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Adult Day Services Staffing & Administration


Updated October 27, 2013

Adult Day Services Staffing & Administration
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In our continuing series on Adult Day Services, we devote this article to Adult Day Care Staffing. Let’s look at the requirements.

  • All employees and volunteers must comply with the criminal history check rules. There must be written procedures to evaluate and determine employment status based on criminal findings.
  • Each staff person and volunteer must be competent and qualified for the position held. Qualified means education or experience dealing with the adult day services population. Staff must hold personal information about participants and their families in confidence, treating all participants with respect and dignity.
  • ADS programs must assure that employees and volunteers comply with standards for tuberculosis testing and hepatitis immunization specified by the local public health department.
  • The staff to participant ratio must be a minimum of one staff person to six participants (1 to 6). ADS programs serving over 50 percent of participants who require full assistance with three or more activities of daily living must have a staff to participant ratio of one to four (1 to 4).
  • Each ADS program that is located within the same facility as another program, (e.g. a hospital, nursing facility, senior center, church or community based care facility) must be separate and distinct with designated staff and staff hours committed to the ADS program.
  • There must be provisions and identified resources for qualified substitute staff.
  • Staff must have sufficient knowledge to provide essential services to the participants. There must be at least one staff person or combination of staff on duty at all times who are knowledgeable of: the fire, safety and disaster plan; infection control; CPR and first aid; body mechanics and transfer techniques; personal care; mandatory reporting laws of abuse and neglect; managing behavioral symptoms; and the needs of the participants.


There must be general orientation and continued in-service training for both paid staff and volunteers including, but not limited to: program mission and philosophy; mandatory reporting laws of abuse and neglect and indicators of abuse; behavioral intervention and behavior acceptance and accommodations; standard precautions; participant rights; fire, safety, disaster plan and emergency procedures; body mechanics and transfer techniques; and assistance with ADLs.


Each ADS program must develop and implement a plan of operation. The plan of operation must be reviewed and, if necessary, revised annually. The plan must include:

  • a definition of the target population
  • geographical definition of the service area
  • description of basic services and any optional services
  • hours and days of operation
  • admission and discharge policies and procedures
  • staffing
  • statement of participants' rights and grievance procedure
  • rates
  • procedures for reporting suspected abuse

Advisory Committee

An ADS program must have a body that serves as an advisory committee. Members of the advisory committee must be representative of the community and must include family members of current or past participants and non-voting staff representatives. The advisory committee must meet at least twice a year and must have an opportunity, at least annually, to review and make recommendations on program policies. Agendas and minutes must be on file at the ADS program site.

Discharge and Grievance Policy

Among the criteria needed, the ADS program must develop a participant discharge policy that includes at a minimum: time frame for termination; criteria for discharge; notification procedures; appeal policy; and end of service.

A grievance policy for resolving participants’ concerns, complaints or discharge from the ADS program must be developed and include, but not limited to, process and time frames, a written response to the participant and a written record of the grievance to be filed at the facility.

As part of the quality assurance plan, the ADS program must develop policies and procedures for evaluating operation and services. The plan must include a survey of employees, participants, families or services providers and referral services discussing all aspects of the ADS program. The ADS program must determine further action to ensure continuous improvement in service delivery. A written report summarizing the annual evaluation findings, with implementation or correction time tables must be posted for review, provided to the ADS program’s advisory committee, and the state’s ADS program coordinator, as well as maintained as part of the facilities permanent record.

Other Policies

The ADS program must have written personnel policies for both staff and volunteers. A records policy for administrative records and participants' records should be maintained. Records include personnel records, fiscal records, statistical reports, government-related records, contracts, organizational records, quality improvement plans or quality assurance plans, advisory committee minutes, certificates of annual fire and health inspections as required by local ordinances, and incident reports.

The ADS programs must develop a written policy on confidentiality and the protection of participants' records.

By following the guidelines in our Adult Day Services hub, you will be well on your way to understanding what it takes to be not only compliant but also successful in this field.

Source DHHS, State of Oregon

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