This chapter establishes minimum operating standards for General Residential Operations (GROs) and Residential Treatment Centers (RTCs) in Texas, which are child-caring facilities licensed by HHSC. It sets requirements for child-to-caregiver ratios during waking and sleeping hours, staffing levels, supervision practices, and special provisions for family residential centers and transitional living programs. Permit holders and administrators of both licensed and unlicensed GROs must ensure continuous compliance with these standards as applicable to the services they provide.
View official source§748.1 What is the purpose of this chapter? The purpose of this chapter is to set forth rules that apply to General Residential Operations and Residential Treatment Centers. Source Note: The provisions of this §748.1 adopted to be effective January 1, 2007, 31 TexReg 7377; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.3 Who is responsible for complying with these minimum standards? (a) For a licensed general residential operation, the permit holder must ensure compliance with the minimum standards in this chapter at all times, with the exception of those minimum standards identified for specific types of services that your operation does not offer. For example, if we license your operation to offer emergency care services only, you do not have to comply with the minimum standards that apply to treatment services for a child with an emotional disorder, treatment services for a child with an intellectual disability, or a transitional living program; however, you must comply with all other applicable minimum standards of this chapter. (b) For an unlicensed general residential operation that is subject to Licensing's regulation, the operation's administrator, owner, or operator or any other controlling person who has the ability to influence or direct the operation's management, expenditures, or policies must ensure compliance with all minimum standards in this chapter at all times, with the exception of those minimum standards identified for specific types of services that the unlicensed operation does not offer. Source Note: The provisions of this §748.3 adopted to be effective January 1, 2007, 31 TexReg 7377; amended to be effective January 1, 2017, 41 TexReg 10393; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.5 How do Residential Treatment Centers comply with the rules of this chapter? Residential Treatment Centers (RTCs) are general residential operations that provide treatment services to children with emotional disorders. RTCs, by definition, must always comply with the rules of this chapter as if 100% of the children in their care require treatment services for emotional disorders. This includes, but is not limited to, services to individual children, personnel requirements, and child/caregiver ratio requirements. Source Note: The provisions of this §748.5 adopted to be effective September 1, 2010, 35 TexReg 7497; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.7 How are these regulations applied to family residential centers? (a) Definition. A family residential center is one that meets all of the following requirements: (1) The center is operated by or under a contract with United States Immigration and Customs Enforcement; (2) The center is operated to enforce federal immigration laws; (3) Each child at the center is detained with a parent or other adult family member, who remains with the child at the center; and (4) A parent or family member with a child provides the direct care for the child except for specific circumstances when the child is cared for directly by the center or another adult in the custody of the center. (b) Classification. A family residential center is a general residential operation (GRO) and must comply with all associated requirements for GROs, unless the family residential center is approved for an individual waiver or variance or an exception is provided in this section. The department is responsible for regulating the provision of childcare as authorized by Chapters 40 and 42, Texas Human Resources Code and Chapter 261, Texas Human Resources Code. The department does not oversee requirements that pertain to other law, including whether the facilities are classified as secure or in compliance with any operable settlement agreements or other state or federal restrictions. (c) Exceptions. A family residential center is not required to comply with all terms of the following Minimum Standards: (1) the limitation of room occupants to four in §748.3357 of this title (relating to What are the requirements for floor space in a bedroom used by a child?), except that nothing in this exception shall be construed to require fewer than 60 square feet per child; (2) the limitation on a child sharing a bedroom with an adult in §748.3361 of this title (relating to May a child in care share a bedroom with an adult?), if the bedroom is being shared in order to allow a child to remain with the child's parent or other family member; and (3) the limitations on children of the opposite gender sharing a room in §748.3363 of this title (relating to May children of opposite genders share a bedroom?), except that nothing in this exception shall be construed to permit children from different families who are over the age of six and members of the opposite