Code of the District of Columbia

§ 44–107.01. Staffing standards.

(a) An ALR shall be supervised by an ALA who shall be responsible for all personnel and services within the ALR.

(b) The ALA shall ensure that each resident has access to appropriate medical, rehabilitation, and psychosocial services as established in the ISP and that there is appropriate oversight, monitoring, and coordination of all components of the ISP, including necessary transportation and the delivery of needed supplies.

(c)(1) An ALA shall be at least 21 years of age.

(2) An ALA shall possess at least a high school diploma or general equivalency diploma (“G.E.D.”) or have served as an operator or administrator of a licensed community residence facility (“CRF”) in the District of Columbia for at least one of the past 3 years in which the CRF has met minimum legal standards. An ALA employed on or after June 24, 2000 shall have at least a high school diploma or G.E.D. and have served as a direct care provider or administrator for at least one of the past three years.

(3) An ALA shall possess satisfactory knowledge of the following:

(A) The philosophy of assisted living;

(B) The health and psychosocial needs of residents;

(C) The resident assessment process;

(D) The development and use of ISPs;

(E) Medication administration, including cuing, coaching, and monitoring residents who self-administer medications, with or without assistance;

(F) The provision of assistance with activities of daily living and personal hygiene;

(G) Residents’ rights;

(H) Fire and life safety codes;

(I) Infection control, including standard precautions to prevent infection;

(J) Food safety and sanitation;

(K) First aid and cardiopulmonary resuscitation (CPR);

(L) Emergency disaster plans;

(M) Human resource management, including staff employment, orientation and training, employee rights and protection against discrimination, harassment, and wrongful discharge; and

(N) Financial management.

(d) An ALA shall:

(1) Employ staff and develop a staffing plan in accordance with this chapter and based upon the following criteria to assure the safety and proper care of residents in the ALR:

(A) The health, mental condition, and psychosocial needs of the residents;

(B) The fulfillment of the 24-hours-a-day scheduled and unscheduled needs of the residents;

(C) The size and layout of the ALR;

(D) The capabilities and training of the employees; and

(E) Compliance with all of the minimum standards in this chapter;

(2) Assure that sufficient staff who know how to implement the ALR’s evacuation plan and emergency management plan are on the premises at all times to implement emergency procedures;

(3) Assure that each person employed by the ALR maintains personal cleanliness and hygiene;

(4) Develop written job descriptions for staff who are responsible for providing personal services to residents and provide a copy of the job description to the employee;

(5) Assign duties to each staff member consistent with his or her level of education, preparation, and experience;

(6) Assure that there is at least one staff member within the ALR at all times who is certified in first-aid and CPR;

(7) Assure that all members of the staff are mentally and physically capable of performing their assigned duties;

(8) Assure that each employee has a background check pursuant to federal and District law executed at the time of initial employment;

(9) Assure that members of the staff appear to be free from apparent signs and symptoms of communicable disease, as documented by a written statement from a healthcare practitioner;

(10) Remove from duty any staff member who is found to have, or is suspected of having, a communicable disease or is mentally or physically incapable of performing her or his duties until the ALA determines that such impairment no longer exists;

(11) Maintain personnel records for each employee that include documentation of criminal background checks, statements of health status, and documentation of the employee’s communicable disease status;

(12) Assure that, during periods of temporary absence of the ALA when residents are on the premises, a staff member who is at least 18 years of age and meets the staffing standards of the ALA required by this section shall assume responsibilities of the ALA; and

(13) Complete the training required by § 44-107.02 and 12 additional hours of training, annually, conducted by a nationally recognized organization that possesses experience in training staff in dementia care, such as the Alzheimer’s Disease and Related Disorders Association, on managing residents who are living with cognitive impairments.

(e) Newly hired staff shall have 30 days to document their communicable disease status. For the purposes of this subsection, “newly hired staff” means any individual who is hired by an ALR regardless of the individual’s previous work experience. An employee who is transferring from one ALR to another ALR that is under the same management or ownership, without break in service, shall not be considered newly hired staff.

(f) Employees shall be required on an annual basis to document freedom from tuberculosis in a communicable form.

(g) The staff shall:

(1) Be at least 21 years of age;

(2) Possess current and appropriate licensure and certifications as required by law;

(3) Possess sufficient skills, education, training, and experience to meet the needs of the residents;

(4) Subject to their assigned duties and responsibilities, possess a satisfactory knowledge of the resident assessment process, use of ISPs, resident health and psychosocial needs, and resident rights;

(5) Complete initial and ongoing training pertaining to the philosophy of care in ALRs and meeting the personal care needs of residents; and

(6) Not work unsupervised without satisfactory completion of the training required by § 44-107.02.

(h) Staff who have not completed the training required by § 44-107.02 must work at all times under the supervision of a staff member who has satisfactorily completed this training.

(i) For the purposes of subsection (g)(5) of this section “ongoing training” means a regularly scheduled program of staff training designed by the ALR to assure that all staff who have direct resident contact possess the skills necessary to provide high quality services in a manner appropriate to the philosophy of assisted living and includes staff training in how to monitor changes in a resident’s condition, including physical and cognitive assessments.