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HomeMy WebLinkAbout840713.tiff R1966947 ORDINANCE NO. 127 RE: RULES AND REGULATIONS GOVERNING THE OPERATION OF BOARD AND CARE HOMES IN WELD COUNTY BE IT ORDAINED BY THE BOARD OF COUNTY COMMISSIONERS OF WELD COUNTY, COLORADO: WHEREAS , the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home CA 0 HC_) Rule Charter, is vested with the authority of administering the o affairs of Weld County, Colorado, and o o WHEREAS , the Board of County Commissioners, sitting as the o W o 3 Board of Health, pursuant to the Weld County Home Rule Charter, oz yr W • possesses certain powers pursuant to Title 25 , Article 1 , Colo- 0 w rado Revised Statutes, and as Board of County Commissioners for � a home rule county pursuant to Title 30 , Article 35 , CRS, to ~ w promulgate regulations pertaining to the health, safety, and cra v welfare of all of the inhabitants of Weld County, including those to z w within incorporated municipalities, and Ln EI om WHEREAS, there are a number of board and care homes in Weld w County currently in operation which are not regulated by either z state or local governmental entities, and WHEREAS , the Board has studied the issue and considered the U a recommendations of the staff of the Human Resources Department orH oN and the Area Agency on Aging and has concluded that there is a m w need for regulations to protect the health and safety of the residents and employees of said homes and the citizens of Weld County. NOW, THEREFORE, BE IT ORDAINED by the Board of County Commissioners of Weld County, Colorado, that the rules and regulations governing the operation of board and care homes in Weld County, attached hereto, as Exhibit "A, " is incorporated herein by this reference. BE IT FURTHER ORDAINED that this Ordinance shall apply to all board and care homes in Weld County whether in an incor- porated or unincorporated portion of the County. 340713 r / �' �', BE IT FURTHER ORDAINED that if any section, subsection, paragraph, sentence, clause , or phrase of this Ordinance is, for any reason, held or decided to be invalid or unconstitutional, such decision shall not affect the validity of the remaining a, O portions. The Board of County Commissioners of Weld County, tH Colorado, hereby declares that it would have passed this Ordi- N O nance and each and every section, subsection, paragraph, Sen- a 0 3 tence, clause, and phrase thereof irrespective of the fact that oa t n- c4 any one or more sections, subsections, paragraphs, sentences, ca U clauses, or phrases might be declared to be unconstitutional or ro x invalid. Ln BE IT FURTHER ORDAINED that this Ordinance shall take effect a w m a.� on June 1 , 1984 . co wThe above and foregoing Ordinance No. 127 was, on motion o a duly made and seconded, adopted by the following vote on the • w 14th day of May , A. D. , 1984. rn G. Z + BOARD OF COUNTY COMMISSIONERS ATTEST: ann� ELD COUNTY, COLORADO a Weld County Clerk and Recorder �et s-2-40- W and Clerk gy he Boars Norman Carlson, Chairman x ) CDD CV D: td=i .°1S jc"t-rk 67citizieni.the° o"nson, Pro-Tem W G. APPROV c‘. • ay ��/if V r en R. Bran ner County Attorney C ck Carlson EXCUSED John T. Martin First Reading: April 2 , 1984 Published: April 5, 1984 Second Reading: April 16 , 1984 Published: April 19 , 1984 Final Reading: May 14 , 1984 Published: May 17 , 1984 -2- EXHIBIT "A" PROPOSED RULES AND REGULATIONS GOVERNING THE OPERATION OF BOARD AND CARE HOMES IN WELD COUNTY SECTION I Purpose The Purpose of these rules and regulations is to provide standards for board and care homes which include requirements for adequate sanitation, cleanliness, equipment, structure, operation and personnel practices of board and care homes and which are designed to protect the health and safety of residents and employees of said homes and the citizens of Weld County. These rules shall apply to all previously existing board rn o and care homes at the time of this enactment, as well as those consequently in existence. ' oo SECTION II Definitions The following definitions shall apply in the interpreta- 0 3 tion and enforcement of board and care homes in Weld County. w 2.1 "Boarder", "resident", "tenant" shall mean any person who pays for • or for whom payment is made for any care or room and board furnished by a • board and care home. N x 2.2 "Board" shall mean the Board of County Commissioners of Weld O ,4 County. .max 2.3 "Licensee" shall mean any person, firm, company, corporation, or u association, whether or not tax exempt, which possesses the ultimate authority and responsibility to operate a board and care facility. in z rl 2.4 "Weld County Health Department" or "Department" means the O z designated agency and its authorized agents mandated by these rules and r • regulations for issuance of licensure and inspection of board and care homes. � w o z 2.5 "Operator" shall mean any person, whether or not the licensee, who cn <4 manages, controls, or performs the day-to-day tasks of operating a board o and care home. U fY. a 2.6 A "board and care home" is a publicly or privately operated living o m arrangement in which room, board, personal assistance and supervision are m co provided in a home-like atmosphere for one or more persons and in which assistance is provided in obtaining supportive services for adults who need and request these services. This excludes all public and private facili- ties which are licensed by the Colorado Department of Health as general hospitals, psychiatric hospitals, community clinics and emergency centers, convalesence centers, nursing care facilities, intermediate health care facilities or residential facilities or community mental health centers or clinics under contract with the Colorado Department of Institutions. 2.7 "Personal assistance" means help given by the board and care home staff to residents who require assistance with activities of daily living as agreed to by the operator and resident as outlined in the Agreement. 2.8 "Agreement" shall mean a written contract between the board and care home operator and the resident designating and documenting the types and cost of services and care, and including a "Board and Care Plan". 2.9 "Board and care plan" means a written description of the functional capabilities of the individual and the individual 's need for personal assistance, supervision, and supportive services. 2.10 "Fiduciary Capacity" shall mean one who acts, transacts or handles money which is not his/her own, but for the benefit of another which implies great confidence and trust and a high degree of good faith. o 2.11 "Daily living activities" means a. walking b. bathing, shaving, brushing teeth, combing hair c. dressing d. eating o w e. getting in and/or out of bed 0 3 f. laundry o x g. cleaning room w h. managing money a i . shopping j . using public transportation w k. writing letters N x 1 . making telephone calls m. obtaining appointments x n. self-administration of medication o. recreation and leisure activities p. other daily living activities co H H 2.12 "Supportive Services" shall mean specific services as required by H the board and care plan or requested by the residents in addition to per- o z sonal assistance and supervision which a resident requires in order to live in the community in the areas of: a) health services, b) rehabilitation r services, c) social services, d) medical , dental and health care services, w e) recreational and leisure activities, f) educational services, g) finan- ko z cial management services that would assist in avoidance of financial a exploitation, h) legal services, i ) vocational services, j) other services o as required in order to meet the resident's needs. a 2.13 "Substance abuse" means the use of any mind or mood altering materials in a manner which deviates from standard medical practice in the o QJ community, which acts to the detriment of the individual residents or the 0 CV public, and includes, but is not limited to, narcotic drugs, dangerous drugs, or alcohol . 2.14 "Narcotic drugs" refers to any drug to which the Federal Controlled Substance Act of 1970 may apply and any drug found by the State Board of Health to have an addiction forming or addiction sustaining liabi- lity similar to morphine or cocaine. -2- 2.15 "Dangerous drugs" refers to Cannibus or any depressing drug, hallucinogenic drug, stimulant drug, or tranquilizer, or any such drugs in a mixture or compound or with any other substance. 2.16 "Alcohol" refers to beverage alcohol , ethylene alcohol , or ethanol . SECTION III Exemptions The following facilities shall be exempt from the applica- tion of this law: 3.1 Facilities intended to house individuals who are under the juris- diction of the criminal system. 3.2 A hospice which serves terminally ill persons. • o 3.3 A board and care home in which the residents are related to the owner by blood, marriage, or adoption as spouse, parent, child, grand- in o parent, granchild, sibling, aunt, uncle, niece, nephew, or first cousin EXCEPT that whenever one or more non-relatives reside in a boarding care a home with the relatives of the owner or operator, the home shall not be • 3 exempt. • o to- NI SECTION IV ca Persons shall not be permitted or allowed to remain as residents in a boarding care home if they: rx 4.1 Are consistently uncontrollably incontinent of urine or feces and r x cannot be managed in the board and care home. x a 4.2 Are unable or unwilling to meet their own personal hygiene needs 00 u under minimal supervision. nz f-I H 4.3 Require tray food service beyond five days. in F o m w 4.4 Require modified diets, unless the board and care home is capable and willing to provide for the modified diet. cs▪ w Z 4.5 Have a reportable, communicable disease or infectious conditions z which are or are likely to be contagious to other residents. z 0 a 4.6 Have acute mental or physical illness, including substance abuse, z unless such illness is no longer acute as determined by the attending physician. oLn ri w O cv 4.7 Have physical limitations prohibiting ambulation unless compensated by artificial means. Persons requiring wheelchairs or walkers must be located on the ground floor and be able to exit the building with minimal assistance. Board and care home operators choosing to serve individuals with wheelchairs shall provide ramps and rails to enable such residents to enter and exit the facility with minimal assistance. -3- Wheelchair residents shall also have access to bedrooms, bathrooms and dining room areas. Residents shall be able to enter and leave wheelchairs and walkers with minimal assistance. 4.8 Are significantly impaired with a sense of direction, orientation as to time, person, and place, or lack the ability to understand and follow instructions relating to the rules of the board and care home, medication storage, room cleanliness, visitors, safety, fire regulations, or have destructive, aggressive or violent behavior towards self or others. 