gender to share a bedroom. (d) Limitation of exception. Notwithstanding subsection (c) of this section, and as further described in §745.8313 of this title (relating to Is a waiver or variance unconditional?), the department retains the authority for placing conditions on the scope of the exceptions authorized for a family residential center, including conditions related to limiting occupancy in accordance with fire safety standards, limitations related to allowing children and adults of the opposite gender to occupy the same room only if they are part of the same family, and any other limitation determined by the department to be necessary to the health, safety, or welfare of children in care. (e) Division of responsibility. In addition to the application materials described in §745.243(6) of this title (relating to What does a completed application for a permit include?), an applicant for a license under this section must submit the policies, procedures, and any other documentation that the department deems necessary to clarify the division of supervisory and caretaking responsibility between employees of the facility and the parents and other adult family members who are housed with the children. The department must approve the documentation during the application process and any subsequent amendments to the policies and procedures. (f) Applicability. This rule is applicable only to the extent that a GRO may provide care to children who are unlawfully present in the United States and in the custody of the federal government. Source Note: The provisions of this §748.7 adopted to be effective March 1, 2016, 41 TexReg 1493; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909; amended to be effective July 8, 2022, 47 TexReg 4337. §748.1001 What is the child/caregiver ratio? The child/caregiver ratio is the maximum number of children for whom one caregiver can be responsible. Source Note: The provisions of this §748.1001 adopted to be effective January 1, 2007, 31 TexReg 7377; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.1003 For purposes of the child/caregiver ratio, how many children can a single caregiver care for during the children's waking hours? (a) The number of children that a single caregiver may care for during waking hours depends on the ages and treatment service needs of the children in the group. A single caregiver may care for five children if at least one child in the group requires treatment services, or eight children if none of the children in the group require treatment services. Children younger than five years old count as two children. (b) You may separate children into groups based on age and/or treatment services in order to vary the child/caregiver ratio required for each group, as long as: (1) The groups remain easily distinguishable and separated, such as by cottage or unit; and (2) The child/caregiver ratio is re-calculated any time groups intermingle, such as on a field trip or in the dining room. (c) A cottage home may be out of ratio during waking hours for short periods to enable a normal home-like routine as long as the care and supervision needs of the children continue to be met. Staff or other caregivers must be on the premises and available to respond in an emergency. These additional staff or caregivers must be specifically addressed in the written professional staffing plan. (d) A child does not count in the child/caregiver ratio while participating in an approved unsupervised childhood activity. Source Note: The provisions of this §748.1003 adopted to be effective September 1, 2010, 35 TexReg 7497; amended to be effective January 1, 2017, 41 TexReg 10422; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.1005 Can child/caregiver ratios be averaged on an operation-wide basis? Each group of children must have sufficient caregivers to meet the required child/caregiver ratio for that group of children. A person may not be counted in the ratio for a group of children if he is caring for children outside the group or working in an administrative capacity. Source Note: The provisions of this §748.1005 adopted to be effective January 1, 2007, 31 TexReg 7377; amended to be effective September 1, 2010, 35 TexReg 7497; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.1007 For purposes of the child/caregiver ratio, how many children can a single caregiver care for when children are asleep at night? (a) The number of children that a single caregiver may care for during night-time sleeping hours depends on whether the caregiver stays awake or sleeps during these hours and on the ages and treatment service needs of the children in the group. Children younger than five years old count as two children. (b) If the caregiver stays awake, the caregiver may care for: (1) 15 children if at least one child in the group requires treatment services; or (2) 24 children if none of the children in the group require treatment services. (c) If the caregiver sleeps, the caregiver may care for: (1) 10 children if at least one child in the group requires treatment services; or (2) 16 children if none of the children in the group require treatment services. (d) You may separate children into groups based on age and/or treatment services in order to vary the child/caregiver ratio required for each group, as long as: (1) The groups remain easily