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Document Citation: 65G-2.013, F.A.C.
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FLORIDA ADMINISTRATIVE CODE
TITLE 65 DEPARTMENT OF CHILDREN AND FAMILY SERVICES
65G AGENCY FOR PERSONS WITH DISABILITIES
CHAPTER 65G-2 LICENSURE OF RESIDENTIAL FACILITIES
Date:
08/31/2009
Document:
65G-2.013 Residential Habilitation Center Standards.
(1) Organization and Administration.
(a) One of the major goals of community placement is to integrate the client to the greatest possible extent with the general population. To this end, community services other than residential habilitation center services should be used extensively. A facility of the size of residential habilitation centers is high in restrictiveness for clients.
(b) To assure adequate provision of services, plans for physical plant, programs and site location, as well as application for licensure, of a proposed residential habilitation center are subject to review and approval by the Agency.
(c) The residential habilitation center need not be a fully self-contained program unit. Residential habilitation center activities shall be coordinated with habilitative educational and recreational activities in which the clients engage outside of the facility.
(d) A residential habilitation center for clients may be a corporation (profit or nonprofit), a partnership or an individual proprietorship.
(e) A corporation shall have on file a copy of its charter approved by the Secretary of State.
(2) Budget and Finance.
(a) An annual budget shall be prepared by the facility and submitted to the area office. A plan of financing shall give assurance of sufficient funds to enable the facility to carry out its defined purposes.
(b) Accounting practices shall conform to basic accounting procedures and financial records shall identify each residential habilitation center expense; individual client accounts for incidental expenses shall be identified; and a corporate residential habilitation center shall verify by a Board of Directors' resolution that the total program can be maintained without dependence on fees for at least 60 days from the date of opening. Proprietorship and partnership facilities shall verify by signed statement that the program can be maintained without dependence on fees for at least 60 days from the date of opening.
(3) Client Records to Be Maintained by the Residential Habilitation Center. The facility shall establish and maintain on the premises an individual record for each client. Pertinent information shall be entered into the client's record in sufficient detail to enable those persons involved in the client's program to provide effective continuing services.
(a) The record shall be kept in a lockable container and include at least:
1. The client's name and date of birth, as supplied by the Agency.
2. Written authorization for routine medical/dental care from the client or guardian and a medical summary, as supplied by the Agency.
3. The name, address and telephone number of the client's physician and dentist, as supplied by the Agency.
4. A record of the client's illnesses and accidents while a resident at the facility.
5. The legal status of the client, as supplied by the Agency.
6. A copy of the client's current habilitation plan, as supplied by the Agency.
7. An accounting of all the client's funds received and/or distributed by the vendor.
(b) All information contained in a client's record shall be considered privileged and confidential, as provided for in Section 393.13, F.S.
(4) Services to Be Provided. Residential habilitation center services shall include, but not be limited to, provision of adequate living accommodations, proper and adequate dietary supervision, appropriate physical care, support, guidance, supervision and assistance with training required to assure each individual the opportunity for personal growth and development. Specific services to be provided shall be defined by the needs of the clients to be served. Consideration shall be given to age, sex, developmental level and specific needs.
(5) Personnel Qualifications, Requirements and Responsibilities.
(a) Sufficient staff shall be provided to ensure that the facility is not dependent upon the use of clients or volunteers. However, a client may be encouraged to perform (age and ability appropriate) personal housekeeping chores such as maintaining his own quarters. A client may be expected to participate in an independent daily living skills program which may include the sharing of, or responsibility for, ordinary household tasks such as meal preparation, grocery shopping, dishwashing, laundering, cleaning of common areas of the residence, lawn care, gardening and other tasks generally performed by a normal family.
(b) Staff identified in the application for licensure and providing direct care services must be at least 18 years of age. Written evidence of the qualifications of the direct care staff shall be maintained. Minimum criteria shall be demonstrated ability to meet the written established job description, appropriate life experiences and an eighth grade education.
(c) Staff shall be of suitable physical and mental ability to care for the client they propose to serve; have knowledge of the needs of the clients; be capable of handling an emergency situation promptly and intelligently; and be willing to cooperate with the supervisory staff.
(d) At least three written character references (excluding relatives) and an employment work history shall be required for direct care staff.
