HomeMy WebLinkAboutPlanning Commission 2012-11-13 (2)'4
5
�r M A R I N
r` f i RERDVE Y PROJECT
S,
Guidelines for Sober Living Environments
Purpose and Philosophy
It is the policy of the Marin County, Department of Health and Human Services to
provide guidance and recommendations for the effective creation and operation
of Sober Living Environments ("SLE") in Marin County, California. The SLE is a
safe, clean, sober, residential environment that promotes individual recovery
through positive peer group interactions among house members and staff. Sober
living housing is affordable, alcohol and drug free and allows the house members
or residents to continue to develop their individual recovery plans and to become
self supporting. In doing so, the SLE must co -exist in a respectful, lawful, non-
threatening manner within residential communities in Marin County. These
guidelines are a minimum standard to which Marin County Department of Health
and Human Services will provide oversight and quality assurance through
monthly reporting, semi-annual site visits and audits with contractual SLE
services.
Marin County Department of Health & Human Services, Division of
Community Wealth, Mental Wealth and Substance Use Services would like
to thank the Marin Recovery Project (MRP) for the amount of time, research
and dedication they provided in developing these Guidelines for Marin
County. The MRP consists of a group of self -identified peer leaders in our
community whose major goals include: (1) Changing public perceptions of
recovery; (2) Promoting effective public policy, and; (3)Demonstrating that
recovery is working for millions of Americans.
Exhibit 5-1
Policies and Procedures
Each House shall have a current Policies and Procedures Manual that sets forth the
rules, regulations, expectations, governance and grievance procedures of the house.
Each house member shall be familiar with the policies and procedures contained in the
Policy and Procedures Manual and will sign an agreement to abide by them while a
member of the house. At a minimum, a House Policies and Procedures Manual shall
contain the following sections:
A. Standards of Operation: The SLE shall provide 24-hour safe housing, free from
alcohol and other drugs which, at a minimum, shall include the following
components;
1. Residents shall be required to attend regular house meetings with house
managers, and/or operators. These meetings may be in a group setting with
other residents of the SLE;
2. Residents shall be provided with opportunities to engage in regular activities
necessary (or optional) that define a residence such as cooking, laundry,
housecleaning, yard work, etc;
3. Each SLE shall have a "common area" with adequate space for the proper
number of residents to assemble for social and/or other group activities;
4. Each SLE shall have adequate personal space for each resident to be
provided dignity, respect and appropriate privacy at all times, and the SLE will
comply with applicable guidelines for the amount of square feet per resident
and the number of residents per room;
a. SLE operators and house managers shall take appropriate measures to
ensure that the personal property of each resident is secure;
6. The SLE shall establish and maintain a culture and environment that is
welcoming and understanding to those they serve;
2. All residents shall have access to the: kitchen, refrigerator, stove, dining
room, laundry facilities, restrooms, and showers to ensure basic needs are
met;
8. The SLE shall post a written description of the procedural processes
regarding chores, assignment of roommates, and primary house rules in a
space that is accessible to all residents;
9. The SLE shall be a non-smoking residence. If the operator's policy is to allow
smoking on the property, a smoking area must be designated clearly in an
outdoor space where smoke will not affect neighbors and is in compliance
with any and all local smoking ruleslordinances. (A Good Neighbor Policy
should also be established between the SLE operator and direct neighbors of
the SLE) Any and all litter generated in a designated smoking area must be
cleaned up daily;
10. Each SLE shall afford residents opportunities to engage in daily recreational,
cultural, physical, and spiritual activities, either as an individual or with a
group;
11. All SLE residents MUST be engaged in employment, treatment, education,
volunteer work, active job search (for a defined period), or other approved
daily activities conducive to the recovery process;
12. SLE proprietors are responsible for ensuring neighborhood parking is in
compliance with town/city ordinances and is NOT intrusive to neighbors;