4.9 Require intravenous therapy. 0 4.10 Are incapable of supervised administration of medication. 0 O 4.11 Require additional care or service beyond those permitted to be performed pursuant to these rules and regulations. a 0 3 SECTION V Licensing w 5.1 The Weld County Health Department under the authority of the Weld County Board of Commissioners is designated to issue licenses for the operation of board and care homes. O a 5.2 It shall be unlawful for any person to operate or cause to be •• operated a board and care home as defined herein unless such facility has been approved and regularly licensed in the manner set forth in these rules a and regulations. iI-1 im 5.3 Any person desiring a license to operate a board and care home H shall file with the Weld County Health Department an application on forms provided by the Department showing: o E o m a a. Name(s) of operator(s) and licensee(s). N b. List of partners (limited or general ) , officers, and share- w holders owning or controlling five percent (5%) or more of z outstanding shares of the corporation. Certified copies of z the Articles of Incorporation, By-Laws, or Partnership Agreement shall be attached to the application. Amendments shall be reported to the Department within thirty (30) days and copies furnished. c. Address(es) of operator(s) and licensee(s). d. Address of board and care home. rn o N e. Age(s) of the operator(s) and licensee(s). f. Disclaimers of any addictions of "substance abuse", "narcotic w drugs", or "dangerous drugs" by operator(s), licensee(s), partner(s), or shareholders with more than five percent (5%) interest, or officers of the licensee corporation. g. A disclosure of any previous felony convictions or crimes involving moral turpitude by the operator(s), licensee(s), partner(s), or shareholders withOore than five percent (5%) interest or officers of the licensee corporation. -4- h. Floor plan indicating doorways, entry ways, number of sleeping rooms, day rooms, living rooms, bathrooms, kitchens, exits, ramps and rails. i . Proof that the board and care facility has been inspected by the local fire department and meets the local codes in effect. j . A written fire and evacuation plan. k. Maximum number of individuals to receive board and care. 1 . Acknowledgement p.f understanding of the board and care ordinance in its entirety.. 5.4 Failure on the part of the licensee to show ability to meet the requirements of the ordinance shall result in a denial of the application a) O for licensure. ti U 0 r- 0 5.5 Upon the submission of an annual license application, there shall • be an annual fee accompanying such application. The rate of fee shall be a based upon the following categories and shall be as set forth by separate 0 action of the Board. a. 1-3 persons h• 113 b. 4-6 persons c. 7-9 persons d. 10-12 persons e. more than 12 N w i x 5.6 After the receipt of the initial application, the Weld County Health • Department shall issue a "probationary" license valid for three months. -4a coo 5.7 Within the three-month probationary period, inspection of the board N z and care home shall be completed by an authorized agent of the Weld County H Health Department and an appointed member by the Area Agency on Aging o m (which may include the local Ombudsman) and a determination made as to whether the board and care home facility meets the requirements of the rules r and regulations set forth herein. rn G z 5.8 Providing that the board and care home facility meets the require- Z ments of the rules and regulations set forth herein, an annual operating o license will be issued the board and care home effective the date the pro- 0g• bationary license was issued. w 5.9 Annual renewal of the operating license is required 30 days prior o to the date of expiration and shall require the submittal of the infor- mation required in §5.3 except that the completed renewal application may indicate that there has been "no change" where appropriate. 5.10 The board and care home operator shall place the license in a conspicuous place in the facility. 5.11 No license granted shall be assignable or transferable and shall apply only to the building described therein. -5- 5.12 Grounds and Procedures for Revocation, Denial or Suspension of License a. Obtaining or attempting to obtain a license by fraudulent means or misrepresentation of any fact and misappropriation of the property of residents. b. Violation of these regulations. c. Refusal to permit entry by Weld County Health Department per- sonnel or their agents for the annual licensing inspection. d. Conduct or practices deemed by the Weld County Health Department to be detrimental to the welfare of the residents rn o of board and care homes. 0 u e. Before any such license issued hereunder is suspended or revoked or upon denial of an application, a written notice OD O shall be given the licensee stating the grounds of denial , o revocation or suspension. Said notice shall indicate the o w date the decision is effective and the reasons for the denial , o 3 revocation or suspension and shall be sent by registered or o certified mail , return receipt requested, to the address of in-Q the licensee given in the application. f. A temporary suspension of license for a period of time not to u exceed 30 days may be invoked for those emergency circumstan- ces which require immediate action pending a hearing on suspension or revocation of the license. The Department of Health first must find that the conduct of the a licensee/operator or their agents or employees or the con- a dition of the board and care home presents an imminent danger u to the health, safety and welfare of the residents of the z board and care home before a temporary order of suspension r' " may issue. Notice shall be given as in §5.12(e) and by F posting of the board and care home. O a 5.13 If a license is denied, revoked or suspended, a reinstatement of a) w the annual operating license shall be considered by the Weld County Health Lo Department if, within 30 days, the conditions upon which revocation was z z based have been corrected and evidence of this fact has been furnished to the Department. W x 5.14 Appeal Process o m o N a. Any action to deny, suspend or revoke an operating license or application may be appealed by submitting a written statement • w of intent to appeal with the Weld County Health Department within fifteen (15) days of the postmarked date of the deci- sion to deny, suspend or revoke. b. The Weld County Health Department shall have the burden of proof by a preponderance of the evidence at the appeal hearing. c. The appeal will be heard by a committee designated by the Board of County Commissioners and chosen to include three (3) members of the Weld County Health Department Advisory Board -6- and three (3) members of the Area Agency on Aging Advisory Board within twenty (20) days after the receipt of notice to appeal . One person shall be chosen by the members of the appeal board to act as chairperson and to conduct the hearings. d. Notice of time, date and place of hearing shall be mailed to the parties seeking appeal at least ten (10) days prior to the hearing. e. The licensee(s) shall be entitled to representation by o counsel , and the Department and the licensee(s) may examine documentary evidence, present testimony on his or her behalf, and cross-examine and impeach witnesses presented by the m o opposing party. f. The hearing shall not be subject to strict judicial or a technical rules of procedure or evidence. Evidence presented 0 3 at the hearing may include oral testimony, witnesses, briefs or memorandums, inspection reports, site visit of the faci- ▪ w lity, and other relevant information. z g. A record, by a method selected by the appeals board, of the o hearing shall be kept. The methods may include use of a Court z reporter, electronic recording device, detailed transcription, or detailed minutes. If the appeals board chooses a method •• other than a Court reporter and the licensee(s) requests the x use of a Court reporter, licensee(s) shall be responsible for the cost of the Court reporter. ▪ a h. The appeals board shall , within seven (7) days of the ter- m u mination of the hearing, make a written report of its findings Ln 2 and recommendations as to whether or not the decision of the H Department was correct, supported by concise statements citing o the basis of the appeal board's decision. i . The Board of County Commissioners shall , within seven (7) ✓ days, issue and mail to the licensee(s), an order which either rn w adopts, with or without amendments, the findings or reconmen- 1 z dations of the appeals board; substitutes the Board of County • Z Commissioners' own findings and conclusion based upon the ri o record; or remands the matter to the appeals board to take a further evidence. This order shall constitute the final z agency decision of Weld County. M 5.15 Inspection O N H Each board and care home shall be periodically inspected, after w initial by an inspection for license, by an authorized agent of the Weld County Health Department, at least once annually. 5.16 Notice of Closing Facility Any licensee of a facility licensed under these rules and regula- tions shall give thirty (30) days notice to the Department prior to closing a facility or to closing any part of a facility. The resident's records shall be given to the resident or a party' responsible for the continued care of the resident. -7- 5.17 The Department shall be notified by the licensee of the change of the operator of the board and care home within thirty (30) days of any change. Notification shall be in writing and shall contain the name of the present and new operator and the date the new operator is to be responsible for the board and care home. The licensee is responsible for making appli- cation for an amended license under the requirements of this Section V. SECTION VI Compliance with local ordinances and regulations 6.1 Board and care home licensees and operators and the operation thereof shall comply with all the applicable zoning, housing, fire, sani- tary and other codes and ordinances of municipalities or Weld County unless more stringently regulated by this ordinance. SECTION VII Qualification of operator(s), persons designated to substitute o U for operators and employees 0 0 7.1 All operators and substitute operators shall be 18 years of age or older. 0 3 7.2 All operators, substitute operators and employees shall read, be familiar with, and follow the rules and regulations for the operation of o w board and care homes. 