BILL ANALYSIS �
SENATE HUMAN
SERVICES COMMITTEE
Senator Jim Beall, Chair
BILL NO: AB 2228
A
AUTHOR: Cooley
B
VERSION: May 7, 2014
HEARING DATE: July 24, 2014
2
FISCAL: Yes
2
2
CONSULTANT: Sara Rogers
8
SUBJECT
Crisis Nurseries
SUMMARY
This bill revises the regulatory licensing requirements for
crisis nurseries regarding the length of services, licensed
capacity, educational and training requirements for lead
caregivers and volunteers, staff to child ratios, and other
requirements.
ABSTRACT
Existing Law:
1)Enacts the Community Care Facilities Act, which provides
for the licensure and oversight of out of home placements
of abused and neglected children by CDSS and which
defines a "crisis nursery" as a facility licensed to
provide short-term, 24-hour residential care and
supervision for children under the age of six who are
voluntarily placed by their parent or guardian due to a
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STAFF ANALYSIS OF ASSEMBLY BILL 2228 (Cooley)
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family crisis or stressful situation for not more than 30
days. (HSC 1516)
2)Exempts crisis nurseries from licensure as a child day
care facility under the California Child Care and
Development Services Act. (HSC 1596.792)
3)Establishes the maximum licensed capacity for a crisis
nursery as 14 children and requires each crisis nursery
to collect and maintain information indicating the total
number of children placed in the program, the length of
stay, the reasons given for the use of the crisis
nursery, and the age of each child. (HSC 1516 (d)(1) and
(e))
4)Provides that a crisis nursery may provide child day care
services for children under the age of 6 at the same site
as the crisis nursery, that each child may receive
services for no more than 30 calendar days in a six-month
period and that the child receiving such services shall
be counted against the licensed capacity of the crisis
nursery. (HSC 1516 (f))
5)Requires a crisis nursery to employ an administrator who
is on the premises for the number of hours necessary to
manage and administer the crisis nursery and who has the
following qualifications:
Specified knowledge and abilities regarding the
care of children in crisis nurseries and in managing
a facility and staff.
A Master's Degree in social work or social
welfare, marriage and family counseling, counseling
psychology or human services; and at least three
years of experience in the field of child or family
services, two years of which were in a managerial or
administrative position.
A Bachelor's Degree in behavioral science and
five years of experience in the field of child and
family services, two years of which were in a
managerial or administrative position. (Title 22 CCR
86564(d))
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1)Requires licensees to designate at least one lead
caregiver to be present at the crisis nursery at all
times when children are present. (Title 22 CCR 86565)
2)Requires a licensee to develop, maintain and implement a
written staff training plan for the orientation,
continuing education, on-the-job training and
development, supervision, and evaluation of all lead
caregivers, caregivers, and volunteers. The licensee
shall incorporate the training plan in the crisis nursery
plan of operation. (Title 22 CCR 86565 (o))
3)Establishes initial and ongoing training and education
requirements for lead caregivers, caregivers and
volunteers, including training in pediatric first aid and
pediatric cardiopulmonary resuscitation, as specified.
(Title 22 CCR 86565)
4)Requires there be at least one employed staff member for
every volunteer caregiver used to meet minimum staff
requirements, that there be one employee or volunteer
caregiver for every three children from 7 a.m. to 7 p.m.
and one employee or volunteer caregiver for every four
children from 7 p.m to 7 a.m. (Title 22 CCR 86565.5)
This bill:
1)Deletes the authority of a crisis nursery to provide
child day care services for children less than six years
of age and instead permits a crisis nursery to provide
"crisis day respite services."
2)Requires CDSS to respond to a request to extend crisis
day respite services beyond the statutory 30-day limit
within five working days and provides that no more than
two extensions may be granted in seven calendar day
increments.
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3)Deletes the requirement that a child receiving child day
care services from a crisis nursery are counted towards
its licensed capacity.
4)Permits a crisis nursery's licensed capacity to be based
upon 35 square feet of indoor activity space per child,
as specified.
5)Codifies regulations requiring all caregivers be
certified in pediatric cardiopulmonary resuscitation
(CPR) and pediatric first aid, as specified.
6)Codifies regulations requiring crisis nursery licensees
to develop, maintain and implement a written staff
training plan for the orientation, continuing education,
on-the-job training and development, supervision, and
evaluation of all lead caregivers, caregivers, and
volunteers, which shall be included in the facility's
plan of operation.
7)Codifies regulations requiring crisis nursery licensees
to designate at least one lead caregiver to be present at
the crisis nursery at all times when children are
present.
