24-Hour Respite Site Operators

24-hour Respite Services, which include the City’s two 24-hour women’s drop-in programs, are designed to broaden the range of services available to those experiencing homelessness. These respite sites provide 24-hour essential supports (including: meals, service referrals, places to rest, etc.) in an environment that prioritizes ease of admission to safe facilities. Having these lower barriers makes respite sites more accessible, especially to those who are vulnerable and who may not otherwise access conventional shelter services.

These Interim Standards apply solely to the following 24-hour Respite Sites:

• 24-hour Respite Sites
• 24-hour Drop-ins for Women

These Interim Standards provide an additional layer of oversight to 24-hour Respite Sites. They ensure that facilities and service delivery are designed to meet the needs of service users while also demonstrating consistency in safety and best practices. Fundamentally, these interim standards are designed to uphold the health, safety, and comfort of all service users and staff of 24-hour Respite Sites.

The City of Toronto values its community partners and is committed to working with both service users and service providers to help maintain compliance with these interim standards.

The Interim Standards take effect on April 30th, 2018, and will be in place while the City engages in a broad consultation process that will be focused on better understanding the opportunities presented by 24-hour Respite Sites and the lived experience of those who use these vital services. These consultations will begin in May 2018, and will lead to an enhanced set of 24-hour respite site standards that will be in place in advance of the 2018/2019 winter season.

a)   24-hour Respite Sites will:

i)   operate on a 24-hour basis, seven (7) days a week;

ii)   ensure the main entrance is visible from the street or clearly marked with signage;

iii)   have access to potable water 24-hours, seven (7) days a week;

iv)   maintain indoor temperatures that will ensure client comfort, or as prescribed by Shelter, Support and Housing Administration (SSHA);

v)   have a site phone for staff use to call for emergency services, make referrals to additional service providers, and report occupancy information. The site phone will be staffed and answered at all times and include the ability to leave a message; and

vi)   designate a staff-only area to store confidential information, necessary office supplies, and perform administrative functions.

a)   24-hour Respite Sites will take all reasonable measures to admit clients to their program at any time during their hours of operation and to accommodate clients with a disability.

b)   24-hour Respite Sites will accommodate pets and have a pet policy including, but not limited to prescribing areas within the facility where pets are permitted/prohibited and outlining owner responsibilities.

c)   24-hour Respite Sites will have a client belongings policy including, but not limited to whether and how client belongings can be stored, retrieved and disposed (i.e., unclaimed or abandoned items).

a)   24-hour Respite Sites will ensure all information relevant to clients is communicated to clients in a manner that is appropriate (e.g., posting information, brochure, client meetings, site orientation) including, but not limited to rules and service restrictions, process for making a complaint, daily schedules (e.g., meal times if provided, snack times, lights on/off times), daily menus (if meals are provided), fire safety plan, and evacuation plan.

a)   24-hour Respite Sites will treat any client’s personal information or personal health information as confidential and will take all reasonable measures to safeguard such information, including, where required, requesting client consent before disclosing or sharing this information.

a)   24-hour Respite Sites will:

i)   maintain good record keeping practices and ensure requested information can be readily provided in response to an audit or requests from the City of Toronto;

ii)   collect and share specific client information as directed and prescribed by the City of Toronto;

iii)   report the number of clients within the facility at the times and in the format prescribed by the City of Toronto;

iv)   report serious incidents and occurrences and death of a client immediately to SSHA; and

v)   report service disruptions that will limit or temporarily suspend operations immediately to SSHA.

a)    24-hour Respite Sites will:

i)   offer three (3) full meals as well as healthy snacks and warm/cold beverages throughout each day. This may include the issuance of an appropriate meal voucher/card in lieu of meals when necessary;

ii)   post a copy of a daily menu, including any potential allergens (e.g., peanuts, nuts, eggs, shellfish, etc.);

iii)   post a notice, stating whether the program can or cannot guarantee allergen-free food, in a conspicuous place in or near the dining area of each program site; and

iiii)   ensure that all foods are prepared, handled, stored and transported in a safe and sanitary manner to reduce the risk of cross-contamination and prevent the spread of food-borne illness in compliance with Toronto Public Health food preparation requirements.

a)    24-hour Respite Sites will offer basic toiletries and hygiene products to clients, including soap, shampoo, a toothbrush, toothpaste, shaving products, pads/tampons and incontinence products, as appropriate, upon admission.

a)   24-hour Respite Sites will:

i)   organize and arrange sleeping areas in a manner that:

(1)   promotes the privacy of a client’s sleeping space;

(2)   reduces the potential for transmission of communicable diseases;

(3)   reduces the potential for conflict between clients;

(4)   provides flexibility to expand / collapse capacity; and

(5)   maintains safety at all times.

