Chapter DCF 52

DCF 52.41(1)(c)4. 4. Arrangement with a physician or a clinic employing a physician to serve as consultant for health care arranged by the center for residents.

DCF 52.41(1)(c)5. 5. Provision for psychological testing, psychiatric examination and treatment as necessary to meet a resident’s needs by having consultation and services available from a psychiatrist licensed as a physician under ch. 448, Stats., or a psychologist licensed under ch. 455, Stats.

DCF 52.41(1)(c)6. 6. Provision for at least 2 dental examinations and cleanings for each resident each year and for other dental examinations and services for residents, as needed, from a dentist licensed under ch. 447, Stats., or a clinic employing dentists licensed under ch. 447, Stats.

DCF 52.41(1)(c)7. 7. Availability of emergency medical services 24 hours a day, 7 days a week.

DCF 52.41(1)(c)8. 8. An explanation of any medical treatment that a resident will receive that is provided to the resident in language that is suitable to the resident’s age and developmental level.

DCF 52.41(1)(c)9. 9. Policies and procedures for hospitalizing a resident, for providing first aid to a resident and for administration of medications in accordance with s. DCF 52.46 (2).

DCF 52.41(1)(c)10. 10. Identification of the circumstances that constitute a medical emergency, and instructions to staff on action to take when suspecting the existence of a medical emergency.

DCF 52.41(1)(c)11. 11. Compliance with ch. DHS 145 for the control and reporting of communicable diseases.

DCF 52.41(1)(c)12. 12. Arrangements for the center’s health care consultant under subd. 4. to annually document and date a review of the adequacy of center health care service delivery including center procedures for administration, storage and disposal of medications as provided under s. DCF 52.46 (3).

DCF 52.41(1)(d) (d) Reasonable and prudent parent standard. Policies and procedures on how the center complies with the requirements of the reasonable and prudent parent standard, including all of the following:

DCF 52.41(1)(d)1. 1. How the communication log under sub. (1m) will be used to inform different shifts of resident care workers and RPPS decision makers of reasonable and prudent parenting requests and decisions made for a resident under s. DCF 52.415 for activities that do not take place in the residential care center and are not supervised by a staff person.

DCF 52.41(1)(d)2. 2. How the information on the forms required under ch. DCF 37 will be incorporated into a new resident’s treatment plan, as required under s. DCF 52.22 (2) (ag).

DCF 52.41(1)(d)3. 3. How the center will ensure the presence on-site of at least one RPPS decision maker at all times.

DCF 52.41(1)(d)4. 4. A process for annually reviewing the parameters and requirements of the reasonable and prudent parent standard in conjunction with the center’s corresponding policies and procedures.

DCF 52.41 Note Note: DCF-F-5123-E, Reasonable and Prudent Parent Standard Review, is an optional form that a center may use to assist with the annual review. The form is available in the forms section of the department website at http://dcf.wisconsin.gov or by writing the Division of Safety and Permanence, P.O. Box 8916, Madison, WI 53708−8916.

DCF 52.41(1m) (1m) Communication log.

DCF 52.41(1m)(a) (a) A residential care center shall require each shift of resident care workers and RPPS decision makers to use a communication log to document and communicate with other resident care workers and RPPS decision makers about residents whom they supervise in common. The communication log shall include all of the following for each shift:

DCF 52.41(1m)(a)1. 1. Each resident’s location, behavior, and program participation.

DCF 52.41(1m)(a)2. 2. Significant incidents involving a resident as provided in sub. (1) (a) 10. and the center’s corresponding policy.

DCF 52.41(1m)(a)3. 3. Reasonable and prudent parenting requests and decisions made for residents under s. DCF 52.415 for activities that do not take place in the residential care center and are not supervised by a staff person.

DCF 52.41(1m)(a)4. 4. Staff arrival and departure times.

DCF 52.41(1m)(b) (b) A residential care center may designate units within the center and require resident care staff and RPPS decision makers to use a separate communication log in each unit.

