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HomeMy WebLinkAbout4.25.22 Health and Hygiene Holding Facility inspections From:York, Danette To:BOS Cc:Nuzum, Danielle; Canton, David Subject:Health and Hygiene Holding Facility inspections Date:Monday, April 25, 2022 8:54:57 AM Attachments:Cover Letter to Butte County Board of Supervisors.docx Chico Police Department.docx Juvenile Hall.docx Oroville Courthouse.docx Paradise Police Department.docx Butte County Jail.docx Chico Courthouse.docx A Combined Itemized Summary.docx Dear Board Members, Per Health and Safety Code 101045 the Health Officer is responsible for conducting Health and Hygiene inspections on the jail and holding facilities within the county. Dr. Canton and team have completed all inspections for calendar year 2021. The inspections were not able to be conducted within the calendar year due to various issues related to the COVID pandemic. Please find a letter to the Board, a copy of the inspection report for each facility inspected, and a combine summary document attached. Feel free to reach out to me or Dr. Canton with any questions you may have. Respectfully, Danette York Public Health Director BUTTE COUNTY PUBLIC HEALTH | F: 530.538.2164 FACEBOOK | TWITTER COUNTY OF BUTTE E-MAIL DISCLAIMER: This e-mail and any attachment thereto may contain private, confidential, and privileged material for the sole use of the intended recipient. Any review, copying, or distribution of this e-mail (or any attachments thereto) by other than the County of Butte or the intended recipient is strictly prohibited. If you are NOT the intended recipient, please contact the sender immediately and permanently delete the original and any copies of this e-mail and any attachments thereto. Public Health Administration DanetteYork, MPH, Director David Canton, DO, MPH, JD, Health Officer, Interim 202 Mira Loma Drive T: 530.552.4000 Oroville, California 95965 F: 530.538.2164 April 14, 2022 Butte County Board of Supervisor’s 25 County Center Dr. Oroville, CA RE: Copy of Annual Jail and Juvenile Hall Health Inspections for Butte County Public Health. Attached are copies of the 2021-2022 jail and holding facilities Health and Hygiene Inspection report required per Health and Safety Code§ 101045. While the inspection was attempted to be scheduled and conducted in calendar year 2021, the inspection could not be coordinated and conducted until 2022 due to various issues relate to the COVID pandemic. Originals sent to Board of State and Community Corrections, FSO Division. Please contact me if you have any questions. Sincerely, David B. Canton, D.O., M.P.H., J.D. Interim Health Officer ADULT COURT AND TEMPORARY HOLDING FACILITIES Local Detention Facility Health Inspection Report Health and Safety Code Section 101045 BSCC #: ___________ FACILITY NAME:COUNTY: Police Department – City of Chico Butte FACILITY ADDRESS (STREET, CITY, ZIP CODE, TELEPHONE): 1460 Humboldt Road, Chico, CA 95928, (530) 897-4900 CHECK THE FACILITY TYPE AS DEFINED IN TITLE 15, COURT HOLDING TEMPORARY HOLDING SECTION 1006: FACILITY: FACILITY: X ENVIRONMENTAL HEALTH EVALUATION DATE INSPECTED: 02/09/2022 ENVIRONMENTAL HEALTH EVALUATORS (NAME, TITLE, TELEPHONE): Alana Kong, Registered Environmental Health Specialist II, (530) 552-3998 Leslie Roberts, Senior Registered Environmental Health Specialist, (530) 552-3872 FACILITY STAFF INTERVIEWED (NAME, TITLE, TELEPHONE): Jeramie Struthers, Lieutenant, (530) 897-5808 NUTRITIONAL EVALUATIONDATE INSPECTED: NUTRITIONAL EVALUATORS (NAME, TITLE, TELEPHONE): FACILITY STAFF INTERVIEWED (NAME, TITLE, TELEPHONE): MEDICAL/MENTAL HEALTH EVALUATION DATE INSPECTED: 02/09/2022 MEDICAL/MENTAL HEALTH EVALUATORS (NAME, TITLE, TELEPHONE): Monica Soderstrom, Division Director, Public Health, (530) 552-3930 David Canton, Public Health Officer, (53) 552-3993 FACILITY STAFF INTERVIEWED (NAME, TITLE, TELEPHONE): Jeramie Struthers, Lieutenant, (530) 897-5808 1 This checklist is to be completed pursuant to the attached instructions. I. ENVIRONMENTAL HEALTH EVALUATION Police Department – City of Chico ARTICLE/SECTIONYESNON/ACOMMENTS Article 12. Food Approach for Providing Food Service If held during a meal time frozen or pre-packaged (Not applicable to CH) snack food that are non-potentially hazardous are available. x Food served in the facility is prepared in the facility. If "No," respond to items 1 and 2 below prior to continuing with the checklist. 1. Food is prepared at another city or county x detention facility. 2. Food is contracted through a private vendor There is no contract through a private vendor. Will who had been inspected and complies with obtain frozen / snack foods from Costco and x provisions of CalCode. Walmart who are permitted food facilities with Butte County Environmental Health. 1245 Kitchen Facilities, Sanitation and Food No kitchen facility or food preparation Service (Not applicable to CH) x Kitchen facilities, sanitation, and food preparation, service and storage comply with standards set forth in CalCode. In facilities where inmates prepare meals for self- consumption, or where frozen meals are pre- prepared food from other facilities permitted pursuant to HSC §114381 is (re)heated and served, x the following CalCode standards may be waived by the local health officer. HSC §114130-114141 HSC §114099.6, 114095-114099.5,114101- 114109, 114123 and 114125 if a domestic or commercial dishwasher, capable of providing x heat to the surface of utensils of at least 165 degrees Fahrenheit, is used to clean and sanitize multi-service utensils and multi-service consumer utensils; HSC §114149-114149.3 except that, regardless of such a waiver, the facility shall provide x mechanical ventilation sufficient to remove gases, odors, steam, heat, grease, vapors and smoke from the kitchen; HSC §114268-114269 x 2 ARTICLE/SECTION YESNO N/A COMMENTS HSC §114279-114282 x 1246 Food Serving and Supervision No food preparation done at this facility (Not applicable to CH) Policies and procedures ensure that appropriate x work assignments are made, and food handlers are adequately supervised. Food is prepared and served only under the immediate supervision of a staff member. Article 14. Bedding and Linens 1270 Standard Bedding and Linen Issue (Not applicable to CH) x The standard issue of clean suitable bedding and linens, for each inmate entering a living area who is expected to remain overnight, shall include, but not be limited to: (a) One serviceable mattress which meets the x requirements of Title 15 §1272; (b) one mattress cover or one sheet; x (c) one blanket or more depending upon climatic conditions. Two blankets or sleep bag may be x issued in place of one mattress cover or one sheet (d) one towel x Temporary Holding facilities which hold persons Typically, not held longer than 4 hours but items above are available since this facility can hold up x longer than 12 hours shall meet the requirements of to 24 hours 1, 2 and 3 above. 1272 Mattresses (Not applicable to CH) x Mattresses are enclosed in an easily cleaned, non- absorbent ticking and conform to the size of the bunk as referenced in Title 24, Part 2, §1231.3.5 Beds (at least 30" wide X 76" long). Any mattress purchased for issue to an inmate in a facility, which is locked to prevent unimpeded access to the outdoors, is certified by the x manufacturer as meeting all requirements of the State Fire Marshal and Bureau of Home Furnishings for penal mattresses at the time of purchase. 3 ARTICLE/SECTION YESNO N/A COMMENTS Article 15. Facility Sanitation and Safety 1280 Facility Sanitation, Safety and Maintenance 900.10.1 and safety checklist Daily janitorial services. There are policies and procedures for the x maintenance of an acceptable level of cleanliness, Contracted with cleanrite / buildrite repair and safety throughout the facility. The plan provides for a regular schedule of Deficiency – all 7 holding cells do not have hot housekeeping tasks and inspections to identify and water. Some holding cell’s hot water button was correct unsanitary or unsafe conditions or work not working practices. Corrective action – provide hot water and fix the x hot water button Deficiency – light in shower is not working Corrective action – repair Itemized Summary I. Environmental Health Evaluation Police Department – City of Chico Page 4 Deficiency – all 7 holding cells do not have hot water. Some holding cell’s hot water button was not working Corrective action – provide hot water and fix the hot water button Deficiency – light in shower is not working Corrective action – repair Summary of environmental health evaluation: There were deficiencies with plumbing fixtures and lighting that need to be addressed. Overall, facility appears to be clean at the time of inspection. 4 III. MEDICAL/MENTAL HEALTH EVALUATION Adult Court and Temporary Holding Facilities ARTICLE/SECTIONYES NO N/A COMMENTS Article 11. Health Services 1200 Responsibility for Health Care Services Addressed in section 905.5.3 of department policy In court holding and temporary holding facilities, the manual facility administrator shall have the responsibility to X develop written policies and procedures which ensure provision of emergency health care services to all inmates. 1207 Medical Receiving Screening Addressed in section 902.11.1 of department policy (Not applicable to CH) manual A receiving screening is performed on all inmates at the time of intake, with the exception of inmates X transferred directly within a custody system with documented receiving screening This screening shall be completed in accordance with written procedures and shall include but not be limited to medical and mental health problems, X developmental disabilities, tuberculosis and other communicable diseases. The screening shall be performed by licensed health Deficiency: Training of facility staff is lacking. personnel or trained facility staff, with Corrective Action: Training program is in documentation of staff training regarding site development per Lt Struthers. Recommend specific forms with appropriate disposition based on X acceleration and implementation of training responses to questions and observations made at program. the time of screening. The training depends on the role staff are expected to play in the receiving screening process. The facility administrator and responsible physician Addressed in section 900.5.4 of department policy manual shall develop a written plan for complying with X Penal Code Section 2656 (orthopedic or prosthetic appliance used by inmates). There shall be a written plan to provide care for any inmate who appears at this screening to be in need X of or who requests medical, mental health, or developmental disability treatment. Written procedures and screening protocol shall be X established by the responsible physician in cooperation with the facility administrator. 5 ARTICLE/SECTIONYES NO N/A COMMENTS 1209 Mental Health Services and Transfer to a Addressed in section 900.3.1 of department policy Treatment Facility manual (Not applicable to CH) X (a) The health authority, in cooperation with the mental health director and facility administrator, shall establish policies and procedures to provide mental health services. These services shall include but not be limited to: 1.Identification and referral of inmates Per policy inmates are referred to local hospital or X with mental health needs; county jail for treatment 2. Mental health treatment programs X provided by qualified staff, including the use of teleheath. X 3. Crisis intervention services; 4. Basic mental health services provided, as X clinically indicated; 5. Medication support services; and, X 6. The provision of health services sufficiently coordinated such that care is appropriately integrated, medical and X mental health needs are met, and the impact of any of these conditions on each other is adequately addressed. (b) Unless the county has elected to implement Addressed in section 902.11.1 of department policy the provisions of Penal Code Section 1369.1, a manual mentally disordered inmate who appears to be a danger to himself or others, or to be gravely disabled, shall be transferred for further evaluation to a designated Lanterman Petris Short treatment facility designated by X the county and approved by the State Department of Mental Health for diagnosis and treatment of such apparent mental disorder pursuant to Penal Code section 4011.6 or 4011.8 unless the jail contains a designated Lanterman Petris Short treatment facility. Prior to the transfer, the inmate may be No licensed health personnel on staff and no treatment given in facility evaluated by licensed health personnel to determine if treatment can be initiated at the correctional facility. Licensed health X personnel may perform an onsite assessment to determine if the inmate meets the criteria for admission to an inpatient facility, or if treatment can be initiated in the correctional facility. 6 ARTICLE/SECTIONYES NO N/A COMMENTS (c) If the county elects to implement the provisions of Penal Code Section 1369.1, the health authority, in cooperation with the facility administrator, shall establish policies X and procedures for involuntary administration of medications. The procedures shall include, but not be limited to: 1. Designation of licensed personnel, including psychiatrist and nursing staff, X authorized to order and administer involuntary medication; 2. Designation of an appropriate setting X where the involuntary administration of medication will occur; 3. Designation of restraint procedures and/or devices that may be used to X maintain the safety of the inmate and facility staff; 4. Development of a written plan to monitor the inmate's medical condition following the initial involuntary administration of a medication, until the inmate is cleared as a result of an evaluation by, or consultation with, a psychiatrist; X 7 ARTICLE/SECTIONYES NO N/A COMMENTS 5. Development of a written plan to provide Addressed in section 900.3.1 of department policy a minimum level of ongoing monitoring manual directing referral of inmates requiring of the inmate following return to facility medication. housing. This monitoring may be performed by custody staff trained to recognize signs of possible medical problems and alert medical staff when indicated; and X 6. Documentation of the administration of X involuntary medication in the inmate's medical record. 1212 Vermin Control Addressed in section 902.15 of department policy (Not applicable to CH) manual The responsible physician shall develop a written X plan for the control and treatment of vermin- infested inmates. There shall be written, medical protocols, signed by the responsible physician, for the treatment of persons suspected of being infested or having contact with a vermin-infested inmate. 1213 Detoxification Treatment Addressed in section 902.3.1 of department policy (Not applicable to CH) manual The responsible physician shall develop written medical policies on detoxification which shall include X a statement as to whether detoxification will be provided within the facility or require transfer to a licensed medical facility. The facility detoxification protocol shall include procedures and symptoms necessitating immediate transfer to a hospital or other medical facility. Facilities without medically licensed personnel in Addressed in section 902.3.1 of department policy attendance shall not retain inmates undergoing manual withdrawal reactions judged or defined in policy, by X the responsible physician, as not being readily controllable with available medical treatment. Such facilities shall arrange for immediate transfer to an appropriate medical facility. 8 ARTICLE/SECTIONYES NO N/A COMMENTS 1220 First Aid Kits Addressed in section 900.5.3 of department policy X manual First aid kit(s) shall be available in all facilities. The responsible physician shall approve the Deficiency: Policy does not specify specific contents contents, number, location and procedure for of first aid kits and there is no documentation periodic inspection of the kit(s). In Court and supporting periodic inspection. Expired contents Temporary Holding facilities, the facility were identified. X administrator shall have the above approval Corrective Action: Update policy to list specific authority, pursuant to Section 1200 of these contents and locations of first aid kits. Establish regulations. policy and implement policy to regularly inspect first aid kits for complete and current status of contents. 1046 Death in Custody Addressed in section 900.9 and 900.11.2 of (a) Death in Custody Reviews for Adults and department policy manual Minors. The facility administrator, in cooperation with the health administrator, shall develop written policy and procedures to ensure that there is X an initial review of every in-custody death within 30 days. The review team shall include the facility administrator and/or the facility manager, the health administrator, the responsible physician and other health care and supervision staff who are relevant to the incident. Deaths shall be reviewed to determine the No Deaths occurred during inspection period appropriateness of clinical care; whether X changes to policies, procedures, or practices are warranted; and to identify issues that require further study. (b) Death of a Minor. Addressed in section 323.7.4 and 323.13 of In any case in which a minor dies while X department policy manual detained in a jail, lockup, or court holding facility: (1) The administrator of the facility shall provide to the Board a copy of the report submitted to the Attorney General under Government Code Section 12525. A copy X of the report shall be submitted within 10 calendar days after the death. No in custody death of a minor occurred during covered inspection period (2) Upon receipt of a report of death of a minor from the administrator, the Board may within 30 calendar days inspect and evaluate the jail, lockup, or court holding X facility pursuant to the provisions of this subchapter. Any inquiry made by the Board shall be limited to the standards and requirements set forth in these regulations. 9 ARTICLE/SECTIONYES NO N/A COMMENTS 1051 Communicable Diseases Addressed in section 902.11.1 of department policy The facility administrator, in cooperation with the manual responsible physician, shall develop written policies X and procedures specifying those symptoms that require segregation of an inmate until a medical evaluation is completed. At the time of intake into the facility, an inquiry shall be made of the person being booked as to whether or not he/she has or has had any communicable X diseases, such as tuberculosis or has observable symptoms of tuberculosis or any other communicable diseases, or other special medical problem identified by the health authority. The response shall be noted on the booking form X and/or screening device. 1052 Mentally Disordered Inmates The facility administrator, in cooperation with the responsible physician, shall develop written policies and procedures to identify and evaluate all mentally disordered inmates, and may include telehealth. If an X evaluation from medical or mental health staff is not readily available, an inmate shall be considered mentally disordered for the purpose of this section if he or she appears to be a danger to himself/herself or others or if he/she appears gravely disabled. An evaluation from medical or mental health staff Inmates are transferred for medical or mental shall be secured within 24 hours of identification or health care X at the next daily sick call, whichever is earliest. Segregation may be used if necessary to protect the safety of the inmateor others. 1055 Use of Safety Cell Safety cell is not in place, inmates requiring safety The safety cell described in Title 24, Part 2, Section cell are not retained in facility 1231.2.5, shall be used to hold only those inmates X who display behavior which results in the destruction of property or reveals an intent to cause physical harm to self or others The facility administrator, in cooperation with the responsible physician, shall develop written policies and procedures governing safety cell use and may X delegate authority to place an inmate in a safety cell to a physician. In no case shall the safety cell be used for X punishment or as a substitute for treatment. An inmate shall be placed in a safety cell only with the approval of the facility manager or designee, or X responsible health care staff; continued retention shall be reviewed a minimum of every four hours. 10 ARTICLE/SECTIONYES NO N/A COMMENTS A medical assessment shall be completed within a maximum of 12 hours of placement in the safety cell or at the next daily sick call, whichever is earliest. X The inmate shall be medically cleared for continued retention every 24 hours thereafter. The facility manager, designee or responsible health care staff shall obtain a mental health opinion/consultation with responsible health care X staff on placement and retention, which shall be secured within 12 hours of placement. Direct visual observation shallbe conducted at least twice every thirty minutes. Such observation shall be X documented. Procedures shall be established to assure administration of necessary nutrition and fluids. Inmates shall be allowed to retain sufficient clothing, or be provided with a suitably designed “safety X garment,” to provide for their personal privacy unless specific identifiable risks to the inmate's safety or to the security of the facility are documented. 1056 Use of Sobering Cell Sobering cell not in place. Inmates requiring The sobering cell described in Title 24, Part 2, sobering are not retained in facility per policy Section 1231.2.4, shall be used for the holding of inmates who are a threat to their own safety or the safety of others due to their state of intoxication and pursuant to written policies and procedures developed by the facility administrator. Such inmates shall be removed from the sobering cell as X they are able to continue in the processing. In no case shall an inmate remain in a sobering cell over six hours without an evaluation by a medical staff person or an evaluation by custody staff, pursuant to written medical procedures in accordance with section 1213 of these regulations, to determine whether the prisoner has an urgent medical problem. At 12 hours from the time of placement, all inmates will receive an evaluation by responsible health care staff. Intermittent direct visual observation of X inmates held in the sobering cell shall be conducted no less than every half hour. Such observation shall be documented. 11 ARTICLE/SECTIONYES NO N/A COMMENTS 1057 Developmentally Disabled Inmates Addressed in section 902.11.1 of department policy The facility administrator, in cooperation with the manual responsible physician, shall develop written policies X and procedures for the identification and evaluation, appropriate classification and housing, protection, and nondiscrimination of all developmentally disabled inmates. The health authority or designee shall contact the Inmates identified as potentially developmentally regional center on any inmate suspected or confirmed disabled are not retained in facility to be developmentally disabled for the purposes of X diagnosis and/or treatment within 24 hours of such determination, excluding holidays and weekends. 1058 Use of Restraint Devices Addressed in section 900.6 of department policy manual The facility administrator, in cooperation with the X responsible physician, shall develop written policies and procedures for the use of restraint devices and may delegate authority to place an inmate in restraints to a responsible health care staff. In addition to the areas specifically outlined in this Addressed in section 306.3 of department policy regulation, at a minimum, the policy shall address the manual following areas: acceptable restraint devices; signs or symptoms which should result in immediate medical/mental health referral; X availability of cardiopulmonary resuscitation equipment; protective housing of restrained persons; provision for hydration and sanitation needs; and exercising of extremities. In no case shall restraints be used for punishment or Addressed in section 306.2 of department policy X as a substitute for treatment. manual Restraint devices shall only be used on inmates who Addressed in section 306.3 of department policy display behavior which results in the destruction of manual property or reveal an intent to cause physical harm to X self or others. Restraint devices include any devices which immobilize an inmate's extremities and/or prevent the inmate from being ambulatory. Physical restraints should be utilized only when it appears less restrictive alternatives would be X ineffective in controlling the disordered behavior. Inmates shall be placed in restraints only with the approval of the facility manager, the facility watch commander, responsible health care staff; X continued retention shall be reviewed a minimum of every hour. A medical opinion on placement and retention shall Since no licensed medical personnel are on staff, be secured within one hour from the time of inmates are not retained in facility if restraints are X required. placement. A medical assessment shall be completed within four hours of placement. 12 ARTICLE/SECTIONYES NO N/A COMMENTS If the facility manager, or designee, in consultation with responsible health care staff determines that an inmate cannot be safely removed from restraints X after eight hours, the inmate shall be taken to a medical facility for further evaluation. Direct visual observation shall be conducted at least twice every thirty minutes toensure that the restraints are properly employed, and to ensure the X safety and well-being of the inmate. Such observation shall be documented. While in restraint devices all inmates shall behoused alone or in a specified housing area for restrained X inmates which makes provisions to protect the inmate from abuse. The provisions of this section do not apply to the use X of handcuffs, shackles or other restraint devices when used to restrain inmates for security reasons. 1058.5 RESTRAINTS AND PREGNANT INMATES Addressed in section 306.3.2 of department policy manual The facility administrator, in cooperation with the responsible physician, shall develop written policies X and procedures for the use of restraint devices on pregnant inmates. In accordance with Penal Code 3407 the policy shall include reference to the following: (1) An inmate known to be pregnant or in recovery after delivery shall not be X restrained by the use of leg irons, waist chains, or handcuffs behindthe body. (2) A pregnant inmate in labor, during delivery, or in recovery after delivery, shall not be restrained by the wrists, X ankles, or both, unless deemed necessary for the safety and security of the inmate, the staff, or the public. (3) Restraints shall be removed when a No licensed medical personnel on staff. Pregnant professional who is currently responsible inmates are transferred if in need of medical care for the medical care of a pregnant inmate and treatment. X during a medical emergency, labor, delivery, or recovery after delivery determines that the removal of restraints is medically necessary. (4) Upon confirmation of an inmate's pregnancy, she shall be advised, orally or X in writing, of the standards and policies governing pregnant inmates. 13 Itemized Summary III. Medical/Mental Health Evaluation Police Department – City of Chico Page 5 Deficiency: Training of facility staff is lacking. Corrective Action: Training program is in development per Lt Struthers. Recommend acceleration and implementation of training program. Page 9 Deficiency: Policy does not specify specific contents of first aid kits and there is no documentation supporting periodic inspection. Expired contents were identified. Corrective Action: Update policy to list specific contents and locations of first aid kits. Establish policy and implement policy to regularly inspect first aid kits for complete and current status of contents. Commendation: Facility has an Automatic External Defibrillator (AED) in place. This is noted as best practice. Best Practice: AED should be included in the first aid inspection policy to ensure it us operational. Narcan should be available in the facility should drug overdose occur. Staff were open and collaborative in the inspection process. Generally, facilities complies with letter and intent of requirements. 14 I. ENVIRONMENTAL HEALTH EVALUATION Juvenile Halls, Special Purpose Juvenile Halls and Camps FACILITY NAME: COUNTY: Butte County Juvenile Hall Butte FACILITY ADDRESS (STREET, CITY, ZIP CODE, TELEPHONE): 41 County Center Dr. Oroville, CA 95965, (530) 538-7311 CHECK THE FACILITY TYPE AS DEFINED IN JUVENILE HALLCAMP TITLE 15, SECTION 1302: DATE EVALUATED: ENVIRONMENTAL HEALTH EVALUATION DEFICIENCIES OR NON COMPLIANCE ISSUES NOTED: YES NO ENVIRONMENTAL EVALUATOR(S) (NAME, TITLE, TELEPHONE): Alana Kong, Registered Environmental Health Specialist II, (530) 552-3998 Leslie Roberts, Senior Registered Environmental Health Specialist, (530) 552-3872 FACILITY STAFF INTERVIEWED (NAME, TITLE, TELEPHONE): Mariah Ruddy, Administration Supervisor, (530) 538-4389 JUV HEALTH ENVIRONMENT PAGE 1 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) I. ENVIRONMENTAL HEALTH EVALUATION Juvenile Halls, Special Purpose Juvenile Halls and Camps ARTICLE/SECTION YESNO N/ACOMMENTS Article 9. Food 1464 Food Services Plan Deficiency: Item (n) The Hazard Analysis Critical Control Point Plan is out of date and was written by previous Food Services Manager. Facilities shall have a written site specific food Corrective Action: The current Food Services service plan that shall comply with the applicable Manager is working to write a new HACCP plan for California Retail Food Code (CalCode). In facilities facility and using the California Retail Food Code. with an average daily population of 50 or more, there shall be employed or available, a trained and experienced food services manager or designee to complete a written food service plan. In facilities of less than an average daily population of 50, that do not employ or have a food services manager available, the facility manager shall complete a written food service plan. The plan shall include, but not be limited to the following policies and procedures: (a) menu planning; (b) purchasing; No (c) storage and inventory control; (d) food preparation; (e) food serving; (f) transporting food; (g) orientation and on-going training; (h) personnel supervision; (i) budgets and food costs accounting; (j) documentation and record keeping; (k) emergency feeding plan; (l) waste management; (m) maintenance and repair; (n) hazard analysis critical control point plan; and, (o) provision for maintaining three days of meals for testing in the event of food-borne illness. JUV HEALTH ENVIRONMENT PAGE 2 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNO N/ACOMMENTS 1465 Food Handlers Education and Monitoring The facility manager, in cooperation with the food services manager, shall develop and implement written policies and procedures to ensure that supervisory staff and food handlers receive ongoing x training in safe food handling techniques, including personal hygiene, in accordance with Section 113947 of the Health and Safety Code, California Retail Food Code (CalCode). The procedures shall include provisions for monitoring compliance that ensure appropriate food handling and personal hygiene requirements. 1466 Kitchen Facilities, Sanitation, and Food At this time no guidance has been received to Storage waive any sections of California Retail Food Code. Kitchen facilities, sanitation, and food preparation, service, and storage shall comply with standards set forth in Health and Safety Code, Division 104, Part 7, Chapters 1-13, Sections 113700 et seq. California Retail Food Code (CalCode). x In facilities where youth prepare meals for self- consumption or where frozen meals or pre-prepared food from other permitted food facilities (see Health and Safety Code Section 114381) are (re)heated and served, the following applicable CalCode standards may be waived by the local health officer: (a) Health and Safety Code Sections 114130- 114141; (b) Health and Safety Code Sections 114099.6, 114095-114099.5, 114101-114109, 114123, and 114125. If a domestic or commercial dishwasher, capable of providing heat to the surface of the utensils of a temperature of at least 165 degrees Fahrenheit, is used for the purpose of cleaning and sanitizing multi-service kitchen utensils and multi-service consumer utensils; (c) Health and Safety Code Sections 114149- 114149.3 except that, regardless of such a waiver, the facility shall provide mechanical ventilation sufficient to remove gases, odors, steam, heat, grease, vapors and smoke from the kitchen; JUV HEALTH ENVIRONMENT PAGE 3 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNO N/ACOMMENTS (d) Health and Safety Code Sections 114268- 114269; and, (e) Health and Safety Code Sections 114279- 114282. 1467 Food Serving and Supervision Policies and site-specific procedures shall be x developed and implemented to ensure that appropriate work assignments are made and food handlers are adequately supervised. Food shall be prepared and/or served only under the immediate supervision of a staff member. Article 10. Clothing and Personal Hygiene 1480 Standard Facility Clothing Issue The youth's personal clothing, undergarments and x footwear may be substituted for the institutional clothing and footwear specified in this regulation. The facility has the primary responsibility to provide clothing and footwear. Clothing provisions shall ensure that: (a) clothing is clean, reasonably fitted, durable, x easily laundered, in good repair, and free of holes and tears. (b) The standard issue of climatically suitable clothing for youth shall consist of but not be limited to: (1) socks and serviceable footwear; (2) outer garments; x (3) new non-disposable underwear which shall remain with the youth throughout their stay, and; (4) undergarments, that are freshly laundered and free of stains, including tee shirts and bras. (c) clothing is laundered at the temperature required by local ordinances for commercial x laundries and dried completely in a mechanical dryer or other laundry method approved by the local health officer. (d) suitable clothing is issued to pregnant x youth. JUV HEALTH ENVIRONMENT PAGE 4 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNO N/ACOMMENTS 1481 Special Clothing x Provision shall be made to issue suitable additional clothing essential for minors to perform special work assignments where the issue of regular clothing would be unsanitary or inappropriate. 1482 Clothing Exchange 807.6 x The facility administrator shall develop and implement written policies and site-specific procedures for the cleaning and scheduled exchange of clothing. Unless work, climatic conditions, or illness necessitates more frequent exchange, outer x garments, except footwear, shall be exchanged at least once each week. Tee shirts, bras, and underwear shall be exchanged daily; youth shall receive their own underwear back x at exchange. 1483 Clothing, Bedding and Linen Supply 807.5 There shall be a quantity of clothing, bedding, and linen available for actual and replacement needs of the facility population. Each facility shall have a written procedure for acquisition, handling, storage, x transportation and processing of clothing, bedding and linen in a clean and sanitary manner. Consideration shall be given to mattress type for pregnant youth or youth with other medical-related needs. 804 1484 Control of Vermin in Minors’ Personal Clothing x There shall be written policies and site-specific procedures developed and implemented by the facility administrator to control the contamination and/or spread of vermin and ecto-parasites in all youths' personal clothing. JUV HEALTH ENVIRONMENT PAGE 5 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNO N/ACOMMENTS Infested clothing shall be cleaned or stored in a closed container so as to eradicate or stop the x spread of the vermin. 1485 Issue of Personal Care Items 807.9 x There shall be written policies and site-specific procedures developed and implemented by the facility administrator for the availability of personal hygiene items. Each female youth shall be provided with sanitary x napkins, panty liners and tampons as requested. Each youth to be held over 24 hours shall be x provided with the following personal care items: (a) toothbrush; x (b) toothpaste; x (c) soap; x (d) comb; x (e) shaving implements; x (f) deodorant; x (g) lotion; x (h) shampoo; and, x (i) post-shower conditioning hair products. x Youth shall not be required to share any personal No personal care items shared care items listed in items (a) through (d). Liquid soap provided through a common dispenser is permitted. Youth shall not share disposable razors. Double edged safety razors, electric razors, and other x shaving instruments capable of breaking the skin, when shared among youth, shall be disinfected between individual uses by the method prescribed by the State Board of Barbering and Cosmetology in Sections 979 and 980, Chapter 9, Title 16, California Code of Regulations. 