BILL ANALYSIS �
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|SENATE RULES COMMITTEE | AB 2228|
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CONSENT
Bill No: AB 2228
Author: Cooley (D)
Amended: 8/4/14 in Assembly
Vote: 21
SENATE HUMAN SERVICES COMMITTEE : 4-0, 6/24/14
AYES: Beall, DeSaulnier, Liu, Wyland
NO VOTE RECORDED: Berryhill
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : 77-0, 5/27/14 (Consent) - See last page for
vote
SUBJECT : Crisis nurseries
SOURCE : California Alliance of Child and Family Services
DIGEST : This bill revises provisions related to crisis
nursery programs by requiring crisis nurseries to be licensed by
the Department of Social Services (DSS) to operate crisis
residential overnight programs, as defined, and authorizes
crisis nurseries to provide crisis day services, as defined.
This bill establishes the maximum licensed capacity for a crisis
residential overnight program at 14 children and requires that
the licensee designate at least one lead caregiver, as
described, to be present at the crisis nursery at all times when
children are present. This bill also modifies the requirements
relating to the use of volunteers to be counted in the
staff-to-child ratios in a crisis nursery, as specified, and
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prescribes requirements relating to when a child has a health
condition that requires medication.
ANALYSIS :
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 the Department of Social
Services (DSS) 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 family
crisis or stressful situation for not more than 30 days.
2.Exempts crisis nurseries from licensure as a child day care
facility under the California Child Care and Development
Services Act.
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.
4.Provides that a crisis nursery may provide child day care
services for children under the age of six 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.
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:
A. Specified knowledge and abilities regarding the care of
children in crisis nurseries and in managing a facility and
staff.
B. A Master's Degree in social work or social welfare,
marriage and family counseling, counseling psychology or
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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.
C. 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.
1.Requires licensees to designate at least one lead caregiver to
be present at the crisis nursery at all times when children
are present.
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.
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 (CPR), as specified.
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.
This bill:
1.Defines "crisis nursery" to mean a facility licensed to
operate a program to provide short-term care and supervision
for children under six years of age who are voluntarily placed
for temporary care by a parent or legal guardian due to a
family crisis or stressful situation.
2.Requires a crisis nursery to be licensed to operate a crisis
residential overnight program and permits a crisis nursery to
also provide crisis day services.
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3.Requires a crisis nursery to be organized and operated on a
nonprofit basis by either a private nonprofit corporation or a
nonprofit public benefit corporation.
4.Defines "crisis day services" to mean temporary, nonmedical
care and supervision for children under six years of age who
are voluntarily placed by a parent or legal guardian due to a
family crisis or stressful situation for less than 24 hours
per day. Prohibits a child from receiving crisis day services
at a crisis nursery for more than 30 calendar days, or a total
of 360 hours, in a six-month period unless an exception is
issued.
5.Defines "crisis residential overnight program" to mean a
short-term, 24-hour nonmedical residential care and
supervision, including overnight, for children under six years
of age who are voluntarily placed by a parent or legal
guardian due to a family crisis or stressful situation for no
more than 30 days.
6.Defines "voluntarily placed" to mean a child, who is not
receiving Aid to Families with Dependent Children-Foster Care,
placed by a parent or legal guardian who retains physical
custody of, and remains responsible for, the care of his/her
children who are placed for temporary emergency care.
Specifies that "voluntarily placed" does not include placement
of a child who has been removed from the care and custody of
his/her parent or legal guardian and placed in foster care by
a child welfare services agency.
7.Permits a crisis nursery to provide crisis day services for
children under six years of age at the same site that it is
providing crisis residential overnight services.
8.Prohibits a child from receiving crisis day services at a
crisis nursery for more than 30 calendar days, maximum of 12
hours per day, or a total of 360 hours, in a six-month period
unless an exception is issued to allow a child to receive
additional crisis day services in a six-month period, as
specified.
9.Clarifies that no more than two exceptions, in seven-calendar
day or 84-hour increments, may be granted per child in a
six-month period.
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1.Requires a crisis nursery license to be issued for a specific
capacity, as determined.
2.Requires the maximum licensed capacity for crisis day services
to be based on 35 square feet of indoor activity space per
child. Specifies that bedrooms, bathrooms, halls, offices,
isolation areas, food-preparation areas, and storage places
shall not be included in the calculation of indoor activity
space. Includes floor area under tables, desks, chairs, and
other equipment intended for use as part of children's
activities in the calculation of indoor space.
3.Requires at least 75-square feet per child of outdoor activity
space based on the total licensed capacity. Specifies that
swimming pools, adjacent pool decking, and natural or man-made
hazards shall not be included in the calculation of outdoor
activity space.
4.Specifies the maximum licensed capacity for a crisis
residential overnight program shall be 14 children and that a
child who has been voluntarily placed in a crisis residential
overnight program shall be included in the licensed capacity
for crisis day services.
5.Requires all caregivers to be certified in pediatric CPR and
pediatric first aid, as specified.
6.Requires the 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 and to incorporate the training plan in the crisis
nursery plan of operation.
7.Requires the licensee to designate at least one lead caregiver
to be present at the crisis nursery at all times when children
are present. Requires the lead caregiver to have one of the
following education and experience qualifications:
A. Completion of 12 postsecondary semester units or
equivalent quarter units, with a passing grade, as
determined by the institution, in classes with a focus on
early childhood education, child development, or child
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health at an accredited college or university, as
determined, 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. At least three
semester units, or equivalent quarter units, or equivalent
experience shall include coursework or experience in the
care of infants.