DCF 52.41(2) (2) Program planning and scheduling.

DCF 52.41(2)(a) (a) A center shall have a written daily program of general activities which meet the developmental needs of the residents.

DCF 52.41(2)(b) (b) The program of activities shall provide each resident with experiences which encourage self-esteem and a positive self-image through:

DCF 52.41(2)(b)1. 1. Leisure-time activities.

DCF 52.41(2)(b)2. 2. Social interaction within the center and, if appropriate, the community.

DCF 52.41(2)(b)3. 3. Self-expression and communication.

DCF 52.41(2)(b)4. 4. Gross and fine motor development.

DCF 52.41(2)(b)5. 5. Daily living activities, including but not limited to, grooming and hygiene, toileting and common household chores such as making beds, cooking and washing clothes.

DCF 52.41(2)(b)6. 6. Interpersonal relations with peers, family, friends, staff and where possible and as appropriate, members of the opposite sex.

DCF 52.41(2)(b)7. 7. Opportunity for paid work within the constraints of child labor laws, resident rights and the resident’s treatment plan.

DCF 52.41(2)(c) (c) A center shall make maximum use of small groups to aid individual residents in preserving or attaining a sense of personal identity in daily living. The center shall:

DCF 52.41(2)(c)1. 1. Group residents according to age, developmental levels and social needs, with the ages of residents being primarily within a 4 year age range but not to exceed a 6 year age range.

DCF 52.41(2)(c)2. 2. Group residents under supervision of their own resident care worker and give a group opportunities to form and attain group self-identity in daily living and social activities.

DCF 52.41(2)(d) (d) A center shall ensure that nonambulatory residents:

DCF 52.41(2)(d)1. 1. Spend a major portion of the daytime hours out of bed.

DCF 52.41(2)(d)2. 2. Spend a portion of the daytime hours out of their bedroom area.

DCF 52.41(2)(d)3. 3. Have planned daily activity and exercise periods.

DCF 52.41(2)(d)4. 4. Are able to move around by various methods and devices whenever possible.

DCF 52.41(3) (3) Staff-to-resident ratio.

DCF 52.41(3)(a) (a) In this subsection, “supervision” means guidance of the behavior and activities of a resident by a staff member to ensure the safety and well-being of the resident.

DCF 52.41(3)(b) (b) The staff-to-resident ratios for staff providing supervision of residents shall be as follows:

DCF 52.41(3)(b)1. 1. ‘1:8 during waking hours.’ A residential care center shall have at least one staff member awake and providing supervision for every 8 or fewer residents present in a program unit during waking hours.

DCF 52.41(3)(b)2. 2. ‘1:15 during sleeping hours.’ A residential care center shall have at least one staff member awake and providing supervision for every 15 or fewer residents present in the program unit during sleeping hours. Each staff member shall be within hearing or call of residents being supervised without reliance on the use of electronic monitoring devices.

DCF 52.41(3)(b)3. 3. ‘Congregate living area.’ A licensee shall ensure that a staff member provides sight and sound supervision at all times in each congregate living area of the center when residents are present. In this subdivision, “congregate living area” means any area in a center used for living or recreation except a bedroom, bathroom, or hallway.

DCF 52.41(3)(c) (c) The staff-to-resident ratios in par. (b) are the minimal staffing requirements for resident care staff. The number of resident care staff providing supervision shall be increased as necessary to meet the needs of residents and to ensure their safety and welfare.

DCF 52.41 Note Note: Section DCF 52.55 (1) (b) 1. requires that staff can safely evacuate all residents from the center in one trip for fire safety.

DCF 52.41(3)(d) (d) No resident may be in a residential care center without supervision by a staff member.

DCF 52.41(3)(e) (e) A licensee shall ensure that supervision is provided for each resident appropriate to the resident’s age, maturity, behavior, and developmental level and sufficient to ensure the safety of all residents in the residential care center.

DCF 52.41(3)(f) (f) Supervision of residents shall be by a staff member who meets or exceeds the qualifications of a resident care worker under s. DCF 52.12 (2) (e).