1486 Personal Hygiene 807.12 x There shall be written policies and site-specific procedures developed and implemented by the facility administrator for showering/bathing and brushing of teeth. JUV HEALTH ENVIRONMENT PAGE 6 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNO N/ACOMMENTS Youth shall be permitted to shower/bathe upon assignment to a housing unit and on a daily basis x thereafter and given an opportunity to brush their teeth after each meal. 1487 Shaving x Youth shall have access to a razor daily, unless their appearance must be maintained for reasons of identification in Court. All youth shall have equal opportunity to shave face and body hair. The facility administrator may suspend this requirement in relation to youth who x are considered to be a danger to themselves or others. 1488 Hair Care Services 807.10 Written policies and site-specific procedures shall be developed and implemented by the facility x administrator to comply with Title 16, Chapter 9, Sections 979 and 980, California Code of Regulations. Hair care services shall be available in all juvenile facilities. Youth shall receive hair care services monthly. Equipment shall be cleaned and disinfected after each haircut or procedure, by a method approved by x the State Board of Barbering and Cosmetology. Article 11. Bedding and Linens 1500 Standard Bedding and Linen Issue Clean laundered, suitable bedding and linens, in x good repair, shall be provided for each youth entering a living area who is expected to remain overnight, shall include, but not be limited to: a) one mattress or mattress-pillow combinationMattress-pillow combination x which meets the requirements of Section 1502 of these regulations; (b) one pillow and a pillow case unless provided Extra pillows are available for purchase x for in (a) above; (c) one mattress cover and a sheet or two x sheets; (d) one towel; and, x JUV HEALTH ENVIRONMENT PAGE 7 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNO N/ACOMMENTS (e) one blanket or more, upon request. x 1501 Bedding and Linen Exchange 807.7 x The facility administrator shall develop and implement site specific written policies and procedures for the scheduled exchange of laundered bedding and linen issued to each youth housed. Washable items such as sheets, mattress covers, x pillow cases and towels shall be exchanged for clean replacement at least once each week. The covering blanket shall be cleaned or laundered x once a month. 1502 Mattresses x Any mattress issued to a youth in any facility shall conform to the size of the bed as referenced in Title 24, Section 1230.2.5 and be enclosed in an easily cleaned, non-absorbent ticking. Any mattress purchased for issue to a youth in a facility, which is locked to prevent unimpeded access to the outdoors, shall be certified by the x manufacturer as meeting all requirements of the State Fire Marshal and Bureau of Home Furnishings test standard for penal mattresses at the time of purchase. Article 12. Facility Sanitation and Safety 1510 Facility Sanitation, Safety and Maintenance 800-802 - Sanitation / maintenance 806 – Youth safety The facility administrator shall develop and Inmates are responsible to keep their own rooms x implement written policies and site-specific clean. Staff have daily janitorial checklist for procedures for the maintenance of an acceptable facility. level of cleanliness, repair and safety throughout the facility. JUV HEALTH ENVIRONMENT PAGE 8 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNO N/ACOMMENTS The plan shall provide for a regular schedule of Deficiency- holding cell 3, intake shower room, housekeeping tasks, equipment, including restraint rooms E12 and F1-F8 have no hot water at the devices, and physical plant maintenance and hand washing sinks inspections to identify and correct unsanitary or Corrective action – provide hot water unsafe conditions or work practices in a timely manner. Deficiency – hot water button at hand wash sinks x in rooms E3, E13, and F11 are not working Corrective action – repair Deficiency – light is out in room E12 Corrective action – repair The use of chemicals shall be done in accordance to the product label and Safety Data Sheet which may x include the use of Personal Protection Equipment (PPE). Medical care housing as described in Title 24, Section 13-201(c)6 shall be cleaned and sanitized x according to policies and procedures as established by the health administrator. 1511 Smoke Free Environment 1211.1-1211.4 The facility administrator shall develop policies and x procedures that assure youth are not exposed to use of tobacco products or electronic nicotine delivery system devices while in the facility or in the custody of staff. JUV HEALTH ENVIRONMENT PAGE 9 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) Itemized Summary I. Environmental Health Evaluation Juvenile Halls, Special Purpose Juvenile Halls and Camps Page 2 Deficiency - Item (n) The Hazard Analysis Critical Control Point Plan is out of date and was written by previous Food Services Manager. Corrective Action - The current Food Services Manager is working to write a new HACCP plan for facility and using the California Retail Food Code Page 9 Deficiency-holding cell 3, intake shower room, rooms E12 and F1-F8 have no hot water at the hand washing sinks Corrective action – provide hot water Deficiency – hot water button at hand wash sinks in rooms E3, E13, and F11 are not working Corrective action – repair Deficiency – light is out in room E12 Corrective action – repair Summary of environmental health evaluation: Deficiencies were found throughout rooms for plumbing fixtures and lighting that need to be addressed. Rooms D1-16 and Condor Pod were not being occupied. Suggested best practices: Prior to rooms being occupied check for hot water, plumbing, and lighting to ensure it’s in good working condition. This facility has required policies and procedures in place. Summary of environmental health inspection: Raw shell eggs being used for juveniles. If former HACCP plan for using raw shell eggs in meals is not found create one or cease using raw shell eggs. JUV HEALTH ENVIRONMENT PAGE 10 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) II. NUTRITIONAL HEALTH EVALUATION Juvenile Halls, Special Purpose Juvenile Halls and Camps FACILITY NAME: COUNTY: Butte County Juvenile Hall Butte FACILITY ADDRESS (STREET, CITY, ZIP CODE, TELEPHONE): 41 County Center Dr. Oroville, CA 95965, (530) 538-7311 CHECK THE FACILITY TYPE AS DEFINED IN JUVENILE HALLCAMP TITLE 15, SECTION 1302: DATE EVALUATED: JUVENILE FACILITY NUTRITIONAL HEALTH REVIEW AND EVALUATION DEFICIENCIES OR NON COMPLIANCE ISSUES NOTED: YES NO NUTRITIONALEVALUATOR(S) (NAME, TITLE, TELEPHONE): Amber McPherson, Registered Dietitian, 530-552-3917 FACILITY STAFF INTERVIEWED (NAME, TITLE, TELEPHONE): Patricia Norton, Food Services manager 530-538-6369 JUV HEALTH ENVIRONMENT PAGE 11 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) II. NUTRITIONAL HEALTH EVALUATION ARTICLE/SECTION YESNON/A COMMENTS Article 9. Food 1460 Frequency of Serving 3 meals per day and 1 snack Meals shall be served at least three times in any 24- X hour period. Hot food served at most meals At least one of these meals shall include hot food. Food shall be offered to youth at the time of initial intake, shall be served to youth if more than 14 X hours pass between meals, and shall be served to youth on medical diets as prescribed by the attending physician. Snack provided q night A snack shall be provided to all youth between 2 to 4 X hours after the dinner meal is served. A minimum of twenty minutes shall be allowed for the actual consumption of each meal except for X those youth on medical diets where the responsible physician has prescribed additional time. Provisions shall be made for youth who may miss a X regularly scheduled facility meal. They shall be provided with a substitute meal and beverage, and youth on medical diets shall be X provided with their prescribed meal. 1461 Minimum Diet Per RD analysis on 9/28/21, rotating menus meet Title 15 standards & meet USDA standards for Facility meals are based on nutritional standards breakfast and lunch which may include the Federal Child Nutrition Meal Program. The minimum diet provided shall be based upon the nutritional and caloric requirements found X in the 2011 Dietary Reference Intakes (DRI) of the Food and Nutrition Board, Institute of Medicine of the National Academies; the 2008 California Food Guide, and the 2015-2020 Dietary Guidelines for Americans. Facilities shall have a written process for how Deficiency: No written process for how vegetarian vegetarian or vegan diets may be requested and or vegan diets may be requested, granted or denied. granted or denied. Religious diets, and when X provided, vegetarian or vegan diets, must conform Corrective Action: Write process for how to these nutrition standards. vegetarian or vegan diets may be requested, granted or denied. The nutritional requirements for the minimum diet are specified in the following subsections. Snacks X may be included as part of the minimum diet. A wide variety of foods should be served. JUV HEALTH ENVIRONMENT PAGE 12 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNON/A COMMENTS (a) Protein Group. Includes: beef, veal, lamb, pork, poultry, fish, eggs, cooked dry beans, Per RD analysis on 9/28/21, 30-35 g protein served peas, lentils, nuts, peanut butter, and textured vegetable protein (TVP). One serving equals qd (~210 g q week) 14 grams or more of protein; the daily requirements shall equal two servings (a total X of 196 grams per week). In addition, there shall be a requirement to serve a third serving from the legumes three days a week, and/or three servings from another protein group. One serving equals, but is not limited to, one of the following examples: 2 to 3 oz. (without bone) lean, cooked meat, poultry or fish 2 medium eggs 1 cup cooked dry beans, peas, or lentils 4 Tbsp. peanut butter 8 oz. tofu 2 1/4 oz. dry, or 1 cup rehydrated, canned, or frozen TVP 1/2 cup seeds 2/3 cup nuts (b) Dairy Group. Includes milk (fluid, evaporated or dry; nonfat; 1% or 2% reduced fat, etc.); cheese (cottage, cheddar, etc.); yogurt; ice X cream or ice milk, and pudding. A serving is equivalent to 8 oz. of fluid milk and provides at least 250 mg of calcium. All milk shall be pasteurized and fortified with 1% pasteurized & fortified milk serves breakfast, vitamins A and D. For persons 9-18 years of lunch, dinner and snack X age, including pregnant and lactating women, the daily requirement is four servings. One serving equals, but is not limited to, one X of the following examples: JUV HEALTH ENVIRONMENT PAGE 13 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNON/A COMMENTS 8 oz. fluid milk (nonfat, 1% or 2% reduced fat) 1 1/2 oz. natural cheese 2 oz. processed cheese 1 1/2 cups of low fat, or nonfat cottage cheese X 1 1/2 cups of ice milk,or ice cream 1/3 cup nonfat dry milk 1/2 cup nonfat, or low-fat evaporatedmilk 1 cup nonfat, or low fat plain yogurt 1 cup pudding (c)Vegetable-Fruit Group. Includes: fresh, Fruit or vegetable serve q lunch and dinner, fruit frozen, dried, and canned vegetables and served q breakfast fruits. One serving equals: 1/2 cup vegetable X or fruit; 6 oz. of 100% juice; 1 medium apple, orange, banana, or potato; 1/2 grapefruit, or 1/4 cup dried fruit. The daily requirement shall be at least six Six: 2 at dinner, 2 at lunch, 1 at breakfast & 1 @ servings; at least one serving per day, or snack X seven (7) servings per week, shall be from each of the following three categories: (1) One serving of a fresh fruit or vegetable. X Vitamin C juice (2) One serving of a Vitamin C source containing 30 mg. or more. One serving X equals, but is not limited to the foods described in the regulation. (3) One serving of a Vitamin A source fruit or Carrots on menu frequently. If not already on vegetable containing 200 micrograms menu recommend adding other Vitamin A rich X Retinol Equivalents (RE) or more. One sources like cantaloupe, sweet potatoes, winter serving equals, but is not limited to the squash, apricots, spinach, kale or collard greens foods described in the regulation. (d) Grain Group. Includes: bread, rolls, pancakes, sweet rolls, ready-to-eat, or cooked cereals, corn bread, pasta, rice, tortillas, etc., and any food item containing whole or enriched grains. At least four (4) servings from this X group must be made with some whole grains. The daily requirement for youth shall be a minimum of six (6) servings, or 42 servings per week. One serving equals, but is not limited to the foods described in the regulation. JUV HEALTH ENVIRONMENT PAGE 14 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNON/A COMMENTS (e) Calories. Recommended daily caloric allowancesfor both females and males is a minimum of 2500calories not to exceed X 3000. Calorie increases withthe exception of a medical diet may occur as collaboratively determined by the facility manager, dietitian, food service manager and physician. (1) Pregnant youth shall be provided with a diet as approved by a doctor in X accordance with Penal Code Section 6030(e) and a supplemental snack, if medically indicated. (2) In keeping with chronic disease prevention goals, total dietary saturated fat shall not exceed 10 percent of total calories on a weekly basis. Facility dietitians shall consider the X recommendations and intent of the 2015-2020 Dietary Guidelines of Americans of reducing overall added sugar and sodium levels. Herbs and spices may be used to improve the taste and eye appeal of food served. 1462 Medical Diets Nursing communicates with dietary X Only the attending physician shall prescribe a medical diet. The medical diets utilized by a facility shall be Deficiency: Medical diets are not planned, prepared or served with consultation of an RD. planned, prepared, and served with the consultation X of a registered dietitian. Corrective Action: Have RD plan and prepare medical diet manual for use by facility. The facility manager shall comply with any medical X diet prescribed for a youth. Diet orders shall be maintained on file for at least X one year. Deficiency: Medical diet manual not available. The facility manager and responsible physician shall ensure that the medical diet manual, with sample Corrective Action: Medical diet manual will be menus for medical diets, shall be available in both X available in both the medical unit and the food the medical unit and the food service office for service office. reference and information. A registered dietitian shall review, and the Deficiency: Medical diet manual not available or approved. responsible physician shall approve the diet manual on an annual basis. X Corrective Action: Medical diet manual will be approved on an annual basis by the RD and responsible physician. JUV HEALTH ENVIRONMENT PAGE 15 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNON/A COMMENTS 1463 Menus Menus shall be planned at least one month in advance of their use. Menus shall be planned to X provide a variety of foods considering the cultural and ethnic makeup of the facility, thus, preventing repetitive meals. Menus shall be approved by a registered dietitian X before being used. If any meal served varies from the planned menu, Substitution log kept on file. X the change shall be noted in writing on the menu and/or production worksheet. Deficiency: Substitutions are not evaluated by RD. Menus, as planned and including changes, shall be retained for one year and evaluated by a registered Corrective Action: Have RD evaluate substitution X dietitian at least annually. logs to provide feedback on appropriate substitutions. 1464 Food Service Plan Facilities shall have a written site-specific food Foodservice plan from 2014, recommended service plan that shall comply with the applicable reviewing and updating. California Retail Food Code (CalCode). In facilities with an average daily population of 50 or more, there shall be employed or available, a trained and experienced food services manager or designee to complete a written food service plan. In facilities of X less than an average daily population of 50, that do not employ or have a food services manager available, the facility manager shall complete a written food service plan. The plan shall include, but not be limited to the following policies and procedures: (a)menu planning; X (b) purchasing; X (c)storage and inventory control;X (d) food preparation;X (e) food serving; X (f) transporting food; X (g)orientation and on-going training; X (h) personnel supervision; X (i) budgets and food costs accounting; X (j) documentation and record keeping; X (k) emergency feeding plan; X (l) waste management; and, X (m) maintenance and repair. X JUV HEALTH ENVIRONMENT PAGE 16 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNON/A COMMENTS (n) hazard analysis critical control point plan; Old HACCP plan on file and staff not trained on and, X procedures. Recommend updating HACCP plan and training all staff Deficiency: No provision for maintaining 3 days of (o) provision for maintaining three days of meals meals for testing in the event of food-borne for testing in the event of food-borne illness. illness. X Corrective Action: Create provision for maintaining 3 days of meals for testing. 1465 Food Handlers Education and Monitoring Policy and procedure manual in useand ongoing The facility manager, in cooperation with the food training provided services manager, shall develop and implement written policies and procedures to ensure that supervisory staff and food handlers receive ongoing training in safe food handling techniques, including personal hygiene, in accordance with Section 113947 of the Health and Safety Code, California Retail Food Code (CalCode). The procedures shall include provisions for monitoring compliance that ensure appropriate food handling and personal hygiene requirements. All staff certified in food service 1466 Kitchen Facilities, Sanitation, and Food Storage Kitchen facilities, sanitation, and food preparation, service, and storage shall comply with standards set forth in Health and Safety Code, Division 104, Part 7, Chapters 1-13, Sections 113700 et seq. California Retail Food Code (CalCode). In facilities where youth prepare meals for self- consumption or where frozen meals or pre-prepared food from other permitted food facilities (see Health and Safety Code Section 114381) are (re)heated and served, the following applicable CalCode standards may be waived by the local health officer: (a)Health and Safety Code Sections 114130- 114141; (b) Health and Safety Code Sections 114099.6, 114095-114099.5, 114101-114109, 114123, and 114125. If a domestic or commercial dishwasher, capable of providing heat to the surface of the utensils of a temperature of at least 165 degrees Fahrenheit, is used for the purpose of cleaning and sanitizing multi- service kitchen utensils and multi-service consumer utensils; JUV HEALTH ENVIRONMENT PAGE 17 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNON/A COMMENTS (c)Health and Safety Code Sections 114149- 114149.3 except that, regardless of such a waiver, the facility shall provide mechanical ventilation sufficient to remove gases, odors, steam, heat, grease, vapors and smoke from the kitchen; (d) Health and Safety Code Sections 114268- 114269; and, (e) Health and Safety Code Sections 114279- 114282. 1467 Food Serving and Supervision Policies and site-specific procedures shall be X developed and implemented to ensure that appropriate work assignments are made and food handlers are adequately supervised. Food shall be prepared and/or served only under the immediate supervision of a staff member. JUV HEALTH ENVIRONMENT PAGE 18 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) Itemized Summary II. Nutritional Health Evaluation Juvenile Halls, Special Purpose Juvenile Halls and Camps Page 12 Deficiency - No written process for how vegetarian or vegan diets may be requested, granted or denied. Corrective Action - Write process for how vegetarian or vegan diets may be requested, granted or denied. Page 14 Carrots on menu frequently. If not already on menu recommend adding other Vitamin A rich sources like cantaloupe, sweet potatoes, winter squash, apricots, spinach, kale or collard greens. Page 15 Deficiency - Medical diets are not planned, prepared or served with consultation of an RD. Corrective Action - Have RD plan and prepare medical diet manual for use by facility. Deficiency - Medical diet manual not available. Corrective Action - Medical diet manual will be available in both the medical unit and the food service office. Deficiency - Medical diet manual not available or approved. Corrective Action - Medical diet manual will be approved on an annual basis by the RD and responsible physician Page 16 Deficiency - Substitutions are not evaluated by RD. Corrective Action - Have RD evaluate substitution logs to provide feedback on appropriate substitutions. Foodservice plan from 2014, recommended reviewing and updating. Page 17 Old HACCP plan on file and staff not trained on procedures. Recommend updating HACCP plan and training all staff Deficiency - No provision for maintaining 3 days of meals for testing in the event of food-borne illness. Corrective Action - Create provision for maintaining 3 days of meals for testing. Menus and frequency of serving meet the nutritional requirements based on nutritional standards which include the Federal Child Nutrition Meal Program. Menus are planned well in advance and provide a variety of foods considering the cultural and ethnic makeup of the facility. Kitchen staff receive ongoing training in safe food handling techniques. Deficiencies were found include lack of medical diet manual, planning of vegetarian or vegan diets, proper review of substitutions by Registered Dietitian and provision to maintaining 3 days of meals for testing JUV HEALTH ENVIRONMENT PAGE 19 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) III. MEDICAL/MENTAL HEALTH EVALUATION Juvenile Halls, Special Purpose Juvenile Halls and Camps FACILITY NAME: COUNTY: Butte County Juvenile Hall Butte FACILITY ADDRESS (STREET, CITY, ZIP CODE, TELEPHONE): 41 County Center Drive, Oroville, CA 95965 530-538-7311 CHECK THE FACILITY TYPE AS DEFINED IN JUVENILE HALLCAMP TITLE 15, SECTION 1302: X DATE EVALUATED: MEDICAL/MENTAL HEALTH EVALUATION DEFICIENCIES OR NON COMPLIANCE ISSUES NOTED: YES NO MEDICAL/MENTAL EVALUATOR(S) (NAME, TITLE, TELEPHONE): David Canton, DO, MPH, JD, Interim Health Officer, Butte County Public Health 530-552-3993 Monica Soderstrom, RN, PHN, Division Director, Community Health, Butte County Public Health (530) 552-3930 FACILITY STAFF INTERVIEWED (NAME, TITLE, TELEPHONE): Tarah Foster, Health Services Administrator, Wellpath 530-538-6863 Lauren Tuft, RN (530) 538-6381 Mariah Ruddy, Juvenile Hall Administrator, (530) 552-4461 JUV HEALTH ENVIRONMENT PAGE 20 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) III. MEDICAL/MENTAL HEALTH EVALUATION Juvenile Halls, Special Purpose Juvenile Halls and Camps ARTICLE/SECTION YESNO N/A COMMENTS Article 8. Health Services 1400 Responsibility for Health Care Services Addressed in Wellpath policy HCD 210 Y A-01 X The facility administrator shall ensure that health care services are provided to all youth. The facility shall have a designated health administrator who, in cooperation with the behavioral/mental health director and facility administrator and pursuant to a written agreement, contract or job description, is administratively responsible to: (a)develop policy for health care X administration; (b) identify health care providers for the X definedscope of services; (c)establish written agreements as necessary X to provide access to health care; (d) develop mechanisms to assure that those X agreements are properly monitored; and, (e)establish systems for coordination among X health care service providers. When the health administrator is not a physician, there shall be a designated responsible physician X who shall develop policy in health care matters involving clinical judgments. 1401 Patient Treatment Decisions Addressed in Wellpath policy HCD 210 Y A-03 Clinical decisions about the treatment of individual X youth are the sole province of licensed health care professionals, operating within the scope of their license and within facility policy defining health care services. Safety and security policies and procedures that are Addressed in Wellpath policy HCD 210 Y B-04 X applicable to youth supervision staff also apply to health care personnel. JUV HEALTH ENVIRONMENT PAGE 21 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNO N/A COMMENTS 1402 Scope of Health Care Addressed in Wellpath policy HCD 210 Y E-11 (a)The health administrator, in cooperation with the facility administrator, shall develop X and implement written policy and procedures to define the extent to which health care shall be provided within the facility and delineate those services that shall be available through community providers. Each facility shall provide: (1) at least one health care provider to X provide treatment; and, (2) health care services which meet the Addressed in Wellpath policy HCD 210 Y A-01; Y E- minimum requirements of these 07; Y E08 regulations and be at a level to address emergency, acute symptoms and/or conditions and avoid preventable deterioration of health while in X confinement. (b) When health services are delivered within Addressed in Wellpath policy HCD 110 D-03 the juvenile facility, staff, space, X equipment, supplies, materials, and resource manuals shall be adequate to the level of care provided. Addressed in Butte County Probation Policy 702.12 (c) Consistent with security requirements and public safety, written policy and procedures for juvenile facilities shall provide for parents, guardians, or other legal custodians, at their own expense, to X authorize and arrange for medical, surgical, dental, behavioral/mental health or other remedial treatment of youth that is permitted under law. 1403 Health Care Monitoring and Audits Addressed in Wellpath policy HCD 110- A-06 performed in conjunction with Butte County Jail (a) In juvenile facilities with on-site health care staff, the health administrator, in X cooperation with the facility administrator, shall develop and implement written policy and procedures to collect statistical data and submit at least annual summaries of health care services to the facility administrator. JUV HEALTH ENVIRONMENT PAGE 22 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNO N/A COMMENTS (b) The health administrator, in cooperation with theresponsible physician and the facility administrator, shall establish policies X and procedures to assure that the quality and adequacy of health care services are assessed at least annually. (1) Policy and procedures shall identify a process for correcting identified deficiencies in the medical, dental, X mental health and pharmaceutical services delivered. (2) Based on information from these assessments, the health administrator shall provide the facility administrator X with an annual written report on medical, dental, mental health and pharmaceutical services. (c) Medical, behavioral/mental and dental services shall be reviewed at least quarterly, at documented administrative X meetings between the health and facility administrators and other staff, as appropriate. 1404 Health Care Staff Qualifications Addressed in Wellpath policy HCD 110 Y C-09 (a) The health administrator shall, at the time of recruitment for health care positions, X develop education and experience requirements that are consistent with the community standard and the needs and understanding of the facility population. Hiring practices will take into consideration cultural awareness and linguistic competence. (b) In all juvenile facilities providing on-site health care services, the health administrator, in cooperation with the facility administrator, shall establish policy X and procedures to assure that State licensure, certification, or registration requirements and restrictions that apply in the community, also apply to health care personnel who provide services to youth. (c)Appropriate credentials shall be accessible for review. Policy and procedures shall X provide that these credentials are periodically reviewed and remain current. JUV HEALTH ENVIRONMENT PAGE 23 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNO N/A COMMENTS (d) The health administrator shall assure that position descriptions and health care practices require that health care staff X receive the supervision required by their license and operate within their scope of practice. 1405 Health Care Staff Procedures Addressed in Wellpath policy HCD 210 Y A-07, HCD 110 Y C-07 & HCD 210 Y-C-06 The responsible physician for each facility providing on-site health care may determine that a clinical X function or service can be safely and legally delegated to health care staff other than a physician. When this is done, the function or service shall be performed by staff operating within their scope of practice pursuant to written protocol, standardized procedures or direct medical order. 1406 Health Care Records Addressed in Wellpath policy HCD 210 Y-H-01 In juvenile facilities providing on-site health care, the X health administrator, in cooperation with the facility administrator, shall maintain individual and dated health records that include when applicable, but are not limited to: (a) intake health screening form; X (b)health appraisals/medical examinations; X (c) health service reports (e.g., emergency X department, dental, psychiatric, and other consultations); (d)complaints of illness or injury; X (e) names of personnel who treat, prescribe, X and/or administer/deliver prescription medication; (f)location where treatment is provided; X (g)medication records in conformance with X Title 15, Section 1438; (h)progress notes; X (i) consent forms; X (j) authorizations for release of information; X (k)copies of previous health records; X (l) immunization records; X (m) laboratory reports; and, X JUV HEALTH ENVIRONMENT PAGE 24 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNO N/A COMMENTS (n)individual treatment plan. X Addressed in Wellpath policy HCD 210Y H-02 Written policy and procedures shall provide for maintenance of the health record in a locked area or secured electronically, separate from the confinement record. Access to the medical and/or X behavioral/mental health record shall be controlled by the health administrator and shall assure that all confidentiality laws related to the provider-patient privilege apply to the health record. Health care records shall be retained in accordance X with community standards. 1407 Confidentiality Addressed in Wellpath policy HCD 210Y H-02 (a) For each juvenile facility that provides on- site health services, the health administrator, in cooperation with the facility administrator, shall establish policy and procedures, consistent with applicable laws, for the multi-disciplinary sharing of health information. These policies and X procedures shall address the provision for providing information to the court, child supervision staff and to probation. Information in the youth's case file shall be shared with the health care staff when relevant. The nature and extent of information shared shall be appropriate to treatment planning, program needs, protection of the youth or others, management of the facility, maintenance of security, and preservation of safety and order. (b) Medical and behavioral/mental health Addressed in Wellpath policy HCD 210Y A-09 services shall be conducted in a private manner such that information can be X communicated confidentially consistent with HIPAA. (c) Youth shall not be used to translate Butte County Probation Department 602.4.2 confidential medical information for other X non-English speaking youth. JUV HEALTH ENVIRONMENT PAGE 25 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNO N/A COMMENTS 1408 Transfer of Health Care Summary and Records Addressed in Wellpath policy HCD 210Y H-03 The health administrator, in cooperation with the facility administrator, shall establish written policy and procedures to assure that a health care summary and relevant records are forwarded to X health care staff in the receiving facility when a youth is transferred to another jurisdiction, and to the local health officer, when applicable. Policies shall include: (a) a summary of the health record, or documentation that no record exists at the X facility, is sent in an established format, prior to or at the time of transfer; Addressed in Wellpath policy HCD 210Y H-02 (b) relevant health records are forwarded to X the health care staff of the receiving facility; (c) notification to health care staff of the receiving facility prior to or at the time of X the release or transfer of youth with known or suspected communicable diseases; (d) applicable authorization from the youth and/or parent-legal guardian is obtained prior to transferring copies of actual health X records, unless otherwise provided by court order, statute or regulation having the force and effect of law; and, (e) confidentiality of health records is X maintained. 1408.5 Release of Health Care Summary and Addressed in Wellpath policy HCD 210Y H-02 Records X After youth are released to the community, health record information shall be promptly transmitted to specific physicians or health care facilities in the community, upon request and with the written authorization of the youth and/or parent/guardian. In special purpose juvenile halls and other facilities that do not have on-site health care staff, policy and procedures shall assure that youth supervision staff X forward non-confidential information on medications and other treatment orders prior to or at the time of transfer. JUV HEALTH ENVIRONMENT PAGE 26 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNO N/A COMMENTS 1409 Health Care Procedures Manual For juvenile facilities withon-site health care staff, the health administrator, in cooperation with the X facility administrator, shall develop, implement and maintain a facility-specific health services manual of written policies and procedures that address, at a minimum, all health care related standards that are applicable to the facility. Health care policy and procedure manuals shall be available to all health care staff, to the facility X administrator, the facility manager, and other individuals as appropriate to ensure effective service delivery. Each policy and procedure for the health care delivery system shall be reviewed at least every two years and revised as necessary under the direction X of the health administrator. The health administrator shall develop a system to document that this review occurs. The facility administrator, facility manager, health X administrator and responsible physician shall designate their approval by signing the manual. 1410 Management of Communicable Diseases Addressed in Wellpath policy HCD 210Y B-01 The health administrator/responsible physician, in cooperation with the facility administrator and the X local health officer, shall develop written policies and procedures to address the identification, treatment, control and follow-up management of communicable diseases. The policies and procedures shall address, but not be limited to: (a) intake health screening procedures; X X (b) identification of relevant symptoms; X (c) referral for medical evaluation; (d) treatment responsibilities during detention;X (e) coordination with public and private X community-based resources for follow-up treatment; (f) applicable reporting requirements; and, X X (g) strategies for handling disease outbreaks. JUV HEALTH ENVIRONMENT PAGE 27 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNO N/A COMMENTS The policies and procedures shall be updated as necessary to reflect communicable disease priorities X identified by the local health officer and currently recommended public health interventions. 