0 7.3 All operators, substitute operators, and employees upon employment shall be familiar with and comply with the rules and regulations regarding ✓ z preparation, handling of food, and the health rules and regulations n w outlined in these rules and regulations. to 7.4 Any person who is involved in substance abuse, uses alcohol excessively, uses narcotic drugs or dangerous drugs, is physically or men- tally unable to adequately and safely perform the duties of an operator as • Z required by this ordinance, or has been convicted of a felony or a crime of w moral turpitude, shall not be approved as a licensee or act as operator o m subject to the provisions of CRS 1973, §24-5-101 . 7.5 Operators and substitute operators shall : w w a. Be able to assume the overall responsibility for the day-to- rn z day management and operation of a board and care home and o 4 possess a willingness, understanding, and capacity to work with residents and have the capability of giving equal z treatment to residents without distinction related to sex, age, race, religion, ancestry or national origin. 0 o b. Be able to recognize emergencies and be able to contact o N emergency services (such as 911 ) , ambulances, fire departments and the police. m w 7.6 Employees shall : a. Provide supervision of the self-administration of medication. b. Possess the willingness, understanding, and capacity to work with residents and the capability of giving equal treatment to residents without distinction related to sex, age, color, race, religion, ancestry or national origin. -8- c. Possess the ability to contact the emergency services (such as 911 ) , ambulance, fire department and the police. d. Possess the ability to prepare and serve meals, perform house- keeping functions and perform transportation services. e. Not use intoxicants excessively, be addicted to drugs, use dangerous drugs, or exhibit behavior which would adversely affect the safety of the resident. SECTION VIII Duties of licensees, operators, substitute operators and employees 8.1 The licensees and operators shall at all times be responsible for the management of the board and care home and for the 24-hour supervision of the residents. 8.2 The licensee and operator shall not require a resident to perform any duties normally performed by the operator unless a written agreement is entered into with the resident describing in detail the duties to be per- °a o formed, the hours to be worked, and the compensation to be received. This written agreement shall be available for inspection. No resident shall be r employed if he/she does not possess the qualifications required of the employees or operators.o 0 8.3 The department shall be notified by the licensee within thirty o• (30) days of the change of the operator of the board and care home. 8.4 The licensee shall have on file with the Weld County Health o Department a written fire and evacuation plan and shall adhere to the codes of the fire district in their appropriate areas. The fire evacuation plan shall be posted and discussed with residents and employees. 0 ,4 x 8.5 The licensee and operator shall at all times provide sufficient paid staff to provide for the welfare, safety, and specialized supervision a as stated in the rules and regulations. The ratio of staff to the number of residents shall be at least one staff to seven residents, unless the z operator can show that a ratio of less than 1 to 7 is sufficient to provide for services as outlined in this ordinance and the resident agreement. in E oa 8.6 The operator has the responsibility of knowing that each room is equipped and maintained in a safe condition and that each room meets the w requirements of this ordinance. rn z SECTION IX >4 Location Location of the board and care home shall meet the require- dments of the zoning laws of the municipalities or County of Weld. CZ) rl SECTION X Facility Requirements M G N N 10.1 Communication Systems w114 There shall be at least one non-pay telephone in each building -9- readily available to summon help in case of fire or other emergency. The phone shall be located and be easily accessible to provide for privacy, and shall be available for personal use by the residents. 10.2 Water Supply a. Water used for domestic purposes in board and care homes shall meet the requirements in the Sanitary Standards and Regulations for Public Accomodations of the Colorado Department of Health, Section 4.0. In the event that a non-potable water supply is used for irrigation, fire protec- rn o tion, or other purposes, it shall be adequately color-coded or labeled to lessen any chance of it being used for domestic purposes. Cross connec- N o tions of any kind are prohibited. o b. The water heater shall be capable of heating water in an ade- o w quate supply to be drawn at every kitchen sink, lavatory, basin, shower, o S tub etc. to a temperature no less than 100 degrees fahrenheit. o 10.3 All sewage and liquid wastes shall be discharged into a public w sewage system where such system is available. Otherwise, sewage and liquid wastes shall be collected, treated and disposed of in an individual sewage disposal system which meets the requirements of the Weld County Health Department. Discharge of sewage or liquid wastes directly off the surface of the ground, into the bodies of water, directly on to ground water, or z through storm sewers is prohibited. 10.4 Garbage and Refuse Disposal Ln H Garbage and refuse shall be stored and disposed in accordance to H the Sanitary Standards and Regulations for Public Accomodations of the cm Colorado Department of Health, Section 6.1. 10.5 Electrical Utilities rn Ga 1/40 z a. Board and care homes shall be served by electrical services of m a capacity to meet the needs of the home. Lighting methods other than household current electricity shall not be permitted except during power u x failure emergencies, during which time only battery-operated lights shall z be used. Operable flashlights shall be available and identified and o N accessible to all employees. r, ri b. Sufficient electrical outlets and at least one per each bed ro w shall be provided to permit the use of bedlamps, radios, and electrical appliances as desired or required. c. Each sleeping room shall be provided with a minimum of 30 ft. candles of artificial light. There shall be an electrical wall switch in each sleeping room to control at least one light in the room. At the resident's request, bedside lamps or reading lamps shall be provided. The board and care home must abide by the applicable electrical code in effect at the time of application. -10- 10.6 Heating Capacity Heat shall be maintained in all rooms at a temperature of at least 70 degrees during the day and at least 65 degrees during the night. 10.7 Safety Regulations Appropriate warning signs and directions for the use of equipment and facilities shall be posted adjacent to potential hazards and equipment. 10.8 Smoking Regulations Board and care homes whose policy permits smoking shall provide a smoking free area to those residents who request it. a, O 10.9 Fire Safety rn o The board and care home shall be in compliance with the fire codes for the appropriate fire district or municipality and the premises w shall be made available for inspection by the local fire department at 0 0 S appropriate times. oa " a SECTION XI Residents' Rooms and Furnishings 11.1 Sleeping Rooms w N a a. No more than four (4) persons can be housed in one sleeping u room in a board and care home. For rooms occupied by more than one person, a beds shall be spaced not closer than 36" laterally or end to end, and shall allow for sufficient space of not less than 60 square feet of floor space w u per person in single bed rooms and 50 square feet per bed in multiple bed rooms, unless the operator can show by reason of special circumstance that Ln z H an amount less than this is adequate. Bunk beds are prohibited. E o m 11.2 Doors and entryways to sleeping rooms shall be identified and a floor plan submitted to and approved by the Weld County Health Department at the time of initial application for licensing. rn w • z 11.3 Only rooms having doors directly accessible to a hallway, living • < room or other acceptable usage area shall be used as sleeping rooms. No 0 beds are to be permitted in corridors, halls, living rooms, or kitchens. ua a 11.4 A storage facility shall be provided for each resident's bedroom. m At the resident' s request, the storage facility shall be equipped with a o M lock and key. A duplicate key to the resident 's storage facility will be CD CNI in the operator's possession. Upon request the resident shall be provided w with a lock and key for their room which may be opened from either side. A duplicate key to the resident's room shall be in the operator's possession. 11.5 Each resident shall be provided with a comfortable bed not less than 36" wide with springs and mattress in good, clean condition. Roll- away beds, cots, or davenports are not acceptable. -11- 11.6 Each boarder shall be provided with at least one comfortable pillow; clean, adequate, light-weight, warm bedding; and clean waterproof mattress protector and mattress pad. At least two clean sheets and one clean pillow case shall be provided to each resident each week. 11.7 Each sleeping room shall be provided with at least one chair, in good condition, for each resident. 11.8 There shall be at least one non-combustible wastebasket in each sleeping room. 11.9 Carpets or other floor coverings shall be securely fastened to the floor or have non-skid backing, and shall not be permitted to become hazar- dous because of curling edges or tattered sections. 11.10 All sleeping rooms occupied or used by residents shall be kept in c o a sanitary condition at all times. It shall be the operator's respon- o sibility to supervise the sanitary maintenance of sleeping rooms, and, if o residents are unwilling or unable to properly care for their own rooms the —Iv operator shall provide such maintenance services. A w 11.11 Cooking shall not be permitted in sleeping rooms. Cooking acti- o O 3 vities shall be confined to areas provided and approved for such purpose. oa 11.12 Residents shall be allowed to have visitors in their rooms as o well as other areas of the home and premises. V a 11'.13 Residents shall be permitted upon reasonable request to keep per- - sonal items and furnishings, including furniture, in their rooms which shall provide continuity from their previous living situation. x • SECTION XII Toilet and Bathing Facilities m U Z 12.1 Every board and care home shall have a minimum of one toilet, one ' H lavatory and one bathing facility for each ten persons or less. Where two Ln H or more toilets are required, they shall not be in the same room. Hand o a washing facilities shall be available in every room where there is a • toilet. At least one shower shall be provided. CT CTw w a. Toilets, bathtubs and showers shall be so located as to be m z reasonably accessible to all users without traveling more than one story. � Fc b. No toilet or bathroom shall be so located that access requires w x passage through the established kitchen, pantry, food preparation, food x sotrage, or dishwashing area. This restriction shall not be construed as o prohibiting the necessity or use of a toilet room adjacent to the above- r--N named area for use by personnel engaged in the food services of the home. w w c. Kitchen and bathroom floors shall be of water resistent materials, smooth enough to be easily clean and not slippery. Walls shall be washable. -12- d. Approved grab bars shall be installed at each tub or shower. e. All toilet seats shall be constructed of non-absorbent material , free from cracks and kept clean. f. Each resident shall be provided with soap and have clean bath towels weekly. g. All toilet rooms and bathrooms shall be ventilated to the out- side air. Unless windows in these rooms can be safely and easily opened and closed, ventilation shall be accomplished by acceptable ducts and fans. SECTION XIII Space Requirements 13.1 Suitable day room or living room space shall be provided for the usual functions of daily living which include social and pastime activi- ri o ties, which shall be distinct from sleeping areas. All areas shall be well lighted, heated and ventilated. InO 13.2 Traffic to and from any room shall not be through a resident's a bedroom. o W O 3 SECTION XIV Food Service and Nutrition oa L' o 14.1 All food service facilities shall maintain acceptable practice of sanitation, refrigeration, and food storage procedures. o a 14.2 Minimum of three (3) meals in each 24-hour period shall be pro- c.] vided each resident with not more than a 14-hour span between the evening x meal and breakfast. 