distinguishable and separated, such as by cottage or unit; and (2) The child/caregiver ratio is re-calculated any time groups intermingle, such as on a field trip. (e) A cottage home may be out of ratio during night-time sleeping hours for short periods to enable a normal home-like routine as long as the care and supervision needs of the children continue to be met. Staff or other caregivers must be on the premises and available to respond in an emergency. These additional staff or caregivers must be specifically addressed in the written professional staffing plan. Source Note: The provisions of this §748.1007 adopted to be effective September 1, 2010, 35 TexReg 7497; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.1009 How many caregivers must I employ? You must employ an adequate number of qualified caregivers to meet the needs of children, taking into account each child's age, medical, physical, and mental condition and other factors that affect the amount of supervision the child requires, including enough caregivers to meet: (1) Child/caregiver ratios; and (2) All of their responsibilities required in §748.685 of this title (relating to What responsibilities does a caregiver have when supervising a child or children?). Source Note: The provisions of this §748.1009 adopted to be effective January 1, 2007, 31 TexReg 7377; amended to be effective January 1, 2017, 41 TexReg 10393; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.1011 What employees can be counted as a caregiver in the child/caregiver ratio? The child/caregiver ratio only includes qualified caregivers who are working directly with a child or group of children. Source Note: The provisions of this §748.1011 adopted to be effective January 1, 2007, 31 TexReg 7377; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.1013 How does a caregiver care for a child needing constant supervision during sleeping hours? (a) A caregiver must always be awake when caring for a child needing constant supervision, such as a medically fragile child or a child that is an immediate danger to self or others. (b) To facilitate continuous care for a child, the caregiver may move a child to a location where the caregiver can directly and continuously supervise a child until there is no longer an immediate danger to self or others. The caregiver must provide comfortable sleeping arrangements for the child. Source Note: The provisions of this §748.1013 adopted to be effective January 1, 2007, 31 TexReg 7377; amended to be effective January 1, 2017, 41 TexReg 10393; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.1015 How does the child/caregiver ratio apply if I provide care for both children in care and children of caregivers, or for both children and adult residents? (a) The child/caregiver ratio applies to the children of caregivers who are present with children in care. (b) For both children and adult residents, you must maintain the ratio as outlined in §748.1935 of this title (relating to How does the child/caregiver ratio apply if I provide care to both children and adults?). Source Note: The provisions of this §748.1015 adopted to be effective January 1, 2007, 31 TexReg 7377; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.1017 How does the child/caregiver ratio apply to activities that occur away from my operation? (a) The child/caregiver ratio applies to activities sponsored or conducted by the operation, including field trips, higher risk recreational activities, and appointments that occur away from the operation. (b) You must have additional caregivers to meet the special needs of children when there are activities away from your operation, for example a non-ambulatory child. Source Note: The provisions of this §748.1017 adopted to be effective January 1, 2007, 31 TexReg 7377; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.1019 What are the supervision requirements for a transitional living program? A caregiver counted in the child/caregiver ratio who is responsible for supervising children of the same gender in a transitional living program must: (1) Reside in or within close physical proximity of the children's living quarters; (2) Be onsite at the operation during times when children are awake, but the caregiver is not physically present with the children; (3) Be physically available to the children at all times; (4) Be capable of responding quickly in an emergency; and (5) Be capable of monitoring the comings and goings of the children in the program. Source Note: The provisions of this §748.1019 adopted to be effective January 1, 2007, 31 TexReg 7377; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.1021 When does a child who is in a transitional living program not need supervision? (a) The child must be 16 years old or older. (b) You must evaluate each child in a transitional living program to determine whether the child needs supervision. The evaluation must: (1) Include a written plan defining the periods of time the child may be left unsupervised; (2) Include a written plan for addressing behavioral problems that a child may have while in the transitional living program; and (3) Identify how the child may contact the caregivers when caregivers are not physically present with the child, such as being available to the child by telephone or other means of contact. (c) The child's service