his is the Sept 99 version of the stan - CRJ STAFF …crjustice.org/sqa/CH std checklist ACRS 4th Ed - Part1-12...2014/12/09 · CRJ - 8Coolidge House 4-ACRS-1A-08 (Ref. 3-ACRS-2D-01)

CHECKLIST

ADULT COMMUNITY RESIDENTIAL SERVICES

Fourth Edition

COOLIDGE HOUSE

CRJ - Coolidge House 1

4-ACRS-1A-01 (MANDATORY) (Ref. 3-ACRS-4D-05) The facility potable water source and supply are sanitary and are approved by an independent, qualified agency or individual to be in compliance with jurisdictional laws and regulations.

SELF-EVALUATION Agency Personnel

STANDARDS COMPLIANCE AUDIT Visiting Committee

Staff Signature(s)

________________________________

________________________________

Auditor Signature(s)

________________________________

________________________________

Compliance Noncompliance Not Applicable


List documentation to support compliance or explain non-applicability of standard

Sanitation and Housekeeping P&P

Letter from Boston Water & Sewer Commission

Information about Boston Water & Sewer

List reasons for noncompliance or non-applicability. Note: List all deficiencies if standard is in noncompliance. Include the square footage, ratios, footcandles, dBA=s, etc. Make your complete comments on this page with attachments, if necessary. BE VERY SPECIFIC!

STANDARDS COMPLIANCE CHECKLIST


4-ACRS-1A-02 (MANDATORY) (Ref. 3-ACRS-4D-02) The facility complies with the sanitation and health codes of the jurisdiction having authority.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________





Health Permit

Food Services Inspection

Certificate of Compliance for Kitchen Grease Exhaust

House Details List




4-ACRS-1A-03 (Ref. 3-ACRS-4D-01) Sanitation and safety inspections are conducted weekly, inspection results are reviewed, and deficiencies are corrected.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________





Room Search Forms

Daily Inspection Sheets




4-ACRS-1A-04 (MANDATORY) (Ref. 3-ACRS-4D-03) Waste is disposed of properly in accordance with an approved plan by the appropriate regulatory agency.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Sanitation and Housekeeping P&P Site Cleanliness License Daily Inspection Sheets Room Search Forms EZ Disposal Invoices




4-ACRS-1A-05 (MANDATORY) (Ref. 3-ACRS-4D-04) Vermin and pests are controlled.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________





AAA Exterminating Treatment Plan Letter

AAA pink site documents

AAA invoices




4-ACRS-1A-06 (Ref. 3-ACRS-4D-06) The facility is clean and in good repair, and a housekeeping and maintenance plan is in effect.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________





House Details List

Daily Inspection Sheets




4-ACRS-1A-07 (Ref. 3-ACRS-2D-01) (Revised January 2008) Documentation is provided by an independent, qualified source that lighting is at least 20 footcandles at desk level and in personal grooming areas.



Staff Signature(s)

________________________________

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________________________________

________________________________




Resident Living Environment P&P

Email from Turner Engineers re: foot candles




4-ACRS-1A-08 (Ref. 3-ACRS-2D-01) (Revised August 2002) (Interpretation August 2002) Air circulation is at least 15 cubic feet of outside or recirculated filtered air per minute per person and should be checked not less than once per accreditation cycle.



Staff Signature(s)

________________________________

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________________________________

________________________________





Email from Turner Engineers re: ventilation




4-ACRS-1A-09 (Ref. 3-ACRS-2A-01) The facility conforms to all applicable building codes and applicable federal laws.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Zoning and Building Code Compliance P&P

City of Boston Inspection Certificate

Certificate of Use and Occupancy




4-ACRS-1A-11 (Ref. 3-ACRS-2E-07) Space is provided for janitorial supplies in one or more locations that are accessible to the living and activity areas.



Staff Signature(s)






Floor plans




4-ACRS-1A-12 (Ref. 3-ACRS-2C-07) Offenders have access to operable showers with temperature-controlled hot and cold running water, at a minimum ratio of one shower for every eight offenders, unless national or state building or health codes specify a different ratio. Water for showers is thermostatically controlled to temperatures ranging from 100 degrees Fahrenheit to 120 degrees Fahrenheit to ensure the safety of offenders and to promote hygienic practices.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________





Shower ratios

Daily Kitchen Temperature Checklist




4-ACRS-1A-13 (Ref. 3-ACRS-1A-13) Offenders have access to writing and seating space.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Resident Furnishings P&P

Photo of writing/seating areas




4-ACRS-1A-14 (Ref. 3-ACRS-2C-03) Male and female offenders do not occupy the same sleeping room.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________





Bedsheets




4-ACRS-1A-15 (Ref. 3-ACRS-2C-11) (Revised January 2007) Offenders are permitted to decorate their living and sleeping quarters with personal possessions. Rules regarding the decorating of living/sleeping quarters are available to all offenders and staff. These rules are reviewed annually and revised, if necessary.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________





Intake Process P&P

Resident Handbook

Memo

Photo of resident room




4-ACRS-1B-01 (Ref. 3-ACRS-3B-09) (MANDATORY) (Revised-August 2002) An annual safety inspection of all vehicles is conducted by qualified individuals and in accordance with state statutes for any vehicle that is owned, leased or used in the operation of the facility.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Not applicable: Brooke House does not have a vehicle




4-ACRS-1B-02 (Ref. 3-ACRS-3B-09) Safety repairs are completed immediately. Vehicles are not used again until repairs are made.