14.3 The diet for all residents shall be well balanced, palatable, pro- w co U perly prepared, attractively served, and sufficient in quality and quantity z to meet current recommended daily dietary allowances of the Food and H Nutrition Board of the National Academy of Sciences - National Research o E Council . N 14.4 If a resident of the board and care home requires a special diet, m w and the board and care home is capable and willing to provide such diet, 1/4O the services of a dietary consultant shall be available through the Weld • z County Health Department and/or Weld County Area Agency on Aging. 14.5 For board and care homes with more than two or more residents, w there must be some evidence of meal planning available for inspection. a o Lfl 14.6 There shall be enough food on hand to prepare at least two (2) o N days menus. ▪ w 14.7 The kitchen/dining area or areas shall be kept clean, sanitary and provided with suitable furniture and adequate space to provide comfortable seating for all residents. -13- SECTION XV Resident Medication Requirements 15.1 Persons may be permitted to use oxygen. All oxygen tanks shall be properly secured at all times. The room in which oxygen is used and stored shall be posted "no smoking". The residents shall be responsible for main- taining oxygen equipment in a clean and sanitary manner. 15.2 No resident will be required by virtue of his residence in a board and care home to surrender the right to possess and self-administer any medication which belongs to the resident. a. At the resident's request, a private storage place shall be o supplied for storing drugs. The drug storage facility will be accessible only to the operator or assistant operator or individual resident at all kr, o times. —I O b. When a resident enters a facility following a written referral o w from a physician, and the basis of the referral is conditioned upon the resident's need for supervision for the self-administration of medication, o a the resident's medication shall be stored under lock and key and be Q accessible only to the operator or assistant operator. a c. Prescription drugs or medications which are to be administered by a legally qualified person, or administered by the operator under direc- N tzl tion of a physician, shall be stored in places accessible only to those legally qualified persons, or the operator and not to any resident. All • medications placed in storage must remain in the original containers. • Notation should be made that the medication was administered in accordance m u with the directions of the physician. � z H d. When the operator or any employee of a board and care home has F reason to doubt the wisdom or safety of a resident self-administering his z or her drugs, the question will be brought promptly to the attention of • that resident's physician or health care provider. mw w e. Prescription drugs belonging to a resident who has died shall z be surrendered to the family or other authorized representative and shall o Fr4 be disposed of. w SECTION XVI Resident' s Records Lo 16.1 Records shall be maintained concerning each resident and shall be o N available for inspection by authorized representatives of the Weld County Health Department. The records shall be legibly recorded, shall be pro- m w tected at all times from possible loss, damage, or unauthorized use. All medical , psychological and sociological information shall be held in strict confidence. These records shall be maintained for inspection for at least five years after residency has been terminated or longer if extended by the Weld County Health Department or an authorized representative. -14- 16.2 The records required above shall include the following information: a. full name of resident and former address b. date of arrival , date of departure, and documentation of the next place of residence c. name, home address, telehone number of relative(s) and/or responsible party that should be notified in case of emergency d. name, address, and telephone number of resident's physician, m o or primary health care provider o e. sex, date of birth, marital status, social security number, and full legal name of spouse f. a description of the resident's medication, including name of ca drug, dosage, and directions for administration g. written records of accidents, injuries, illnesses, violent 0 3 behavior towards self or others that occurs after admission o a to-lw 16.3 A copy of the information contained in section 16.2 shall be main- • tained as confidential and released to no one except the Weld County Health • Department, resident's physician, or any other person authorized by a resi- • dent or authorized representative of the resident or transferring physician by a written release. SECTION XVII Evaluation of Resident's Health Status co u 17.1 The Weld County Health Department or an authorized representative of the resident may request physicians, nurses, or other health care provi- H ders to conduct a special or general examination of a resident to determine un F physical and/or mental health status as it relates to continued occupancy O a in a board and care home. 17.2 The physician, nurse, or other health care provider conducting O1 w this examination shall notify the resident or their authorized represen- t z tative and the operator of the reason for this examination. rn z � F SECTION XVIII Residents' Rights ua w The residents of a board and care home shall have the same rights as x nursing home residents, as outlined in Colorado Revised Statutes §25-1-120 M N and 25-1-121. The residents shall be assured privacy and protection from moral , social and financial exploitation. Residents who have complaints or grievances have the right to notify the Weld County Health Department. w SECTION XIX Requirements Pertaining to Funds, Personal Property and Bank Accounts of Residents 19.1 The resident shall handle his or her funds or he/she may authorize the board and care home operator to handle the resident's personal funds or -15- property. In the event the operator is handling personal funds or pro- perty, the operator shall be deemed to be a fiduciary of said property or funds and shall be fully responsible for the funds. 19.2 There shall be a running account of all financial transactions. In the event that a check is being cashed or money is being held for a resident, there shall be an accounting of the transaction which shall include but not be limited to: the date the money was received from the resident and disbursed, source of funds , any and all deductions for room and board and other expenses, any advancements, and the balance. The resi- rn o dent shall sign all transctions for the account. An account shall begin o (J with the date of the handling of the personal funds of the resident and shall be kept on file for no less than five (5) years and shall be -i v available for inspection. as 19.3 Funds of each resident handled by the operator shall be protected 0 3 from theft and loss, and the operator shall be responsible for their safe keeping. These funds shall not be made available for the operator' s per- o w sonal use, or for operating expenses of the facility above and beyond the a agreed monthly room and board charges. O w 19.4 When an operator or an employee has permission to use the bank N a account of a resident, the operator or employee shall keep an up-to-date •• w record of any such bank accounts. These accounts shall be made available -I x for inspection as long as the resident is in the board and care home. a w coo SECTION XX Miscellaneous Requirements to z 20.1 Each board and care operator will be responsible for developing w house rules for residents' care and use of the facilities. Such rules shall o a be adopted with residents' input and shall not conflict with any provisions w of this ordinance. rp rn w 20.2 Rules for residents' behavior shall be given to each resident upon l0 z admission to the home and shall be posted. O1z o SECTION XXI Resident's Agreement u 21.1 A written "Resident's Agreement" shall be executed at the time of admission or prior thereto, between the board and care home operator and el O0 N the resident or legal guardian. Each party will be provided with a copy of O CN such agreement, and the board and care home shall keep such agreement on file until five (5) years after its expiration. wiw 21.2 Each Agreement shall set forth the following terms: a. rates and charges b. types of services provided which include, but are not limited to: -16- 1. list of "personal assistance" provided to residents for daily living activities as defined in this ordinance. 2. list of "supportive services" provided and requested by the resident and the board and care home operator as defined in this ordinance. 