1411 Access to Treatment Addressed in Wellpath policy HCD 210Y A-01 X The health administrator, in cooperation with the facility administrator, shall develop writtenpolicy and procedures to provide unimpeded access to health care. 1412 First Aid/AED and Emergency Response Addressed in Wellpath policy HCD 210Y H-02 X The health administrator/responsible physician, in cooperation with the facility administrator, shall establish facility-specific policies and procedures to assure access to first aid and emergency services. (a) First aid kits shall be available in designated Addressed in Wellpath policy HCD 210Y D-07 areas of each juvenile facility. The Deficiency: First aid kits are available but contents responsible physician shall approve the are not uniform or defined in policy. Process is in contents, number, location and procedure place for inspecting kits but has holes that allows for periodic inspection of the kits. X gaps in ensuring contents are current an complete. Corrective Action: Amend policy to include inventory list, inventory quantity, location of all first aid kits and process for ensuring contents are complete and up-to-date. (b)Automated external defibrillators (AED) shall be available in each juvenile facility. X The facility administrator shall ensure that device is maintained properly per manufacturer standard. Addressed in Wellpath policy HCD 210Y C-04 Youth supervision and health care staff shall be trained and written policies and procedures X established to respond appropriately to emergencies requiring first aid and AED. JUV HEALTH ENVIRONMENT PAGE 28 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNO N/A COMMENTS 1413 Individualized Treatment Plans With the exception of special purpose juvenile halls, the health administrator and behavioral/mental health director responsible physician, in cooperation X with the facility administrator, shall develop and implement policy and procedures to assure that Addressed in Wellpath policy HCD 210Y G-01 & coordinated and integrated health care treatment G-04 plans are developed for all youth who are receiving services for significant medical, behavioral/mental health or dental health care concerns. Policies and procedures shall assure: (a) Health care treatment plans are considered in X facility program planning. (b)Health care restrictions shall not limit Addressed in Butte County Probation Department participation of a youth in school, work Policy 602.5 assignments, exercise and other programs, X beyond that which is necessary to protect the health of the youth or others. (c) Relevant health care treatment plan information shall be shared with youth X supervision staff in accordance with Section 1407 for purposes of programming, implementation and continuity of care. (d)Accommodations for youth who may have X special needs when using showers and toilets and dressing/undressing. Treatment planning by health care providers shall address: (a) Pre-release and discharge planning for Addressed in Wellpath policy HCD 210Y E-13 continuing medical, dental and behavioral/mental health care, including medication, following release or transfer, X which may include relevant authorization for transfer of information, insurance, or communication with community providers to ensure continuity of care. (b)Participation in relevant programs upon X return into the community to ensure continuity of care. (c) Youth and family participation (if applicable X and available). (d)Cultural responsiveness, awareness and Addressed in Butte County Probation Department X linguistic competence. Policy 504.3&504.31 (e)Physical and psychological safety. X (f)Traumatic stress and trauma reminders when X applicable. JUV HEALTH ENVIRONMENT PAGE 29 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNO N/A COMMENTS 1414 Health Clearance for in-Custody Work and Program Assignments Addressed in Wellpath policy HCD 210Y C-06 The health administrator/responsible physician, in X cooperation with the facility administrator, shall develop health screening and monitoring procedures for work and program assignments that have health care implications, including, but not limited to, food handlers. 1415 Health Education Addressed in: Wellpath policy HCD 210Y A-01; Butte County Probation Department Policy 702.6.4 & 6.5; With the exception of special purpose juvenile halls, the health administrator for each juvenile facility, in Health Annual Training Manual X cooperation with the facility administrator, shall develop written policies and procedures to assure that interactive and gender and developmentally appropriate medical, behavioral/mental health and dental health education and disease prevention programs are provided to youth. The education program content shall be updated as necessary to address current health and community X priorities that meet the needs of the confined population. 1416 Reproductive Services and Sexual Health Addressed in: For all juvenile facilities, the health administrator, in Health Education Training Manual & Butte County cooperation with the facility administrator, shall Probation Department Policy 702.6.4 & 702.6.5 develop written policies and procedures to assure that reproductive and sexual health services are available to all youth in accordance with current public health guidelines X Such services shall include but not be limited to those prescribed by Welfare and Institutions Code X Sections 220, 221 and 222 and Health and Safety Code Section 123450. JUV HEALTH ENVIRONMENT PAGE 30 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNO N/A COMMENTS Section 1417. Pregnant/Post-Partum Youth Addressed in Wellpath policy HCD 210Y G-09 With the exception of special purpose juvenile halls, the health administrator for each juvenile facility, in cooperation with the facility administrator, shall X develop written policies and procedures pertaining to pregnant and post-partum youth as required by Penal Code Section 6030(e) and limitations on the use of restraints in accordance with Penal Code Section 6030(f) and Welfare and Institutions Code Sections 220, 221, and 222. Written policies and procedures shall also include the following: X (a) Pregnant youth will receive information regarding options for continuation of pregnancy, termination of pregnancy and adoption. (b)Pregnant youth receive prenatal care, including physical examination, nutrition guidance, childbirth, breast feeding and X parenting education, counseling and provisions for follow up and post-partum care, (c) Availability of a breast pump and X procedures for storage, delivery or disposal for lactating youth. (d)Qualified medical professionals develop a plan for pregnant youth that includes direct communication of medical information and X transfer of medical records regarding prenatal care to the obstetrician who will be providing prenatal care and delivery in the community. 1418. Youth with Developmental Disabilities Addressed in Wellpath policy HCD 210Y G-01 Policy and procedures shall require that any youth who is suspected or confirmed to have a X developmental disability is referred to the local Regional Center for the Developmentally Disabled for purposes of diagnosis and/or treatment within 24 hours of identification, excluding holidays and weekends. JUV HEALTH ENVIRONMENT PAGE 31 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNO N/A COMMENTS Addressed in Wellpath policy HCD 210Y E-02 1430 Medical Clearance/Intake Health and Screening The health administrator/responsible physician, in cooperation with the facility administrator and X behavioral/mental health director shall establish policies and procedures for a documented intake health screening procedure to be conducted immediately upon entry to the facility. Policies and procedures shall also define when a health evaluation and/or treatment shall be obtained prior to acceptance for booking. For adjudicated youth who are confined in any juvenile facility for successive stays, each of which totals less than 96 hours, the responsible physician X shall establish a policy for a medical evaluation and clearance. This evaluation and clearance shall include screening for communicable disease. The responsible physician shall establish criteria defining the types of apparent health conditions that would preclude acceptance of a youth into the X facility without a documented medical clearance. The criteria shall be consistent with the facility's resources to safely hold the youth. Intake personnel shall ensure that youth who are unconscious, semi-conscious, profusely bleeding, severely disorientated, known to have ingested substances, intoxicated to the extent that they are a threat to their own safety or the safety of others, in X alcohol or drug withdrawal or otherwise urgently in need of medical attention shall be immediately referred to an outside facility for medical attention and clearance for booking. Written documentation of the circumstances and X reasons for requiring a medical clearance whenever a youth is not accepted for booking is required. Written medical clearance, and when possible, a medical evaluation with progress notes are required X for admission to the facility. Procedures for an intake health screening shall consist of a defined, systematic inquiry and observation of every youth booked into the juvenile X facility. The screening shall be conducted immediately upon entry to the facility and may be performed by either health care personnel or trained youth supervision staff. JUV HEALTH ENVIRONMENT PAGE 32 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ARTICLE/SECTION YESNO N/A COMMENTS Screening procedures shall include but not be limited to: X (a) Medical, dental and behavioral/mental health concerns that may pose a hazard to the youth or others in the facility; (b)Health conditions that require treatment X whilethe youth is in the facility; and, (c) Identification of the need for accommodations, e.g., physical or X developmental disabilities, gender identity or medical holds. Any youth suspected to have a communicable disease that could pose a significant risk to others in X the facility shall be separated from the general population pending the outcome of an evaluation by healthcare staff. Procedures shall require timely referral for health care commensurate with the nature of any problems X or complaint identified during the screening process. Addressed in Wellpath policy HCD 210Y G-06 , 06.A 1431 Intoxicated Youth and Youth With a Substance Use Disorder (a) The responsible health administrator/physician, in cooperation with the facility administrator, shall X develop and implement written policy and procedures that address the identification and management of alcohol and other substance intoxication. Withdrawal, and treatment of substance use disorder in accordance with Section 1430. JUV HEALTH ENVIRONMENT PAGE 33 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) (b) Policy and procedures shall address: (1)a medical clearance shall be obtained prior X to booking any youth who is intoxicated to the extent that they are a threat to themselves or others; (2) designated housing, including use of any X intoxicated youth; (3) symptoms known history of ingestion or withdrawal that should prompt immediate X referral for medical evaluation and treatment; (4)determining when the youth is no longer considered intoxicated and documenting X when the monitoring requirements of this regulation are discontinued; (5) medical responses to youth experiencing X intoxication or withdrawal reactions; (6) management of pregnant youth who use X alcohol or other substances; (7) initiation of substance abuse counseling Facility does not have staffing to provide MAT for and/or treatment during confinement and opioid use disorder. X referral procedures for continuation upon release to the community consistent with Section 1413 and Section 1355; (8) coordination with behavioral/mental health services in cases of substance abusing X youth with known or suspected mental illness. (9) how, when and by whom the youth will be X monitored when intoxicated; (10) the frequency of monitoring and the X documentation required; (11) that when a youth is intoxicated, experiencing progressive or severe X intoxication or withdrawal, they shall be immediately medically evaluated; and, (12)that intoxication beyond four hours from X the time of admission shall require a medical evaluation 1432 Health Assessment Addressed in Wellpath policy HCD 210Y E-11 & E- 04 The health administrator/responsible physician, in X cooperation with the facility administrator for each juvenile hall, shall develop and implement written policy and procedures for a health assessment of youth and for the timely identification of conditions necessary to safeguard the health of the youth JUV HEALTH ENVIRONMENT PAGE 34 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) (a)The health assessment shall be completed within 96 hours of admission, excluding holidays, to the facility and result in a compilation of identified problems to be considered in classification, treatment, and the multi-disciplinary management of the youth while in custody and in pre-release X planning. It shall be conducted in a location that protects the privacy of the youth and conducted by a physician, or other licensed or certified health professional working within his/her scope of practice and under the direction of a physician. (1) At a minimum, the health assessment shall include, but is not limited to, health X history, examination, laboratory and diagnostic testing, and immunization reviews as outlined below: (A) The health history includes but is not limited to: Review of the intake health screening, history of illnesses, operations, injuries, medications, allergies, immunizations, systems review, exposure to communicable diseases, family health history, habits (e.g., tobacco, alcohol and other substances), developmental history including strengths and supports available to the youth (e.g., school, home, and peer relations, activities, X interests), history of recent trauma- exposure which may require immediate attention (including physical and sexual abuse, sexual assault, neglect, violence in the home, traumatic loss) and current traumatic stress symptoms, pregnancy needs, sexual activity, contraceptive methods, reproductive history, physical and sexual abuse, neglect, history of mental illness, self-injury, and suicidal ideation. JUV HEALTH ENVIRONMENT PAGE 35 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) (B)The physical examination includes but is not limited to: Temperature, height, weight, pulse, blood pressure, appearance, gait, head and neck, a preliminary dental and visual acuity screening, hearing screening, X lymph nodes, chest and cardiovascular, breasts, abdomen, genital (pelvic and rectal examination, with consent, if clinically indicated), musculoskeletal, neurologic. (C)Laboratory and diagnostic testing includes, but is not limited to: Tuberculosis screening and testing for sexually transmitted diseases for sexually active youth. Additional X testing should be available as clinically indicated, including pregnancy testing, urinalysis, hemoglobin or hematocrit. (D) Review and update of the immunization records within two X weeks in accordance with current public health guidelines. (2) The physical examination and laboratory and diagnostic testing components of the health assessment may be modified by the health care provider, for youth admitted with an adequate examination done within the last 12 months, provided there is reason to believe that no substantial X change would be expected since the last full evaluation. When this occurs, health care staff shall review the intake health screening form and conduct a face-to-face interview with the youth. The health history and immunization review should be done within 96 hours of admission excluding holidays. (3)Physical exams shall be updated annually X for all youth. Addressed in Wellpath HCD 210 Y E-04 (b) For adjudicated youth who are confined in any juvenile facility for successive stays, each of which totals less than 96 hours, the responsible physician shall establish a policy for a medical assessment. If this assessment X cannot be completed at the facility during the initial stay, it shall be completed prior to acceptance at the facility. This evaluation and clearance shallinclude screening for communicable disease. JUV HEALTH ENVIRONMENT PAGE 36 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) (c)For youth who are transferred to and from Addressed in Wellpath HCD 210Y E-02 juvenile facilities outside their detention system, the health administrator, in X cooperation with the facility administrator, shall develop and implement policy and procedures to assure that a health assessment: (1) is received from the sending facility at or X prior to the time of transfer; (2) is reviewed by designated health care X staff at the receiving facility; and, (3) is identified and any missing required X assessments are scheduled within 96 hours. Addressed in Wellpath HCD 210Y E-02 (d) The health administrator/responsible physician shall develop policy and procedures to assure that youth who are transferred among juvenile facilities within the same X detention system, receive a written health care clearance. The health record shall be reviewed and updated prior to transfer and forwarded to facilities that have licensed on- site health care staff. 1433 Requests for Health Care Services Addressed in Wellpath policy HCD 210Y H A-01 Also Wellpath policy HCD 210_Y- E-07 The health administrator, in cooperation with the X facility administrator, shall develop policy and Non-emergency Services procedures to establish a daily routine for youth to convey requests for emergency and non-emergency and Wellpath Policy HCD 210_Y- E-08 medical, dental and behavioral/mental health care Emergency Services services. (a) Youth shall be provided the opportunity to Addressed in Wellpath Policy HCD 210 Y-E-07, confidentially convey either through, written section 6.2 or verbal communications, request for X medical, dental or behavioral/mental health services. Provisions shall be made for youth who have language or literacy barriers. (b)Youth supervision staff shall relay requests Addressed in Wellpath policy HCD-210_Y-E-07 from the youth, initiate referrals when a need (section 6.6) for services is observed, and advocate for the x And HCD-210_Y-G-04 Mental Health Services youth when the need for medical, dental and behavioral/mental services appears to be urgent. (c) Staff shall inquire and make observations of Addressed in Wellpath Policy HCD 210 Y-G-04 each youth regarding their medical, dental x and behavioral/mental health including the presence of trauma-related behaviors, injury and illness. (d)There shall be opportunities available on a Addressed in Wellpath Policy HCD 210 Y-E-08 twenty-four hour per day basis for youth and x staff to communicate the need for emergency medical and behavioral/mental health care services. JUV HEALTH ENVIRONMENT PAGE 37 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) (e)Provision shall be made for any youth Addressed in Wellpath Policy HCD 210 Y-E-07 and requesting medical, dental and Y- E-08 behavioral/mental health care attention, or x observed to be in need of health care, to be given that attention by licensed or certified health care personnel. (f)All medical, dental and behavioral/mental Facility uses a paper chart system. Charts were x health care requests shall be documented and made available for inspectors to review. maintained. 1434 Consent and Refusal for Health Care Addressed in Wellpath Policy HCD-210 _Y-I-04 Informed Consent and Right to Refuse x The health administrator, in cooperation with the facility administrator, shall establish written policy and procedures to obtain informed consent for health care examinations and treatment. (a) All immunizations, examinations, Addressed inWellpath Policy HCD 210 Y-I-04 treatments, and procedures requiring verbal or x written informed consent in the community also require that consentfor confined youth. (b)There shall be provision for obtaining Addressed in Wellpath Policy HCD 210 Y-I-04 parental consent and obtaining authorization for health care services from the court when there is no x parent/guardian or other person standing in loco parentis, including the requirements in Welfare and Institutions Code Section 739. (c) Policy and procedures shall be consistent Policies consistent with minor consent laws for with applicable statutes in those instances where s state of CA the youth's consent for testing or treatment is sufficient or specifically required. (d)Conservators can provide consent only Addressed in Wellpath Policy HCD 210 Y-I-04 x within limits of their court authorization. Youth may refuse, verbally orin writing, non-Addressed in Wellpath Policy HCD 210 Y-O-04 emergency medical, dental and behavioral/mental x health care. 1435 Dental Care Addressed in Wellpath Policy HCD 210_Y-E-06 Oral Care The health administrator, in cooperation with the facility administrator, shall develop and implement Youth sees RN first for assessment. Referred to x written policy and procedures to require that dental community dental provider who takes Medi-Cal treatment be provided to youth as necessary to which provides continuity of care after discharge. respond to acute conditions and to avert adverse List of providers in Rolodex. effects on the youth's health and require preventive services as recommended by a dentist. Treatment shall not be limited to extractions. Addressed in Wellpath Policy HCD 210 Y-E-06 Annual dental exams shall be provided to any youth x detained for longer than one year. JUV HEALTH ENVIRONMENT PAGE 38 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) 1436 Prostheses and Orthopedic Devices Addressed in Wellpath Policy HCD 210_Y-G-14 (a)The health administrator, in cooperation withDurable Medical Equipment and Medical Supplies the facility administrator and the responsible x physician shall develop written policy and procedures regarding the provision, retention and removal of medical and dental prostheses, including eyeglasses and hearing aids. (b) Prostheses shall be provided when the health Addressed in Wellpath Policy HCD 210 Y-G-14 of the youth would otherwise be adversely x affected, as determined by the responsible physician. Addressed in Wellpath Policy HCD 210 Y-G-14 (c) Procedures for retention and removal of prostheses shall comply with the requirements x of Penal Code Section 2656. 1437 Mental Health Services Addressed in Wellpath Policy HCD 210_Y-G-04 Mental Health Services and The health administrator/responsible physician, in Y-G-05 Suicide Prevention cooperation with the behavioral/mental health x director and the facility administrator, shall establish policies and procedures to provide behavioral/mental health services. These services shall include, but not be limited to: (a)screening for behavioral/mental health problems at intake performed by either behavioral/mental/medical health personnel or trained youth supervision staff; history of x recent exposure to trauma which may require immediate attention (including physical and sexual abuse, sexual assault, neglect, violence in the home, traumatic loss), current traumatic stress symptoms, and pregnancy needs (b) assessment by a behavioral/mental health x provider when indicated by the screening process; (c)therapeutic services and preventive services x where resources permit; (d) crisis intervention and the management of x acute psychiatric episodes; (e)stabilization of persons with mental disorders x and the prevention of psychiatric deterioration in the facility setting; (f) initial and periodic medication support x services; (g) assurance that any youth who displays significant symptoms of severe depression, suicidal ideation, irrational, violent or self- x destructive behaviors, shall be provided a mental status assessment by a licensed behavioral/mental health clinician, psychologist, or psychiatrist. (h) transition planning for youth undergoing behavioral/mental health treatment, including arrangements for continuation of medication x and services from behavioral/mental health providers, including providers in the community where appropriate. JUV HEALTH ENVIRONMENT PAGE 39 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) Absent an emergency, unless the juvenile facility has been designated as a Lanterman-Petris-Short (LPS) facility, and youth meet the criteria for involuntary commitment under the LPS Act in Welfare and Institutions Code Section 5000 et seq., all services x shall be provided on a voluntary basis. Voluntary mental health admissions may be sought pursuant to Penal Code Section 4011.8 or Welfare and Institutions Code Section 6552. 1437.5 Transfer to a Treatment Facility Policy 519 addresses Transportation outside of the facility. The health administrator/responsible physician, in x cooperation with the behavioral/mental health Youth are evaluated at a local hospital and are not director and the facility administrator, shall establish usually transferred directly to a Behavioral Health policies and procedures for the transfer of youth to treatment facility. a treatment facility. These policies and procedures shall include but are not limited to: (a) Youth who appear to be a danger to themselves or others, or to be gravely disabled, due to a mental health condition x shall be evaluated either pursuant to applicable statute or by on-site health personnel to determine if treatment can be initiated at the juvenile facility, and (b)Provision for timely referral, transportation, and admission to licensed mental health x facilities, and follow-up for youth whose psychiatric needs exceed the treatment capability of the facility. 1438 Pharmaceutical Management Addressed in Wellpath policy HCD-210_Y-D-01 Pharmaceutical Operations For all juvenile facilities, the health administrator, in consultation with a pharmacist and in cooperation s with the facility administrator, shall develop and implement written policy, establish procedures, and provide space and accessories for the secure storage, controlled administration, and disposal of all legally obtained drugs. (a) Such policies, procedures, space and accessories Addressed in Wellpath Policy HCD 210 Y-D-01, shall include, but not be limited to, the following: section 6.21 x (1) securely lockable cabinets, closets, and refrigeration units; (2) a means for the positive identification of Addressed in Wellpath Policy HCD 21—Y-D-02 x the recipient of the prescribed medication; Medical Services (3) administration/delivery of medicines to x youth as prescribed; (4) confirmation that the recipient has ingested x the medication; JUV HEALTH ENVIRONMENT PAGE 40 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) (5)documenting that prescribed medications x have or have not been administered, by whom, and if not, for what reason; (6) prohibition of the delivery of medication x from one youth to another; (7) limitation to the length of time medication x may be administered without further medical evaluation; (8) the length of time allowable for a x physician's signature on verbal orders, not to exceed seven (7) days; Addressed in Wellpath policy HCD 210_Y-C-04 (9) training by medical staff for non-licensed personnel which includes, but is not limited Health Training of Staff to: delivery procedures and documentation; recognizing common symptoms and side-effects that should x result in contacting health care staff for Addressed in Wellpath policy HCD 210_Y-C-08 evaluation; procedures for consultation for Health Care Liaison confirming ingestion of medication; and, consultation with health care staff for monitoring the youth's response to medication; (10) a written report shall be prepared by a The Health Services Administrator receives pharmacist, no less than annually, on the monthly statistics from pharmaceutical contractor status of pharmacy services in the x Correct RX and has access to Correct Rx website for institution. The pharmacist shall provide data sooner if needed. the report to the health authority and the facility administrator; and, Addressed in Wellpath Policy HCD 210_Y-D-02 (11) transition planning, including plan for x uninterrupted continuation of medication. Medication Services (b) Consistent with pharmacy laws and regulations, Addressed in Wellpath Policy HCD 210_Y-D-01 the health administrator shall establish written x Pharmaceutical Operations protocols that limit the following functions to being performed by the identified personnel: (1) Procurement shall be done only by a x physician, dentist, pharmacist, or other persons authorized by law. (2)Storage of medications shall assure that stock supplies of legend medications shall only be accessed by licensed health personnel. Supplies of legend medications x that have been properly dispensed and supplies of over-the-counter medications may be accessed by both licensed and trained non-licensed personnel. (3) Repackaging shall only be done by a Addressed in Wellpath Policy HCD 210 Y-D-02, physician, dentist, pharmacist, or other x Section 6.17 persons authorized by law. JUV HEALTH ENVIRONMENT PAGE 41 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) (4)Preparation of labels can be done by Correct Rx is contract pharmacy licensed physician, dentist, pharmacist or Crystal Pharmacy is local back-up other personnel, provided the label is checked and affixed to the medication container by the physician, dentist, or x pharmacist before administration or deliveryto the youth. Labels shall be prepared inaccordance with Section 4076 and 4076.5 of the Business and Professions Code. (5) Dispensing shall only be done by a x physician, dentist, pharmacist, or other person authorized by law. (6) Administration of medication shall only be done by licensed health personnel who are x authorized to administer medication and acting on the order of a prescriber. (7)Licensed health care personnel and trained non-licensed personnel may deliver x medication acting on the order of a prescriber. (8)Disposal of legend medication shall be done in accordance with pharmacy laws and regulations Any controlled substances that need to be and requires any combination of two of the destroyed or disposed of are taken to the jail for following classifications: physician, dentist, x processing. pharmacist, or registered nurse. Controlled substances shall be disposed of in accordance with Drug Enforcement Administration disposal procedures. (c) The responsible physician shall establish policies Addressed in Wellpath policy HCD 210_Y-E-11 and procedures for managing and providing over-x Nursing Protocols and Y-D-01 the-counter medications to youth. 1439 Psychotropic Medications Addressed in Wellpath policy HCD 210_Y-I-02 Emergency Psychiatric Medications The health administrator/responsible physician, in x cooperation with the behavioral/mental health Addressed in Wellpath policy HCD 210_Y-G-02, director and the facility administrator, shall develop sections 6.1-6.4 and implement written policies and procedures governing the use of voluntary and involuntary Patients with Sepcial Health Needs psychotropic medications. (a) These policies and procedures shall include, but not be limited to: (1) protocols for health care providers written Addressed in Wellpath Policy HCD 210 Y-I-02, and verbal orders for psychotropic section 6.3 & x medications in dosages appropriate to the Y-D-01 youth's need; (2) the length of time medications may be Addressed in Wellpath Policy HCD 210 Y-D-02, x ordered and administered before re- section 6.7 evaluation by a health care provider; JUV HEALTH ENVIRONMENT PAGE 42 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) (3)provision that youth who are on Addressed in Wellpath Policy HCD 210Y-D-02, psychotropic medications prescribed in the section 6.9 community are continued on their x medications when clinically indicated pending verification in a timely manner by a health care provider (4) re-evaluation and further determination of Addressed in Wellpath Policy HCD 210 Y-D-02 continuing psychotropic medication, if x needed, shall be made by a health care provider; Addressed in Wellpath Policy HCD 210 Y-D-02 (5) provision that the necessity for uninterrupted continuation on psychotropic medications is addressed in pre-release x planning and prior to transfer to another facility or program including authorization for transfer of prescriptions; and, (6)provision for regular clinical/administrative Addressed in Wellpath Policy HCD 210 Y-D-02 review of utilization patterns for all x psychotropic medications, including every emergency situation. (b) Psychotropic medications shall not be Addressed in Wellpath policy HCD 210-Y-I-04 administered to a youth absent an emergency unless x Informed Consent and Right to Refuse informed consent has been given by the legally authorized person or entity. (1) Youth shall be informed of the expected Addressed in Wellpath Policy HCD 210Y-I-04, benefits, potential side effects and x section 6.2 alternatives to psychotropic medications. (2) Absent an emergency, youth may refuseAddressed in Wellpath Policy HCD 210 Y-I-04 x psychotropic medication without disciplinary consequences. Addressed in Wellpath Policy HCD 210 Y-I-02 (c) Youth found by a health care provider to be an imminent danger to themselves or others by reason of a mental disorder may be involuntarily given psychotropic medication immediately necessary for the preservation of life or the prevention of serious bodily harm, and when there is insufficient time to obtain consent from the parent, guardian, or court x before the threatened harm would occur. It is not necessary for harm to take place or become unavoidable prior to initiating treatment. All involuntary administrations of psychotropic medications shall be documented and reviewed by the facility administrator or designee and health administrator. Addressed in Wellpath Policy HCD 210 Y-I-02 (d) Assessment and diagnosis must support the administration of psychotropic medications. x Administration of psychotropic medication is not allowed for coercion, discipline, convenience or retaliation. JUV HEALTH ENVIRONMENT PAGE 43 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) 1452 Collection of Forensic Evidence Addressed in Wellpath Policy HCD 201_y-I-03 Forensic information The health administrator, in cooperation with the facility administrator, shall establish policies and x procedures assuring that forensic medical services, including drawing of blood alcohol samples, body cavity searches, and other functions for the purpose of prosecution are collected by appropriately trained medical personnel who are not responsible for providing ongoing health care to the youth. 1453 Sexual Assaults Addressed in Wellpath Policy HCD 210-Y-B-04A and Y-B-05 Federal Sexual Abuse Policy 605x The health administrator, in cooperation with the x facility administrator, shall develop and implement policy and procedures for treating victims of sexual assaults, preservation of evidence and for reporting such incidents to local law enforcement. The evidentiary examination and initial treatment of Addressed in Wellpath Policy HCD 210 Y-B-05, victims of sexual assault shall be conducted at a section 6.11 health facility that is separate from the custodial x facility and is properly equipped and staffed with personnel trained and experienced in such procedures. 