(e) Each facility shall have a person designated as administratively responsible on site. This may be the licensee or an individual appointed by the licensee. The administrator shall be a person of responsible character and integrity, qualified by education, training, and/or experience to effectively manage the facility. The administrator should have completed college level course work applicable to the functions of the facility, such as education, special education, social work, sociology, health, psychology or child development, or have at least a high school diploma and three years relevant experience in working with children, adolescents or adults. The administrator shall designate a capable person who, in his/her absence but under his/her supervision, will perform all the necessary duties of the position.
(f) The number of staff needed for a given facility is dependent upon the size and kind of program, the type of clients and the competency of staff. The facility shall maintain at least the staffing pattern established by licensure.
(g) Staff Responsibilities. Staff of a residential habilitation center shall:
1. Create a congenial and homelike atmosphere within the community residence.
2. Plan, supervise, and/or prepare nutritious meals.
3. Be supportive of each client in developing attitudes and behaviors appropriate to community living.
4. Be supportive of and encourage each client's participation in the day training/vocational program prescribed.
5. Be supportive of each client in developing those skills necessary to ensure his/her independence within his/her scope of competency in the community (i.e., budget management, planning and preparing meals, housecleaning, personal grooming and hygiene).
6. Provide for and ensure each individual's right to privacy, in accordance with the Bill of Rights of Persons with Developmental Disabilities, Section 393.13, F.S.
7. Establish and maintain house rules and regulations, in consultation with clients, for the orderly operation of the residential habilitation center.
8. Protect each client's rights and freedoms and maintain the confidentiality of personal information concerning the client, in accordance with the Bill of Rights of Persons with Developmental Disabilities, Section 393.13, F.S.
9. Help establish self-government within the meaning of Section 393.13, F.S.
10. Make the facility accessible to members of the Local Advocacy Council.
11. Participate in the annual reassessment of each client as requested by area office staff and cooperate with the Agency in implementing the habilitation plan.
12. Participate in training sessions made available by the Agency.
(h) The residential habilitation center shall develop a weekly schedule indicating its staff coverage.
(i) The residential habilitation center shall have written personnel policies, practices and procedures. This shall include a job description for each position.
(j) The residential habilitation center shall maintain on file the training, education and experience of each direct care staff member.
(k) At least one staff person shall be on duty on the premises at any time a client is present. An exception to this regulation may be granted by the Agency for a semi-independent living program.
(l) At least one staff person shall be on call when the facility is not occupied by clients.
(m) Staff Training.
1. There shall be a staff training program that is appropriate to the size and nature of the facility and includes but is not limited to:
a. Orientation for all new employees to acquaint them with the philosophy, organization, program, practices and goals of the facility.
b. Continuing in-service training to update and improve staff skills and competencies.
c. In-service training for volunteers.
2. There shall be a record of all staff training on file.
(6) Facility and Site Requirements.
(a) The facility shall be located, equipped, and designed to assure safe care and supervision for all clients to enable them to utilize the surrounding community resources necessary to meet their needs. Mobile homes, as defined by Section 320.01, F.S., shall not be utilized for residential habilitation center facilities.
(b) Those facilities serving the physically handicapped client shall not have architectural barriers that prevent that client's participation in normal situations. Ramps, doors, corridors, toileting and bathing facilities, furnishings and equipment shall be designed to meet the individual client's needs.
(7) Federal, State, County and City Requirements.
(a) The residential habilitation center is responsible for complying with all applicable laws, rules, regulations, or ordinances of each governmental unit in which the facility is located, including but not limited to those relating to buildings, fire, sanitation, health, safety, zoning, civil rights and employment.
(b) Any building planned for use as a residential habilitation center shall be inspected and approved in accordance with the design for occupancy by the following agencies and others as required: local or state fire authority, county health department, local zoning department. The following fire safety standards shall be included in or added to the requirements of the inspection performed by the local fire inspection authority:
1. The use of unvented gas and oil heaters is prohibited.
2. The use of electric portable heaters shall be in accordance with the facility's wiring capacity.
3. The facility shall be equipped with smoke detection and alarm devices.
4. All gas-fired devices shall be equipped with an automatic pilot gas shut-off control.
5. Extension cords shall not extend from one room to another. Multiple electric outlet adapters shall not be used for more than two extensions at a time.
6. All electrical wiring shall be fully insulated.
7. Attic space shall not be used for storage of volatile materials.
8. Volatile materials shall not be stored where water heaters are located.
9. Volatile materials shall be isolated from the clients' living area. Such items shall be stored in approved metal containers.
