The 24-Hour Respite Site Standards (TRS) outline minimum requirements for all City-administered 24-Hour Respite Sites and 24-Hour Women’s Drop-In programs. Developed in partnership with staff, sector partners and people with lived experience, the standards ensure these programs prioritize ease of access to safe, indoor resting spaces, meals and referrals to community services.
Toronto Shelter and Support Services works with staff and partners to continuously update these standards to improve service delivery. The latest update, released in December 2025, incorporates administrative and operational changes introduced through Directives since the TRS was first launched in 2018. It also aligns with sector best practices and includes enhancements to better support equity-deserving groups, including new standards to support 2SLGBTQ+ clients.
Chiara Cautillo
Anabella Wainberg
Suhal Ahmed
Rowida Anwari
Vanita Arora
Noorjahan Bala
Emma Bell-Scollan
Lorraine Clarke
Paige Court
Ashleigh Dalton
Liz Fatona
Tommica Givans
Simone A. Goring
Ashley Holland
Abiraa Karalasingam
Karima Kinlock-Quamina
Devorah Kobluk
Alison Kooistra
Trish Lenz
Marlee Maracle
Anne McGregor
Leslie O’Reilly
Heath Priston
Jennifer Rajab
Simone Richards
Chiquitita Santarromana
Greg Seraganian
Kiefer Shields
Anthony Singh
Ubah Tahalil
Karen Tizzard
Bonnie Wakely
Linda Wood
Shafeeq Armstrong
Rosa Stall
Practice Health Check
The 519 staff:
The City of Toronto relies on and values community-based partnerships with the not-for-profit sector to deliver many housing and homelessness support services, including 24-Hour Respite Site services.
24-Hour Respite Site services are a type of service that provides essential services to individuals experiencing homelessness in an environment that prioritizes ease of access to safe indoor space. These services include resting spaces, meals and referrals to additional support programs.
In contrast to Emergency Shelters, which prioritize helping clients find more appropriate and permanent forms of housing, 24-Hour Respite Sites prioritize ease of access to immediately essential services as listed above. As a result, 24-Hour Respite Sites are generally more accessible, especially to those who are vulnerable and who may not otherwise access shelters.
The 24-Hour Respite Site Standards (TRS) establish standards for all 24-Hour Respite Sites funded by the City of Toronto including all 24-Hour Respite sites, any winter respite sites and all 24-hour women’s drop-in sites. Each of these programs are included in the term “24-Hour Respite Site” and are expected to meet the standards established in this TRS document.
Providers, including their Board of Directors, will consult qualified legal professionals and/or other appropriate advisors about any and all legal and financial obligations related to their operations. Providers are expected to review, adhere and follow, all applicable federal, provincial and municipal legislation/regulations, their operating agreements, and the Principles of Service Delivery (as described under Section 3) for additional guidance and clarity.
Providers and clients that require clarification on a respite-related matter that is not addressed by the TRS are advised to review the Principles of Service Delivery for guidance and/or contact Toronto Shelter and Support Services.
24-Hour Respite Sites exist and operate as a low-barrier service model, prioritizing ease of access to immediate essential services. Supports are available to help clients find more permanent forms of housing, although service planning is not a precondition for respite programs. The policy context outlined below is to be understood through the lens that 24-Hour Respite Sites prioritize ease of access for clients, especially for those who may not otherwise access shelters.
HousingTO 2020-2030 Action Plan is the City’s blueprint for action across the full housing spectrum – from homelessness to rental and ownership housing to long-term care for seniors – to create a city where housing opportunities are available for all. HousingTO was adopted by Toronto City Council in 2019. HousingTO updates and builds upon the City’s first housing plan, Housing Opportunities Toronto Action Plan 2010-2020. It aligns with other City policies such as the Poverty Reduction Strategy, Resilience Strategy, TransformTO, and the Seniors Strategy. It sets targets to be achieved over the next 10 years with estimates of the financial investments necessary to achieve success. The Plan outlines increased accountability and oversight over a range of government resources necessary for improving housing outcomes for residents. HousingTO includes as a key strategic action to Prevent Homelessness and Improve Pathways to Housing Stability. TSSS is responsible for implementing the components of HousingTO that relate to the homelessness service system.
Consistent with the vision of HousingTO is the updated Toronto Housing Charter – Opportunities for All. The updated Housing Charter expresses the City’s policy approach to housing as one that begins and ends with human rights. A “human-rights based approach to housing” is consistent with the National Housing Strategy Act. It is based on the need to ensure that all residents have equal opportunity to thrive and on the recognition that adequate housing is essential to the inherent dignity and well-being of the person and to building healthy, sustainable communities
The Homelessness Solutions Service Plan sets out implementation priorities to guide the collective efforts of the homelessness service system over three years (2022-2024), while also defining outcome statements that guide longer term planning towards our shared goal of ending chronic homelessness in Toronto. The Service Plan outlines the Housing First, Human Rights and Person-Centred approaches as guiding TSSS in addressing homelessness. The Service Plan also provides further context on service delivery, who service users are and how the homelessness service sector operates within the broader housing system. The Service Plan was approved by Toronto City Council in November 2021.
By setting the minimum requirements for respite services, the TRS play an important part in fulfilling the priorities of the Homelessness Solutions Service Plan.
The City’s approach to addressing homelessness is grounded in a Housing First approach. Housing First focuses on helping people find permanent housing as quickly as possible, with the supports they need to live as independently as possible, without any preconditions such as accepting treatment or abstinence. The underlying philosophy of Housing First is that people are more successful in moving forward with their lives if they first have housing. The Housing First approach includes providing individualized, person-centred supports that are strengths-based, trauma-informed, grounded in a harm reduction philosophy and promote self-sufficiency.
Coordinated Access to Housing and Supports (Coordinated Access) is a systems-level approach for addressing homelessness that provides a consistent way to identify, assess and equitably connect people experiencing homelessness to City-funded housing and supports. TSSS adopted a Coordinated Access approach in 2017, after signing onto the international Built for Zero campaign. The approach brings government agencies, Indigenous leaders, Indigenous housing and service providers from the Toronto Indigenous Community Advisory Board (TICAB), service providers and service users to work together and set priorities for the best use of supportive housing resources to achieve shared outcomes. Coordinated Access is a key component of several municipal plans, including the 2020-2030 HousingTO Action Plan and the Homelessness Solutions Service Plan. It is internationally recognized as a best practice for reducing homelessness and is mandated by provincial and federal levels of government.
TSSS is committed to a continued focus on equity in its delivery of homelessness services, which includes addressing Anti-Black racism and incorporating an intersectional and inclusive approach to its work. TSSS will continue supporting Black service users and staff by advancing the City’s actions in the Toronto Action Plan for Confronting Anti-Black Racism, and by advancing organizational priorities and initiatives. The TRS reflects the commitments and principles in TSSS’s Harm Reduction Framework and the Meeting in the Middle – Engagement Strategy and Action Plan, which was co-created with Indigenous housing and service providers to more meaningfully addressing Indigenous homelessness in Toronto. The plan outlines specific commitments shared with Indigenous Partners and TSSS to deliver services that collaboratively reflect, and adapt to, the changing needs of the Indigenous community. The TRS also supports 2SLGTBQ+ clients and clients with disabilities, and recognizes the intersectionalities that shape the lived experiences of those accessing 24-Hour Respite Sites.
The City of Toronto is the legislated provincial Consolidated Municipal Service Manager responsible for the administration of provincial and federal funding and the planning and management of the housing and homeless service system.
TSSS is the City Division assigned primary responsibility for managing a coordinated and effective system of shelter and homelessness services designed to help people find and keep permanent housing.
TSSS is responsible for
The role of Providers is to deliver high-quality services to individuals or households experiencing homelessness while fulfilling the obligations set out in their Operating Agreements and in the TRS, as well as adhering to applicable legislation. Providers must ensure that all contracted services meet the applicable TRS.
In addition to Providers’ own quality improvement processes and the activities listed under Section 12.2.1 Program Accountability, TSSS undertakes a number of activities and uses a variety of tools to ensure that Providers deliver services in an effective and efficient manner.
TSSS conducts audits/reviews of Providers’ operations in order to
Audits and reviews are conducted both at regular intervals and as needed and may include, but are not limited to program reviews, site visits, organizational reviews, monitoring plan implementations.
Program Reviews are conducted to ensure that Providers are in compliance with the TRS in order to ensure high-quality service delivery to clients. Program Reviews typically focus on models and processes.
Site Review are conducted to ensure that respites are well-maintained and in a state of good repair. The primary purpose of a Site Review is to ensure the health and safety of all persons on respite property.
Organizational Reviews are conducted to ensure that Providers’ finances are in good standing and that their governance and administrative functions comply with the TRS. Providers may be required to demonstrate their compliance with applicable legislation and generally accepted professional practices. Organizational Reviews are often combined with Program and Site Reviews as part of a comprehensive evaluation of a respite’s operations.
TSSS implements a Respite Monitoring Plan on a case-by-case basis when there are concerns that a Provider is not meeting its contractual obligations, including meeting the TRS. A Respite Monitoring Plan is implemented in response to difficulties arising from poor financial controls, service-level disruptions, frequent and severe complaints against a respite and/or its staff or significant damage to a respite’s physical assets that impact on the respite’s ability to provide service, and which requires remediation. A Respite Monitoring Plan could be implemented at more than one respite site if the Provider operates programs at more than one site. TSSS develops and administers Respite Monitoring Plans in consultation with Providers to determine how to proceed with remediation while delivering the best possible services to clients.
In order to maintain the relevance and responsiveness of the TRS to the evolving realities of 24-Hour Respite Site service delivery, the TRS are subject to amendment. Proposed amendments to the TRS will be reviewed by TSSS in consultation with stakeholders to determine their feasibility and impact. Amendments to the TRS are subject to approval from the General Manager, TSSS.
TSSS reserves the right to introduce interim amendments to the TRS outside of the regularly scheduled amendment process via TSSS Directives.
SMIS is a secure, web-based application used to collect, store and retrieve client information and to facilitate efficient utilization of, and access to 24-Hour Respite Sites by identifying available resting spaces in real time. The use of SMIS is mandatory at all City-funded 24-Hour Respite Sites and shelters.
The analysis of SMIS information provides valuable insights for policy development, system planning and for the preparation for Program, Site and/or Organizational reviews.
The following definitions reflect the meanings of terms as they are used in the implementation and operation of the TRS. For further clarification of these or related terms, please contact TSSS.
A low-barrier service with fewer requirements than a shelter program, that provides essential services to individuals experiencing homelessness in an environment that operates on a 24/7 basis and prioritizes ease of access to safe indoor space. Services provided include resting spaces, meals and service referrals. 24-Hour Respites include Winter Respites.
A not-for-profit organization that is contracted by TSSS to operate a 24-Hour Respite Site through an Operating Agreement. In instances where TSSS directly operates a site, the City of Toronto is the provider. Provider is used interchangeably with 24-Hour Respite Site Providers throughout the TRS. 24-Hour Respite Sites provide a low-barrier service with fewer requirements than a shelter program that provides essential services to individuals experiencing homelessness, in an environment that operates on a 24/7 basis and prioritizes ease of access to safe indoor space.
A type of 24-Hour Respite Site that also provides daytime drop-in services to women, transgender, Two-Spirit, and gender diverse people who are experiencing homelessness.
An acronym that refers collectively to Two-Spirit, lesbian, gay, bisexual, transgender, transsexual, queer, and questioning people. While terms and identities frequently change and more inclusive acronyms may be introduced elsewhere (e.g., LGBTQQIP2SAA, LBGTQIA), 2SLGBTQ+ will be used as the all-encompassing term in the TRS. It is important to recognize that not all 2SLGBTQ+ people agree on the labels or apply them to describe themselves. (related terms: Two-spirit People and Transgender Person).
The process of admitting and assigning a client to a resting space within a 24-Hour Respite Site.
The policies and practices that are embedded in Canadian institutions that reflect and reinforce beliefs, attitudes, prejudice, stereotyping and/or discrimination that are directed at people of Black African descent and are rooted in their unique history and experience of enslavement and colonization here in Canada.
Strategies, theories, and actions that challenge social and historical inequalities/injustices that have become part of systems and institutions and allow certain groups to dominate over others.
An active and consistent process of change to eliminate individual, institutional, and systemic racism.
Any person with Black African origin or descent, and who self-identifies as such (e.g., African, African Canadian, Afro-Caribbean).
BRASS is a safety alert system within the City’s Shelter Information Management System (SMIS) that allows for increased information sharing across programs using SMIS about clients with a history of violent behaviour. Shelter providers may use this information to create proactive safety and case plans for clients
A real-time list of people experiencing homelessness in a community. In Toronto, the By-Name List (BNL) is generated daily using information gathered by all shelter programs including 24-hour respite sites and Warming Centres that use the City’s Shelter Management Information System (SMIS). It includes a robust set of data points that support the implementation of the equitable distribution of housing resources at a household level. Clients must consent to be on the BNL.
Program staff, including contracted staff, who are responsible for cleaning or maintaining the 24-Hour Respite Site including, but not limited to cleaners, custodians, maintenance workers, handypersons and superintendents (related term: Program Staff).
Any individual who uses any of the programs, support, amenities or services of a 24-Hour Respite Site.
Program staff, including contracted staff who liaise, interact and work most directly with clients to offer support and assistance including, but not limited to administrative support, housing supports, counselling and referrals. (related term: Program Staff).
A situation in which private interests or personal considerations may affect a person’s judgment in acting in the best interest of their organization or client. It includes using a person’s power derived from a position of authority, access to confidential information, time during working hours, or use of material or facilities for private gain or advancement or the expectation of private gain or advancement. A conflict may occur when an interest benefits the person, any member of the person’s family, friends or business associates.
A systems-level approach for addressing homelessness that provides a consistent way to identify, assess, and equitably connect individuals experiencing homelessness to City-funded housing and supports (related terms: Service, Triage, Assessment and Referral Support (STARS), Service Triage, Assessment and Referral Support (STARS) Housing Checklist Module, Service Triage, Assessment and Referral Support (STARS) Intake and Triage Module).
Daytime locations that offer access to a range of services which may include food, showers, laundry facilities, health services, information and referrals, and social and recreational activities. Services are provided in a welcoming, safe and non-stigmatizing environment. Operate year-round.
The act of calling a transgender or gender diverse person by their birth name after they have chosen a new name. Deadnaming is considered disrespectful and can be a form of gender-based violence or aggression, as it denies their current gender identity and can be emotionally harmful.
Program staff, including contracted staff, who are involved in the handling, storage, planning, preparation or serving of food or meals including, but not limited to kitchen staff, cooks, dietitians, nutritionists and servers (related term: Program Staff).
The process of concluding a client’s stay, including the use of SMIS to release a client’s assigned resting space (related terms: Planned Discharge, Unplanned Discharge).
Disability is understood as any physical, mental, developmental, cognitive, learning, communication, sight, hearing, sensory or functional limitation that, in interaction with a barrier, hinders a person’s full and equal participation in society. A disability can be permanent, temporary or episodic, and visible or invisible.
Discrimination is any practice or behaviour, whether intentional or not, which has a negative impact on an individual or group protected in the Ontario Human Rights Code by excluding, denying benefits or imposing burdens upon them. It is any action or decision that treats an individual or group negatively and/or denies social participation and/or human rights for reasons that include, but are not limited to, an individual’s or group’s perceived or actual: race, ancestry, place of origin, colour, ethnic origin, citizenship, creed, sex, sexual orientation, gender identity, gender expression, age, marital status, family status, disability, the receipt of public assistance, substance use, medical status, mental health status, physical appearance or hygiene.
A companion animal that provides comfort, emotional support or therapeutic benefit, such as alleviating or mitigating some symptoms of a mental or psychiatric disability (related term: Service Animal).
An official alert issued when the outdoor temperature is likely to cause detrimental effects on human health. These alerts can be issued when the temperature reaches a prescribed threshold that is either very high (i.e., Heat Alert, Extreme Heat Alert) or very low (i.e., Cold Alert, Extreme Cold Weather Alert).
