(1) Licensees must:

(a) Not use:

(i) Physical restraints:

(A) To redirect or de-escalate a situation, unless the child's or youth's behaviors pose an immediate risk to the physical safety of themselves or another individual or serious property damage. If restraint is necessary, it must be reasonable and used to:

(I) Prevent children or youth from harming themselves or others; or

(II) Protect property from serious damage;

(B) As a form of punishment or discipline; or

(C) If the use of the restraint restricts breathing, inflicts pain as a strategy for behavior control, or is likely to cause injury that is more than temporary. This includes, but is not limited to:

(I) Restriction of body movement by placing pressure on joints, chest, heart, or vital organs;

(II) Sleeper holds;

(III) Arm twisting;

(IV) Hair holds;

(V) Choking or putting arms around the throat; or

(VI) Chemical restraints, such as pepper spray; or

(ii) Mechanical restraints unless ordered by the child's or youth's licensed health care provider and approved by LD;

(b) Obtain prior written approval before using physical or mechanical restraints on a regular basis from the:

(i) Child's or youth's representatives; and

(ii) LD licensor; and

(c) Develop and follow policies and procedures that are approved by the department, when behavior management practices include use of physical restraint, including:

(i) Who may authorize the use of physical restraint; and

(ii) The circumstances when physical restraint may be used, including:

(A) Time limitations; and

(B) Supervisory monitoring; and

(iii) How personnel will document incidents involving the use of physical restraint in an incident log.

(2) The program director must complete the following after incidents that involve the use of physical restraint:

(a) Review the incident report with the personnel who used physical restraint to verify the decision to use physical restraint and its application were appropriate; and

(b) Report the incident to department intake if it meets the criteria in WAC 110-145-2780.

(3) Personnel must be trained using a behavior management training approved by LD prior to using physical restraint.