This chapter establishes minimum operating standards for child-placing agencies (CPAs) in Texas, governing the verification and ongoing monitoring of foster homes, admission and placement processes for children in care, child rights protections, caregiver responsibilities for infant and toddler care, discipline, education, and medical/dental care. CPAs must conduct supervisory visits, compliance evaluations, and maintain detailed documentation for each foster home and child in care. The rules cover the full lifecycle of a foster placement, from pre-placement assessment through post-placement monitoring and discharge planning.
View official source§749.1 What is the purpose of this chapter? The purpose of this chapter is to set forth the rules that apply to child-placing agencies. Source Note: The provisions of this §749.1 adopted to be effective January 1, 2007, 31 TexReg 7469; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §749.3 Who is responsible for complying with the rules of this chapter? The permit holder must ensure compliance with all rules of this chapter at all times, with the exception of those rules identified for specific types of services that your agency does not offer. For example, if we grant you a permit to offer adoption services only, you do not have to comply with rules that apply to foster care services; however, you must comply with all other rules of this chapter. Source Note: The provisions of this §749.3 adopted to be effective January 1, 2007, 31 TexReg 7469; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909. §749.1101 Foster Home Verification Change Management (a) A child-placing agency (CPA) must monitor a foster home (home) for changes that invalidate the home's verification. (b) If something happens that makes a home's verification invalid, a new or temporary verification must be given after the CPA checks that the home follows the laws and rules in this chapter. (c) Changes that automatically invalidate a home's verification include: (1) marriage, divorce, separation, death, birth, or any other change in household composition; (2) changes in the home's address or location; (3) changes in the number of children a home may have in care; (4) changes in the ages or sex of children for whom the home is authorized to provide care; and (5) changes in the types of services the home will provide. (d) A home must notify its respective CPA of an active criminal investigation or an investigation by the Texas Department of Family and Protective Services. Source Note: The provisions of this §749.1101 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1103 Foster Home Compliance Evaluation. (a) A child-placing agency (CPA) must complete an annual evaluation to ensure a foster home (home) is following all the laws and rules that apply to the home. (b) The CPA must evaluate a home's compliance with relevant laws and rules each time: (1) there is an allegation of a deficiency in the home; (2) there is a major life change in the home that invalidates the verification; or (3) the CPA receives a report of family violence at the home from the Texas Department of Family and Protective Services. (c) When a deficiency is found during an evaluation, the CPA must: (1) develop a plan to achieve compliance that includes: (A) a list of all the actions or changes the home needs to make to correct deficiencies, including: (i) how much time the home has to correct the deficiencies; and (ii) what will happen if the deficiencies are not corrected; and (B) a decision about whether a child in care may stay in the home and if the home may accept a new child into care before the deficiencies are corrected; and (2) ensure the home corrects any deficiencies by either inspecting the home again or obtaining proof that issues are corrected. Source Note: The provisions of this §749.1103 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1105 Foster Home Supervisory Visits. (a) Child placing staff must visit the foster home (home) at least every three months for supervisory visits. (b) The supervisory visits must happen inside the home. (c) Within a 12-month period: (1) two of the visits must be unannounced; (2) one visit must have all household members present; and (3) both foster parents, if there are two, must be present for one visit every six months. (d) At least once every three months the supervisory visit must evaluate any: (1) changes to household members, frequent visitors, or persons who will provide support as a caregiver during an unexpected event or crisis; and (2) changes to the home that have an impact on the health, safety, or well-being of a child in care as determined by the child-placing agency. Source Note: The provisions of this §749.1105 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1107 Inactive Foster Homes (a) A child-placing agency (CPA) may place a foster home (home) on inactive status if the CPA makes sure there are no children in care. Inactive status cannot be used instead of closing the home if there are ongoing concerns that could harm the health or safety of a child in care. (b) If the CPA puts a home on inactive status or takes the home off inactive status, the CPA must inform Child Care Regulation by submitting an Agency Home Report Form. (c) A home on inactive status does not require monitoring or supervisory visits. (d) If a home wants to have active status again and care for a child, the CPA must make a supervisory visit to the home to ensure it meets the laws and rules in this chapter before a child can be placed in the home. (e) Background checks are not required for