planning team must approve the evaluation. (d) You must document the evaluation of the child and the approval in the child's record. You must review and update the evaluation during the child's service planning meetings. Source Note: The provisions of this §748.1021 adopted to be effective January 1, 2007, 31 TexReg 7377; amended to be effective January 1, 2017, 41 TexReg 10393; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.1023 Is my operation permitted to have a transitional living program with living quarters, a cottage, or a house with both male and female residents? You must not have living quarters, a cottage, or a house with both male and female residents, unless caregivers are always present when children are at the living quarters, cottage, or house of the transitional living program. Source Note: The provisions of this §748.1023 adopted to be effective January 1, 2007, 31 TexReg 7377; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.1101 What rights does a child in care have? (a) A child's rights are cumulative of any other rights granted by law or other Licensing rules. (b) The following categories include the child's rights that you must adhere to: (1) Safety and care, including: (A) The right to good care and treatment that meets the child's needs in the most family-like setting possible; (B) The right to be free from abuse, neglect, and exploitation; and (C) The right to fair treatment; (2) Family contacts, including the right to maintain regular contact with the child's parents and siblings, unless restrictions are necessary because of the child's best interest, the decision of an appropriate professional, or a court order; (3) Living a normal life, including: (A) The right to be able to communicate in a language or any other means that is understandable to the child at admission or within a reasonable time after an emergency admission, if applicable, such as having a plan for an interpreter, having at least one person at the operation at all times who can communicate with the child in the child's own language, or other means to communicate with the child in the child's own language; (B) The right to receive educational services appropriate to the child's age and developmental level; (C) The right to have the child's religious needs met; (D) The right to participate in childhood activities, including unsupervised childhood activities away from the operation and the caregivers, that are appropriate for the child's age, maturity, and developmental level; (E) The right to privacy, including sending and receiving unopened mail, making and receiving phone calls, keeping a personal journal, and having visitors, unless the child's best interest, appropriate professionals, or court order necessitates restrictions; (F) The right to personal care, hygiene, and grooming equipment and supplies and training in how to use them; (G) The right to have comfortable clothing, which is suitable to the child's age and size and similar to the clothing of other children in the community. Teenagers should have reasonable opportunities to select the clothing; (H) The right to clothing that protects the child against the weather; (I) The right to have personal items in the child's room and to get additional items within reasonable limits; (J) The right to personal space in the child's bedroom to store the child's clothes and belongings; (K) The right to be informed of search policies and be free of unreasonable searches and unreasonable removal of personal items; (L) Depending on the child's age and maturity, the right to seek employment, keep the child's own money, have a bank account in the child's name, and get paid for any work done for the operation as part of the child's service plan or vocational training, with the exception of assigned routine duties that relate to the child's living environment, such as cleaning the child's room, or other chores, or work assigned as a disciplinary measure; (M) The right to consent in writing before taking part in any publicity or fund raising activity for the operation, including the use of the child's photograph; (N) The right to refuse to make public statements showing gratitude to the operation; and (O) The right to not be pressured to get an abortion, give up her child for adoption, or parent her child, if applicable; (4) Discipline, including: (A) The right to be free from any harsh, cruel, unusual, unnecessary, demeaning, or humiliating treatment or punishment. This means the child must not be: (i) Shaken; (ii) Subjected to or threatened with corporal punishment, including spanking or hitting the child; (iii) Forced to do unproductive work that serves no purpose except to demean the child, such as moving rocks from one pile to another or digging a hole and then filling it in; (iv) Denied food, sleep, a bathroom, mail, or family visits as punishment; (v) Subjected to remarks that belittles or ridicules the child or the child's family; (vi) Threatened with the loss of placement or shelter as punishment; and (vii) Subjected to demeaning behavior to embarrass, control, harm, intimidate, or isolate the child. "Demeaning behavior" may include using physical force, rumors, threats, or inappropriate comments; (B) The right to discipline that is appropriate to the child's age, maturity, and developmental level; and (C) The right