DCF 52.41(3)(g) (g) An inexperienced resident care worker who is required to take the traineeship program s. DCF 52.12 (5) (g) may only be counted in the ratios in par. (b) if the trainee is working with an experienced resident care worker who meets the qualifications in s. DCF 52.12 (2) (e).

DCF 52.41(3)(h) (h) A residential care center shall have at least one full-time equivalent resident services case manager under s. DCF 52.12 (1) (a) 3. for every 16 or fewer residents. A residential services case manager who is working less than full-time may have a maximum caseload that is the equivalent of 2.5 hours per week for each resident.

DCF 52.41(4) (4) Recreation.

DCF 52.41(4)(a) (a) A center shall provide leisure and recreational programming suitable for the ages, abilities and interests of the center’s residents. This programming shall be consistent with the center’s overall program goals and shall offer residents a variety of indoor and outdoor recreational activities.

DCF 52.41(4)(b) (b) A center shall have well drained outdoor recreation areas that are free of hazards.

DCF 52.41(5) (5) Religious practices. A center shall provide residents with opportunities for voluntary religious expression and participation. The center shall:

DCF 52.41(5)(a) (a) Have written policies on religious training.

DCF 52.41(5)(b) (b) Obtain the written consent of the resident’s parent or guardian for church attendance and religious instruction when agency practice varies from that of the resident or the resident’s family.

DCF 52.41(5)(c) (c) Arrange for residents to participate in religious exercises in the community whenever possible.

DCF 52.41(6) (6) Center applied policies and procedures. Center policies and procedures affecting residents and their interests shall be applied in a consistent and fair manner.

DCF 52.41(7) (7) Other services.

DCF 52.41(7)(a) (a) A center may operate on the center grounds other services or enterprises not governed by the center’s license only if the center obtains the written consent of the department. Examples of other center nonresident services that may be allowed by the department to operate on center grounds are shelter care services, outpatient counseling services, day treatment services and day student educational services.

DCF 52.41(7)(b) (b) A center which provides temporary shelter care services need not obtain a separate shelter care license under ch. DCF 59 if the personnel requirements in s. DCF 52.12 or 59.04, the child care requirements found in s. DCF 59.05, the requirements for records and reports found in s. DCF 59.07 and the physical plant standards in subch. VI of this chapter or in s. DCF 59.06 are met.

DCF 52.41(8) (8) Resident accounts and restitution plan.

DCF 52.41(8)(a) (a) The center shall have procedures for maintaining and managing a separate account for each resident’s money and as applicable, shall comply with the provisions under s. 51.61 (1) (v), Stats.

DCF 52.41(8)(b) (b) The center shall, as applicable, have in place a restitution plan for a resident and as applicable, that is coordinated with any other restitution ordered by a court or as part of an agreement under ch. 938, Stats., that describes procedures for deducting sums from a resident’s account or earnings as restitution for damages done by the resident. Deductions made for restitution shall be in accordance with a restitution plan as follows:

DCF 52.41(8)(b)1. 1. Before a center may withhold a part of a resident’s earnings or account balance, a restitution plan shall be made a part of the resident’s treatment record.

DCF 52.41(8)(b)2. 2. The restitution plan shall take into consideration the resident’s ability to pay or be as prescribed under court order.

DCF 52.41 History History: Cr. Register, February, 2000, No. 530, eff. 9-1-00; correction in (1) (b) 7. made under s. 13.93 (2m) (b) 7., Stats., Register, June, 2001, No. 546; corrections in (1) (a) 8., 10., (b) 2., 4., (c) 3., 9., 11., 12., (3) (a), (c) and (7) (b) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635; EmR1106: emerg. r. and recr. (3), eff. 9-16-11; CR 11-026: am. (1) (a) 10., r. and recr. (3) Register December 2011 No. 672, eff. 1-1-12; EmR1414: emerg. am. (1) (a) 3., eff. 8-1-14; CR 14-054: am. (1) (a) 3. Register April 2015 No. 712, eff. 5-1-15; EmR1633: emerg. am. (1) (intro.), cr. (1) (d), (1m), eff. 11-18-16; CR 16-051: am. (1) (intro.), cr. (1) (d), (1m) Register July 2017 No. 739, eff. 8-1-17; CR 21-107: r. and recr. (1) (c) 8. Register June 2022 No. 798, eff. 7-1-22.