a home that is on inactive status. If the home returns to active status, the background checks must be active and in an Eligible or Conditional status before a child can be placed in the home. Source Note: The provisions of this §749.1107 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1109 Ongoing Monitoring Documentation Requirements. A child-placing agency (CPA) must document and maintain the following information in the foster home's (home's) record. (1) When checking the home for compliance or completing a supervisory visit: (A) the date the evaluation or supervisory visit was completed and the household members present; (B) a summary of the topics talked about, which rules were checked, and any deficiencies found, signed by each foster parent present; (C) the CPA's plan to correct any deficiencies found; and (D) a follow-up plan including proof that all deficiencies have been corrected. (2) For a home on inactive status: (A) the agreement between the CPA and foster parents that the home will be placed on inactive status and will not accept placement; and (B) when a home on inactive status wishes to return to active status, the CPA must check and ensure that the home is following all laws and rules in this chapter and has done the necessary background checks. The CPA must document this before a child can be placed in the home. Source Note: The provisions of this §749.1109 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1201 Admission Criteria (a) A child-placing agency (CPA) may admit a child or young adult for placement in a foster home (home) after ensuring: (1) the child or young adult meets the CPA's admission policy; (2) the CPA and home can provide the services the child or young adult requires; and (3) the home can meet the child or young adult's specific needs. (b) The CPA may admit a young adult into the care of a home if the young adult: (1) comes immediately from another residential child-care operation; (2) will continue to need the same level of care and is unlikely to physically or intellectually progress over time; and (3) is in the legal custody of the Texas Department of Family and Protective Services. (c) A child, at least 14 years old, or young adult may be admitted to a CPA's transitional living program as a non-emergency admission. Source Note: The provisions of this §749.1201 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1203 Initial Requirements at the Time of Admission or Verification (a) For each child in care living in the foster home (home) at the time of verification or who is subsequently placed in the home, a child-placing agency (CPA) must obtain the following information, if available, before verifying the home or admitting the child into care: (1) the child's name, and date of birth; (2) a brief description of the circumstance that led to the reason the child needs a placement and the reason the last placement ended; (3) the child's current health status, chronic or acute health conditions, such as asthma, diabetes, special dietary needs, allergies, and medications the child is taking, including possible side effects; (4) identification of the child's immediate treatment and educational needs; (5) identification and assessment of any of the child's high-risk behaviors, the results of the suicide risk screening, and supervision needs; and (6) known contraindication to the use of restraint. (b) The CPA must provide prospective caregivers with the child's initial admission information within 24 hours after the date of admission. Source Note: The provisions of this §749.1203 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1205 Admission Assessment (a) A child-placing agency (CPA) must complete the admission assessment within 15 days after the date of admission. The admission assessment for a child in care must include: (1) legal status, and the circumstances that led to the referral for foster care; (2) all history of abuse, neglect, or exploitation and history of trauma; (3) current medical status, including the: (A) results of the most recent medical and dental examinations; (B) all medical diagnoses requiring treatment services; and (C) results of all psychiatric, psychological, or psychosocial assessments; (4) mental and behavioral health history, including substance use history; (5) developmental and educational history; (6) social history, including the home environment, the quality of family relationships, family functioning, and religion; (7) criminal history, if applicable; and (8) documentation of how the CPA can meet the needs and behaviors of the child in care, and the services the CPA plans to provide to the child in care. (b) If a child in care receives treatment services for primary medical needs, the admission assessment must also include: (1) confirmation that the child in care can live safely in a foster home setting and that the foster parents have the skills to meet the needs of the child in care; and (2) all physician orders related to the child in care. (c) The admission assessment must be given to the caregivers and professional service providers who are working with the child in care within five days after the assessment is finished. Source Note: The provisions of this §749.1205 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1207 Admission Orientation Requirements (a) Within seven days after the date of admission, a child-placing agency (CPA) must provide an orientation to each child in care who is at least five years old or older. The orientation must be easy for the child in care to understand, in the main language and communication