B.C. Reg. 536/80

O.C. 2539/80
Filed November 27, 1980

REPEALED BY B.C. REG. 96/2009

EFFECTIVE JANUARY 15, 2010

Community Care and Assisted Living Act

Adult Care Regulations

[includes amendments up to B.C. Reg. 419/2008, April 1, 2009]

Contents
  Definitions
  Repealed
  2.1  Facility exempted from the Act
  2.2  Exemptions under section 16 of the Act
  Licence application
  General regulations
  4.1  Posting of licence
  Physical requirements
  5.1  Bedroom space requirements
  5.2  Bedroom furnishings
  5.3  Bedroom privacy
  5.4  Bedroom windows
  5.5  Bedroom illumination
  5.6  Room temperature
  5.7  Bathrooms and bathing facilities
  5.8  Bathrooms and bathing facilities in residential care facilities
  5.9  Bathrooms and bathing facilities in residential care homes

or specialized residential care facilities
  5.10  Water temperature
  5.11  Signalling devices
  5.12  Mobility and access
  5.13  Telephones
  5.14  Signage
  5.15  Dining area
  5.16  Lounges and recreation areas in residential care facilities
  5.17  Lounges and recreation areas in residential care homes

or specialized residential care facilities
  5.18  Outside activity area
  5.19  Accessibility in residential care facilities
  5.20  Accessibility in residential care homes
  5.21  Designated work areas
  5.22  Maintenance
  5.23  Fire safety requirements in residential care homes
  Manager
  6.1  Employee standards
  6.2  Health of employees
  6.3  Communications
  6.4  Repealed
  6.5  Employee responsible for recreation and leisure services
  6.6  Supervisor of care staff
  6.7  Supervision by health care professionals
  6.8  General staffing coverage and patterns
  6.9  Supplies, employees and operations
  6.10  Care and supervision
  Nutrition care plan in community care facilities

with 24 or fewer persons in care
  7.1  Nutrition care plan in community care facilities

with 25 or more persons in care
  7.2  Supervisor of food services in community care facilities

with 50 or more persons in care
  7.3  Preparation and service of food
  7.4  Food service schedule
  7.5  Eating aids and supplements
  7.6  Menu planning
  7.7  Monitoring nutrition needs
  7.8  Nutrition and food services audit program
  7.9  Person in care participation in food services
  7.10  Training of staff responsible for food services
  7.11  Food services records
  Definitions
  8.1  Supervising pharmacist
  8.2  Medication safety and advisory committee
  8.3  Storage of medication
  8.4  Administration of medication
  8.5  Changes to directions for use of medication
  8.6  Self-administration of medication
  8.7  Medication records
  8.8  Return of medication to pharmacy
  Policies respecting persons in care
  9.1  Access to health services
  9.2  Oral health
  9.3  Care plans
  9.4  Confidentiality
  10–10.2  Repealed
  10.3  Privacy
  10.4  Firearms
  10.5  Visitors
  10.6  Reportable incidents
  10.7  Investigations
  10.8  Neglect and abuse
  10.9  Restrictions on the use of restraints
  10.10  Emergency restraints
  10.11  Reassessment
  10.12  Monitoring
  10.13  Reassessment standards
  10.14  Dispute resolution
  11  Access to lounge, activity and recreation areas
  11.1  Social activities and recreational programs
  11.2  Materials and equipment
  11.3  Person in care or person in care/family councils
  12  Limited exemption for community care facilities

licensed on or before August 1, 2000
  12.1  Unacceptable threat to health or safety
  13  Financial and statistical reports
  14  Notice of change of operation of community care facility
  15  Repealed
Schedule 1
Schedule 2
Form A

Definitions

1In these regulations, unless the context requires otherwise:

"Act" means the Community Care and Assisted Living Act;

"application date" means the date on which the completed application is received by the medical health officer;

"British Columbia Building Code" means the National Building Code as adopted, with modifications, by B.C. Reg. 295/98, the British Columbia Building Code Regulation;

"contact person" means an individual who is willing to assist in making application for care or is willing to maintain contact in the interest of the applicant's general welfare;

"dietitian" means a person who is a registrant of the College of Dietitians of British Columbia;

"food services" means all of, or those parts of, the operation of a community care facility related to the provision of meals to the persons in care and includes, but is not limited to, menu planning, food purchasing, food storage and preparation, the serving of meals, space and equipment requirements and sanitation;

"funding program" means a program operated by a government, or an agency of a government, under which funds are provided to licensees;

"health care provider" means a practitioner who is authorized to provide health care by

(a) a regulatory body, listed under section 6 of the Health Professions Regulation, B.C. Reg. 237/92, or

(b) the board of registration for social workers established under the Social Workers Act;

"nutrition care plan" means that part of the care plan of each person in care that assesses the person in care's nutrition status and specifies the nutrition care to be provided to that person in care;

"reportable incident" means a reportable incident as set out in Schedule 1;

"residential care facility" means a facility, other than a specialized residential care facility, licensed under the Act to provide care to 7 or more persons;

"residential care home" means a community care facility licensed under the Act to provide care to 3 to 6 persons;

"restraint" means any chemical, electronic, mechanical, physical or other means of controlling a person in care's freedom of movement in a community care facility, including

(a) isolating the person in care,

(b) administering any medication that incapacitates the person in care, and

(c) using, without the person in care's permission, any devices, such as belts, bed rails and chair trays, that primarily control the person in care's behavior rather than ensuring the person in care's safety,

but does not include an electronic device that is only used to monitor the whereabouts of a person in care in a community care facility;

"specialized residential care facility" means a facility licensed under the Act to provide care to 7 or more persons with an addiction, a physical, mental health or developmental disability, or a chronic or progressive condition, that is not primarily due to the aging process;

"specialized residential care home" means a residential care home that provides care for persons with an addiction, a physical, mental health or developmental disability, or a chronic or progressive condition, that is not primarily due to the aging process;

"substitute decision maker" means a person who is authorized to make decisions on behalf of a person in care.

[am. B.C. Regs. 7/87, s. 1; 405/87; 179/88; 387/92 s. 1; 81/93; 22/97, s. 1; 119/99, s. 1; 279/2000, s. 1;

366/2002, s. 1; 217/2004, App. 1, ss. 1 and 12 (b) and (d); 457/2004, Sch. 1, s. 1.]

Repealed

2Repealed. [B.C. Reg. 279/2000, s. 2.]

Facility exempted from the Act

2.1(1)  Supportive recovery residences constitute a class of facility designated not to be a community care facility for the purposes of the Act and this regulation.

(2)  For the purpose of subsection (1), a "supportive recovery residence" is a residence that

(a) provides a safe and drug-free environment for persons recovering from drug or alcohol addictions, and

(b) provides not more than 2 prescribed services.

[en. B.C. Reg. 294/2001, s. 1; am. B.C. Reg. 457/2004, Sch. 1, s. 2.]

Exemptions under section 16 of the Act

2.2(1)  An applicant for an exemption or a variation of an exemption under section 16 of the Act must provide, in writing and in a form acceptable to the medical health officer, the information requested by the medical health officer.

(2)  If the exemption or variation requested under subsection (1) is not granted, or is not granted in full, the medical health officer must provide to the applicant for the exemption written reasons for not granting the exemption or for not granting part of the exemption.

(3)  The medical health officer may grant an exemption to any section of the Act or regulation, except those listed in Schedule 2.