3. "board and care plan" outlining the functional capabilities of the board and care home residents and their need for personal assistance. c. No contract, or any provision therein, shall be construed to relieve any facility of any requirement or obligation imposed by these rules and regulations. d. This "Resident's Agreement" can be amended at the request of either party. The agreement shall set forth the board and care home operator' s policy on the notification of any change rn 0 in the amount of fee or types of services provided. rO 21.3 Involuntary transfer or discharge of a resident from a facility °I o shall be preceded by a minimum written notice of thirty (30) days except in a the following instances: a 0 3 a. When an emergency transfer or discharge is mandated by the o resident's health care needs and is in accordance with the medical justifi- vtw cation of the attending physician. ca b. When the transfer or discharge is necessary for the physical zsafety of the other residents as documented in the records. N SECTION XXII Prohibited Practice The licensee, operator, substitute operator, or employee shall not nzr a establish or practice policies of punishment by physical restraint, isola- 00 tion, corporal punishment, personal humiliation, or the wihholding of food, " H water or clothing to any boarder, resident or tenant. w o Cn SECTION XXIII a The Weld County Board of Commissioners and the Weld County Department o w of Health do not assume any responsibility or liability to the residents by 1/4O z the promulgation of these regulations or the issuance of a license. o z O Ua W a om M N o N ri rl M -17- fault of Publication OF COLORADO. 1 ss. runty of Weld. I n' �1� ---oy of LEGAL 'j that IiEGR5. ^'"".�� 'r+ County c! Weld. be 9 duly sworn. soy publish', of - A RE: RULEf AND REGULATIONS OSESEW eIO THE OPERATION OP 20.2io ORDINANCE-NO.WI WARS.AND CARE HOMES IN WEkif'�UUTY i the some is c weekly newspaper of general BE n. ay THE pomp 191E COUNTY EOMYIISSIONERS or illation and printed rid published in the WELD COUNTY,COLORADO; .,. n of .J C.,.. 'WHEREAS,Me Wardetainfy of Weld CaWlty,Wendt, psreYrt to conade stel a e1t9 Ma SHAW Hein Rulo Warr,it said count brill store: that the notice or Seer- veesad ADM authority ld iiMNRI the Wham a Wild CMS, intent. of which the annexed is a true copy. rillittlAS Ilse Board ell-mss,sitting as the Band of s been published in said weekly newspaper aatigL#yrsea*t to the IIMg Won*song Rain Charter,pessebses SerMIR —.—.-Nis-1------- j consecutive j to T i county INfuses,ate w r PaRenaL M TM*IS, ea SS,CRS,Is groans corm M s sent May, n6: that the nonce v.-as published in the an Sean egg ein!ldhatataate�l usiy,;wining tint MO ?galas and entire issue of every number of said hnaoFpogwlga��ate ewspoPer during the period and time of publi .ARAM VAS,there ere a amble om hone in WWI Camly mirmmRY oporaN,emehldk are P td tad py *Moor slate or tom titian of said notice and in the newspaper genoremente eetlKes,aW proper and not in a supplement thereof: that the IptEREAS,the Ward las SWIM MM Issue and alesillored the ream- RNRgatlafs of the staff of 1M N Department lad Me Argil first publication of sold nonce was contained in WWI en Aging and has conningf�o M a IoW,1x regghtMtts to the issue of saiddiewspayer becalm dale the Pact Me health and safely of tin r 15an imMNw ei said Mate SSW L hens of Weld County. G: day of 'VLF A.D.. I9 NESS THEREFORE, BE IT OR O bY Rte BM el Ceanry �J•� /�,'"`'" WMtltfYsiatars of Weld County; 5o .Mai iM ry1N mill and the lost publication thereof. m tin/issue of resift Hie�Pera St Wine M WS ggMy.a 1 said aiewsPaper bearing data. the 1�, day c: Isola fie EWES 4.04 is_ '1MeR ny Mli tflersea- Q•(// ..K R~WHIR ORDANiEC�6�YMosYtYlOPIUM sR awl , 19 std: that the said endure homes In Weld Comfy whether Man Incorporated ar unincorporated ... penis of the Candy.- ..RE IT FURTHER ORDAINED Mat Lief stolen,subsection,paragraph, n sedtMce,clause,a phrase of this Orgiastic, N,for any meson, held or /A' / snow to arMvalld or YeanitiMtfamF,such declaim shall tiot-aflKt In published continuously and unintetruPb validity of the remaining portions.The BNrd of Camay Commissioners e ho been Y Mid County Colorado, horny Anatol Riat it would have,passed this bellysecu during the period of at least lisadutwo con- Ordinance s ,ads and wary section,mbseetgen,paragraph, sentence, secuhve weeks next prior to the first issue thereof clans,and phrase thereof irrespective of Me fact that any on or mere section subsection,paragraphs,sentences,clauses,or phrases mien he containing said notice or advertisement above declared M be ueeensMvilonal or Wan. referred to: and that said newspaper was at the .•BE IT FURTHER ORDAINED that MM Ordinance fall take effect on "tat 1, 19M. time of each of the publications of said notice. -.Thitebw,Pad terpelegArdinaate Nl.NWwa,,Di anon airy made and duly qualified for that purpose within the mean. seaended,Spied by the Mann venom the—day'.tf" e made lad ing of an act. entitled. "An Act Concerning Legal BOARD OF COUNTY COMMISSIONERS ATTEST: WELD COUNTY,COLORADO Nation. Advertisements and Publications, and Weld County Clerk and Recorder Norman Carlson,Chairman the Foes of Printers end Publishers thereof, and and Clerk to the Board - lo Repeal all Acts and Parts of Acts in Conflict By: Deputy Counly.Cierc.. Jacquelin Johnson,Pro-Tem with the and all am of this s Act."h approved port) o- APPROVEDAS TO FORM: 1921, ell amendments thereof, and portico- Gene R.Branmor Icily as amended by an act approved, March 3D. County Attorney ' Chuck Carlson 192 an act opproved Ma l9. 1931. First Reading: April 2, 1984 John{Martin Published: April 5, 1984 • P ;slier Second-Reading: April 16, 1984 Published: April 19, 1984 Subscribed c sworn to before me this e Pinot Reading: Nay 14, 1984 . A.D.. 192.� Published: May 17, 1984 - - day of My commission expires Notary Public ELIZABETH MASSEY. 22019 W.C.RD. 54 GREELEY, CO 80631 1 is Page 10 LA SALLE LEADER April 19, 1984 / • Weld County Legal Notices • PROPOSED RULES AND REGULATIONS GOVERNING THE OPERATION OF SECTION V Licensing BOARD AND CARE HOMES IN WELD COUNTY 5.1 The Weld County Health Department under the authority of the Weld SECTION I i County Board of Commissioners Is designated to issue licenses for the operation of board and care homes. Purpose The Purpose of these rules and regulations is to provide standards for board add care homes which include requirements for adequate 5.2 It shall be unlawful for any person to operate or cause to be sanitation, cleanliness, equipment, structure, operation and personnel operated a board and care home as defined herein unless such facility has practices of board and care homes and which are designed to protect the been approved and regularly licensed in the manner set forth In these rules health and safety of residents and employees of said homes and the citizens and regulations. of Weld County. These rules shall apply to all previously existing board and care homes at the time of this enactment, as well as those consequently 5.3 Any person desiring a license to operate aboard and care hone, In existence. ' shall file with the Weld County Health Department an application on forms SECTION II provided by the Department showing: a. Name(s) of operator(s) and licensee(s). Definitions The following definitions shall apply in the lnterpreta- b. List of partners (limited or general), officers, and share- tion and enforcement of board and care homes in Weld County. holders owning or controlling five percent 15%1 or mare of outstanding shares of the corporation. Certified copies of 2.1 "Boarder", "resident", "tenant" shall mean.any person who pays for the Articles of Incorporation, By-Laws, or Partnership or for whom payment is made for any care or room and board furnished by a Agreement shall be attached to the application. Amendments board and care home. shall be reported to the.Department within thirty (30) days shed. 2.2 "Board" shall mean the Board of County Commissioners of Weld one copes rfnoperut a. andreopiesl of operator(s) and tic enseel s 1. County. O. Address of board and care home. e. Age(s) of the operator(s) and licensee(s). 2.3 "licensee" shall mean any person, firm, company, corporation, or f. Disclaimers of any addictions of "substance abuse", 'narcotic association, whether or not tax exempt, which possesses the ultimate drugs", or "dangerous drugs" by operator(s), licensee(sl, authority and responsibility to operate a board and care facility. partner(s), or shareholders with more than five percent (5%) interest, or officers of the licensee corporation. 2.4 "Weld County Health Department" or "Department" means the g. A disclosure of any previous felony convictions or crimes designated agency and its-authorized agents mandated by these rules and involving moral turpitude by the operator(s), licensee(s), regulations for issuance of licensure and inspection of board and care - partner(s), or shareholders withmore than five percent (5i1 homes. interest or officers of the licensee corporation. 2.5 "Operator" shall mean any person, whether or not the licensee, who h. Floor plan indicating doorways, entry ways, number of sleeping manages, controls, or performs the day-to-day tasks of operating a board rooms, day rooms, living rooms, bathrooms, kitchens, exits, and care home. - ramps and rails. I. Proof that the board and care facility has been inspected 2.6 A "board and care home" is a publicly or privately operated living by the local fire department and meets the local codes in arrangement inare which room, board, personal assistance and supervision effect. provided in a home-like atmosphere for one or more persons and in which J. A written fire and evacuation plan. assistance is provided In obtaining supportive services for adults who need k. Maximum number of Individuals to receive board and care. and request these services. This excludes all public and private facili- 1. Acknowledgement of understanding of the board and care ties which are licensed by the Colorado Department of Health as general ordinance in it9 entirety• hospitals, psychiatric hospitals, community clinics and emergency centers, - ' convalesence centers, nursing care facilities, Intermediate health care 5.4 Failure on the part of the licensee to show ability to meet the facilities or residential facilities or community mental health centers or requirements of the ordinance shall result in a denial of the application clinics under contract with the Colorado Department of Institutions. for licensure. , 2.7 "Personal assistance" means help given by the board and care home 5.5 Upon the submission of an annual license application, there shall staff to residents who require assistance with activities of dally living be an annual fee accompanying such application. The rate of fee shall be as agreed to by the operator and resident as outlined in the Agreement. based upon the following categories and shall be as set forth by separate 2.8 "Agreement" shall mean a written contract between the hoard and action of the Board. care home operator and the resident designating and documenting the types a. 1-3 persons and cost of services and care, and including a "Board and Care Plan". b. 1-3 persons 2.9 "Board and care plan" means a written description of the functional c. 2-9 persons capabilities of the individual and the individual's need for personal d. 10-12 persons assistance, supervision, and supportive services. e. mare than 12 2.10 "Fiduciary Capacity" shall mean one who acts, transacts or handles 5.6 After the receipt of the initial application, the Weld County Health money which is not his/her own, but for the benefit of another which Department shall issue a "probationary" license valid for three months. implies great confidence and trust and a high degree of goad faith. 