Staff Signature(s)

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________________________________

________________________________








4-ACRS-1B-03 (Ref. 3-ACRS-3B-09) Vehicles are operated only by licensed drivers.



Staff Signature(s)

________________________________

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________________________________

________________________________








4-ACRS-1B-04 (Ref. 3-ACRS-3B-09) Vehicles and drivers are insured in conformance with state statutes.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________








4-ACRS-1C-01 (Ref. NEW) Emergencies are analyzed and the results used to initiate or revise policy and/or procedure to prevent future occurrences.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Emergency Plans P&P

Memo




4-ACRS-1C-01-1 (Ref. NEW) (Added January 2003) Critical incidents are defined for the facility along with a debriefing to be conducted after each such incident. The debriefing process includes coordination and feedback about the incident with designated staff of the facility as soon as possible after the incident. A debriefing includes, but is not limited to: a review of staff and offender actions during the incident a review of the incident’s impact on staff and offenders a review of corrective actions taken and still needed plans for improvement to avoid another incident



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Emergency Plans P&P

Memo




4-ACRS-1C-02 (MANDATORY) (Ref. 3-ACRS-3B-06) There is a written emergency plan, which includes an evacuation plan, to be used in the event of a major emergency. The plan is reviewed annually, updated if necessary. The plan includes the following:

• location of building/room floor plan • use of exit signs and directional arrows that are easily seen and read • location of publicly posted plan

SELF-EVALUATION

Agency Personnel STANDARDS COMPLIANCE AUDIT

Visiting Committee

Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Emergency Plans P&P

Memo

Floor plans

Emergency Evacuation Plan in English

Emergency Evacuation Plan in Spanish




4-ACRS-1C-04 MANDATORY (Ref. 3-ACRS-3B-07) All facility personnel are trained in the implementation of written emergency plans.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Emergency Plans P&P

Employee Orientation Checklist

Training Schedule




4-ACRS-1C-05 MANDATORY (Ref. 3-ACRS-3B-07) Emergency plans are disseminated to appropriate local authorities.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Emergency Plans P&P

Floor plans

Copies of letters with emergency plans sent to authorities




4-ACRS-1C-06 (Ref. 3-ACRS-3B-10) There is a written work stoppage or job action plan. Copies of this plan are available to appropriate supervisory personnel who are required to familiarize themselves with its contents.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Work Stoppage P&P

Memo

Training Schedule




4-ACRS- 1C-07 (Ref. 3-ACRS-3B-10) The facility operates continuously in the event of employee work stoppage or other job action.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Work Stoppage Plans P&P

Memo




4-ACRS-1C-08 MANDATORY (Ref. 3-ACRS-2A-03) Comply with the regulations of the fire authority having jurisdiction.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Fire Safety Plans P&P

Boston Fire Inspection

Boston Fire Permit




4-ACRS-1C-09 MANDATORY (Ref. 3-ACRS-3B-06) (Revised August 2007) There is a written evacuation plan to be used in the event of a fire. The plan is certified by an independent qualified agency or individual trained in the application of national fire safety codes. The plan is reviewed annually, updated if necessary and reissued to the local fire jurisdiction. The plan includes the following:

• location of building/room floor plan • use of exit signs and directional arrows that are easily seen and read • location of publicly posted plan • at least quarterly drills in all facility locations, and on every shift, including administrative areas

SELF-EVALUATION


Visiting Committee

Staff Signature(s)

________________________________

________________________________


________________________________

________________________________





Emergency Plans P&P

Resident Handbook

Fire Drills

Floor Plans

Copy of letter with emergency plans sent to Boston Fire Department

Training Schedule




4-ACRS-1C-10 MANDATORY (Ref. 3-ACRS-3B-01) A qualified person conducts fire inspections at least quarterly or at intervals approved by the fire authority having jurisdiction, following the procedures stated for variances, exceptions, or equivalences. Equipment is tested as specified by the manufacturer or the fire authority, whichever is more frequent.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________






Boston Fire Permit


Carlysle Sprinkler Systems Inspection

Gorham Fire Extinguisher Inspection

Invoices from Carlysle, Gorham, RE Lyons




4-ACRS-1C-11 MANDATORY (Ref. 3-ACRS-3B-01) Secure an annual inspection by the authority having jurisdiction or other qualified person(s).



