Child and Family Services (PA-CFS) 25: Resource Family Use of Physical Interventions
Resource parents who use physical interventions are trained and supported by the agency to deploy them in a manner that ensures safety and well-being when positive behavior support and de-escalation measures have proven ineffective in crisis situations.
Physical interventions do not include actions in response to age- or development-related behaviors demonstrated by young children such as physically holding a three-year-old who tries to run into the street.
NA The agency does not work with children placed in out-of-home care.
NA The agency does not permit resource families to use physical interventions.
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Full Implementation, Outstanding Performance A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.
All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions; exceptions do not impact service quality or agency performance.
Substantial Implementation, Good Performance A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
The majority of the standards requirements have been met and the basic framework required by the standard has been implemented.
Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.
Partial Implementation, Concerning Performance A rating of (3) indicates that the agency's observed infrastructure and/or practices require significant improvement.
The agency has not implemented the basic framework of the standard but instead has in place only part of this framework.
Omissions or exceptions to the practices outlined in the standard occur regularly, or practices are implemented in a cursory or haphazard manner.
Service quality or agency functioning may be compromised.
Capacity is at a basic level.
Unsatisfactory Implementation or Performance A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.
The agency’s observed service delivery infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
Behavior support policy
Behavior support procedures
Table of contents for resource parent physical intervention training curriculum
Documentation tracking completion of required trainings and evaluation
Documentation of incident reporting and review
Interviews may include:
Review resource parent records
Review case records
The agency’s policy and procedures:
prohibit the use of locked seclusion and mechanical restraints by resource families;
define which physical interventions resource families are and are not allowed to use, and under what circumstances; and
outline what to do following an incident.
The policy and procedures should align with the information the agency provides families in PA-BSM 2.01. Given that COA’s standards prohibit the use of locked seclusion by resource families, resource parents should never lock a child in a room. If there are concerns about the child’s safety, the resource family should consult with the case worker and behavior support plan for alternative options.
Physical interventions are discontinued as soon as possible and are prohibited from use:
by anyone other than the resource parents or other adult caregivers who have been approved by the agency;
as a form of punishment or discipline;
for the convenience of resource parents;
in response to property damage that does not involve imminent danger to self or others;
when contraindicated in the child’s behavior plan;
for longer than 15 minutes for children aged nine and younger; and
for longer than 30 minutes for children aged ten and older.
The case worker and resource family establish procedures for:
how to notify the agency following each use of a physical intervention;
documentation of the incident; and
debriefing with the child and resource family members involved in or witness to the incident.
Debriefing should address:
the physical and emotional state of everyone involved;
precipitating events; and
how the incident was handled and any additional supports or resources needed in order to avoid future incidents.
Resource parents are trained on the child’s individualized behavior support and management plan at placement, and receive annual training and evaluation on permitted physical interventions, including:
when it is appropriate to use a physical intervention;
proper and safe use of interventions, including time limits for use;
understanding the experience of being placed in manual restraints;
assessing physical and mental status, including signs of physical distress;
response techniques to prevent and reduce injury;
assessing when to discontinue the physical intervention; and
negative effects that can result from the misuse of restrictive interventions.
To ensure competency, resource parents should receive a post-test and be observed in practice.
NA The agency is not responsible for resource parent training.