(4)  In determining whether to grant an application under subsection (1) for a variation to

(a) an exemption that was granted to a licensee or applicant for a licence under section 5 (3) of the Community Care Facility Act, R.S.B.C. 1996, c.60, before that section was repealed,

(b) a substitute requirement that was imposed on a licensee or applicant for a licence under section 5 (4) of the Community Care Facility Act before that section was repealed, or

(c) an alternative arrangement approved by the medical health officer under

(i)  sections 4 (5) (a) (i) and 6 (2) of this regulation before those sections were amended, or

(ii)  sections 5 (2), 5.3 (2), 5.8 (4), 5.13 (2), 5.18 (4), 5.21 (2), 6.4, 7.4 (4), 7.7 (2), or 8.6 (1) of this regulation before those sections were repealed,

the medical health officer must accept the exemption, substitute requirement, or alternative arrangement on its face and consider only the merits of the application under subsection (1).

[en. B.C. Reg. 217/2004, App. 1, s. 2.]

Licence application

3(1)  An applicant for a licence to operate a community care facility must

(a) submit an application to the medical health officer, and

(b) provide, in the form specified by the medical health officer, the information set out in subsection (3).

(2)  An applicant for a licence must immediately notify the medical health officer of any change in the information provided under subsection (1) (b).

(3)  Every application for a licence must be accompanied by

(a) three copies of the site plan, drawn to a scale of not less than 1:500, and of the floor plans of the proposed community care facility, drawn to a scale of 1:100, showing

(i)  building elevations and grade relationships,

(ii)  measured sound levels of the proposed site if considered necessary by the medical health officer,

(iii)  the inside dimensions of each room and the width of each corridor and stair,

(iv)  the size and location of the fixed equipment in each room,

(v)  typical room layout for each residential room and bathroom, drawn to a scale of not less than 1:50,

(vi)  the location, size and height of sill from the floor of all windows,

(vii)  the location of accommodation reserved for family,

(viii)  the location of accommodation reserved for employees, including employees' rooms and washrooms, and

(ix)  such other information as the medical health officer may from time to time require,

(b) a statement of proposed monthly revenue and expenditures which must include the expected cost of staff salaries and benefits, food, supplies, utilities, maintenance, taxes, mortgage principal and interest payments, insurance and programs,

(c) a staffing plan setting out

(i)  the number of full time equivalent care staff the applicant proposes to employ and their qualifications, and

(ii)  the name, age, professional qualifications and relevant experience of the person who will be the manager,

(d) if the applicant purchases or rents the premises, a copy of the purchase agreement or lease, and

(e) if the applicant is a society, a copy of the constitution and bylaws of the society.

(4)  Prior to commencing the construction or renovations of a community care facility, a licensee or an applicant for a licence must

(a) submit all plans for the construction or renovation to the medical health officer, and

(b) receive approval of the plans from the medical health officer.

[am. B.C. Regs. 26/83, s. 1; 387/92, s. 2; 199/96, s. 1 (a); 264/96, Sch. B; 279/2000, s. 3; 217/2004, App. 1, ss. 3 and 12 (b).]

General regulations

4(1)  Repealed. [B.C. Reg. 217/2004, App. 1, s. 4 (a).]

(1.1)  The licensee must establish and follow an admission screening procedure that

(a) ensures accommodation only to those persons for whom safe and adequate care can be provided, and

(b) takes into consideration

(i)  staffing,

(ii)  community care facility design, construction and equipment,

(iii)  the health, safety and well-being of other persons in care, and

(iv)  any criteria set by the funding program.

(2)  The licensee shall maintain in safe keeping a separate and confidential record of each person accommodated which shall show

(a) the person's name, date of birth and sex,

(b) the person's date of arrival,

(c) the name and telephone number of the person's sponsor, contact person or next of kin,

(d) the name and telephone number of a person or agency to contact in the event of accident or illness,

(e) the name and telephone number of a medical practitioner to contact in the event of accident or illness,

(f) any medications and therapeutic diets prescribed by, and any special instructions given by, the person's medical practitioner, dentist or podiatrist,

(g) any medical disabilities or pertinent information made known to the licensee by the person, the person's medical practitioner, the next of kin or sponsor, or the contact person,

(h) the individual plan of care for each person in care, and

(i) the departure date of the person, reason for departure and new address.

(3)  The licensee shall

(a) require that all persons being admitted to a licensed community care facility comply with the immunization program of the ministry and participate in its tuberculosis control program,

(a.1) record each person in care's compliance with and participation in the program referred to in paragraph (a),

(b) maintain a separate record of, and issue receipts for, all effects, money and valuables held in trust or safekeeping for the persons in care,

(c) maintain a record of and obtain receipts for any disbursements made on behalf of the persons in care,

(d) keep records in a manner and on forms acceptable to the medical health officer,

(e) keep a record of all effects, monies and valuables returned to the person in care, next of kin, sponsor or legal representative at time of discharge or death, and

(f) on request, submit to the medical health officer copies of the records including reports and information regarding care and treatment of persons in care, numbers of staff on duty each day and hours of work, and the maintenance, operation and management of the community care facility.

(4)  The licensee shall

(a) notify the medical health officer immediately of any change in the information provided under section 3,

(b) whenever the manager is temporarily absent, ensure

(i)  that a competent full time adult person approved by the medical health officer is placed in charge, and

(ii)  that adequate care staff is maintained on duty to meet the needs of the persons in care,

(c) notify the medical health officer

(i)  if the manager resigns or is expected to be absent from duty for more than 21 consecutive days, and

(ii)  of the name, age and qualifications of the replacement,

(d) Repealed. [B.C. Reg. 62/81.]

(e) ensure that persons in care have immediate access to an employee who is certified to administer first aid,

(f) provide an approved first aid kit and such special equipment as required by the medical health officer, maintained in good condition and kept in a place that is readily accessible to employees,

(g) ensure that a telephone with posted emergency numbers is available to employees in the event of an accident or sudden illness,

(h) Repealed. [B.C. Reg. 119/99, s. 2 (b).]

(i) ensure that known wanderers carry identification,

(j) and (k) Repealed. [B.C. Reg. 119/99, s. 2 (b).]

(l) state that the community care facility is licensed and give the licence number whenever the services of the community care facility are advertised, and

(m) maintain the premises of the community care facility in a sanitary condition and in good repair.

(5)  The licensee shall not

(a) provide a service

(i)  of a type other than that specified on the licence,

(ii)  to more than the number of persons specified on the licence, and

(iii)  to a person in care confined to a wheelchair, unless the room, bathroom and dining room facilities assigned to the person have been specifically designed or modified to accommodate a person in a wheelchair, and

(b) Repealed. [B.C. Reg. 119/99, s. 2 (b).]

(c) other than in an emergency

(i)  send a person in care to a hospital except on the direction of the person in care's medical practitioner, and

(ii)  transfer a person in care to another community care facility without the prior consent of the person in care or the prior approval of the next of kin or sponsor.

(iii)  Repealed. [B.C. Reg. 387/92, s. 3.]

(6)  Repealed. [B.C. Reg. 177/86, s. 1.]

[am. B.C. Regs. 177/86, s. 1; 387/92, ss. 2, 3; 464/94; 119/99, s. 2; 217/2004, App. 1, ss. 4 and 12 (b) and (d).]

Posting of licence

4.1(1)  A licensee must display the following in a prominent place in the community care facility:

(a) the licensee's licence, including any terms or conditions of the licence;

(b) the name of the manager.

(2)  Subsection (1) does not apply to a licensee whose licence is issued in respect of a private single family dwelling as defined in section 9 (7) of the Act.