Staff Signature(s)

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________________________________

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4-ACRS-1C-12 MANDATORY (Ref. 3-ACRS-3B-01) A fire prevention plan provides for fire protection service.



Staff Signature(s)

________________________________

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________________________________

________________________________







Memo




4-ACRS-1C-13 MANDATORY (Ref. 3-ACRS-3B-02) The facility has a fire protection alarm system and an automatic detection system.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________










4-ACRS-1C-14 MANDATORY (Ref. 3-ACRS-3B-01) Provide fire protection equipment at locations throughout the facility approved by the fire authority that has jurisdiction.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________






Boston Fire Permit


Gorham Fire Extinguishers Inspection



Floor plans

Invoices (Carlysle, Gorham RE Lyons)




4-ACRS-1C-15 MANDATORY (Ref. 3-ACRS-3B-04) Furnishings comply with fire safety performance requirements.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________





Bob Barker Invoices

Bob Barker Flammability Ratings




4-ACRS- 1C-16 MANDATORY (Ref. 3-ACRS-3B-05) Handle and store all flammable materials safely.

• Where smoking is permitted, provide noncombustible receptacles for smoking materials and separate containers for other combustible refuse at accessible locations throughout living quarters.

• Provide special containers for flammable liquids and for rags used with flammable liquids.

• Empty and clean all receptacles and containers daily.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________





Resident Handbook

Employee Orientation Checklist




4-ACRS-1C-17 MANDATORY (Ref. 3-ACRS-3B-03) Control the use and storage of all toxic and caustic materials.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________





Memo

MSDS

Photo




4-ACRS-1C-18 (Ref. NEW) Train staff and offenders in the proper use and safe handling of toxic and caustic materials.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________





Resident Handbook

Resident Handbook Acknowledgment Forms

Training Schedule




4-ACRS-2A-01 (Ref. 3-ACRS-3A-10) Access to and egress from the facility are controlled.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Resident Accountability P&P

Vendor/Contractor Supervision P&P

Resident Handbook

Itineraries

Visitor’s Log

Photos




4-ACRS-2A-02 (Ref. 3-ACRS-5C-09) Movement of visitors is monitored and controlled.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Visitation P&P

Vendor/Contractor Supervision P&P

Resident Handbook

Visitor’s Log




4-ACRS-2A-03 (Ref. 3-ACRS-1C-19 and 3A-03) The facility administrator and/or governing authority systematically determine and review staffing requirements at least annually. Staffing plans are implemented.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Adult Services Budget




4-ACRS-2A-04 (Ref. 3-ACRS-3A-02) Staff members are available in the facility 24 hours a day to respond to offender needs.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Staff Availability P&P

Desk Staff Schedule/WEDO Schedule




4-ACRS-2A-05 (Ref. 3-ACRS-3A-02) When both males and females are housed in the facility, at least one male and one female staff member are on duty at all times.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




No females housed at Brooke House




4-ACRS-2A-06 (Ref. 3-ACRS-1C-18) If employee’s contracts are governed by civil service or unions, procedures provide for provisional appointments to ensure that short-term personnel, both full-time and part-time, can be available during emergencies.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Not applicable: Community Resources for Justice is not governed by civil service unions




4-ACRS-2A-07 (Ref. NEW) A risk assessment is conducted for each offender either prior to admission or within 48 hours of admission.

SELF-EVALUATION


Visiting Committee

Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Resident Admission Criteria P&P

LSIs




4-ACRS-2A-08 (Ref. 3-ACRS-4A-05) The program advises the referring authority when a prospective offender is not accepted into the program, stating specific reasons.

SELF-EVALUATION


Visiting Committee

Staff Signature(s)

________________________________

________________________________


________________________________

________________________________





Memo




4-ACRS-2A-09 (Ref. 3-ACRS-3A-04) Information about routine operations and unusual incidents that occur at all locations in the facility are consistently recorded.

(a) Offender careworker staff maintain a permanent log. (b) Offender careworker staff prepare shift reports.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Shift summaries from general log




4-ACRS-2A-10 MANDATORY (Ref. 3-ACRS-3A-07) Possession and use of weapons is prohibited in the facility except in case of an emergency.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Weapons P&P

Resident Handbook

Memo




4-ACRS-2A-11 (Ref. 3-ACRS-3A-11) The facility has a system of accountability for offenders assigned to work and educational release, furloughs, and other temporary absences from the facility. The facility has a system for physically counting offenders. There are at least three offender counts daily. Staff monitor the movement of offenders into and out of the facility.

SELF-EVALUATION


Visiting Committee

Staff Signature(s)

________________________________

________________________________


________________________________

________________________________





Bedsheets

Headcounts




4-ACRS-2A-12 (Ref. 3-ACRS-3A-12) Absconders are detected and promptly reported. Timely notification is made to the facility with jurisdiction over the offender and others as appropriate.