Exhibit 54L
13. SLE proprietors shall establish and maintain a "Good Neighbor Policy."
D. Admission and Discharge
1. Each SLE shall have a written admission procedure;
2. Each SLE shall have a written. policy for discharge, grounds for discharge and
discharge protocols that address the personal property of residents, referral
to further services, monies paid, and information sharing ,if applicable;
3. Each prospective resident shall be interviewed and assessed by the House
Manager to determine whether he or she is an appropriate fit for the SLE;
4. If the prospective resident. is referred from another source, the interviewer
may contact that source as a means of gathering information about the
suitability of the prospective resident and Releases of Information (HIPAA,
42 -CFR) may be requested for this purpose;
5. If the prospective resident is currently involved with the criminal justice
system (probation/parole), releases of information (42 -CFR) may also be
requested by the interviewer;
6. Any/all prescription medications must be disclosed by the prospective
resident and a 7 -day minimum supply must be on hand prior to the resident
moving into the SLE. (Prospective residents CANNOT be denied services
based on prescribed medications);
7. Copies of all policies, procedures, house rules and expectations shall be
presented to the prospective resident during the interview process, and
specific questions or concerns of the resident at this time should be recorded
as a means of documenting their understanding of the rules and
expectations;
8. Admission and SLE residency documents shall be kept in a resident's file at
the premises at all times.
C. Eligibility for Residency; Eligibility shall be determined through a formal interview
process set forth by the proprletor/management of the SLE. At a minimum,
prospective residents must be willing to comply with and meet the following criteria:
1. Residents must demonstrate being clean and sober by one or more of the
following means:
a. Submit a negative urinalysis sample;
b. Be actively enrolled in an alcohol and other drug treatment program;
c. Regular attendance at self-help groups such as AA, NA, CA, etc.
2. SLE residents must demonstrate employment (paid or volunteer), ability to
pay, or making a good faith effort to do so (determined by SLE operator or
House Manager), be actively enrolled in a formal alcohol or other drug
treatment program or be involved with community service work for a minimum
of 20 hours per week as acceptable by the SLE operator and the resident's
supervising officer (if applicable).
3. Residents must possess a willingness and demonstrate the ability to comply
with all SLE House rules, standards and procedures.
Exhibit 5-t'3
D. House Rules: SLE rules must he clearly defined; Any optional rules the SLE
proprietor chooses to implement must be for the needs of the residents, shall not be
overly burdensome, and must be consistent across multiple residents. The following
should be considered minimum mandatory standards for every SLE:
1. There shall be no consuming alcohol and/or other drugs by anyone on the
property of the SLE;
2. Alcohol and items containing alcohol shall not be brought onto the property
for any reason;
3. Alcohol and other drug use may be grounds for dismissal from the SLE; Upon
being notified of possible alcohol and/or other drug use by a resident, the
House Manager shall first refer the resident for detoxification services for up
to three days, Further, a resident has the right to file a grievance if dismissed
from the residence without being referred to detoxification services. Note: The
SLE operator or House Manager assumes NO fiscal responsibility for
payment for,detoxification for a resident of the SLE;
4. Regular attendance of house meetings shall be mandatory for all residents
and it shall be the responsibility of SLE management to ensure proper
participation;
S. Operators or House Managers in charge of an individual SLE facility must be
accessible to residents daily. The operator and/or House Manager shall be
clearly and easily identified and shall remain available at all times;
6. Each SLE shall have in its house rulebook a policy addressing visitation
including hours, terms of contact, areas for visitation, visitor access, child
visitation and monitoring, etc.
E. A Confidentiality Policy: The SLE shall protect the privacy of Individuals being
served and will not disclose confidential information without express written consent
except as required or permitted by law. The House Manager will maintain release
forms for house members to authorize the release of information, The SLE shall
also affirmatively inform house members' of the privacy of information disclosed in
house meetings or other SLE activities. SLE management shall remain
knowledgeable of and obey all state and federal laws and regulations relating to
confidentiality of records for the providers of services. Confidential information
acquired during residency at the SLE shall be safeguarded from illegal or
inappropriate use, access and disclosure, or from loss, unsecured maintenance of
records or recording of an activity or presentation without appropriate releases.
Forms will be provided to house members for the authorization to release
information in compliance with Federal Law 42 -CFR Pill.
F. A Sexual Harassment and Verbal Abuse Policy: The SLE will not tolerate any
behavior that is abusive, harassing or intimidating toward House Manager,
volunteers, house members' or visitors.
G. A Weapons, Alcohol, Illegal Drugs and Illegal Activity Policy: The SLE strictly
prohibits on its property the possession, and/or use of firearms, other weapons,
illegal drugs, illegal activities and acts or threats of violence. Such acts shall be
reported to the local law enforcement agencies immediately. Residents will be
terminated from the house for such offenses. House Managers found to have
violated the policy may face immediate termination. Each SLE shall have a written
Exhibit 5-4
policy addressing weapons, alcohol and other drug use, relapse, and illegal activity
by residents and staff.