method of the child in care, and suitable for the age of the child in care. (b) Orientation must include information about the CPA's child-care policies. Source Note: The provisions of this §749.1207 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1209 Placement Agreement (a) A placement agreement is a child-placing agency's (CPA's) agreement with the foster child's parent or the foster child that defines the CPA's roles and responsibilities and authorizes the CPA to obtain or provide services for the foster child. A CPA placement agreement must include: (1) authorization from the parent permitting the CPA to care for the child in care; (2) the reason for placement and anticipated length of time in care; and (3) a medical consent form signed by the parent. (b) For a transitional living program, a child 16 years old or older in care may sign the placement agreement without parental consent if the child in care: (1) resides separately from the parent, independently manages the financial affairs of the child in care, is unmarried and pregnant, or a parent; and (2) the CPA attempts to notify the parent of the child in care of the location of the child in care. Source Note: The provisions of this §749.1209 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1211 Pre-Placement Requirements (a) Before placement, child placement staff must: (1) ensure the placement is suitable for the needs and behaviors of the child in care by using the initial admission information and the home study for the foster home (home); and (2) talk to the child in care about why the child in care is being placed and confirm the understanding and response of the child in care. (b) For non-emergency placements, a child at least six months of age or older in care must visit the home at least once before placement. (c) During the pre-placement visit, child placement staff must observe the interaction between the child in care and household members. (d) There must be time between the pre-placement visit and placement to allow the child in care and foster parents to each meet privately with child placement staff to discuss and consider placement. Source Note: The provisions of this §749.1211 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1213 Post-Placement Visits (a) Child placement staff must have monthly in-person visits with each child in care. (b) Monthly visits must meet the following requirements. (1) At least half of the visits must occur in the foster home. (2) The child placement staff must ensure the child in care is safe and the basic needs of the child in care are being met. (3) The visits must: (A) be for a length of time to address the needs and behaviors of a child in care who is verbal, or observe the child in care if they are non-verbal; (B) provide an opportunity to meet privately; and (C) provide an opportunity for the child in care to discuss feelings about how the placement is working out. Source Note: The provisions of this §749.1213 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1215 Ongoing Placement of Young Adults When a young adult continues living in a foster home or child-placing agency after turning 18 years old, the young adult may share a sleeping space with a youth who is 16 years of age or older, provided the age difference between the youth and young adult does not exceed two years. Source Note: The provisions of this §749.1215 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1217 Admission and Placement Information Documentation A child-placing agency (CPA) must document and maintain the following information in the record of the child in care: (1) the initial admission information obtained, including the date of admission, why any initial admission information could not be obtained, if applicable, and the date the prospective caregiver was provided the information; (2) admission orientation provided to the child in care, if the child in care is at least five years old or older, including the date the orientation occurred; (3) the admission assessment, including the date the information was provided to the caregivers and professional service providers working with the child in care; (4) the signed and dated placement agreement; (5) attempts to notify a parent of the location of the child in care, if the child in care is signing the placement agreement without parental consent; and (6) the pre-placement visit and post-placement meeting details, including topics discussed and the dates each visit and meeting occurred. Source Note: The provisions of this §749.1217 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1301 Child-Placing Agency Responsibilities Related to Child Rights (a) A child-placing agency (CPA) must protect the rights of a child in care and ensure caregivers and adoptive parents do not take away or limit the child's rights while the child is in care. (b) The CPA is responsible for removing the child in care from a situation where abuse, neglect, or exploitation exists. (c) The CPA must review the child's rights with the child in care and the parent of the child in care unless the parent's consent is not required. The CPA must also provide the child in care and the parent of the child in care a written copy of the child's rights. (d) Child rights must be: (1) written in plain language; and (2) given in a way that is easy for the individual to understand. Source Note: The provisions of this §749.1301 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1303 Child Rights The rights of a child in care include any other rights given by law or other Child Care Regulation rules. A