An immune system reaction that occurs soon after contact with a certain food and which may be life-threatening. Even a tiny amount of the allergy-causing food can trigger signs and symptoms such as digestive problems, hives, decreased blood pressure and/or swollen airways.
A digestive system reaction that occurs soon after eating a certain food and which results in difficulty digesting a particular food. This can lead to symptoms such as intestinal gas, abdominal pain or diarrhea.
A comprehensive approach to healthcare that supports and affirms an individual’s gender identity and expression, especially when it differs from their sex assigned at birth. It encompasses a range of medical, psychological, and social supports that can include using a person’s preferred name and pronouns to hormone therapy and surgeries.
Refers to individuals who do not identify as exclusively man or woman and includes those who identify as non-binary, Two-Spirit, gender fluid.
The way people communicate or express their gender identity publicly; often through behaviour and physical appearance (e.g., choice of clothing, the length and style of hair, or by emphasizing, de-emphasizing or changing physical characteristics). Chosen names and pronouns are also ways in which people express gender. Gender expression is totally separate from sexual orientation (related terms: Gender Identity, Trans).
A person’s subjective experience of their own gender, which may not match their birth-assigned sex or physical appearance. Gender identity is linked to a sense of self, the sense of being woman, man, both, neither or anywhere on the gender spectrum (non-binary). Gender identity is separate from sexual orientation (related terms: Gender Expression, Trans).
An evidence-based philosophy, approach, set of practical strategies, policies or any programs, aimed at reducing the adverse health, social and economic consequences associated with substance use (both legal and illegal) in ways that are non-judgmental and non-coercive. (related terms: Opioid Agonist Treatment, Naloxone, Safer Crack Smoking Equipment, Safer Injection Equipment, Safer Sex Products).
A resting space that has been assigned to a client who is not physically present in the 24-Hour Respite Site. A resting space may be held for incoming clients or clients who have arranged to arrive beyond the maximum queue/hold time.
A philosophy and approach to addressing homelessness that focuses on helping individuals to find permanent housing as quickly as possible with the supports they need to maintain it. The underlying philosophy of Housing First is that people are more successful in moving forward with their lives if they have housing first. Housing First principles include rapid access to housing with no housing readiness requirements, client choice, strengths based and client-centred supports, and a focus on community integration.
Any occurrence or event that takes place on 24-Hour Respite Site premises or involves active 24-Hour Respite Site clients or staff which may compromise the health, safety or well-being of those involved (related term: Serious Occurrence).
The process of initially assessing a client’s needs, eligibility and suitability for admission to a resting space and recording the results of the assessment in SMIS. An Intake can lead to a Referral or Admission (related terms: Admission, Referral, STARS Intake & Triage, and Referral)
Program staff who are responsible for the supervision or management of other program staff or programs. Management staff include, but are not limited to shift leaders, supervisors, managers, senior managers and executive directors (related term: Program Staff).
Any prescribed or over-the-counter substance used to treat disease, injury or relieve discomfort including, but not limited to medicine, drugs, supplements and remedies.
Commonplace daily, subtle messages, slights and insults against marginalized people that are verbal, unconscious, and take a psychological and physiological toll on the target person or group.
The act of intentionally or unintentionally referring to a person, relating to a person, or using language to describe a person that doesn’t align with their affirmed gender. It might involve using incorrect pronouns, using the wrong gendered name, or arguing with a person about their gender. To misgender someone is to ignore their identity and disregard their needs.
A plan to monitor some or all aspects of a contracted organization’s operations deemed to be insufficient in complying with requirements of the TRS and/or terms of their Operating Agreement. TSSS develops and administers monitoring plans in consultation with Providers to determine how to best proceed with remediation while minimizing disruptions to clients.
A fast-acting medication used to temporarily reverse the effects of opioid overdoses. Naloxone is also referred to as an opioid antagonist since it is used to counter the effects of opioid overdose (related terms: Opioid Agonist Treatment).
An emergency contact which could include but is not restricted to a client’s closest living relative/relatives that has been documented in the Shelter Management Information Systems (SMIS). This information would be shared with other service providers, police and coroner in cases of death. The absence of providing this information does not preclude a client from receiving service.
A resting space that has been assigned to a client as indicated in SMIS, who is temporarily out of their resting space but present elsewhere in the 24-Hour Respite Site during the final count (related terms: Held Resting Space).
A contract between the City of Toronto and a not-for-profit organization that sets out the terms and conditions of services provided on behalf of the City to individuals and families experiencing homelessness.
An effective treatment for addiction to opioid drugs such as heroin, oxycodone, hydromorphone (Dilaudid), fentanyl, and Percocet. The treatment involves taking the opioid agonists methadone or suboxone to prevent withdrawal and reduce cravings for opioid drugs (related terms: Naloxone).
Organizational reviews are conducted to ensure that Providers’ finances are in good standing and that their governance and administrative functions comply with the requirements of the TRS and terms of their Operating Agreement. Providers may be required to demonstrate their compliance with applicable legislation and generally accepted professional practices.
A peer worker is someone with personal lived experience of mental illness, substance use, poverty or homelessness, or experience supporting family or friends with such experiences, and who is employed to help clients with their recovery. A peer worker may be employed as paid staff or as a volunteer depending on the staffing model and service philosophy of the host organization. Within the TRS, peer workers are considered voluntary positions. Providers who employ paid peer workers should consider them to be program staff while reviewing the standards (related term: Program Staff).
The information collected to register and identify an individual in the homelessness system. This information includes the information collected during an Intake in SMIS, information collected through case management supports and services, and physical and mental health documentation.
A domestic or tamed animal kept for companionship or pleasure, excluding those prohibited under Municipal Code, Chapter 349 – Animals.
A voluntary or anticipated discharge at any time by the client, resulting from a client meeting the goals of their service plan, or to facilitate a client’s transfer to housing or more appropriate programs/supports (related terms: Discharge, Unplanned Discharge).
Program reviews are conducted to ensure that Providers are in compliance with the requirements of the TRS in order to promote high-quality service delivery to clients. Program reviews typically focus on program models and processes.
Any paid employee of a 24-Hour Respite Site. Volunteers, students and third-party service workers are not considered program staff for the purposes of the TRS (related terms: Cleaning/Maintenance Staff, Client Support Staff, Dietary Staff, Management Staff).
Negative attitudes, feelings, or irrational aversion to, fear or hatred of gay, lesbian, bisexual, transgender, queer, or questioning people. It encompasses homophobia, biphobia, and transphobia and can be manifested in numerous ways, such as verbally, emotionally, and through physical attacks.
Following an Intake, the process of connecting a client to an alternative bedded program or service. During service planning, a referral is the process of connecting a client to a resource, support, or service outside of the 24-Hour Respite Site where they are staying (related terms: Admission, Intake, and STARS Intake & Triage).
The identified room or area within a 24-Hour Respite Site specifically made up of resting spaces to allow clients to lay or rest (related term: Resting Space).
A cot, mat or similar apparatus and associated space that can be assigned to a client and where a client can lay or rest (related term: Resting Area).
A restorative approach seeks to repair harm and rebuild relationships emphasizing accountability, responsibility and positive relationships rather than punishment. This approach provides an opportunity for those harmed and those who take responsibility for the harm to communicate about, and address their needs, following a conflict.
Equipment used to help people who smoke crack cocaine or crystal methamphetamine to reduce the potential harm to themselves (e.g., to prevent the transmission of communicable diseases). Safer drug smoking equipment may include Pyrex stems, brass screens, chop sticks and mouthpieces (related term: Harm Reduction).
Equipment used to help people who inject drugs to reduce the potential harm to themselves (e.g., to prevent the transmission of blood-borne diseases). Safer injection equipment may include syringes in various sizes and brands, sterile water, alcohol swabs, tourniquets, filters, acidifiers and cookers (related term: Harm Reduction).
Products used to help individuals reduce the potential harm (e.g., to prevent the transmission of communicable diseases) associated with sexual practices. Safer sex products may include condoms and lubes (related term: Harm Reduction).
A safer space is a supportive, non-threatening environment where all people feel comfortable to express themselves and share experiences without fear of discrimination or reprisal. Safer space(s) are not limited to physical spaces and include psychological and social factors that affect an environment. Safety is relative and not all people feel safe under the same conditions.
An incident that involves serious injuries, overdose, attempted suicide, serious assaults, death, fire, the possession or use of a weapon or a significant service disruption (related terms: Incident, Service Disruption).
An animal that can be readily identified as one that is being used by a person for reasons relating to the person’s disability, as listed under the Integrated Accessibility Standards of the Accessibility for Ontarians with Disabilities Act, 2005 (related term: Emotional Support Animal).
Any situation that renders a 24-Hour Respite Site unable to provide its regular services and/or maintain a high standard of service delivery. Service disruptions can be either planned (e.g., renovations scheduled weeks or months in advance, etc.), or unplanned (e.g., structural damage to a 24-Hour Respite Site building that results from severe weather, etc.) (related term: Serious Occurrence).
A formally documented, individualized plan for a client that sets out their objectives, responsibilities and the course(s) of action established to help them to achieve their goals. Service plans may include sub-components (or sub-plans) depending on the particular needs of a client (related term: Support Services).
An operational policy that results in a temporary restriction of an individual from an organization or program, such as shelters, 24-hour Respite Sites, Winter Respite Sites, Daytime, or 24-Hour Drop-ins for a limited length of time due to a particular incident or behaviour. Service restrictions are meant to be issued as a method of last resort.
A common assessment tool that provides a standardized way to understand service users’ support needs and assist staff to connect service users to housing and resources. The STARS tool includes three components: The STARS Intake & Triage, The STARS Housing Checklist, and The STARS Supports Assessment (related terms: Intake and STARS Housing Checklist Module).
The STARS Housing Checklist is used by caseworkers to support service planning for securing and maintaining housing. The Housing Checklist is part of Toronto’s common assessment tool, the Service Triage, Assessment and Referral Support (STARS) tool (related terms: Admission and Intake).
The STARS Intake and Triage module captures a client’s general information and support needs. The Intake and Triage module is part of Toronto’s common assessment tool, the Service Triage, Assessment and Referral Support (STARS) tool (related terms: Admission and Intake).
Site visits are conducted by City staff to ensure that program facilities and sites are protected, secure, well-maintained and in a state of good repair. The primary purpose of a Site visit is to ensure the health and safety of all persons at the program facility/site.
A secure, web-based system that provides real-time information on available shelter beds and resting spaces across all City operated and funded shelters and 24-Hour Respite Sites. The system is used to collect, store and retrieve client information to improve service planning and to facilitate access to available services, as well as to support case management. The use of SMIS is mandatory at all City-funded shelters and designated 24-Hour Respite Sites.
Any program or service offered by a Provider or other service provider to help clients meet their goals or needs including, but not limited to resting spaces, meal programs, housing help services, employment programs, etc.
A communication bulletin notifying 24-Hour Respite Site providers of new service requirements or prescribed action(s) required under the authority of the Operating Agreement, TSSS, City Council resolution or other legislation. TSSS Directives may also be used to clarify an existing 24-Hour Respite Site standard or to issue interim service requirements or standard(s).
An umbrella term that describes people with diverse gender identities and gender expressions that do not conform to stereotypical ideas about what it means to be a girl/ woman or boy/man in society. Trans’ identities include a person whose gender identity or gender expression is different from the gender associated with their sex assigned at birth. A transgender person may or may not undergo medically supportive treatments to align their bodies with their internally felt gender identity. The term also includes but is not limited to clients who identify as transgender, transsexual, cross-dressers or gender non-conforming (gender variant or gender-queer) for the purposes of the TRS (related terms: Gender Expression and Gender Identity).
This term is culturally specific to North American Indigenous communities to describe from a cultural perspective people who are gay, lesbian, bisexual, trans, or intersex. The term can also describe a societal and spiritual role that certain people played within traditional societies, where they filled a role as an established middle gender. This 2SLGBTQ+ term is not exclusive to gender identity and can also refer to sexual orientation (related terms: 2SLGBTQ+ and Transgender Person).
An involuntary or unanticipated discharge that either results from a client’s unilateral action to discontinue receiving service from a 24-Hour Respite Site (e.g., failure to return) or a service restriction (related terms: Discharge, Planned Discharge, Service Restriction).
Any object that is used or intended to be used to cause harm to a person or threaten harm to a person.
A brief check-in with a client focused on their general wellbeing and safety through personal engagement while in their living environment. Consideration should be given to the time at which wellness checks are conducted, avoiding mealtimes, early morning or when clients are sleeping; except for when the client safety plan requires it.
A 24-hour Respite Site that is only open during the winter season from November 15-April 15, and that is open continuously regardless of weather conditions. Services include resting spaces, meals, and referrals to additional support programs.
(a) Providers and their Board of Directors are responsible to ensure that they comply with all relevant aspects of applicable federal, provincial and municipal legislation/regulations.
(b) Providers are responsible to review the legislation and keep themselves informed, as legislations are amended from time to time.
(i) In the event of any legal conflict between the 24-Hour Respite Site Standards and applicable legislation, the applicable legislation shall prevail to the extent of the conflict.
(c) Providers and their Board of Directors will comply with reference standards, policies and guidelines prescribed by TSSS.
(d) Providers and their Board of Directors will comply with all of the terms and conditions of their Operating Agreements, the 24-Hour Respite Site Standards and TSSS Directives.
(e) Providers and their Board of Directors will consult qualified legal professionals and/or other appropriate advisors about any and all legal and financial obligations related to their operation as a respite.
The Principles of Service Delivery are designed to guide Providers and their Board of Directors in their decision making and to prioritize the clients’ experience. These principles are particularly helpful in the event that the TRS are unclear or silent on an issue in question. Program staff and board members will refer to these principles in such circumstances to inform their actions, decision-making or service approach.
Services will be delivered with compassion and without judgement, free from discrimination, harassment, racism, and oppression. Service delivery will respect each client’s rights, privacy, and dignity, and will be guided by equity, diversity, and inclusion.
Access and supports are provided using a low-barrier, client-centred and trauma-informed approach that is grounded in harm reduction and approached from an anti-racism/anti-oppression perspective. Staff will utilize restorative practices and acknowledge and respect the unique needs, intersectionalities and barriers experienced by equity-deserving client groups. Clients will be involved in all key decisions related to their care and support.
Services are delivered in a manner that promotes and enhances the safety of clients, staff, volunteers and visitors.
Helping clients to find and maintain housing is an effective way to support their transition from homelessness to permanent housing. Clients are provided with information, opportunities and choices to access housing and related supports.
Service quality relies on clear, practical and achievable outcomes. Services are delivered with a focus on continuous improvement.
All persons have the right to seek services. Providers will work to identify and remove real or perceived barriers that prevent or inhibit client access to services, and support equitable client access and outcomes. No person will be denied service based on race, sexual orientation, gender identity, gender expression, disability, or any other personal characteristic protected by law.
Services are built on positive community relations and a network of supports to achieve better outcomes for clients.
(a) Providers will have a set of Client Rights and Responsibilities, including a Client Code of Conduct, which will be posted in conspicuous areas of the 24-Hour Respite Site.
(b) At a minimum, clients have the right to
(i) Expect that program staff will follow requirements of the TRS
(ii) Be treated in a non-judgmental and respectful way
(iii) An environment free from anti-Black racism (e.g., discrimination, prejudice, and harassment) and anti-Indigenous racism
(iv) An environment free from discrimination based on gender identity and/or expression, and sexual orientation (e.g., biphobia, homophobia, transphobia, and queerphobia)
(v) Participate in a fair and clear complaint resolution and appeal process without fear of reprisal
(vi) Provide feedback about current and potential program policies and services and the way services are delivered
(vii) Actively participate in the identification of their housing and personal goals
(viii) Receive support or referral from program staff to help achieve their housing and personal goals
(ix) Be given clear and accurate information in order to make informed decisions about the support services they receive
(x) Receive assistance from program staff with understanding information that is presented to them and with completing forms or other paperwork
(xi) Request and receive access to their personal and health information if it is collected and stored by the program
(xii) Have their personal and health information and privacy protected to the extent that legislation allows
(xiii) Contact TSSS directly for information about the homelessness services system, 24-Hour Respite Sites and to provide feedback about their service experience.