10. All doors with locks must be readily opened from the inside.
11. At least a 2 1/2 pound, type ABC portable fire extinguisher shall be maintained in the kitchen area of the facility. It shall be serviced annually and so tagged.
12. No exit, stairway, corridor, ramp, fire escape, or other means of exit shall be used for storage purposes or otherwise be obstructed from use in case of emergency.
13. All equipment such as heating and cooling units, washers, dryers, refrigeration systems, stoves, hoods, etc., shall be properly installed, vented and maintained in good repair.
14. All doors and windows designed to open shall be operable.
15. Smoking shall be permitted only in areas determined safe for this activity. Clients shall not be permitted to smoke in bed except those confined to bed by infirmity may be permitted to do so under direct supervision of staff.
16. There shall be a written evacuation plan, which includes procedures and a schematic diagram, for the removal of residents from the building in the event of fire. Such plan shall take into consideration the mental and physical handicaps of the clients.
17. All employees shall be instructed in their duties according to the written evacuation plan.
18. A fire drill shall be held at least monthly. Dates and results (time and day, evacuation time and signature of person conducting the drill) of monthly fire drills shall be maintained in the facility record one year from the date of the drills.
(c) A residential habilitation center shall meet fire safety standards prior to issuance of a license and must be in complete compliance for annual renewal.
(d) The local authorized fire inspector shall be requested to inspect the facility for compliance with local codes and ordinances including but not limited to these standards.
1. The inspection may be made by the person designated by the Agency who has training in fire safety standards for community residential facilities for clients, when the local authorized fire authority indicates in writing that he/she is unwilling or unable to honor the request for inspection.
2. Any approval given when an inspection is completed by this designated person shall include the person's name and a verification of his/her authority.
3. Exception: Only the local fire authorities shall give approval for multi-storied frame dwellings.
(e) The residential habilitation center shall be inspected by the county health department prior to issuance of a license and must be in complete compliance for annual renewal.
(8) Residential Habilitation Center Plant.
(a) Living and Dining.
1. A minimum of 35 square feet of combined living and dining area shall be provided per resident of the facility.
2. The living area shall be provided with an adequate number of furnishings for the usual functions of daily living and social and diversional activities. These furnishings shall be sturdily constructed and of satisfactory design to meet the daily needs of residents of the facility.
3. The dining area furnishings shall be adequate in number, well constructed and of satisfactory design to meet the daily needs of the residents of the facility.
(b) Kitchen.
1. The kitchen shall be large enough to accommodate the equipment and personnel needed to prepare and properly serve the required number of meals.
2. The kitchen shall have equipment, utensils, and supplies to properly store, prepare and serve the required number of meals. Chipped, cracked and otherwise unsafe utensils shall not be used.
(c) Bedrooms.
1. Bedrooms shall be arranged so that privacy is assured for clients. Sole access to these rooms shall not be through a kitchen, bathroom or other bedrooms. A maximum of four residents shall share a bedroom used by clients.
2. Single bedrooms for clients shall provide at least 80 square feet of usable floor space. Multi-occupancy rooms shall provide at least 60 square feet per person of usable floor space.
3. Bedroom arrangements shall be compatible with the physical needs of the clients. Beds for clients shall be located so as to avoid drafts from windows and excessive heat from heat sources.
4. Usable floor areas shall include only those areas with vertical wall heights of five feet or more.
5. An enclosed closet space adequate for the belongings of each resident shall be provided.
6. Bedroom doors shall not have vision panels.
7. Each client shall have an individual bed. Each client's bed shall have a clean, firm, comfortable mattress. Beds shall be of suitable dimensions to accommodate the clients who are using them. Bunk beds shall not be used unless appropriate to the age and functioning ability of the client.
8. Bedding and linens shall be provided for each client. These include a suitable pillow, pillow case, sheets, blanket and spread. Bedding shall be appropriate to the season. Bed linens shall be replaced with clean linens at least once each week, or more frequently as required.
9. Bedroom furnishings for clients shall include adequate shelf space, individual chest or dresser space, mirror, draperies or shades and bedspread.
10. The client shall be allowed to decorate his/her private quarters in an individual style which will respect the care of the property.
(d) Bathroom.