H. A Prescribed Medication Policy: Each facility shall have a written policy
regarding the use and storage of residents' prescribed medications. Medications
must be properly secured. The policy concerning the storage of medications does
not apply to those medications, such as an asthma Inhaler, to which medical
necessity'requires the resident to have immediate access. The SLE shall not
dispense medication but must ensure it is securely stored by the resident.
A Drug and Alcohol Testing Protocol as follows:
1. Each SLE shall have a written policy addressing the policies and procedures
of specimen collection and shall maintain appropriate urinalysis equipment
and/or access to an outside drug and alcohol testing service so that all
residents may be tested at random to protect the safety and integrity of the
house and its residents;
2. Parole, Probation or the Courts may impose and provide drug and alcohol
testing to the residents referred by the Courts and/or Probation;
3. Positive drug tests of residents shall be reported immediately to the probation
officer/parole agent or to the courts, as applicable.
J. Documentation/Record Keeping
Each SLE Manager shall keep a record of all residents as follows:
a. A resident's date of birth, emergency contact Information, pertinent
emergency medical information, list of current medications and
pharmacy where prescriptions are on file, employer or school contact
information and any releases of information that are deemed
necessary by the House Manager. Incidents of relapse should also be
documented;
b. A resident sign in/out sheet should be placed near the main
entrance/exit of the residence;
c. Each SLE shall keep clear records of rent/expenses paid and provide
each resident with a receipt each and every month, or as appropriate,
when rent/expenses are paid;
d. The SLE shall have clear policies concerning curfew, prescribed
medications, urinalysis monitoring, visitation, rent/expense payments,
disposal of medications, relapse, resident/consuiner conduct and
expectations, and resident departures from those requirements shall
be documented;
e. Each SLE shall have a specific policy addressing relapse and the
actions taken by fhe house manager to address an incident of
relapse.
K. An Incident Report Policy: The SLE House Mangerwill complete an internal
incident report for all incidents involving house members. The incident report will be
completed within 72 hours of the occurrence of an on-site incident or, in the case of
an off-site incident when House Manager became aware of, or reasonably should
have known of an incident that occurred. The incident report will provide:
Exhibit 5-5
I . A detailed description of the event including the date, time, location,
individuals, name involved, and action taken.
2. The House Manager responsible for completing the report will sign it and
record the date and time it was completed,
3. All incident reports will be stored in a single, separate file.
4. The House Manager or his/her designee will be responsible for reviewing
incident reports and, all incidents will be evaluated to determine opportunities
to improve.
Incidents involving criminal activity or the need for emergency services (IE:
fire, 911, violence, or serious injury) shall be reported to Marin County's
Department of Health and Human Services within 72 hours. Reports shall be
made for all incidents including:
6. Any violation of client rights, including but not limited to, allegations of abuse,
neglect and exploitation;
6. Accidents and injuries;
i. Illegal or violent behavior;
8. Fire;
9. Medical emergencies;
10. Psychiatric emergencies;
11. Suicide attempt by an active house member (on or off site);
12. Medical or psychiatric emergencies that result in admission to an inpatient
unit of a medical or psychiatric facility;
13. Release of confidential information without house members' consent;
14. Any other significant disruptions or rules violations (site specific).
L. A Client Grievance Policy: Each SLE must have a written grievance procedure.
Each house member will receive a copy of the grievance procedure within 48 hours
of admission to the SLE. The House Manager will explain the grievance procedure
clearly and, after this explanation and review, both the resident and the House
Manager will sign the grievance procedure acknowledgement form which will be
maintained in the SLE files. Copies of the grievance forms are to be readily
available to house members, House Managers will advise house members whether
they have cause or not to file a grievance about any violation of client rights or
organization rules, but the house member may do so at his or her discretion. The
SLE will provide necessary help and materials in order for the grievance form to be
complete and appropriately submitted. If a grievance is made, the following may
occur:
1. Marin County Department of Health and Human Services will evaluate the
grievance thoroughly and objectively, obtaining additional Information as
needed;
2. Marin County Department of Health and Human Services will provide a
response to the house member within fourteen (14) business days of
receiving the grievance;
3. Marin County Department of Health and Human Services will provide
technical assistance and mediate unresolved grievances when appropriate;
4. All grievances will be filed and documented, including the final disposition and
keep record of it in a central file;
Exhibit 5-6
5. Marin County Department of Health and Human Services does not restrict or
discourage, or will not interfere with house members communication with an
attorney or other organizations for the purposes of filing or pursuing a
grievance;
6. Marin County Department of Health and Human Services adheres to these
standards to protect the welfare df the resident the SLE Man_ ager/Proprietor,
and the community at large.
