CRS, Inc. Coastal Residential Services, Inc. 120 Henderson Drive Jacksonville, NC 28540 Phone: 910 938-9550 Fax

1. CRS, Inc.Coastal Residential Services, Inc.120 Henderson DriveJacksonville, NC 28540Phone: 910 938-9550 Fax : 910 938-5912 Client Residential Handbook

2. Mission Statement CRS, Inc. is committed to ensuring that every individual is provided a home-like but therapeutic environment which will enhance a smooth integration into the community. CRS, Inc. strives for an atmosphere of firm, fair and equitable limits respecting the rights and property of others, while providing an opportunity for consumers to demonstrate positive social behavior. CRS, Inc. operates from a model which assumes that everyone can learn, one never stops learning, and the rate and direction of learning is influenced by training.

3. PHILOSOPHY STATEMENT Coastal Residential Services, Inc., provides a specialized approach to personnel selection, management and supervision. CRS believes that the consumer's safety and well being are the most important factors in placing and supervision of clients. We will make every effort to place the most appropriate individual based on recommendations and criteria. As an employee of CRS, Inc., you are expected to adhere to company Policy and Procedures. If questions should arise, please direct them to the Program Director of CRS, Inc.

4. Your Rights 1. To be treated with respect, consideration, dignity, and full recognition of his or her individuality and right to privacy. 2. To receive care and services which are adequate appropriate and in compliance with relevant federal and state laws and rules and regulations. 3. To receive upon admission and during his or her stay a written statement of services provided by the facility and the charges for these services.  4. To be free of mental and physical abuse, neglect, and exploitation.  5. Except in emergencies, to be free from chemical and physical restraint unless authorized for a specified period of time by a physician according to clear and indicated medical need.  6. To have his or her personal and medical records kept confidential and not disclosed without the written consent of the individual or guardian, which consent shall specify to ho the disclosed may be made, except as required by applicable state or federal statute or regulation or by third party contract. It is not the intent of this section to prohibit access to medical records by the treating physician except when the individual objects in writing. Records may also be disclosed without the written consent of the individual to agencies, institutions or individuals which are providing emergency medical services to the individual. Disclosure of information shall be limited to that which is necessary to meet the emergency.  7. To receive a reasonable response to his or her request from the facility administrator and staff.  8. To associate and communicate privately and without restriction with people and groups of his or her own choice on his or her own or their initiative at any reasonable hour.  9. To have access to any reasonable hour to a telephone where he or she may speak privately.  10. To send and receive mail promptly and unopened, unless the resident request that someone open and read mail, and to have access at his or her expense to writing instruments, stationery, and postage.  11. To be encouraged to exercise his or her rights as a resident and citizen, and to be permitted to make complaints and suggestions without fear of coercion or retaliation.  12. To have and use his or her own possession where reasonable and have an accessible, lockable space provided for security of personal valuables. This space shall be accessible only to the resident, the administrator, or supervisor-in-charge.

5. Confidentiality (a) CRS, Inc. facilities that maintains records with confidential information shall provide a secure place for storage of records and shall develop written policies and procedures regarding controlled access to those records. (b) CRS, Inc. facilities shall ensure that only authorized employees or other individuals authorized by the facility director have access to the records. (c) CRS, Inc. facilities Managers shall ensure that a clinical staff member is present in order to explain and protect the record when a client or a client's legally responsible person comes to the facility to review the client record. A delegated employee shall document such review in the client's record. CRS, Inc. facilities that maintains confidential information in an automated data processing system shall develop written policies and procedures regarding the provision of safeguards to ensure controlled access to such information. In the event that a client or a client’s legally responsible person request to review the client record, the designated QP must be present to review and explain the contents of the record with him/her. Review of the record will be documented in the client service record. ALL OF CRS, INC. employees, contract providers, and any individual with access to confidential information will sign statements that they understand the rules governing confidentiality and agree to comply with said rules Employees will sign a Client Rights and Confidentiality Agreement upon employment, and when revision are made in the requirements. The signed agreement will include date, title, program, statement of understanding and agreement to hold information confidential, and acknowledgment of penalties for unauthorized disclosure.

6. Client Grievance CRS, Inc. provides all consumers at all times to express their opinions, concerns, suggestions and/or complaints regarding service delivery. If consumer of the program or guardian is not satisfied with a decision made by a staff member, he/she will: 1. Talk with Hab Tech and register a complaint and seek a resolution. 2. Talk with Program Manager and register a complaint and seek a resolution.   3. If resolution is not found, the consumer and staff will meet with the Program Director. 4. If resolution is not found, advocate will be procured and assist the consumer in presenting the issue and going to the next step.   5. A meeting with the Chairman of the Board, or his designee may be requested. 6. For a final decision, a letter will be submitted by the resident with assistance from the advocate as needed, requesting a review of the grievance by the entire Board.   7. The decision of the Board of Directors is considered final.