ii)   offer new or clean bedding, including a blanket, two sheets, a pillow and a towel to all newly admitted clients; and when otherwise necessary to preserve safety and cleanliness;

iii)   not permit structures to be erected by clients (e.g., tents, privacy screens);

iv)   maintain a consistent lighting schedule in sleeping areas (i.e., when lights are turned down/up);

v)   provide safe and accessible washroom facilities and ensure they are clean and maintained in a good state of repair at all times; and

vi)   provide safe and accessible showering facilities and ensure that clients have privacy while showering at all times.

a)   24-hour Respite Sites will ensure that program facilities and sites are well maintained in order to provide a safe, healthy and accessible physical environment for all service users.

b)   24-hour Respite Sites will:

i)   have an infection prevention and control (IPAC) program in place that is supported by best practices and Toronto Public Health; including, but not limited to policies, practices and procedures focused on routine practice, client hygiene, environmental guidelines, and management of public health concerns;

ii)   make readily available to clients, information that allows for easy access to harm reduction services, and where requested, refer clients to appropriate resources upon request;

iii)   have naloxone kits (injectable or nasal spray) available onsite. At least one staff on each shift will be trained in the administration of naloxone; and

iv)   have a minimum of one sharps container in each client washroom.

c)    24-hour Respite Sites will:

i)     have a site-specific safety/security plan in place;

ii)   have fully operational life and fire safety system(s), free from defects. All annual and monthly inspections will be complete, accurate and logged;

iii)   comply with all Fire Code requirements and have a valid and updated site-specific fire safety plan approved by Toronto Fire at least every 12 months;

iv)   have a site-specific emergency and evacuation plan in place and posted for the duration of its operation;

v)   ensure site-specific emergency and evacuation plans, at a minimum, include: lock down procedures; identify locations of main shut off valves and switches, procedure of shutting down/starting up HVAC, water, gas; procedures for evacuating clients with disabilities; procedures for evacuating pets and animals, identify evacuation site;

vi)   have enough stocked first aid kits available onsite for the capacity of occupants for that site. At least one staff on each shift will have valid first aid training;

vii)   ensure rounds are regularly conducted to monitor site occupancy, maintain occupant safety and identify hazards and issues. All rounds will be logged and logs will be made available to SSHA upon request; and

viii)   not permit the use of broken or defective chairs, cots/mats or equipment by staff or clients and regularly inspect, clean, repair or replace such items.

a)    24-hour Respite Sites will:

i)   comply with SSHA’s approved Referral Protocol during instances when they are not able to provide a space for a client at the facility; and

ii)   offer transportation assistance to clients, taking into account any client limitations (e.g., mobility, visual impairment) and safety considerations.

a)    24-hour Respite Sites will:

i)   limit the use of service restrictions to the greatest extent possible (consistent with a low-barrier service approach) while still maintaining the safety and security of staff;

ii)   issue a service restriction when deemed necessary, giving due consideration to the service restricted client’s safety and welfare;

iii)   inform clients of, and document the reason for, any service restriction, the date/time that the service restriction was issued, the date/time that the service restriction will be lifted, and the name of the staff person(s) who issued the service restriction; and

iv)   offer to refer clients subject to a service restriction, in a manner that complies with SSHA’s Referral Protocol, to alternative service providers.

a)   24-hour Respite Sites will:

i)   have a maintenance plan and/or contact information for regular, after-hour and emergency facilities/maintenance services or a contracted vendor that can provide such services;

ii)   maintain complete and accurate inspection, service and maintenance records for building operations. Records and logs will be made available to SSHA upon request;

iii)   ensure facilities are regularly cleaned (directly or through contracted service), with established cleaning schedule and cleaning log to mark date/time when various areas were cleaned. Logs will be made available to SSHA upon request;

iv)   maintain adequate inventories of cleaning supplies and ensure all supplies are appropriately labeled and stored in a safe and secure location at all times when not in use by an authorized staff. Hazardous materials and related items will be inaccessible to clients at all times;

v)   have waste bins (i.e., food waste, garbage and recycling) throughout the facility and collect waste safely and at frequent intervals to prevent noxious odours or unsanitary conditions;

vi)   have a pest control plan and/or contact information for pest control services and/or a contracted vendor that can perform regularly scheduled inspections and treat the facility for bed bugs, rodents and other pests; and

vii)   maintain complete and accurate inspection and service records for pest control. Records and logs will be made available to SSHA upon request.

a)   24-hour Respite Sites will:

i)   have a complaints and appeals policy, including but not limited to reporting/documenting complaints, responding professionally and appropriately to complaints, analyzing/evaluating complaints and taking any necessary corrective action. Records and logs will be made available to SSHA upon request.

ii)   inform clients of, and post in a conspicuous area of the program facility, this complaint and appeals process.