M. SLE Manager's Requirements: Overall supervision for each SLE must be
adequate for the number of people residing in the SLE and appropriate
operators/House Managers must be accessible on an on-call basis 24 hours a day,
7 days a week.. In addition, Operators/House Managers are expected to have the
following qualifications and responsibilities:
1. House Managers must have at least two years of sobriety (if in recovery), be
CPR certified, possess adequate crisis intervention skills and be trained in
cultural competence;
2. At a minimum, House Managers are responsible for the safely of the
premises and those who reside there. Additional responsibilities include;
collection of rent (if appropriate per SLE operator) documentation and
maintenance of records, uphold house rules, and supervise residents as
needed, maintain property inside and out, ensure adherence to parking
restrictions, smoking rules, etc are enforced;
3. If more than one manager is appointed to the SLE; shift notes should be kept
as a means of documenting incidents, if they occur,
N. A Code of Conduct which provides that:
1. House Managers are to conduct themselves in a professional manner at all
times, adhere to all policies and procedures including ethical and personal
standards. House Managers are also expected to treat consumers/residents,
volunteers, neighbors and guests with respect both on and off premises;
2. No SLE will permit any House Manager to enter into a business relationship
with any house member or their family. They shall not employ them while the
house member is living in the SLE;
3. House Managers, house members and/or volunteers shall not engage in any
conduct of a criminal or disruptive nature that would bring discredit upon the
House, its residents, the County of Marin or the State of California;
4. A violation of professional conduct may result in disciplinary action against
the House Manager up to and including discharge from the SLE depending
on the severity of the infraction;
5. All disciplinary actions will be handled on an individual basis and the
discipline rendered will take into consideration overall work history, the
nature of the offense and consideration of the extenuating circumstances, if
any.
6. Willfully engaging in any act that can be shown to be harmful to the interest
of the SLE or its residents may result In termination.
O. A Conflict of Interest Statement: No volunteer, agent, or participant is to attempt
to secure privileges or advantages from anyone in the SLE.
Exhibit 5-7
P. Physical Environment of the SLE
1. Exit doors must be clearly marked and barriers to appropriate personal
contact among residents should be eliminated;
2. Heating and cooling units shall be sufficient to keep residents comfortable at
all times, and shall be in working order;
3. The SLE shall maintain zoning conformance, posses all required permits and
follow all minimum fire prevention requirements including;
4. There shall be no smoking inside the building;
S. Any/all smoking materials must be disposed of safely and neatly outside the
residence;
G. Stoves and cooking areas shall be kept clean and adequately maintained;
Y. Smoke detectors and fire extinguishers shall be installed in accordance with
the local Fire Marshal regulations and requirements;
B. Emergency exit routs and disaster plans should be clearly posted in common
areas and reviewed annually;
9. Appropriate locks shall be in placed on all doors and windows.
Q. A Continuity Policy: in the event that the SLE is no longer able to continue its
service, residents will be referred to other community agencies that can continue
housing or rehabilitative support prior to the date of discontinuing service.
Exhibit 5-8
Checklist for Submission
�11111��z
To and ensure proper processing of your application, make sure you have enclosed the
following, filled out completely and signed with a check for the appropriate amount.
1. Application for Certification
2. Site Visit Form and Fee
3. Copy of Standards of Operation
4. Copy ofAdmission and discharge
5. Copy of Eligibility for Residency
6. Copy of House Rules
7. Copy of Confidentiality Policy
8. Copy of Sexual Harassment and Verbal Abuse Policy
9. Copy of Weapons, Alcohol, Illegal Drugs and Illegal Activity Policy
10. Copy of Prescribed Medication Policy
11. Copy of Drug and Alcohol Testing Protocol
12. Copy of Your Testing Log
13. Copy of Your Relapse Policy
14. Copy of Documentation/Record Keeping
15. Copy of Incident Report Policy
16. Copy of Grievance Policy and Procedures
17. Copy of Manager's Requirements (lob Description)
18. Copy of Code of Conduct
19. Copy of Conflict of interest Statement
20, Physical Environment of the SLE
21. Copy of Continuity Policy
22. Building Permits if any
23. Article of Incorporation in any
Please make sure to go over the Certification Checklist and see that you comply with
everything. If you aren't in compliance and a return visit is warranted another site visit fee will
need to be paid.