(c) Clients will
(i) Follow the rules of the program
(ii) Treat all individuals with respect
(iii) Be responsible for the care, behaviour and control of their pet, emotional support animal or service animal while on the grounds of a 24-Hour Respite Site
(iv) Respect the property belonging to the program, clients, staff, volunteers, visitors and members of the neighbourhood in which the 24-Hour Respite Site is located.
(d) Clients will not
(i) Discriminate against any individual or group of individuals
(ii) Engage in violent, abusive or harassing behaviour
(iii) Impose personal beliefs or standards on others
(iv) Engage in racist and/or anti-Black racist behaviour, including using racist and/or anti-Black language (e.g., racial slurs) and/or anti-Indigenous racism
(v) Engage in any form of queerphobia, including biphobia, transphobia and homophobia, or discriminate against any individual based on sexual orientation, gender identity or gender expression.
(a) Client input will be sought in multiple ways to support service improvements and to improve client experiences, including but not limited to exit interviews, discharge surveys, one-on-one interviews, client surveys, client focus groups, client advisory groups and/or residents’ meetings.
(i) Providers will seek input from clients who identify as part of equity-deserving groups, including Black clients, Indigenous clients and clients from 2SLGBTQ+ communities.
(b) Clients must be consulted about significant policy or program changes.
(c) Providers will hold a minimum of one (1) residents’ meeting monthly to obtain residents’ opinions and input about 24-Hour Respite Site operations and proposed policy or program changes.
(i) Notice of a residents’ meeting must be posted in conspicuous areas of the 24-Hour Respite Site at least one (1) week in advance of the meeting.
(ii) Residents will be encouraged to attend and participate in these meetings.
(iii) Minutes must be recorded at these meetings and the minutes and resolutions to any concerns or issues raised must be posted in an area accessible to residents within two (2) weeks of the meeting and remain posted until the next residents’ meeting.
(d) Providers will ensure that alternate and accessible communication formats and supports are available to accommodate clients with disabilities.
(e) Providers will assist TSSS in its implementation of any system-wide survey of 24-Hour Respite Site clients, such as the Street Needs Assessment and the Client Satisfaction Survey.
(a) Providers will respond professionally and appropriately to all complaints from all individuals.
(b) Providers will have a policy and procedures regarding compliments, complaints and appeals that at a minimum will
(i) Outline how compliments and complaints can be made at the program level, how they will be kept confidential and documented, how complaints and appeals made at the program level will be investigated and resolved
(ii) Outline that any client dissatisfied with the resolution of their complaint can escalate their complaint to TSSS for a process review when all other options have been exhausted
(iii) Make clear that clients have the right to a fair and clear complaint resolution and appeal process without fear of reprisal, and include a process for anonymous complaints
(iv) Identify a staff who will act as complaint lead, as part of the complaint policy. The complaint lead will have completed CABR, 2SLGBTQ+ cultural competency and awareness and trauma informed trainings and be in a supervisory role. Clients will be made aware of who the complaint lead is and be reminded of this when filing a complaint.
(v) Offer alternative and accessible modes of submitting (a) complaint(s), as per AODA, to support clients in making a complaint, compliment or appeal, including for those involving ABR, other than through a written submission
(vi) Include informing clients of the status of their complaint throughout the review process, no later than 2 weeks after the initial reporting of the complaint
(c) Providers will implement a process that allows incidents involving queerphobia, including biphobia, homophobia and transphobia, to be shared confidentially
(d) Providers will offer supports to 2SLGBTQ+ clients who experience and report incidents of discrimination and/or queerphobia, including homophobia and transphobia
(e) Providers will have a policy and procedures regarding complaints involving anti-Black racism (ABR). This will, at a minimum, include:
(i) Ensuring awareness among clients that complaints involving ABR should be reported, and that the level and quality of service received by a client reporting a complaint involving ABR will in no way be impacted by reporting such a complaint
(ii) Providing a process that allows complaints involving ABR to be shared anonymously (e.g., complaints box)
(iii) Clear guidelines on how complaints involving ABR will be processed and how the client will be made aware of the status of their complaint throughout the review process, and no later than 2 weeks after the initial reporting of the complaint
(iv) Supports for client(s) who experienced incident(s) involving ABR
(v) A follow-up process for client(s) engaging in ABR-related behaviour that will support learning and understanding of the impact of ABR-related behaviour on the person(s) affected (e.g., review of ABR policies, follow-up meetings, etc.)
(f) Providers will
(i) Submit a copy of the (a) policies and procedures to TSSS and resubmit a copy whenever the document(s) are updated or otherwise revised
(ii) Offer a copy of the (a) policies and procedures or a plain language version of the policy and procedures (e.g., simplified orientation brochure) to clients upon their request
(g) Providers must inform all clients of this process, post their complaint and appeals process in a conspicuous area of the 24-Hour Respite Site, inform clients of who the complaint lead is for their location, and keep a written record of formal complaints, including the investigation process and the resolution.
(h) Providers will provide the contact information for TSSS to clients who
(i) Have exhausted a program’s complaints process, remain dissatisfied with how their complaint was addressed and who wish to escalate their complaint for process review.
(ii) Wish to submit a compliment or complaint about a TSSS program, service or responsibility.
(i) Providers will explain the role of the Ombudsman Toronto as the final step in the complaints process once the TSSS process has been exhausted. The Provider will provide the contact information for Ombudsman Toronto to individuals who have already gone through the Provider and TSSS’ complaints process and wish to pursue their complaint with Ombudsman Toronto, or as requested by the complainant.
(j) Compliments and complaints are valuable sources of information about a provider’s performance and can highlight areas of achievement and areas for improvement. Providers will collect, analyze, and evaluate all compliments and complaints and take any necessary corrective action.
(a) Providers will submit a copy of all policies, plans and procedures included in Section 8 to TSSS and resubmit a copy whenever the document(s) are updated or otherwise revised.
(b) Providers will operate their programs on a 24-hour basis, seven (7) days a week, unless stated otherwise in their Operating Agreement.
(c) Providers will support low-barrier service delivery and promote a high and consistent level of customer service by ensuring ease of access and respectful, empathetic and timely response to requests for services. Providers will give due considerations to the vulnerabilities and unique circumstances of clients when establishing and enforcing program rules.
(d) Providers with a website must post up-to-date contact information and clear directions to the 24-Hour Respite Site location, unless exempted by TSSS.
(e) Providers must be able to respond to requests for service made by phone or in person.
(f) Providers will endeavor to have a program staff person respond to telephone requests for service in real-time.
(g) Providers must have an automated voicemail system capable of storing incoming messages and relaying key information to any caller requesting service who does not reach a program staff person. Incoming messages must be responded to within a reasonable period of time.
(h) Automated outgoing messages for each 24-Hour Respite Site’s main telephone number must include
(i) The program’s name and client group(s) it serves
(ii) Directions to the 24-Hour Respite Site
(iii) Clear direction regarding when program staff will return calls
(iv) Direction to contact Toronto 311 if the caller requires more immediate support services
(v) Direction to call 911 if the caller is in danger or in need of emergency services (e.g., paramedics, police, fire).
(a) Providers will have an intake/assessment policy and procedures to resting spaces that focus on welcoming clients to the 24-Hour Respite Site, emphasizing ease of access, assessing clients for program eligibility and immediate needs, responding to service requests and explaining the collection of personal information, when information is collected.
(i) Providers may ask clients about potentially dangerous items in a manner that complies with the requirements of section 11.2.1 Weapons and Prohibited Items.
(ii) Submit a copy of the policy and procedures to TSSS and resubmit a copy whenever the document(s) are updated or otherwise revised
(iii) Offer a copy of the policy and procedures or a plain language version of the policy and procedures (e.g., simplified orientation brochure) to clients upon their request.
(b) Providers will offer to refer unaccompanied clients between the ages of 16-18 years to a youth-serving shelter, or age-appropriate support program in a manner that complies with the requirements of section 8.2 Referrals.
(i) Providers will report unaccompanied clients who appear to be under the age of 16 to a Children’s Aid Society as required under Ontario’s Child, Youth and Family Services Act, 2017, follow the instructions provided by the Children's Aid Society and document the interaction.
(c) Providers will take all reasonable measures to 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. Providers will
(i) Submit a copy of the policy and procedures to TSSS and resubmit a copy whenever the document(s) are updated or otherwise revised
(ii) Offer a copy of the policy and procedures or a plain language version of the policy and procedures (e.g., simplified orientation brochure) to clients upon their request.
(d) Providers will conduct an intake/assessment to determine the immediate/basic service need(s) and related accessibility requirements or accommodation (i.e., modified service) needs of a client.
(e) Providers will complete an intake/assessment in SMIS, completing at a minimum only those fields that are required to save the intake request in real time.
(f) The intake/assessment will determine, at a minimum, if
(i) There is an available resting space in their program
(ii) The client identifies as a member of the particular client group served by the program
(iii) There are no active service restrictions for the client at the admitting shelter
(g) Providers will ask all clients for their gender identity rather than assume.
(i) Providers will support the choices of gender diverse, transgender and Two-Spirit clients to gain access to resting areas designated for the gender the client identifies with and/or that will best preserve their safety and dignity.
(ii) In instances where gender diverse, transgender and Two-Spirit clients express concerns about their safety or dignity, providers will accommodate requests for a resting space in a non-gender specific /private area, if possible, or in a resting area that the client believes will best preserve their safety and dignity, regardless of their gender identity.
(h) Providers will not use immigration status as a basis to deny clients access to 24-Hour Respite Site services. Immigration status information will not be used to determine service eligibility at intake/assessment or admission process, unless approved by TSSS.
(i) Immigration status will be collected to facilitate suitable placement and supports
(i) Providers will request Next of Kin/Emergency contact information and record client’s response in SMIS. The absence of providing this information does not preclude a client from receiving service.
(j) Providers will take all reasonable measures to accommodate clients with disabilities.
(k) Providers will take all reasonable measures to accommodate clients accompanied by service animals or emotional support animals, or a pet.
(i) Providers will have a plan outlining how clients with pets will be accommodated. The plan will be submitted to TSSS for review and consideration of exemptions.
(l) Providers who cannot accommodate a client with a disability will make a referral to another suitable support service including another 24-Hour Respite Site program, a shelter, or another appropriate program and will offer appropriate transportation assistance, in a manner the complies with the requirement of section 8.2 Referrals.
(m) Providers will not deny access based on a client’s substance use or substance use history.
(n) The presence of a Behavioural Risk Alert in SMIS does not provide grounds for providers to deny access or services to clients.
(o) Access during intake/assessment may be denied in cases where:
(i) There is an active service restriction for the client at the selected 24-Hour Respite site
(ii) A client’s behaviour could compromise the health and safety of the client or other individuals within the site
(p) Providers will record all service denials at assessment in the referral notes in SMIS in real time, and refer the client to another suitable support service, including another 24-Hour Respite Site program, a shelter, or another appropriate service and offer appropriate transportation assistance, as described under section 8.2 Referrals.
(a) Providers will have a referral policy and procedures and
(i) Submit a copy of the policy and procedures to TSSS and resubmit a copy whenever the document(s) are updated or otherwise revised
(ii) Offer a copy of the policy and procedures or a plain language version of the policy and procedures (e.g., simplified orientation brochure) to clients upon their request.
(b) Providers will refer the client to another 24-Hour Respite Site, a shelter or another appropriate program when providers are not able to admit them to their site, provide the requested support service or as directed in 24-Hour Respite Site referral protocols.
(c) If a client is provided a referral, program staff will give them clear directions and offer transportation assistance to the other location so that they can reach their destination, taking into account any safety considerations and client limitations (e.g., mobility, visual impairment, etc.)
(d) When referring clients to a 24-Hour Respite Site, shelter, or another program, the referring program will
(i) Review SMIS information regarding resting space or bed availability at other 24-Hour Respite Sites or shelters
(ii) Verbally review the Notice of Collection with the client and ask for their permission to enter their information into SMIS
(iii) Verify the existing intake/assessment or complete an intake/assessment in SMIS, filing in only those fields in SMIS that are required to save the intake request
(iv) Contact the receiving 24-Hour Respite Site, shelter, or program via telephone to confirm that a space is available
(v) Complete the referral in SMIS in real-time.
(e) If the referral is not to a bedded program, the disposition of the referral will be recorded in SMIS in real time and the referred client will be given the necessary information to contact the appropriate support services.
(f) When referring a client to support services, Providers will take a client’s preferences into account as much as possible.
(g) When referring a client with mobility or health issues to another program, program staff will first obtain client consent to communicate any mobility or health needs to the receiving 24-Hour Respite Site, shelter or program, and then will ensure that the receiving location is able to accommodate the client prior to executing the referral.
(h) When referring a client with a service restriction, program staff will provide only as much relevant information as is reasonably required to inform the receiving 24-Hour Respite Site, shelter, or program about the serviced restricted client and the potential threat or danger concerns that resulted in the service restriction.
(i) When a Provider is unable to complete a referral, the provider will
(i) Assist an in-person client to contact Central Intake and provide the client with Central Intake’s contact information
(ii) Transfer phone request to Central Intake or provide the client with Central Intake's contact information.
(j) For clients who decline or refuse a referral, Providers will offer transportation assistance to an alternative destination within reasonable proximity taking into account any client limitations (e.g., mobility, visual impairment) and safety considerations.
(a) Providers will have a policy and procedures for admission to resting spaces and
(i) Submit a copy of the policy and procedures to TSSS and resubmit a copy whenever the document(s) are updated or otherwise revised
(ii) Offer a copy of the policy and procedures or a plain language version of the policy and procedures (e.g., simplified orientation brochure) to clients upon their request.
(b) Providers will admit clients to resting spaces at any time during their hours of operation when
(i) There is an available space to meet the client's service needs
(ii) The client identifies as a member of the particular client group served by the program
(iii) There are no active service restrictions for the client at the admitting program
(c) Providers will verbally review the Notice of Collection consent form with the client and ask for their permission to enter their information into SMIS.
(d) Providers will verbally review the SMIS BRASS Notice of Collection with clients, notifying the client that
(i) Should they be part of an incident of workplace violence, where their behaviour resulted in physical injury or threatened physical injury, the incident will be recorded in SMIS and a Behavioural Risk Alert will appear on their SMIS record.
(ii) Information about the incident can and may be shared with other programs using SMIS when the client accesses other services.
(iii) This information will be provided to workers to reduce the risk of another incident of workplace violence and to support proactive safety and case planning.
(e) Providers will verbally review the By Name List (BNL) Consent to ensure that clients provide informed consent to be considered for the housing opportunities available through the TSSS Coordinated Access process.
(f) Providers will record admissions in SMIS in real-time (i.e., concurrent with the assignment of a resting space to a client).
(g) Providers will request only as much information as is necessary to provide service to a client.
(h) Providers admitting clients to a respite program will collect the following client information upon admission or as soon as possible thereafter and record the response in the SMIS Intake
(i) Personal information, including name, date of birth, gender, pronouns and racial identity
(ii) Living situation, including sleeping arrangements, reason for seeking service and how long the client has been staying in Toronto
(iii) Demographic information
(iv) The Support Needs Checklist and comments
(v) The Support Level Triage and rationale
(vi) Source of income
(i) Providers will ask, but not require from clients being admitted to a 24-Hour Respite program the following information upon admission or when possible thereafter, and record the responses in SMIS
(i) Personal contact information, including the client’s phone number, email address, or other contact information, if the client is willing to share this information
(ii) The identification section, where ID is available, and the client is willing to share it
(iii) Next of Kin or Emergency contact information
(j) Providers will ask all clients for their gender identity rather than assume.
(i) Providers will support the choices of gender diverse, transgender Two-Spirit clients to gain access to resting areas that are designated for the gender that the client identifies with and that will best preserve their safety and dignity.