[en. B.C. Reg. 217/2004, App. 1, s. 5.]

Physical requirements

5(1)  A licensee must ensure that

(a) each bedroom used to accommodate persons in care is designed, constructed and maintained as a single occupancy bedroom or a double occupancy bedroom,

(b) no more than one person in care is accommodated in a single occupancy bedroom,

(c) no more than 2 persons in care are accommodated in a double occupancy bedroom, and

(d) the number of double occupancy bedrooms does not exceed 5 percent of the maximum number of persons in care that the community care facility is licensed to accommodate, as specified in the licence.

(2)  Repealed. [B.C. Reg. 217/2004, App. 1, s. 6.]

[en. B.C. Reg. 279/2000, s. 4; am. B.C. Regs. 366/2002, s. 2; 217/2004, App. 1, ss. 6 and 12 (b) and (d).]

Bedroom space requirements

5.1(1)  A single occupancy bedroom used to accommodate a person in care who does not require a walker, wheelchair or other mobility aid must have a usable floor area of not less than 8.00 m2 exclusive of the entranceway or swing of the entrance door, clothes closets, armoires, built in cabinets or en suite washroom.

(2)  A single occupancy bedroom used to accommodate a person in care who requires a walker, wheelchair or other mobility aid must have a usable floor area of not less than 11.00 m2exclusive of the entranceway or swing of the entrance door, clothes closets, armoires, built in cabinets or en suite washroom.

(3)  A double occupancy bedroom used to accommodate persons in care who do not require a walker, wheelchair or other mobility aid must have a usable floor area of not less than 14.00 m2 exclusive of the entranceway or swing of the entrance door, clothes closets, armoires, built in cabinets or en suite washroom.

(4)  A double occupancy bedroom used to accommodate persons in care who require a walker, wheelchair or other mobility aid must have a usable floor area of not less than 18.00 m2 exclusive of the entranceway or swing of the entrance door, clothes closets, armoires, built in cabinets or en suite washroom.

(5)  Each person in care must be provided a separate clothes closet or armoire having not less than 0.50 m2of floor area in the person in care's bedroom.

[en. B.C. Reg. 279/2000, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Bedroom furnishings

5.2(1)  A licensee, within the limits necessary to maintain the health, safety and well-being of all persons in care in the community care facility, must permit each person in care to bring into the community care facility, and keep in the person in care's room, furniture, ornaments or other personal possessions.

(2)  A licensee must provide for the exclusive use of each person in care, and maintain in a sanitary condition and in good repair, furnishings which, in the opinion of the medical health officer, are appropriate to meet the needs of the persons in care.

[en. B.C. Reg. 279/2000, s. 4; am. B.C. Reg. 217/2004, App. 1, s.12 (b) and (d).]

Bedroom privacy

5.3(1)  Each bedroom must be directly accessible from a corridor or hallway without passing through any other room.

(2)  Repealed. [B.C. Reg. 217/2004, App. 1, s. 6.]

(3)  Unless the health, safety or well-being of the persons in care make it unsuitable, a licensee must provide for a person in care who requests it a bedroom door that can be locked from inside the bedroom.

[en. B.C. Reg. 279/2000, s. 4; am. B.C. Reg. 217/2004, App. 1, ss. 6 and 12 (d).]

Bedroom windows

5.4(1)  Each bedroom must have a window area not less than 10 percent of the floor area of the bedroom required under this regulation.

(2)  Each bedroom must have a window that can be readily opened for ventilation, unless

(a) the health, safety or well-being of the persons in care make this unsuitable, or

(b) the community care facility is equipped with an air conditioning system or mechanical ventilating system.

(3)  If a bedroom is used to accommodate a person in care who is non-ambulatory, the bedroom must have at least one window that provides visibility from a sitting position to the outside.

(4)  Each bedroom must have window coverings in good repair which maintain the person in care's privacy and block out light.

[en. B.C. Reg. 279/2000, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (b) and (d).]

Bedroom illumination

5.5Each bedroom must, in the opinion of the medical health officer, have sufficient natural or artificial illumination to provide task or reading, bathroom and general illumination sufficient to meet the needs and preferences of each person in care accommodated in the bedroom.

[en. B.C. Reg. 279/2000, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Room temperature

5.6A licensee must maintain

(a) a safe and comfortable temperature in the common areas of the community care facility provided for use by the persons in care, and

(b) a temperature in each bedroom that meets the needs and preferences of the person in care.

[en. B.C. Reg. 279/2000, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (b) and (d).]

Bathrooms and bathing facilities

5.7Person in care bathrooms and bathing rooms must be equipped with

(a) a door,

(b) a door lock that can be opened from the outside in the case of an emergency,

(c) slip resistant material on the bottom of each bathtub and shower, and

(d) conveniently located and securely attached grab bars of an appropriate type beside each toilet, bathtub and shower, as required to meet the needs and preferences of the persons in care.

[en. B.C. Reg. 279/2000, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Bathrooms and bathing facilities in residential care facilities

5.8(1)  The licensee of a residential care facility must provide

(a) for a range of persons in care on a floor and in the same wing indicated in column 1 of the following table, the number of bathing facilities indicated in column 2 to the right of that range:

COLUMN 1 COLUMN 2
Persons in care on floor and in wing Bathing facilities on floor and in wing
7 - 25 2
26 - 40 3
41 - 60 4
61 - 75 5

(b) washbasin and toilet facilities

(i)  adjacent to the dining, lounge, and recreational areas, and

(ii)  appropriate to the needs of the persons in care,

(c) a separate washbasin and toilet for the exclusive use of each 2 persons in care, and

(d) despite paragraph (c), for each bedroom used to accommodate a person in care over the age of 65 years, a separate washbasin and toilet reserved for the exclusive use of the persons in care in the bedroom.

(2)  The bathing facilities referred to in subsection (1) must, in the opinion of the medical health officer, be of a type that is sufficiently and appropriately equipped to meet the needs of the persons in care.

(3)  The licensee of a residential care facility must ensure that, if a person in care requires a walker or wheelchair, the bathroom for the person in care is wheelchair accessible.

(4)  Repealed. [B.C. Reg. 217/2004, App. 1, s. 6.]

[en. B.C. Reg. 279/2000, s. 4; am. B.C. Reg. 217/2004, App. 1, ss. 6 and 12 (d).]

Bathrooms and bathing facilities in residential care homes

or specialized residential care facilities

5.9(1)  The licensee of a residential care home or specialized residential care facility must provide

(a) one washbasin and one toilet for each 3 persons in care, and

(b) one bathtub or shower for each 4 persons in care.

(2)  The washbasins, toilets, bathtubs and showers referred to in subsection (1) must, in the opinion of the medical health officer, be of a type that is sufficiently and appropriately equipped to meet the needs of the persons in care.

[en. B.C. Reg. 279/2000, s. 4; am. B.C. Regs. 366/2002, s. 3; 217/2004, App. 1, s. 12 (d).]

Water temperature

5.10A licensee must ensure that the temperature of the hot water supplied to the bathtubs, showers and handbasins used by the persons in care will not exceed 49º Celsius.

[en. B.C. Reg. 279/2000, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Signalling devices

5.11If one or more persons in care require monitoring to ensure health and safety, the licensee must provide a monitoring system, appropriate to the needs of the persons in care and staff, that will signal staff if a person in care requires help and the location of the person in care.