to have restrictions or disciplinary policies explained to the child at admittance and when the measures are imposed; (5) Plans for the child while in care, including: (A) The right to have a comprehensive service plan that addresses the child's needs, including transitional and discharge planning; and (B) The right to actively participate in the development of the child's service plan within the limits of the child's comprehension and ability to manage the information. The child has the right to a copy or summary of the plan. A child 14 years of age or older has the right to review and sign the service plan, unless there is a reason not to provide the plan; (6) Medical care and records, including: (A) The right to medical, dental, vision, and mental health care and developmental services that adequately meet the child's needs. The right to request that the care or services be separate from adults (other than young adults) who are receiving services; (B) The right to be free of unnecessary or excessive medication; and (C) The right to confidential care and treatment, including keeping medical records and operation records private and only discussing them when it is about the child's care; and (7) Complaints, including the right to make calls, reports, or complaints without interference, coercion, punishment, retaliation, or threats of punishment or retaliation. The child may make these calls, reports, or complaints anonymously. Depending upon the nature of the complaint, the child has the right to call, report, or complain to: (A) The DFPS Texas Abuse/Neglect Hotline at 1-800-252-5400; (B) The HHSC Ombudsman for Children and Youth Currently in Foster Care at 1-844-286-0769; (C) The DFPS Office of Consumer Affairs at 1-800-720-7777; or (D) Disability Rights of Texas at 1-800-252-9108. Source Note: The provisions of this §748.1101 adopted to be effective January 1, 2017, 41 TexReg 10393; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.1103 How must I inform a child and the child's parents of their rights? (a) Within seven days after you admit a child into your operation, you must review the child's rights with the child and a child's parent, unless the parent's consent is not required. You must also provide the child and a child's parent with a written copy of the child's rights. (b) Child rights must be written in: (1) Simple, non-technical terms; and (2) English, unless the person does not understand English. The child's rights must be written in the person's primary language, if possible. (c) If the person you are informing has a visual or auditory impairment, you must explain the child's rights in a manner that is understandable to the person. (d) The person you are informing of the child's rights must sign a statement indicating that the person has read and understands these rights. A copy of a timely signed "CPS Rights of Children and Youth in Foster Care" will meet this standard. You must put the signed copy in the child's record. Source Note: The provisions of this §748.1103 adopted to be effective January 1, 2007, 31 TexReg 7377; amended to be effective January 1, 2017, 41 TexReg 10393; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.1107 What right does a child have regarding contact with his parent(s)? (a) You must allow contact between a child and his parent(s) whose parental rights have not been terminated according to: (1) Your policies; and (2) The provisions of a court order or any visitation agreements. (b) You must document in the child's record: (1) Any plans for contact between the child and a parent; and (2) Any decision to limit contact with a parent. (c) Before the service planning team, treatment director, or professional level service provider can temporarily restrict ongoing contacts or communication between the child and a parent, you must: (1) Explain the reasons for the restrictions to the child and the child's parent; and (2) Document the reasons in the child's record. (d) Restrictions imposed by you that continue for more than 30 days must be re-evaluated monthly by a professional level service provider, who also must: (1) Explain the reasons for the continued restrictions to the child and the child's parents; and (2) Document the reasons in the child's record. (e) If you limit communications or visits with a parent for practical reasons, such as geographical distance or expense, you must discuss the limits with the child and the child's parents. You must document the limits in the child's record. Source Note: The provisions of this §748.1107 adopted to be effective January 1, 2007, 31 TexReg 7377; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.1109 What right does a child have regarding contact with siblings? (a) A child must have a reasonable opportunity for sibling visits and contacts in an effort to preserve sibling relationships. (b) You must address plans for sibling visits and contacts in the child's record. (c) When you restrict sibling contact, you must include justification in the child's record. Restrictions imposed by you that continue for more than 60 days must be re-evaluated every 60 days by a professional level service provider, who also must: (1) Explain the reasons for the continued restrictions to the child; and (2) Document the reasons in the child's record. (d) If barriers to visits exist, such as unavoidable