child-placing agency (CPA) must follow the child's rights, which include the following. (1) Safety and care. (A) The right to care and treatment that meets the needs of the child in care in the most family-like setting possible. (B) The right to be free from abuse, neglect, and exploitation. (C) The right to fair treatment. (2) Family contacts. The right to maintain regular contact with the parents, siblings, and other extended family of the child in care, unless restrictions are necessary to protect the health, safety, or well-being of the child in care, as determined by the service plan or a court order. (3) Living a normal life. (A) The right to communicate in the way the child in care prefers. The CPA must make every reasonable effort to place the child in the care of foster parents who can communicate with the child. (B) The right to receive educational services appropriate to the age and developmental level of the child in care. (C) The right to have the religious needs of the child in care met. (D) The right to participate in childhood activities, including those with the foster family and other activities outside the home, suitable for the age and development of the child in care. (E) The right to privacy, which includes sending and receiving unopened mail, making and receiving phone calls, keeping a personal journal, and having visitors, unless it is necessary to limit these activities to keep the health, safety, or well-being of the child in care protected, as determined by the service plan or a court order. (F) The right to personal care, hygiene, grooming equipment and supplies, and training in how to use them. (G) The right to have comfortable clothes, including shoes, that fit well and are similar to what other children in the community wear and teenagers should have opportunities to pick out their own clothes. (H) The right to clothing and shoes that protect the child in care against the weather. (I) The right to have personal items at the foster home of the child in care and to get additional personal items when needed. (J) The right to personal space in the sleeping space of the child in care to store clothes and belongings. (K) The right to be informed of search policies and free of unreasonable searches and unreasonable removal of personal items. (L) Depending on the age and maturity of the child in care, the right to seek employment, keep money belonging to the child in care, and have a bank account in the name of the child in care. (M) The right to consent in writing before taking part in any publicity or fund-raising activity for the home or the CPA, including the use of the photograph of the child in care, and to withdraw the consent. (N) The right to refuse to make public statements showing gratitude to the home or the CPA. (O) The right to not be pressured to make a medical decision about a pregnancy, give up a child for adoption, or parent the child, if applicable. (4) Discipline. (A) The right to be free from any harsh, cruel, unusual, unnecessary, demeaning, or humiliating treatment or punishment; this means the child in care must not be: (i) shaken; (ii) subjected to or threatened with corporal punishment, including spanking or hitting the child in care; (iii) forced to be outside in excessive heat or cold for excessive periods; (iv) forced to do unproductive work that serves no purpose except to demean the child in care, such as moving rocks from one pile to another or digging a hole and then filling it in; (v) denied food, sleep, a bathroom, mail, or family visits as punishment; (vi) subjected to remarks that belittle or ridicule the child in care or the family of the child in care; (vii) threatened with the loss of placement or shelter as punishment; (viii) 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; and (ix) subjected to emergency behavior intervention as punishment, aversive conditioning, or rebirthing, hug, or holding therapy. (B) The right to discipline that is appropriate to the age, maturity, and developmental level of the child in care. (C) The right to have restrictions or disciplinary policies explained to the child in care at admittance and when the measures are imposed. (5) Plans for the child while in care. (A) The right to have a comprehensive service plan that addresses the needs of the child in care, including transitional and discharge planning. (B) The right to actively participate in the development of the service plan within the limits of the comprehension of the child in care. The child in care has the right to a copy or summary of the plan. A child 14 years old or older in care has the right to review and sign the service plan. (6) Medical care and records. (A) The right to medical, dental, vision, and mental health care and developmental services that adequately meet the needs of the child in care. (B) The right to request that the care or services be separate from adults (other than young adults in care) who are receiving services. (C) The right to be free of unnecessary or excessive medication. (D) The right to confidential care and treatment, including keeping medical records and agency records private and only discussing the records when necessary to provide the child with care. (7) Complaints. (A) The right to make anonymous calls, reports, or complaints without interference, coercion, punishment, retaliation, or threats of punishment or retaliation. (B) The child in care has the right to contact: (i) the Texas Department of Family and Protective Services Abuse/Neglect Hotline; (ii) the Texas Health and Human Services Commission Ombudsman for