(ii) In instances where gender diverse, transgender and Two-Spirit clients express concerns about their safety or dignity, providers will accommodate requests for a resting space in a non-gender specific /private area, if possible, or in a resting area that the client believes will best preserve their safety and dignity, regardless of their gender identity.
(k) Providers will not use immigration status as a basis to deny clients admission to 24-Hour Respite Site services. Immigration status information will not be requested or collected in order to determine service eligibility at intake/assessment or admission process, unless approved by TSSS.
(i) Immigration status will be collected to facilitate suitable placement and supports.
(l) Providers will take all reasonable measures to accommodate clients with a disability.
(i) Providers will take all reasonable measures to accommodate clients accompanied by service animals or emotional support animals.
(ii) Providers that cannot accommodate clients with a disability will make a referral to an accessible 24-Hour Respite Site or shelter and offer appropriate transportation assistance, as described under section 8.2 Referrals.
(m) Providers will take all reasonable measures to accommodate clients accompanied by their pet.
(i) Providers will have a plan outlining how clients with pets will be accommodated. The plan will be submitted to TSSS for review and consideration of exemptions.
(n) Providers will not base admission decisions on a client’s substance use or substance use history.
(o) Providers will record all denials of admission in SMIS in real-time and refer the client to another 24-Hour Respite Site program, a shelter, or another appropriate program, offering appropriate transportation assistance, in a manner that complies with the requirement of section 8.2 Referrals.
(a) 24-hour Respite Site orientation information will be provided to all clients upon admission or as soon as reasonable and no later than 24 hours after their admission. At a minimum, program orientation information will include
(i) Program rules
(ii) Meal time information
(iii) Availability and location of non-gender specific and/or accessible washrooms
(iv) Option to access sleeping areas and washrooms designated for the gender the client identifies with and/or that will best preserve their safety and dignity
(v) Harm reduction policy
(vi) Resting space assignment and discharge information (including immediate discharge times)
(vii) Nearby amenities and services (e.g., stores, community centre, library, daytime drop-ins, etc.) available in the surrounding area
(viii) Health and Safety information including key aspects of a program’s emergency plan, evacuation plan and identifying emergency exits
(ix) Client rights and responsibilities
(x) Service restriction information
(xi) The process for making compliments and complaints
(xii) A list of resources specifically for equity-deserving groups, including but not limited to Black clients, 2SLGBTQ+ clients, and Indigenous clients (e.g., mental health providers specializing in supporting Black communities, 2SLGBTQ+ community organizations, etc.)
(xiii) Verbally reviewing the SMIS BRASS Notice of Collection with clients, as stated in section 8.3 Admissions
(xiv) Informing clients of the 2SLGBTQ+ staff liaison(s) and CABR lead(s).
(b) A tour of the program will be offered to all admitted clients. Tours for interested clients will be arranged as soon as reasonable and no later than 48 hours after their admission.
(c) During orientation, as described in section 10.3.1 Harm Reduction, providers will explain what harm reduction services are available at the location and will make explicit that
(i) The site is a harm reduction positive location
(ii) Harm reduction supplies and naloxone are readily available, onsite or through mobile community services
(iii) All clients will be offered a naloxone kit and training
(iv) Substance use in and of itself is not a reason for service restriction
(v) Staff are concerned about the safety of people who use drugs at the site and are available to help with safety planning and arranging post-drug use safety checks.
(a) Providers will queue and hold resting spaces for incoming clients for a maximum of two (2) hours.
(b) Providers will release queued and held resting spaces immediately after two (2) hours if the client has not arrived and an extension has not been granted, in order to show availability for other waiting clients.
(c) Providers may grant extensions beyond the two (2) hour queue/hold time under extenuating circumstances (e.g., employment obligations, client appointments or lengthy travel time to the 24-Hour Respite Site) or as approved by the 24-Hour Respite Site.
(d) Providers will document approved extensions to the two (2) hour queue/ hold time in SMIS in real time and no later than two (2) hours after granting the extension.
(e) Providers will inform incoming clients of the two (2) hour queue/hold time and the potential loss of resting space resulting from late arrival.
(f) Queue clearing must be done on a regularly scheduled basis and a minimum of four (4) times per shift during 24-Hour Respite Site’s hours of operation.
(a) There is no prescribed limit to the length of time a client may stay in a 24-Hour Respite Site. Length of stay will be determined on a case-by-case basis, taking a client’s best interest into account.
(i) Leave with Permission requests and/or approvals are not permitted in 24-Hour Respite Sites.
(a) Providers will have a policy and procedures for planned and unplanned discharges from resting spaces that include how clients retrieve their belongings and how unclaimed client belongings will be stored, handled and/or disposed, as per section 9.3 Client Privacy and Personal Space
(i) Providers will offer a copy of the (a) policies and procedures or a plain language version of the policy and procedures (e.g., simplified orientation brochure) to clients upon their request
(b) Providers will record discharges in SMIS in real-time.
(i) Appropriate management staff or designee will review all recorded discharges in SMIS within 14 days to ensure that the recorded disposition is accurate, and revise if needed.
(c) Providers will ensure that they use a restorative approach with a client to repair any harm/damage resulting from their behaviour, prior to issuing a discharge.
(a) Providers will ensure that interested clients have a discharge plan in place (e.g., to housing, to treatment, to hospital). Discharge plans will be developed in collaboration with clients whenever possible.
(b) As part of a client’s planned discharge and transition out of a 24-Hour Respite Site, program staff will:
(i) Provide information in writing and assistance to interested clients regarding resources relevant to the next stage of their service plan, including community services and key personal supports. Every effort should be made to connect clients with specialized supports, in particular for 2SLGBTQ+, Indigenous, Black, senior, refugee/newcomer and youth clients.
(ii) Where applicable, review consent forms and summarize information for interested clients or for the next service provider to assist in ensuring continuity of service, in a manner that complies with the requirements of section 12.6.4 Sharing/Disclosure of Client Information.
(a) Providers must immediately discharge clients who are known to have been away from the site for 12 hours without making arrangements with program staff or notifying program staff of their intended return.
(i) Programs that have evening check-in times will inform clients if a failure to return at the specified check-in time will result in a discharge
(b) Providers are exempted from having a discharge plan for interested clients, when the discharge is unplanned as a result of
(i) Admission to health care or correctional facilities
(ii) A decision to leave and/or failure to return to the 24-Hour Respite Site
(iii) A service restriction
(a) Providers will have a policy and procedures for service restrictions, including an appeals process and description of when the use of agency-wide service restrictions is permitted.
(b) Providers will make clients aware of the service restriction policy upon admission or as soon as possible and no later than twenty-four (24) hours after their admission.
(i) The service restriction policy will be posted in conspicuous areas of the site.
(ii) Providers will offer a copy of the (a) policies and procedures or a plain language version of the policy and procedures (e.g., simplified orientation brochure) to clients upon their request.
(c) Service restrictions may only be issued as a last resort to address
(i) Incidents involving violence, threats of violence (including threatening behaviour)
(ii) Incidents involving ABR that threaten the well-being of clients and/or staff
(iii) Incidents involving discrimination based on gender identity and/or expression, and/or sexual orientation (e.g., homophobia, transphobia, and queerphobia), that threaten the well-being of clients and/or staff
(iv) Serious occurrence arising from behaviours that cause dangerous circumstances for others
(v) The violation of significant program rules
(d) Providers will limit the use of significant service restrictions (i.e., lasting 30 days or longer) to only the most serious situations that have resulted from client’s actions/behaviour.
(e) Service restrictions lasting 30 days or longer may only be issued with the approval of TSSS by
(i) Completing the SMIS Incident Report module describing the serious occurrence
(ii) Submitting the Request Form for Service Restrictions lasting 30 or longer (at 24-Hour Respites) or 90 days or longer (at shelters) to TSSS for review
(f) All service restrictions must be approved by the site lead or designate prior to being issued.
(i) All service restrictions involving incidents of ABR and/or Black clients will be reviewed by the onsite CABR lead through an ABR lens, either at the time-of-service restriction or within 36 hours
(ii) All service restrictions involving 2SLGBTQ+ clients will be reviewed by the program’s Equity, Diversity and Inclusion committee through an equity lens, either at the time-of-service restriction or within 36 hours
(g) Providers will document the following information about a client’s service restriction in SMIS in real time
(i) The date, time, included site(s), and reason(s) for the service restriction
(ii) The date and time the service restriction will be lifted
(iii) The name of the program staff person who issued the service restriction
(iv) The date that the service restriction will be reviewed with the client
(h) Providers will provide clients with the following information both verbally and in writing upon the issuance of a service restriction or within 36 hours and upload this supporting documentation into SMIS
(i) The reason for the service restriction
(ii) The date that the service restriction will be reviewed with the client
(iii) The date the service restriction will be lifted
(iv) Information about the client’s right to initiate an appeal of their service restriction.
(i) Irrespective of whether the client was provided with the information in 8.6.3 (g), either upon the issuance of a service restriction or within 36 hours, Providers will, in SMIS
(i) Document if the client was informed, both/either verbally and in writing, of the information in 8.6.3 (h)
(ii) Upload the written document intended for and/or provided to the client
(j) Clients wishing to appeal a service restriction will be advised by program staff of the site’s internal processes for handling such appeals.
(i) If the client has exhausted the 24-Hour Respite Site's internal processes and is not satisfied with how their service restriction appeal was handled, program staff will direct the client to contact TSSS in order to request a process review.
(k) Providers will refer the service restricted client to another 24-Hour Respite Site program, a shelter, or another appropriate program and offer appropriate transportation assistance, in a manner the complies with the requirement of section 8.2
(i) Providers will not prohibit client access to other support services provided at the site because of a service restriction unless the service restriction is agency-wide due to the severity of the client’s actions/behaviour.
(ii) Providers will refer the service restricted client to another program to receive the support services that they cannot access due to the agency-wide service restriction, in a manner that complies with the requirements of section 8.2 Referrals.
(l) During a Weather Alert, an Extreme Weather Alert, smog alert or when directed by TSSS, Providers will temporarily suspend all service restrictions, except in cases where a Provider determines that the service-restricted client poses an immediate threat or danger to another individual’s health or safety, or the security of the site.
(a) TSSS may require providers to provide extreme weather responses outlined below any time that weather conditions create a risk for clients, regardless of whether a Weather Alert, and Extreme Weather Alert or smog alert is declared.
(b) During a Weather Alert, an Extreme Weather Alert, smog alert or when directed by TSSS, Providers will, at a minimum
(i) Divert resources as needed to ensure continued delivery of core support services (i.e., ensuring availability of resting spaces, providing meals)
(ii) Ensure at least one (1) air-conditioned cooling area is available to clients during a heat-based Weather Alert / Extreme Weather Alert or smog alert
(iii) Temporarily suspend all service restrictions, except in cases where a Provider determines that the service-restricted client poses an immediate threat or danger to another individual’s health or safety, or the security of the 24-Hour Respite Site
(iv) Refer the service restricted client to another program or shelter in a manner that complies with the requirements of section 8.2 Referrals.
(v) Based on available supplies and a client's need, Providers will assist clients to obtain basic clothing and footwear appropriate for the season.
(c) Providers that have been pre-approved by TSSS may exceed their funded capacity during Weather Alerts, as per their Operating Agreement.
(i) Providers will not exceed their maximum building occupancy as set out by Regulation 213/07: Fire Code (made under the Fire Prevention and Protection Act, 1990) under any circumstances.
(ii) Providers will have the expanded, TSSS approved resting spaces set up to admit clients by 7:00 p.m. on the day of the Weather Alert/Extreme Cold Weather Alert being called and will ensure the capacity is updated in SMIS.
(iii) Providers may temporarily use alternative sleeping arrangements that may not meet the requirements found under section 9.3.1 Resting Areas and Spaces, if all resting spaces are occupied
(a) Providers will prioritize the provision of a place to rest, meals and service referrals to clients.
(b) Providers will ensure that contractors and sub-contractors abide by applicable requirements of section 9.
(c) Providers will submit a copy of all policies, plans and procedures included in Section 9 to TSSS and resubmit a copy whenever the document(s) are updated or otherwise revised.
(a) Upon admission to a resting space outfitted with cots or mats, Providers will offer each client clean linens consisting of a minimum of two (2) sheets, one (1) blanket, one (1) pillow and one (1) pillowcase. Additional linens must be available if requested by clients to help maintain reasonable hygiene, cleanliness and comfort.
(b) Providers will inform clients about the availability of towels and provide them upon admission.
(c) Providers will provide laundering facilities and supplies onsite or have a contract in place with a laundering service for their linens.
(d) If laundry facilities are available onsite, clients may launder their own clothes, linens and towels as long as instructions about the safe use of the laundry facilities are provided.
(a) Providers will assist clients to obtain items needed to maintain basic hygiene and grooming. At a minimum, Providers will offer each client their own supply of soap, shampoo, a toothbrush, toothpaste, shaving products (e.g., razors), menstrual products and incontinence products as appropriate upon admission or no later than twelve (12) hours after admission and upon request for the duration of the client’s stay.
(b) Providers will provide toiletries and hygiene products that are low fragrance or fragrance-free and hypoallergenic, where possible.
(c) Gender diverse, transgender and Two-Spirit clients, etc.) may have a need for toiletries and hygiene supplies that is different than other clients. Providers will work with these clients to provided needed supplies (e.g., binding tape, binders, tucking underwear, breast forms, hip pads).
(d) Providers will supply hygiene products specific to Black clients (e.g., shea butter, black African soap, black castor oil, shampoo, and hair care products for Afro-textured hair, etc.).
(i) Providers will consult with Black clients to best determine which culturally appropriate hygiene products to provide.
(e) Providers may require clients with an income to purchase toiletries and hygiene products.
(f) Providers will ensure that safer sex products are always accessible and available to clients, without administrative barriers or having to request them
(a) Based on available supplies and a client’s need, Providers will assist clients to obtain basic clothing and footwear appropriate for the season, including options that are non-gendered and, when available, representative of their gender identity.
(b) Clients will be offered public transit fare based on their immediate needs and the provider’s policies.
(a) In order to promote a healthy diet among clients, Providers will
(i) Offer clients safe and nutritious food to meet their dietary needs
(ii) Refer clients with special dietary requirements (e.g., pregnant and elderly clients, etc.) to food and nutrition supports (e.g., prenatal program, community program, etc.) to supplement their diet, if necessary
(iii) Ensure meals and snacks are of a size, quality, variety and nutritional value to meet the recommended guidelines of Canada’s Food Guide
(iv) Avoid serving food with poor nutritional value (e.g., foods high in processed sugar, fat and salt)
(v) Not use or withhold food to influence behaviour (either as a reward or penalty)
(vi) Consult with a registered dietitian, preferably one who is knowledgeable of ethnically diverse diets, on an annual basis or more frequently as needed, for support in menu planning and other food services, and other food security and nutrition-related supports
(vii) Post in a conspicuous place in or near the dining area of each 24-Hour Respite Site a copy of Section 9.2 Food, Diet and Nutrition, a current copy of Canada’s Food Guide, a daily schedule of meal times and a daily menu that will list potential allergens (e.g., peanuts, nuts, eggs and shellfish) in the listed menu items (where possible) and a notice stating whether the program can or cannot guarantee allergen-free food.
(b) Providers must offer meals to clients in a manner that complies with the requirements of section 9.2.1 Meal Program.
(a) Providers will as much as possible plan meal menus at least one (1) week in advance, following the guidance and recommendations from Canada’s Food Guide.
(b) Providers will have culturally diverse menu offerings as part of their menu planning.
(c) Providers will provide three (3) nutritious meals, a minimum of one (1) nutritious snack per 24-hour period, water and warm/cold beverages during operating hours, in a manner that complies with the requirements of section 9.2 (a)(iii).
(d) Providers may issue meal vouchers/cards in lieu of meals when necessary.
(e) Providers must be able to provide reasonable amounts of food to a client who has pre-arranged for a replacement meal outside of regularly scheduled mealtimes.
(f) Providers will ensure that clients can provide input and feedback in a manner that complies with the requirements of section 6.1 Client Input and will incorporate this feedback into menu planning whenever possible.