Staff Signature(s)

________________________________

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________________________________

________________________________





General log documentation of escapes




4-ACRS-2A-13 (Ref. 3-ACRS-4H-01) The electronic monitoring program has a system of accounting for an offender at all times, including verification of activities, reporting of tardiness and/or absence from required services or activities, as well as other program violations.

SELF-EVALUATION


Visiting Committee

Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Not applicable: There is no electronic monitoring at Brooke House




4-ACRS-2A-14 (Ref. 3-ACRS-4H-02 and 4H-03) Access to computer equipment is limited to authorized personnel with security codes. Adequate power and communication backup systems provide continuous, uninterrupted operations.

SELF-EVALUATION


Visiting Committee

Staff Signature(s)

________________________________

________________________________


________________________________

________________________________








4-ACRS-2A-15 (Ref. 3-ACRS-4H-05) Any interruption in service is documented and reported to the authority having jurisdiction.



Staff Signature(s)

________________________________

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________________________________

________________________________








4-ACRS-2A-16 (Ref. 3-ACRS-4H-08) A detailed written offender schedule is developed and signed by a staff member and the offender.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________








4-ACRS-2A-17 (Ref. 3-ACRS-4H-10) Provisions are made for those who are unable to pay program costs.



Staff Signature(s)

________________________________

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________________________________

________________________________








4-ACRS-2B-01 (Ref. 3-ACRS-3A-05) MANDATORY (Revised August 2000) Physical force is used only in instances of self-protection, protection of the offender or others, prevention of property damage, prevention of escape, or to maintain or regain control.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Use of Force P&P

Memo




4-ACRS-2B-02 (Ref. 3-ACRS-3A-06) Persons injured in an incident immediately receive a medical examination and treatment.

SELF-EVALUATION


Visiting Committee

Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Use of Force P&P

Memo




4-ACRS-2B-03 (Ref. NEW) Use of force incidents are investigated; findings are aggregated and analyzed.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Use of Force P&P

Memo




4-ACRS-2C-01 (Ref. 3-ACRS-3A-13) The contraband policy is provided to staff and offenders.

SELF-EVALUATION


Visiting Committee

Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Searches P&P

Resident Handbook

Resident Handbook Acknowledgment Forms




4-ACRS-2C-02 (Ref. 3-ACRS-3A-13) Searches are conducted to control contraband.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Searches P&P

Resident Handbook

U/A sheets

Weekly Safety and Sanitation Checklists

Room searches




4-ACRS-2C-03 (Ref. 3-ACRS-3A-15) All physical evidence obtained in connection with a violation of law and/or facility regulation is preserved, controlled, and disposition made. At a minimum, procedures address the following:

• chain of custody • evidence handling • location & storage requirements



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Searches P&P

Resident Handbook

Contraband Incident Reports




4-ACRS-2C-04 (Ref. 3-ACRS-4E-09) Manual or instrument inspection of body cavities is conducted only when there is reason to do so and when authorized by the facility administrator or designee.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Not applicable: Brooke House does not conduct body cavity searches




4-ACRS- 2C-05 (Ref. 3-ACRS-4E-09) Inspection of body cavities is conducted in private by health-care personnel.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Not applicable: Brooke House does not conduct body cavity searches




4-ACRS-2C-06 (Ref. NEW) Only staff of the same sex as the offender participate in strip searches.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Not applicable: Brooke House does not conduct strip searches




4-ACRS-2D-01 MANDATORY (Ref. 3-ACRS-3A-14)(Revised January 2001) A control plan(s) for keys, tools and utensils addresses access, use and storage.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Control and Use of Keys, Tools, and Equipment P&P

Key Inventory

Tool Control Plan

Utensil Control Plan

Tool Inventory

Tool sign in/sign out




4-ACRS-2D-02 MANDATORY (Ref. 3-ACRS-3A-14)(Revised 2001) Tools and utensils are used in accordance with the prescribed system.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________





Tool Inventory

Tool Control Plan

Utensil Control Plan

Tool sign in/sign out




4-ACRS-2D-03 MANDATORY (Ref. 3-ACRS-3A-14)(Revised 2001) Keys are used in accordance with the prescribed system.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________





Staff Key Inventory

Key Return Form for staff




4-ACRS- 3A-01 (Ref. 3-ACRS-3C-01) Offender rules and disciplinary regulations describe violations, sanctions and penalties.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Resident Rules and Sanctions P&P

Resident Handbook

Incident Reports

Discipline Guidelines




4-ACRS-3A-02 (Ref. 3-ACRS-3C-01) Facility rules and regulations are reviewed at least annually and updated, if necessary.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________





Resident Handbook

Memo




4-ACRS-3A-03 (Ref. 3-ACRS-3C-02) All program rules and regulations pertaining to offenders are conspicuously posted in the facility or included in a handbook that is accessible to all offenders and staff.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________