DCF 52.415 DCF 52.415 Promoting normalcy.

DCF 52.415(1) (1) Similar to peers. A residential care center shall promote normalcy and the healthy development of a resident by supporting the resident’s right to participate in extracurricular, enrichment, cultural, and social activities and have experiences that are similar to peers of the same age, maturity, or development.

DCF 52.415(2) (2) RPPS decision maker.

DCF 52.415(2)(a) (a) A residential care center shall ensure the presence on-site of at least one RPPS decision maker at all times to make decisions regarding the participation of a resident in age or developmentally appropriate extracurricular, enrichment, cultural, and social activities.

DCF 52.415(2)(b) (b) An RPPS decision maker may be a licensee, authorized representative of the licensee, or any staff person specified in s. DCF 52.12 (1) (a) 1. to 5.

DCF 52.415(2)(c) (c) An RPPS decision maker shall have knowledge of a resident and access to the resident’s treatment plan and other resident case records under s. DCF 52.49 related to the decision-making factors in sub. (4).

DCF 52.415(2)(d) (d) An RPPS decision maker shall document in the communication log under s. DCF 52.41 (1m) decisions made under this section for activities that do not take place in the residential care center and are not supervised by a staff person.

DCF 52.415(2)(e) (e) An RPPS decision maker shall document on a form prescribed by the department any decision made under this section that requires written permission from the center in lieu of the resident’s parent or guardian. The completed form shall be placed in the resident’s case record under s. DCF 52.49 (2) (b).

DCF 52.415 Note Note: DCF-F-5124-E, Reasonable and Prudent Parent Decision Record, is available in the forms section of the department website at http://dcf.wisconsin.gov or by writing the Division of Safety and Permanence, P.O. Box 8916, Madison, WI 53708−8916.

DCF 52.415(3) (3) Reasonable and prudent parent standard. When an RPPS decision maker is making a decision regarding a resident’s participation in activities, the RPPS decision maker shall use a decision-making standard that is characterized by careful and sensible parental decisions that maintain the health, safety, best interests, and cultural, religious, and tribal values of the resident while at the same time encouraging the emotional and developmental growth of the resident, if the activities meet the conditions in pars. (a) and (b) as follows:

DCF 52.415(3)(a) (a) Areas covered by the standard. The resident is participating or wants to participate in extracurricular, enrichment, cultural, or social activities, including all of the following.

DCF 52.415(3)(a)1. 1. Activities related to transportation, such as obtaining a driver’s license, driving, or carpooling with peers and other adults.

DCF 52.415(3)(a)2. 2. Formal or informal employment and related activities, such as opening an account in a bank or credit union.

DCF 52.415(3)(a)3. 3. Activities related to peer relationships, such as visiting with friends, staying overnight at a friend’s house, or dating.

DCF 52.415(3)(a)4. 4. Activities related to personal expression, such as haircuts; hair dying; clothing choices; or sources of entertainment, including games and music.

DCF 52.415(3)(b) (b) Age or developmentally appropriate activities. The resident is participating or wants to participate in activities that are suitable based on any of the following criteria:

DCF 52.415(3)(b)1. 1. Activities that are generally accepted as suitable for children of the same chronological age or level of maturity or that are determined to be developmentally appropriate for a child based on the cognitive, emotional, physical, and behavioral capacities that are typical for children of the same age or age group.

DCF 52.415(3)(b)2. 2. Activities that are suitable based on this resident’s cognitive, emotional, physical, and behavioral capacities.

DCF 52.415 Note Note: The reasonable and prudent parent standard does not apply to a child receiving respite care services.