(i) Providers will consult with Black clients to provide culturally appropriate meals, and additional condiments and spices.
(g) Providers will inform Black clients of culturally relevant nutrition programs and/or food preparation opportunities outside of the 24-Hour Respite Site (e.g., connect clients to community kitchens, etc.).
(a) Providers will ask clients about food allergies, food intolerances, religious dietary restrictions or medically prescribed diets and will accommodate clients’ needs as much as possible. Clients must be specifically notified if their dietary restrictions cannot be met.
(i) Providers will work with interested clients to develop a dietary plan that meets the client’s needs including, but not limited to, applying for special diet allowances or referring clients to nutrition support programs.
(ii) Clients who have been medically diagnosed as undernourished or underweight will be offered additional food servings and/or a high-protein or high-calorie dietary supplement over and above regular meals.
(b) Providers serving pregnant clients will
(i) Offer the client additional food at mealtimes and make nutritious snacks available at all times in between, and offer meal-time flexibility and menu alternatives to help meet their dietary needs
(ii) Refer the client to food and nutrition supports (e.g., prenatal program, community program, etc.) to supplement their diet, if necessary.
(c) Clients who do not eat meat will have access to protein-based vegetarian food options (e.g., beans or soy-based products) at every meal and at snack time. Vegetarian food options must meet the basic nutritional requirements of Canada’s Food Guide.
(d) Food preparation will, as much as possible, reflect the cultural diversity of clients. Every attempt will be made to mark special cultural holidays and traditional occasions with special meals.
(i) Providers that contract third-party food vendors (e.g., caterers), will aim to contract food vendors that offer culturally diverse meals, including those that reflect the cultural diversity of Black clients, and mark special cultural holidays and traditions with meals that correspond to those events.
(a) Providers will 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 transmission of food-borne illness in compliance with Toronto Public Health food preparation requirements and the requirements found under Food Premises Regulation 493/17 (made under the Health Protection and Promotion Act, 1990).
(b) Providers will ensure that all program staff who handle or prepare food receive Safe Food Handler training and certification.
(i) Providers will ensure that all clients and/or volunteers who handle or prepare food either receive Safe Food Handler training and certification or are supervised by a person who has received Safe Food Handler training and certification.
(c) Providers that prepare food onsite will be subject to regular inspections by Toronto Public Health.
(d) Providers will ensure donated foods are safe, of good quality and come from an inspected source.
(i) Food must be received in containers with tight-fitting lids or other suitable methods to protect it from contamination or adulteration.
(ii) Food must be transported, stored and served in a manner that complies with requirements found under Food Premises Regulation 493/17 (made under the Health Protection and Promotion Act, 1990).
(a) Providers that use security/surveillance cameras on or around the site will post a notice in a conspicuous place informing clients of the purpose and presence of such cameras.
(b) Providers will have a client belongings policy and procedures including, but not limited to whether and how client belongings can be stored, retrieved, disposed (i.e., unclaimed or abandoned items, etc.) and
(i) Submit a copy of the policy and procedures to TSSS, and resubmit a copy whenever the document(s) are updated or otherwise revised.
(ii) Provide a copy of the policy and procedures or a plain language version of the policy and procedures (e.g., simplified orientation brochure) to clients upon their request.
(c) Providers will make every effort to provide dedicated personal storage space (e.g., lockers, allocated space within a larger storage area, etc.) for clients and may limit the number of bags or amount of personal belongings that a client may bring into the site.
(d) Providers that offer to centrally store client belongings will do so in manner that minimizes the potential for pest infestation and will ensure client belongings are reasonably bagged, labelled and documented upon both receipt from, and collection by the client.
(i) If identification is being stored or held for a client, it will be treated as personal information and subject to the requirements of section 12.6.3 Storage of Client Information. Additional precautions must be taken to ensure identification is securely stored and protected against theft or access by anyone other than the client.
(e) Providers will hold unattended or unclaimed client belongings of value (e.g., identification, wallet, key documents) for a minimum of 30 days before disposing of them. All other unattended or unclaimed items will be held for a minimum of 24 hours, subject to available space, before they are disposed.
(i) Identification must be destroyed in such a manner that the information contained on the identification cannot be reconstructed or retrieved.
(f) Providers will take all reasonable measures to ensure client comfort and privacy including, but not limited to the installation and maintenance of window coverings on all exterior windows, in a manner that complies with the requirements of section 9.3 (f) (i).
(i) Notwithstanding the requirements of section 9.3 (f), Providers will not permit structures to be erected by clients (e.g., makeshift tents, privacy screens) that may create a hazardous or unsafe condition within the site.
(g) Providers that have the additional space at their 24-Hour Respite Sites will consider designating
(i) A quiet space and/or overflow space that can be used for clients who are seeking quiet, a place to meditate, pray or to be used for clients who need time to de-escalate their emotions
(ii) A program area that can be used for client support functions (e.g., housing support, mobile clinic, etc.) that provides some privacy
(iii) A program area for Black clients to access and create Black-only safer spaces (e.g. hold Black client groups and/or meetings, etc.).
(iv) A dedicated resting/program area for clients who are in different stages of sobriety/recovery and wish to remove themselves from areas where substance use may be taking place
(v) A dedicated resting area for clients with service animals, emotional support animals or pets
(vi) A dedicated resting area for women, if the site is not exclusive to women.
(h) Providers will accommodate requests by Indigenous clients to use traditional medicines, including when they are practicing ceremony, such as smudging, praying, and/or other traditional practices, in quiet and safe spaces, indoors and outdoors.
(a) Providers will ensure that designated resting areas are physically or functionally separated from dining areas and other communal areas. Functional separation may be applied in situations where a multi-functional space is exclusively assigned a single, specific use for a dedicated period of time daily.
(b) Providers will opt for multiple and smaller resting areas/rooms over fewer and larger resting areas as much as possible.
(i) When assigning resting spaces, the use of alternatives to cots or mats is permitted with TSSS approval.
(c) Providers may enhance the privacy of a client’s resting area, but must do so in a manner that does not diminish safety (e.g., obstructed sight lines, emergency egress, etc.) or result in unsanitary, hazardous or unsafe conditions within the site, including, but not limited to using screens, half walls, rearranging furniture or the layout of the sleeping area in order to create a more private space.
(d) Providers will establish and post a regular lighting schedule to coincide with resting hours (i.e., when lights are turned down/up, on/off, etc.) for communal resting areas.
(e) As much as possible, resting spaces will be arranged in a manner that
(i) Reduces the transmission of communicable diseases
(ii) Reduces the potential for conflict between clients
(iii) Facilitates clear walking paths and sightlines for emergency evacuations
(iv) Does not block air vents, windows, doors, plumbing or access panels
(v) Does not expose a client to existing or potential dangers (e.g., under a shelf stocked with heavy items, etc.)
(vi) Allows for the efficient use of space and provides flexibility to expand and contract capacity (e.g., by zone, by numbered resting spaces or areas).
(f) Providers will reasonably ensure that all resting spaces are pest resistant and fire/moisture retardant, can be easily cleaned and disinfected or covered by a material designed to achieve these same qualities.
(g) Providers will have a cleaning schedule that describes how resting spaces are to be cleaned, sanitized and disinfected between client uses and replacement plan for resting spaces, which will at a minimum, include an inspection schedule for bed bugs and common defects (e.g., stains, rips and tears).
(h) Providers will provide a minimum of 3.5 m.2 of personal space per client in resting areas to decrease the transmission of communicable diseases and conflict between clients.
(i) Providers will maintain a lateral separation of at least 0.75 m. between resting spaces and a vertical separation of at least 1.1 m. between the lowest hanging section of an overhead object (e.g., light fixture, bulkhead, air duct, plumbing, etc.) or as directed by TSSS.
(i) Lateral separation exceptions may be made for couples that request it.
(j) Providers will prepare floor plans that illustrate the spacing of resting spaces in designated resting areas.
(k) Providers will seek TSSS approval prior to arranging resting spaces (or alternative sleeping arrangements) in a manner other than described under section 9.3.1 Resting Areas and Spaces
(l) If clients are assigned to single or multiple-occupancy rooms, Providers will have procedures outlining how room checks will be completed, including how clients will inform staff of their preferred gender of the staff conducting (a) room check(s). Procedures should outline how Providers will ensure that room checks are done by a staff of the requested gender, so long as there are staff on-shift available of the gender requested , and that when completing (a) room check(s), staff will announce themselves, and give time for clients to acknowledge staff before entering, when possible and unless a safety concern is present
(a) To assist clients with their hygiene needs, Providers will provide:
(i) A minimum of one (1) washroom that is barrier-free, accessible and designated non-gender specific in each 24-Hour Respite Site
(ii) A minimum of one (1) shower that is barrier-free, accessible and designated non-gender specific in each 24-Hour Respite Site
(iii) A minimum of one (1) toilet for every 15 clients up to the first 100 clients and one (1) toilet for every 30 clients thereafter. Urinals may replace up to half the number of required toilets in men’s washrooms.
(iv) A minimum of one (1) washbasin for every 15 clients. Up to four (4) foam alcohol-based hand sanitizer stations (containing at least 70% alcohol) in washrooms may be used as an equivalent to meet this requirement. These stations may not make up more than a third of the required number of washbasins.
(v) A minimum of one (1) soap dispenser within 0.6 m. of each washbasin
(vi) A minimum of one (1) shower for every 20 clients. Where sufficient number of showers are not available directly onsite, providers will arrange for alternative options (approved by TSSS) for clients to access the required number of showers.
(b) Providers will take all reasonable measures to ensure that clients have privacy while using the washroom and showering.
(i) Providers will ensure that communal showers have shower curtains or equivalent privacy feature(s).
(ii) In locations where privacy is limited, Providers will adopt reserved shower times for clients who request it or other methods that support client privacy.
(c) Providers must stock each washroom with an adequate supply of toilet paper, liquid soap for dispensers, paper towels and/or a hands-free hand dryer. Where possible, providers will stock each washroom with menstrual products.
(d) Providers will ensure that sharps containers are made available in each bathroom stall in communal washrooms and are secured and tamper proof.
(i) Providers will inform clients of the presence of sharps containers and how to use them.
(a) Providers will submit a copy of all policies, plans and procedures included in Section 10 to TSSS and resubmit a copy whenever the document(s) are updated or otherwise revised.
(a) Providers will offer social/recreational programming or opportunities for clients to engage in social/recreational activities.
(a) Providers will offer some degree of service planning to their clients and provide such services to interested clients. Client participation in service planning is neither mandatory nor a condition of service. Service planning will be offered in a safe and non-judgmental environment, free from harassment, abuse, discrimination, violence, racism and oppression.
(i) Where possible, providers will offer clients from equity-deserving groups, including Black clients, 2SLGBTQ+ clients and Indigenous clients, the opportunity to work with case workers who self-identify as part of these communities, races, and cultures to support service planning.
(b) Providers will work to engage all clients in some level of service planning, regardless of a client’s interest and/or willingness to participate in service planning.
(i) Providers will document all attempts at service planning activities in a client's service plan file.
(ii) Program staff will summarize service plan notes in a client’s file every two (2) months and
upon significant events (e.g., prior to a client transferring to another provider, prior to a client’s discharge, upon the resumption of support services after a substantial hiatus, etc.)
(iii) Appropriate management staff or designates will review and sign-off on service plan summary notes.
(c) Providers will ensure that clients are made aware of 2SLGBTQ+, Indigenous, Black, senior, refugee/newcomer and youth specialized supports and services available within the program.
(i) Providers who are not able to provide specialized services to 2SLGBTQ+, Indigenous, Black, senior, refugee/newcomer and youth clients will provide appropriate referrals to specialized services and programs, if desired by the client.
(d) As part of the service planning, program staff will
(i) Focus first and foremost on client engagement and building a relationship with clients
(ii) Provide new clients with preliminary information about resources and support services, upon admission or no later than 24 hours after admission
(iii) Conduct any client interviews or assessments in a private space and/or in a manner that protects a client's privacy and their personal/health information and ensure any collection, storage and sharing of client information complies with the requirements of section 10.4 Privacy and Confidentiality of Client Information.
(a) Engage with interested clients to determine their immediate needs/concerns (e.g., health, harm reduction needs, safety considerations) upon admission or as soon as possible thereafter, as described in section 8.3 Admission.
(b) Use the SMIS Consent Form to obtain consent from clients engaging in service planning to share information with relevant support services and health care providers, as described in section 12.6.4 Sharing/Disclosure of Client Information.
(c) An initial assessment of an interested client may include, but is not limited to identifying, documenting, or updating the following items:
(i) Reason(s) for service
(ii) Family/household members who are not present in 24-Hour Respite Site
(iii) Specialized supports for 2SLGBTQ+, Indigenous, Black, senior, refugee/newcomer and youth clients
(iv) Cultural/communication considerations
(v) Disability and mobility issues
(vi) Need for personal identification documents, including updating the identification section in SMIS, where ID is available and the client is willing to share it
(vii) Need for health and mental health supports
(viii) Need for substance use and harm reduction supports
(ix) Need for financial supports as they relate to the client’s housing plan
(x) History of housing, homelessness and current housing needs
(xi) Employment history and employability needs
(xii) Educational goals and supports
(xiii) Legal issues affecting the client
(xiv) Need for daily living/life skills supports
(xv) Service/supports currently provided by other organizations
(xvi) Client identified concerns.
(d) Providers may request and collect immigration status information only to assist interested clients to obtain or replace identification or determine eligibility for social assistance programs (e.g., housing subsidy programs, GIS, OW/ODSP, OAS, CPP), services (e.g., Housing Help, health care) or refugee specific programs that require this information.
(e) Providers will ensure that the collected information from interested clients is appropriately added into the STARS Intake and Triage and Housing Checklist modules in SMIS and will update them when new information is shared.
(f) Program staff will work with interested clients to document a service plan based on the results of the client’s assessment that is collaborative, respectful, client-centered, approached from an anti-oppression and trauma-informed care perspective, guided by the principles of harm reduction and focused on attainment of personal goals and on improved housing outcomes for clients.
(g) Program staff will offer to provide a written copy of the service plan to the client, in a manner that complies with the requirements of section 12.6.4 Sharing/Disclosure of Client Information.
(h) Program staff will engage regularly with interested clients to
(i) Identify goals and priorities in collaboration with the client
(ii) Identify who needs to be involved (case conferencing, referrals, advocacy) and their responsibility for each goal
(iii) Identify steps toward achieving identified goals with the client
(iv) Identify challenges and potential solutions
(v) Review and document progress to date and update the service plan at the start of each meeting and at the point of service transition (e.g., when the client transitions to another support program, service, shelter provider or agency).
(i) Program staff will document relevant interactions with interested clients in a clear and consistent manner and include such service plan notes in a client’s service plan file.
(j) Program staff will document all meetings with interested clients in a clear and consistent manner and include such service plan notes in a client’s service plan file. All service plan notes will, at a minimum, include the following information
(i) The date of the meeting
(ii) The date of the case note(s)
(iii) The location of the meeting
(iv) The name and role of the person making the note(s)
(v) Contact information for all third parties named in the note(s)
(vi) Scan/copy of all relevant supporting documentation.
(k) Program staff will update service plan notes at a minimum of once per week, even if there is no contact with the interested client. Such documentation will also include all appointments missed by the client including those with physicians, other support services workers, etc.
(l) Service plan summaries will describe, at a minimum, key information and the status of the current service plan, including but not limited to:
(i) Goals identified in the service plan
(ii) Actions/activities the client has completed
(iii) Outstanding goals or actions.
(m) Upon a client’s planned discharge, staff will
(i) Provide information in writing and assistance to the client regarding resources relevant to the next stage of their service plan, including community services and key personal supports
(ii) Review consent forms and summarize information for the client or next provider to assist in ensuring continuity of service in a manner that complies with the requirements of section 12.6.4 Sharing/Disclosure of Client Information
(iii) Update the STARS Housing Checklist module with any housing-related supports provided following their discharge.