Resident Handbook




4-ACRS-3A-04 (Ref. 3-ACRS-3C-02 and 4A-05 and 4H-06) At the time of admission, facility staff discuss program goals, service(s) available, rules governing conduct, access to health care, and program rules with the offender. Orientation is completed with five working days and is documented by a statement signed and dated by the offender and staff. When a literacy or communication problem exists, a staff member assists the offender.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________





Intake P&P

Resident Handbook

Brooke House intake sheets

Resident Handbook Acknowledgment forms

Individual Service Plans (ISP)

Case notes




4-ACRS-3A-05 (Ref. 3-ACRS-4A-07) (Revised August 2013) Offenders receive written orientation materials and/or translations in their language, if they do not understand English. When a literacy problem exists, a staff member assists the offender in understanding the material.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________





Resident Handbook in Spanish




4-ACRS-3A-06 (Ref. 3-ACRS-4A-08) If fees are collected, there is documentation that the offender has been informed of the policies and procedures regarding nonpayment of fees.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Intake Process P&P


Resident Handbook




4-ACRS-3A-07 (Ref. NEW) Staff model desired behaviors in accordance with a facility code of ethics. Staff members reinforce proper offender behavior and correct offender misbehavior.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________





Employee Handbook

Employee Checklist

Standards of Employee Conduct




4-ACRS-4A-01 MANDATORY (Ref. 3-ACRS-4C-02) [Applicable only to facilities that prepare OR serve food to offenders.] (Revised August 2010) If the facility prepares and serves food to offenders, dietary allowances are reviewed at least annually by a qualified nutritionist, dietician or physician to ensure that they meet the nationally recommended allowances for basic nutrition for the types of offenders housed in the facility.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Food Services P&P

Dietician’s License

Letter from Pine Street Inn

Menus




4-ACRS-4A-02 MANDATORY (Ref. 3-ACRS-4C-03) [Applicable only to facilities that prepare and serve food to offenders.] (Revised August 2004) Written policy, procedure, and practice provide for special diets as prescribed by appropriate medical or dental personnel. Prescriptions for therapeutic diets should be specific and complete, furnished in writing to the food service manager, and rewritten annually, or more often as clinically indicated.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Food Services P&P

Documentation of special medical diets




4-ACRS-4A-03 (Ref. 3-ACRS-4C-04) Special diets are provided for offenders whose religious beliefs require the adherence to religious dietary laws.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Food Services P&P

Receipts from purchase of Kosher food

Memo




4-ACRS-4A-04 Revised August 2010 (MANDATORY). (Ref. 3-ACRS-4C-05) [Applicable only to facilities that prepare OR serve food to offenders.] Food service staff members comply with all sanitation and health codes enacted by state or local authorities.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Food Services P&P

Health Permit



Servsafe Certificates




4-ACRS-4A-04-1 (Ref. 3-ACRS-4C-05) Added August 2011. All staff, contractors, and inmate workers who work in the food service department are trained in the use of food service equipment and in the safety procedures to be followed in the food service department.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Food Services P&P (re: licensing and certification & inspections)

Chore Checklist Resident Handbook Acknowledgement

Form House Meeting Agenda Memo

List reasons for noncompliance or non-applicability. Note: List all deficiencies if standard is in noncompliance. Include the square footage, ratios, foot candles, dBA=s, etc. Make your complete comments on this page with attachments, if necessary. BE VERY SPECIFIC!



4-ACRS-4A-05 (Ref. 3-ACRS-2E-04) [Applicable only to facilities that prepare OR serve food to offenders.] (Revised August 2010) Adequate space is provided for food preparation and service, and for an eating area and seating for all who dine at the same time.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Food Services P&P

Resident Handbook

Floor plans




4-ACRS-4A-06 (Ref. 3-ACRS-2E-05) [Applicable only to facilities that prepare OR serve food to offenders.] (Revised August 2010) When the facility has a kitchen, the kitchen, dining, and food storage areas are properly ventilated, properly furnished, and clean.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Food Services P&P

Floor plans

Daily Inspection sheets




4-ACRS-4A-07 (Ref. 3-ACRS-4C-07) [Applicable only to facilities that prepare OR serve food to offenders.] (Revised August 2010)

Food service practices provide for the following: • Weekly inspection of all food service areas, including dining and food

preparation areas and equipment; • Sanitary, temperature-controlled storage facilities for all foods; • Daily checks of refrigerator and water temperatures.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Food Services P&P

Floor plans

Daily Inspection sheets

Daily kitchen temperature checklist




4-ACRS-4A-08 (Ref. 3-ACRS-2E-06) [Applicable only to facilities that prepare OR serve food to offenders.] (Revised August 2010) Toilet and wash basin facilities are available to food service personnel and offenders in close proximity to the food preparation area.