geographic distance and expense issues, the operation must make provisions for sibling contact through letters, telephone calls, or some other means. Source Note: The provisions of this §748.1109 adopted to be effective January 1, 2007, 31 TexReg 7377; amended to be effective September 1, 2010, 35 TexReg 7497; amended to be effective January 1, 2017, 41 TexReg 10393; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.1111 What right to privacy does a child have in his contact with others? (a) Except as determined by the child's service planning team, treatment director, professional level service provider, or parent, you may not: (1) Open or read the child's incoming or outgoing mail, including electronic mail, unless necessary to assist the child with reading or writing; or (2) Listen to or screen the child's telephone calls unless the child needs assistance with using the telephone. (b) You must document in the child's record: (1) Any reason for restrictions on the child's mail or telephone calls that you impose; and (2) A list of the mail or telephone calls that you restrict. (c) You must inform the child and his parent about restrictions you place on the child. (d) Restrictions imposed by you that continue for more than 30 days must be re-evaluated monthly by a professional level service provider, who also must: (1) Explain the reasons for the continued restrictions to the child; and (2) Document the reasons in the child's record. Source Note: The provisions of this §748.1111 adopted to be effective January 1, 2007, 31 TexReg 7377; amended to be effective September 1, 2010, 35 TexReg 7497; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.1113 Under what circumstances may I conduct a search for prohibited items or items that endanger a child's safety? (a) A child's possessions must be free of unreasonable searches and unreasonable removal of personal items. (b) You may search a child, his possessions, or his room when you have reasonable suspicion: (1) Of the presence of a prohibited item or an item that endangers the child's safety; (2) That the child made suicidal threats or threatened to hurt himself or others; or (3) That the child was involved in theft. (c) Residential treatment centers and emergency care services programs may conduct routine searches (such as upon return from a home visit or return from school) as long as the routine searches are: (1) Justified in your policies; (2) Conducted uniformly; and (3) Do not involve the removal of clothing, other than outer clothing, such as coats, jackets, hats, gloves, shoes, or socks. (d) Only a caregiver of the same gender as the child may conduct a search that involves the removal of clothing, other than outer clothing, such as coats, jackets, hats, gloves, shoes, or socks. (e) If a search involves the removal of clothing (other than outer clothing), a second caregiver must witness the search. (f) The caregiver must ensure that other children do not witness a search that involves the removal of clothing, other than outer clothing. Source Note: The provisions of this §748.1113 adopted to be effective January 1, 2007, 31 TexReg 7377; amended to be effective September 1, 2010, 35 TexReg 7497; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.1115 May a caregiver conduct a body cavity search of a child in care? With the exception of a child's mouth, a caregiver may not conduct a body cavity search of a child in care. Source Note: The provisions of this §748.1115 adopted to be effective January 1, 2007, 31 TexReg 7377; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.1117 What must I document regarding a search? You must document the following in the child's record when you conduct a search under §748.1113(b) of this title (relating to Under what circumstances may I conduct a search for prohibited items or items that endanger a child's safety?): (1) The date of the search; (2) The name of the child; (3) Reason for the search; (4) A description of what you searched; (5) The clothing removed, if applicable; (6) The name of the caregivers conducting the search; (7) The name of the witness, if applicable; (8) The results of the search; and (9) The resolution of the issue with the child, including increased supervision, additional counseling, or disciplinary consequences. Source Note: The provisions of this §748.1117 adopted to be effective January 1, 2007, 31 TexReg 7377; amended to be effective September 1, 2010, 35 TexReg 7497; amended to be effective January 1, 2017, 41 TexReg 10393; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.1119 What techniques am I prohibited from using on a child? Certain techniques must not be used on a child, including: (1) Chemical restraints. For more information on emergency behavior intervention, see Subchapter N of this chapter (relating to Emergency Behavior Intervention); (2) Aversive conditioning, which includes, but is not limited to, any technique designed to or likely to cause a child physical pain, the application of startling stimuli, and the release of noxious stimuli or toxic sprays, mists, or substances in proximity to the child's face; (3) Pressure points; (4) Rebirthing therapy; (5) Hug and/or holding therapy; and (6) Taser or stun guns. Source Note: The provisions of this §748.1119 adopted to be effective January 1, 2007, 31 TexReg 7377; amended to be