7. Search and Seizure A. Each client shall be free from unwarranted invasion of privacy.   Authorized Searches: 1. Coastal Residential may search a consumer and his personal belongings upon admission. Personal items will be logged in on the personal inventory sheet. The personal inventory sheet will remain in the facility at all times.   2. Coastal Residential may search a consumer and his personal belongings upon his return from off-facility visits or after a visitation from visitors only when there is reason to believe that the consumer my have items in his persons that will cause a danger to himself or to others.   3. Coastal Residential may search a consumer and his personal belongings if staff has reasonable belief that the consumer has been drinking or using paraphernalia or belief that the consumer has stolen property. B. Scope of Searches: 1. The procedures are intended for the security, to protect the facility from liability, and provide an inventory personal property.   a. Employees of Coastal Residential will only conduct a search on company property. b. Employees may search the facility and the grounds of facility.   c. Only a licensed physician my conduct a body cavity search if there is probable cause to do so.The search will be conducted in the presence of a nursing staff. One member of the search must be of the same sex. C. Search Procedure: 1. The search must be authorized in writing by the Program Director or the employee in charge at the time of the search. a. Searches may be conducted only if there is reasonable belief that the consumer has in possession a contraband, paraphernalia or any other instrument which may cause danger to himself or others. b. Two staff members must be present at the time of the search. One staff member must be a member of the same sex. c. The consumer must be notified of the search before that search is conducted. d. The search must be documented on the search and seizure form, in the client service record, and followed by an incident reporting form. D. Account of Seized Property: 1. If contraband if recovered from the search, contact local law enforcement for advice only fordisposition of the property. The Program Director will notify the QP of the search; the QP or Program Director will notify the President of the property seized. 2. If paraphernalia or controlled substances is recovered from the search, the Program Director along with QP will transport the substances to the pharmacy for destruction.   3. If alcoholic beverages are seized during the search, the Program Director will dispose of the beverage.   4. If property seized such as scissors, razors, over the counter medication, alcoholic grooming aids, or other items prohibited by the facility will be placed on the client personal inventory sheet and will be given back to the consumer upon discharge from the facility. 5. If property seized that belongs to guardian or other person, the property will be returned upon there request.

8. Communicable Diseases CRS, Inc. does everything possible to protect consumers, staff, and family members from communicable diseases. Should a consumer be diagnosed with having or have contracted a communicable disease, the physician will report it to the local health department, CRS administrative staff, and the consumer when appropriate.   The physician will determine the course of treatment to be carried out for the consumer. All staff will follow the orders provided by the physician decisively. The physician will verify the individuals diagnosis as having a communicable disease is able to be in direct contact with others, and will not present as a transmission risk.   At any time the physician is unable to assure precautions, the individual with the communicable disease will not be able to return to the site until such actions have been discussed and only upon the release of the physician.

9. Guest and Visitors CRS, Inc. has set guidelines for staff to deal appropriately with guest and visitors who come to a facility.   Guest and visitors are welcomed to visit a facility, however, if possible arrangements should be made and approved before hand with Program Manager.   Staff should determine what visitor's business is and then provide assistance as appropriate. Service Records and other confidential issues should be protected by staff until appropriate authorization and clearance is obtained or in the presence of Program Manager. Staff will accompany visitors while they are at the facility to ensure that consumer privacy is maintained and guard against theft or other inappropriate actions. 4. All visitors who do not have a signed confidentiality form are to do so.   5. A copy of this confidentiality form should be maintained.   6. Media/press are to be redirected to main office.  

10. Client Activities CRS, Inc. shall provide activities for clients to assure that: 1. The CRS, Inc. program shall provide space and supervision to ensure the safety and welfare of the individuals served. The Consumer will have the opportunity to choose activities of choice. 2. The CRS, Inc. program shall be suitable for the ages, interests, developmental levels, and treatment/habilitation needs of the individuals served. 3. The CRS, Inc. Program Director shall establish a resident council that meets on a regularly scheduled basis to discuss and plan issues related to: (1) facility governance (2) Individuals' served self-governance (3) Events and activities 4. Minutes of the resident council meeting shall be recorded by individuals served or staff and shall be available for review and inspection by authorized persons. 5. CRS, Inc. is dedicated to assuring that all individuals remain safe at all times during activities. At no time will individuals attend any water/swimming activities unless a certified lifeguard is present. 6. CRS, Inc. will assure that when two are more preschool children who require special assistance with boarding or riding in a vehicle are transported in the same vehicle, there shall be one adult, other than the driver, to assist in supervision of the children.