1. Sole access to the bathroom shall not be through a kitchen or another individual's bedroom.
2. A toilet and lavatory facility shall be provided for every six residents.
3. A minimum of one tub or shower facility shall be provided for every eight residents.
4. Bathrooms shall be well ventilated by natural or mechanical methods.
5. Toilets, tubs and showers used by clients shall provide for individual privacy.
6. Each client shall be provided a separate and appropriate place for keeping his/her own toothbrush and a towel.
7. Toilet and bathing area fixtures shall approximate normal patterns found in residential construction, except where special requirements are applicable for physically handicapped clients or for special program needs.
(e) Administrative or Office Space. An area of the facility shall be designated as office space where files, desk, telephone, and other administrative tools and equipment are installed. Provisions shall be made for locking and protecting confidential files and other types of records, e.g., account books, inventories, audits, client records, and client funds.
(f) Laundry.
1. Laundry services and/or appliances for laundry shall be available within the facility or accessible to clients commercially.
2. Laundry services must be provided for those residents without ability to obtain these services for themselves.
(g) Storage. Storage space shall be available to accommodate residents, luggage and personal belongings.
(h) Outdoor. The grounds surrounding the facility shall be sufficient to allow social, recreational and physical activities.
(i) Housekeeping. Every facility shall have equipment and supplies to:
1. Keep the building in a clean, safe and orderly condition.
2. Control odors by appropriate sanitation practices, effective cleaning procedures and proper use of ventilation.
3. Prohibit use of bath tubs, showers and lavatories for janitorial or storage purposes.
(j) Heating and Cooling. Temperature and humidity shall be maintained within a normal comfort range for the climate. The heating apparatus employed shall not constitute a burn hazard to the clients.
(k) Lighting. All areas of the facility shall be lighted in accordance with the usage of the area.
(l) Maintenance.
1. The facility shall maintain the interior and exterior of the building in a clean, safe, presentable and repaired condition.
2. The grounds and all buildings on the grounds shall be maintained in a safe, sanitary and presentable condition.
3. All outdoor garbage and other waste materials shall be kept in covered containers until removed. Containers shall be emptied as often as necessary to prevent public nuisance, health hazards and unsightliness at least in accordance with all applicable state and local ordinances. The facility shall be kept free of unnecessary and unusable accumulations of possessions for the operation of the facility, including equipment and supplies of residents, staff, or the facility's owner that constitute health and/or fire hazards.
(m) Insect and Rodent Control. The facility shall be maintained free of infestations of insects and rodents. The facility shall have a pest control program provided by maintenance personnel or by contract with a pest control agency.
(9) Food Services.
(a) Quality and Variety. Food and beverages shall be of adequate quantity and variety, served at appropriate temperatures, prepared by methods which conserve nutritional value, and served in a form easy for clients to manage.
1. Within reason, dietary practices in keeping with the religious requirements of the client's faith group shall be observed at the request of the client or guardian.
(b) Frequency of Meals. For clients not routinely absent from the facility for work or other purposes, at least three meals shall be prepared at regular times during each twenty-four (24) hour period. If a client is absent from a facility for work or approved programs during a regular meal time, he or she must be provided with a take-out meal, if other provisions are not made by the client or the facility.
(c) Meal Planning.
1. When food services are not supervised by a nutritionist, a dietitian shall be consulted at least annually. The area office staff can assist the facility in securing these services. Summaries of the consultations shall be retained in the facility's administrative records one year from date of consultation. Completion of a food preparation management course shall substitute dietary consultation.
2. Menus shall be planned and written at least two days in advance and dated. Menus, as served, shall be kept on file for a minimum of one month.
3. Fresh food supplies sufficient for two days and staple food supplies sufficient for at least five days shall be available at the facility at all times.
(d) Dining and Serving Arrangements.
1. Dining and serving arrangements shall provide for a variety of eating experiences and the opportunity for clients to make food selections with guidance.
2. Clients shall be encouraged to eat with staff members.
3. Except when prevented by health reasons or by physical limitations specific to the eating process, all clients, including the multiple handicapped and non-ambulatory, shall be given the opportunity to eat or be fed in the dining area.
(10) Client Life in Residential Habilitation Centers.
(a) Staff interaction with clients shall be individualized and appropriate to differences in personal goals, abilities, age and circumstances.
(b) Each client shall receive adequate and appropriate attention each day from the staff regardless of the client's chronological age, degree of retardation, or accompanying handicaps.
