§ 1358. Use of Physical Restraints.

(a) The facility administrator, in cooperation with the responsible physician and mental health director, shall develop and implement written policies and procedures for the use of restraint devices.

(b) Physical restraints may be used only for those youth who present an immediate danger to themselves or others, who exhibit behavior which results in the destruction of property, or reveals the intent to cause self-inflicted physical harm. The circumstances leading to the application of restraints must be documented.

(c) Restraint devices include any devices which immobilize a youth's extremities and/or prevent the youth from being ambulatory. Physical restraints should be utilized only when it appears less restrictive alternatives would be ineffective in controlling the disordered behavior.

(d) In addition to the areas specifically outlined in this regulation, as a minimum, the policy shall address the following areas: known medical conditions that would contraindicate certain restraint devices and/or techniques; acceptable restraint devices; signs or symptoms which should result in immediate medical/mental health referral; availability of cardiopulmonary resuscitation equipment; protective housing of restrained youth; provision for hydration and sanitation needs; and exercising of extremities.

(e) Youth shall be placed in restraints only with the approval of the facility manager or designee. The facility manager may delegate authority to place a youth in restraints to a physician. Reasons for continued retention in restraints shall be reviewed and documented at a minimum of every hour.

(f) A medical opinion on the safety of placement and retention shall be secured as soon as possible, but no later than two hours from the time of placement. The youth shall be medically cleared for continued retention at least every three hours thereafter.

(g) A mental health consultation shall be secured as soon as possible, but in no case longer than four hours from the time of placement, to assess the need for mental health treatment.

(h) Continuous direct visual supervision shall be conducted to ensure that the restraints are properly employed, and to ensure the safety and well-being of the youth. Observations of the youth's behavior and any staff interventions shall be documented at least every 15 minutes, with actual time of the documentation recorded. While in restraint devices all youth shall be housed alone or in a specified housing area for restrained youth which makes provision to protect the youth from abuse. In no case shall restraints be used as punishment or discipline, or as a substitute for treatment. Additionally, the affixing of hands and feet together behind the back (hogtying) is prohibited.

(i) The provisions of this section do not apply to the use of handcuffs, shackles or other restraint devices when used to restrain youth for movement or transportation reasons.

(j) The use of restraints on pregnant youth is limited in accordance with Penal Code Section 6030(f) and Welfare and Institutions Code Section 222.

HISTORY

1. New section filed 3-6-97; operative 4-5-97 (Register 97, No. 10).

2. Amendment of subsections (a), (c) and (d) filed 1-11-2001; operative 2-10-2001 (Register 2001, No. 2).

3. Amendment of subsections (b)-(d) filed 6-23-2003; operative 7-23-2003 (Register 2003, No. 26).

4. New subsection (f) filed 5-23-2008 as an emergency; operative 5-23-2008 (Register 2008, No. 21). Pursuant to Penal Code section 5058.3, a Certificate of Compliance must be transmitted to OAL by 10-30-2008 or emergency language will be repealed by operation of law on the following day.

5. Certificate of Compliance as to 5-23-2008 order transmitted to OAL 9-10-2008 and filed 10-23-2008 (Register 2008, No. 43).

6. Amendment of section and Note filed 12-2-2013; operative 4-1-2014 (Register 2013, No. 49).

Note

Note: Authority cited: Sections 210 and 885, Welfare and Institutions Code. Reference: Section 6030(f), Penal Code; and Section 222, Welfare and Institutions Code.