1454 Participation in Research Addressed in Wellpath policy HCD 210_Y-I-05, section 6.3 Medical Research The health administrator, in cooperation with the facility administrator, shall develop site specific policy and procedures governing biomedical or x behavioral research involving youth. Human subjects' research shall occur only when ethical, medical and legal standards for human research are met as verified by Institutional Review Board (IRB) approvals. Written policy and procedure shall require assurances for the safety of the youth and informed consent. Addressed in Wellpath Policy HCD 210 Y-I-05 Participation shall not be a condition for obtaining privileges or other rewards in the facility. The court, x health administrator, and facility administrator shall be informed of all such proposed actions. JUV HEALTH ENVIRONMENT PAGE 44 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) 1329 Suicide Prevention Plan Addressed in Wellpath Policy HCD 210-Y-G-05 Suicide Prevention The facility administrator, in collaboration with the healthcare and behavioral/mental health administrators, shall plan and implement written x policies and procedures which delineate a Suicide Prevention Plan. The plan shall consider the needs of youth experiencing past or current trauma. Suicide prevention responses shall be respectful and in the least invasive manner consistent with the level of suicide risk. The plan shall include the following elements: Addressed in Wellpath Policy HCD 210 Y-G-05, section 6.1 (a)Suicide prevention training asrequired in x Section 1322, Youth Supervision Staff Orientation, and Training and the Juvenile Corrections Officer Core Course. (b)Screening, Identification Assessment and Addressed in Wellpath Policy HCD 210 Y-G-05, x Precautionary Protocols section 6.2 (1) All youth shall be screened for risk of Addressed in Wellpath Policy HCD 210 Y-G-05, x section 6.4.2 suicide at intake and as needed during detention. (2) All youth supervision staff who perform intake processes shall be trained in x screening youth for risk of suicide. (3) All youth who have been identified during the intake screening process to be at risk of suicide shall be referred to x behavioral/mental health staff for a suicide risk assessment. (4) Precautionary protocols shall be developed to ensure the youth's safety x pending the behavioral/mental health assessment. (c) Referral process to behavioral/mental health Addressed in Wellpath Policy HCD 210 Y-G-05, x staff for assessment and/or services. section 6.2.3 (d)Procedures for monitoring of youth x identified at risk for suicide. (e) Safety Interventions (1) Procedures to address intervention protocols for youth identified at risk for x suicide which may include, but are not limited to: (A) Housing consideration x (B) Treatment strategies including x trauma-informed approaches JUV HEALTH ENVIRONMENT PAGE 45 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) (2) Procedures to instruct youth supervision staff how to respond to youth who exhibit x suicidal behaviors. (f)Communication (1) The intake process shall include communication with the arresting officer and family guardians regarding the youth's x past or present suicidal ideations, behaviors or attempts. (2) Procedures for clear and current information sharing about youth at risk for x suicide with youth supervision, healthcare, and behavioral/mental health staff. (g)Debriefing of Critical Incidents Related to Addressed in Wellpath Policy HCD 210 Y-G-05, x Suicides or Attempts section 6.11.1 (1) Process for administrative review of the circumstances and responses proceeding, x during and after the critical incident. (2) Process for a debriefing event with Addressed in Wellpath Policy HCD 210 Y-G-05, x affected staff. section 12.1 (3) Process for a debriefing event with Addressed in Wellpath Policy HCD 210 Y-G-05, x affected youth. section 12.1 (h)Documentation (1) Documentation processes shall be developed to ensure compliance with this x regulation Youth identified at risk for suicide shall not be denied the opportunity to participate in facility programs, services and activities which are available to other non-suicidal youth, unless deemed x necessary for the safety of the youth or security of the facility. Any deprivation of programs, services or activities for youth at risk of suicide shall be documented and approved by the facility manager. Section 1357 Use of Force This is a custody policy (not health staff) Lexipol policy 514 The facility administrator, in cooperation with the x responsible physician, shall develop and implement written policies and procedures for the use of force, which may include chemical agents. Force shall never be applied as punishment, discipline, retaliation or treatment. JUV HEALTH ENVIRONMENT PAGE 46 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) (a)At a minimum, each facility shall develop policies and procedures which: (1)restricts the use of force to that which is x deemed reasonable and necessary, as defined in Section 1302 to ensure the safety and security of youth, staff, others and the facility. (2) outline the force options available to staff including both physical and non-physical x options and define when those force options are appropriate. (3) describe force options or techniques that are x expressly prohibited by the facility. (4) describe the requirements of staff to report any inappropriate use of force, and to take x affirmative action to immediately stop it. (5) define a standardized reporting format that includes time period and procedure for documenting and reporting the use of force, including reporting requirements of management and line staff and procedures for reviewing and tracking use of force incidents by x supervisory and or management staff, which include procedures for debriefing a particular incident with staff and/or youth for the purposes of training as well as mitigating the effects of trauma that may have been experienced by staff and/or the youth involved. (6) Include an administrative review and a system for investigating unreasonable use of x force. (7) define the role, notification, and follow-up procedures required after use of force incidents x for medical, mental health staff and parents or legal guardians. (8) describe the limitations of use of force on pregnant youth in accordance with Penal Code x Section 6030(f) and Welfare and Institutions Code Section 222. (b) Facilities that authorize chemical agents as a force option shall include policies and procedures that: x (1) identify who is approved to carry and/or utilize chemical agents in the facility and the type, size and the approved method of deployment for those chemical agents. JUV HEALTH ENVIRONMENT PAGE 47 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) (2) mandate that chemical agents only be used when there is an imminent threat to the youth's x safety or the safety of others and only when de- escalation efforts have been unsuccessful or are not reasonably possible. (3) outline the facility's approved methods and timelines for decontamination from chemical agents. This shall include that youth who have been exposed to chemical agents shall not be x left unattended until that youth is fully decontaminated or is no longer suffering the effects of the chemical agent. (4) define the role, notification, and follow-up procedures required after use of force incidents x involving chemical agents for medical, mental health staff and parents or legal guardians. (5) provide for the documentation of each incident of use of chemical agents, including the reasons for which it was used, efforts to de- escalate prior to use, youth and staff involved, x the date, time and location of use, decontamination procedures applied and identification of any injuries sustained as a result of such use. (c) Facilities shall develop policies and procedure which require that agencies provide initial and regular training in use of force and chemical agents when appropriate that address: x (1) known medical and behavioral health conditions that would contraindicate certain types of force; (2) acceptable chemical agents and the methods x of application. (3) signs or symptoms that should result in immediate referral to medical or behavioral x health. (4) instruction on the Constitutional Limitations x of Use of Force. (5) physical training force options that may x require the use of perishable skills. (6) timelines the facility uses to define regular x training. JUV HEALTH ENVIRONMENT PAGE 48 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) 1358 Use of Physical Restraints Addressed in Wellpath Policy HCD 210_Y-I-01, sections 6.8-6.14 Restraints and Seclusion The facility administrator, in cooperation with the responsible physician and mental health director, x shall develop and implement written policies and Juvenile Detention Manual Custody Policy, procedures for the use of restraint devices. Restraint devices include any devices which immobilize a Lexipol 515, Butte County Probation Department youth's extremities and/or prevent the youth from being ambulatory. 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 x cause self-inflicted physical harm. Physical restraints should be utilized only when it appears less restrictive alternatives would be ineffective in controlling the youth's behavior. In no case shall restraints be used as punishment or discipline, or as a substitute for treatment. The use of restraint devices that attach a youth to a wall, floor or other fixture, including a restraint chair, or through affixing of hands and feet together behind x the back (hogtying) is prohibited. The use of restraints on pregnant youth is limited in accordance with Penal Code Section 6030(f) and Welfare and Institutions Code Section 222. 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 x transportation within the facility. Movement within the facility shall be governed by Section 1358.5, Use of Restraint Devices for Movement Within the Facility. Youth shall be placed in restraints onlywith the approval of the facility manager or designee. The facility manager may delegate authority to place a x youth in restraints to a physician. Reasons for continued retention in restraints shall be reviewed and documented at a minimum of every hour. 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. x The youth shall be medically cleared for continued retention at least every three hours thereafter. A mental health consultation shall be secured as soon as possible, but in no case longer than four x hours from the time of placement, to assess the need for mental health treatment. JUV HEALTH ENVIRONMENT PAGE 49 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) Continuous direct visual supervision shall be conducted to ensure that the restraints are properly employed, and to ensure the safety and well-being x 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. In addition to the requirements above, policies and x procedures shall address: (a) documentation of the circumstances leading to x an application of restraints. (b) known medical conditions that would contraindicate certain restraintdevices and/or x techniques. (c) acceptable restraint devices. x (d) signs or symptoms which should result in x immediate medical/mental health referral. (e) availability of cardiopulmonary resuscitation x equipment. (f) protective housing of restrained youth. While in restraint devices, all youth shall be housed alone or x in a specified housing area for restrained youth which makes provision to protect the youth from abuse. (g) provision for hydration and sanitation needs. x (h) exercising of extremities.x Custody policy (not health staff) 1358.5 Use of Restraint Devices for Movement and Transportation Within the Facility Restraints are not used for transportation and The Facility Administrator, in cooperation with the movement within the facility x responsible physician and behavioral/mental health director, shall develop and implement written policies and procedures for the use of restraint devices when the purpose is for movement or transportation within the facility that shall include the following: (a) identification of acceptable restraint devices, staff approved to utilize restraint devices and the x required training. (b) the circumstances leading to the application of x restraints must be documented. JUV HEALTH ENVIRONMENT PAGE 50 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) (c) an individual assessment of the need to apply restraints for movement or transportation that includes consideration of less restrictive x alternatives, consideration of a youth's known medical or mental health conditions, trauma informed approaches, and a process for documentation and supervisor review and approval. (d) consideration of safety and security of the facility, with a clearly defined expectation that x restraint devices shall not be used for the purposes of discipline or retaliation. (e) the use of restraints on pregnant youth is limited in accordance with Penal Code Section 6030(f) and x Welfare and Institutions Code Section 222. 1359 Safety Room Procedures Addressed in Wellpath Policy HCD 210-Y-E-09A Safety Cell Placement and Retention, & (a) The facility administrator, and where applicable, Custody Policy, Lexipol 507, Butte County in cooperation with the responsible physician, shall Probation Department develop and implement written policies and procedures governing the use of safety rooms, as described in Title 24, Part 2, Section 1230.1.13. The Intake area has a safety room that has been used s room shall be used to hold only those youth who approximately three times in 24 years. 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. A safety room shall not be used for punishment or discipline, or as a substitute for treatment. Policies and procedures shall: (1) include provisions for administration of necessary nutrition and fluids, access to a x toilet, and suitable clothing to provide for privacy; (2) provide for approval of the facility manager, x or designee, before a youth is placed into a safety room; (3) provide for continuous direct visual supervision and documentation of the youth's x behavior and any staff interventions every 15 minutes, with actual time recorded; (4) provide that the youth shall be evaluated by x the facility manager, or designee, every four hours; (5)provide for immediate medical assessment, x where appropriate, or an assessment at the next daily sick call; and, (6) provide a process for documenting the reason for placement, including attempts to x use less restrictive means of control, and decisions to continue and end placement. JUV HEALTH ENVIRONMENT PAGE 51 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) (b)The placement of a youth in the safety room shall x be accomplished in accordance with the following: (1) safety room shall not be used before other less restrictive options have been attempted x and exhausted, unless attempting those options poses a threat to the safety or security of any youth or staff. (2)safety room shall not be used for the purposes x of punishment, coercion, convenience, or retaliation by staff. (3) safety room shall not be used to the extent x that it compromises the mental and physical health of the youth. Addressed in Lexipol policy 601 (c) A youth may be held up to four hours in the safety room. After the youth has been held in the x safety room for a period of four hours, staff shall do one or more of the following: (1)return the youth to general population. x (2)consult with mental health or medical staff, x (3)develop an individualized plan that includes the goals and objectives to be met in order x to reintegrate the youth to general population. (d) If confinement in the safety room must be extended beyond four hours, staff shall develop an individualized plan that includes the requirements of x Section 1354.5 and the goals and objectives to be met in order to integrate the youth to general population. Itemized Summary III. Medical/Mental Health Evaluation Juvenile Halls, Special Purpose Juvenile Halls and Camps Page 28 Addressed in Wellpath policy HCD 210Y D-07 Deficiency: First aid kits are available but contents are not uniform or defined in policy. Process is in place for inspecting kits but has holes that allows gaps in ensuring contents are current and complete. Corrective Action: Amend policy to include inventory list, inventory quantity, location of all first aid kits and process for ensuring contents are complete and up-to-date Page 34 Facility does not have staffing to provide MAT for opioid use disorder. Commendations: (1) Facility is a Vaccines for Children (VFC) provider and RN is committed to getting immunizations up to date. New data logger information for VFC appliances will be forwarded to the RN by local health department vaccine coordinator. (2) RN provides Covid screening outside facility before youth enter to decrease transmission in to facility. (3) RN provides reproductive health education to youth in facility. Local health department, health education specialist will connect with RN to coordinate education efforts and promote birth control methods and STD testing available at Public Health clinics. JUV HEALTH ENVIRONMENT PAGE 52 Juvenile Facilities BSCC FORM 458 (Rev.01/2019) ADULT COURT AND TEMPORARY HOLDING FACILITIES Local Detention Facility Health Inspection Report Health and Safety Code Section 101045 BSCC #: ___________ FACILITY NAME:COUNTY: Oroville - Butte County Courthouse Butte FACILITY ADDRESS (STREET, CITY, ZIP CODE, TELEPHONE): One Court Street, Oroville, CA 95965 CHECK THE FACILITY TYPE AS DEFINED IN TITLE 15, COURT HOLDING TEMPORARY HOLDING SECTION 1006: FACILITY: X FACILITY: ENVIRONMENTAL HEALTH EVALUATION DATE INSPECTED: 02/07/2022 ENVIRONMENTAL HEALTH EVALUATORS (NAME, TITLE, TELEPHONE): Alana Kong, Registered Environmental Health Specialist II, (530) 552-3998 Leslie Roberts, Senior Registered Environmental Health Specialist, (530) 552-3872 FACILITY STAFF INTERVIEWED (NAME, TITLE, TELEPHONE): Robert Allen, Deputy Sheriff, (530) 532-7002 NUTRITIONAL EVALUATIONDATE INSPECTED: NUTRITIONAL EVALUATORS (NAME, TITLE, TELEPHONE): FACILITY STAFF INTERVIEWED (NAME, TITLE, TELEPHONE): MEDICAL/MENTAL HEALTH EVALUATION DATE INSPECTED: 02/07/2022 MEDICAL/MENTAL HEALTH EVALUATORS (NAME, TITLE, TELEPHONE): Monica Soderstrom, Division Director, Public Health, (530) 552-3930 David Canton, Public Health Officer, (53) 552-3993 FACILITY STAFF INTERVIEWED (NAME, TITLE, TELEPHONE): Robert (Bobby) Allen, BCSO Sergeant, (530) 538-7817 Scott Miller, Courthouse Administrator This checklist is to be completed pursuant to the attached instructions. 1 I. ENVIRONMENTAL HEALTH EVALUATION Adult Court and Temporary Holding Facilities ARTICLE/SECTION YESNO N/A COMMENTS Article 12. Food Approach for Providing Food Service (Not applicable to CH) x Food served in the facility is prepared in the facility. If "No," respond to items 1 and 2 below prior to continuing with the checklist. 1. Food is prepared at another city or county Sack lunches will be provided by the Butte County detention facility. Jail in the event the prisoner is housed during the x noon meal. No potentially hazardous foods that need time temperature control are served. No utensils provided for safety reasons. 2. Food is contracted through a private vendor No private vendor utilized. Butte County Jail has a who had been inspected and complies with x permitted kitchen with Butte County provisions of CalCode. Environmental Health. 1245 Kitchen Facilities, Sanitation and Food No kitchen facility or food preparation Service (Not applicable to CH) x Kitchen facilities, sanitation, and food preparation, service and storage comply with standards set forth in CalCode. In facilities where inmates prepare meals for self- consumption, or where frozen meals are pre- prepared food from other facilities permitted pursuant to HSC §114381 is (re)heated and served, x the following CalCode standards may be waived by the local health officer. HSC §114130-114141 HSC §114099.6, 114095-114099.5,114101- 114109, 114123 and 114125 if a domestic or commercial dishwasher, capable of providing x heat to the surface of utensils of at least 165 degrees Fahrenheit, is used to clean and sanitize multi-service utensils and multi-service consumer utensils; HSC §114149-114149.3 except that, regardless of such a waiver, the facility shall provide x mechanical ventilation sufficient to remove gases, odors, steam, heat, grease, vapors and smoke from the kitchen; 2 ARTICLE/SECTION YESNO N/A COMMENTS HSC §114268-114269 x HSC §114279-114282 x 1246 Food Serving and Supervision No food preparation done at this facility (Not applicable to CH) Policies and procedures ensure that appropriate x work assignments are made, and food handlers are adequately supervised. Food is prepared and served only under the immediate supervision of a staff member. Article 14. Bedding and Linens 1270 Standard Bedding and Linen Issue Inmates never held longer than 12 hours (Not applicable to CH) x The standard issue of clean suitable bedding and linens, for each inmate entering a living area who is expected to remain overnight, shall include, but not be limited to: (a) One serviceable mattress which meets the x requirements of Title 15 §1272; (b) one mattress cover or one sheet; x (c) one blanket or more depending upon climatic conditions. Two blankets or sleep bag may be x issued in place of one mattress cover or one sheet (d) one towel x Temporary Holding facilities which hold persons x longer than 12 hours shall meet the requirements of 1, 2 and 3 above. 1272 Mattresses (Not applicable to CH) x Mattresses are enclosed in an easily cleaned, non- absorbent ticking and conform to the size of the bunk as referenced in Title 24, Part 2, §1231.3.5 Beds (at least 30" wide X 76" long). Any mattress purchased for issue to an inmate in a facility, which is locked to prevent unimpeded access to the outdoors, is certified by the x manufacturer as meeting all requirements of the State Fire Marshal and Bureau of Home Furnishings for penal mattresses at the time of purchase. 3 ARTICLE/SECTION YESNO N/A COMMENTS Article 15. Facility Sanitation and Safety 1280 Facility Sanitation, Safety and Maintenance Policies and procedures in place but not being adhered to. There are policies and procedures for the x maintenance of an acceptable level of cleanliness, Janitorial contract with Pro-Line Cleaning Services, repair and safety throughout the facility. Inc. The plan provides for a regular schedule of Deficiency – holding cell next to the attorney housekeeping tasks and inspections to identify and visiting room and cells 42 and 43 have no hot correct unsanitary or unsafe conditions or work water practices. Corrective action –provide hot water. Hot water was turned back on during inspection, corrected on stie. Deficiency – lights in the holding cell (next to x attorney visiting room) and the attorney visiting room were not working. Corrective action – repair Deficiency – A chain was hooked onto the back of the char in the attorney visiting room Corrective action – remove the chain Itemized Summary I. Environmental Health Evaluation Oroville Courthouse Page 4 Policies and procedures in place but not being adhered to. Janitorial contract with Pro-Line Cleaning Services, Inc. Deficiency – holding cell next to the attorney visiting room and cells 42 and 43 have no hot water Corrective action – provide hot water. Hot water was turned back on during inspection, corrected on stie. Deficiency – lights in the holding cell (next to attorney visiting room) and the attorney visiting room were not working. Corrective action – repair Deficiency – A chain was hooked onto the back of the char in the attorney visiting room Corrective action – remove the chain Summary of environmental health evaluation: Deficiencies found with plumbing fixtures and lighting within the facility that need to be addressed. The hot water was turned off due to holding cells being unoccupied, which was then turned on during the inspection. Have policies in place to ensure hot water is turned on when cells are going to be occupied and to check lights regularly to ensure they are working. Best Practices: Have soap available for inmates to wash their hands, when requested. 4 III. MEDICAL/MENTAL HEALTH EVALUATION Adult Court and Temporary Holding Facilities ARTICLE/SECTIONYES NO N/A COMMENTS Article 11. Health Services 1200 Responsibility for Health Care Services Staff was not initially aware of manual but manual In court holding and temporary holding facilities, the was identified during visit facility administrator shall have the responsibility to X develop written policies and procedures which ensure provision of emergency health care services to all inmates. 1207 Medical Receiving Screening Manual addresses cases should a prisoner be taken (Not applicable to CH) into custody at the court house pending transfer to the jail where screen would occur. X A receiving screening is performed on all inmates at the time of intake, with the exception of inmates transferred directly within a custody system with documented receiving screening This screening shall be completed in accordance with written procedures and shall include but not be limited to medical and mental health problems, X developmental disabilities, tuberculosis and other communicable diseases. The screening shall be performed by licensed health personnel or trained facility staff, with documentation of staff training regarding site specific forms with appropriate disposition based on X responses to questions and observations made at the time of screening. The training depends on the role staff are expected to play in the receiving screening process. The facility administrator and responsible physician shall develop a written plan for complying with X Penal Code Section 2656 (orthopedic or prosthetic appliance used by inmates). There shall be a written plan to provide care for any inmate who appears at this screening to be in need X of or who requests medical, mental health, or developmental disability treatment. Written procedures and screening protocol shall be X established by the responsible physician in cooperation with the facility administrator. 5 ARTICLE/SECTIONYES NO N/A COMMENTS 1209 Mental Health Services and Transfer to a Manual does address cases where person is taken Treatment Facility into custody in the court house pending transfer to the jail where services would occur. (Not applicable to CH) X (a) The health authority, in cooperation with the mental health director and facility administrator, shall establish policies and procedures to provide mental health services. These services shall include but not be limited to: 1.Identification and referral of inmates X with mental health needs; 2.Mental health treatment programs X provided by qualified staff, including the use of teleheath. 3. Crisis intervention services; X 4. Basic mental health services provided, as X clinically indicated; X 5. Medication support services; and, 6. The provision of health services sufficiently coordinated such that care is appropriately integrated, medical and X mental health needs are met, and the impact of any of these conditions on each other is adequately addressed. (b) Unless the county has elected to implement the provisions of Penal Code Section 1369.1, a mentally disordered inmate who appears to be a danger to himself or others, or to be gravely disabled, shall be transferred for further evaluation to a designated Lanterman Petris Short treatment facility designated by X the county and approved by the State Department of Mental Health for diagnosis and treatment of such apparent mental disorder pursuant to Penal Code section 4011.6 or 4011.8 unless the jail contains a designated Lanterman Petris Short treatment facility. Prior to the transfer, the inmate may be evaluated by licensed health personnel to determine if treatment can be initiated at the correctional facility. Licensed health personnel may perform an onsite assessment X to determine if the inmate meets the criteria for admission to an inpatient facility, or if treatment can be initiated in the correctional facility. 6 ARTICLE/SECTIONYES NO N/A COMMENTS (c) If the county elects to implement the provisions of Penal Code Section 1369.1, the health authority, in cooperation with the facility administrator, shall establish policies X and procedures for involuntary administration of medications. The procedures shall include, but not be limited to: 1. Designation of licensed personnel, including psychiatrist and nursing staff, X authorized to order and administer involuntary medication; 2. Designation of an appropriate setting X where the involuntary administration of medication will occur; 3. Designation of restraint procedures and/or devices that may be used to X maintain the safety of the inmate and facility staff; 4. Development of a written plan to monitor the inmate's medical condition following the initial involuntary administration of a medication, until the inmate is cleared as a result of an evaluation by, or consultation with, a psychiatrist; X 7 ARTICLE/SECTIONYES NO N/A COMMENTS 5. Development of a written plan to provide a minimum level of ongoing monitoring of the inmate following return to facility housing. This monitoring may be performed by custody staff trained to recognize signs of possible medical problems and alert medical staff when indicated; and X 6. Documentation of the administration of X involuntary medication in the inmate's medical record. 1212 Vermin Control Manual does address cases where individual is taken (Not applicable to CH) into custody in the court house and transferred to the jail where control and treatment would occur. The responsible physician shall develop a written X plan for the control and treatment of vermin- infested inmates. There shall be written, medical protocols, signed by the responsible physician, for the treatment of persons suspected of being infested or having contact with a vermin-infested inmate. 1213 Detoxification Treatment (Not applicable to CH) The responsible physician shall develop written medical policies on detoxification which shall include X a statement as to whether detoxification will be provided within the facility or require transfer to a licensed medical facility. The facility detoxification protocol shall include procedures and symptoms necessitating immediate transfer to a hospital or other medical facility. Facilities without medically licensed personnel in attendance shall not retain inmates undergoing withdrawal reactions judged or defined in policy, by X the responsible physician, as not being readily controllable with available medical treatment. Such facilities shall arrange for immediate transfer to an appropriate medical facility. 8 ARTICLE/SECTIONYES NO N/A COMMENTS 1220 First Aid Kits X First aid kit(s) shall be available in all facilities. The responsible physician shall approve the Deficiency: First aid kits contents are not contents, number, location and procedure for standardized. Manual is not specific as to contents periodic inspection of the kit(s). In Court and and quantity. While policy states kits are to be Temporary Holding facilities, the facility inspected at least monthly, expired items were administrator shall have the above approval found in the kits and contents varied from kit to kit. authority, pursuant to Section 1200 of these Corrective Action: edit manual to make specific list regulations. of contents and review inspection process to ensure X compliance with policy. Best practice would be to have first aid kits in both court houses mirror each other in content and location. 1046 Death in Custody Addressed in section 2.1046 of manual (a) Death in Custody Reviews for Adults and Minors. The facility administrator, in cooperation with the health administrator, shall develop written policy and procedures to ensure that there is X an initial review of every in-custody death within 30 days. The review team shall include the facility administrator and/or the facility manager, the health administrator, the responsible physician and other health care and supervision staff who are relevant to the incident. Deaths shall be reviewed to determine the appropriateness of clinical care; whether changes to policies, procedures, or practices X are warranted; and to identify issues that No in custody deaths occurred in court house require further study. during inspection period. (b) Death of a Minor. No death of in custody minor occurred in court In any case in which a minor dies while X house during inspection period. detained in a jail, lockup, or court holding facility: (1) The administrator of the facility shall provide to the Board a copy of the report submitted to the Attorney General under X Government Code Section 12525. A copy of the report shall be submitted within 10 calendar days after the death. (2) Upon receipt of a report of death of a minor from the administrator, the Board may within 30 calendar days inspect and evaluate the jail, lockup, or court holding X facility pursuant to the provisions of this subchapter. Any inquiry made by the Board shall be limited to the standards and requirements set forth in these regulations. 9 ARTICLE/SECTIONYES NO N/A COMMENTS 1051 Communicable Diseases Addressed in section 2.1051 of the manual The facility administrator, in cooperation with the responsible physician, shall develop written policies X and procedures specifying those symptoms that require segregation of an inmate until a medical evaluation is completed. At the time of intake into the facility, an inquiry shall be made of the person being booked as to whether or not he/she has or has had any communicable X diseases, such as tuberculosis or has observable symptoms of tuberculosis or any other communicable diseases, or other special medical problem identified by the health authority. The response shall be noted on the booking form X and/or screening device. 1052 Mentally Disordered Inmates Addressed in section 2.1052 for Court House Policy The facility administrator, in cooperation with the manual. responsible physician, shall develop written policies and procedures to identify and evaluate all mentally disordered inmates, and may include telehealth. If an X evaluation from medical or mental health staff is not readily available, an inmate shall be considered mentally disordered for the purpose of this section if he or she appears to be a danger to himself/herself or others or if he/she appears gravely disabled. An evaluation from medical or mental health staff shall be secured within 24 hours of identification or X at the next daily sick call, whichever is earliest. Segregation may be used if necessary to protect the safety of the inmate or others. 1055 Use of Safety Cell Safety cell is not available The safety cell described in Title 24, Part 2, Section 1231.2.5, shall be used to hold only those inmates X who display behavior which results in the destruction of property or reveals an intent to cause physical harm to self or others The facility administrator, in cooperation with the responsible physician, shall develop written policies and procedures governing safety cell use and may X delegate authority to place an inmate in a safety cell to a physician. In no case shall the safety cell be used for X punishment or as a substitute for treatment. An inmate shall be placed in a safety cell only with the approval of the facility manager or designee, or X responsible health care staff; continued retention shall be reviewed a minimum of every four hours. 10 ARTICLE/SECTIONYES NO N/A COMMENTS A medical assessment shall be completed within a maximum of 12 hours of placement in the safety cell or at the next daily sick call, whichever is earliest. X The inmate shall be medically cleared for continued retention every 24 hours thereafter. The facility manager, designee or responsible health care staff shall obtain a mental health opinion/consultation with responsible health care X staff on placement and retention, which shall be secured within 12 hours of placement. Direct visual observation shallbe conducted at least twice every thirty minutes. Such observation shall be X documented. Procedures shall be established to assure administration of necessary nutrition and fluids. Inmates shall be allowed to retain sufficient clothing, or be provided with a suitably designed “safety X garment,” to provide for their personal privacy unless specific identifiable risks to the inmate's safety or to the security of the facility are documented. 1056 Use of Sobering Cell Sobering Cell is not available The sobering cell described in Title 24, Part 2, Section 1231.2.4, shall be used for the holding of inmates who are a threat to their own safety or the safety of others due to their state of intoxication and pursuant to written policies and procedures developed by the facility administrator. Such inmates shall be removed from the sobering cell as X they are able to continue in the processing. In no case shall an inmate remain in a sobering cell over six hours without an evaluation by a medical staff person or an evaluation by custody staff, pursuant to written medical procedures in accordance with section 1213 of these regulations, to determine whether the prisoner has an urgent medical problem. At 12 hours from the time of placement, all inmates will receive an evaluation by responsible health care staff. Intermittent direct visual observation of X inmates held in the sobering cell shall be conducted no less than every half hour. Such observation shall be documented. X 11 ARTICLE/SECTIONYES NO N/A COMMENTS 1057 Developmentally Disabled Inmates Addressed in section 1.1059 of Court House Policy The facility administrator, in cooperation with the manual. responsible physician, shall develop written policies X and procedures for the identification and evaluation, appropriate classification and housing, protection, and nondiscrimination of all developmentally disabled inmates. The health authority or designee shall contact the Deficiency: Contacting regional center is not regional center on any inmate suspected or confirmed addressed in policy manual. to be developmentally disabled for the purposes of X diagnosis and/or treatment within 24 hours of such Corrective action: edit policy and train staff to determination, excluding holidays and weekends. contact regional center for inmates thought to be developmentally disabled. 