(c) The residential habilitation center shall be operated in such a manner that there is flexibility to meet the individual needs of the clients.
(d) Clients shall be allowed to express their ideas and concerns for incorporation into the program.
(e) Clients shall be allowed free use of all space within the facility, with due regard for privacy, personal possessions of other residents/staff, and reasonable house rules.
(f) Clients shall be encouraged to interact and assist each other.
(g) Clients shall have the right of communication with parent/guardians, social workers, friends, and other interested persons.
(11) Training for Clients.
(a) The residential habilitation center shall reinforce the implementation of the client's habilitation plan.
(b) The residential habilitation center shall insure that all clients receive habilitative programming to meet their individualized needs which includes:
1. The residential habilitation center will assist the client in exercising maximum independence in the following areas:
a. Self-care skills:
I. Eating.
II. Dressing.
III. Toileting.
IV. Bathing.
V. Grooming.
b. Daily living skills (community living skills, homemaking skills, first-aid, use of telephone, etc.).
c. Communication skills (verbal or nonverbal language) to include:
I. Receptive language.
II. Expressive language.
III. Functional reading.
IV. Functional writing.
d. Social skills (adaptive behavior necessary for independence on the job and in the community).
e. Motor skills:
I. Fine motor skills.
II. Gross motor skills.
f. Recreation skills/interests.
g. Human growth and development (sex education).
h. Basic knowledge (cognitive development) to include:
I. Pre-academic skills.
II. Academic skills.
i. Job related skills to include:
I. Personal work interests.
II. Work capabilities.
III. Work habits.
IV. Practical work interests.
V. Community mobility.
VI. Job seeking skills.
(12) Safety.
(a) All poisonous and toxic compounds and potentially hazardous instruments shall be used with extreme caution. Compounds harmless for human consumption shall be used whenever possible. Poisonous and toxic compounds shall not be stored in an area which may constitute a hazard to the clients. Such items shall be safeguarded and not commingled with food items in storage or elsewhere.
(b) Where appropriate, the residential habilitation center shall provide adequate fencing around swimming pools, against busy streets, and surrounding other hazardous areas.
(c) The residential habilitation center shall have on the premises first aid supplies including at least gauze, tape, tweezers, scissors, and a thermometer. The supplies shall be maintained in places known to and readily available to all staff responsible for the safety and welfare of the clients.
(d) Staff shall have completed a basic first aid course, including instruction in the Heimlich maneuver and cardio-pulmonary resuscitation, as arranged for by the area office.
(13) Transportation.
(a) The residential habilitation center shall provide or arrange for incidental transportation within the community as would usually be available to an individual in his/her own home.
(b) Clients shall be encouraged to utilize public transportation in areas where it is available and appropriate to the clients' ability.
(c) Any vehicle operated by the residential habilitation center in which clients are transported shall have a current license and inspection sticker, carry at least minimum insurance coverage as required by state law, and be operated by a driver holding an appropriate valid driver's license.
(14) Medications.
(a) The residential habilitation center shall develop in conjunction with a qualified pharmacist, nurse or physician, written policies and procedures that govern the safe supervision and storage of drugs, and provide an accountable system of distribution of medications.
(b) No client shall be given prescriptive medication or treatment except upon the written order of the physician.
(c) All prescription medication shall be kept in its original container bearing the original dated label with legible information stating the prescription number, directions for use, client's name, physician's name, and address of the issuing pharmacy.
(d) A client whom the physician has deemed capable of handling his/her own medications should be encouraged to do so. The residential habilitation center shall assist the resident in the self-administration of medications by making the medications available and reminding the client to take medications at appropriate times.
(e) A daily record must be kept of prescription medication administered, except when self-medication is approved as part of the habilitation plan. The record must specify client's name, date, time, dosage, name of medicine and signature of person administering.
(f) Medications shall be kept in a locked enclosure.
(15) Discipline and Abuse. Each client shall receive humane discipline.
(a) The facility shall have a written statement of policies and procedures for the control and discipline of clients.
(b) The facility shall take all reasonable precautions to assure that no client is exposed to, or instigates such behavior as might be physically or emotionally injurious to him/herself or to another person.
(c) Facility staff shall be instructed by Agency staff in the Developmental Disabilities Abuse Act abuse reporting procedures and shall report suspicion or evidence of abuse in accordance with Section 39.201 or 415.1034, F.S.
