<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".19" citation="COMAR 10.09.81.19" title_num="10" subtitle_num="09" chapter_num="81" heading="Specific Conditions for Participation — Senior Center Plus.">
  <text>To participate in the ICS Program as a provider of Senior Center Plus services, as specified in Regulation .36 of this chapter, a provider shall:</text>
  <paragraph num="A.">
    <text>Be approved and monitored by the Maryland Department of Aging as a nutrition service provider;</text>
  </paragraph>
  <paragraph num="B.">
    <text>Meet all local and State requirements to operate as a nutrition site, which include but are not limited to inspection and approval of the facility by the local fire marshal, periodic fire drills, and inspection and approval by the local sanitarian to assure compliance with health department requirements for food service facilities;</text>
  </paragraph>
  <paragraph num="C.">
    <text>Assure that the facility is accessible to individuals with disabilities;</text>
  </paragraph>
  <paragraph num="D.">
    <text>Maintain adequate records on participants, including progress notes and outcomes;</text>
  </paragraph>
  <paragraph num="E.">
    <text>Provide at least one staff person per eight clients, with additional staffing if required by the Maryland Department of Aging depending on participants' functional levels;</text>
  </paragraph>
  <paragraph num="F.">
    <text>Employ as the center's manager or in another staff position an individual who:</text>
    <paragraph num="(1)">
      <text>Is a licensed health professional or a licensed social worker;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Has at least 3 years’ experience in direct patient care at an adult day care center, nursing facility, or health-related facility;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Is literate and able to communicate in English; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Participates in training specified and approved by the Maryland Department of Aging;</text>
    </paragraph>
  </paragraph>
  <paragraph num="G.">
    <text>Provide Senior Center Plus services, as specified in Regulation .36 of this chapter, to participants at least 4 hours a day, 1 or more days a week on a regularly scheduled basis, in an out-of-home, outpatient setting;</text>
  </paragraph>
  <paragraph num="H.">
    <text>Serve at least one nutritional meal per day that:</text>
    <paragraph num="(1)">
      <text>Is prepared in a licensed food service establishment;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Meets at least one-third of the daily recommended dietary allowance; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Does not constitute a full nutritional regimen of three meals per day;</text>
    </paragraph>
  </paragraph>
  <paragraph num="I.">
    <text>Serve snacks, as desired by the participants, when the day program exceeds 6 hours; and</text>
  </paragraph>
  <paragraph num="J.">
    <text>Have menus reviewed and approved quarterly by a registered dietitian for nutritional adequacy.</text>
  </paragraph>
</regulation>