5.7 Within the three-month probationary period, inspection of the board 2.11 "Daily living activities" means and care home shall be completed by an authorized agent of the Weld County a. walking Health Department and an appointed member by the Area Agency on Aging b. bathing, shaving, brushing teeth, combing hair (which may include the local Ombudsman) and a determination made as to c. dressing whether the board and care home facility meets the requirements of the rules d. eating - . and regulations set forth herein. e. getting in and/or out of bed f. laundry - 5.8 Providing that the board and care home facility meets the require- s. cleaning room -cents of the rules and regulations set forth herein,an annual operating h. managing money license will be issued the board and care home effective the date the pro- . shopping bationary license was issued. J.. using Public transportation writing 5.9 Annual_renewal of the operating license if required 30 days prior 1. obtaining telephone calls "--"—�- ctoa ion' equire dint§5.l on and sthat"thedcoe'tedVrenewal-af lie tion may n, self-admg appointments indicate required in §5.3 except that the completed renewal i application cation may .self-administration eats and of medication indl cafe that there has been 'no change'where appropriate. o. recreation and leisure activities P. other daily living activities 5.10 The board and care home operator shall place the license-in a conspicuous place in the facility. 2.12 "Supportive Services" shall mean specific services as required by the board and care plan or requested by the residents in addition to per- • $,11 no license granted shall be assignable or transferable and shall spool assistance and supervision which a resident requires in order to live apply only to the building described therein. in the community in the areas of: a) health services, b) rehabilitation services, c) social services, 0) medical, dental and health care services. 5.12 Grounds and Procedures for Revocation, Denial or Suspension el recreational and leisure activities, it educational services, gl fmnan- of License cial management services that would assist In avoidance of financial exploitation. h) legal services, i) vocational services, JI other services • a. Obtaining or attempting to obtain a license by fraudulent as required in order to meet the resident's needs. means ormisrepresentation of any fact and misappropriation 2.13 "Substance abuse"means the use of any mind or mood altering of the property of residents. materials in a manner which deviates from standard medical practice in the b. Violation of these regulations. community, which acts to the detriment of the individual residents or the c. Refusal to permit entry by Weld County Health Department per- public, and includes; buds not limited to, narcotic drugs. dangerous sonnel or their agents for the annual licensing inspection. drugs, or Alcohol. d. Conduct or practices deemed by the Weld County Health Department to be detrimental to the welfare of,the residents 2.14 "Narcotic drugs" refers to any drug to which the federal of board and care homes. Controlled Substance Act of 1970 may apply and any drug found by Ow State e. Before any such license issued hereunder is suspended or Board of Health to have an addiction forming or addiction sustaining liahi- revoked or upon denial of an application, a written notice lity similar to morphine Or cocaine. shall be given the licensee stating the grounds of denial, revocation or suspension. Said notice shall indicate the 2.15 "Dangerous drugs" refers to Cannibus or any depressing drug, date the decision Is effective and the reasons for the denial, , hallucinogenic drug, stimulant drug, or tranquilizer, or any such drugs in revocation or suspension and shell be sent by registered or n mixture or compound or with any other substance. certified mail, return receipt requested, to the address of the licensee given in the application. 2.16 "Alcohol" refers to beverage alcohol, ethylene alcohol, or ethanol. f. A temporary suspension of license for a period of time not to exceed 30 days may be invoked for those emergency circumstan- SECTION III . ces which require immediate action pending a hearing on suspension or revocation of the license. The Department of Exemptions The following facilities shall be exempt from the applica- Health first must find that the conduct of the tion of this law: licensee/operator or their agents or employees or the con- dition of the board and care home presents an imminent danger 3.1 Facilities intended to house individuals who are under the Juris- to the health, safety and welfare of the residents of the diction of the criminal system. board and care home before a temporary order of suspension may issue. Notice shall be given as in §5.12(e) and by 3.2 A hospice which serves terminally 111 persons. • posting of the board and care home. • 3.3 A board and care home in which the residents are related to the 5.13 If a license Is denied, revoked or suspended, a reinstatement of owner by blood, marriage, or adoption as spouse, parent, child, grand- the annual operating license shall be considered by the Weld County Health parent. granchild, sibling, aunt, uncle, niece, nephew, or first cousin Department if, within 30 days" the conditions upon which revocation was EXCEPT that whenever one or more non-relatives reside in a boarding care based have been corrected and evidence of this fact has been furnished to home with the relatives of the owner or operator, the home shall not be the Department. I. The Beard of County Commissioners shall, within seven (7) days, Issue and sail to the licensee(s), an order which either adopts, with or vitheet amev, en[5, the findings or recommen- dations of the appeals board; substitutes the Board of County Commissioners' own findings and conclusion based upon the record; or remands the matter tb the appeals board to take further evidence. This order shall constitute the final agency decision of This County. 5.15 Insoe<tion Each board and care Mae shall he periodically inspected, after initial by an inspection for license, by en authorised agent of the Weld County Health Department, at least once annually. 5.16 N ti f CI sin Facility Any licensee of a facility licensed under these rules and regula- tions facilitylorato closings(3 any pa) rt of noa tice facility.theDepartment resident's rior ro ecordsclosing shall be given to the resident or a party responsible for the continued care of the resident. 5.17 The Department shall the Operator of the board and be oename nithin thirty the change of (30) daysofany change. Notification shall be in writing and shall contain the name of the present and new operator and the date the new operator is to be responsible for making for a an ameendede li�se The derlicensee the requirements responsible ments of this for Section appli- cationV SECTION VI Compliance with local ordinances and regulations 6.1 Board and care home licensees and operators and the operation thereof shall comply with all the applicable zoning, housing, fire, sani- tary and other codes dnd by this ordinance. ordinances ins of municipalities or Weld County unless more stringently other l c regulated SECTION VII Qualification of operator(sl, persons designated to substitute for operators and employees 7.1 All operators and substitute operators shall be lB years of age or older. 7.2 All operators, satstitute operators and employees shall read, be familiar with, and follow the rules and regulations for the operation of board and care homes. 7.3 All operators. substitute operators, and employees upon employment shall be familiar with and comply with the rules and regulations regarding preparation, handling and food. the hea th rules and regulations outlined on these rules 7.4 Any person who is involved in substance abuse, uses alcohol excessively, uses narcatsc drugs or dangerous drugs, is physically or men- tally unable to adequately and safely perform the duties of an operator as required by this ordinance, or has been convicted of a felony or a crime of moral turpitude, shall not be approved as a licensee or act as operator subject to the provisions of CAS 197J. 624-5-101. 7.5 Operators and substitute operators shall: a. Be able to assume the overall responsibility for the day-to- day management and operation of a board and care home and possess a willingness, understanding, and capacity to work with residents and have the capability of giving equal treatment to residents without distinction related to sex, age, race, religion, ancestry or national origin. b. Be able to recognize emergencies and be able to contact emergency services (such as 911), ambulances, fire departments and the police. 7.6 Employees shall: a. Provide supervision of the self-administration of medication. b. Possess the willingness, understanding, and capacity to work with residents and the capability of giving equal treatment to residents ancestrycoron related to snational origin age, color, c. Possess the ability to contact the emergency services (such as 9ll), ambulance, fire-department and the police. d. Possess the ability to prepare and serve meals, perform house- keeping functions and perform transportation services. e. Not use intoxicants excessively, be addicted to drugs, use dangerous drugs. or exhibit behavior which would adversely affect the safety of the resident. SECTION VIII Duties of licensees, operators,substitute operators and employees • 0.1 The licensees and operators shall at all times be responsible for the management of the board and care home and for the 24-hour supervision of the residents. 8.2 The licensee and operator shall not require a resident to perform any duties normally performed by the operator unless a written agreement is entered into with the resident describing in detail the duties to be per- formed, the hours to be worked, and the compensation to be received. This written agreement shall be available for inspection. No resident.shall be employed if he/she does not possess the qualifications required of the employees or operators. 8.3 The department shall be notified by the licensee within thirty (30) days of the change of the operator of the board and care home. 8.4 The licensee shall have on file with the Weld County Health Department a written fire and evacuation plan and shall adhere to the codes of the fire district in their appropriate areas. The fire evacuation plan shall be posted and discussed with residents and employees. 