Children and Youth in Foster Care; (iii) the DFPS Office of Consumer Affairs; and (iv) Disability Rights Texas. Source Note: The provisions of this §749.1303 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1305 Conducting Searches for Items that Endanger a Child's Safety (a) For a child in care, an employee or caregiver may conduct a physical search of the child, the clothing or possessions of a child in care, or the room of a child in care only when there is reasonable suspicion that: (1) an unlawful or prohibited item is present that endangers the safety of the child in care; (2) the child in care made suicidal threats or threatened to self-harm or hurt others; or (3) the child in care is suspected of or was involved in a theft. (b) If a search of a child in care involves the removal of clothing (other than outer clothing such as coats, jackets, hats, gloves, shoes, or socks): (1) only a caregiver that is the same sex as the child in care may conduct the search; (2) there must be an adult witness who is the same sex as the child in care; and (3) the caregiver must ensure that other children do not witness the search. (c) With the exception of the mouth of a child in care, a caregiver or employee may not conduct a body cavity search of a child in care. Source Note: The provisions of this §749.1305 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1307 Child Rights Documentation Requirements A child-placing agency (CPA) must document and maintain the following information in the record of the child in care. (1) A statement signed within seven days after the CPA admits a child into care that each required individual reviewed and understood the child's rights. A signed copy of the "CPS Rights of Children and Youth in Foster Care" meets this requirement. (2) Plans for contact between the child in care and a parent and the child in care and the siblings of the child in care, including any restrictions the CPA places on the contacts. (3) When conducting a search that results in the removal of personal items or clothing worn by the child in care the: (A) name of the child in care, date of the search, and name of the person conducting the search, including any witnesses; (B) reason for the search and a description of what was searched, including the articles of clothing removed, if applicable; and (C) results of the search and resolution of the issue with the child in care. Source Note: The provisions of this §749.1307 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1401 Infants: Basic Care and Supervision (a) Each infant in a foster home must receive individual attention, including play, talking, cuddling, and holding. (b) A caregiver must provide prompt attention to an infant's physical needs, such as feeding and diapering. (c) A caregiver must ensure that the environment is safe for each infant, including: (1) keeping the area free of objects that may choke or harm the infant; and (2) protecting the infant by ensuring electrical outlets have childproof covers or safety outlets. (d) Items necessary for diaper changing must be kept out of the reach of infants and other children in care. (e) A caregiver must never leave an infant unsupervised. (1) a sleeping infant is considered supervised if the caregiver: (A) is within eyesight or hearing range of the infant and can intervene as needed; or (B) uses a video camera or audio monitoring device to monitor the infant and is close enough to the infant to intervene as needed. (2) An awake infant is considered supervised if the caregiver is within eyesight of the infant and is close enough to the infant to intervene as needed. For short periods of time during regular household activities, the infant may be out of the caregiver's sight, as long as: (A) the infant is within hearing range of the caregiver; (B) the infant's environment is free of any safety hazards; and (C) the caregiver can intervene immediately, as needed. Source Note: The provisions of this §749.1401 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1403 Infants: Cribs (a) A foster home (home) that provides care to a child in care who is an infant must have an individual crib for the infant. All cribs must: (1) have a firm, flat mattress that snugly fits the sides of the crib, and the mattress must not be supplemented with additional foam material or pads and must be waterproof or washable; (2) have sheets that fit snugly and do not present an entanglement hazard; (3) be bare, except for a mattress with a tight-fitting sheet, for an infant who is younger than 12 months old; and (4) be assembled per the manufacturer's instructions with no loose hardware, damaged parts, or entrapment hazards. (b) A home may use a full-sized, portable, or mesh-side crib if: (1) the caregivers follow the manufacturer's instructions; and (2) the crib has mesh that is securely attached to the top of the rails and floor plate, and the folded sides are securely latched in place when raised. (c) The home may not use a stackable crib, bean bag, waterbed, or foam pad as sleeping equipment for an infant. (d) A caregiver must never leave an infant in a crib, portable crib, or mesh-side crib with a side folded down. (e) An infant receiving treatment services for primary medical needs may have special items that assist with safe sleep at the written recommendation of a health-care professional. The child-placing agency (CPA) must keep the written recommendation in the record of the child in care. (f) The CPA must notify the parent of each child in care of each home verified by the CPA of any deficiencies relating to subsections (a)(1), (a)(3), (b), or (c) of this section. Source Note: The provisions of this §749.1403 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1405 Infants: Safe Sleep Requirements (a) A caregiver must place an infant who is unable to turn over without assistance in a face-up sleep position unless a health-care professional orders otherwise. A child-placing agency (CPA) must keep any orders from a health-care professional in the record of the child in care. (b) An infant's head, face, or crib must not be covered at any time by any item, including a blanket, linen, or clothing. (c) An infant must not co-sleep with an individual at any time in any location. (d) An infant must not sleep in a restrictive device, such as a car seat, swing, bouncy seat, or highchair. If an infant falls asleep in one of these devices, the caregiver must move the infant to a crib as soon as possible. (e) An infant who can roll over without assistance must not be swaddled. (f) The CPA must notify the parent of each child of each foster home verified by the CPA of any deficiencies cited in this section. Source Note: The provisions of this §749.1405 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1407 Infants: Equipment Safety (a) A highchair, swing, stroller, infant carrier, rocker, bouncer seat, or similar item that a foster home (home) uses for an infant must have safety straps fastened when the equipment is in use with the infant. The caregivers must follow the manufacturer's instructions. (b) A home may not use any of the following types of equipment for infants: (1) baby walkers; (2) baby bungee jumpers; and (3) accordion safety gates. Source Note: The provisions of this §749.1407 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1409 Infants: Feeding Requirements (a) Caregivers must feed an infant based on the recommendations of the infant's health-care professional. (b) Unless recommendations from the health-care professional are contrary, caregivers must hold the infant while feeding the infant if the infant is: (1) birth through six months old; or (2) unable to sit unassisted in a highchair or other seating equipment during feeding. (c) Caregivers must never prop a bottle by supporting it with anything other than the infant's or caregiver's hands. (d) A caregiver who cares for more than one infant must: (1) sterilize shared bottles or training cups between uses by different infants; and (2) clean highchair trays before each use. Source Note: The provisions of this §749.1409 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1411 Toddlers: Basic Care Requirements (a) Each toddler must receive individual attention, including play, talking, and cuddling. (b) A caregiver must ensure that the environment is safe for each toddler, including: (1) keeping the area free of objects that may choke or harm the toddler; and (2) protecting the toddler from dangerous items or areas, such as ensuring each accessible electrical outlet has a childproof cover or safety outlet. (c) A caregiver must never leave a toddler unsupervised. A toddler is supervised if the caregiver: (1) is within eyesight or hearing range of the toddler and can intervene as needed; or (2) uses a video camera or an audio monitoring device to monitor the toddler and is close enough to the toddler to intervene as needed. Source Note: The provisions of this §749.1411 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1413 Additional Requirements for Pregnant Children in Care For a pregnant child in care, a child-placing agency must: (1) ensure information, training, and counseling is available about pregnancy, prenatal care, childbirth, and recovery from childbirth; and (2) inform the child in care, within seven days after the date of admission or on learning about the pregnancy, of the right not to be pressured to make a medical decision about the pregnancy, give up the child for adoption or parent the child. Source Note: The provisions of this §749.1413 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1415 Additional Requirements for Children in Care Receiving Treatment Services for Primary Medical Needs or Intellectual Disabilities (a) A caregiver who cares for a child in care receiving treatment services for primary medical needs or an intellectual disability must follow recommendations from the medical providers for the child in care, including recommendations relating to physical and sensory stimulation. (b) A caregiver must ensure a child in care receiving treatment services for primary medical needs or an intellectual disability has opportunities for physical and sensory stimulation. Source Note: The provisions of this §749.1415 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1417 Discipline and Punishment (a) Only a caregiver known to and knowledgeable of a child in care may discipline the child. (b) All disciplinary measures used with a child in care must be consistent with the child's rights related to discipline and punishment in this chapter. Source Note: The provisions of this §749.1417 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1419 Normalcy and Reasonable and Prudent Parent Requirements A foster parent must ensure a child in care can participate in childhood activities, including unsupervised activities, using the reasonable and prudent parent standard. For a child in care, the foster parent must consider the: (1) age, level of maturity, overall abilities and developmental level, and desires; and (2) behavioral history and ability to safely participate in a proposed activity considering the surrounding circumstances, hazards, risks, and