8)Codifies regulations requiring lead caregivers to have
one of the following education and experience
qualifications:
Completion of 12 postsecondary units, as specified,
in classes with a focus on early childhood education,
child development, or child health at an accredited
college or university, and six months of work
experience in a licensed group home, licensed infant
care center, or comparable group child care program or
family day care;
A current and valid Child Development Associate
(CDA) credential, with the appropriate age level
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endorsement issued by the CDA National Credentialing
Program, and at least six months of on-the-job
training or work experience in a licensed child care
center or comparable group child care program; or
A current and valid Child Development Associate
Teacher Permit issued by the California Commission on
Teacher Credentialing, as specified.
1)Codifies regulations requiring lead caregivers to have a
minimum of 24 hours of training and orientation before
working with children, permits one year experience in a
supervisory position in a child care or group care
facility to be substituted for 16 hours of training and
orientation, and requires lead caregivers to undergo at
least 20 hours of ongoing training, as specified.
2)Codifies regulations requiring general caregiver staff to
complete a minimum of 24 hours of initial training within
the first 90 days of employment, which may include first
aid and CPR and shall be included in the written staff
training plan, and requires that at least eight hours of
training be completed before the caregiver may be left
alone with children or counted in the staff-to-child
ratios, as specified.
3)Reduces the number of hours of training a person must
undergo in order to volunteer at a crisis nursery from
eight to five hours in the following ways:
a) Reduces crisis nursery job shadowing from four to
two hours; and
b) Reduces from two hours to one hour the amount of
training a volunteer must receive on community care
licensing regulations.
4)Adds "child guidance techniques" to existing training
requirements for volunteers.
5)Reduces the number of hours of training a volunteer must
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undergo before being included in staff-to-child ratio
requirements from 20 to eight hours, and from four hours
of job shadowing to two hours, and from two hours of
community care licensing regulations to one hour.
6)Deletes existing training requirements that volunteers
must undergo 12 hours of CPR training and eight hours of
child health and safety training and instead requires
eight hours of training that covers child care health and
safety issues, trauma-informed care, the importance of
family and sibling relationships, temperaments of
children, self-regulation skills and techniques, and
program child guidance techniques.
7)Reduces staff-to-child ratio requirements for preschool
age children from 1:3 to 1:6 between 7 a.m. and 7 p.m.
8)Reduces staff-to-child ratio requirements for infants
from 1:3 to 1:4 during the hours of operation between 7
a.m. and 7 p.m.
9)Reduces staff-to-child ratio requirements for all
children from 1:4 to 1:6 during the hours of operation
between 7 p.m. and 7 a.m.
10)Requires licensees and caregivers who provide medication
assistance to children to do all of the following:
Assist children with the taking of the medication,
follow instructions as outlined by an appropriate
medical professional, store the medication
appropriately, as specified, and administer the
medication as directed on the label or as advised by a
physician in writing;
Administer nonprescription medication without the
consent of the child's physician as long as the
medication is administered in accordance with the
product label and the child's parent has consented in
writing to the use of the medication, as specified;
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Develop and implement a written plan to record the
administration of prescription and nonprescription
medications and to inform the child's authorized
representative daily, for day care, and upon discharge
for overnight care, when the medications have been
given; and
Return all medications to the child's authorized
representative when the child is withdrawn from the
facility, as specified.
FISCAL IMPACT
An Assembly Appropriations Committee states there would be
minor and absorbable costs to CDSS to reflect changes in
the licensing requirements.
BACKGROUND AND DISCUSSION
Purpose of the bill:
According to the author, current law and regulations
governing crisis nurseries have not been updated to reflect
changes made by SB 1214 (Wolk) Chapter 519, Statutes of
2010, which prohibits the use of crisis nurseries as a
placement for foster children, effective July 1, 2012. The
author states that this bill brings laws and regulations
pertaining to crisis nurseries into alignment with child
day care regulations in order to make it possible for
existing crisis nurseries to remain in operation and
provide a safe environment for young children of families
in crisis.
Crisis Nursery Model
Crisis nurseries were created as a separate licensing
category under the Community Care Facilities Act under SB
855 (Machado), Chapter 664, Statutes of 2004, to provide a
temporary and emergency housing and shelter facility
placement option for parents. The intent of the care model
is to provide a voluntary 24-hour placement option for
families with young children who are facing difficult or
extreme financial, health, or other challenges to prevent
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the need for or the engagement of child welfare services.
Under the statute, the crisis nurseries were limited to
specified counties and were intended to serve children
under the age of six who were voluntarily placed by their
parent or guardian under their temporary care or, under
limited circumstances, were temporarily placed by a county
child welfare service agency.