1058 Use of Restraint Devices Addressed in section 2.1058 of the Court Holding Facility Manual The facility administrator, in cooperation with the X responsible physician, shall develop written policies and procedures for the use of restraint devices and may delegate authority to place an inmate in restraints to a responsible health care staff. In addition to the areas specifically outlined in this regulation, at a minimum, the policy shall address the following areas: acceptable restraint devices; signs or symptoms which should result in immediate medical/mental health referral; X availability of cardiopulmonary resuscitation equipment; protective housing of restrained persons; provision for hydration and sanitation needs; and exercising of extremities. In no case shall restraints be usedfor punishment or X as a substitute for treatment. Restraint devices shall only be used on inmates who display behavior which results in the destruction of property or reveal an intent to cause physical harm to X self or others. Restraint devices include any devices which immobilize an inmate's extremities and/or prevent the inmate from being ambulatory. Physical restraints should be utilized only when it X appears less restrictive alternatives would be ineffective in controlling the disordered behavior. Inmates shall be placed in restraints only with the Deficiency: Section 2.1058(5) of Court Holding Facility Manual allows for review every 2 hours. approval of the facility manager, the facility watch X commander, responsible health care staff; Corrective action: amend policy and procedure to continued retention shall be reviewed a minimum of comply with standard of every hour. every hour. 12 ARTICLE/SECTIONYES NO N/A COMMENTS A medical opinion on placement and retention shall Deficiency: Section 2.1058 (5) of Policy allows for be secured within one hour from the time of medical opinion within 6 hours placement. A medical assessment shall be X Corrective action: amend policy and procedure to completed within four hours of placement. comply with standard of within four (4) hours in Court Holding Facility Manual If the facility manager, or designee, in consultation Addressed in section 2.1058(6) of Court Holding with responsible health care staff determines that Facility Manual an inmate cannot be safely removed from restraints X after eight hours, the inmate shall be taken to a medical facility for further evaluation. Direct visual observation shall be conducted at least Addressed in section 2.1058(5) of Court Holding twice every thirty minutes to ensure that the Facility Manual X restraints are properly employed, and to ensure the safety and well-being of the inmate. Such observation shall be documented. While in restraint devices all inmates shall be housed Addressed in section 2.1058(5) of Court Holding alone or in a specified housing area for restrained Facility Manual X inmates which makes provisions to protect the inmate from abuse. The provisions of this section do not apply to the use of handcuffs, shackles or other restraint devices X when used to restrain inmates for security reasons. 1058.5 RESTRAINTS AND PREGNANT INMATES Addressed in section 2.1058(6) of Court Holding Facility Manual The facility administrator, in cooperation with the responsible physician, shall develop written policies X and procedures for the use of restraint devices on pregnant inmates. In accordance with Penal Code 3407 the policy shall include reference to the following: (1) An inmate known to be pregnant or in recovery after delivery shall not be X restrained by the use of leg irons, waist chains, or handcuffs behind the body. (2) A pregnant inmate in labor, during delivery, or in recovery after delivery, shall not be restrained by the wrists, X ankles, or both, unless deemed necessary for the safety and security of the inmate, the staff, or the public. (3) Restraints shall be removed when a professional who is currently responsible for the medical care of a pregnant inmate X during a medical emergency, labor, delivery, or recovery after delivery determines that the removal of restraints is medically necessary. 13 ARTICLE/SECTIONYES NO N/A COMMENTS (4) Upon confirmation of an inmate's pregnancy, she shall be advised, orally or X in writing, of the policies governing pregnant inmates. Itemized Summary III. Medical/Mental Health Evaluation Oroville Courthouse Page 9 Deficiency - First aid kits contents are not standardized. Manual is not specific as to contents and quantity. While policy states kits are to be inspected at least monthly, expired items were found in the kits and contents varied from kit to kit. Corrective Action -edit manual to make specific list of contents and review inspection process to ensure compliance with policy. Best practice:would be to have first aid kits in both court houses mirror each other in content and location. Page 12 Deficiency - Contacting regional center is not addressed in policy manual. Corrective action - edit policy and train staff to contact regional center for inmates thought to be developmentally disabled. Deficiency - Section 2.1058(5) of Court Holding Facility Manual allows for review every 2 hours. Corrective action - amend policy and procedure to comply with standard of every hour. Page 13 Deficiency-Section 2.1058 (5) of Policy allows for medical opinion within 6 hours Corrective action-amend policy and procedure to comply with standard of within four (4) hours in Court Holding Facility Manual Overall, the facility seemed to be operated in an appropriate fashion. Deputies were cooperative and forthright in assisting with and facilitating the inspection. Deficiencies are primarily related to policy edits and . training to the policies 14 ADULT COURT AND TEMPORARY HOLDING FACILITIES Local Detention Facility Health Inspection Report Health and Safety Code Section 101045 BSCC #: ___________ FACILITY NAME:COUNTY: Town of Paradise Police Department Butte FACILITY ADDRESS (STREET, CITY, ZIP CODE, TELEPHONE): 5595 Black Olive Dr. Paradise, CA 95969 (530) 872-6161 CHECK THE FACILITY TYPE AS DEFINED IN TITLE 15, COURT HOLDING TEMPORARY HOLDING SECTION 1006: FACILITY: FACILITY: X ENVIRONMENTAL HEALTH EVALUATION DATE INSPECTED: 02/08/2022 ENVIRONMENTAL HEALTH EVALUATORS (NAME, TITLE, TELEPHONE): Alana Kong, Registered Environmental Health Specialist II, (530) 552-3998 Leslie Roberts, Senior Registered Environmental Health Specialist, (530) 552-3872 FACILITY STAFF INTERVIEWED (NAME, TITLE, TELEPHONE): Anthony Borgman, Lieutenant, (530) 872-6161 ext. 202 NUTRITIONAL EVALUATIONDATE INSPECTED: NUTRITIONAL EVALUATORS (NAME, TITLE, TELEPHONE): FACILITY STAFF INTERVIEWED (NAME, TITLE, TELEPHONE): MEDICAL/MENTAL HEALTH EVALUATION DATE INSPECTED: 02/08/2022 MEDICAL/MENTAL HEALTH EVALUATORS (NAME, TITLE, TELEPHONE): Monica Soderstrom, Division Director, Public Health, (530) 552-3930 David Canton, Public Health Officer, (53) 552-3993 FACILITY STAFF INTERVIEWED (NAME, TITLE, TELEPHONE): Anthony Borgman, Lieutenant, (530) 872-6161 ext. 202 Officer Cameron Kovacs This checklist is to be completed pursuant to the attached instructions. 1 I. ENVIRONMENTAL HEALTH EVALUATION Adult Court and Temporary Holding Facilities ARTICLE/SECTIONYESNON/ACOMMENTS Article 12. Food Approach for Providing Food Service 902.9.2 Prisoner Food Service (Not applicable to CH) x Food served in the facility is prepared in the facility. If "No," respond to items 1 and 2 below prior to continuing with the checklist. 1. Food is prepared at another city or county x detention facility. 2. Food is contracted through a private vendor x who had been inspected and complies with provisions of CalCode. 1245 Kitchen Facilities, Sanitation and Food No kitchen facility or food preparation Service (Not applicable to CH) x Kitchen facilities, sanitation, and food preparation, service and storage comply with standards set forth in CalCode. In facilities where inmates prepare meals for self- consumption, or where frozen meals are pre- prepared food from other facilities permitted pursuant to HSC §114381 is (re)heated and served, x the following CalCode standards may be waived by the local health officer. HSC §114130-114141 HSC §114099.6,114095-114099.5,114101- 114109, 114123 and 114125 if a domestic or commercial dishwasher, capable of providing x heat to the surface of utensils of at least 165 degrees Fahrenheit, is used to clean and sanitize multi-service utensils and multi-service consumer utensils; HSC §114149-114149.3 except that, regardless of such a waiver, the facility shall provide x mechanical ventilation sufficient to remove gases, odors, steam, heat, grease, vapors and smoke from the kitchen; HSC §114268-114269 x HSC §114279-114282 x 2 ARTICLE/SECTION YESNO N/A COMMENTS 1246 Food Serving and Supervision No food preparation done at this facility (Not applicable to CH) Policies and procedures ensure that appropriate x work assignments are made, and food handlers are adequately supervised. Food is prepared and served only under the immediate supervision of a staff member. Article 14. Bedding and Linens 1270 Standard Bedding and Linen Issue Held for 6 hours max (Not applicable to CH) x The standard issue of clean suitable bedding and linens, for each inmate entering a living area who is expected to remain overnight, shall include, but not be limited to: (a) One serviceable mattress which meets the x requirements of Title 15 §1272; x (b) one mattress cover or one sheet; (c) one blanket or more depending upon climatic Blanket available conditions. Two blankets or sleep bag may be x issued in place of one mattress cover or one sheet x (d) one towel Temporary Holding facilities which hold persons x longer than 12 hours shall meet the requirements of 1, 2 and 3 above. 1272 Mattresses (Not applicable to CH) x Mattresses are enclosed in an easily cleaned, non- absorbent ticking and conform to the size of the bunk as referenced in Title 24, Part 2, §1231.3.5 Beds (at least 30" wide X 76" long). Any mattress purchased for issue to an inmate in a facility, which is locked to prevent unimpeded access to the outdoors, is certified by the x manufacturer as meeting all requirements of the State Fire Marshal and Bureau of Home Furnishings for penal mattresses at the time of purchase. 3 ARTICLE/SECTION YESNO N/A COMMENTS Article 15. Facility Sanitation and Safety 1280 Facility Sanitation, Safety and Maintenance 902.22 Janitorial services 3 times per week There are policies and procedures for the x maintenance of an acceptable level of cleanliness, repair and safety throughout the facility. The plan provides for a regular schedule of Deficiency – light is out in right holding cell housekeeping tasks and inspections to identify and x Corrective action – repair correct unsanitary or unsafe conditions or work practices. Itemized Summary I. ENVIRONMENTAL HEALTH EVALUATION Paradise Police Department Page 4 Deficiency – light is out in right holding cell Corrective action –repair Summary of environmental health evaluation: Overall the facility is clean and in good working condition. 4 III. MEDICAL/MENTAL HEALTH EVALUATION Adult Court and Temporary Holding Facilities ARTICLE/SECTIONYES NO N/A COMMENTS Article 11. Health Services 1200 Responsibility for Health Care Services Addressed in section 900.5.3 of the Department In court holding and temporary holding facilities, the Policy Manual. Policies also address staff facility administrator shall have the responsibility to maintaining CPR and basic first aid training and X develop written policies and procedures which access to first aid kit. ensure provision of emergency health care services to all inmates. 1207 Medical Receiving Screening Addressed in section 902.11.1 of the Department (Not applicable to CH) Policy Manual X A receiving screening is performed on all inmates at the time of intake, with the exception of inmates transferred directly within a custody system with documented receiving screening This screening shall be completed in accordance Medical screening form template reviewed and with written procedures and shall include but not be stack of completed screenings done in the past year X were available for review by inspectors. limited to medical and mental health problems, developmental disabilities, tuberculosis and other communicable diseases. Training of facility staff done every two years The screening shall be performed by licensed health personnel or trained facility staff, with documentation of staff training regarding site specific forms with appropriate disposition based on X responses to questions and observations made at the time of screening. The training depends on the role staff are expected to play in the receiving screening process. The facility administrator and responsible physician Addressed in section 900.5.4 of the Department shall develop a written plan for complying with Policy Manual X Penal Code Section 2656 (orthopedic or prosthetic appliance used by inmates). There shall be a written plan to provide care for any Section 467.1 of Policy manual addresses Medical inmate who appears at this screening to be in need Aid and Response. Section 467.4 addresses X of or who requests medical, mental health, or Transporting Ill and Injured Persons. developmental disability treatment. Written procedures and screening protocol shall be established by the responsible physician in X cooperation withthe facility administrator. 5 ARTICLE/SECTIONYES NO N/A COMMENTS 1209 Mental Health Services and Transfer to a Addressed in section 902.11.1 of the Department Treatment Facility Policy Manual (Not applicable to CH) X (a) The health authority, in cooperation with the mental health director and facility administrator, shall establish policies and procedures to provide mental health services. These services shall include but not be limited to: 1.Identification and referral of inmates Inmate requiring mental health services are not with mental health needs; X maintained within the facility and transferred for care 2. Mental health treatment programs X provided by qualified staff, including the use of teleheath. X 3. Crisis intervention services; 4. Basic mental health services provided, as X clinically indicated; 5. Medication support services; and, X 6. The provision of health services sufficiently coordinated such that care is appropriately integrated, medical and X mental health needs are met, and the impact of any of these conditions on each other is adequately addressed. (b) Unless the county has elected to implement the provisions of Penal Code Section 1369.1, a mentally disordered inmate who appears to be a danger to himself or others, or to be gravely disabled, shall be transferred for further evaluation to a designated Lanterman Petris Short treatment facility designated by X the county and approved by the State Department of Mental Health for diagnosis and treatment of such apparent mental disorder pursuant to Penal Code section 4011.6 or 4011.8 unless the jail contains a designated Lanterman Petris Short treatment facility. 6 ARTICLE/SECTIONYES NO N/A COMMENTS Prior to the transfer, the inmate may be No licensed health personnel are on staff. Any evaluated by licensed health personnel to inmates requiring evaluation are transferred to the county jail or local medical facilities determine if treatment can be initiated at the correctional facility. Licensed health X personnel may perform an onsite assessment to determine if the inmate meets the criteria for admission to an inpatient facility, or if treatment can be initiated in the correctional facility. (c) If the county elects to implement the provisions of Penal Code Section 1369.1, the health authority, in cooperation with the facility administrator, shall establish policies X and procedures for involuntary administration of medications. The procedures shall include, but not be limited to: 1. Designation of licensed personnel, including psychiatrist and nursing staff, X authorized to order and administer involuntary medication; 2. Designation of an appropriate setting X where the involuntary administration of medication will occur; 3. Designation of restraint procedures and/or devices that may be used to X maintain the safety of the inmate and facility staff; 7 ARTICLE/SECTIONYES NO N/A COMMENTS 4. Development of a written plan to No licensed medical personnel areon staff. No monitor the inmate's medical condition medications are given. following the initial involuntary administration of a medication, until the inmate is cleared as a result of an evaluation by, or consultation with, a psychiatrist; X 5. Development of a written plan to provide Addressed in section 900.3.1 of the Department a minimum level of ongoing monitoring Policy Manual of the inmate following return to facility housing. This monitoring may be performed by custody staff trained to recognize signs of possible medical problems and alert medical staff when indicated; and X 6. Documentation of the administration of X involuntary medication in the inmate's medical record. 8 ARTICLE/SECTIONYES NO N/A COMMENTS 1212 Vermin Control Addressed in section 902.15 of the Department (Not applicable to CH) Policy Manual The responsible physician shall develop a written X plan for the control and treatment of vermin- infested inmates. There shall be written, medical protocols, signed by the responsible physician, for the treatment of persons suspected of being infested or having contact with a vermin-infested inmate. 1213 Detoxification Treatment Detoxification is not available in this facility. (Not applicable to CH) Addressed in section 902.3.1 of the Department Policy Manual The responsible physician shall develop written medical policies on detoxification which shall include X a statement as to whether detoxification will be provided within the facility or require transfer to a licensed medical facility. The facility detoxification protocol shall include procedures and symptoms necessitating immediate transfer to a hospital or other medical facility. Facilities without medically licensed personnel in Addressed in section 902.3.1 of the Department attendance shall not retain inmates undergoing Policy Manual withdrawal reactions judged or defined in policy, by X the responsible physician, as not being readily controllable with available medical treatment. Such facilities shall arrange for immediate transfer to an appropriate medical facility. 1220 First Aid Kits Addressed in section 900.5.3 of the Department X Policy Manual First aid kit(s) shall be available in all facilities. The responsible physician shall approve the Deficiency: Policy is not in place with location and contents, number, location and procedure for approved inventory list of contents of first aid kits. periodic inspection of the kit(s). In Court and Also, Policy is not in place for consistent inspection of kits for currency and completeness Temporary Holding facilities, the facility administrator shall have the above approval Corrective Action: update policy manual to include X authority, pursuant to Section 1200 of these inventory list of first aid kits, locations, and regulations. inspection procedure. 9 ARTICLE/SECTIONYES NO N/A COMMENTS 1046 Death in Custody Addressed in section 900.9 of the Department Policy (a) Death in Custody Reviews for Adults and Manual Minors. The facility administrator, in cooperation with the health administrator, shall develop written policy and procedures to ensure that there is X an initial review of every in-custody death within 30 days. The review team shall include the facility administrator and/or the facility manager, the health administrator, the responsible physician and other health care and supervision staff who are relevant to the incident. Deaths shall be reviewed to determine the No in custody deaths occurred during the inspection appropriateness of clinical care; whether period X changes to policies, procedures, or practices are warranted; and to identify issues that require further study. (b) Death of a Minor. In any case in which a minor dies while X detained in a jail, lockup, or court holding facility: (1) The administrator of the facility shall No in custody deaths of a minor occurred during the provide to the Board a copy of the report inspection period submitted to the Attorney General under X Government Code Section 12525. A copy of the report shall be submitted within 10 calendar days after the death. (2) Upon receipt of a report of death of a minor from the administrator, the Board may within 30 calendar days inspect and evaluate the jail, lockup, or court holding X facility pursuant to the provisions of this subchapter. Any inquiry made by the Board shall be limited to the standards and requirements set forth in these regulations. 1051 Communicable Diseases Addressed in section 902.11.1 of the Department The facility administrator, in cooperation with the Policy Manual responsible physician, shall develop written policies X and procedures specifying those symptoms that require segregation of an inmate until a medical evaluation is completed. At the time of intake into the facility, an inquiry shall be made of the person being booked as to whether or not he/she has or has had any communicable X diseases, such as tuberculosis or has observable symptoms of tuberculosis or any other communicable diseases, or other special medical problem identified by the health authority. The response shall be noted on the booking form X and/or screening device. 10 ARTICLE/SECTIONYES NO N/A COMMENTS 1052 Mentally Disordered Inmates Addressed in section 902.11.1 of the Department The facility administrator, in cooperation with the Policy Manual responsible physician, shall develop written policies and procedures to identify and evaluate all mentally disordered inmates, and may include telehealth. If an X evaluation from medical or mental health staff is not readily available, an inmate shall be considered mentally disordered for the purpose of this section if he or she appears to be a danger to himself/herself or others or if he/she appears gravely disabled. An evaluation from medical or mental health staff Inmates requiring mental health are transferred to shall be secured within 24 hours of identification or the county jail or local medical facilities. No mental X at the next daily sick call, whichever is earliest. health care or treatment is provided in this facility Segregation may be used if necessary to protect the safety of the inmate or others. 1055 Use of Safety Cell Safety cell is not available in this facility. Inmates The safety cell described in Title 24, Part 2, Section requiring Safety cell are transferred 1231.2.5, shall be used to hold only those inmates X who display behavior which results in the destruction of property or reveals an intent to cause physical harm to self or others The facility administrator, in cooperation with the responsible physician, shall develop written policies X and procedures governing safety cell use and may delegate authority to place an inmate in a safety cell to a physician. In no case shall the safety cell be used for X punishment or as a substitute for treatment. An inmate shall be placed in a safety cell only with the approval of the facility manager or designee, or X responsible health care staff; continued retention shall be reviewed a minimum of every four hours. A medical assessment shall be completed within a maximum of 12 hours of placement in the safety cell or at the next daily sick call, whichever is earliest. X The inmate shall be medically cleared for continued retention every 24 hours thereafter. The facility manager, designee or responsible health care staff shall obtain a mental health X opinion/consultation with responsible health care staff on placement and retention, which shall be secured within 12 hours of placement. Direct visual observation shallbe conducted at least X twice every thirty minutes. Such observation shall be documented. 11 ARTICLE/SECTIONYES NO N/A COMMENTS Procedures shall be established to assure administration of necessary nutrition and fluids. Inmates shall be allowed to retain sufficient clothing, or be provided with a suitably designed “safety X garment,” to provide for their personal privacy unless specific identifiable risks to the inmate's safety or to the security of the facility are documented. 1056 Use of Sobering Cell Sobering cell is not available in the facility. The sobering cell described in Title 24, Part 2, Intoxicated detainees are transferred to local Section 1231.2.4, shall be used for the holding of medical facilities for treatment. inmates who are a threat to their own safety or the safety of others due to their state of intoxication and pursuant to written policies and procedures developed by the facility administrator. Such inmates shall be removed from the sobering cell as X they are able to continue in the processing. In no case shall an inmate remain in a sobering cell over six hours without an evaluation by a medical staff person or an evaluation by custody staff, pursuant to written medical procedures in accordance with section 1213 of these regulations, to determine whether the prisoner has an urgent medical problem. At 12 hours from the time of placement, all inmates will receive an evaluation by responsible health care staff. Intermittent direct visual observation of X inmates held in the sobering cell shall be conducted no less than every half hour. Such observation shall be documented. 1057 Developmentally Disabled Inmates Addressed in section 902.11.1 of the Department The facility administrator, in cooperation with the Policy Manual responsible physician, shall develop written policies X and procedures for the identification and evaluation, appropriate classification and housing, protection, and nondiscrimination of all developmentally disabled inmates. The health authority or designee shall contact the Developmentally disabled detainees are transferred regional center on any inmate suspected or confirmed to the county jail or local medical facilities as X to be developmentally disabled for the purposes of deemed appropriate diagnosis and/or treatment within 24 hours of such determination, excluding holidays and weekends. 1058 Use of Restraint Devices Addressed in section 900.6 of the Department Policy Manual The facility administrator, in cooperation with the X responsible physician, shall develop written policies and procedures for the use of restraint devices and may delegate authority to place an inmate in restraints to a responsible health care staff. 12 ARTICLE/SECTIONYES NO N/A COMMENTS In addition to the areas specifically outlined in this regulation, at a minimum, the policy shall address the Addressed in section 306.3 of the Department Policy following areas: Manual acceptable restraint devices; signsor symptoms which should result in immediate medical/mental health referral; availability of cardiopulmonary resuscitation equipment; protective housing of restrained persons; X provision for hydration and sanitation needs; and exercising of extremities. In no case shall restraints be used for punishment or Addressed in section 306.2 of the Department Policy X as a substitute for treatment. Manual Restraint devices shall only be used on inmates who Addressed in section 306.3 of the Department Policy display behavior which results in the destruction of Manual property or reveal an intent to cause physical harm to X self or others. Restraint devices include any devices which immobilize an inmate's extremities and/or prevent the inmate from being ambulatory. Physical restraints should be utilized only when it appears less restrictive alternatives would be X ineffective in controlling the disordered behavior. Inmates shall be placed in restraints only with the approval of the facility manager, the facility watch commander, responsible health care staff; X continued retention shall be reviewed a minimum of every hour. A medical opinion on placement and retention shall Licensed personnel are not on staff. Detainees be secured within one hour from the time of requiring longer than short term restraints are X placement. A medical assessment shall be transferred completed within four hours of placement. If the facility manager, or designee, in consultation with responsible health care staff determines that an inmate cannot be safely removed from restraints X after eight hours, the inmate shall be taken to a medical facility for further evaluation. Direct visual observation shall be conducted at least twice every thirty minutes to ensure that the X restraints are properly employed, and to ensure the safety and well-being of the inmate. Such observation shall be documented. 13 ARTICLE/SECTIONYES NO N/A COMMENTS While in restraint devices all inmates shall be housed alone or in a specified housing area for restrained X inmates which makes provisions to protect the inmate from abuse. The provisions of this section do not apply to the use of handcuffs, shackles or other restraint devices X when used to restrain inmates for security reasons. 1058.5 RESTRAINTS AND PREGNANT INMATES Addressed in section 306.3.2 of the Department Policy Manual The facility administrator, in cooperation with the responsible physician, shall develop written policies X and procedures for the use of restraint devices on pregnant inmates. In accordance with Penal Code 3407 the policy shall include reference to the following: (1) An inmate known to be pregnant or in recovery after delivery shall not be X restrained by the use of leg irons, waist chains, or handcuffs behind the body. (2) A pregnant inmate in labor, during delivery, or in recovery after delivery, shall not be restrained by the wrists, X ankles, or both, unless deemed necessary for the safety and security of the inmate, the staff, or the public. (3) Restraints shall be removed when a Pregnant inmates requiring medical care or professional who is currently responsible treatment are transferred to local medical facilities for the medical care of a pregnant inmate and not retained with in the Holding facilities. X during a medical emergency, labor, delivery, or recovery after delivery determines that the removal of restraints is medically necessary. (4) Upon confirmation of an inmate's pregnancy, she shall be advised, orally or X in writing, of the standards and policies governing pregnant inmates. Itemized Summary III. Medical/Mental Health Evaluation Paradise Police Department Page 9 Deficiency: Policy is not in place with location and approved inventory list of contents of first aid kits. Also, Policy is not in place for consistent inspection of kits for currency and completeness Corrective Action: update policy manual to include inventory list of first aid kits, locations, and inspection procedure. Staff were cooperative and collaborative in completion of the inspection. Generally, the facility meets the inspection requirements. Facility does have an Automatic External Defibrillator (AED) in hallway nearby holding facility cells with an inspection checklist. Best Practice: Best practice would be to include Narcan with emergency medical supplies. The location should be central in the Department facility to be available to all parts of the building and defined in the policy manual 14 ADULT TYPE I, II, III and IV FACILITIES Local Detention Facility Health Inspection Report Health and Safety Code Section 101045 BSCC #: ___________ FACILITY NAME:COUNTY: Butte County Jail Butte FACILITY ADDRESS (STREET, CITY, ZIP CODE, TELEPHONE): 33 County Center Dr. Oroville, CA 95965 (530) 538-7471 TYPE I: TYPE II: TYPE III: XTYPE IV: CHECK THE FACILITY TYPE AS DEFINED IN TITLE 15, SECTION 1006: ENVIRONMENTAL HEALTH EVALUATION DATE INSPECTED: 02/08/2022 ENVIRONMENTAL HEALTH EVALUATORS (NAME, TITLE, TELEPHONE): Alana Kong, Registered Environmental Health Specialist II, (530) 552-3998 Leslie Roberts, Senior Registered Environmental Health Specialist, (530) 552-3872 FACILITY STAFF INTERVIEWED (NAME, TITLE, TELEPHONE): Douglas Brownfield, Compliance Sergeant, (530) 588-7940 NUTRITIONAL EVALUATIONDATE INSPECTED: 02/08/2022 NUTRITIONAL EVALUATORS (NAME, TITLE, TELEPHONE): Amber McPherson, Registered Dietitian, Public Health Program Manager, (530) 552-3917 FACILITY STAFF INTERVIEWED (NAME, TITLE, TELEPHONE): Jarod Agurkis, Kitchen Operation Gwendalen Ramirez, Food Services Director, Trinity Services Group MEDICAL/MENTAL HEALTH EVALUATION DATE INSPECTED: 02/08/2022 MEDICAL/MENTAL HEALTH EVALUATORS (NAME, TITLE, TELEPHONE): Monica Soderstrom, Division Director, Public Health, (530) 552-3930 David Canton, Public Health Officer, (530) 552-3993 FACILITY STAFF INTERVIEWED (NAME, TITLE, TELEPHONE): Tarah Foster, Health Services Administrator, (530)538-6863 This checklist is to be completed pursuant to the attached instructions. 1 I. ENVIRONMENTAL HEALTH EVALUATION Adult Type I, II, III and IV Facilities ARTICLE/SECTION YESNO N/A COMMENTS Article 12. Food Approach for Providing Food Service Food served in the facility is prepared in the x facility. If "No," respond to items 1 and 2 below prior to continuing with the checklist. 1. Food is prepared at another city or county detention facility. 2. Food is contracted through a private vendor who had been inspected and complies with provisions of CalCode. 1230 Food Handlers 903.4 The responsible physician, in cooperation with the food services manager and the facility x administrator, shall develop written procedures for medical screening of inmate food service workers prior to working in the facility kitchen. There shall be written procedures for education 901.3, 903.5 and ongoing monitoring and cleanliness of these workers in accordance with standards set forth in x Health and Safety Code, California Retail Food Code. 2 ARTICLE/SECTION YESNO N/A COMMENTS 1243 Food Service Plan Chapter 9, s. 900, 901, 902, 903, 904, 905, 906, Facilities shall have a written food service plan that 907 and 908. shall comply with the applicable California Retail Food Code. In facilities with an average daily population of 100 or more, there shall be employed or available, a trained experienced food services manager to prepare and implement a food service plan. In facilities of less than an average daily population of 100 that do not employ or have a food services manager available, the facility administrator shall prepare a food service plan. The plan shall include, but not limited to, the following policies and procedures: (a) menu planning; (b) purchasing; x (c) storage and inventory control; (d) food preparation; (e) food serving; (f) transporting food; (g) orientation and ongoing training; (h) personnel supervision; (i) budgets and food cost accounting; (j) documentation and record keeping; (k) emergency feeding plan; (l) waste management; (m) maintenance and repair; and (n) three-day mainline sample tray. 3 ARTICLE/SECTION YESNO N/A COMMENTS 1245 Kitchen Facilities, Sanitation and Food Deficiency: Cold holding of dressings in staff salad Service bar at 46 degrees F. (a) Kitchen facilities, sanitation, and food Corrective Action: Maintain potentially hazardous preparation, service, and storage shall comply food at or below 41 degrees F. with standards set forth in Health and Safety Code, Division 104, Part 7, Chapters 1-13, Deficiency: Basins of mixed ingredients in walk-in Sections 113700 et seq. California Retail Food refrigerator to cool observed at 44 degrees F after Code. 24 hours. Corrective Action: Mixed ingredients must cool to 41 degrees F or colder in 4 hours. When cooling foods maintain food depths at 2 – 3 inches to cool quickly. Deficiency: Not all utensils stored in clean drawer or protected from possible contamination. x Corrective Action: Clean drawers or storage areas to be use for utensil storage. Deficiency: Colanders and bowls in one area stored unprotected from contamination. Corrective Action: Store all bowls, etc bottom side up to prevent contamination of food contact surfaces. Deficiency: One area of floor cove and wall under utensil washing sink broken/damaged. Corrective Action: Repair floor cove and wall damaged in utensil washing area. (b)In facilities where inmates prepare meals for At this time no guidance has been received to self-consumption or where frozen meals or pre- waive any sections of California Retail Food Code prepared food from other permitted food in this facility. x facilities (see Health and Safety Code Section 114381) are (re)heated and served, the following applicable California Retail Food Code standards may be waived by the local health officer: 1) HSC §114130-114141. 2) H & S Sections 114099.6, 114095- Deficiency: Dish machine high temperature rinse 114099.5, 114101-114109, 114123, and not 160 degrees F at dish. 114125, if a domestic or commercial dishwasher capable of providing heat to the Corrective Mitigation: Contact Technician ad surface of the utensils of a temperature of schedule service/repair. Until repair, mitigation to x at least 165 degrees Fahrenheit, is used for wash, utensils in dish machine and use chemical the purpose of cleaning and sanitizing sanitizer solution in 3 compartment sink to multi-service utensils and multi-service complete sanitizer cycle. consumer utensils; 4 ARTICLE/SECTION YESNO N/A COMMENTS 3) H & S Sections 114149-114149.3 except that, regardless of such a waiver, the facility shall provide mechanical ventilation sufficient to remove gases, odors, steam, heat, grease, vapors and smoke from the kitchen; 4)HSC § 114268-114269; and, 5) HSC § 114279-114282 1246 Food Serving and Supervision 903.6 Policies and procedures shall be developed and implemented to ensure that appropriate work x assignments are made and food handlers are adequately supervised. Food shall be prepared and served only under the immediate supervision of a staff member. Article 13. Inmate Clothing and Personal Hygiene 1260 Standard Institutional Clothing The standard issue of climatically suitable clothing x to inmates held after arraignment in all but Court Holding, Temporary Holding and Type IV facilities shall include, but not be limited to: (a) Clean socks and footwear; x (b)Clean outergarments; and, x (c) Clean undergarments; x 1) for males - shorts and undershirt, and 2) for females -bra and two pairs of panties. The inmates' personal undergarments and footwear may be substituted for the institutional undergarments and footwear specified in this x regulation. This option notwithstanding, the facility has the primary responsibility to provide the personal undergarments and footwear. Clothing is reasonably fitted, durable, easily x laundered and repaired. 