[en. B.C. Reg. 279/2000, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Mobility and access

5.12(1)  The bedrooms must be on the ground floor if there is no elevator for persons in care who require walkers, wheelchairs or other mobility aids.

(2)  A licensee must not provide accommodation to a person in care who uses a walker, wheelchair or other mobility aid unless the person in care has access to at least one conveniently located entrance, exit and bathroom and has access to and may move freely within the dining room, lounge or living room and the person in care's bedroom.

(3)  Within the limits necessary to maintain the health, safety or well-being of all person in care, a licensee must ensure that emergency call buttons, panic hardware, telephones, light switches and elevator controls can be accessed readily by all persons in care.

[en. B.C. Reg. 279/2000, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Telephones

5.13(1)  A licensee must provide at least one conveniently located telephone for use by persons in care only that

(a) has a private line,

(b) has adaptations, as necessary, for persons in care with disabilities, and

(c) is accessible to the persons in care at all times.

(2)  Repealed. [B.C. Reg. 217/2004, App. 1, s. 6.]

[en. B.C. Reg. 279/2000, s. 4; am. B.C. Reg. 217/2004, App. 1, ss. 6 and 12 (d).]

Signage

5.14A licensee must post and maintain directional signs and provide other means of directional information or assistance that, in the opinion of the medical health officer, are sufficient and appropriate to meet the needs and protect the health, safety and well-being of the persons in care.

[en. B.C. Reg. 279/2000, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Dining area

5.15A licensee must provide one or more dining areas that provide

(a) seating to accommodate all persons in care,

(b) not less than 2.00 m2 of floor space for each person in care, and

(c) sufficient tables designed to accommodate persons in care in wheelchairs.

[en. B.C. Reg. 279/2000, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Lounges and recreation areas in residential care facilities

5.16The licensee of a residential care facility must provide

(a) one or more readily accessible and comfortably furnished lounges, containing, in total, not less than 1.50 m2 of floor area for each person in care,

(b) one or more readily accessible, suitably equipped and furnished areas where recreational activities may be carried out containing, in total, not less than 1.00 m2 of floor area for each person in care, and

(c) a sanitary method of dispensing fresh drinking water to persons in care in the areas referred to in paragraphs (a) and (b).

[en. B.C. Reg. 279/2000, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Lounges and recreation areas in residential care homes

or specialized residential care facilities

5.17The licensee of a residential care home or specialized residential care facility must provide one or more comfortably furnished lounges or living rooms containing, in total, not less than 2.00 m2 of floor area for each person in care.

[en. B.C. Reg. 279/2000, s. 4; am. B.C. Regs. 366/2002, s. 3; 217/2004, App. 1, s. 12 (d).]

Outside activity area

5.18(1)  A licensee must provide one or more readily accessible outside activity areas

(a) including, in total, not less than 1.50 m2 in area for each person in care, and

(b) including a surfaced patio area and comfortable and safe seating.

(2)  A reasonable portion of the areas described in subsection (1) must provide shelter from the sun and inclement weather.

(3)  If a person in care who uses a walker, wheelchair or other mobility aid is accommodated,

(a) the licensee must provide access by a ramp to the outside activity area, and,

(b) a ramp described in paragraph (a) must comply, except for width, with the requirements for ramps for persons with disabilities as described in the British Columbia Building Code.

(4)  Repealed. [B.C. Reg. 217/2004, App. 1, s. 6.]

[en. B.C. Reg. 279/2000, s. 4; am. B.C. Reg. 217/2004, App. 1, ss. 6 and 12 (d).]

Accessibility in residential care facilities

5.19Each corridor in a residential care facility that accommodates persons in care who use walkers or wheelchairs must have a width of not less than 1.83 m.

[en. B.C. Reg. 279/2000, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Accessibility in residential care homes

5.20The licensee of a residential care home that accommodates a person in care with a disability must ensure that all areas of the residential care home ordinarily used by the person in care are accessible if a walker, wheelchair or other mobility aid is used by the person in care.

[en. B.C. Reg. 366/2002, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Designated work areas

5.21(1)  A licensee must provide the following appropriately furnished and equipped areas:

(a) a work area for administrative work and other staff use;

(b) a secure location for medications and person in care records;

(c) safe and adequate storage areas for cleaning agents, chemical products and other hazardous materials;

(d) separate utility areas for clean and soiled work.

(2)  Repealed. [B.C. Reg. 217/2004, App. 1, s. 6.]

(3)  A licensee must ensure that laundry facilities

(a) not for use by persons in care are secured, and

(b) for use by persons in care have a slip resistant floor surface.

[en. B.C. Reg. 279/2000, s. 4; am. B.C. Reg. 217/2004, App. 1, ss. 6 and 12 (d).]

Maintenance

5.22(1)  A licensee must ensure that all rooms and common areas in the community care facility are well ventilated and maintained in a good state of repair and in a safe and sanitary condition.

(2)  A licensee must ensure that emergency exits are not obstructed or secured in a manner that prevents unimpeded exit in an emergency.

[en. B.C. Reg. 279/2000, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (b).]

Fire safety requirements in residential care homes

5.23The licensee of a residential care home must ensure that the community care facility has the following, maintained in a good state of repair at all times:

(a) interconnected smoke alarms, installed in each bedroom and in each corridor leading to a bedroom;

(b) sprinklers which comply with the British Columbia Building Code;

(c) emergency lighting which will automatically illuminate the corridors and stairs for a minimum of 30 minutes in the event of a power failure.

[en. B.C. Reg. 279/2000, s. 4; am. B.C. Regs. 366/2002, s. 5; 217/2004, App. 1, s. 12 (b).]

Manager

6(1)  A licensee who is not also the manager of the community care facility must ensure that the manager

(a) is a person of good character,

(b) has the personality, ability and temperament necessary to manage a community care facility in a manner that will maintain the spirit, dignity and individuality of the persons in care, and

(c) is physically and mentally competent to carry out assigned duties.

(2)  A manager must not manage more than one community care facility.

[en. B.C. Reg. 217/2004, App. 1, s. 7.]

Employee standards

6.1A licensee must ensure that each of its employees who works in or about a community care facility

(a) has the personality, ability and temperament necessary to maintain the spirit, dignity and individuality of the persons being cared for,

(b) possesses the training and experience and demonstrates the skills necessary to carry out the duties assigned to the employee, and

(c) is physically and mentally competent to carry out the duties assigned to the employee.

[en. B.C. Reg. 217/2004, App. 1, s. 8.]

Health of employees

6.2The licensee must do all of the following:

(a) require each employee, as a condition of employment, unless otherwise authorized by the medical health officer,

(i)  to submit a certificate from a medical practitioner before beginning employment and at any other times required by the medical health officer, certifying that the person is medically capable of carrying out assigned duties, and

(ii)  to comply with the immunization program of the Ministry of Health and participate in its tuberculosis control program;

(b) record each employee's compliance with and participation in the program referred to in paragraph (a) (ii) and, on request of the medical health officer, make records available to the medical health officer.

[en. B.C. Reg. 119/99, s. 3; am. B.C. Reg. 457/2004, Sch. 1, s. 3.]

Communications

6.3The licensee must have

(a) an employee on duty at all times who can communicate effectively

(i)  on all matters relating to the care of each person in care, and

(ii)  with community emergency services, and

(b) mechanisms in place to facilitate effective communication between persons in care and staff.

[en. B.C. Reg. 119/99, s. 3; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Repealed

6.4Repealed. [B.C. Reg. 217/2004, App. 1, s. 6.]