11. Consent for Treatment CRS, Inc. shall assure that the consumer's understanding of the rights responsibilities, and services they are requesting through the signing of a service agreement. CRS, Inc. shall provide a written services agreement to be signed by a consumer and/or legal guardian before entry into the program. The agreement will specify the services which CRS, Inc. agrees to provide. 1. Prior to admission it is the responsibility of the QP or Program Manager to meet with the Case Manager, Consumer, and/or guardian to explain the consent for services agreement and other necessary forms required. The Program Manager is to assure completion, and if necessary, complete with the consumer and/or guardian. 2. All parties will sign the agreement, signifying comprehension of, and intended compliance. 3. The original agreement will be kept in the consumer's service record and will be updated annually.

12. House Rules 1.                  Phone calls are to be limited to 10 minutes. 2.                  At no time will there be overnight guest of the opposite sex. 3.                  You are responsible for any broken or damaged property in any manner by your own person. 4.                  No eating in bedrooms. 5.                  No smoking in bedrooms. 6.                  No firearms or weapons allowed on the premises. 7.                  No borrowing money from staff or peers. 8.                  No lending money to staff or peers. 9.                  No pornography materials are to be exposed, these materials are to remain in your personal bedroom. 10.              All will clean behind themselves. 11.              No paraphernalia allowed on the premises. 12.              No experimental toxins allowed on the premises. 13.              No alcoholic beverages. 14.              No pets allowed without the approval of CRS, Inc. 15.              No invading or intruding in/on others personal property. 16.              No profanity. 17.              No abuse is to be inflicted upon any other person. 18.              No visitors before 9am and after 9pm. Notification of visits must be made aware to the Program Manager in order for courtesy to room-mate. 19.              When listening to the radio / tv, please be considerate of others and keep the volume down. 20.              Individuals will not purchase items from staff members. 21.              Be considerate of others and complete personal hygiene tasks daily.

13. Your rights in a 24-hour adult facility While you are in a CRS facility, you will have the right to receive necessary medial care if you are sick. However, your insurance or legal guardian if under the age of 18 may be billed for medical care that is beyond regular services. While you reside in the CRS facility, you will have the right to: Send and receive sealed mail and to have access to writing materials, postage, and staff assistance; Contact and consult with …lawyer, your own doctor, or other private professional at your own expense; Contact and consult with a client advocate; and Make and receive confidential phone calls…long distance at your expense; Receive visitors between 8am and 9pm for 6 hours daily…2 of those hours will be after noon; Communicate and meet, under supervision, with other individual who want to communicate and meet with you; Make visits outside of the facility, unless you are being held in the facility because of judicial criminal proceedings; Be out of doors daily…and have access to facilities and equipment for physical exercise several times a week; Have individual storage space for your private use; Keep personal possessions and clothing, except as prohibited by law; Keep and spend a reasonable sum of your own money; Participate in religious worship; Retain a driver’s license, unless prohibited by the law.

14. HIPAAHealth Insurance Portability and Accountability Act CRS, Inc. is committed to following and abiding by all laws and regulations set fourth by the federal government in accordance to you private information. CRS, is required by law to: Protect the privacy of certain health information that identifies you. This health information may be information about healthcare services we provide to you or payment for those services. It may also be information about your past, present or future medical conditions. Provide you with a Notice of Privacy Practices explaining our legal duties and privacy practices with respect to health information on in the manner that we have described in the notice. Consistent with the legal requirement, the Notice will describe and provide you with some examples of various way in which we may use or disclose your health information with or without your prior written authorization. The Notice will also describe CRS’s legal duties and your privacy rights with respect to your health information, and provide you with information about how to make privacy related complaints.

15. Questions If there is any information in this handbook that you do not understand, please ask for help. You may ask: The person who is responsible for your care, such as Program Manager, Program Director, Habilitation Technicians, or Qualified Professionals. At any time you think that you have been denied rights, you may contact… A family member or friend A client advocate or attorney, or The Client to Human Rights Committee At any time, for any reason, you feel that you cannot get the information or help you need from the people in your facility You can get help about your rights from: The Governors Advocacy Council for Persons with Disabilities 1-800-821-6922 The North Carolina Mental Health Consumer’s Organization, Inc. 1-800-326-3842 The North Carolina CARELINE at 1-800-622-7030 Each of these toll-free numbers is open Monday through Friday, Between 8am and 5pm