supervision of the activity. Source Note: The provisions of this §749.1419 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1421 Educational Services: General A child-placing agency (CPA) must arrange appropriate education for each child in care, including: (1) ensuring each child in care attends an educational facility or program that is accredited or otherwise recognized by state law and is the least restrictive educational setting to meet the needs and abilities of the child in care; (2) advocating for the child in care to receive educational and related services to which the child in care is entitled under provisions of federal and state law and regulations, including the implementation of an Individual Education Plan (IEP) for students receiving special education services; (3) ensuring that the education program is appropriate to the intellectual and social functioning of the child in care and encourages normalization through appropriate stimulation and by encouraging self-help skills; and (4) designating a liaison between the CPA and the school of the child in care. Source Note: The provisions of this §749.1421 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1423 Educational Services: Caregiver Responsibilities Caregivers must: (1) know how the child in care is doing in school by looking at the report cards and other information about the child in care from the school; (2) request Admission, Review, and Dismissal (ARD), Individual Education Plan (IEP), and Individual Transitional Planning (ITP) meetings, if concerned with an education program for a child in care or if the child in care does not appear to be making progress; (3) attend ARD, IEP, ITP meetings, or other school staffings and conferences to represent the educational best interests of a child in care; and (4) know what is in the IEP or ITP for a child in care and support the school's efforts to implement the IEP or ITP, if applicable. Source Note: The provisions of this §749.1423 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1501 General Medical, Dental, and Medication Requirements (a) A child in care must receive timely routine and emergency medical and dental care. (b) At admission, a child-placing agency (CPA) must verify whether a child in care has had a medical examination within the past year and a dental examination within the past year, if the child in care is at least six months old. If the CPA determines that a child in care has not had one of these examinations during that time frame, the CPA must schedule any medical or dental examinations the child in care may need. (c) Only someone who is trained and allowed to provide medicine can do so. (d) The CPA must ensure caregivers follow orders and recommendations from a physician or other health-care professional. (e) All medications must be stored securely and properly according to the label's instructions and in a way that makes the medications inaccessible to children in care. (f) A child in care may only self-administer medication after the CPA: (1) obtains written parental consent for the child in care to self-administer medication; (2) updates the service plan to include the self-administration of medication and any requirements for caregiver supervision; and (3) consults with the health-care professional who prescribed the medication and notes any concerns of the health-care professional in the record for the child in care. Source Note: The provisions of this §749.1501 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1503 Immunization Requirements A child-placing agency must ensure each child in care meets and continues to meet applicable immunization requirements as specified by the Texas Department of State Health Services. Source Note: The provisions of this §749.1503 adopted to be effective August 10, 2026, 51 TexReg 5197. §749.1505 Documentation Requirements for Medical and Dental Care. (a) A child-placing agency (CPA) must verify that the following is documented either in the record or in the health passport, if applicable, of a child in care: (1) each medical and dental visit or hospitalization, including a discharge summary; (2) applicable immunization requirements; and (3) any known contraindicated prescription, non-prescription medications, and supplements. (b) The foster home (home) must document and maintain in the record of a child in care: (1) a daily medication log for each prescription medication administered to a child in care of any age, and non-prescription medication or supplement dispensed to a child in care under five years old; and (2) documentation of all medication errors, adverse reactions, and side effects of a medication. (c) The CPA must provide the daily medication log to the foster parents. The log must include: (1) the name of the child in care and the person who administered the medication or supplement; (2) the name, strength, and dosage of the medication or supplement administered; and (3) the date and time the medication or supplement was administered. (d) The CPA must provide the documentation form for medication errors, adverse reactions, and side effects to the foster parents. The form must include: (1) the name of the child in care; (2) the name of the medication; (3) a description of the error, adverse reaction, or side effect; and (4) how the caregiver ensured the safety of the child in care. (e) When a child in care self-administers a dose of medication, the home must review the medication and record the daily dosage. Source Note: The provisions of this §749.1505 adopted to be effective August 10, 2026, 51 TexReg 5197.