Employee responsible for recreation and leisure services

6.5(1)  The licensee must designate at least one employee of a residential care facility, qualified by training and experience, to have specific responsibility to organize and supervise social activities and recreational programs for the persons in care.

(2)  The licensee must provide sufficient time to the employee designated under subsection (1) to carry out the social activities and recreational programs of the facility.

[en. B.C. Reg. 119/99, s. 3; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Supervisor of care staff

6.6The licensee must designate one employee, qualified by training and experience, to have specific responsibility for

(a) supervision of the care staff,

(b) coordination and monitoring of all activities relating to the day to day care of the persons in care, and

(c) managing unusual situations or emergencies.

[en. B.C. Reg. 119/99, s. 3; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Supervision by health care professionals

6.7(1)  If persons in care are accommodated who have assessed health needs that require full-time supervision by a health care professional, a licensee must have a sufficient number of health care professionals on duty at all times who have the appropriate experience, training and qualifications to meet the identified needs of the persons in care.

(2)  If persons in care are accommodated who have assessed health needs that require less than full-time supervision by a health care professional, a licensee must ensure that each person in care's health care plan specifies

(a) the amount and type of professional supervision required,

(b) the identity and qualifications of the health care professional providing the supervision, and

(c) the required intervention by the health care professional.

[en. B.C. Reg. 119/99, s. 3; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

General staffing coverage and patterns

6.8A licensee must

(a) have a sufficient number of employees on duty at all times to meet the needs of the persons in care and to provide a safe standard of care for the persons in care,

(b) assign duties and responsibilities to care staff that are consistent with their experience, competence and training,

(c) maintain staffing patterns that are appropriate to provide for the safety and well-being of the persons in care, and

(d) maintain staffing levels that take into consideration the standards of the funding programs.

[en. B.C. Reg. 119/99, s. 3; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Supplies, employees and operations

6.9The medical health officer may order the licensee to provide additional supplies or employees, or to alter the method of operation, if, in the opinion of the medical health officer, the supplies, employees or operations are inadequate or insufficient to meet the needs of the persons in care.

[en. B.C. Reg. 119/99, s. 3; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Care and supervision

6.10A licensee must provide to all persons in care a level of care and supervision that, in the opinion of the medical health officer, is appropriate to meet the needs of the persons in care.

[en. B.C. Reg. 457/2004, Sch. 1, s. 4.]

Nutrition care plan in community care facilities

with 24 or fewer persons in care

7(1)  a licensee of a community care facility with 24 or fewer persons in residence must ensure that a nutrition care plan is

(a) developed for each new person in care within 2 weeks of admission,

(b) documented in the care plan of the person in care,

(c) reviewed as set out in the care plan of the person in care and at least once within 14 weeks of admission,

(d) monitored to ensure implementation, and

(e) revised in response to the person in care's needs.

(2)  A licensee of a community care facility with 24 or fewer persons in residence must ensure that the services of a dietitian are obtained in response to a person in care's needs and on the recommendation of

(a) either the person in care's primary health care provider or the medical health officer, and

(b) the funding program, if any.

[en. B.C. Reg. 22/97, s. 2; am. B.C. Regs. 217/2004, App. 1, s. 12 (b)-(d); 457/2004, Sch. 1, s. 5.]

Nutrition care plan in community care facilities

with 25 or more persons in care

7.1A licensee of a community care facility with 25 or more persons in residence must ensure that a dietitian

(a) develops a nutrition care plan for each new person in care within 2 weeks of admission,

(b) documents the nutrition care plan in the care plan of the person in care,

(c) reviews the nutrition care plan as set out in the care plan of the person in care and at least once within 14 weeks of admission,

(d) monitors the nutrition care plan to ensure implementation, and

(e) revises the nutrition care plan in response to the changing needs of the person in care.

[en. B.C. Reg. 22/97, s. 2; am. B.C. Regs. 217/2004, App. 1, s. 12 (b)-(d); 457/2004, Sch. 1, s. 5.]

Supervisor of food services in community care facilities

with 50 or more persons in care

7.2(1)  For the purposes of this section, a supervisor of food services must be

(a) a nutrition manager who has membership in the Canadian Society of Nutrition Management,

(b) a person who is eligible for membership in the Canadian Society of Nutrition Management, or

(c) a dietitian.

(2)  A licensee of a community care facility with 50 or more persons in residence must obtain the services of a supervisor of food services to ensure adequate management of food services.

[en. B.C. Reg. 22/97, s. 2; am. B.C. Regs. 217/2004, App. 1, s. 12 (b); 457/2004, Sch. 1, s. 5.]

Preparation and service of food

7.3(1)  A licensee must ensure that meals and snacks

(a) are nutritious,

(b) are of adequate caloric value, based on the most recent edition of Canada's Food Guide to Healthy Eating published by the government of Canada,

(c) meet the requirements of each person in care depending on age, gender, level of activity and other relevant factors,

(d) fulfil the requirements of the person in care's nutrition care plan, and

(e) fulfil the requirements of any therapeutic diet ordered by the person in care's primary health care provider.

(2)  A licensee must ensure that a person in care receives an adequate amount of fluids throughout the day to ensure hydration.

(3)  A licensee must ensure that meals and snacks are prepared and served in a manner which

(a) preserves their nutritive value,

(b) offers variety, appeal and texture,

(c) fulfils the requirements of the person in care's nutrition care plan, and

(d) as far as is reasonably practical, recognizes the person in care's personal dining and food preferences, religious practices, and cultural customs.

(4)  A licensee must ensure that meals and snacks are provided in designated dining areas.

(5)  Despite subsection (4), meals and snacks may be provided by room tray service where this need has been identified in the care plan of the person in care or where the person in care is unable to attend the dining room.

(6)  A licensee must ensure that persons in care receive ample time to finish meals.

(7)  A licensee must apply any additional standards regarding the preparation and service of food set by the medical health officer.

[en. B.C. Reg. 22/97, s. 2; am. B.C. Reg. 217/2004, App. 1, s. 12 (c) and (d).]

Food service schedule

7.4(1)  A licensee must ensure that

(a) a breakfast is available between 7:00 a.m. and 9:00 a.m.,

(b) a noon meal is available between 11:45 a.m. and 1:00 p.m.,

(c) an evening meal is served after 5:00 p.m., and

(d) a minimum of 2 nutritious snacks are provided, one of which must be provided in the evening.

(2)  Despite subsection (1) (a), (b) and (c), if a person in care will be absent during a meal period the licensee must ensure that a packed meal is provided if required.

(3)  Despite subsection (1) (a) and (b), if persons in care choose, arrangements may be made for a brunch to be served on weekends and holidays.

(4)  Repealed. [B.C. Reg. 217/2004, App. 1, s. 6.]

(5)  A snack or packed meal provided under this section must be included in the daily or monthly charge.

[en. B.C. Reg. 22/97, s. 2; am. B.C. Reg. 217/2004, App. 1, ss. 6 and 12 (d).]

Eating aids and supplements

7.5A licensee must provide each person in care with

(a) any nutrition supplements required by the person in care's nutrition care plan or ordered by the person in care's primary health care provider,

(b) any tube feedings ordered by the person in care's primary health care provider, and

(c) any eating aids, personal assistance or supervision if required if the person in care has difficulty eating or where required by the person in care's nutrition care plan.

[en. B.C. Reg. 22/97, s. 2; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Menu planning

7.6(1)  A licensee must ensure that

(a) a cycle menu written for a minimum of 4 weeks is developed and used,

(b) menu substitutions are made from the same food groups and provide similar nutrition value, and

(c) any additional standards set by the medical health officer are applied to menu planning.