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Food Service P&P

Photograph of bathroom closest to kitchen

Floor Plans




4-ACRS-4B-01 (Ref. 3-ACRS-4D-10) Articles necessary for maintaining proper personal hygiene are provided and are readily available to offenders. Articles include at least the following:

• soap • shampoo • toothbrush • toothpaste or powder • a comb • toilet paper • special hygiene items for female offenders



Staff Signature(s)

________________________________

________________________________


________________________________

________________________________




Personal Hygiene Articles P&P

Photograph of hygiene kit

Photograph of a resident’s personal hygiene items




4-ACRS-4B-02 (Ref. 3-ACRS-4D-07) Offenders have access to laundry facilities.



Staff Signature(s)

________________________________

________________________________


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Resident Handbook

Resident Laundry sign out sheets




4-ACRS- 4B-03 (Ref. 3-ACRS-2C-02) Offenders have access to the following facilities and conditions:

sanitation facilities, including access to toilets for use without staff assistance 24 hours a day

a washbasin with hot and cold running water a bed, and adequate storage space for clothes and personal belongings natural light from a source within 20 feet of the sleeping room temperatures that are appropriate to the summer and winter comfort zones



Staff Signature(s)

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Photograph of resident room and bathroom




4-ACRS-4B-04 (Ref. 3-ACRS-4D-09)(Revised January 2001) Offenders are issued suitable, clean bedding and linen, including two sheets, a pillow and pillowcase, one mattress, not to exclude a mattress with integrated pillow, and sufficient blankets to provide comfort under existing temperature controls. There is provision for linen exchange, including towels, at least weekly.



Staff Signature(s)

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Resident Handbook

Photograph of linen closet




4-ACRS-4B-05 (Ref. 3-ACRS-2E-08) Space is provided in the facility to store and issue clothing, bedding, and other items required for personal hygiene.



Staff Signature(s)

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Personal Hygiene Articles P&P

Photograph of linen closet

Photograph of hygiene kit




4-ACRS- 4C-01 MANDATORY (Ref. 3-ACRS-4E-03) Offenders have unimpeded access to health care and to a system for processing complaints regarding health care.



Staff Signature(s)

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Healthcare Services P&P

Resident Handbook

Medical visits with itineraries

General log notes of ambulance rides




4-ACRS-4C-02 MANDATORY (Ref. 3-ACRS-4E-01) The facility has a designated health authority with responsibility for health care pursuant to a written agreement, contract, or job description. The health authority may be a physician, health administrator, or health agency.



Staff Signature(s)

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Resident Handbook

Letters from medical providers

Memo




4-ACRS-4C-03 MANDATORY (Ref. 3-ACRS-4E-02) Twenty four hour emergency medical, dental, and mental health care is provided for offenders, which includes arrangements for the following:

on-site emergency first aid and crisis intervention

emergency evacuation of the offender from the facility

use of an emergency medical vehicle

use of one or more designated hospital emergency rooms or other appropriate health facilities

emergency on-call physician, dentist, and mental health professional services when the emergency health facility is not located in a nearby community

security procedures providing for the immediate transfer of offenders, when appropriate



Staff Signature(s)

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General log notes for ambulance rides




4-ACRS-4C-04 MANDATORY (Ref. 3-ACRS-4E-18) A training program for careworker staff and other personnel is established by a recognized health authority in cooperation with the facility administrator that includes the following:

• signs, symptoms, and action required in potential emergency situations • administration of first aid and cardiopulmonary resuscitation (CPR) • methods of obtaining assistance • signs and symptoms of mental illness, retardation, and chemical dependency • procedures for patient transfers to appropriate medical facilities or health-care

providers



Staff Signature(s)

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Floor plans

CPR cards

CPR curriculum

Signs & Symptoms Training staff attendance roster

Signs & Symptoms Training curriculum

Training schedule




4-ACRS-4C-05 (Ref. 3-ACRS-4E-19) (Revised August 2002) First aid kits are available in designated areas of the facility. Contents and locations are approved by the health authority. An automatic external defibrillator is available for use at the facility.



Staff Signature(s)

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Floor plans

List of contents in first aid kits

Photograph of AED




4-ACRS-4C-06 MANDATORY (Ref. 3-ACRS-4E-08) Medical, dental and mental health screening is performed by health-trained or qualified health-care personnel on all offenders upon arrival at the facility. The screening includes the following: Inquiry into:

• current illness and health problems, including venereal diseases and other infectious diseases; • dental problems; • mental health problems including suicide attempts or ideation; • use of alcohol and other drugs, which includes types of drugs used, mode of use, amounts used,

frequency of use, date or time of last use, and a history of problems that may have occurred after ceasing use (e.g., convulsions);

• other health problems designated by the responsible physician Observation of: • behavior, which includes state of consciousness, mental status, appearance, conduct, tremor, and

sweating; • body deformities, ease of movement, etc.; • condition of skin, including trauma markings, bruises, lesions, jaundice, rashes and infestations,

and needle marks or other indications of drug abuse.