1261 Special Clothing Provision shall be made to issue suitable additional clothing, essential for inmates to perform such x special work assignments as food service, medical, farm, sanitation, mechanical, and other specified work. 5 ARTICLE/SECTION YESNO N/A COMMENTS 1262 Clothing Exchange 807.4.2 There shall be written policies and procedures x developed by the facility administrator for the scheduled exchange of clothing. Unless work, climatic conditions, illness, or California Retail Food Code necessitates more frequent exchange, outergarments, except x footwear, shall be exchanged at least once each week. Undergarments and socks shall be exchanged twice x each week. 1263 Clothing Supply There shall be a quantity of clothing, bedding, and x linen available for actual and replacement needs of the inmate population. Written policy and procedures shall specify x handling of laundry that is known or suspected to be contaminated with infectious material. 805.4 1264 Control of Vermin in Inmates’ Personal Clothing There shall be written policies and procedures x developed by the facility administrator to control the contamination and/or spread of vermin in all inmates' personal clothing. Infested clothing shall be cleaned, disinfected, or x stored in a closed container so as to eradicate or stop the spread of the vermin. 1265 Issue of Personal Care Items 807.7 There shall be written policies and procedures x developed by the facility administrator for the issue of personal hygiene items. Each female inmate shall be provided with sanitary x napkins, panty liners, and tampons as requested. Each inmate to be held over 24 hours who is unable to supply himself/herself with the following x personal care items, because of either indigency or the absence of an inmate canteen, shall be issued: (a)Toothbrush, x (b) Dentifrice, x x (c) Soap, 6 ARTICLE/SECTION YESNO N/A COMMENTS x (d) Comb, and (e)Shaving implements.x Inmates shall not be required to share any personal x care items listed in items “a” through “d.” Inmates will not share disposable razors. Double edged safety razors, electric razors, and other shaving instruments capable of breaking the skin, when shared among inmates, must be disinfected x between individual uses by the method prescribed by the State Board of Barbering and Cosmetology in Sections 979 and 980, Division 9, Title 16, California Code of Regulations. 1266 Showering 807.10 There shall be written policies and procedures x developed by the facility administrator for inmate showering/bathing. Inmates shall be permitted to shower/bathe upon x assignment to a housing unit and at least every other day or more often if possible. 1267 Hair Care Services x (a)Hair care services shall be available. (b) Inmates, except those who may not shave for reasons of identification in court, shall be allowed to shave daily and receive hair care x services at least once a month. The facility administrator may suspend this requirement in relation to inmates who are considered to be a danger to themselves or others. (c) Equipment shall be disinfected, after each use, by a method approved by the State Board of Barbering and Cosmetology to x meet the requirements of Title 16, Division 9, Sections 979 and 980, California Code of Regulations. Article 14. Bedding and Linens 1270 Standard Bedding and Linen Issue The standard issue of clean suitable bedding and x linens, for each inmate entering a living area who is expected to remain overnight, shall include, but not be limited to: (a)one serviceable mattress which meets the x requirements of Section 1272 of these regulations; (b) one mattress cover or one sheet;x 7 ARTICLE/SECTION YESNO N/A COMMENTS x 2 upon intake (c) one towel; and, (d) one blanket or more depending upon climatic conditions. x Two blankets or sleep bag may be issued in place of one mattress cover or one sheet. 1271 Bedding and Linen Exchange 807.4.1 There shall be written policies and procedures x developed by the facility administrator for the scheduled exchange of laundered and/or sanitized bedding and linen issued to each inmate housed. Washable items such as sheets, mattress covers, and towels shall be exchanged for clean x replacement at least once each week. If a top sheet is not issued, blankets or sleep bags shall be laundered or dry cleaned at least once a x month or more often if necessary. If a top sheet is issued, blankets shall be laundered or dry cleaned at least every three months. 1272 Mattresses Any mattress issued to an inmate in any facility shall be enclosed in an easily cleaned, non- x absorbent ticking, and conform to the size of the bunk as referenced in Title 24, Part 2, Section 1231.3.5, Beds. Any mattress purchased for issue to an inmate in a facility which is locked to prevent unimpeded access to the outdoors shall be certified by the x manufacturer as meeting all requirements of the State Fire Marshal and the Bureau of Home Furnishings' test standard for penal mattresses at the time of purchase. Article 15. Facility Sanitation and Safety 1280 Facility Sanitation, Safety and Maintenance 208, 807.9, 807.10 The facility administrator shall develop written Inmates clean their own cells when needed under x policies and procedures for the maintenance of an supervision. Cells may be cleaned when inmates acceptable level of cleanliness, repair and safety are not in their cell, for example at court, when throughout the facility. needed. 8 ARTICLE/SECTION YESNO N/A COMMENTS Such a plan shall provide for a regular schedule of Deficiency- In South dorm the light fixture in the housekeeping tasks and inspections to identify and bathroom is broken correct unsanitary or unsafe conditions or work Corrective action- repair practices which may be found. Deficiency- cell K hand wash sink has a leaky pipe Corrective action- repair Deficiency- cells 4 and 62 have low water pressure Corrective action – Increase water pressure so inmates can adequately wash their hands x Deficiency – cells 86 and 54 have no hot water Corrective action – provide hot water Deficiency – cell H sink is not working Corrective action – repair Deficiency – cell 66 toilet is leaking Corrective action – repair Deficiency- cell M has lights that are out Corrective action – repair Medical care housing as described in Title 24, Part 2, Section 1231.2.14, shall be cleaned and sanitized x according to policies and procedures established by the health authority. 9 Itemized Summary I. Environmental Health Evaluation Butte County Jail Page 4 Deficiency- Cold holding of dressings in staff salad bar at 46 degrees F. Corrective Action: Maintain potentially hazardous food at or below 41 degrees F. Deficiency-Basins of mixed ingredients in walk-in refrigerator to cool observed at 44 degrees F after 24 hours. Corrective Action - Mixed ingredients must cool to 41 degrees F or colder in 4 hours. When cooling foods maintain food depths at 2 – 3 inches to cool quickly. Deficiency-Not all utensils stored in clean drawer or protected from possible contamination. Corrective Action-Clean drawers or storage areas to be use for utensil storage. Deficiency - Colanders and bowls in one area stored unprotected from contamination. Corrective Action - Store all bowls, etc bottom side up to prevent contamination of food contact surfaces. Deficiency - One area of floor cove and wall under utensil washing sink broken/damaged. Corrective Action - Repair floor cove and wall damaged in utensil washing area. Deficiency - Dish machine high temperature rinse not 160 degrees F at dish. Corrective Mitigation - Contact Technician ad schedule service/repair. Until repair, mitigation to wash, utensils in dish machine and use chemical sanitizer solution in 3 compartment sink to complete sanitizer cycle. Page 9 Deficiency- In South dorm the light fixture in the bathroom is broken Corrective action- repair Deficiency- cell K hand wash sink has a leaky pipe Corrective action- repair Deficiency- cells 4 and 62 have low water pressure Corrective action – Increase water pressure so inmates can adequately wash their hands Deficiency–cells 86 and 54 have no hot water Corrective action–provide hot water Deficiency –cell H sink is not working Corrective action–repair Deficiency – cell 66 toilet is leaking Corrective action – repair Deficiency- cell M has lights that are out Corrective action – repair There are deficiencies with plumbing fixtures and lighting within the facility that need to be addressed. Summary of environmental health inspection of food facility: There are deficiencies with food cold holding temperatures, cooling ingredients, adequate sanitation of utensils using hot water rinse, some utensil storage and one area of kitchen floor and floor cove damage that need to be addressed. 10 II. NUTRITIONAL HEALTH EVALUATION Adult Type I, II, III and IV Facilities ARTICLE/SECTIONYES NO N/A COMMENTS Article 12. Food 1230 Food Handlers The Environmental Health Inspector retains primary responsibility to determine compliance with Section 1230. Compliance should be assessed (Note: Title 15, § 1230 is in Article 11, MMH, but in consultation with the Nutrition Inspector so that inspected under Environmental Health due to the findings on the Environmental Health CalCode reference.) Evaluation reflect the observations, expertise and Do not identify consensus of both parties. The text of the compliance with this regulation is provided here for reference only. regulation here. The responsible physician, in cooperation with the food services manager and the facility administrator, See comments. shall develop written procedures for medical screening of inmate food service workers prior to working in the facility kitchen. There shall be written procedures for education and ongoing monitoring and cleanliness of these workers in accordance with standards set forth in Health and Safety Code, California Retail Food Code. 1240 Frequency of Serving In Temporary Holding, Type I, II, and III facilities, and X those Type IV facilities where food is served, food shall be served three times in any 24-hour period. At least one of these meals shall include hot food. X Supplemental food must be served to inmates if X more than 14 hours pass between meals. Supplemental food must be served to inmates on X medical diets in less than a 14-hour period if prescribed by the responsible physician. A minimum of fifteen minutes shall be allowed for the actual consumption of each meal except for X those inmates on medical diets where the responsible physician has prescribed additional time. Provisions shall be made for inmates who may miss a regularly scheduled facility meal. X They shall be provided with a substitute meal and beverage, and inmates on medical diets shall be provided with their prescribed meal. 11 ARTICLE/SECTIONYES NO N/A COMMENTS 1241 Minimum Diet The minimum diet provided shall be based upon the Menus and diets meet the minimum standards for nutritional and caloric requirements found in the local detention facilities. 2011 Dietary Reference Intakes (DRI) of the Food 3000 calories per day. and Nutrition Board, Institute of Medicine of the X National Academies, the 2008 California Food Guide, Menus analyzed by Registered Dietitian using and the 2015-2020 Dietary Guidelines for NetNutrition application from CBORD Americans. Facilities providing religious, vegetarian or medical diets, shall also conform to these nutrition standards. The nutritional requirements for the minimum diet are specified in the following subsections. A daily or > 42 grams protein per day. weekly average of the food group's requirement is acceptable. A wide variety of food should be served. 4-week daily summary. (a) Protein Group. Includes beef, veal, lamb, Pinto beans served 3 days per week. pork, poultry, fish, eggs, cooked dry beans, X peas, lentils, nuts, peanut butter and textured vegetable protein (TVP). One serving equals 14 grams or more of protein; the daily requirements shall be equal to three servings (a total of 42 grams per day or 294 grams per week). In addition, there shall be a requirement to serve a fourth serving from the legumes three days a week. (b) Dairy Group. Includes milk (fluid, evaporated or dry; nonfat, 1% or 2% reduced fat, etc.); 1% Milk served qd @ breakfast. cheese (cottage, cheddar, etc.); yogurt; ice cream or ice milk; and pudding. A serving is Beverage Calcium PC served at lunch and dinner. equivalent to 8 oz. of fluid milk and provides at least 250 mg. of calcium. All milk shall be Sliced cheese served one x qd. X pasteurized and fortified with Vitamins A and D. The daily requirement is three servings. One serving can be from a fortified food containing at least 150 mg. of calcium. For persons 15-17 years of age, or pregnant and lactating women, the requirement is four servings of milk or milk products. (c)Vegetable-Fruit Group. Includes fresh, frozen, dried and canned vegetables and fruits. One Fruit served q breakfast serving equals: 1/2 cup vegetable or fruit; 6 ounces of 100% juice; 1 medium apple, X > 1 serving vegetable served at lunch orange, banana, or potato; 1/2 grapefruit; or 1/4 cup dried fruit. The daily requirement of Fruit or vegetable serving served at dinner fruits and vegetables shall be five servings. At least one serving shall be from each of the following three categories: (1) One serving of a fresh fruit or vegetable X per day, or seven (7) servings per week. (2) One serving of a Vitamin C source X containing 30 mg. or more per day or seven (7) servings per week. 12 ARTICLE/SECTIONYES NO N/A COMMENTS (3) One serving of a Vitamin A source, fruit Carrots served daily. Recommend adding other or vegetable, containing 200 micrograms Vitamin A rich sources like cantaloupe, sweet X Retinol Equivalents (RE) or more per day, potatoes, winter squash, apricots, spinach, kale or or seven servings per week. collard greens (d) Grain Group. Includes bread, rolls, pancakes, sweet rolls, ready-to-eat cereals, cooked cereals, corn bread, pasta, rice, tortillas, etc. and any food item containing whole or Wheat bread served at breakfast and dinner (2 enriched grains. At least three servings from slices at breakfast, 4 slices at dinner. 2 servings at this group must be made with whole grains. lunch (cornbread or tortillas) The daily requirements shall be a minimum of six servings. Providing only the minimum servings outlined in this regulation is not X sufficient to meet the inmates' caloric requirements. Additional servings from the dairy, vegetable-fruit, and bread-cereal groups must be provided in amounts to meet caloric requirements. Saturated dietary fat should not exceed 10 percent of total calories on a weekly basis. Fat shall be added only in minimum amounts necessary to make the diet palatable. Facility diets shall consider the recommendations and intentions of the 2015-2020 Dietary Guidelines X of Americans of reducing overall sugar and sodium levels 1242 Menus 4-week rotating menus planned in advance and approved by Registered Dietitian Menus in Type II and III facilities, and those Type IV facilities where food is served, shall be planned at least one month in advance of their use. Menus shall X be planned to provide a variety of foods, thus preventing repetitive meals. Menus shall be approved by a registered dietitian before being used. If any meal served varies from the planned menu, Email Dietitian when substitutions need to be the change shall be noted in writing on the menu X made and/or production sheet. Menus, as planned, including changes, shall be X evaluated by a registered dietitian at least annually. 13 ARTICLE/SECTIONYES NO N/A COMMENTS 1243 Food Service Plan Foodservice plan by Trinity Services Group. Facilities shall have a written food service plan that shall comply with the applicable California Retail Food Code. In facilities with an average daily population of 100 or more, there shall be employed or available, a trained experienced food services X manager to prepare and implement a food service plan. In facilities of less than an average daily population of 100 that do not employ or have a food services manager available, the facility administrator shall prepare a food service plan. The plan shall include, but not limited to, the following policies and procedures: (a) menu planning; X X (b) purchasing; (c) storage and inventory control;X (d) food preparation;X X (e)food serving; (f) transporting food;X X (g) orientation and ongoing training; (h) personnel supervision; X (i)budgets and food cost accounting; X X (j)documentation and record keeping; (k)emergency feeding plan; X (l)waste management; X X (m) maintenance and repair; and, (n) three-day mainline sample tray. X 1245 Kitchen Facilities, Sanitation and Food Service a) Kitchen facilities, sanitation, and food preparation, service, and storage shall comply with standards set forth in Health and Safety Code, Division 104, Part 7, Chapters 1-13, Sections 113700 et seq. California Retail Food Code. 14 ARTICLE/SECTIONYES NO N/A COMMENTS b)In facilities where inmates prepare meals for self-consumption or where frozen meals or pre-prepared food from other permitted food facilities (see Health and Safety Code Section 114381) are (re)heated and served, the following applicable California Retail Food Code standards may be waived by the local health officer: (1) H & S Sections 114130-114141; (2) H & S Sections 114099.6, 114095- 114099.5, 114101-114109, 114123, and 114125, if a domestic or commercial dishwasher capable of providing heat to the surface of the utensils of a temperature of at least 165 degrees Fahrenheit, is used for the purpose of cleaning and sanitizing multi-service utensils and multi-serviceconsumer utensils; (3) H & S Sections 114149-114149.3 except that, regardless of such a waiver, the facility shall provide mechanical ventilation sufficient to remove gases, odors, steam, heat, grease, vapors and smoke from the kitchen; (4) H & S Sections 114268-114269; and, (5) H & S Sections 114279-114282. 1246 Food Serving and Supervision Policies and procedures shall be developed and Foodservice supervisor staffed 5 days/week implemented to ensure that appropriate work assignments are made and food handlers are adequately supervised. Food shall be prepared and served only under the immediate supervision of a staff member. 15 ARTICLE/SECTIONYES NO N/A COMMENTS 1247 Disciplinary Separation Diet (a)A disciplinary separation diet which is nutritionally balanced may be served to an inmate. No inmate receiving a prescribed medical diet is to be placed on a disciplinary separation diet without review by the responsible physician or pursuant to a written plan approved by the physician. Such a diet shall be served twice in each 24 hour period and shall consist of one-half of the loaf (or a minimum of 19 oz. cooked loaf) described in the regulation, or other equally X nutritious diet, along with two slices of whole wheat bread and at least one quart of drinking water if the cell does not have a water supply. The use of disciplinary separation diet shall constitute an exception to the three-meal-a- day standard. Should a facility administrator wish to provide an alternate disciplinary diet, such a diet shall be submitted to the Board for approval. 16 ARTICLE/SECTIONYES NO N/A COMMENTS (b) The disciplinary diet loaf shall consist of the following: 2-1/2 oz. nonfat dry milk 4-1/2 oz. raw grated potato 3 oz. raw carrots, chopped or grated fine 1-1/2 oz. tomato juice or puree 4-1/2 oz. raw cabbage, chopped fine 7 oz. lean ground beef, turkey or rehydrated, canned, or frozen Textured Vegetable Protein (TVP) X 2-1/2 fl. oz. oil 1-1/2 oz. whole wheat flour 1/4 tsp. salt 4 tsp. raw onion, chopped 1 egg 6 oz. dry red beans, pre-cooked before baking (or 16 oz. canned or cooked red kidney beans) 4 tsp. chili powder 1248 Medical Diets The responsible physician, in consultation with the Physician orders for medical diets facility administrator, shall develop written policies X and procedures that identify the individual(s) who are authorized to prescribe a medical diet. The medicaldiets utilized by a facility shall be planned, prepared and served with consultation X Medical diets preplanned and approved by from a registered dietitian. Registered Dietitian The facility manager shall comply with any medical X diet prescribed for an inmate. The facility manager and responsible physician shall ensure that the medical diet manual, which includes X sample menus of medical diets, shall be available in both the medical unit and the food service office for reference and information. 17 ARTICLE/SECTIONYES NO N/A COMMENTS A registered dietitian shall review, and the Deficiency: No signature of responsible physician responsible physician shall approve, the diet manual on diet manual. on an annual basis. X Corrective Action: Responsible physician shall approve diet manual and will provide approval annually. Pregnant women shall be provided a balanced, X nutritious diet approved by a doctor. . Itemized Summary II. Nutritional Health Evaluation Butte County Jail Page 13 Carrots served daily. Recommend adding other Vitamin A rich sources like cantaloupe, sweet potatoes, winter squash, apricots, and spinach, kale or collard greens Page 18 Deficiency: No signature of responsible physician on diet manual. Corrective Action: Responsible physician shall approve diet manual and will provide approval annually. Frequency of serving and minimum diet meet the requirements based upon the nutritional and caloric requirements found in the 2011 Dietary Reference Intakes (DRI) of the Food and Nutrition Board, Institute of Medicine of the National Academies, the 2008 California Food Guide, and the 2015-2020 Dietary Guidelines for Americans. Menus are planned in advance, approved by a Registered Dietitian and provide a variety of foods. Foodservice plan provided by Trinity Services Group and complies with the applicable California Retail Food Code. A deficiency was found in the approval of the diet manual by the responsible physician. No other deficiencies were found. 18 III. MEDICAL/MENTAL HEALTH EVALUATION Adult Type I, II, III and IV Facilities ARTICLE/SECTION YESNO N/ACOMMENTS Article 11. Health Services 1200 Responsibility for Health Care Services Addressed in Wellpath Policy HCD-110_A-02 In Type I, II, III and IV facilities, the facility x Responsible Health Authority administrator shall have the responsibility to ensure provision of emergency and basic health care services to all inmates. Medical, dental, and mental health matters involving Addressed in Wellpath Policy HCD-110_A-03 clinical judgments are the sole province of the x Medical Autonomy responsible physician, dentist, and psychiatrist or psychologist respectively. Security regulations applicable to facility personnel Addressed in Wellpath Policy HCD-110_B-09. x also apply to health personnel. Staff meeting annually on this topic. Each facility shall have at least one physician Monthly schedule and calendar of physician x available to treat physical disorders. coverage shared with inspectors In Type IV facilities, compliance may be attained by Although this is not a Type IV facility, Wellpath providing access into the community; however, in policies related to this need were shared: such cases, there shall be a written plan for the x treatment, transfer, or referral in the event of an Wellpath E-09 (Continuing, coordination and quality emergency. of care) and D-08 (Hospitals and specialty care) In court holding and temporary holding facilities, the facility administrator shall have the responsibility to x develop written policies and procedures which ensure provision of emergency health care services to all inmates. 1202 Health Service Audits Addressed in Wellpath Policy HCD-110_A-06 The health authority shall develop and implement a Continuous Quality Improvement (CQI) x written plan for annual statistical summaries of health care and pharmaceutical services that are provided. CQI Committee meets quarterly The responsible physician shall also establish a x mechanism to assure that the quality and adequacy of these services are assessed annually. The plan shall include a means for the correction of x identified deficiencies of the health care and pharmaceutical services delivered. Based on information from these audits, the health CQI Committee quarterly meetings: review monthly authority shall provide the facility administrator with x stats and provide annual report an annual written report on health care and pharmaceutical services delivered. 19 ARTICLE/SECTION YESNO N/ACOMMENTS 1203 Health Care Staff Qualifications Addressed in Wellpath policy HCD 110_C-01 Credentials State and/or local licensure and/or certification requirements and restrictions, including those x defining the recognized scope of practice specific to the profession, apply to health care personnel Inspectors were shown a spread sheet used for working in the facility the same as to those working tracking all clinical staff licenses, TB tests, CPR in the community. expiration dates Copies of licensing and/or certification credentials Actual copies of credentials are kept at Wellpath x shall be on file in the facility or at a central location home office where they are available for review. 1204 Health Care Procedures Addressed in Wellpath Professional Nursing Protocols, dated January 2021 (pocket guides also Health care performed by personnel other than a available to staff) x physician shall be performed pursuant to written protocol or order of the responsible health care Wellpath Policy and Procedure manual signed staff.6/7/21 1205 Health Care Records Addressed in Wellpath policy HCD110_A-08 x (a) The health authority shall maintain individual, Health Records complete and dated health records in compliance with state statute to include, but not be limited to: (1) Receiving screening form/history x A-08 and E-02 (Receiving Screening) (2) Health evaluation reports; x (3) Complaints of illness or injury; x (4) Names of personnel who treat, prescribe, and/or administer/deliver prescription x medication; (5) Location where treated; and, x A-08 (Med Admin recorded in chart) (6) Medication records in conformance with Title x 15 §1216. (b)The physician/patient confidentiality privilege A-07 and A-08 applies to the health care record. Access to the x health record shall be controlled by the health authority or designee. The health authority shall ensure the confidentiality of each inmate's health care record file (paper or electronic) and such files shall be x maintained separately from and in no way be part of the inmate's other jail records. Within the provisions of HIPAA 45 C.F.R., Section 164.512(k)(5)(i), the responsible physician or designee shall communicate information obtained in the course of health x screening and care to jail authorities when necessary for the protection of the welfare of the inmate or others, management of the jail, or maintenance of jail security and order. 20 ARTICLE/SECTION YESNO N/ACOMMENTS (c) Written authorization by the inmate is necessary A-08 for transfer of health care record information Includes Release of Information unless otherwise provided by law or x administrative regulations having the force and effect of law. (d)Inmates shall not be used for health care x recordkeeping. 1206 Health Care Procedures Manual Policies and procedures are reviewed annually. The health authority shall, in cooperation with the Last signed 6/7/2021/ facility administrator, set forth in writing, policies x and procedures in conformance with applicable state and federal law, which are reviewed and updated at least every two years and include but are not limited to: (a)Summoning and application of proper Addressed in Wellpath policy HCD 110_ E-02 x medical aid; Addressed in Wellpathpolicy HCD 110-A_11 (b)Contact and consultation with other treating x health care professionals; On call Provider contact (c)Emergency and non-emergency medical and Addressed in Wellpath policy HCD 110 E-02 x dental services, including transportation; (d)Provision for medically required dental and Addressed in Wellpath policy HCD 110_F-01 x medical prostheses and eyeglasses; Pts with chronic disease & other special needs Custody staff makes notification (e) Notification of next of kin or legal guardian in x case of serious illness which may result in death; (f)Provision for screening and care of pregnant HAddressed in Wellpath policy CD 110_F-05 and lactating women, including prenatal and Counseling and Care of Pregnant Patient postpartum information and health care, x including but not limited to access to necessary vitamins as recommended by a doctor, information pertaining to childbirth education and infant care; (g)Screening, referral and care of mentally Addressed in Wellpath policy F-01 x disordered and developmentally disabled Chronic and special needs inmates; (h)Implementation of special medical programs; x Addressed in Wellpath policy HCD 110 F-01 (i) Management of inmates suspected of or Infection Control Manual x confirmed to have communicable diseases; (j) The procurement, storage, repackaging, Addressed in Wellpath policy HCD 110_D-01 labeling, dispensing, administration/delivery x (Pharmaceutical Ops) and E-09 (Medication to inmates, and disposal of pharmaceuticals; Verification) (k) Use of non-physician personnel in providing Covered by Wellpath nursing protocols x medical care; (l) Provision of medical diets; Addressed in Wellpath policy HCD 110_D-05 x (Medical diets) (m) Patient confidentiality and its exceptions; x Addressed in Wellpath policy HCD 110 A-08 21 ARTICLE/SECTION YESNO N/ACOMMENTS Addressed in Wellpath policy HCD 110_E-09 (n)the transfer of pertinent individualized health care information, or individual Continuity of Care documentation that no health care information is available, to the health authority of another correctional system, x medical facility, or mental health facility at the time each inmate is transferred and prior notification pursuant to Health and Safety Code Sections 121361 and 121362 for inmates with known or suspected active tuberculosis disease. Addressed in Wellpath policy HCD 110 E-09 Procedures for notification to the transferring x health care staff shall allow sufficient time to prepare the summary. The summary information shall identify the Addressed in Wellpath policy HCD 110 E-09 sending facility and be in a consistent format that includes the need for follow-up care, diagnostic tests performed, medications x prescribed, pending appointments, significant health problems, and other information that is necessary to provide for continuity of health care. Infection Control Manual Necessary inmate medication and health care information shall be provided to the transporting staff, together with precautions x necessary to protect staff and inmate passengers from disease transmission during transport; (o)forensic medical services, including drawing Addressed in Wellpath policy HCD 110_G-04 of blood alcohol samples, body cavity Therapeutic Relationship, Forensic Information, and searches, and other functions for the purpose x Disciplinary Action of prosecution shall not be performed by medical personnel responsible for providing ongoing care to the inmates; (p)Provisions for application and removal of Addressed in Wellpath policy HCD 110_G-01 restraints on pregnant inmates consistent x Restraints/Seclusion. with Penal Code Section 3407; Section 6.15.1 Pregnant patients (q)Other services mandated by statute; and, x (r) provisions for timely and appropriate medical Addressed in Wellpath policy HCD 110 E-02 and mental health screenings, access to Receiving Screening & medical and mental health services, and no- F-06 Response to Sexual Abuse cost access to contraception and STD x treatment, for inmates who have reported sexual abuse or sexual harassment, regardless of the location where the incident(s) occurred. 22 ARTICLE/SECTION YESNO N/ACOMMENTS 1206.5 Management of Communicable Diseases Addressed in Wellpath Policy HCD 110_B-02 Infectious Disease and Control (a) The responsible physician, in conjunction with the facility administrator and the county x health officer, shall develop a written plan to address the identification, treatment, control Infection Control Manual, July 2019 and follow-up management of tuberculosis and other communicable diseases. The plan shall cover the intake screening Addressed in Wellpath policy HCD 110 B-02 procedures, identification of relevant Infection Control Manual symptoms, referral for a medical evaluation, treatment responsibilities during x incarceration and coordination with public health officials for follow-up treatment in the community. The plan shall reflect the current local LHD attests to ongoing communication regarding incidence of communicable diseases which x STD testing/treatment for inmates as well as Covid threaten the health of inmates and staff.response testing for inmates and staff (b)Consistent with the above plan, the health Addressed in Wellpath policy HCD 110 B-02 authority shall, in cooperation with the facility Infection Control Manual administrator and the county health officer, x set forth in writing, policies and procedures in conformance with applicable state and federal law, which include, but are not limited to: (1) The types of communicable diseases to x be reported; (2) The persons who shall receive the x medical reports; (3) Sharing of medical information with x inmates and custody staff; (4) Medical procedures required to identify x the presence of disease(s) and lessen the risk of exposure to others; x (5) Medical confidentiality requirements; (6) Housing considerations based upon x behavior, medical needs, and safety of the affected inmates; (7) Provision for inmate consent that address x the limits of confidentiality; and, (8) Reporting and appropriate action upon x the possible exposure of custody staff to a communicable disease. 1207 Medical Receiving Screening Addressed in Wellpath policy HCD 110_E-02 With the exception of inmates transferred directly within a custody system with documented receiving x screening, a screening shall be completed on all inmates at the time of intake 23 ARTICLE/SECTION YESNO N/ACOMMENTS Addressed in Wellpath policy HCD 110 E-02 This screening shall be completed in accordance with written procedures and shall include but not be Receiving Screening limited to medical and mental health problems, x developmental disabilities, tuberculosis and other communicable diseases. The screening shall be performed by licensed health Addressed in Wellpath Policy HCD 110_C-01 personnel or trained facility staff, with Credentials documentation of staff training regarding site x specific forms with appropriate disposition based on responses to questions and observations made at the time of screening. The training depends on the role staff are expected Addressed in Wellpath Policy HCD 110_C-02 (Clinical to play in the receiving screening process. x Performance Enhancement) and C-03 (Professional Development) The facility administrator and responsible physician Addressed in Wellpath Policy HCD 110_F-10 shall develop a written plan for complying with x Durable Medical Equipment and Supply Penal Code Section 2656 (orthopedic or prosthetic appliance used by inmates). There shall be a written plan to provide care for any Addressed in Wellpath Polciy HCD 110 E-02 inmate who appears at this screening to be in need x Receiving Screening of or who requests medical, mental health, or developmental disability treatment. Written procedures and screening protocol shall be Addressed in Wellpath Policy HCD 110 F-01 x established by the responsible physician in cooperation with the facility administrator. 1207.5 Special Mental Disorder Assessment Addressed in Wellpath Policy HCD 110 E-02 An additional mental health screening will be The receiving screening document contains this performed, according to written procedures, on field. This is assessed on intake and at day 14 women who have given birth within the past year x and are charged with murder or attempted murder of their infants. Such screening will be performed at intake and if the assessment indicates postpartum psychosis a referral for further evaluation will be made. 1208 Access to Treatment Addressed in Wellpath Policy HCD 110_A-01 The health authority, in cooperation with the facility Access to Care administrator, shall develop a written plan for identifying and/or referring any inmate who appears x to be in need of medical, mental health or Wellpath Policy HCD 110_E-09 developmental disability treatment at any time Continuity, Coordinaiton and Quality of Care during during his/her incarceration subsequent to the Incarceration receiving screening. 