In this chapter, the following terms have the meanings indicated. Terms Defined. “Activities of daily living” means normal daily activities, including: Eating or being fed; Grooming, bathing, and oral hygiene; Mobility, transfer, ambulation, and use of environmental aids to assist the individual to achieve greater independence; Toileting; and Dressing. “Activities coordinator” means the individual assigned to develop and direct the activity program for the adult day care center. “Actual harm deficiency” means: A condition existing in a center; or An action or inaction by the center staff that has caused physical or emotional injury or impairment to a participant. “Adult Day Care Assessment and Planning System (ADCAPS)” means a system that is comprised of a comprehensive assessment completed by the RN, that is designed to evaluate the participant’s strengths and needs, which facilitates the development of a problem list, service plans, and personal goals that make up the individualized plan of care. "Center" means any nonresidential program meeting the definition in Health-General Article, §14-201(b) or 14-301(b), Annotated Code of Maryland. “Certified medication technician (CMT)” means an individual who is certified as a medication technician as defined in Health Occupations Article, §8-6A, Annotated Code of Maryland. “Certified Nursing Assistant (CNA)” means an individual who is certified as a nursing assistant as defined in Health Occupations Article, §8-6A, Annotated Code of Maryland. “Chemical restraint” means the use of a drug or medication that is not a standard treatment for a participant's condition to control or restrict the participant's movement “Cognitively intact” means a participant who has sufficient judgment, planning, organization, self-control, and the persistence needed to manage the normal demands of the participant's environment. “Communicable disease” has the meaning stated in COMAR 10.06.01.02 and 10.06.01.03. “Deficiency” means a condition existing in a center, or an action or inaction by the center staff that result in the potential for more than minimal harm, actual harm, or serious and immediate threat to one or more participants. “Department” means the Maryland Department of Health. “Direct participant care” means day-to-day direct assistance to participants in accomplishing activities of daily living and in meeting health and psychosocial needs. “Employee” means a full-time or part-time staff individual who works regular hours for pay. “Existing center” means a center that is licensed by the Department or has its plans approved by the Department at the time of adoption of the regulations of this chapter. “Full-time” means 40 hours per week or the standard workweek adopted by the center. “Governing body” means the individual, partnership, agency, group, corporation, or other entity set up to assume full legal responsibility for the policy determination, management, operation, and financial liability of the center. “Individual plan (IP)” means a document that specifies assessments, services, supports, and training required by the individual as specified in COMAR 10.22.05. “Informal Dispute Resolution (IDR)” means an informal process that provides a licensee the opportunity to question the Department about deficiencies cited on a recent inspection. "Health care provider” means an individual who is licensed, certified, or otherwise authorized under the Health Occupations Article to provide health care services. “Licensed practical nurse (LPN)” means an individual: Licensed to practice licensed practical nursing as defined in Health Occupations Article, §8-301, Annotated Code of Maryland; and Whose practice is in accordance with the provisions of COMAR 10.27.10. “Licensed social worker” means an individual who is licensed to practice social work as defined in Health Occupations Article, Annotated Code of Maryland. “Mental illness” has the meaning stated in COMAR 10.09.70.10A. “New center” means a center that does not have plans approved by the Department. “Office of Health Care Quality (OHCQ)” means the Office of Health Care Quality of the Maryland Department of Health. “Ongoing pattern” means the occurrence of any potential for more than minimal harm or greater deficiency on two consecutive on-site visits as a result of annual surveys, follow up visits, any unscheduled visits, or complaint investigations. “Participant” means a health-impaired adult whose: Illness or disability does not require 24-hour inpatient care; and Needs cannot be satisfactorily met in an episodic ambulatory care setting but require at least 1 day of care per week in a day care program. “Part-time” means less than full-time. “Physical restraint” means the use of a device or physical action to prevent, suppress, or control head, body or limb movement, that cannot be readily and easily removed by the participant knowingly and with intent. “Physician” means an individual licensed to practice medicine as defined in Health Occupations Article, §14-301, Annotated Code of Maryland. “Potential for more than minimal harm deficiency” means a condition existing in a center or an action or inaction by the center staff that has the potential to cause actual harm to the participant. “Pre-licensure site visit” means an on-site survey to determine if a center is ready to begin operating in accordance with the requirements set forth in this chapter. “Problem list” means issues and concerns identified from the assessment. “Program assistant” means an individual assigned to perform activities, supportive functions, and direct participant care under appropriate supervision. “Registered nurse (RN)” means an individual licensed to practice as a registered nurse as defined in Health Occupations Article, §8-301, Annotated Code of Maryland. “Secretary” means the Secretary of Health or the Secretary's designee. “Self-administer” means the act of a participant taking medication at the correct time, by the correct route, and in the correct dosage, as prescribed by an authorized prescriber. “Serious and immediate threat” means a situation in which immediate corrective action is necessary because a center's noncompliance with one or more State regulations has caused, or is likely to cause, serious injury, harm, impairment to, or death of a participant receiving care in the center. “Significant change of condition” means a change in the participant’s physical, mental, or psychological status as defined by the registered nurses comprehensive assessment. “Sustained compliance” means a period of 30 days following the date of notice of corrective action with no deficiencies. “Volunteer” means an individual who: Gives help, does a service, or takes an obligation, on-site for 8 hours or more per week, without payment; and Serves or acts of his or her own free will under the direction of the administrative staff of the center. “Written agreement” means a legally binding contract between two or more parties that sets forth terms and conditions and which has been reduced to writing and signed and dated by all parties.