Staff Signature(s)

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Institution medical exams and CRJ medical intakes

Intake sheets with medical appointment sheets




4-ACRS-4C-07 (Ref. NEW) Each newly admitted resident who was not transferred from a correctional facility undergoes a medical examination within 14 days of admission.



Staff Signature(s)

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Memo




4-ACRS-4C-08 (Ref. 3-ACRS-4E-12) Medical examinations are conducted for any employee or offender suspected of having a communicable disease.



Staff Signature(s)

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Communicable Disease List

Memo




4-ACRS-4C-09 (Ref. 3-ACRS-4E-13) The facility provides for the management of serious and infectious diseases.



Staff Signature(s)

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Serious and Infectious Diseases P&P

Memo

Hepatitis A & C brochures




4-ACRS-4C-10 (Ref. 3-ACRS-4E-14) Revised January 2008. Policies direct actions to be taken by employees concerning offenders who have been diagnosed with HIV, including, at a minimum, the following:

• appropriate safeguards for staff and offenders • when and under what conditions offenders are to be separated • staff and offender training procedures • issues of confidentiality • counseling and support services



Staff Signature(s)

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Serious and Infectious Diseases P&P


HIV Brochure




4-ACRS-4C-11 (Ref. 3-ACRS-4E-17) Access to dental care is made available to each offender.



Staff Signature(s)

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Medical appointment sheets

Itineraries




4-ACRS-4C-12 (Ref. 3-ACRS-4E-20) Policy and procedure direct the possession and use of controlled substances, prescribed medications, supplies, and over-the-counter drugs. Prescribed medications are administered according to the directions of the prescribing physician.



Staff Signature(s)

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Prescription/Medication Control P&P


Resident Handbook




4-ACRS-4C-13 (Ref. NEW) If medications are distributed by facility staff, records are maintained and audited monthly, and include the date, time and name of the resident receiving the medication, and the name of the staff distributing it.



Staff Signature(s)





Prescription/Medication Control P&P


Medication audits




4-ACRS-4C-14 (Ref. 3-ACRS-4E-23) If female offenders are housed, access to pregnancy management services is made available.



Staff Signature(s)





Not Applicable: No females at Brooke House




4-ACRS-4C-14-1 (Added January 2003) When nursing infants are allowed to remain with their mothers, provisions are made for a nursery, staffed by qualified persons, where infants are placed when they are not in the care of their mothers.



Staff Signature(s)

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Not Applicable: No females at Brooke House




4-ACRS-4C-15 (Ref. 3-ACRS-4E-15) Access to mental health services is made available to offenders.



Staff Signature(s)

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Resident Handbook

Itineraries

Appointment sheets




4-ACRS-4C-16 MANDATORY (Ref. 3-ACRS-4E-16) There is a written suicide prevention and intervention program that is reviewed and approved by a qualified medical or mental health professional. All staff with offender supervision responsibilities are trained in the implementation of the suicide prevention program.



Staff Signature(s)

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Suicide Prevention Policy signed off by CSMA Senior Clinician

Memo

Training schedule

Samaritans curriculum

CRJ Intake Sheet




4-ACRS-4C-17 (Ref. 3-ACRS-4E-06) If treatment is provided by health-care personnel other than a physician, dentist, psychologist, optometrist, podiatrist, or other independent provider is performed pursuant to written standing or direct orders by personnel authorized by law to give such orders.



Staff Signature(s)

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________________________________

________________________________




Not applicable: No medical services are provided at Brooke House

Memo




4-ACRS-4C-18 (Ref. 3-ACRS-4E-05) If the facility provides medical treatment, personnel who provide health-care services to offenders are qualified. Duties and responsibilities of such personnel are governed by written job descriptions approved by the health authority. Verification of current credentials and job descriptions are on file in the facility. Appropriate state and federal licensure, certification or registration requirements, and restrictions apply.



Staff Signature(s)

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Memo




4-ACRS-4C-19 (Ref. 3-ACRS-4E-24) If the facility provides medical treatment, offenders make medical decisions with informed consent. All informed consent standards in the jurisdiction are observed and documented for offender care.



Staff Signature(s)

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Memo




4-ACRS-4C-20 MANDATORY (Ref. 3-ACRS-4E-25) Offenders do not participate in medical, pharmaceutical, or cosmetic experiments. This does not preclude individual treatment of an offender based on his or her need for a specific medical procedure that is not generally available.



Staff Signature(s)

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Resident Handbook

Memo




4-ACRS-4C-21 (Ref. 3-ACRS-4E-26) Individuals designated by the offender are notified in case of serious illness or injury.



Staff Signature(s)

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Emergency Contact Notification P&P

Intake sheets




4-ACRS-4C-22 (Ref. NEW) If medical treatment is provided by the facility, accurate health records for offenders are maintained separately and confidentially.



Staff Signature(s)

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4-ACRS-4C-23 (Ref. 3-ACRS-4E-28) If medical treatment is provided by the facility, the method of recording entries in the records, the form and format of the records, and the procedures for their maintenance and safekeeping are approved by the health authority.



