(a) Physical restraint shall be limited to those circumstances where all appropriate approved proactive, non-physical behavior management techniques have been tried and failed, or the circumstances of the incident render use of de-escalation techniques impractical and one of the following circumstances exists:

(b) Staff who are expected to use physical restraints must be successfully trained in the behavioral intervention program prior to being permitted to engage in physical restraint. Such staff may be retrained periodically as necessary, but shall be trained, at a minimum, annually.

(c) Physical restraints shall not be used as punishment, retaliation, discipline, administrative convenience or harassment/embarrassment of youth.

(d) The following shall not be permitted:

(e) All instances of physical restraint shall be followed by a medical review, as soon as possible, but no later than 24 hours after the restraint.

(f) Staff shall be notified of and observe any medical restrictions on use of restraints.

(g) Staff shall monitor the youth during a physical restraint for signs of distress and adjust position if the youth complains that he or she cannot breathe.

(h) If a youth demonstrates distress such as failure to breathe, vomiting, unconsciousness, or mental breakdown, the restraint shall end and immediate medical/mental health assistance shall be obtained.

(i) All staff involved in a restraint situation shall document their involvement.

(j) All instances of physical restraints shall be logged and statements, debriefings and video preserved.

(k) For youth under the age of 18, the youth’s parent/guardian shall be notified of the restraint.

(l) There shall be a post-restraint protocol for youth and staff to review the issue with a goal toward averting future occurrences and checking well-being.