(d) Facility staff shall be knowledgeable of provisions of the Bill of Rights of Persons with Developmental Disabilities, Section 393.13, F.S.
(16) Religious Observance. The religious preferences of the client, or in the case of a minor, the parents or the guardian, shall be respected. Included is the right not to participate in any religious activity. The facility shall make arrangements for reasonable participation, if requested by the clients.
(17) Rights of Parents and Guardians. The admission of a client to a facility shall not be construed by parents, legal guardians or facility staff as a termination or restriction of the rights and responsibilities of such parents and guardians. Parents, legal guardians, and other responsible persons shall be encouraged to organize as volunteer groups for the purpose of promoting the welfare of the clients of the facility.
(18) Community Relationship. The residential habilitation center administration shall encourage understanding and support by, and integration with, the community, such as by establishing cooperative agreements with clinics, park departments, volunteer organizations, and similar community resources.
(19) Intake and Placement Procedures.
(a) Intake:
1. The residential habilitation center shall have written criteria and procedures for admission. The residential habilitation center must require in the referral material for each admission, current medical, psychological, educational and social data pertinent to the placement of the client.
2. The residential habilitation center shall have an orientation plan that lessens anxiety and acquaints the client with the program.
3. Referred clients and their families shall be given an opportunity to visit the residential habilitation center prior to placement.
4. A residential habilitation center serving clients shall not provide residential services to any private client whose physical or mental condition might adversely affect the welfare and development of Agency clients accepted by the facility. The residential habilitation center shall have prior approval of the area office staff of its intent to accept other than Agency clients.
5. Area office staff shall be notified of any admissions which may vary from criteria included in the application for licensure as a retardation residential facility.
(b) Placement. Prior to any request for transfer, except of an emergency nature, of the client from the residential habilitation center, the transfer and reasons for transfer shall be discussed with the client, social worker and other interested persons by the residential habilitation center staff.
(20) Accountability for Residential Habilitation Centers. The licensee is aware that the residential habilitation center is an independent contractor delivering services to the Agency under the provisions of a bilateral executory contract. The safe custody of clients under the contractor's control is the responsibility of the independent contractor and the Agency shall assume no liability for actions brought against the contractor, including but not limited to the following:
(a) Tort action for damage to property or person.
(b) Payment of payroll-related costs such as workers' compensation, withholding taxes, fair employment practices, and unemployment insurance.
(21) Responsibility for Clients.
(a) Whenever the whereabouts of a client is unknown and the client is determined to be missing, the designee of the Area Administrator who is assigned to be the contact person according to established procedures shall be notified.
(b) If this person cannot be reached immediately, and there exists a true emergency, then this fact shall be reported to the law enforcement agency having jurisdiction in the community.
(22) Client Exploitation. The Area Administrator or his/her designee must be notified in advance of any planned solicitation activity by the residential habilitation center. A client, or a class of clients, may not be exploited through the use of name, picture, or person in association with his/her disability for the purpose of securing donations.
(23) Emergencies.
(a) There shall be a written plan on file, at the facility and area office, which specifies action and procedures for meeting emergency situations such as fire and natural disasters. This plan shall be developed with the assistance of appropriate resource persons such as the local fire marshall, area office staff, and the civil defense officer, and shall include plans for assignment of staff and clients to specific tasks and responsibilities.
(b) The staff shall be knowledgeable in procedures for handling emergencies.
(c) Serious illness, accident, injury, death, assault, and missing clients should be handled as an emergency. The staff should meet the immediate needs of the client and then report the incident by telephone to the area office as instructed by the social worker serving the facility. In case of suspected abuse, the incident shall also be reported to the Central Abuse Hotline.
(d) There shall be at least one telephone which is accessible to staff and clients at any time for emergency use. Clients (age and ability appropriate) shall be trained to dial the emergency number.
(e) The following telephone numbers shall be readily accessible to staff and clients at each telephone extension in the facility:
1. Police.
2. Fire Department.
3. Clients' Doctors.
4. Rescue Squad/Ambulance.
5. Social Worker, Office.
6. Agency Area Office.
7. Emergency on-call number, as assigned by the area office.
8. Relief Staff.
9. Central Abuse Hotline.
10. Local Advocacy Council and/or the Council Chairperson.
11. Area Administrator.
12. Other relevant persons.
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