B. A current and valid Child Development Associate (CDA)
credential, with the appropriate age level 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.
C. A current and valid Child Development Associate Teacher
Permit issued by the California Commission on Teacher
Credentialing.
1.Requires lead caregivers to have a minimum of 24 hours of
training and orientation before working with children. One
year experience in a supervisory position in a child care or
group care facility may substitute for 16 hours of training
and orientation. The written staff training plan shall
require the lead caregiver to receive and document a minimum
of 20 hours of annual training directly related to the
functions of his/her position.
2.Requires caregiver staff to complete a minimum of 24 hours of
initial training within the first 90 days of employment.
Eight hours of training shall be completed before the
caregiver staff is responsible for children, left alone with
children, and counted in the staff-to-child ratios, as
described. A maximum of four hours of training may be
satisfied by job shadowing.
3.Requires volunteers to complete a minimum of 16 hours of
training, as specified.
4.Requires, prior to assuming the duties and responsibilities of
a crisis caregiver or being counted in the staff-to-child
ratio, volunteers to complete at five hours of initial
training divided as follows:
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A. Two hours of crisis nursery job shadowing.
B. One hour of review of community care licensing
regulations.
C. Two hours of review of the crisis nursery program,
including the facility mission statement, goals and
objectives, child guidance techniques, and special needs of
the client population they serve.
1.Requires, within 90 days, volunteers who are included in the
staff-to-child ratios to do both of the following:
A. Acquire a certification in pediatric first aid and
pediatric cardiopulmonary resuscitation.
B. Complete at least 11 hours of training covering 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.
1.Requires at least one employed staff or volunteer caregiver
for each group of six preschool age children, or fraction
thereof, and one employed staff or volunteer caregiver for
each group of four infants, or fraction thereof, from
7 a.m. to 7 p.m.
2.Requires there to be at least one paid caregiver or volunteer
caregiver for each group of six children, or fraction thereof,
from 7 p.m. to 7 a.m.
3.Specifies that when a child has a health condition that
requires prescription medication, the licensee shall ensure
that the caregiver does all of the following:
A. Assists children with the taking of the medication as
needed.
B. Ensures that instructions are followed as outlined by
the appropriate medical professional.
C. Stores the medication in accordance with the label
instructions in the original container with the original
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unaltered label in a locked and safe area that is not
accessible to children.
D. Administers the medication as directed on the label and
prescribed by the physician in writing.
1.Requires the licensee to obtain, in writing, approval and
instructions from the child's authorized representative for
administration of the prescription medication for the child.
This documentation shall be kept in the child's record.
2.Prohibits the licensee from administering prescription
medication to a child in accordance with instructions from the
child's authorized representative if the authorized
representative's instructions conflict with the physician's
written instructions or the label directions as prescribed by
the child's physician.
3.Permits nonprescription medications to be administered without
approval or instructions from the child's physician if all of
the following conditions are met:
A. Nonprescription medications shall be administered in
accordance with the product label directions on the
nonprescription medication container or containers.
B. For each nonprescription medication, the licensee shall
obtain, in writing, approval and instructions from the
child's authorized representative for administration of the
nonprescription medication to the child. This
documentation shall be kept in the child's record.
1.Prohibits the licensee from administering nonprescription
medication to a child in accordance with instructions from the
child's authorized representative if the authorized
representative's instructions conflict with the product label
directions on the nonprescription medication container or
containers.
2.Requires the licensee to develop and implement a written plan
to record the administration of the prescription and
nonprescription medications and to inform the child's
authorized representative daily, for crisis day services, and
upon discharge for overnight care, when the medications have
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been given.
3.Requires, when no longer needed by the child, or when the
child is removed or discharged from the crisis nursery, all
medications to be returned to the child's authorized
representative or disposed of after an attempt to reach the
authorized representative.
Background
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 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).
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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 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 California
Alliance of Child and Family Services, 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.
Comments
According to the author's office, existing law and regulations
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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's office
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.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
SUPPORT : (Verified 8/12/14)
California Alliance of Child and Family Services (source)
Contra Costa County
ASSEMBLY FLOOR : 77-0, 5/27/14
AYES: Achadjian, Alejo, Allen, Ammiano, Bigelow, Bloom,
Bocanegra, Bonilla, Bonta, Bradford, Brown, Buchanan, Ian
Calderon, Campos, Chau, Ch�vez, Chesbro, Conway, Cooley,
Dababneh, Dahle, Daly, Dickinson, Donnelly, Eggman, Fong, Fox,
Frazier, Beth Gaines, Garcia, Gatto, Gomez, Gonzalez, Gordon,
Gorell, Gray, Grove, Hagman, Hall, Harkey, Roger Hern�ndez,
Holden, Jones, Jones-Sawyer, Levine, Linder, Logue, Lowenthal,
Maienschein, Mansoor, Medina, Melendez, Mullin, Muratsuchi,
Nazarian, Nestande, Olsen, Pan, Perea, John A. P�rez, V.
Manuel P�rez, Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas,
Skinner, Stone, Ting, Wagner, Waldron, Weber, Wieckowski,
Wilk, Williams, Yamada, Atkins
NO VOTE RECORDED: Patterson, Quirk-Silva, Vacancy
JL:e 8/12/14 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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