Prior to SB 855's adoption, crisis nurseries were licensed
as a group home under the Community Care Facility Act, and
it was argued that those regulations were excessive and
inappropriate for crisis nurseries due to differences in
the care needs of very young children who were voluntarily
placed by a parent compared to the needs of children that
were removed from parental custody by county child
protective services workers due to abuse or neglect. The
bill at that time included a sunset of January 1, 2008,
which was subsequently extended to January 1, 2014.
Due to concerns with crisis nurseries serving as a
temporary placement for children removed from their homes
by county social workers, SB 1214 (Wolk) Chapter 519,
Statutes of 2010 eliminated crisis nurseries as an
allowable child welfare placement effective January 1,
2012. Following this agreement the state eliminated the
sunset, allowing crisis nurseries to exist permanently
under SB 1319 (Liu) Chapter 663, Statutes of 2012.
Five crisis nurseries are licensed in California currently,
located in Concord, Davis, Nevada City and two in
Sacramento. Since 2009, more than 9,000 children have been
served by these nurseries. On average, the lengths of stay
have ranged from eight hours to just over 24 hours with 44
children staying for the maximum allowable days. No
exemptions have been requested or granted for children to
stay beyond the 30-day limit.
Currently there are no state of federal monies made
available to crisis nurseries, with all five nurseries rely
upon philanthropic support and local funds to operate. In
many instances a related group home provider will support
and manage a local crisis nursery, usually at a substantial
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financial loss. As a result, crisis nurseries rely
substantially on trained volunteers to meet the staffing
requirements.
Crisis Nursery Day Care Services
According to the sponsor, this bill seeks to bring
child-to-staff ratios into alignment with current day child
care licensing ratio standards, which are based on a square
feet per child ratio.
Current child care regulations require child care
facilities to maintain 75 square feet of outdoor space per
child and at least 35 square feet of indoor space per
child. This bill applies only the latter standard of 35
square feet of indoor space and is silent on outdoor space.
A remaining difference in regulations is that crisis
nurseries would permit volunteers to count toward the
caregiver-child ratios, whereas child care regulations do
not. Conversely, crisis nurseries have a higher standard of
training in pediatric CPR and first aid and must ensure
that all staff have such training, while child care
providers must only ensure that a staff member with such
training is present at all times. Crisis nursery staff and
volunteers are subject to the same criminal record
clearance requirements as child care providers and the
crisis nursery administrator and lead caregiver education
and experience requirements are similar to the teacher
requirements provided for under child care regulations.<1>
Related legislation:
AB 578 (Dickinson) 2014 seeks to establish a two-year pilot
project in Sacramento and Yolo counties for the purpose of
evaluating the effectiveness of crisis nurseries.
SB 1319 (Liu) Chapter 663, Statutes of 2012 eliminated the
sunset date.
SB 1214 (Wolk) Chapter 519, Statutes of 2010 extended the
-------------------------
<1> CCR Title 22 101216.1
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sunset date to January 1, 2014, but eliminated provisions
of the original legislation which permitted Crisis
Nurseries to provide emergency respite care for a limited
number of foster children. Effective July 1, 2012, Crisis
Nurseries were only permitted to serve children placed
voluntarily by their parents or legal guardians.
SB 104 (Machado) Chapter 288, Statutes of 2007 extended the
sunset date to January 1, 2011.
SB 855 (Machado) Chapter 664, Statutes of 2004 established
Crisis Nurseries as a separate licensing category, with a
sunset date of January 1, 2009.
COMMENTS
Currently, crisis nurseries that wish to provide child day
care services must either count those children toward their
14-child capacity, or must be separately licensed as child
care providers. The sponsors state that this bill is an
attempt to merge licensing standards for crisis nurseries
and their separately licensing child care centers into a
single licensure.
Such a merging is challenging because the regulatory
requirements relevant for a 24-hour facility are very
different from those of a day care facility. For example,
existing regulations for crisis nurseries require that each
child has an individual bed, as specified, whereas child
day care requirements permit the use of floor mats for
naps. Additionally, crisis nursery regulations require a
set availability of showers and space for personal items,
standards that may not apply for children in day care. The
bill would permit capacity for day care to increase in
proportion to the space per child requirements, but it is
unclear if such standards would apply to all children in
the licensed capacity, including children receiving day
care services. Additionally, current child care standards
requiring child care facilities to maintain 75 square feet
of outdoor space per child have not been added to this
bill.
Should the bill pass this committee, the author may wish to
clarify which of these standards would apply to children
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receiving 24-hour or night-time care services and which
apply to children who are present only for day-care
services.
PRIOR VOTES
Assembly Floor 77 - 0
Assembly Appropriations 17 - 0
Assembly Human Services 7 - 0
POSITIONS
Support: California Alliance of Child and Family
Services
Contra Costa County
Oppose: None received.
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