(a) Providers will support clients who seek to address their health and mental health care needs. At a minimum, Providers will
(i) Assist clients with finding appropriate health and mental health services and make referrals when a program cannot provide the requested services, including treatment, harm reduction and abstinence-based services and supports
(ii) Ensure that 2SLGBTQ+, Indigenous, Black, senior, refugee/newcomer and youth clients are aware of specialized health and mental health supports and services
(iii) Provide additional food servings and/or dietary supplements to clients with special dietary requirements or refer such clients to another program or service that provides the relevant dietary supports in a manner that complies with the requirements of sections 9.2 (ii), 9.2.2 Dietary Restrictions and Accommodation and 8.2 Referrals.
(iv) Providers will ensure that the proper technological equipment and supports are available to clients for virtual health and mental health care appointments, when possible
(v) Providers will provide clients with a private space to attend virtual health and mental health care appointments, when possible.
(a) Providers will have a harm reduction policy and procedures that will make explicit that the program operates using a harm reduction approach. The policy and procedures will include, at a minimum, prevention and response to overdose, wellness checks, and how supplies are distributed, collected and disposed.
(i) Providers will offer a copy of the (a) policies and procedures or a plain language version of the policy and procedures (e.g., simplified orientation brochure) to clients upon their request.
(b) Providers are encouraged to establish an onsite harm reduction advisory committee to ensure services are informed by resident needs and input, in a manner that complies with Section 6.1 Client Input.
(i) The committee will be led by clients with living experience of substance use and supported by site staff or harm reduction agency workers
(ii) Providers will support resident-led or community-based harm reduction initiatives (e.g., peer-led programs, resident requests for room checks, etc.)
(iii) For Providers who are unable to establish an onsite harm advisory committee, harm reduction will be made a standing item at monthly resident meetings.
(c) During admission, in conjunction with the requirements of section 8.3 Admission, Providers will explain what harm reduction services are available and will make explicit that
(i) The site is a harm reduction positive location
(ii) Harm reduction supplies and naloxone are readily available, onsite or through mobile community services
(iii) All clients will be offered a naloxone kit and training upon admission
(iv) Substance use in and of itself is not a reason for service restriction
(v) Staff are concerned about the safety of people who use drugs at the site and are available to help with safety planning and arranging post-drug use safety checks.
(d) Providers will ensure naloxone kits (injectable or nasal spray) are available at all sites for staff and client use. All program staff on each shift will be trained in overdose prevention, recognition and response, including the administration of naloxone.
(e) Providers will post signage in washrooms and washroom stalls, and other visible areas (e.g., entrances, etc.), noting
(i) Overdose prevention initiatives available onsite
(ii) The availability of naloxone and other harm reduction supplies (i.e., safer injection equipment, safer smoking equipment, and safer sex products)
(iii) Encouragement of substance users to let another client or staff know they are using.
(f) Providers will ensure
(i) Sharps containers are secured against tampering and available throughout a site and in each bathroom, or in each bathroom stall
(ii) Clients are informed of the availability of sharps containers and how to use them.
(g) Providers will provide safer drug use equipment, safer sex products, training and related supports to clients (if qualified to do so)
(i) Providers will ensure that supplies will be easily accessible 24/7, (e.g., through zero barrier access in open common areas, peer satellite programming, site staff, or visiting harm reduction staff).
(h) Upon the request of a client, Providers will refer clients to an organization that offers harm reduction supplies, training and related support services for
(i) Opioid agonist treatment (buprenorphine, methadone, etc.)
(ii) Supervised consumption services
(iii) Free testing for sexually transmitted and blood borne infections
(iv) Free vaccinations
(v) Naloxone distribution and training
(vi) General nursing services (e.g., assessing injection-related abscesses, counselling, pregnancy testing and supportive decision-making, referrals to internal and external services).
(i) Providers will ensure that clients who smoke substances do so outdoors.
(j) Providers will prioritize best practices around overdose prevention over gathering limitations, including in the context of an outbreak of communicable illness.
(i) Providers will ensure that clients will be permitted to meet to provide support for safer drug use and overdose response.
(ii) During an outbreak of a communicable illness, providers will encourage clients to continue practicing IPAC measures even while engaging in substance use and harm reduction activities.
(k) Providers will neither prohibit nor confiscate the following items from clients
(i) Life-saving medications (e.g., Epi-pens, nitroglycerin tablets, asthma inhalers, naloxone, etc.) or medications that have been prescribed
(ii) Safer drug use supplies and/or safer sex products
(iii) Personal property, including substances
(iv) Sacred medicines belonging to Indigenous clients.
(l) Providers will support clients who wish to engage in harm reduction programs by offering public transit fare to attend such programs or related appointments.
(m) Providers will not discharge clients or impose service restrictions on the basis of substance use on or off site, ensuring to comply with section 8.6 Discharges and section 8.6.3 Service Restrictions.
(n) All sites, including new and relocating sites will undergo a mandatory Harm Reduction and Overdose Preparedness Assessment as directed by TSSS.
(o) Providers will ensure staff document any client death where overdose is the suspected cause of death using the Death of a Shelter Resident Reporting Form.
(p) Providers will make grief and loss support available to clients immediately following a client death or overdose related traumatic event, and in an ongoing manner following the event. Support may include de-briefing, healing circles, one-on-one counselling, and peer to peer supports.
(a) Providers will have a policy and procedures regarding client medication (narcotic and non-narcotic) including, but not limited to its management, issuance, administration, secure storage, disposal and who is authorized by the Provider to access client medications and provide medication-related assistance.
(b) Providers will encourage clients to self-administer medication as much as possible and will not require clients to surrender their medications.
(c) Clients will be fully responsible for securely storing, accessing and administering their medication(s).
(d) Some clients may require support from program staff (e.g., reminders, assistance with opening containers, storing medications, etc.) or request program staff to help administer their medication where a physical limitation prevents the client from self-administering their medication. Only program staff authorized by the Provider may provide reasonable medication-related assistance to clients.
(e) Providers will treat medication information as a confidential health information, as described under section 12.6 Privacy and Confidentiality of Client Information.
(f) Providers that store medications for clients will do so in a manner that complies with the requirements of section 10.3.3 Secure Storage and Disposal of Medication and will maintain a consistent method of documenting medication information containing, at a minimum
(i) Name of client
(ii) Name of client's medication
(iii) Date and time medication is accessed by or issued to the client
(iv) Name of the staff person who issued and/or helped to administer the medication
(v) Client signature confirming receipt of medication.
(g) Providers are not responsible for ensuring that clients adhere to the prescribed instructions for taking medications and will release stored medication to clients whenever they request it.
(h) Providers with concerns about the ability of a client to self-administer medication or with misuse of medication and/or the safety of the medication will
(i) First discuss these concerns with the client
(ii) If still concerned, seek client consent to consult with the client's health care professional (e.g., nurse, psychiatrist, physician) or the pharmacist who dispensed the medication to the client.
(a) Only authorized program staff and/or the client will have access to the client’s medication that is being stored by the Provider.
(b) At a minimum, all medications stored on behalf of a client will be
(i) Inventoried and labeled appropriately
(ii) Stored in separate containers for each client
(iii) Kept in a safe and secure temperature appropriate location (e.g., a locked cabinet in an office, or locker or locked drawer in a client's room, etc.) at all times other than the time that the medication is accessed or administered.
(c) Providers will provide secure refrigerator space in an access-restricted area dedicated to the sole storage of medications requiring refrigeration.
(d) Providers will not store medications in the same refrigerator that is used to store food, as described under section 9.2.2 Dietary Restrictions and Accommodation.
(e) Providers will
(i) Specify how long unclaimed, unused and/or expired medication will be kept before it is properly disposed
(ii) Treat all unclaimed, unused and/or expired medications as hazardous waste and either drop off these medications at a pharmacy, a City of Toronto Household Hazardous Waste Depot, or arrange for third party collection and disposal.
(a) Providers will have a policy and procedures that
(i) Details how services are provided to 2SLGBTQ+ clients in a manner that preserves their safety and dignity and that recognizes the needs of gender diverse, transgender and Two-Spirit clients
(ii) How discrimination and bias toward 2SLGBTQ+ clients within respites will be addressed and includes clear consequences for any person(s), including clients, staff and/or volunteers, who engage in queerphobic behavior, including biphobic, homophobic and/or transphobic behaviour
(iii) Offer a copy of the (a) policies and procedures or a plain language version of the policy and procedures (e.g., simplified orientation brochure) to clients upon their request
(b) Providers will develop and implement policies and procedures that are gender inclusive.
(i) All clients will be made aware of respite policies supporting 2SLGBTQ+ clients, in addition to other measures addressing queerphobic behavior, including biphobic, homophobic and/or transphobic behaviour, at orientation and as needed throughout their stay in the program
(c) Providers will ask all clients for their gender identity rather than assume and will accept gender identity and gender expression as defined by a client.
(i) In all their interactions, program staff will use a client's chosen name and pronouns and will not misgender or deadname a client and/or request that a client use their deadname in interactions with staff or to seek program supports and services.
(ii) Providers will have pronoun pins/stickers available for clients and staff to wear.
(d) At any point during their stay, clients can inform staff that their name, gender identity, and/or pronoun(s) differ from those provided during intake and staff will update the client’s SMIS profile accordingly
(i) Providers will assist 2SLGBTQ+ clients in accessing, completing, and submitting any and all required documentation to legally change identifying information to correspond with their gender identity.
(e) Providers will make their services accessible to gender diverse, transgender and Two-Spirit clients in their self-identified gender.
(f) Providers will support the choices of gender diverse, transgender and Two-Spirit clients to gain access to resting areas and washrooms designated for the gender the client identifies with and/or that will best preserve their safety and dignity.
(i) In instances where gender diverse, transgender and Two-Spirit clients express concerns about their safety or dignity, Providers will accommodate requests for a resting space in a gender-neutral/private room, if possible, or in a resting area that the client believes will best preserve their safety and dignity, regardless of their gender identity.
(g) Providers will designate (a) staff liaison(s) who leads the implementation of 2SLGBTQ+ policies, programs and supports
(i) The 2SLGBTQ+ liaison(s) will support 2SLGBTQ+ clients in accessing respite programs and services, as requested.
(h) Gender diverse, transgender and Two-Spirit clients may have a need for toiletries and hygiene supplies that are different than other clients. Providers will work with clients to provide additional supplies.
(i) Providers will continue to provide toiletries and hygiene supplies based on the client’s need for the duration of the client’s stay.
(ii) Providers may discontinue providing toiletry and hygiene products if a client’s service plan requires it or if a client has an income and is able to purchase them.
(i) Providers will display visual markers (e.g. queer positive posters, Pride flags, etc.) that promote gender-inclusive and queer-positive spaces in all common areas, sleeping areas and washrooms, including spaces used to conduct an intake
(i) Providers will post signage promoting the use of pronouns to support the gender identity and/or gender expression of gender diverse, transgender and Two-Spirit clients.
(j) Providers will provide a minimum of one (1) washroom that is designated non-gender specific, barrier-free, and accessible that ensures compliance with applicable regulatory requirements in each 24-Hour Respite Site. Where possible, Providers will stock each washroom with menstrual products.
(k) Providers will inform all clients of the availability and location of non-gender specific and/or accessible washrooms.
(i) In instances where a non-gender specific and/or accessible washroom are not available, Providers will provide gender diverse, transgender and Two-Spirit clients with sole access to the communal washroom that best preserves their safety and dignity.
(l) Providers will take all reasonable measures to ensure that clients have privacy while showering.
(i) Providers will ensure that communal showers have shower curtains or equivalent privacy feature(s), or provide gender diverse, transgender and Two-Spirit clients with sole access to communal shower facilities, if requested.
(m) Providers will treat hormones that belong to gender diverse, transgender and Two-Spirit clients as any other medication and will not consider them a prohibited substance nor confiscate them.
(i) Gender diverse, transgender and Two-Spirit clients will be provided with (a) sharps container(s), if requested.
(n) Providers will consult with 2SLGBTQ+ clients to create a safe and welcoming environment
(i) Providers will ensure that 2SLGBTQ+ clients have access to resources and opportunities to create 2SLGBTQ+-only safer spaces within shelters (e.g., 2SLGBTQ+ shelter client groups and/or meetings, etc.).
(o) Providers will establish opportunities for 2SLGBTQ+ clients to engage in and lead peer support programs, including for 2SLGBTQ+ specific support programs and resources (e.g. groups and/or one-on-one supports).
(p) Providers will support year-round programming that celebrates the identities of 2SLGBTQ+ clients (e.g., Pride Month events, discussions led by 2SLGBTQ+ community organizations, etc.).
(i) 2SLGBTQ+ clients will be consulted about programming to ensure that it is reflective of 2SLGBTQ+ communities and of their diversity across other identities.
(q) Providers will establish partnerships with 2SLGBTQ+-positive mental health and health/services providers, including those that offer programming specific for 2SLGBTQ+ Black and racialized clients, and support 2SLGBTQ+ clients in accessing these services.
(i) Providers will help gender diverse, transgender and Two-Spirit clients seek access to gender affirming care, as requested by a client.
(r) Providers will ensure that 2SLGBTQ+ clients are aware of health and mental health supports and services that are specific to 2SLGBTQ+ communities and that are reflective of the diversity within those communities (e.g., Two-Spirit specific resources, resources aimed at queer newcomers/refugees etc.)
(i) Providers that are not able to provide health or support services to 2SLGBTQ+ clients will provide appropriate referrals to 2SLGBTQ+-positive health/services providers.
(s) Providers will establish partnerships with 2SLGBTQ+ community organizations.
(i) Providers will inform 2SLGBTQ+ clients of community programs and services and help 2SLGBTQ+ clients access these by offering public transit fare to attend such programs or access related services.
(t) Providers will consult with 2SLGBTQ+ service organization(s) for on-site programming guidance for 2SLGBTQ+ clients.
(u) Providers will work to invite members from 2SLGBTQ+ communities to attend resident meetings and programming to support 2SLGBTQ+ clients
(v) Providers will seek input from 2SLGBTQ+ clients for the purpose of program planning/development/evaluation (e.g. exit interviews, discharge interviews, suggestion boxes, etc.).
(w) Providers will arrange opportunities for all clients to learn about 2SLGBTQ+ communities and/or participate in 2SLGBTQ+–related activities, including educational sessions and/or workshops
(x) Providers will seek additional 2SLGTBQ+ training resources and opportunities that increase staff understanding of 2SLGBTQ+ communities to supplement mandatory training
(y) Providers will demonstrate self-evaluation and service improvement specific to practices and policies based on leading practices that support 2SLGBTQ+ clients, including through policy reviews and client feedback.
(a) Providers will have a policy affirming their commitment to and support of reconciliation efforts that recognizes the unique needs and history of Indigenous peoples and includes clear actions towards truth and reconciliation to best support Indigenous people experiencing homelessness.
(i) Clients will be made aware of this policy during orientation and as needed throughout their stay
(ii) Providers will offer a copy of the (a) policies and procedures or a plain language version of the policy and procedures (e.g., simplified orientation brochure) to clients upon their request
(b) Providers will support staff access to awareness and safety training around Indigenous cultures and histories and will seek training from Indigenous organizations to deliver trainings on Indigenous cultural competencies.
(c) Providers will support Indigenous clients in accessing sacred medicines.
(i) Providers will not confiscate sacred medicines belonging to Indigenous clients.
(ii) Further to the requirements of section 9.3 (h), Providers will accommodate Indigenous client requests for an appropriate and dignified space, indoors and outdoors, to smudge or use medicines.
(d) Providers will ensure that Indigenous clients are aware of Indigenous-specific supports and services.
(i) Providers that are not able to provide services to Indigenous clients will provide appropriate referrals to Indigenous service providers, which include supporting access to (an)/(a) Elder(s)/Knowledge keeper(s), if desired by the client.
(e) Providers are encouraged to seek partnerships with Indigenous services providers in a way that respects the self-determination and autonomy of Indigenous organizations.
(a) Providers will recognize the unique needs/barriers faced by clients with various disabilities resulting in a higher representation of clients with disabilities within the population of people experiencing homelessness.