(2)  Despite subsection (1), if a community care facility offers only emergency or short-term stay programs, a weekly menu may be developed and used.

[en. B.C. Reg. 22/97, s. 2; am. B.C. Reg. 217/2004, App. 1, s. 12 (b).]

Monitoring nutrition needs

7.7(1)  A licensee must ensure that

(a) the nutrition needs of each person in care are monitored to a level acceptable to the medical health officer,

(b) the height and weight of each person in care is recorded on admission,

(c) the weight of each person in care is monitored and recorded monthly thereafter, and

(d) appropriate intervention is initiated when a person in care experiences a significant weight change.

(2)  Repealed. [B.C. Reg. 217/2004, App. 1, s. 6.]

[en. B.C. Reg. 22/97, s. 2; am. B.C. Reg. 217/2004, App. 1, ss. 6 and 12 (d).]

Nutrition and food services audit program

7.8A licensee must ensure that a nutrition and food services audit program acceptable to the medical health officer is in place.

[en. B.C. Reg. 22/97, s. 2.]

Person in care participation in food services

7.9(1)  A licensee must encourage persons in care to participate in food services activities such as menu planning, meal preparation and related activities as far as is reasonably practical, or if required by a person in care's nutrition care plan.

(2)  A licensee must ensure that a person in care who is involved in the preparation of food is adequately supervised to ensure that the food is safely prepared and handled.

[en. B.C. Reg. 22/97, s. 2; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Training of staff responsible for food services

7.10A licensee must ensure that staff responsible for food services

(a) have the training necessary to ensure that food is safely prepared and handled and meets the nutrition needs of the persons in care, and

(b) receive on-going education regarding food services, nutrition and, where required, assisted eating techniques.

[en. B.C. Reg. 22/97, s. 2; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Food services records

7.11A licensee must maintain a record for at least one year of

(a) food purchases,

(b) menu plans and menu substitutions,

(c) food services audits, and

(d) food services education and training programs attended by those individuals involved in providing food services to persons in care.

[en. B.C. Reg. 22/97, s. 2; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Definitions

8For the purposes of sections 8.1 to 8.8:

"medication" means a drug as defined in the Pharmacy Operations and Drug Scheduling Act;

"medication administration record" means a record of the administration of all doses of medication to a person in care;

"practitioner" means a person authorized under the Pharmacy Operations and Drug Scheduling Act to prescribe drugs.

[en. B.C. Reg. 268/97; am. B.C. Regs. 217/2004, App. 1, s. 12 (d); 419/2008, App. s. 1 (a).]

Supervising pharmacist

8.1A licensee must appoint a supervising pharmacist to serve on the medication safety and advisory committee and provide consultation to staff members regarding medication-related problems and interactions.

[en. B.C. Reg. 268/97.]

Medication safety and advisory committee

8.2(1)  A licensee must appoint a medication safety and advisory committee consisting of, but not limited to,

(a) the manager of the community care facility or person designated by the manager,

(b) the supervising pharmacist appointed under section 8.1, and

(c) where one is employed by the licensee, the health professional responsible for the immediate supervision of all health care services provided in the community care facility.

(2)  The medication safety and advisory committee must establish and review as required

(a) policies and procedures for the safe and effective storage, handling and administration of the person in care's medications which comply with the Pharmacy Operations and Drug Scheduling Act,

(b) training and orientation programs for staff members who store, handle or administer medications to persons in care and

(c) policies and procedures for the immediate response to and reporting of medication errors and adverse reactions to medications.

[en. B.C. Reg. 268/97; am. B.C. Regs. 217/2004, App. 1, s. 12 (b) and (d); 419/2008, App. s. 1 (b).]

Storage of medication

8.3A licensee must ensure that a person in care's medications are safely and securely stored in accordance with the policies and procedures established by the medication safety and advisory committee.

[en. B.C. Reg. 268/97; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Administration of medication

8.4(1)  A licensee must ensure that only medications which have been prescribed by a practitioner or ordered by a health care provider are administered to a person in care.

(2)  A licensee must ensure that

(a) only staff members administer medications to a person in care, and

(b) if a person in care leaves the community care facility, appropriate arrangements are made for the administration of the person in care's medications in accordance with the policies and procedures established by the medication safety and advisory committee.

(3)  A licensee must ensure that a staff member who stores, handles or administers medication to persons in care

(a) is 19 years of age or older, and

(b) has successfully completed the training programs established by the medication safety and advisory committee.

(4)  A licensee must ensure that a pharmacist packages all medications and records all medications on the person in care's medication administration record.

(5)  A licensee must ensure that, except where authorized by the medication safety and advisory committee, a person in care's medications remain in the original labelled container or package provided by the dispensing pharmacist until administered.

(6)  A licensee must ensure that a staff member who administers a medication follows the policies and procedures established by the medication safety and advisory committee.

(7)  A licensee must ensure that, if an adverse reaction to a medication occurs, a staff member immediately

(a) documents the reaction on the person in care's medication administration record,

(b) notifies the practitioner who prescribed the medication or the health care provider who ordered the medication,

(c) notifies the dispensing pharmacist, and

(d) follows the policies and procedures established by the medication safety and advisory committee.

[en. B.C. Reg. 268/97; am. B.C. Regs. 208/99; 217/2004, App. 1, s. 12 (b) and (d).]

Changes to directions for use of medication

8.5A licensee must ensure that

(a) a staff member does not make handwritten changes to the directions for use of a medication on the medication container or package, and

(b) where changes in the directions for use of a medication are made by a practitioner or a health care provider, the changes are promptly recorded on the person in care's medication administration record and the supervising pharmacist is promptly notified.

[en. B.C. Reg. 268/97; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Self-administration of medication

8.6(1)  Repealed. [B.C. Reg. 217/2004, App. 1, s. 6.]

(2)  The medical health officer may approve a person in care's request to self-administer a medication in accordance with a self-medication plan developed by

(a) the person in care,

(b) the medication safety and advisory committee, and

(c) the person in care's primary health care provider.

(3)  A licensee must ensure that a person in care who self-administers a medication is provided with

(a) the medication as required, and

(b) a secure place in the person in care's room to store the medication.

[en. B.C. Reg. 268/97; am. B.C. Reg. 217/2004, App. 1, ss. 6 and 12 (d).]

Medication records

8.7A licensee must ensure that

(a) a medication administration record is maintained for each person in care and retained for at least one year, and

(b) a self-medication plan referred to in section 8.6 (2) is recorded in the care plan of the person in care.

[en. B.C. Reg. 268/97; am. B.C. Reg. 214/2004, App. 1, s. 12 (c) and (d).]

Return of medication to pharmacy

8.8A licensee must ensure that a person in care's medication is returned to the dispensing pharmacy when

(a) the person in care is no longer taking the medication, or

(b) the expiry date on the medication has passed.

[en. B.C. Reg. 268/97; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Policies respecting persons in care

9A licensee must develop and implement written policies to guide staff actions in all matters relating to the care of persons in care.

[en. B.C. Reg. 329/97; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Access to health services

9.1A licensee must ensure that a person in care is assisted in obtaining health services as required and that an emergency call system for a medical practitioner is in place.

[en. B.C. Reg. 329/97; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Oral health

9.2(1)  For the purposes of this section, dental health care professional means a person who is a member of

(a) the College of Dental Surgeons of British Columbia,

(b) the College of Dental Hygienists of British Columbia, or

(c) the College of Denturists of British Columbia.