effective January 1, 2017, 41 TexReg 10393; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.2301 What are the requirements for disciplinary measures? (a) Only a caregiver known to and knowledgeable of a child may discipline the child. (b) Each disciplinary measure must: (1) Be consistent with your policies and procedures; (2) Not be physically or emotionally damaging to the child; (3) Be individualized to meet each child's needs; (4) Be appropriate to the child's level of understanding, age, and developmental level; and (5) Be appropriate to the incident and severity of the behavior demonstrated. (c) The goal of each disciplinary measure must be to teach the child acceptable behavior and self-control. The caregiver must explain the reason for the disciplinary measure when the caregiver imposes the measure. Source Note: The provisions of this §748.2301 adopted to be effective January 1, 2007, 31 TexReg 7377; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.2303 May I use corporal punishment for children in care? (a) You may not use or threaten to use corporal punishment with any child in care. (b) Corporal punishment is the infliction of physical pain on any part of a child's body as a means of controlling or managing the child's behavior. It includes: (1) Hitting or spanking a child with a hand or instrument; or (2) Forcing or requiring the child to do any of the following as a method of managing or controlling behavior: (A) Perform any form of physical exercise, such as running laps or doing sit ups or push ups; (B) Hold a physical position, such as kneeling or squatting; or (C) Do any form of "unproductive work." Source Note: The provisions of this §748.2303 adopted to be effective January 1, 2007, 31 TexReg 7377; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.2305 What is "unproductive work"? (a) "Unproductive work" is work that serves no purpose except to demean the child. Examples include moving rocks or logs from one pile to another or digging a hole and then filling it in. Unproductive work is never an appropriate behavior management tool. (b) "Unproductive work" does not include work that corrects damage that the child's behavior caused. For example, you may require a child who defaces a fence or wall to repaint it. This example includes a logical consequence and is an acceptable behavior management tool. Source Note: The provisions of this §748.2305 adopted to be effective January 1, 2007, 31 TexReg 7377; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.2307 What other methods of punishment are prohibited? In addition to corporal punishment, prohibited discipline techniques include: (1) Any harsh, cruel, unusual, unnecessary, demeaning, or humiliating discipline or punishment; (2) Denial of mail or visits with their families as discipline or punishment; (3) Threatening with the loss of placement as discipline or punishment; (4) Using sarcastic or cruel humor; (5) Maintaining an uncomfortable physical position, such as kneeling, or holding his arms out; (6) Pinching, pulling hair, biting, or shaking a child; (7) Putting anything in or on a child's mouth; (8) Humiliating, shaming, ridiculing, rejecting, or yelling at a child; (9) Subjecting a child to abusive or profane language; (10) Placing a child in a dark room, bathroom, or closet; (11) Requiring a child to remain silent or inactive for inappropriately long periods of time for the child's age; (12) Confining a child to a highchair, box, or other similar furniture or equipment as discipline or punishment; (13) Denying basic child rights as discipline or punishment; (14) Withholding food that meets the child's nutritional requirements; and (15) Using or threatening to use emergency behavior intervention as discipline or punishment. Source Note: The provisions of this §748.2307 adopted to be effective January 1, 2007, 31 TexReg 7377; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909; amended to be effective April 25, 2022, 47 TexReg 2248. §748.2309 To what extent may I restrict a child's activities as a behavior management tool? (a) Within limits, a caregiver may restrict a child's activities as a behavior management tool. (b) Restrictions of activities that will be imposed on a child for more than fourteen days, must have prior approval by the treatment director, service planning team, or professional level service provider. (c) Restrictions to a particular room or building that will be imposed on a child for more than 24 hours must have prior approval by the treatment director, service planning team, or professional level service provider. (d) You must inform the child and parent about any restrictions that you place on the child. (e) Documentation of all approvals, justification for the restriction, and informing the child and parents must be in the child's record. Source Note: The provisions of this §748.2309 adopted to be effective January 1, 2007, 31 TexReg 7377; amended to be effective January 1, 2017, 41 TexReg 10393; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §748.2311 May a child or adult in care discipline or punish another person in care? No. A person in care must not discipline or punish another person in care. Source Note: The provisions of this §748.2311 adopted to be effective January 1, 2007, 31 TexReg 7377; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909.