(b) Providers will provide all new program staff, students, peer workers and volunteers with a site-specific orientation or orientation information prior to starting work. At a minimum, the orientation information will cover AODA requirements, including service animals.
(c) Providers will ensure that alternate and accessible communication formats and supports are available to accommodate clients with disabilities, and that staff know how to access them.
(d) Providers will take all reasonable measures to accommodate clients with disabilities. Those providers that cannot accommodate clients with disabilities will make a referral to another 24-Hour Respite Site program, an accessible shelter, or other appropriate program and will offer appropriate transportation assistance taking into account any client limitations (e.g., mobility, visual impairment) and safety considerations.
(e) To assist clients with their hygiene needs, Providers will provide
(i) A minimum of one (1) washroom that is designated non-gender specific, barrier-free and accessible that ensures compliance with applicable regulatory requirements in each 24-Hour Respite Site
(ii) A minimum of one (1) shower that is s designated non-gender specific, barrier-free and accessible that ensures compliance with applicable regulatory requirements in each 24-Hour Respite Site.
(f) Evacuation plans will, at a minimum include procedures for evacuation of clients with mobility issues or other disabilities, as well as service animals.
(a) Providers will develop and implement ABR policies and procedures to address discrimination and bias toward Black clients within 24-Hour Respite Sites, that, at a minimum, include clear consequences for any person(s) engaging in ABR behavior, including clients, staff and/or volunteers.
(i) All clients will be made aware of policies around ABR, in addition to other measures addressing ABR at orientation and as needed throughout their stay in the program.
(b) Providers will designate (a) staff to act as a CABR lead that supports the implementation of CABR policies, programs and supports.
(c) Providers will establish a safe and welcoming environment for Black clients in a 24-Hour Respite Site, established through consultation with Black clients and staff (e.g., use of positive imagery and culturally appropriate décor).
(i) Providers that have additional space, as per 9.3 (g) Privacy and Personal Space, will ensure that Black clients have access to resources and opportunities to create Black-only safer spaces within programs (e.g., Black client groups and/or meetings, etc.).
(d) Providers will seek partnerships with organizations that offer services and/or programs that specifically support Black clients.
(e) Providers will ensure that Black clients have access to culturally competent health and mental health services and supports, as well as resources that address the effects of trauma on Black individuals.
(f) Providers will consult with Black-service organization(s) for on-site programming guidance for Black clients.
(g) Providers will support year-round Afrocentric programming to celebrate the identities of Black clients (e.g., Black History Month, information/awareness of prominent African leaders and inventors, Afro/Caribbean dance, culture, and arts etc.).
(i) Black clients will be consulted in the program planning so that it is reflective of the Black community within the program (e.g., ethnicity, Black 2SLGBTQ+ clients).
(h) Providers will arrange opportunities for all clients to learn and/or participate in CABR–related activities, including educational sessions and/or workshops.
(i) Providers will seek input from Black clients for the purpose of program development, planning and evaluation (e.g., exit interviews, discharge interviews, suggestion boxes, etc.), and provide updates on implementation and outcomes.
(j) Providers will commit to continuous self-evaluation and service improvement specific to ABR practices and policies based on leading practices.
(k) Providers will ensure that there are multiple opportunities for staff to affirm their commitment to and support to confronting anti-Black racism (e.g., the creation of a Black staff peer support group).
(l) Providers will ensure staff have ongoing access to awareness raising activities around Black cultures and histories and Confronting Anti-Black Racism (e.g., promotion of Black community events, guest speakers, presentations, storytelling).
(m) Providers will seek out ABR training resources to supplement mandatory ABR trainings.
(n) Providers will ensure that there are Black staff only ABR trainings, workshops, and activities.
(a) Providers will ensure that contractors and sub-contractors abide by applicable requirements of Section 11.
(b) Providers will submit a copy of all policies, plans and procedures included in Section 11 to TSSS and resubmit a copy whenever the document(s) are updated or otherwise revised.
(a) Providers will have an infection prevention and control (IPAC) program in place to prevent or reduce the likelihood of transmitting communicable diseases that at a minimum will
(i) Have written IPAC policies and procedures that will identify roles and responsibilities of all staff, surveillance strategies for hazards and sources of infection, risk mitigation strategies, documentation and reporting procedures, and training and education requirements for employees
(ii) Be updated to reflect any City-issued IPAC-related Directives
(b) Providers will have an outbreak management plan that at a minimum includes
(i) A process for identifying and mobilizing the outbreak management team
(ii) Procedures for communication with Toronto Public Health and other stakeholders
(iii) Protocols for surveillance of new cases, along with case and contact management
(iv) Strategies for client placement and in-situ isolation plans when applicable
(v) Strategies for containment including identification of the outbreak area and staff co-horting plans (vi) Environmental control measures including cleaning, disinfecting and environmental services
(vii) Distribution and use of the appropriate personal protective equipment (PPE)
(viii) Surveillance testing where applicable
(ix) A process for continued client admissions and transfers when applicable
(x) Annual plans for updates and revisions, with submission to TSSS.
(c) Providers will provide personal protective equipment (e.g., mask, respirator, goggles, disposable gloves, etc.) and supplies to staff and clients as directed by Toronto Public Health and/or TSSS, and train program staff to use them properly and appropriately.
(d) Providers will promote frequent hand hygiene among clients and staff to reduce the transmission of communicable diseases.
(e) Providers will provide alcohol-based hand sanitizer that contains at least 70% alcohol to supplement hand hygiene in high contact areas (e.g., reception and dining areas) and take appropriate measures to control or prevent misuse or misapplication of the product.
(f) Providers will ensure that general IPAC practice signage are posted in conspicuous areas as appropriate (e.g. hand washing and food safety guidelines, personal hygiene practices, etc.).
(g) If a client or staff appear ill or has an illness that presents a health risk to other clients/staff, Providers will encourage the client/staff to seek medical treatment.
(i) When possible, Providers will facilitate client referrals to community medical resources in a manner that complies with the requirements of section 8.2 Referrals
(ii) Providers will monitor for unusual patterns of illness. When a higher-than-normal number of people with similar types of illness is identified over a short period of time (few days), program staff will contact Toronto Public Health.
(h) Providers will recommend that all program staff consult a health care professional about updating their vaccinations, including Health Canada-approved COVID-19 vaccine series, annual Influenza vaccination and completing a TB skin test.
(i) Providers will provide program staff with training and information about communicable diseases and infection control including, but not limited to
(i) 24-Hour Respite Site IPAC Program including Routine Practices (i.e., risk assessment, hand hygiene, personal protective equipment, environmental controls, administrative controls) and environmental cleaning and disinfection Food Safety (via Food Handler’s Certification training)
(ii) Specific diseases that are of public health significance, such as tuberculosis (TB), HIV, Hepatitis B and C
(iii) The 24-Hour Respite Site's response plan for individual cases or outbreaks of communicable disease
(iv) Procedures for dealing with occupational exposure to blood or bodily fluids, biohazardous waste management, sharps injuries and the safe handling of all sharps.
(i) Providers will have a documented cleaning and disinfection plan that will comply with the requirements of section 11.3.1 Custodial Services.
(j) Providers will review the heating, ventilation and air conditioning (HVAC) systems of their facilities, and will consider enhanced air disinfection practices to limit the spread of communicable illnesses through structural improvement or augmentation as needed (e.g., with the use of portable high-efficiency particulate absorbing (HEPA) filtration systems).
(k) Providers will regularly monitor Toronto Public Health updates and provide educational updates or training to staff on the above topics.
(a) Providers will ensure adequate staff-to-client ratio for any given shift taking into account facility size and layout, client capacity, high client traffic periods, client and staff safety, monthly and seasonal factors and other planning and scheduling considerations.
(b) Program staff must be on shift at any and all times during that program’s hours of operation. When on shift, all program staff must be alert and attentive to the activities within the program. Staff sleeping while on shift is prohibited.
(c) In addition to complying with the requirements of section 10.3.1 Harm Reduction (d), Providers will ensure that at least one (1) program staff who holds a valid certification in Standard First Aid and CPR must be on duty at all times in the 24-Hour Respite Site.
(d) Providers will ensure that a naloxone kit and an approved first aid kit are available at the site that complies with the requirements of Regulation 1101: First Aid Requirements (made under the Workplace Safety and Insurance Act, 1997)
(e) All program staff on each shift will be trained in overdose prevention, recognition and response, including the administration of naloxone.
(f) Providers will ensure that all individuals are safe and secure within the facility.
(i) Entrances to the 24-Hour Respite Site must be secured against unwanted entry but must allow unrestricted exiting.
(ii) Exterior doors to the site must be capable of being locked and must operate as designed.
(iii) Emergency exits must be equipped with an alarm to alert staff of unauthorized entry and exits.
(iv) Door alarms must be checked daily.
(g) Program staff will conduct and log rounds or checks throughout a 24-Hour Respite Site’s operations. Rounds will be regularly scheduled and occur more frequently in areas that warrant it. Rounds will include but are not limited to resting area/resting space checks, bathroom checks, checks for secured and unobstructed entry/exits and the documentation and resolution of issues that are identified.
(h) Providers will have a policy and procedures regarding hazardous products and the reporting of unsafe conditions by any individual within the site that, at a minimum, includes hazardous product labelling, storage, disposal and program staff training requirements in the use of personal protective equipment and safe handling of hazardous products.
(i) Providers will have a policy and procedures in place for the safe collection, removal and disposal of solid waste, recyclable materials, organic waste, biohazardous and hazardous waste.
(j) Providers will have a policy and procedures for inspecting a client’s resting space, room and/or personal belongings for situations where such an inspection is considered necessary in order to maintain the health, safety and security of clients or staff, and to maintain the good condition and security of the site.
(k) Providers will install and maintain at least one (1) eye wash station according to the manufacturer’s instructions. The eyewash station must be in an area of the site that is easily accessible by anyone and identified with a highly visible sign.
(l) Providers will ensure lighting levels are adequate and suitable for the intended function of a given space and path of travel to exits.
(m) Providers will introduce tools, processes and systems to improve the safety and security of the site as resources become available. These may include using client advisory groups and /or restorative approach(es) to managing conflicts, acquiring an automated external defibrillator, installing emergency alarms in washrooms or providing personal panic alarms to allow clients to signal if they are experiencing a medical emergency, the use of two-way radios, security cameras and/or a public address system.
(n) In addition to meeting the requirements of section 12.5.2 Incident Reporting, Providers will debrief and review all incidents with staff to identify lessons that can help to prevent or mitigate such incidents from recurring.
(i) Serious incidents will be debriefed and reviewed no later than 24 hours after its occurrence.
(a) Providers will have a prohibited items policy and procedures regarding weapons and other items deemed potentially dangerous or prohibited by the provider that at a minimum includes their confiscation, safe handling and disposal when such items are brought anywhere inside the site or on-site property.
(i) Providers will offer a copy of the (a) policies and procedures or a plain language version of the policy and procedures (e.g., simplified orientation brochure) to clients upon their request
(b) Providers may
(i) Ask clients about any and all items that a client intends to bring into the site. Staff may refuse to admit a client if staff have reasonable grounds to believe that the client is in possession of a weapon or other prohibited items and the client refuses to disclose the items in question
(ii) Confiscate and/or dispose of items deemed potentially dangerous
(iii) Offer to store, secure or dispose of potentially dangerous items and may refuse to admit a client who will not surrender a potentially dangerous item(s).
(c) Providers will seek guidance from the Toronto Police Service whenever confiscating, securing and disposing of weapons or other prohibited items or whenever they suspect there to be firearms or weapons, in or around the site.
(d) Providers will neither prohibit nor confiscate the following items from clients
(i) Life-saving medications (e.g., Epi-pens, nitroglycerin tablets, asthma inhalers, naloxone, etc.) or medications that have been prescribed
(ii) Hormones that belong to gender diverse, transgender and Two-Spirit clients
(iii) Safer Injection Equipment, safer crack smoking equipment and/or safer sex products, as described under section 10.3.1 Harm Reduction
(iv) Personal property, including substances, as described under section 10.3.1 Harm Reduction
(v) Sacred medicines belonging to Indigenous clients.
(a) Providers will comply with all applicable legislation and codes regarding property standards, building and elevator maintenance, building and elevator operations, ventilation, heating/cooling, plumbing, fire/life safety systems and accessibility.
(b) When planning significant renovations to their facility, or undertaking work that requires a building permit, Providers will notify TSSS, comply with all applicable building codes, fire codes, bylaws, legislations and review relevant design considerations found in
(i) Environmental Control Best Practices: Guidelines to Reduce TB Transmission in Homeless Shelters and Drop-In Centres
(ii) The facility’s Building Condition Audit (BCA) and Capital Reserve Fund Forecast (CRFF)
(iii) A professional energy audit and an accessibility audit of the facility
(iv) Sections 9.3 Privacy and Personal Space, 9.3.1 Resting Areas and Spaces and 9.3.2 Washrooms
(iv) Sections 11.2 (m), 11.3 (c) – (i).
(c) Providers will have a main entrance that is visible from the street or that is clearly marked with signage.
(d) Providers will designate smoking areas that are sited in a location that minimizes the potential for negative interactions with neighbours.
(e) Providers will designate a private, staff-only area for the storage of confidential information and office supplies and for the performance of administrative functions.
(f) Providers will have a dedicated site telephone and an established telephone number for administrative functions and staff use.
(g) Providers will have internet access onsite for administrative functions and tasks including, but not limited to, SMIS access.
(h) Providers will maintain a minimum heated temperature of 21°C (i.e., the temperature should not drop below 21°C) and a maximum cooling temperature of 26°C (i.e., the temperature should not exceed 26°C) for indoor spaces. Any substantial failure to maintain these temperatures must be reported to TSSS’s immediately.
(i) Providers will ensure as much as possible that all textiles used as interior treatments for rooms and furniture (e.g., window coverings, upholstered furniture, carpet/rugs, cot/mat or similar apparatus) are pest resistant, fire/moisture retardant and can be easily cleaned and disinfected.
(a) Providers will have a policy and procedures for emergency custodial service response. Regular custodial services will be available seven (7) days per week.
(b) Providers will have a policy and procedures for emergency custodial response to blood and body fluid spills and outbreaks.
(c) Providers will have a documented cleaning and disinfection plan, as per section 11.1 Infection Prevention and Control, that will include, at a minimum
(i) A cleaning and disinfection schedule that documents the frequency of cleaning and disinfection and any modifications needed in response to the threat of the spread or outbreak of communicable diseases (i.e., frequency and times of cleaning and disinfecting)
(ii) How resting areas and spaces are cleaned, sanitized and disinfected between client uses
(iii) Selection and use of cleaning/disinfecting products and equipment; including documentation of the disinfectant’s drug identification number (DIN) from Health Canada and manufacturer Safety Data Sheets
(iv) Appropriate PPE for cleaning/disinfection tasks
(v) Documentation noting when cleaning and disinfecting was completed for all areas/items identified in the cleaning plan.
(d) Providers will clean and disinfect washrooms in a manner that complies with the requirements of section 11.3.1 Custodial Services.
(e) Providers will maintain adequate inventories of cleaning and disinfecting 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 must be inaccessible to clients at all times, unless the client(s) has received WHMIS training.
(f) Providers will have waste bins (i.e., food waste, garbage, recycling) throughout the facility and will collect waste safely and at frequent intervals to prevent noxious odours or unsanitary conditions.
(i) Providers will store waste in impervious containers. Containers must be fitted with appropriate liners and cleaned regularly.
(ii) Providers will store waste and waste containers in a secure location prior to being disposed, collected or transported.
(g) Providers will have dedicated laundry bins to store and transport clean linens in a manner that limits contamination of the linens. Clean linens will be stored and transported separately from soiled linens (i.e., sealed against cross-contamination).
(h) Providers will have dedicated laundry bins to store and transport soiled linens in a manner that eliminates cross-contamination. Soiled linens should be handled with minimum agitation to avoid spreading contaminants.
(i) Providers must provide sharps containers and must have procedures, including safety practices and required personal protective equipment, for the collection and disposal of sharps found inside/outside the 24-Hour Respite Site premises
(i) Providers will maintain a regular schedule of monitoring sharps containers and ensuring a contract is in place with a biohazardous waste disposal company to replace them when they are full.