(2)  A licensee must encourage a person in care to obtain an examination by a dental health care professional at least once every year.

(3)  A licensee must ensure that a person in care is assisted in

(a) maintaining daily oral health,

(b) obtaining professional dental services as required, and

(c) following a recommendation or order for dental treatment made by a dental health care professional providing care to the person in care.

[en. B.C. Reg. 329/97; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Care plans

9.3(1)  A licensee must ensure that staff develop and implement an individualized care plan for a person in care who remains in a community care facility for two or more weeks.

(2)  A care plan must include

(a) a plan for the person in care's health care, including any self-medication plans,

(b) a plan for the person in care's oral health care,

(c) a nutrition care plan, and

(d) a plan for the person in care's recreation and leisure activities.

(3)  A care plan must take into consideration the abilities, the physical, social and emotional needs and the cultural and spiritual preferences of the person in care.

(4)  A care plan must be

(a) completed within six weeks of the person in care's admission to the community care facility,

(b) reviewed on a regular basis and modified according to the current needs and abilities of the person in care, and

(c) accessible at all times to staff who provide direct care to the person in care.

(5)  A licensee must encourage a person in care to participate in the development and review of his or her care plan.

[en. B.C. Reg. 329/97; am. B.C. Reg. 217/2004, App. 1, ss. 9 and 12 (d).]

Confidentiality

9.4A licensee must ensure that staff respect a person in care's privacy and make reasonable efforts to preserve the confidentiality of the person in care's personal information.

[en. B.C. Reg. 329/97; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Repealed

10–10.2Repealed. [B.C. Reg. 141/2002, s. 2.]

Privacy

10.3A licensee must, to the greatest extent possible while maintaining the health, safety and well-being of all the persons in care, ensure that

(a) the personal privacy of each person in care is respected, and

(b) the privacy of each person in care's bedroom, locker and storage area is respected.

[en. B.C. Reg. 119/99, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Firearms

10.4A licensee must not permit firearms in or about the community care facility.

[en. B.C. Reg. 119/99, s. 4; am. B.C. Reg. 217/2004, App. 1, ss. 10 and 12 (b).]

Visitors

10.5A licensee must, to the greatest extent possible while maintaining the health, safety and well-being of all the persons in care, ensure that residents are able to

(a) receive visitors of their choice at any time, and

(b) communicate with visitors in private.

[en. B.C. Reg. 119/99, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Reportable incidents

10.6(1)  Repealed. [B.C. Reg. 217/2004, App. 1, s. 6.]

(2)  If a reportable incident occurs, the licensee must promptly inform the following persons:

(a) the person in care's contact person and the person in care's primary health care provider;

(b) the medical health officer and the applicable funding program, using a form specified by the medical health officer.

(3)  The licensee must have written policies and procedures acceptable to the medical health officer for the reporting of incidents under subsection (1).

(4)  A licensee must maintain a log of

(a) minor accidents and illnesses that do not require medical attention and are not reportable incidents, and

(b) unexpected events involving persons in care.

[en. B.C. Reg. 119/99, s. 4; am. B.C. Reg. 217/2004, App. 1, ss. 6, 10 and 12 (d).]

Investigations

10.7(1)  A licensee must not prevent or hinder an investigation that is being conducted by a medical health officer.

(2)  The licensee must have written policies and procedures acceptable to the medical health officer for ensuring the health and safety of persons in care during an investigation of a reportable incident.

[en. B.C. Reg. 119/99, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Neglect and abuse

10.8A licensee must ensure that no person in care is subjected to neglect, emotional abuse, financial abuse, physical abuse or sexual abuse, as those terms are defined in section 1 of Schedule 1.

[en. B.C. Reg. 119/99, s. 4; am. B.C. Regs. 217/2004, App. 1, s. 12 (d); 457/2004, Sch. 1, s. 6.]

Restrictions on the use of restraints

10.9(1)  Subject to subsection (2), a licensee must ensure that a restraint is not administered

(a) for the purposes of punishment or discipline, or

(b) for the convenience of the staff of the community care facility.

(2)  A restraint may be used if all of the following apply:

(a) all alternatives to the use of a restraint have been exhausted;

(b) the restraint is as minimal as possible;

(c) the restraint has been approved by the person in care or, if the person in care is incapable of giving approval, by the person in care's medical practitioner and the person in care's substitute decision maker;

(d) the use of a restraint is documented in the care plan of the person in care;

(e) the staff administering the restraint have received training in the use and monitoring of the restraint;

(f) there are written policies and procedures acceptable to the medical health officer that pertain to all aspects of the use of the restraint.

[en. B.C. Reg. 119/99, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (b)-(d).]

Emergency restraints

10.10Despite section 10.9, the licensee may apply a restraint to a person in care if

(a) there is an emergency,

(b) the restraint is necessary to preserve the person in care's life or to prevent serious physical harm to the person in care or others, and

(c) the restraint is as minimal as possible.

[en. B.C. Reg. 119/99, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Reassessment

10.11(1)  The need for a restraint must be reassessed within 24 hours after the first use of the restraint.

(2)  If the need for a restraint continues beyond the 24 hour period referred to in subsection (1), the need to use the restraint must be reassessed on the earlier of the following:

(a) the time specified in the care plan of the person in care;

(b) the time specified by the persons who approved the use of the restraint;

(c) at least once every 30 days.

(3)  The results of the reassessment under subsections (1) and (2) must be recorded in the care plan of the person in care.

[en. B.C. Reg. 119/99, s. 4; am. B.C. Reg. 214/2004, App. 1, s. 12 (c).]

Monitoring

10.12(1)  If a person in care is restrained under section 10.9 or 10.10, the licensee must

(a) record, on a form acceptable to the medical health officer, the reasons for, and the use of, the restraint, and

(b) keep a detailed record of the staff's compliance with the requirements of paragraph (a).

(2)  During the use of a restraint, the licensee must ensure that the comfort and safety of the person in care is monitored in accordance with standards acceptable to the medical health officer.

[en. B.C. Reg. 119/99, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Reassessment standards

10.13(1)  When reassessing the need for a restraint, the licensee must ensure that consultation occurs to the greatest extent possible between all individuals who approved the use of the restraint.

(2)  Approval for a standing order for the continued use of a restraint must be determined by considering whether

(a) all alternatives to using a restraint have been exhausted,

(b) the restraint is as minimal as possible, and

(c) the restraint is in the person in care's best interest or is necessary for the protection of other persons.

[en. B.C. Reg. 119/99, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Dispute resolution

10.14The licensee must ensure that

(a) a fair, prompt and effective process is established for persons in care and their families or substitute decision maker to express a concern, make a complaint or resolve a dispute,

(b) there is no retaliation as a result of a person in care, family member or substitute decision maker expressing a concern or making a complaint,

(c) all complaints, concerns and disputes are responded to promptly, and

(d) a record of all complaints and concerns, and the responses to them, is maintained by the licensee and, on request, is made available to the medical health officer.

[en. B.C. Reg. 119/99, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Access to lounge, activity and recreation areas

11A licensee must, to the greatest extent possible while maintaining the health, safety and well-being of the persons in care, allow the persons in care free access to the lounge or to other designated activity spaces throughout the day and evening.