0.5 The licensee and operator shall at all times provide sufficient paid staff to provide for the welfare, safety, and specialized supervision as stated in the rules and regulations. The ratio of staff to the number of residents shall be at least one staff to seven residents, unless the operator can show.that a ratio of less than 1 to 7 is sufficient to provide for services as outlined in this ordinance and the resident agreement. 8.6 The operator has the responsibility of knowing that each room is equipped and maintained in a safe condition and that each room meets the requirements of this ordinance. SECTION Ix Location Location of the board and care home shall meet the require- ments�the zoning laws of the municipalities or County of Weld. SECTION y Facility Requirements 10.1 Cemnunicg ion Systems There shall be at least one non-pay telephone in each building readily available to summon help in case of fire or other emergency. The phone shall be located and be easily accessible to provide for privacy, and shall'be available for personal use by the residents. 10.2 Water Supply _+ exempt. SECTION IV 5.14 Appeal Process Persons shall not be permitted or allowed to remain as residents in a a. Any action to deny, suspend or revoke an operating license or boarding care home if they: application may be appealed by submitting_a written statement 4.1 Are consistently uncontrollably incontinent of urine or feces and of intent to appeal with the.Weld County Health Department within fifteen (15) days of the postmarked date of the deci- cannot be managed in the board and care home. sion to deny, Suspend or revoke. 4.2 Are unable or unwilling to meet their own personal hygiene needs b. The Weld County Health Department shall have the burden of under minimal supervision. proof by a preponderance of the evidence at the appeal hearing. 4.3 Require tray food service beyond five days. c. The appeal will be heard by a committee designated by the Board of County Commissioners and chosen to include three (3) 4.4 Require modified diets, unless the board and care home is capable members of the Weld County Health Department Advisory Board one willing to provide for the modified diet. and three (3) members of the Area Agency on Aging Advisory Board within twenty (20) days after the receipt of notice 4.5 Nave a reportable, commJnic able disease or 7nl ettious conditions which are or are likely to be contagious to other residents. to appeal. One person shall be chosen by the members of th! _ appeal board to act as chairperson and to conduct the 4.6 Have acute mental or physical illness, Including substance abuse, hearings. unless such illness is no longer acute as determined by the attending d. Notice of tame, date and place of hearing shall be mailed to physician. the parties seeking appeal at least ten (lo) days prior to the hearing. 4.] Have physical limitations prohibiting ambulation unless compensated _ e. The licensee(s) shall be entitled to representation by by artificial means. Persons requiring wheelchairs or walkers must be counsel, and the Department and the licensee(s) may examine located on the ground floor and be able to exit the building with minimal documentary evidence, present testimony on his or her behalf. assistance. Board and care home operators choosing to serve individuals and cross-examine and Impeach witnesses presented by the with wheelchairs shell provide ramps and rails to enable such residents to opposing party. enter and exit the facility with minimal assistance. f. The hearing shall not be subject to strict judicial or technical rules of procedure or evidence. Evidence presented Wheelchair residents shall also have access to bedrooms, bathrooms and at the hearing may include oral testimony, witnesses, briefs dining room areas. Residents shall be able to enter and leave wheelchair, or memorandums, inspection reports, site visit of the fat i- and walkers with minimal assistance. lity, and other relevant information. g. A record, by a method selected by the appeals board, of the 4.8 Are significantly impaired with a sense of direr ti CM, or l rnl.at inn hearing shall be.kept. The methods may include use of a Court as to time• person, and place, or lack the ability to mubmstand mul follow reporter, electronic recording device, detailed transcription. Instructions relating to the rules of the board and care home, medical ion or detailed minutes. If the appeals board chooses a method storage, room cleanliness, visitors, safety, fire regulations, on have other than a Court reporter and the licensees) requests the destructive, aggressive or violent behavior towards self or others. use of a Court reporter, licensee(s) shell be responsible for the cost of the Court reporter. 4.9 Requite intravenous therapy. h. The appeals board shall, within seven (7) days of the ter- mination of the hearing, make a written report of its findings 4.10 Are incapable of supervised administration of medication. end recommendations as to whether or not the decision of the Department was correct, supported by concise statements citing 4,11 Require additional care or service beyond those permitted to be the basis of the appeal board's decision. performed pursuant to these rules and regulations. •qurrY^"u - ayeo 6u iPie oq e i ai ouo'lung 'bu!lq is 'pl4V�ue+fi mrP Lu suet uap�sa+ a. Water used for domestic purposes In _ meet the requirements in the Sanitary Standards and Regulations for Public Accomodations of the Colorado Department of Health, Section 4.0. In the event that a non-potable water supply is used for irrigation, fire protec- tion, or other purposes. It,shall be adequately color-coded or labeled to lessen any chance of'it being used for domestic purposes. Cross connec- tions of any kind are,prohibited. b. The water heater shall be capable of heating water in an ade- quate supply to be drawn at every kitchen sink, lavatory, basin, shower, tub etc. to a temperature no less than 100 degrees fahrenheit. 10.3 All sewage and liquid wastes shall be discharged into a public sewage system where such system is available. Otherwise, sewage and liquid wastes shall be collected, treated and disposed of in an individual sewage disposal system which meets the requirements of the Weld County Health Department. Discharge of sewage or liquid wastes directly off the surface of the gfound, into the bodies of water, directly on to ground water, or through storm sewers is proh;bited. • 10.4 Garbage and Refuse Disposal Garbage and refuse shall be stored and disposed in accordance to the Sanitary Standards and Regulations for Public Accomodations of the Colorado Department of Health, Section 6.1. 10.5 Electrical Utilities a. Board and care homes shall be served by electrical services of a capacity to meet the needs of the home. Lighting methods other than household 2urrent electricity shall not be permitted except during power failure emergencies, during which time only battery-operated lights shall be used. Operable flashlights shall be available and identified and accessible to all employees. b. Sufficient electrical outlets and at least one per each bed shall be provided to permit the use of bedlamps, radios, and electrical appliances as desired or required. _ c. Each sleeping'room shall be provided with a minimum of 30 ft. candles of artificial light. There shall be an electrical wall switch in each sleeping room to control at least one light in the room. At the resident's request, bedside lamps or reading lamps shall be provided. The board and care home must abide by the applicable electrical code In effect at the time of application. Continued on page 11 • ,1 A Weld County Legal Noti Continued from page IC 10.6 Heating Capacity Heat shall be maintained in all rooms at a temperature of at least 70 degrees during the day and at least 65 degrees during the night. 10.7 Safety Regulations Appropriate warning signs and directions for the use of equipment and facilities shall be posted adjacent to potential hazards and equipment. 10.8 Smoking Regulations. Board and care homes whose policy permits smoking shall provide a smoking free area to those residents who'request it. 10.9 Fire Safety The board end care home shall be in compliance with the fire codes for the appropriate fire district or municipality and the premises shall be made available for inspection by the local fire department at appropriate times. SECTION XI Residents' Rooms and Furnishings ' 11.1 Sleeping Rooms a. No more than four (4) persons can be housed in one sleeping room In a board and care home. For rooms occupied by more than one person, beds shall be spaced not closer than 36" laterally or end to end, end shall allow for sufficient space of not less than 60 square feet of floor space per person'In single bed rooms and 60 square feet per bed in multiple bed rooms, unless the operator can show by reason of special circumstance that an amount less than this is adequate. Bunk beds are prohibited, 11.2 Doors and entryways to sleeping rooms shall be identified and a floor plan submitted to end approved by the Weld County Health Department at the time of initial application for licensing. 11.3 Only rooms having doors directly accessible to a hallway, living room or other acceptable usage area shall be used as sleeping rooms. No beds are to be permitted in corridors, halls, living rooms, or kitchens. 11.4 A storage facility shall be provided for each resident's bedroom. At the resident's request, the storage facility shall be equipped with a lock and key. A duplicate key to the resident's storage facility will be in the operator's possession. Upon request the resident shall be provided with a lock and key for their room which may be opened from either side. A duplicate key to the resident's room shall be in the operator's possession. 11.5 Each resident shall be provided with a comfortable bed not less than 36' wide with springs and mattress in good, clean condition. Roll- away beds, cots, or davenports are not acceptable. 11.6 Each boarder shall be provided with At least one comfortable pillow; clean, adequate, light-weight, warm bedding; and clean waterproof mattress protector and mattress pad. At least two clean sheets end one • clean pillow case shell be provided to each resident each week. 11.7 Each sleeping room shall be provided with at least one chair, in good condition, for each resident. 11.8 There shall be at least one non-combustible wastebasket in each sleeping room. 11.9 Carpets or other floor coverings shall be securely fastened to the floor or have non-skid backing, and shall not be permitted to become hazar- dous because of curling edges or tattered sections. 11.10 All sleeping rooms occupied or used by residents shall be kept.in a sanitary condition at all times. It shall be the operator's respon- sibility to supervise the sanitary maintenance of sleeping rooms, and, if residents are unwilling or unable to properly care for their own rooms the operator shall provide such maintenance services. 11.11 Cooking shell not be permitted in sleeping rooms. Cooking acti- vities shall be confined to areas provided and approved for such purpose. 