Staff Signature(s)

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4-ACRS-4C-24 (Ref. 3-ACRS-4E-29) If medical treatment is provided by the facility, for offenders being transferred to other facilities, summaries or copies of the medical history record are forwarded to the receiving facility prior to or at arrival.



Staff Signature(s)

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4-ACRS-5A-01 (Ref. 3-ACRS-4B-02) An objective assessment of each offender's risk and need, specifies the type of program needed and provides for regular review.



Staff Signature(s)

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Resident Program Plans P&P

Individual Service Plans (ISPs)

Level of Service Inventory (LSIs)




4-ACRS-5A-02 (Ref. 3-ACRS-4F-01) Offenders are provided with interventions targeted to factors that relate to their individual criminal behavior.



Staff Signature(s)

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ISPs

Itineraries




4-ACRS-5A-03 (Ref. 3-ACRS-4B-01 and 4B-03 and 4H-07) Staff design and complete an offender's personalized program plan within 14 days of admission. The plan includes measurable criteria of expected behavior and accomplishments, a time schedule for achieving specific goals, and scheduled progress reviews. The plan is documented with staff and offender signatures. Offenders have input into planning, problem solving, and decision making related to their participation in the program.



Staff Signature(s)

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ISP

Intake sheets




4-ACRS-5A-04 (Ref. 3-ACRS-4B-04) Any change in a personalized program plan is reviewed and discussed with the offender. This review is dated and documented by staff and offender signatures.



Staff Signature(s)

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Case notes showing level changes




4-ACRS-5A-05 (Ref. 3-ACRS-4B-05) Offender progress in the program is measured through objective assessment at least every six months and at discharge. The outcome of each review is documented.



Staff Signature(s)

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LSIs

Closing summaries




4-ACRS-5A-06 (Ref. 3-ACRS-4B-07) The facility administrator has the authority to remove or transfer an offender from the program.



Staff Signature(s)

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Closing summaries




4-ACRS-5A-07 (Ref. 3-ACRS-4F-02 and 4F-03) Each offender is assigned a facility staff member who meets with and counsels that offender as necessary, consistent with his/her individual treatment plan.



Staff Signature(s)

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Intake Process P&P

Comprehensive Case Management P&P

Case notes

Case load assignment

Resident Handbook




4-ACRS-5A-08 (Ref. 3-ACRS-4E-08-1)(Revised January 2001) Provide for early identification and treatment of inmates with alcohol and drug abuse problems through a standardized battery assessment. This battery shall be documented and include, at a minimum, the following:

• screening and sorting • clinical assessment and reassessment; • medical assessment for appropriate drug and alcohol program assignment based

on the needs of the individual offenders (if not done within the past six months); • referrals



Staff Signature(s)

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TDAT Referrals?




4-ACRS- 5A-09 (Ref. 3-ACRS-4F-12) If the facility operates a urine surveillance program, procedures provide instructions for the collection and processing of samples, the interpretation of results and the response to violations.



Staff Signature(s)

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Urine Collection P&P

Resident Handbook

Alco-Sensor Test Logs

Kroll Urine Sample Test form

Kroll Urine Results form

Incident report




4-ACRS-5A-10 (Ref. NEW) Health education is provided to offenders. Health education includes information on medical services and immunizations, personal hygiene, dental hygiene, nutrition, venereal disease, HIV and AIDS, tuberculosis and other communicable diseases.



Staff Signature(s)

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Resource Manual and Access to Community Services P&P

Resident Handbook




4-ACRS-5A-11 (Ref. 3-ACRS-4F-06) Staff use community resources, either through referrals for service or by contractual agreement, to provide offenders with the services to meet their program needs.



Staff Signature(s)

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Treatment Services P&P


Itineraries




4-ACRS-5A-12 (Ref. 3-ACRS-4F-05) The agency maintains and periodically updates a directory of functioning community agencies, or uses a directory that is maintained and updated by another agency.



Staff Signature(s)

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Resident Handbook

Coming Home Directory




4-ACRS-5A-13 (Ref. 3-ACRS-4G-02) Offenders are aided with their transition to the community, including referrals to assist offenders in locating suitable housing.



Staff Signature(s)

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Housing and Transitional Assistance P&P

Housing Searches




4-ACRS-5A-14 (Ref. 3-ACRS-4G-04) Each offender should be given gradual increased responsibility in the community prior to release, dependent upon his/her ability to accept responsibility.



Staff Signature(s)

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Pass Program/Program Related Activties P&P

Home passes


Documents

his is the Sept 99 version of the stan - CRJ STAFF …crjustice.org/sqa/CH std checklist ACRS 4th Ed - Part1-12...2014/12/09 · CRJ - 8Coolidge House 4-ACRS-1A-08 (Ref. 3-ACRS-2D-01)