24 ARTICLE/SECTION YESNO N/ACOMMENTS Addressed in Wellpath Policy HCD 110 E-02 The written plan shall also include the assessment and treatment of such inmates as described in Title x Receiving Screening 15, Section 1207, Medical Receiving Screening. Addressed in Wellpath Policy HCD 110 E-02 and E-05 Assessment and treatment shall be performed by either licensed health personnel or by persons x operating under the authority and/or direction of licensed health personnel. 1208.5. Health Care Maintenance Addressed in Wellpath Policy HCD 110_B-03 For inmates undergoing prolonged incarceration, an Clinical Preventive Services age appropriate and risk factor based health x maintenance visit shall take place within the inmate's second anniversary of incarceration. Initial Health history and exam Annual exam The specific components of the health maintenance examinations shall be determined by the responsible x physician based on the age, gender, and health of the inmate. Thereafter, the health maintenance examinations x shall be repeated at reasonable intervals as determined by the responsible physician. 1209 Mental Health Services and Transfer to a Wellpath Policy HCD 110_E-05 Treatment Facility Mental Health Screening and Evaluation & (a) The health authority, in cooperation with the mental health director and facility x administrator, shall establish policies and procedures to provide mental health services. Wellpath Policy HCD 110_F-03 These services shall include but not be limited to: Mental Health Services 1.Identification and referral of inmates x with mental health needs; 2. Mental health treatment programs provided by qualified staff, including the x Addressed in Wellpath Policy HCD 110_F-03A use of telehealth. Mental Health Services and Telepsychiatry 3. Crisis intervention services; x 4. Basic mental health services provided, as x clinically indicated; 5. Medication support services; and, Addressed in Wellpath Policy HCD 110 F-03 and F- x 03A 25 ARTICLE/SECTION YESNO N/ACOMMENTS 6. The provision of health services sufficiently coordinated such that care is appropriately integrated, medical and x mental health needs are met, and the impact of any of these conditions on each other is adequately addressed. (b)Unless the county has elected to implement Inmates are transferred to local hospital emergency the provisions of Penal Code Section 1369.1, department for 51-50 evaluation and then to Butte a mentally disordered inmate who appears to County Behavioral Health Psychiatric Health Facility be a danger to himself or others, or to be (PHF) if not able to assess and treat at the jail. gravely disabled, shall be transferred for further evaluation to a designated Lanterman Petris Short treatment facility designated by the county and approved by the State Department of Mental Health for diagnosis and treatment of such apparent mental disorder pursuant to Penal Code section x 4011.6 or 4011.8 unless the jail contains a designated Lanterman Petris Short treatment facility. Prior to the transfer, the inmate may be evaluated by licensed health personnel to determine if treatment can be initiated at the correctional facility. Licensed health personnel may perform an onsite assessment to determine if the inmate meets the criteria for admission to an inpatient facility, or if treatment can be initiated in the correctional facility. (c)If the county elects to implement the Addressed in Wellpath Policy HCD 110_G-03 and G- provisions of Penal Code Section 1369.1, the 03A health authority, in cooperation with the Emergency Psychiatric Meds facility administrator, shall establish policies x and procedures for involuntary administration of medications. The procedures shall include, but not be limited to: 1. Designation of licensed personnel, including psychiatrist and nursing staff, x authorized to order and administer involuntary medication; 2. Designation of an appropriate setting x where the involuntary administration of medication will occur; Separate restraint procedures 3. Designation of restraint procedures and/or devices that may be used to x maintain the safety of the inmate and facility staff; 4. Development of a written plan to monitor the inmate's medical condition following the initial involuntary x administration of a medication, until the inmate is cleared as a result of an evaluation by, or consultation with, a psychiatrist; 26 ARTICLE/SECTION YESNO N/ACOMMENTS 5. Development of a written plan to provide a minimum level of ongoing monitoring of the inmate following return to facility housing. This monitoring may be x performed by custody staff trained to recognize signs of possible medical problems and alert medical staff when indicated; and 6. Documentation of the administration of x involuntary medication in the inmate's medical record. 1210 Individualized Treatment Plans Addressed in Wellpath Policy HCD F-03 (a)For each inmate treated by a mental health x service in a jail, the responsible health care shall develop a written treatment plan. The custody staff shall be informed of the Addressed in Wellpath Policy HCD 110_E-10 treatment plan when necessary, to ensure Discharge coordination and cooperation in the ongoing x care of the inmate. This treatment plan shall include referral to treatment after release from the facility when recommended by treatment staff. (b) For each inmate treated for health conditions for which additional treatment, special accommodations and/or a schedule of follow- up care is/are needed during the period of incarceration, responsible health care staff shall develop a written treatment plan. The x custody staff shall be informed of the treatment plan when necessary, to ensure coordination and cooperation in the ongoing care of the inmate. This treatment plan shall include referral to treatment after release from the facility when recommended by treatment staff. 1211 Sick Call Addressed in Wellpath Policy HCD 110_E-07 There shall be written policies and procedures Non-emergency Health Care Requests developed by the facility administrator, in cooperation with the health authority, which x provides for a daily sick call conducted for all inmates or provision made that any inmate requesting medical/mental health attention be given such attention. 1212 Vermin Control Infection Control Manual, Section 10 The responsible physician shall develop a written plan for the control and treatment of vermin- infested inmates. There shall be written, medical x protocols, signed by the responsible physician, for the treatment of persons suspected of being infested or having contact with a vermin-infested inmate. 27 ARTICLE/SECTION YESNO N/ACOMMENTS 1213 Detoxification Treatment Addressed in Wellpath Policy HCD 110-F_04B The responsible physician shall develop written Medication Assisted Treatment medical policies on detoxification which shall include a statement as to whether detoxification will be provided within the facility or require transfer to a Provide medically supervised withdrawal and licensed medical facility. The facility detoxification x treatment. Will continue methadone or Suboxone if protocol shall include procedures and symptoms inmate comes in on either. Have policy to initiate necessitating immediate transfer to a hospital or MAT but do not have enough staff to implement it. other medical facility. Only pregnant women get started on MAT (if indicated) to protect fetus. Facilities without medically licensed personnel in attendance shall not retain inmates undergoing withdrawal reactions judged or defined in policy, by x the responsible physician, as not being readily controllable with available medical treatment. Such facilities shall arrange for immediate transfer to an appropriate medical facility. 1214 Informed Consent Addressed in Wellpath Policy HCD 110-G-05 The health authority shall set forth in writing a plan X for informed consent of inmates in a language understood by the inmate. Except for emergency treatment, as defined in Business and Professions Code Section 2397 and Title 15, Section 1217, all examinations, treatments X and procedures affected by informed consent standards in the community are likewise observed for inmate care. In the case of minors, or conservatees, the informed Minors are not kept in this facility. Competency is consent of parent, guardian or legal custodian applies dealt with in Wellpath Policy HCD 400-A-04 X where required by law. Any inmate who has not been adjudicated to be incompetent may refuse non- emergency medical and mental health care. Absent informed consent in non-emergency situations, a court order is required before X involuntary medical treatment can be administered to an inmate. 1215 Dental Care Addressed in Wellpath Policy HCD 110-E-06 The facility administrator shall develop written policies and procedures to ensure emergency and X medically required dental care is provided to each inmate, upon request, under the direction and supervision of a dentist, licensed in the state. 28 ARTICLE/SECTION YESNO N/ACOMMENTS 1216 Pharmaceutical Management Last pharmacist audit done 12/6/2021 (a) The health authority in consultation with a pharmacist and the facility administrator, shall develop written plans, establish procedures, and provide space and X accessories for the secure storage, the controlled administration, and disposal of all legally obtained drugs. Such plans, procedures, space and accessories shall include, but not be limited to, the following: (1)Securely lockable cabinets, closets and X refrigeration units: (2)A means for the positive identification of X the recipient of the prescribed medication; (3) Procedures for administration/delivery of X medicines to inmates as prescribed; (4) Confirming that the recipient has Addressed in Wellpath Policy HCD 110-D-02 ingested the medication or accounting X for medication under self-administration procedures outlined in Title 15, Section 1216(d); (5) That prescribed medications have or X have not been administered, by whom, and if not, for what reason; (6) Prohibiting the delivery of drugs by X inmates; (7) Limitation to the length of time medication may be administered without X further medical evaluation; and, (8) Limitation to the length of time required X for a physician's signature on verbal orders. Report dated 12/6/2021 (9) Awritten report shall be prepared by a pharmacist, no less than annually, on the status of pharmacy services in the X institution. The pharmacist shall provide the report to the health authority and the facility administrator. (b)Consistent with pharmacy laws and regulations, the health authority shall establish written protocols that limit the following functions to being performed by the identified personnel: (1) Procurement shall be done by a X physician, dentist, pharmacist, or other persons authorized by law. 29 ARTICLE/SECTION YESNO N/ACOMMENTS (2) Storage of medications shall assure that stock supplies of legend medications shall be accessed only by licensed health personnel. Supplies of legend X medications that have been dispensed and supplies of over-the-counter medications may be accessed by either licensed or non-licensed personnel. (3) Repackaging shall only be done by a X physician, dentist, pharmacist, or other persons authorized by law. (4) Preparation of labels can only be done by a physician, dentist, pharmacist or other persons, either licensed or non-licensed, provided the label is checked and affixed to the medication container by the X physician, dentist, or pharmacist before administration or delivery to the inmate. Labels shall be prepared in accordance with section 4076, Business and Professions Code. (5) Dispensing shall only be done by a X physician, dentist, pharmacist, or persons authorized by law. (6) Administration of medication shall only be done by licensed health personnel X who are authorized to administer medication acting on the order of a prescriber. (7) Delivery of medication may be done by either licensed or non-licensed X personnel, e.g., custody staff, acting on the order of a prescriber. (8) Disposal of legend medication shall be Addressed in PH-100-03 Pharmaceutical Waste done in accordance with pharmacy laws Category A-1 Corporate Policies and Procedures by and regulations and requires any Department combination of two of the following Best Practice: Corporate Policies should be classifications: physician, dentist, X incorporated into local policies and procedures. pharmacist, or registered nurse. Controlled substances shall be disposed of in accordance with the Drug Enforcement Administration disposal procedures. (c)Policy and procedures on “over-the-counter” Over the counter meds delivered via commissary. medications shall include, but not be limited X to, how they are made available, documentation when delivered by staff and precautions against hoarding large quantities. (d)Policy and procedures may allow inmate self- administration of prescribed medications under limited circumstances. Policies and procedures shall include but are not limited to the following considerations: 30 ARTICLE/SECTION YESNO N/ACOMMENTS (1) Medications permitted for self- administration are limited to those with no recognized abuse potential. Medications for treatment of X tuberculosis, psychotropic medication, controlled substances, injectables and any medications for which documentation of ingestion is essential are excluded from self-administration. (2) Inmates with histories of frequent rule violations of any type, or who are found X to be in violation of rules regarding self- administration, are excluded from self- administration. (3) Prescribing health care staff document Addressed in Wellpath Policy HCD 400-A-04 that each inmate participating in self- administration is capable of X understanding and following the rules of the program and instructions for medication use. (4) Provisions are made for the secure X storage of the prescribed medication when it is not on the inmate's person. (5) Provisions are made for the consistent Deficiency: Provision are in place for enforcement of enforcement of self-medication rules by self-medication but not included in formal written both custody and health care staff, with policies and procedures systems of communication among them X Corrective Action: Incorporate processes into when either one finds that an inmate is in written policies and procedures to ensure consistent violation of rules regarding self- administration. practice (6) Provisions are made for health care staff Deficiency: Provision are in place for compliance to perform documented assessments of with self-medication but not included in formal inmate compliance with self- written policies and procedures administration medication regimens. X Corrective Action: Incorporate processes into Compliance evaluations are done with written policies and procedures to ensure consistent sufficient frequency to guard against hoarding medication and deterioration of practice the inmate's health. 1217 Psychotropic Medications The responsible physician, in cooperation with the X facility administrator, shall develop written policies and procedures governing the use of psychotropic medications. An inmate found by a physician to be a danger to him/herself or others by reason of mental disorders X may be involuntarily given psychotropic medication appropriate to the illness on an emergency basis. 31 ARTICLE/SECTION YESNO N/ACOMMENTS Psychotropic medication is any medication prescribed for the treatment of symptoms of X psychoses and other mental and emotional disorders An emergency is a situation in which action to impose treatment over the inmate's objection is immediately necessary for the preservation of life or the prevention of serious bodily harm to the inmate X or others, and it is impracticable to first gain consent. It is not necessary for harm to take place prior to treatment. If psychotropic medication is administeredduring an emergency, such medication shall be only that which is required to treat the emergency condition. The medication shall be prescribed by a physician X following a clinical evaluation. The responsible physician shall develop a protocol for the supervision and monitoring of inmates involuntarily receiving psychotropic medication. Psychotropic medication shall not be administered to an inmate absent an emergency unless the inmate has given his or her informed consent in accordance with Welfare and Institutions Code Section 5326.2, or has been found to lack the X capacity to give informed consent consistent with the county's hearing procedures under the Lanterman-Petris-Short Act for handling capacity determinations and subsequent reviews. Addressed in Wellpath Policy HCD 110-G-03(6.4.6) There shall be a policy which limits the length of time both voluntary and involuntary psychotropic medications may be administered and a plan of X monitoring and re-evaluating all inmates receiving psychotropic medications, including a review of all emergency situations. Addressed in Wellpath Policy HCD 110-G-04 The administration of psychotropic medication is not X allowed for disciplinary reasons. 1220 First Aid Kits X First aid kit(s) shall be available in all facilities. The responsible physician shall approve the Deficiency: There was no evidence of a formalized contents, number, location and procedure for and approved list of supplies but there is a list that is periodic inspection of the kit(s). used for inventory and inspection is occurring X Corrective Action: establish and publish policy that defines content, location & inspection of first aid kits 32 ARTICLE/SECTION YESNO N/ACOMMENTS ARTICLE 4, RECORDS AND PUBLIC INFORMATION 1046 Death in Custody Addressed in Wellpath Policy HCD 110-A-09 (a) Death in Custody Reviews for Adults and Minors. The facility administrator, in cooperation with the health administrator, shall develop written policy and procedures to ensure that there is an initial review of every in-custody X death within 30 days. The review team shall include the facility administrator and/or the facility manager, the health administrator, the responsible physician and other health care and supervision staff who are relevant to the incident. Deaths shall be reviewed to determine the appropriateness of clinical care; whether X changes to policies, procedures, or practices are warranted; and to identify issues that require further study. (b) Death of a Minor. Minors are not held in this facility In any case in which a minor dies while X detained in a jail, lockup, or court holding facility: (1)the administrator of the facility shall provide to the Board a copy of the report submitted to the Attorney General under Government X Code Section 12525. A copy of the report shall be submitted within 10 calendar days after the death. (2)Upon receipt of a report of death of a minor from the administrator, the Board may within 30 calendar days inspect and evaluate the jail, lockup, or court holding facility X pursuant to the provisions of this subchapter. Any inquiry made by the Board shall be limited to the standards and requirements set forth in these regulations. ARTICLE 3, TRAINING, PERSONNEL AND MANAGEMENT 1030. Suicide Prevention Program. Addressed in Wellpath Policy HCD 110-B-05 The facility shall have a comprehensive written suicide prevention program developed by the facility X administrator, in conjunction with the health authority and mental health director, to identify, monitor, and provide treatment to those inmates who present a suicide risk. (a) Suicide prevention training for all staff that X have direct contact with inmates. (b) Intake screening for suicide risk immediately X upon intake and prior to housing assignment. 33 ARTICLE/SECTION YESNO N/ACOMMENTS (c) Provisions facilitating communication among arresting/transporting officers, facility staff, X medical and mental health personnel in relation to suicide risk. (d) Housing recommendations for inmates at X risk of suicide. (e) Supervision depending on level of suicide X risk. (f) Suicide attempt and suicide intervention X policies and procedures. (g) Provisions for reporting suicides and suicides X attempts. (h) Multi-disciplinary administrative review of suicides and attempted suicides as defined by X the facility administrator. ARTICLE 5, CLASSIFICATION AND SEGREGATION 1051 Communicable Diseases Addressed in Wellpath Policy HCD 110-B-02 The facility administrator, in cooperation with the responsible physician, shall develop written policies X and procedures specifying those symptoms that require segregation of an inmate until a medical evaluation is completed. At the time of intake into the facility, an inquiry shall Addressed in Wellpath Policy HCD 110-E-02 be made of the person being booked as to whether or not he/she has or has had any communicable X diseases, such as tuberculosis or has observable symptoms of tuberculosis or any other communicable diseases, or other special medical problem identified by the health authority. The response shall be noted on the booking form X and/or screening device. 1052 Mentally Disordered Inmates Addressed in WellpathPolicy HCD 110-E-05 The facility administrator, in cooperation with the responsible physician, shall develop written policies and procedures to identify and evaluate all mentally disordered inmates, and may include telehealth. If an X evaluation from medical or mental health staff is not readily available, an inmate shall be considered mentally disordered for the purpose of this section if he or she appears to be a danger to himself/herself or others or if he/she appears gravely disabled. An evaluation from medical or mental health staff Addressed in Wellpath Policy HCD 110-F-03 shall be secured within 24 hours of identification or X at the next daily sick call, whichever is earliest. Segregation may be used if necessary to protect the safety of the inmate or others. 34 ARTICLE/SECTION YESNO N/ACOMMENTS 1055 Use of Safety Cell Addressed in Wellpath Policy HCD 110-G-02A The safety cell described in Title 24, Part 2, Section 1231.2.5, shall be used to hold only those inmates X who display behavior which results in the destruction of property or reveals an intent to cause physical harm to self or others The facility administrator, in cooperation with the responsible physician, shall develop written policies X and procedures governing safety cell use and may delegate authority to place an inmate in a safety cell to a physician. In no case shall the safety cell be used for Addressed in Wellpath Policy HCD 110-G-04 X punishment or as a substitute for treatment. An inmate shall be placed in a safety cell only with the approval of the facility manager or designee, or X responsible health care staff; continued retention shall be reviewed a minimum of every four hours. A medical assessment shall be completed within a maximum of 12 hours of placement in the safety cell X or at the next daily sick call, whichever is earliest. The inmate shall be medically cleared for continued retention every 24 hours thereafter. The facility manager, designee or responsible health care staff shall obtain a mental health X opinion/consultation with responsible health care staff on placement and retention, which shall be secured within 12 hours of placement. Direct visual observation shall be conducted at least Addressed in Butte County Sheriff Office Jail Policy X 719 twice every thirty minutes. Such observation shall be documented. Procedures shall be established to assure administration of necessary nutrition and fluids. Inmates shall be allowed to retain sufficient clothing, or be provided with a suitably designed “safety garment,” to provide for their personal privacy unless specific identifiable risks to the inmate's safety or to the security of the facility are documented. 35 ARTICLE/SECTION YESNO N/ACOMMENTS 1056 Use of Sobering Cell Addressed in Wellpath Policy HCD 110-F-04 The sobering cell described in Title 24, Part 2, Section 1231.2.4, shall be used for the holding of inmates who are a threat to their own safety or the safety of others due to their state of intoxication and pursuant to written policies and procedures developed by the facility administrator. Such inmates shall be removed from the sobering cell as X they are able to continue in the processing. In no case shall an inmate remain in a sobering cell over six hours without an evaluation by a medical staff person or an evaluation by custody staff, pursuant to written medical procedures in accordance with section 1213 of these regulations, to determine whether the prisoner has an urgent medical problem. At 12 hours from the time of placement, all inmates Addressed in Butte County Sheriff Office Jail Policy will receive an evaluation by responsible health care 516 X staff. Intermittent direct visual observation of inmates held in the sobering cell shall be conducted no less than every half hour. Such observation shall be documented. 1057 Developmentally Disabled Inmates Addressed in Wellpath Policy HCD 110-E-05 The facility administrator, in cooperation with the responsible physician, shall develop written policies and procedures for the identification and evaluation, X appropriate classification and housing, protection, and nondiscrimination of all developmentally disabled inmates. The health authority or designee shall contact the Addressed in Wellpath Policy HCD 110-E-02 regional center on any inmate suspected or confirmed to be developmentally disabled for the purposes of diagnosis and/or treatment within 24 hours of such X No evidence seen of developmentally disabled determination, excluding holidays and weekends. inmate or documentation of contacting regional center. 1058 Use of Restraint Devices Addressed in Wellpath Policy HCD 110-G-01 and Butte County Sheriff Office Policy 511 The facility administrator, in cooperation with the responsible physician, shall develop written policies X and procedures for the use of restraint devices and may delegate authority to place an inmate in restraints to a responsible health care staff. 36 ARTICLE/SECTION YESNO N/ACOMMENTS In addition to the areas specifically outlined in this regulation, at a minimum, the policy shall address the following areas: acceptable restraint devices; signs or symptoms which should result in immediate medical/mental health referral; availability of X cardiopulmonary resuscitation equipment; protective housing of restrained persons; provision for hydration and sanitation needs; and exercising of extremities. In no case shall restraints be used for punishment or X as a substitute for treatment. Restraint devices shall only be used on inmates who display behavior which results in the destruction of property or reveal an intent to cause physical harm X to self or others. Restraint devices include any devices which immobilize an inmate's extremities and/or prevent the inmate from being ambulatory. Physical restraints should be utilizedonly when it X appears less restrictive alternatives would be ineffective in controlling the disordered behavior. Inmates shall be placed in restraints only with the approval of the facility manager, the facility watch X commander, responsible health care staff; continued retention shall be reviewed a minimum of every hour. A medical opinion on placement and retention shall be secured within one hour from the time of X placement. A medical assessment shall be completed within four hours of placement. If the facility manager, or designee, in consultation with responsible health care staff determines that X an inmate cannot be safely removed from restraints after eight hours, the inmate shall be taken to a medical facility for further evaluation. Direct visual observation shall be conducted at least twice every thirty minutes to ensure that the restraints are properly employed, and to ensure the X safety and well-being of the inmate. Such observation shall be documented. While in restraint devices all inmates shall be housed alone or in a specified housing area for restrained X inmates which makes provisions to protect the inmate from abuse. 37 ARTICLE/SECTION YESNO N/ACOMMENTS The provisions of this section do not apply to the use of handcuffs, shackles or other restraint devices X when used to restrain inmates for security reasons. 1058.5Restraints and Pregnant Inmates Addressed in Butte County Sheriff Office Policy 511 The facility administrator, in cooperation with the responsible physician, shall develop written policies X and procedures for the use of restraint devices on pregnant inmates. In accordance with Penal Code 3407 the policy shall include reference to the following: (1) An inmate known to be pregnant or in recovery after delivery shall not be restrained X by the use of leg irons, waist chains, or handcuffs behind the body. (2) Apregnant inmate in labor, during delivery, or in recovery after delivery, shall not be X restrained by the wrists, ankles, or both, unless deemed necessary for the safety and security of the inmate, the staff, or the public. (3) Restraints shall be removed when a professional who is currently responsible for the medical care of a pregnant inmate during X a medical emergency, labor, delivery, or recovery after delivery determines that the removal of restraints is medically necessary. (4) Upon confirmation of an inmate's pregnancy, she shall be advised, orally or in writing, of X the standards and policies governing pregnant inmates. 38 Itemized Summary III. Medical/Mental Health Evaluation Butte County Jail Page 30 Best Practice: Corporate Policies for pharmaceutical destruction should be incorporated into local policies and procedures Page 31 Deficiency: Provision are in place for enforcement of self-medication rules but not included in formal written policies and procedures Corrective Action: Incorporate for enforcement of self-medication rules into written policies and procedures to ensure consistent practice Deficiency: Provision are in place for assessment of inmate compliance with self-medication but not included in formal written policies and procedures Corrective Action: Incorporate processes for assessment of inmate compliance with self-medication into written policies and procedures to ensure consistent practice Page 32 Deficiency: There was no evidence of a formalized and approved list of first aid kit supplies but there is a list that is used for inventory and inspection is occurring. There is a list of supplies for emergency bags (different than first aid kits.) Corrective Action: establish and publish policy that defines content, location & inspection of first aid kits as required by Butte County Sheriff Office Policy 704 Best Practice: Adding Automatic External Defibrillators and Narcan to the first aid supply list, location and inspection policy. Medical equipment should be annually inspected for calibration and electrical safety. Butte County Sheriff Office Policy authorizes health authority to adopt and implement policies on AED and to ensure staff are trained on the use. 39 ADULT COURT AND TEMPORARY HOLDING FACILITIES Local Detention Facility Health Inspection Report Health and Safety Code Section 101045 BSCC #: ___________ FACILITY NAME:COUNTY: Chico - North Butte County Courthouse Butte FACILITY ADDRESS (STREET, CITY, ZIP CODE, TELEPHONE): 1775 Concord Avenue Chico, CA 95928, (530) 532-7002 CHECK THE FACILITY TYPE AS DEFINED IN TITLE 15, COURT HOLDING TEMPORARY HOLDING SECTION 1006: FACILITY: X FACILITY: ENVIRONMENTAL HEALTH EVALUATION DATE INSPECTED: 02/07/2022 ENVIRONMENTAL HEALTH EVALUATORS (NAME, TITLE, TELEPHONE): Alana Kong, Registered Environmental Health Specialist II, (530) 552-3998 Leslie Roberts, Senior Registered Environmental Health Specialist, (530) 552-3872 FACILITY STAFF INTERVIEWED (NAME, TITLE, TELEPHONE): Jake Smith, Sergeant, (530) 990-4999 NUTRITIONAL EVALUATIONDATE INSPECTED: NUTRITIONAL EVALUATORS (NAME, TITLE, TELEPHONE): FACILITY STAFF INTERVIEWED (NAME, TITLE, TELEPHONE): MEDICAL/MENTAL HEALTH EVALUATION DATE INSPECTED: 02/07/2022 MEDICAL/MENTAL HEALTH EVALUATORS (NAME, TITLE, TELEPHONE): Monica Soderstrom, Division Director, Public Health, (530) 552-3930 David Canton, Public Health Officer, (53) 552-3993 FACILITY STAFF INTERVIEWED (NAME, TITLE, TELEPHONE): Jake Smith, Sergeant, (530) 990-4999 This checklist is to be completed pursuant to the attached instructions. 1 I. ENVIRONMENTAL HEALTH EVALUATION Adult Court and Temporary Holding Facilities ARTICLE/SECTION YESNO N/A COMMENTS Article 12. Food Approach for Providing Food Service (Not applicable to CH) x Food served in the facility is prepared in the facility. If "No," respond to items 1 and 2 below prior to continuing with the checklist. 1. Food is prepared at another city or county Sack lunches are provided by the Butte County Jail detention facility. in the event the prisoner is housed during the x noon meal. No potentially hazardous foods that need time temperature control are served. No utensils provided for safety reasons. 2. Food is contracted through a private vendor No private vendor utilized. Butte County Jail has a who had been inspected and complies with x permitted kitchen with Butte County provisions of CalCode. Environmental Health. 1245 Kitchen Facilities, Sanitation and Food No kitchen facility or food preparation Service (Not applicable to CH) x Kitchen facilities, sanitation, and food preparation, service and storage comply with standards set forth in CalCode. In facilities where inmates prepare meals for self- consumption, or where frozen meals are pre- prepared food from other facilities permitted pursuant to HSC §114381 is (re)heated and served, x the following CalCode standards may be waived by the local health officer. HSC §114130-114141 HSC §114099.6, 114095-114099.5,114101- 114109, 114123 and 114125 if a domestic or commercial dishwasher, capable of providing x heat to the surface of utensils of at least 165 degrees Fahrenheit, is used to clean and sanitize multi-service utensils and multi-service consumer utensils; HSC §114149-114149.3 except that, regardless of such a waiver, the facility shall provide x mechanical ventilation sufficient to remove gases, odors, steam, heat, grease, vapors and smoke from the kitchen; 2 ARTICLE/SECTION YESNO N/A COMMENTS HSC §114268-114269 x HSC §114279-114282 x 1246 Food Serving and Supervision No food preparation done at this facility (Not applicable to CH) Policies and procedures ensure that appropriate x work assignments are made, and food handlers are adequately supervised. Food is prepared and served only under the immediate supervision of a staff member. Article 14. Bedding and Linens 1270 Standard Bedding and Linen Issue Inmates never held longer than 12 hours (Not applicable to CH) x The standard issue of clean suitable bedding and linens, for each inmate entering a living area who is expected to remain overnight, shall include, but not be limited to: (a) One serviceable mattress which meets the x requirements of Title 15 §1272; (b) one mattress cover or one sheet; x (c) one blanket or more depending upon climatic conditions. Two blankets or sleep bag may be x issued in place of one mattress cover or one sheet (d) one towel x Temporary Holding facilities which hold persons x longer than 12 hours shall meet the requirements of 1, 2 and 3 above. 1272 Mattresses (Not applicable to CH) x Mattresses are enclosed in an easily cleaned, non- absorbent ticking and conform to the size of the bunk as referenced in Title 24, Part 2, §1231.3.5 Beds (at least 30" wide X 76" long). Any mattress purchased for issue to an inmate in a facility, which is locked to prevent unimpeded access to the outdoors, is certified by the x manufacturer as meeting all requirements of the State Fire Marshal and Bureau of Home Furnishings for penal mattresses at the time of purchase. 3 ARTICLE/SECTION YESNO N/A COMMENTS Article 15. Facility Sanitation and Safety 1280 Facility Sanitation, Safety and Maintenance Butte County Sheriff’s Office Court Holding Facility Manual 2.1280- Facility Sanitation There are policies and procedures for the x maintenance of an acceptable level of cleanliness, Janitorial contract with Pro-Line Cleaning Services, repair and safety throughout the facility. Inc. The plan provides for a regular schedule of Deficiency- holding cell 104 has low water pressure from hand washing sink. housekeeping tasks and inspections to identify and correct unsanitary or unsafe conditions or work Corrective action –repair to provide adequate practices. water pressure to properly wash hands x Deficiency- holding cell 104 and corridor between cells 201 and 202 have lights that are out. Corrective action – repair, maintenance has a work order in. Itemized Summary I. Environmental Health Evaluation Chico Courthouse Page 4 Deficiency- holding cell 104 has low water pressure from hand washing sink. Corrective action – repair to provide adequate water pressure to properly wash hands Deficiency- holding cell 104 and corridor between cells 201 and 202 have lights that are out. Corrective action – repair, maintenance has a work order in. Summary of environmental health evaluation: Some deficiencies with plumbing and lighting were seen but are being addressed. This facility has required policies and procedures in place. Overall, facility is in good condition. Suggested best practices: Have soap available for inmates to wash their hands, when requested. 