notified; and

(x) date information was filed in the case.

(B) Documentation of reports received from OCCY includes:

(i) date report was received;

(ii) facility name and case number;

(iii) date of investigation;

(iv) oversight specialist involved in the investigation;

(v) recommendations;

(vi) date corrective action plan is due;

(vii) date corrective action plan was submitted;

(viii) date licensing staff was notified; and

(ix) date information was filed in the case.

(2) All reports received from OCA, OCCY, OHCA, law enforcement, and CFSD are forwarded to appropriate residential licensing staff to review for possible non‑compliances with licensing requirements. If review of information indicates non-compliances, residential licensing staff investigates in accordance with policy regarding follow-up on non‑compliances, OAC 340:110-1-47.2, or a complaint investigation, OAC 340:110-1-47.1.

(3) All information in the licensing file, including confidential information, except CFSD, is made available to OCA, OCCY, and OHCA.

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