11.12 Residents shall be allowed to have visitors in their rooms as well as other areas of the home and premises. 11.13 Residents shall be permitted upon reasonable request to keep per- sonal items and furnishings, including furniture, in their rooms which shall provide continuity from their previous living situation. SECTION XII Toilet and Bathing Facilities 12.1 Every board and care home shall have a minimum of one toilet, one lavatory and one bathing facility for each ten persons or less. Where two or'more toilets are required, they shall not be in the same room. Hand washing facilities shall be available in every room where there is a toilet. At least one shower shall be provided. a. Toilets, bathtubs and showers shall be so located as to be reasonably accessible to all users without traveling more than one story. b. No toilet or bathroom shall be so located that access requires passage through the established kitchen, pantry, food preparation, food sttrage, or dishwashing area. This restriction shall not be construed as prohibiting the necessity or use of a toilet room adjacent to the above- named area for use by personnel engaged in the food services of the home. c. Kitchen and bathroom floors shall be of water resistent materials, smooth enough to be easily clean and not slippery. Walls shall be washable. d. Approved grab bars shall he installed at each tub or shower. e. All toilet seats shall be constructed of non-absorbent material, free from cracks and kept clean. • f. Each resident shal I be provided with snap and have clean bath towels weekly. g. All toilet rooms and bathrooms shall be venti laced is the out- side air. Unless windows In these rooms can be safely and cui ly opened and closed, ventilation shall be accomplished by acceptable ducts and fans. SECTION Xill Space Requirements 13.1 Suitable day room or living room space shall be provided for the usual functions of daily living which include social and pastime activi- ties, which shall be distinct Iron' sleeping areas. All areas shall be well lighted,.heated and ventilated. 13.2 Traffic to and from any room shall not be through a resident's bedroom. SECTION XIV Food Service and Nutrition 14.1 All food service facilities shall maintain acceptable practice of sanitation, refrigeration, and food storage procedures. 14.2 Minimum of three (3) meals in each 24-hour period shall be pro- vided each resident with not.more than a 14-hour span between the evening meal and breakfast. 14.3 The diet for all residents shall. be well balanced, palatable, pro- perly prepared, attractively served, and sufficient in quality and quantity to meet current recommended daily dietary allowances of the Food and Nutrition Board of the National Academy of Sciences - National Research Council. 14.4 If a resident of the board and care home requires a special diet, and the board and care home is capable and willing to provide such diet, the services of a dietary consultant shall be available through the Weld County Health Department and/or Weld County Area Agency on Aging. 14.5 For board and care homes with more than two or more residents, there must be some evidence of meal planning available for inspection. 14.6 There shall be enough food on hand to prepare at least two (2) days menus. 14.2 The kitchen/dining area or areas shall be kept clean, sanitary and provided with suitable furniture and adequate space to provide comfortable seating for all residents. SECTION XV Resident Medication Requirements ces b. When a resident enters a facility following a written referral from a physician, and the basis of the referral is conditioned upon the resident's need for supervision for the self-administration of medication, the resident's medication shall be stored under lock and key and be accessible only to the operator or assistant operator. c. Prescription drugs or medications which are to be administered by a legally qualified person, or administered by the operator under direc- tion of a physician. shall be stored in places accessible only to those legally quell(led persons, or the operator and not to any resident. All medications placed in storage must remain in the original containers. Notation should be made that the medication was administered in accordance with the directions of the physician. d. When the operator or any employee of a board and care home has reason to doubt the wisdom or safety of a resident self-administering his or her drugs, the question will be brought promptly to the attention of that resident's physician or health care provider. e. Prescription drugs belonging to a resident who has died shall be surrendered to the family or other authorized representative and shall be disposed of. SECTION XVI Resident's Records 16.1 Records shall be maintained concerning each resident and shall be available for inspection by authorized representatives of the Weld County Health Department. The records shall be legibly recorded, shall Im pro- tected at all times from possible loss, damage, or unauthorized use. All medical, psychological and sociological information shall be bold iii strict confidence. These records shall be maintained for Inspection for at least. five years after residency has been terminated or longer if extended by the Weld County Health Department or an authorized representative. 16.2 The records required above shall include the following information: a. full name of resident and former address h. date of arrival, date of departure, and documentation of the next place of residence c. name, home address, telehone number of relative(s) and/or responsible party that should be notified in case of emergency d. namee address, and telephone number of resident's physician, or primary health care provider e. sex, date of birth, marital status, social security number, and full legal name of spouse f.' a description of the resident's medication, including name of drug, dosage, and directions for administration g. written records of accidents, injuries, illnesses, violent behavior towards self or others that occurs after admission 16.3 A copy of the information contained in section 16.2 shall be main-. tanned as confidential and released to no one except the Weld County Health I Department, resident's physician, or any other person authorized by a resi- dent or authorized representative of the resident or transferring physician by a written release. SECTION 0011 Evaluation of Resident's Health Status 17.1 The Weld County Health Department or an authorized representative of the resident may request physicians, nurses, or other health care provi- I ders to conduct a special or general examination of a resident to determine physical and/or mental health status as it relates to continued occupancy in e board and care home. 17.2 The physician, nurse, or other health care provider conducting this examination shall notify the resident or their authorized represen- tative and the operator of the reason for this examination. SECTION 00111 Residents' Rights The residents of a board and care home shall have the same rights as nursing home residents, as outlined in Colorado Revised Statutes §25-1-120 and 25-1-121. The residents shall be assured privacy and protection from moral, social and financial exploitation. Residents who have complaints or grievances have the right to notify the Weld County Health Department. SECTION Ill Requirements Pertainin tjo_fundsc Personal Property and Bank Accounts of Residents "- 19.1 The resident shall Handle his or her funds or he/she may authorize the board and care hone operator to handle the resident's personal funds or property. In the event the operator is handling personal funds or pro- perty, the operator shall be deemed to be a fiduciary of said property or funds and shall be fully responsible for the funds. 19.2 There shall be a running account of all financial transactions. In the event that a check is being cashed or money is being held for a resident, there shall be an accounting of the transaction which shall include but not be limited to: the date the money was received from the resident and disbursed, source of funds, any and all deductions for room and board and other expenses, any advancements, and the balance. The resi- dent shall sign all transctluns for the account. An account shall begin with the date of the handling of the personal funds of the resident and shall be kept on file for no less than five (5) years and shall be available for Inspection. 19.3 Funds of each resident handled by the operator shall be protected from theft and loss,and the operator shell be responsible for their safe keeping.These funds shall not be made available for the operator's per- sonal use,or for operating expenses of the facility above and beyond Me agreed monthly room and board charges. • 19.0 When an operator or any employee has permission to use the bank account of a resident,the operator or employee shall keep an up-to-date record of any such bank accounts. These accounts shall be made available for inspection as long as the resident is in the board and care home. SECTION XX Miscellaneous Requirements 20.1 Each board and care operator will be responsible for developing house rules for residents'care and use of the facilities.Such rules shall be adopted with resident's input and shall not conflict with any provisions of this ordinance. 20.2 Rules for residents'behavior shall be given to each resident upon admission to the home and shall be posted. SECTION XXI Resident's Agreement 21.1 Awritten"Resident's Agreement"shall be executed at the time of admission or prior thereto,between the board and care home operator and the resident or legal guardian.Each party will be provided with a copy of such agreement,and hie board and care home shall keep such agreement on file until five(51 years after its expiration. 21.2 Each Agreement shall set forth the following terms: a. rates and charges b.types of services provided which include,but are not limited to: 1.list of"personal assistance"provided to residents for daily living activities as defined In this ordinance. • .2. list of "supportive services" provided and requested by the resider*and the board and care home operator as defined in this ordinance. 3."board and care plan"outlining the functional capabilities of the <- board and care home residents and their need for personal assistance. c.No contract,or any provision therein,shall be construed to relieve `f any facility of any requirement or obligation imposed by these rules and regulations. d.This"Resident's Agreement"can be amended at the request of either party.The agnomen shall set forth the board end care home operator's policy on the notification of any change in the amount of 4 fee or types of services provided. ■ ...r....r..................au..a....a....,a_..a........uar.lk.aa .. 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