Program 1 - Residential Services

Comprehensive policies and procedures governing Bonita House residential services programs.

Overview

The Residential Services Program provides 24-hour structured living environments for clients requiring intensive support and supervision. This section outlines all policies and procedures specific to residential care operations.

Admission Policies

Eligibility Criteria

Clients must meet the following criteria for admission:

• Age 18 years or older
• Documented need for residential level of care
• Medical clearance from licensed physician
• Completed assessment by qualified professional
• Voluntary consent or appropriate legal authority

Admission Process

1. Referral Receipt - Document all referral information
2. Initial Screening - Conduct preliminary eligibility review
3. Comprehensive Assessment - Complete full clinical assessment
4. Admission Decision - Multidisciplinary team review
5. Intake Procedures - Complete admission documentation
6. Orientation - Provide client and family orientation

Required Documentation

• Photo identification
• Medical history and current medications
• Insurance verification
• Emergency contact information
• Legal documents (if applicable)
• Consent forms

Daily Operations

Shift Structure

Daily Schedule

6:00 AM - Wake up / Morning medications
7:00 AM - Breakfast
8:00 AM - Morning meeting
9:00 AM - Programming/Activities
12:00 PM - Lunch
1:00 PM - Rest period
2:00 PM - Afternoon programming
5:00 PM - Dinner
6:00 PM - Evening activities
8:00 PM - Evening medications
10:00 PM - Lights out

Client Care Standards

Individual Service Plans

Each client must have an Individual Service Plan (ISP) that includes:

• Treatment goals and objectives
• Service delivery methods
• Timeline for goal achievement
• Progress monitoring schedule
• Discharge planning

Medication Management

All medication administration follows these protocols:

1. Verification - Check client identity and medication
2. Documentation - Record in Medication Administration Record (MAR)
3. Observation - Ensure medication is taken as prescribed
4. Storage - Maintain secure medication storage
5. Disposal - Follow proper disposal procedures

Safety and Security

Environmental Safety

• Daily safety checks of all areas
• Monthly fire drill participation
• Quarterly facility inspections
• Annual safety equipment testing
• Immediate hazard reporting

Client Supervision Levels

Level 1 - Constant Supervision

• Line-of-sight supervision at all times
• 1:1 staffing ratio when indicated
• Documentation every 15 minutes

Level 2 - Close Supervision

• Check-ins every 30 minutes
• Visual confirmation of safety
• Available within immediate response distance

Level 3 - Regular Supervision

• Hourly check-ins
• Independent movement within facility
• Staff available on-site

Emergency Procedures

Medical Emergencies

1. Ensure scene safety
2. Call 911 if life-threatening
3. Provide first aid/CPR as trained
4. Notify supervisor immediately
5. Document incident thoroughly
6. Follow up with medical providers

Behavioral Emergencies

Follow de-escalation protocols:

• Remain calm and speak softly
• Maintain safe distance
• Use verbal de-escalation techniques
• Call for backup if needed
• Implement crisis intervention plan
• Document and debrief

Quality Assurance

Performance Indicators

• Client satisfaction scores
• Incident rates
• Medication error rates
• Treatment plan compliance
• Discharge success rates

Continuous Improvement

Regular quality improvement activities include:

• Monthly case reviews
• Quarterly outcomes analysis
• Annual program evaluation
• Staff feedback sessions
• Client focus groups

Staff Requirements

Qualifications

• Background clearance
• TB testing current
• CPR/First Aid certification
• Relevant education/experience
• Completion of orientation

Training Requirements

All residential staff must complete:

• 40-hour new employee orientation
• Annual 20-hour continuing education
• Mandatory reporter training
• De-escalation techniques
• Medication administration (if applicable)

Documentation Requirements

Daily Documentation

• Shift notes
• Medication administration records
• Incident reports (as needed)
• Client interactions
• Behavioral observations

Periodic Reviews

• Weekly team meetings
• Monthly treatment plan reviews
• Quarterly progress reports
• Annual comprehensive assessments

Compliance and Regulations

This program operates in compliance with:

• Title 22 California Code of Regulations
• HIPAA Privacy and Security Rules
• Americans with Disabilities Act
• Fair Housing Act
• CARF Standards