4 III. MEDICAL/MENTAL HEALTH EVALUATION Adult Court and Temporary Holding Facilities ARTICLE/SECTIONYES NO N/A COMMENTS Article 11. Health Services 1200 Responsibility for Health Care Services Staff was not aware of Court Holding Facility In court holding and temporary holding facilities, the Manual but manual was presented to inspectors at facility administrator shall have the responsibility to start of visit X develop written policies and procedures which ensure provision of emergency health care services to all inmates. 1207 Medical Receiving Screening Court Holding Facility Manual addresses cases (Not applicable to CH) should a prisoner be taken into custody at the court house pending transfer to the jail where screen would occur. X A receiving screening is performed on all inmates at the time of intake, with the exception of inmates transferred directly within a custody system with documented receiving screening This screening shall be completed in accordance with written procedures and shall include but not be limited to medical and mental health problems, X developmental disabilities, tuberculosis and other communicable diseases. The screening shall be performed by licensed health personnel or trained facility staff, with documentation of staff training regarding site specific forms with appropriate disposition based on X responses to questions and observations made at the time of screening. The training depends on the role staff are expected to play in the receiving screening process. The facility administrator and responsible physician shall develop a written plan for complying with X Penal Code Section 2656 (orthopedic or prosthetic appliance used by inmates). There shall be a written plan to provide care for any inmate who appears at this screening to be in need X of or who requests medical, mental health, or developmental disability treatment. Written procedures and screening protocol shall be X established by the responsible physician in cooperation with the facility administrator. 5 ARTICLE/SECTIONYES NO N/A COMMENTS 1209 Mental Health Services and Transfer to a Manual does address cases where person is taken Treatment Facility into custody in the court house pending transfer to the jail where services would occur. (Not applicable to CH) X (a) The health authority, in cooperation with the mental health director and facility administrator, shall establish policies and procedures to provide mental health services. These services shall include but not be limited to: 1.Identification and referral of inmates X with mental health needs; 2.Mental health treatment programs X provided by qualified staff, including the use of teleheath. 3. Crisis intervention services; X 4. Basic mental health services provided, as X clinically indicated; X 5. Medication support services; and, 6. The provision of health services sufficiently coordinated such that care is appropriately integrated, medical and X mental health needs are met, and the impact of any of these conditions on each other is adequately addressed. (b) Unless the county has elected to implement the provisions of Penal Code Section 1369.1, a mentally disordered inmate who appears to be a danger to himself or others, or to be gravely disabled, shall be transferred for further evaluation to a designated Lanterman Petris Short treatment facility designated by X the county and approved by the State Department of Mental Health for diagnosis and treatment of such apparent mental disorder pursuant to Penal Code section 4011.6 or 4011.8 unless the jail contains a designated Lanterman Petris Short treatment facility. Prior to the transfer, the inmate may be evaluated by licensed health personnel to determine if treatment can be initiated at the correctional facility. Licensed health personnel may perform an onsite assessment X to determine if the inmate meets the criteria for admission to an inpatient facility, or if treatment can be initiated in the correctional facility. 6 ARTICLE/SECTIONYES NO N/A COMMENTS (c) If the county elects to implement the provisions of Penal Code Section 1369.1, the health authority, in cooperation with the facility administrator, shall establish policies X and procedures for involuntary administration of medications. The procedures shall include, but not be limited to: 1. Designation of licensed personnel, including psychiatrist and nursing staff, X authorized to order and administer involuntary medication; 2. Designation of an appropriate setting X where the involuntary administration of medication will occur; 3. Designation of restraint procedures and/or devices that may be used to X maintain the safety of the inmate and facility staff; 4. Development of a written plan to monitor the inmate's medical condition following the initial involuntary administration of a medication, until the inmate is cleared as a result of an evaluation by, or consultation with, a psychiatrist; X 7 ARTICLE/SECTIONYES NO N/A COMMENTS 5. Development of a written plan to provide a minimum level of ongoing monitoring of the inmate following return to facility housing. This monitoring may be performed by custody staff trained to recognize signs of possible medical problems and alert medical staff when indicated; and X 6. Documentation of the administration of X involuntary medication in the inmate's medical record. 1212 Vermin Control Manual does address cases where individual is taken (Not applicable to CH) into custody in the court house and transferred to the jail where control and treatment would occur. The responsible physician shall develop a written X plan for the control and treatment of vermin- infested inmates. There shall be written, medical protocols, signed by the responsible physician, for the treatment of persons suspected of being infested or having contact with a vermin-infested inmate. 1213 Detoxification Treatment (Not applicable to CH) The responsible physician shall develop written medical policies on detoxification which shall include X a statement as to whether detoxification will be provided within the facility or require transfer to a licensed medical facility. The facility detoxification protocol shall include procedures and symptoms necessitating immediate transfer to a hospital or other medical facility. Facilities without medically licensed personnel in attendance shall not retain inmates undergoing withdrawal reactions judged or defined in policy, by X the responsible physician, as not being readily controllable with available medical treatment. Such facilities shall arrange for immediate transfer to an appropriate medical facility. 8 ARTICLE/SECTIONYES NO N/A COMMENTS 1220 First Aid Kits Some first aid kits are in court rooms. X First aid kit(s) shall be available in all facilities. The responsible physician shall approve the Deficiency: First aid kits contents are not contents, number, location and procedure for standardized. Manual is not specific as to specific periodic inspection of the kit(s). In Court and contents and quantity. While policy states kits are Temporary Holding facilities, the facility to be inspected at least monthly, expired items were administrator shall have the above approval found in the kits and contents varied from kit to kit. authority, pursuant to Section 1200 of these Corrective Action: edit manual to make specific list regulations. of contents and review inspection process to ensure compliance with policy. X Best practice would be to have first aid kits in both court houses mirror each other in content and location. Would recommend kits be immediately available in closest area to cells as is done at Oroville facility 1046 Death in Custody Addressed in section 2.1046 of manual (a) Death in Custody Reviews for Adults and Minors. The facility administrator, in cooperation with the health administrator, shall develop written policy and procedures to ensure that there is X an initial review of every in-custody death within 30 days. The review team shall include the facility administrator and/or the facility manager, the health administrator, the responsible physician and other health care and supervision staff who are relevant to the incident. Deaths shall be reviewed to determine the appropriateness of clinical care; whether changes to policies, procedures, or practices X are warranted; and to identify issues that No in custody deaths occurred in court house require further study. during inspection period. (b) Death of a Minor. No death of in custody minor occurred in court In any case in which a minor dies while X house during inspection period. detained in a jail, lockup, or court holding facility: (1) The administrator of the facility shall provide to the Board a copy of the report submitted to the Attorney General under X Government Code Section 12525. A copy of the report shall be submitted within 10 calendar days after the death. 9 ARTICLE/SECTIONYES NO N/A COMMENTS (2) Upon receipt of a report of death of a minor from the administrator, the Board may within 30 calendar days inspect and evaluate the jail, lockup, or court holding X facility pursuant to the provisions of this subchapter. Any inquiry made by the Board shall be limited to the standards and requirements set forth in these regulations. 1051 Communicable Diseases Addressed in section 2.1051 of the manual The facility administrator, in cooperation with the responsible physician, shall develop written policies X and procedures specifying those symptoms that require segregation of an inmate until a medical evaluation is completed. At the time of intake into the facility, an inquiry shall be made of the person being booked as to whether or not he/she has or has had any communicable X diseases, such as tuberculosis or has observable symptoms of tuberculosis or any other communicable diseases, or other special medical problem identified by the health authority. The response shall be noted on the booking form X and/or screening device. 1052 Mentally Disordered Inmates Addressed in section 2.1052 for Court House Policy The facility administrator, in cooperation with the manual. responsible physician, shall develop written policies and procedures to identify and evaluate all mentally disordered inmates, and may include telehealth. If an X evaluation from medical or mental health staff is not readily available, an inmate shall be considered mentally disordered for the purpose of this section if he or she appears to be a danger to himself/herself or others or if he/she appears gravely disabled. An evaluation from medical or mental health staff shall be secured within 24 hours of identification or X at the next daily sick call, whichever is earliest. Segregation may be used if necessary to protect the safety of the inmate or others. 1055 Use of Safety Cell Safety cell is not available The safety cell described in Title 24, Part 2, Section 1231.2.5, shall be used to hold only those inmates X who display behavior which results in the destruction of property or reveals an intent to cause physical harm to self or others The facility administrator, in cooperation with the responsible physician, shall develop written policies X and procedures governing safety cell use and may delegate authority to place an inmate in a safety cell to a physician. In no case shall the safety cell be used for X punishment or as a substitute for treatment. 10 ARTICLE/SECTIONYES NO N/A COMMENTS An inmate shall be placed in a safety cell only with the approval of the facility manager or designee, or X responsible health care staff; continued retention shall be reviewed a minimum of every four hours. A medical assessment shall be completed within a maximum of 12 hours of placement in the safety cell or at the next daily sick call, whichever is earliest. X The inmate shall be medically cleared for continued retention every 24 hours thereafter. The facility manager, designee or responsible health care staff shall obtain a mental health opinion/consultation with responsible health care X staff on placement and retention, which shall be secured within 12 hours of placement. Direct visual observation shallbe conducted at least X twice every thirty minutes. Such observation shall be documented. Procedures shall be established to assure administration of necessary nutrition and fluids. Inmates shall be allowed to retain sufficient clothing, or be provided with a suitably designed “safety X garment,” to provide for their personal privacy unless specific identifiable risks to the inmate's safety or to the security of the facility are documented. 1056 Use of Sobering Cell Sobering Cell is not available The sobering cell described in Title 24, Part 2, Section 1231.2.4, shall be used for the holding of inmates who are a threat to their own safety or the safety of others due to their state of intoxication and pursuant to written policies and procedures developed by the facility administrator. Such inmates shall be removed from the sobering cell as X they are able to continue in the processing. In no case shall an inmate remain in a sobering cell over six hours without an evaluation by a medical staff person or an evaluation by custody staff, pursuant to written medical procedures in accordance with section 1213 of these regulations, to determine whether the prisoner has an urgent medical problem. At 12 hours from the time of placement, all inmates will receive an evaluation by responsible health care staff. Intermittent direct visual observation of X inmates held in the sobering cell shall be conducted no less than every half hour. 11 ARTICLE/SECTIONYES NO N/A COMMENTS Such observation shall be documented. X 1057 Developmentally Disabled Inmates Addressed in section 1.1059 of Court Holding Facility The facility administrator, in cooperation with the Manual. responsible physician, shall develop written policies X and procedures for the identification and evaluation, appropriate classification and housing, protection, and nondiscrimination of all developmentally disabled inmates. The health authority or designee shall contact the Deficiency: Contacting regional center is not regional center on any inmate suspected or confirmed addressed in Court Holding Facility Manual. to be developmentally disabled for the purposes of X diagnosis and/or treatment within 24 hours of such Corrective action: edit policy and train staff to determination, excluding holidays and weekends. contact regional center for inmates thought to be developmentally disabled. 1058 Use of Restraint Devices Addressed in section 2.1058 of the Court Holding Facility Manual The facility administrator, in cooperation with the X responsible physician, shall develop written policies and procedures for the use of restraint devices and may delegate authority to place an inmate in restraints to a responsible health care staff. In addition to the areas specifically outlined in this regulation, at a minimum, the policy shall address the following areas: acceptable restraint devices; signs or symptoms which should result in immediate medical/mental health referral; X availability of cardiopulmonary resuscitation equipment; protective housing of restrained persons; provision for hydration and sanitation needs; and exercising of extremities. In no case shall restraints be usedfor punishment or X as a substitute for treatment. Restraint devices shall only be used on inmates who display behavior which results in the destruction of property or reveal an intent to cause physical harm to X self or others. Restraint devices include any devices which immobilize an inmate's extremities and/or prevent the inmate from being ambulatory. Physical restraints should be utilized only when it X appears less restrictive alternatives would be ineffective in controlling the disordered behavior. Inmates shall be placed in restraints only with the Deficiency: Section 2.1058(5) of Court Holding approval of the facility manager, the facility watch Facility Manual allow for review every 2 hours. X commander, responsible health care staff; Corrective action: amend policy and procedure to continued retention shall be reviewed a minimum of comply with standard of every hour. every hour. 12 ARTICLE/SECTIONYES NO N/A COMMENTS A medical opinion on placement and retention shall Deficiency: Section 2.1058 (5) of Policy allows for be secured within one hour from the time of medical opinion within 6 hours placement. A medical assessment shall be X Corrective action: amend policy and procedure to completed within four hours of placement. comply with standard of within four (4) hours in Court Holding Facility Manual If the facility manager, or designee, in consultation Addressed in section 2.1058(6) of Court Holding with responsible health care staff determines that Facility Manual an inmate cannot be safely removed from restraints X after eight hours, the inmate shall be taken to a medical facility for further evaluation. Direct visual observation shall be conducted at least Addressed in section 2.1058(5) of Court Holding twice every thirty minutes to ensure that the Facility Manual X restraints are properly employed, and to ensure the safety and well-being of the inmate. Such observation shall be documented. While in restraint devices all inmates shall be housed Addressed in section 2.1058(5) of Court Holding alone or in a specified housing area for restrained Facility Manual X inmates which makes provisions to protect the inmate from abuse. The provisions of this section do not apply to the use of handcuffs, shackles or other restraint devices X when used to restrain inmates for security reasons. 1058.5 RESTRAINTS AND PREGNANT INMATES Addressed in section 2.1058(6) of Court Holding Facility Manual The facility administrator, in cooperation with the responsible physician, shall develop written policies X and procedures for the use of restraint devices on pregnant inmates. In accordance with Penal Code 3407 the policy shall include reference to the following: (1) An inmate known to be pregnant or in recovery after delivery shall not be X restrained by the use of leg irons, waist chains, or handcuffs behind the body. (2) A pregnant inmate in labor, during delivery, or in recovery after delivery, shall not be restrained by the wrists, X ankles, or both, unless deemed necessary for the safety and security of the inmate, the staff, or the public. (3) Restraints shall be removed when a professional who is currently responsible for the medical care of a pregnant inmate X during a medical emergency, labor, delivery, or recovery after delivery determines that the removal of restraints is medically necessary. 13 ARTICLE/SECTIONYES NO N/A COMMENTS (4) Upon confirmation of an inmate's pregnancy, she shall be advised, orally or X in writing, of the policies governing pregnant inmates. Itemized Summary III. Medical/Mental Health Evaluation Chico Courthouse Overall, the facility seemed to be operated in an appropriate fashion. Deputies were cooperative and forthright in assisting with and facilitating the inspection. Deficiencies are primarily related to policy edits and training to the policies. Page 9 Deficiency: First aid kits contents are not standardized. Manual is not specific as to specific contents and quantity. While policy states kits are to be inspected at least monthly, expired items were found in the kits and contents varied from kit to kit. Corrective Action: edit manual to make specific list of contents and review inspection process to ensure compliance with policy. Best practice would be to have first aid kits in both court houses mirror each other in content and location. Would recommend kits be immediately available in closest area to cells as is done at Oroville facility. Page 12 Deficiency: Contacting regional center is not addressed in Court Holding Facility Manual. Corrective action: edit policy and train staff to contact regional center for inmates thought to be developmentally disabled. Deficiency: Section 2.1058(5) of Court Holding Facility Manual allow for review every 2 hours. Corrective action: amend policy and procedure to comply with standard of every hour. Page 13 Deficiency: Section 2.1058 (5) of Policy allows for medical opinion within 6 hours Corrective action: amend policy and procedure to comply with standard of within four (4) hours in Court Holding Facility Manual 14 Combined Itemized Summary Butte County Facilities Butte County Jail Itemized Summary I. Environmental Health Evaluation Butte County Jail Deficiency- Cold holding of dressings in staff salad bar at 46 degrees F. Corrective Action- Maintain potentially hazardous food at or below 41 degrees F. Deficiency: Basins of mixed ingredients in walk-in refrigerator to cool observed at 44 degrees F after 24 hours. Corrective Action- Mixed ingredients must cool to 41 degrees F or colder in 4 hours. When cooling foods maintain food depths at 2 – 3 inches to cool quickly. Deficiency- Not all utensils stored in clean drawer or protected from possible contamination. Corrective Action- Clean drawers or storage areas to be use for utensil storage. Deficiency- Colanders and bowls in one area stored unprotected from contamination. Corrective Action: Store all bowls, etc bottom side up to prevent contamination of food contact surfaces. Deficiency- One area of floor cove and wall under utensil washing sink broken/damaged. Corrective Action: Repair floor cove and wall damaged in utensil washing area. Deficiency- Dish machine high temperature rinse not 160 degrees F at dish. Corrective Mitigation: Contact Technician ad schedule service/repair. Until repair, mitigation to wash, utensils in dish machine and use chemical sanitizer solution in 3 compartment sink to complete sanitizer cycle. Deficiency- In South dorm the light fixture in the bathroom is broken Corrective action- repair Deficiency- cell K hand wash sink has a leaky pipe Corrective action- repair Deficiency- cells 4 and 62 have low water pressure Corrective action – Increase water pressure so inmates can adequately wash their hands Deficiency – cells 86 and 54 have no hot water Corrective action – provide hot water Deficiency – cell H sink is not working Corrective action – repair Deficiency – cell 66 toilet is leaking Corrective action – repair Deficiency- cell M has lights that are out Corrective action – repair Itemized Summary II. Nutritional Health Evaluation Butte County Jail Carrots served daily. Recommend adding other Vitamin A rich sources like cantaloupe, sweet potatoes, winter squash, apricots, and spinach, kale or collard greens Deficiency: No signature of responsible physician on diet manual. Corrective Action: Responsible physician shall approve diet manual and will provide approval annually. Frequency of serving and minimum diet meet the requirements based upon the nutritional and caloric requirements found in the 2011 Dietary Reference Intakes (DRI) of the Food and Nutrition Board, Institute of Medicine of the National Academies, the 2008 California Food Guide, and the 2015-2020 Dietary Guidelines for Americans. Menus are planned in advance, approved by a Registered Dietitian and provide a variety of foods. Foodservice plan provided by Trinity Services Group and complies with the applicable California Retail Food Code. A deficiency was found in the approval of the diet manual by the responsible physician. No other deficiencies were found. Itemized Summary III. Medical/Mental Health Evaluation Butte County Jail Best Practice: Adding Automatic External Defibrillators and Narcan to the first aid supply list, location and inspection policy. Medical equipment should be annually inspected for calibration and electrical safety. Butte County Sheriff Office Policy authorizes health authority to adopt and implement policies on AED and to ensure staff are trained on the use. Deficiency: Provision are in place for enforcement of self-medication rules but not included in formal written policies and procedures Corrective Action: Incorporate for enforcement of self-medication rules into written policies and procedures to ensure consistent practice Deficiency: Provision are in place for assessment of inmate compliance with self-medication but not included in formal written policies and procedures Corrective Action: Incorporate processes for assessment of inmate compliance with self-medication into written policies and procedures to ensure consistent practice Best Practice: Corporate Policies for pharmaceutical destruction should be incorporated into local policies and procedures Deficiency: There was no evidence of a formalized and approved list of first aid kit supplies but there is a list that is used for inventory and inspection is occurring. There is a list of supplies for emergency bags (different than first aid kits.) Corrective Action: establish and publish policy that defines content, location & inspection of first aid kits as required by Butte County Sheriff Office Policy 704 Chico Courthouse Itemized Summary I. Environmental Health Evaluation Chico Courthouse Deficiency- holding cell 104 has low water pressure from hand washing sink. Corrective action – repair to provide adequate water pressure to properly wash hands Deficiency- holding cell 104 and corridor between cells 201 and 202 have lights that are out. Corrective action – repair, maintenance has a work order in. Itemized Summary III. Medical/Mental Health Evaluation Chico Courthouse Overall, the facility seemed to be operated in an appropriate fashion. Deputies were cooperative and forthright in assisting with and facilitating the inspection. Deficiencies are primarily related to policy edits and training to the policies. Deficiency: First aid kits contents are not standardized. Manual is not specific as to specific contents and quantity. While policy states kits are to be inspected at least monthly, expired items were found in the kits and contents varied from kit to kit. Corrective Action: edit manual to make specific list of contents and review inspection process to ensure compliance with policy. Best practice: would be to have first aid kits in both court houses mirror each other in content and location. Would recommend kits be immediately available in closest area to cells as is done at Oroville facility. Deficiency: Contacting regional center is not addressed in Court Holding Facility Manual. Corrective action: edit policy and train staff to contact regional center for inmates thought to be developmentally disabled. Deficiency: Section 2.1058(5) of Court Holding Facility Manual allow for review every 2 hours. Corrective action: amend policy and procedure to comply with standard of every hour Deficiency: Section 2.1058 (5) of Policy allows for medical opinion within 6 hours Corrective action: amend policy and procedure to comply with standard of within four (4) hours in Court Holding Facility Manual Itemized Summary I. Environmental Health Evaluation Police Department – City of Chico Deficiency – all 7 holding cells do not have hot water. Some holding cell’s hot water button was not working Corrective action – provide hot water and fix the hot water button Deficiency – light in shower is not working Corrective action – repair Itemized Summary III. Medical/Mental Health Evaluation Police Department – City of Chico Deficiency: Training of facility staff is lacking. Corrective Action: Training program is in development per Lt Struthers. Recommend acceleration and implementation of training program. Deficiency: Policy does not specify specific contents of first aid kits and there is no documentation supporting periodic inspection. Expired contents were identified. Corrective Action: Update policy to list specific contents and locations of first aid kits. Establish policy and implement policy to regularly inspect first aid kits for complete and current status of contents. Commendation: Facility has an Automatic External Defibrillator (AED) in place. This is noted as best practice. Best Practice: AED should be included in the first aid inspection policy to ensure it us operational. Narcan should be available in the facility should drug overdose occur. Juvenile Hall Itemized Summary I. Environmental Health Evaluation Juvenile Halls, Special Purpose Juvenile Halls and Camps Deficiency - Item (n) The Hazard Analysis Critical Control Point Plan is out of date and was written by previous Food Services Manager. Corrective Action - The current Food Services Manager is working to write a new HACCP plan for facility and using the California Retail Food Code Deficiency- holding cell 3, intake shower room, rooms E12 and F1-F8 have no hot water at the hand washing sinks Corrective action – provide hot water Deficiency – hot water button at hand wash sinks in rooms E3, E13, and F11 are not working Corrective action – repair Deficiency – light is out in room E12 Corrective action – repair Summary of environmental health evaluation: Deficiencies were found throughout rooms for plumbing fixtures and lighting that need to be addressed. Rooms D1-16 and Condor Pod were not being occupied. Suggested best practices: Prior to rooms being occupied check for hot water, plumbing, and lighting to ensure it’s in good working condition. This facility has required policies and procedures in place. Summary of environmental health inspection: Raw shell eggs being used for juveniles. If former HACCP plan for using raw shell eggs in meals is not found create one or cease using raw shell eggs. Itemized Summary II. Nutritional Health Evaluation Juvenile Halls, Special Purpose Juvenile Halls and Camps Deficiency: No written process for how vegetarian or vegan diets may be requested, granted or denied. Corrective Action: Write process for how vegetarian or vegan diets may be requested, granted or denied. Carrots on menu frequently. If not already on menu recommend adding other Vitamin A rich sources like cantaloupe, sweet potatoes, winter squash, apricots, spinach, kale or collard greens. Deficiency: Medical diets are not planned, prepared or served with consultation of an RD. Corrective Action: Have RD plan and prepare medical diet manual for use by facility. Deficiency: Medical diet manual not available. Corrective Action: Medical diet manual will be available in both the medical unit and the food service office. Deficiency: Medical diet manual not available or approved. Corrective Action: Medical diet manual will be approved on an annual basis by the RD and responsible physician Deficiency: Substitutions are not evaluated by RD. Corrective Action: Have RD evaluate substitution logs to provide feedback on appropriate substitutions. Foodservice plan from 2014, recommended reviewing and updating. Old HACCP plan on file and staff not trained on procedures. Recommend updating HACCP plan and training all staff Deficiency: No provision for maintaining 3 days of meals for testing in the event of food-borne illness. Corrective Action: Create provision for maintaining 3 days of meals for testing. Menus and frequency of serving meet the nutritional requirements based on nutritional standards which include the Federal Child Nutrition Meal Program. Menus are planned well in advance and provide a variety of foods considering the cultural and ethnic makeup of the facility. Kitchen staff receive ongoing training in safe food handling techniques. Deficiencies were found include lack of medical diet manual, planning of vegetarian or vegan diets, proper review of substitutions by Registered Dietitian and provision to maintaining 3 days of meals for testing Itemized Summary III. Medical/Mental Health Evaluation Juvenile Halls, Special Purpose Juvenile Halls and Camps Addressed in Wellpath policy HCD 210Y D-07 Deficiency: First aid kits are available but contents are not uniform or defined in policy. Process is in place for inspecting kits but has holes that allows gaps in ensuring contents are current and complete. Corrective Action: Amend policy to include inventory list, inventory quantity, location of all first aid kits and process for ensuring contents are complete and up-to-date Facility does not have staffing to provide MAT for opioid use disorder. Commendations:(1) Facility is a Vaccinesfor Children (VFC) provider and RN is committed to getting immunizations up to date. New data logger information for VFC appliances will be forwarded to the RN by local health department vaccine coordinator. (2) RN provides Covid screening outside facility before youth enter to decrease transmission in to facility. (3) RN provides reproductive health education to youth in facility. Local health department health education specialist will connect with RN to coordinate education efforts and promote birth control methods and STD testing available at Public Health clinics. Oroville Courthouse Itemized Summary I. Environmental Health Evaluation Oroville Courthouse Policies and procedures in place but not being adhered to. Janitorial contract with Pro-Line Cleaning Services, Inc. Deficiency – holding cell next to the attorney visiting room and cells 42 and 43 have no hot water Corrective action – provide hot water. Hot water was turned back on during inspection, corrected on stie. Deficiency – lights in the holding cell (next to attorney visiting room) and the attorney visiting room were not working. Corrective action – repair Deficiency – A chain was hooked onto the back of the char in the attorney visiting room Corrective action – remove the chain Summary of environmental health evaluation: Deficiencies found with plumbing fixtures and lighting within the facility that need to be addressed. The hot water was turned off due to holding cells being unoccupied, which was then turned on during the inspection. Have policies in place to ensure hot water is turned on when cells are going to be occupied and to check lights regularly to ensure they are working. Best Practices: Have soap available for inmates to wash their hands, when requested. Itemized Summary III. Medical/Mental Health Evaluation Oroville Courthouse Deficiency: First aid kits contents are not standardized. Manual is not specific as to contents and quantity. While policy states kits are to be inspected at least monthly, expired items were found in the kits and contents varied from kit to kit. Corrective Action: edit manual to make specific list of contents and review inspection process to ensure compliance with policy. Best practice: would be to have first aid kits in both court houses mirror each other in content and location. Deficiency: Contacting regional center is not addressed in policy manual. Corrective action: edit policy and train staff to contact regional center for inmates thought to be developmentally disabled. Deficiency: Section 2.1058(5) of Court Holding Facility Manual allows for review every 2 hours. Corrective action: amend policy and procedure to comply with standard of every hour. Deficiency: Section 2.1058 (5) of Policy allows for medical opinion within 6 hours Corrective action: amend policy and procedure to comply with standard of within four (4) hours in Court Holding Facility Manual Overall, the facility seemed to be operated in an appropriate fashion. Deputies were cooperative and forthright in assisting with and facilitating the inspection. Deficiencies are primarily related to policy edits and training to the policies. Paradise Police Department Itemized Summary I. ENVIRONMENTAL HEALTH EVALUATION Paradise Police Department Deficiency – light is out in right holding cell Corrective action – repair Itemized Summary III. Medical/Mental Health Evaluation Paradise Police Department Deficiency: Policy is not in place with location and approved inventory list of contents of first aid kits. Also, Policy is not in place for consistent inspection of kits for currency and completeness Corrective Action: update policy manual to include inventory list of first aid kits, locations, and inspection procedure. Staff were cooperative and collaborative in completion of the inspection. Generally, the facility meets the inspection requirements. Facility does have an Automatic External Defibrillator (AED) in hallway nearby holding facility cells with an inspection checklist. Best Practice: Best practice would be to include Narcan with emergency medical supplies. The location should be central in the Department facility to be available to all parts of the building and defined in the policy manual