Exhibit 5-9
Site Visit Form
Each Certification is good only for the property listed on the certificate. To avoid confusion and
maintain standards, every Sober Living Environment owned or run by the same person or
companymustbe certified. Once certified you will be provided with a certificate specific to
each home, placement on California Recovery Resources as well as bed availability
updated weekly and a listing in California Recovery Resources. Certification is good for one
year.
Site Visit Fees: 1st House Add]. House
Number of SLE's to Certify 1@ $ + @$ Total $
I authorize that I am a representative with permission to make decisions for this business and
am requesting certification for my SLE. I agree to uphold all of these requirements and
minimum standards to maintain the certification, reserves the right to revoke
Certification if the standards are not met.
Date
Print Name
Authorized Signature
Exhibit 5-10
.97
®®
For Offlcial Use Only
'Date Received Appointment Set
_Pass Hold _Fail .
Certificate Date Certificate Number
Authorized by
*Not required butreconnnended
Each Sober Living Environment should be certified for a period of 1 Year.
Failure to continue to meet any of the above requirements will result in revocation of
certification and removal from . Investigations will be conducted when claims are made
that a SLE is not meeting certification requirements.
Exhibit 5-11
Certification Check Sheet
4
Policy and Procedure
The Policy and Procedure Manual includes:
_ Rules
_Regulation
_}lousing Expectations of Residents
_Governance and Grievance Procedures
_SLE keeping organized records of Resident Agreement and receipt of Policy and Procedure
Manual
STANDARDS OF OPERATION
_Residents are required to attend regular house meetings
(review schedule, tracking of attendance)
_Residents offered opportunities to engage in regular activities, e.g., cooking, laundry,
housecleaning, yard work, etc. (review schedules, tracking of participation)
`SLE has a "Common Area" with adequate space for the number of Residents to assemble
_SLE has adequate personal space for each Resident
_SLE has adequate privacy for each Resident
_SLE has followed guidelines for the amount of square feet per Resident and the number of
Residents per room
_SLE Operators/Managers take appropriate measures to ensure that each Resident's personal
property is secure
_SLE has established and maintain a culture and environment that is welcoming and
understanding to those they serve
mull Residents have access to the:
Kitchen
Refrigerator
Stove and Oven
Dining Room
Laundry Facilities
Restroom and Shower
_The SLE is a non-smoking residence
_The SLE has a policy to allow smoking on the property, in a clearly designated outdoor space
where smoke will not affect neighbors and is in compliance with any/all local smoking
rules/ordinances
_The SLE has established "A Good Neighbor Policy" with direct neighbors of the residence
Exhibit 5-12
_Is the designated smoking area litter free and part of a chore schedule to be cleaned up daily
_Does the SLE afford Residents opportunities to engage in daily recreational, cultural,
physical and spiritual activities, either as an individual or group
Are all SLE Residents engaged in employment, treatment, education, volunteer work and/or
actively job searching (for a defined period), or other approved daily activities conducive to the
recovery process
The SLE has a written description of the procedural processes regarding chores, assignment
of roommates, and primary house rules in a place that is accessible to all Residents
DESCRIPTION OF PROPOSED PROGRAM
Program Activities:
Appropriate services and activities
`Builds on existing services .
_Provided in appropriate location(s)
Appropriate steps and timeline for implementation
Program Effectiveness:
_hncoporating evidence -based, promising or locally proven practices with fidelity or
appropriate adjustments
_Addressing common issues this population experiences
Priority Populations:
"Underserved cultural. populations" will be served
_Program will be accessible to/outreach to targeted populations
_Program accessible to physically disabled
Program Staff:
_Appropriate additional staff including training, experience, functions and responsibilities
Ability to provide culturally and linguistically competent services for target population
Numbers Served
_Appropriate for type of services proposed and funds available
_Appropriate ethnicity/culture and age breakdowns given the target population
Implementation Partners and Service Linkages:
_Appropriate partnerships proposed Letters of support from essential partners
_Effective referral plans for Substance Use (SU) and non -SU services
PROGRAM EVALUATION AND RECORDREEPING
Recordkeeping and Reporting:
Adequate record keeping plan for services provided and client demographics
_Ability to maintain client confidentiality
_Adequate plan for data reporting to CMUS (timely submission of fiscal data, utilization data
and other reports)
Evaluation:
_Ability to show improved AU status and/or reduced risk for SU problems
Exhibit 5-13
At least three (3) specific outcomes
_Ability to collect baseline and outcome data
Adequate data gathering instrument(s)
Ability to show that increase in individuals receiving services at agency or by referrals
_Ability to show if program is appropriately designed and implemented
Ability to implement evidence -based or promising practices with fidelity or track
adaptations
PROGRAM BUDGET
Budget:
_Budget attached in form provided
_Appropriate use of funds given proposed project
Budget Narrative:
_Appropriate justification for expenditures
_Third party coverage is identified and plan for collection (Medi -Cal, Medi -Care, insurance)
Financial Records:
_Most recent 1 -year audit attached
LEVERAGING &SUSTAINABILITY
_How will additional supportbe leveraged (cash, federal reimbursements, readiness to
implement, existing resources and services)
—Leveraged funds/resources are sustainable
FISCAL INFORMATION
_Submit documentation that program costs can be carried for at least sixty (60) days
FACILITY
_➢escription of office facilities included?