[en. B.C. Reg. 119/99, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Social activities and recreational programs

11.1A licensee must

(a) provide an ongoing planned program of physical, social and recreational activities that is coordinated with all other person in care services and is based upon each person in care's individual care plan, and

(b) encourage persons in care to participate in the social activities and recreational programs provided by the community care facility, and to take advantage of social and recreational opportunities available in the community.

[en. B.C. Reg. 119/99, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (b) and (d).]

Materials and equipment

11.2(1)  A licensee must provide a sufficient quantity and variety of supplies, materials and equipment for the activities program.

(2)  The supplies, material and equipment referred to in subsection (1) must

(a) be made available without charge to the persons in care, and

(b) be readily accessible and safe for use by the persons in care.

[en. B.C. Reg. 119/99, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Person in care or person in care/family councils

11.3(1)  A licensee must facilitate a forum for persons in care and for family members and substitute decision makers, to meet in order to promote the collective and individual interests of persons in care and the involvement of persons in care in decision making on matters and concerns which affect their day to day living.

(2)  The forum referred to in subsection (1) may consist of a person in care council or a person in care/family council.

(3)  If no person in care council or person in care/family council is established, a licensee must provide an opportunity, at least annually, for persons in care, family members or contact persons, or all of them together, to establish a council or similar organization.

[en. B.C. Reg. 119/99, s. 4; am. B.C. Reg. 217/2004, App. 1, s. 12 (d).]

Limited exemption for community care facilities

licensed on or before August 1, 2000

12(1)  Sections 5 to 5.23 do not apply to a community care facility if

(a) the community care facility was licensed on or before August 1, 2000, and

(b) the community care facility was in operation on August 1, 2000.

(2)  Despite subsection (1), sections 5 to 5.23 apply to any structural renovations or additions to a community care facility, or any new facility constructed on the same property.

[en. B.C. Reg. 278/2005.]

Unacceptable threat to health or safety

12.1The medical health officer may restrict the use as a community care facility of a building referred to in section 12 where the medical health officer has reasonable grounds to believe that the health or safety of a person in care is in danger, or the standard of care is unacceptable.

[en. B.C. Reg. 368/90, s. 2 am. B.C. Regs. 387/92, s. 6; 141/2002, s. 1; 217/2004, App. 1, s. 12 (d).]

Financial and statistical reports

13(1) to (3)  Repealed. [B.C. Reg. 387/92, s. 7 (a).]

(4)  The licensee shall maintain separate financial records for each community care facility in accordance with recognized standard accounting practices.

(5)  When required by the director of licensing the licensee shall provide an annual financial statement audited by an independent public accountant.

(6)  The cost of an audit required under subsection (5) shall be borne by the licensee.

[am. B.C. Regs. 387/92, s. 7; 217/2004, App. 1, s. 12 (a).]

Notice of change of operation of community care facility

14(1)  No licensee shall suspend operation of a community care facility whether temporarily or permanently unless he has given 12 months written notice to the medical health officer.

(2)  No licensee shall sell, lease or otherwise transfer control of a community care facility unless he has

(a) given 120 days written notice to the medical health officer, and

(b) satisfied the medical health officer that the intended purchaser, lessee or transferee

(i)  will continue the operation of the community care facility for at least 12 months from the date of sale, lease or transfer, and

(ii)  has applied to be and is qualified to be a licensee for the community care facility.

(3)  Where the medical health officer is satisfied under subsection (2) (b) it may waive the notice required under subsection (2) (a).

(4)  No licensee shall reduce, expand or otherwise alter the accommodation or service provided by a community care facility unless he has given 120 days written notice to the medical health officer.

(5)  Subsection (2) does not apply to a community care facility operated by a designated corporation under the Health Authorities Act that under section 16 of that Act amalgamates with a regional health board or community health council.

[am. B.C. Regs. 387/92, s. 2; 39/98; 217/2004, App. 1, s. 12 (b).]

Repealed

15Repealed. [B.C. Reg. 387/92, s. 8.]

 

Schedule 1

[en. B.C. Reg. 119/99, s. 5; am. B.C. Reg. 217/2004, App. 1, s. 13.]

Reportable incidents

1For the purposes of this regulation, any of the following is a reportable incident:

"aggressive or unusual behaviour" means aggressive or unusual behaviour by a person in care towards other persons, including another person in care, which has not been appropriately assessed in the individual's care plan;

"attempted suicide" means an attempt by a person in care to take his or her own life;

"death" means any death of a person in care;

"disease outbreak or occurrence" means an outbreak or the occurrence of a disease above the incident level that is normally expected;

"emergency restraint" means any use of a restraint that is not approved and documented in the care plan of a person in care;

"emotional abuse" means any act, or lack of action, which may diminish the sense of well-being of a person in care, perpetrated by a person not in care, such as verbal harassment, yelling or confinement;

"fall" means a fall of such seriousness, experienced by a person in care, as to require emergency care by a physician or transfer to a hospital;

"financial abuse" means

(a) the misuse of the funds and assets of a person in care by a person not in care, or

(b) the obtaining of the property and funds of a person in care by a person not in care without the knowledge and full consent of the person in care or their substitute decision maker;

"medication error" means an error in the administration of a medication which adversely affects a person in care or requires emergency intervention or transfer to a hospital;

"missing or wandering person" means a person in care who is missing;

"motor vehicle injury" means an injury to a person in care that occurs during transit by motor vehicle while the person is under the care and supervision of the licensee;

"neglect" means the failure of a care provider to meet the needs of a person in care, including food, shelter, care or supervision;

"other injury" means an injury to a person in care requiring emergency care by a physician or transfer to a hospital;

"physical abuse" means any physical force that is excessive for, or is inappropriate to, a situation involving a person in care and perpetrated by a person not in care;

"poisoning" means the ingestion of a poison or toxic substance by a person in care;

"service delivery problem" means any condition or event which could reasonably be expected to impair the ability of the licensee, or the employees of the licensee, to provide care or which affects the health, safety or well-being of persons in care;

"sexual abuse" means any sexual behaviour directed towards a person in care by an employee of the licensee, volunteer or any other person in a position of trust, power or authority and includes

(a) any sexual exploitation whether consensual or not, and

(b) sexual activity between children if the difference in age or power between the children is so significant that the older or more powerful child is clearly taking sexual advantage of the younger or less powerful child,

but does not include consenting sexual behaviour between adult persons in care;

"unexpected illness" means any unexpected illness of such seriousness that it requires a person in care to receive emergency care by a physician or transfer to a hospital.

2Repealed. [B.C. Reg. 217/2004, App. 1, s. 13 (g).]

 

Schedule 2

[en. B.C. Reg. 217/2004, App. 1, s. 14.]

[Exemptions not permitted — Section 2.2 (3)]

1For the purposes of section 16 of the Act, a medical health officer may grant an exemption from any but the following sections of the Act:

1 [definitions];

2 [application];

5 [operating or advertising without a licence];

6 [age of licensee or manager];

7 (1) (a), (b) and (d) [standards to be maintained];

18 (2) and (3) [certain advertisements or inducements prohibited];

22 [protection for persons who report].

2For the purposes of section 16 of the Act, a medical health officer may grant an exemption from any but the following sections of this regulation:

1 [definitions];

10.6 [reportable incidents];

10.8 [neglect and abuse];

10.9 (1) [restrictions on the use of restraints — no restraint for punishment or convenience only].

 

Form A

Repealed. [B.C. Reg. 199/96, s. 1 (b).]

[Provisions of the Community Care and Assisted Living Act, S.B.C. 2002, c. 75, relevant to the enactment of this regulation: section 34]