INVESTIGATION STATEMENT
_Statement of whether the agency or current staff have ever been the subject of a public or
private audit or special investigation for improprieties or other irregularities?
LEGAL INFORMATION
_Statement of authority to operate in California included?
Sample Testing Log
* Resident can be identified by initials or number for confidentiality if needed,
Exhibit 5-14
Signed Agreement: Pre -signed House Rules must state:
_No alcohol or drug use allowed
No alcohol, items containing alcohol or drugs are allowed an the property
Anyone possessing drugs or alcohol, under the influence of drugs or alcohol, or refusing
to submit to a drug or alcohol test will immediately be asked to leave in order to preserve the
environment as clean and sober
.Attendance at weekly house meetings is required
_Good Neighbor policy is written and enforced
Home:
_The Residential structure, maintenance, and landscaping should be kept in a manner equal
to, or better than, the surrounding neighborhood.
_There must be no evidence of insect infestation, bedbugs, cockroaches, or rodents.
_There are no holes in the walls or broken items, furnishings or fixtures.
_There is working heat in all living areas
_Water heater is large enough to provide for the number of residents.
_One room in the home must provide enough space and seating for every resident to
participate in house meetings.
A First Aid Kit complete with scissors and tweezers is present.
_Clean, functional and unbroken furniture must be present with no major stains, rips -or tears
that would bring the furniture to a below average standard.
Sleeping Areas:
_Sleeping areas must include a bed for each person
_Sleeping areas must include a dresser or drawer space as well as closet space for each
individual
_Bedrooms are the only rooms to be used as sleeping areas
_Bedrooms used as sleeping areas may notbe used for any other purposes
_No room may be enclosed within another unfinished romp (including a garage)
_Each room shall have a door and at least one working window for fire escape purposes.
_Smoke detectors shall be installed in each bedroom
Each room can have no more beds than is reasonable for the size.
Kitchen and Dining Areas:
_DiningRomn tables and chairs must be suitable for family meals for a minimum of people.
_Kitchen and Dining Tables are kept clear for frequent use
_Space must be provided for dry food storage for all residents
_5 cubic feet of cold food storage per person (1 large fridge per 4 people) must be provided
_Adequate hotwater for dish washing and showering must be provided
_Stove must be clean and free from grease accumulation
Exhibit 5-15
Bathrooms:
_No more than 5 persons per bathroom
Bathrooms shall have no mold or other visible health hazard.
Safety:
_Windows are in working order, unblocked and bars must release from the inside if present.
_Charged fire extinguisher shall be installed as described
_Working smoke detectors are installed as described
_Carbon monoxide detector is installed if gas appliances are used or fireplace is present
_Fire ladder is present on second and third story if applicable
_Emergency contact numbers as well as house phone number and address are posted
Management:
_Management monitors safety and sobriety of residents
_Gas, Electric, Water, Sewer and Garbage must be provided and paid for by management.
_Management has not had, and agrees not to have, dual relationships with residents
_Plumbing and electrical requests are responded to and addressed within 24 hours.
_Maintenance requests are responded to and addressed within one month.
_Cleaning supplies, toilet paper and laundry soap are provided for upkeep of sanitation
_Waste and unused items are dealtwith properly
_Record of signed house rules and resident agreementwill be kept for at least 2 years post
discharge.
_Drug and Alcohol testing must be conducted and documentation completed
_Records of testing dates and results are to be kept for 2 years
All records should be kept confidential and protected by either lock or password
_Management must be clean and sober and agree to submit to drug or alcohol testing upon
request Uy_which would be triggered by someone filing a complaint.
_Place the phone number in a conspicuous place so residents can call if they believe
management/houseparent is using."
Additional Comments:
Reviewed by (Print) Signature/Date
Exhibit 5-16