(a) Providers will have a documented preventive maintenance plan that specifies the manner and frequency with which inspections, preventive maintenance, emergency repairs, routine upkeep and long-term replacements of building components, systems and equipment are conducted, in order to maintain the building in a state of good repair.
(i) All inspections must be performed by personnel qualified to detect and document deficiencies or potential hazards.
(ii) All maintenance must be performed by personnel qualified to perform the maintenance.
(iii) All repairs must be performed by personnel qualified to perform the repairs.
(iv) This plan will be developed in consultation with TSSS for City-owned properties.
(b) Providers will maintain complete and accurate inspection, service and maintenance records/logs for building operations.
(c) Providers will have in-house or contracted building maintenance services available 24 hours per day to respond to on-demand maintenance issues.
(d) Providers will ensure that contractors and sub-contractors abide by their Staff Code of Conduct.
(e) Providers will have a pest control policy and procedures that specifically address bed bugs and have an integrated pest control program to keep sites free of rodents and pests that, at a minimum, includes
(i) Regularly scheduled inspections and treatment conducted by a licensed pest control company
(ii) Documentation of all pest sightings and/or evidence of infestations as well as inspections and treatments and
(iii) A communication plan to inform clients and program staff of treatment plans that, at a minimum, includes a treatment schedule and the precautions required.
(f) Providers will ensure that all furniture is in a state of good repair and have a replacement plan which will, at a minimum, include an inspection schedule for bed bugs and common defects (e.g., stains, rips and tears). Programs will regularly clean and disinfect such items,
(g) Providers will participate in bed bug, other pest-related and facility management surveys conducted by TSSS.
(a) Providers will
(i) Have business continuity, emergency plan, evacuation plan and outbreak management plans specific to each 24-Hour Respite Site
(ii) Review and update such plans every two (2) years or more frequently if required (e.g., as a result of significant renovation, significant staffing changes, etc.), including a clear indication of the revision date on each page of the document
(iii) Submit a copy of these plans to TSSS and resubmit a copy when the plans are updated or otherwise revised
(iv) Ensure program staff are trained on the various components of these plans, at least once a year
(v) Notify TSSS of service disruptions and emergencies in a manner that complies with sections 5.2 Incident Reporting and 12.5.3 Service Disruption Reporting.
(b) Business continuity plans will, at a minimum
(i) Identify resource requirements to continue the provision of essential services (e.g., food, water, shelter, etc.), onsite or offsite, during emergency situations and non-emergency service disruptions (e.g., communicable disease outbreak, temporary power outage, technological disruptions, labour disruption, etc.)
(ii) Include procedures for the determination, management and reporting of service disruptions, which will include, but not be limited to, the requirements described under section 12.5.3 Service Disruption Reporting, and arrangements for referral/transfer of clients to another 24-Hour Respite Site, shelter or other temporary location during a service disruption, if the need arises
(iii) Include 24-hour contact information for 24-Hour Respite Site management staff and related TSSS staff
(iv) Be explained to all staff as part of their orientation to the 24-Hour Respite Site.
(c) Emergency plans will, at a minimum
(i) Provide direction for the 24-Hour Respite Site’s response to ensure the safety and security of clients and staff in a wide range of emergency situations including incidents that require the intervention of security staff when applicable
(ii) Be appropriate for each facility and client group that a 24-Hour Respite Site serves
(iii) Adequately consider potential emergencies that might arise because of natural events (e.g., weather-related emergency, etc.), human-caused events (e.g., overdose, fire, bomb threats, etc.), accidental hazards (e.g., fire, chemical leak, etc.) and technological and infrastructure disruptions (e.g., power failure, gas leak, heat loss, etc.)
(iv) Assume that assistance from the City may not be available for the first 72 hours after a large-scale emergency
(v) Include lock down procedures
(vi) Include a Toronto Fire Services approved fire safety plan as required under Regulation 213/07: Fire Code (made under the Fire Prevention and Protection Act, 1990)
(vii) Include procedures for when to set up a Fire Watch that, at a minimum, identify staff persons trained on the fire safety plan, frequency of rounds per hour and maintenance of a Fire Watch log
(viii) Include information on whether and how building systems (e.g., HVAC, water, gas, etc.) should be safely shut down/start up and by whom (i.e., certified personnel)
(ix) Include 24-hour contact information for 24-Hour Respite Site management staff and TSSS staff
(x) Be explained to all clients and staff as part of their orientation to the 24-Hour Respite Site.
(d) Evacuation plans will be appropriate for each facility and client group a 24-Hour Respite Site serves and include procedures for the total evacuation of the building.
(e) Evacuation plans will include, at a minimum
(i) Procedures for evacuation of clients with mobility issues or other disabilities
(ii) Procedures for evacuation of service animals, emotional support animals and pets
(iii) Procedures for evacuations that take place during peak hours (i.e., when staffing levels are highest) and during off-peak hours (i.e., when staffing levels are minimal)
(iv) Procedures on how to shut down/start up building systems (e.g., HVAC, water, gas) in a safe manner
(v) An evacuation map that is posted in conspicuous areas throughout the 24-Hour Respite Site
(vi) Identify a gathering area(s), located outside of the immediate neighbourhood of the 24-Hour Respite site where clients and staff will assemble after evacuation, as well as a designated site that can be used to temporarily shelter clients and staff from the elements in the event of an evacuation
(viii) Be explained to all clients and staff as part of their orientation to the 24-Hour Respite Site.
(f) Outbreak management plans, in compliance with section 11.1 Infection Prevention and Control Standards, will include, at a minimum
(i) A process for identifying and mobilizing the outbreak management team
(ii) Procedures for communication with Toronto Public Health and other stakeholders
(iii) Protocols for surveillance of new cases, along with case and contact management
(iv) Strategies for client placement and in-situ isolation plans when applicable
(v) Strategies for containment including identification of the outbreak area and staff cohorting plans
(vi) Environmental control measures including cleaning, disinfecting and environmental services
(vii) Distribution and use of the appropriate personal protective equipment (PPE)
(viii) Surveillance testing where applicable
(ix) A process for continued client admissions and transfers when applicable
(x) Annual plans for updates and revisions, with submission to TSSS.
(a) Providers will submit a copy of all policies, plans and procedures included in Section 12 to TSSS and resubmit a copy whenever the document(s) are updated or otherwise revised.
(a) Not-for-profit organizations funded to provide 24-Hour Respite Site services must be governed by a volunteer Board of Directors.
(b) At a minimum, the Board of Directors is responsible for
(i) Developing and reviewing the mandate, mission, values and strategies of the organization
(ii) Setting agency priorities
(iii) Reviewing and approving policies
(iv) Evaluating service models and delivery
(v) Entering into a purchase-of-service contract (i.e., Operating Agreement) with the City
(vi) Ensuring that the organization meets funder expectations, contract conditions and reporting requirements
(vii) Reviewing budgets and expenditures
(viii) Reviewing and approving accounting and reporting procedures
(ix) Conducting an annual performance review of the Executive Director
(x) Ensuring that the organization meets all legislated obligations.
(c) The Board of Directors will have the required number of directors as specified in the agency’s bylaws. Further, the board will solicit diverse membership to reflect the community they serve and with the range of skills required to fulfill this role.
(d) At a minimum, the Board of Directors will ensure that the same number of board members required to reach quorum have received or will receive training in a manner that complies with the requirements of section 12.4.2 Training and Professional Competencies.
(i) The Chair of the Board must be one of the board members that has received or will receive this training.
(e) The Board of Directors must convene regular meetings, conduct an annual general meeting and maintain written records of these meetings. Board minutes and minutes from the annual general meeting must be signed by the Chair or designate to verify acceptance
(a) On an annual basis, Providers will provide program and financial information to TSSS in a format specified by TSSS. Annual budget submissions will be submitted, in the specified format, by a date determined by TSSS. Operating Agreements will be duly signed by the Chair of the Board, designate, or a board member with signing authority.
(b) A 24-Hour Respite Site’s occupancy must not exceed its funded capacity as specified in its Operating Agreement unless approved by TSSS. Providers will only be reimbursed up to the maximum value as specified in the Operating Agreement.
(c) To register an employee as a signing officer, a Delegation of Signing Authority form must be completed and submitted to TSSS.
(d) Providers will ensure that their financial record keeping practices adhere to generally accepted accounting principles. All financial records will be kept for a minimum of seven (7) years and made available for auditing.
(e) Providers will have an annual audit conducted by a qualified, independent auditor. Multi-service organizations and 24-Hour Respite Site providers that provide more than one (1) service/program will provide an audited statement of operations for each 24-Hour Respite Site service/program. Such organizations are required to use the Audited Statement of Shelter Operations template.
(a) TSSS will conduct reviews and audits as described under section 2.3 Quality Assurance. Providers will provide TSSS representatives with full access to financial, service and all other logs, policies, records and documentation that are required under the Operating Agreement and TRS. Random audits of sites may be conducted, and such logs, policies, records and documents must be provided when requested by TSSS representatives. Logs, records and documents must be kept for a minimum of seven (7) years for auditing purposes. TSSS representatives will also be provided with reasonable access to the premises.
(b) During visits, TSSS representatives may wish to meet with program staff, board/sub-committee members, volunteers and/or clients. Program staff will facilitate any such reasonable requests.
(c) Providers will offer a copy of any policy and/or procedure required under the TRS, or a plain language version of the policy and/or procedure (e.g., simplified brochure) to clients upon their request.
(d) Providers will not introduce any ancillary services that detract or otherwise interfere with the effective delivery of the support services as agreed on in their Operating Agreement. If in doubt whether such ancillary services would detract or otherwise interfere, Providers will discuss such plans in advance with TSSS.
(e) Providers, including the Board of Directors, are responsible for ensuring that program staff performance and accountability are properly monitored, evaluated and managed.
(f) Providers will establish (an) Equity, Diversity, and Inclusion committee(s) that works to promote these principles within the shelter and among clients and staff
(i) (An) Equity, Diversity and Inclusion committee(s) will include staff of various roles and be representative of client and staff identities, where possible
(g) Providers, including the Board of Directors, must ensure that all contracted services meet the applicable TRS.
(a) Providers that own their building will have
(i) A Building Condition Audit (BCA) and a Capital Reserve Fund Forecast (CRFF) completed every ten (10) years and updated every three (3) to five (5) years by a qualified professional
(ii) A Capital Plan that is informed by the BCA/CRFF and a preventive maintenance plan
(iii) Providers will maintain a 10-yr State of Good Repair Plan, submit to TSSS and provide updates
(b) Providers are encouraged to have a professional energy audit and an accessibility audit conducted at least once every ten (10) years and to prepare and implement an energy management plan and accessibility upgrades based on the audits findings.
(c) Providers are encouraged to review the City of Toronto Shelter Design and Technical Guidelines for relevant guidance and best-practices applicable to 24-Hour Respite spaces
(a) Providers will have a community relations/outreach policy and plan that will include, at a minimum, how providers will
(i) Actively engage with the surrounding community
(ii) Establish regular communications through various channels to foster positive relationships and address any concerns
(iii) Respond to community concerns in a manner that complies with the requirements of Section 7 Compliments, Complaints and Appeals
(i) Submit a copy of the policy and procedures to TSSS and resubmit a copy whenever the document(s) are updated or otherwise revised.
(b) Providers will provide the contact information for TSSS and the Office of the Ombudsman to any individual who wishes to make a complaint about a City of Toronto or TSSS program, service or responsibility.
(a) Providers will
(i) Have a conflict of interest policy and procedures for declaring and reporting a conflict of interest
(ii) Submit a copy of the policy and procedures to TSSS, and resubmit a copy whenever the document(s) are updated or otherwise revised.
(b) At a minimum, 24-Hour Respite Site staff and board members
(i) Will not use their positions to give anyone special treatment that would advance their own interests or that of any member of the employee’s family, their friends or business associates
(ii) Will not accept gifts, money, discounts or favours including a benefit to family members, friends or business associates for doing work that the provider pays them to do. The exceptions to this are promotional gifts or those of nominal value (e.g., coffee mug or letter opener with the company’s logo)
(iii) Will not engage in any outside work or business activity that conflicts with their duties as staff or board member, which use their knowledge of confidential plans, projects or information about the organization’s assets that will, or is likely to, negatively influence or affect them in carrying out their duties as staff or board member
(iv) Will not use, or permit the use of, the provider’s property, facilities, equipment, supplies or other resources for activities not associated with their work. Any exceptions to this must be expressly approved by either the Executive Director or the Chair of the Board
(v) May not disclose confidential or privileged information about the property, or affairs of the organization, or use confidential information to advance personal or others’ interests, except in instances where the staff or board member is providing necessary information to allege or report wrongdoing on the part of the provider or Board of Directors (i.e., whistle blowing)
(vi) Who knowingly have financial interests in a contract, purchase, sale or other business transaction with the provider, or have family members, friends or business associates with such interests, will not represent or advise the provider in such transactions.
(a) Providers will have a designated supervisor (or lead) onsite at all times, who has decision-making authority for all aspects of a site’s operations.
(b) Providers will
(i) Have a policy and procedures regarding staff hiring, training and performance management
(ii) Have a policy and procedures regarding student, peer worker and, volunteer placements and the scope of work and supervision requirements for these placements
(iii) Have a policy and procedures regarding how contractors and contracted services (e.g., building maintenance, pest control, cleaning services, security, health services, etc.) are engaged including, but not limited to service expectations of contractors/employees of the contracted services and compliance with an established code of conduct. They will also include any training, skills or knowledge requirements specified by Providers.
(c) Providers will provide all new program staff, student, peer worker and volunteer with a site-specific orientation or orientation information prior to starting work. At a minimum, the orientation information will cover key program policies, procedures and processes, including
(i) Staff Code of Conduct
(ii) Client Rights and Responsibilities
(iii) Compliments, Complaints, and Appeals Process
(iv) Harm Reduction and Overdoes Response
(v) Conflict of Interest policy
(vi) Health and Safety information including key aspects of a 24-Hour Respite Site’s emergency plan (including fire safety plan), evacuation plan and identifying emergency exits
(vii) IPAC program information, including appropriate use of PPE
(viii) AODA requirements, including service animals
(ix) Anti-Black Racism policy and procedures
(x) Policy and procedures that support 2SLGBTQ+ clients and communities
(xi) Any other information that is immediately required for the employee to perform their work safely, effectively and professionally (e.g., naloxone administration, food safety, handling sharps, use of personal protective equipment, etc.)
(d) Providers are encouraged to recommend that staff consult (a) health care professional(s) about updating their vaccinations, including Health Canada-approved COVID-19 vaccine series, annual Influenza vaccination, and completing a TB skin test.
(e) Program staff will comply with the requirements of section 12.4.1 Staff Code of Conduct.
(a) Providers will have a Staff Code of Conduct that outlines acceptable, professional behaviour that applies to all staff, and which will be posted in conspicuous areas of the 24-Hour Respite Site.
(b) At a minimum, a Staff Code of Conduct will explicitly include that all program staff will
(i) Understand and acknowledge the power inherent in their position and work from an inclusive client-centered, anti-racism and anti-oppression approach
(ii) Act professionally, with integrity, objectivity and equity
(iii) Treat all individuals in a respectful, non-judgmental way
(iv) Follow the 24-Hour Respite Site Standards
(v) Clearly explain the purpose of requests for a client's personal information
(vi) Ensure that clients have clear and accurate information in order to make informed decisions
(vii) Acknowledge that their workplace is a client's temporary place of respite and attempt to minimize the negative impacts of staff presence
(viii) Acknowledge when they are in a situation they are not adequately skilled to handle and seek direction and support from their peers and supervisors
(ix) Strive to continuously update their professional knowledge and skills
(x) Abide by all of the 24-Hour Respite Site's policies and procedures.
(b) At a minimum, a Staff Code of Conduct will include that no program staff will
(i) Discriminate against any individual or group of individuals
(ii) Engage in violent, abusive or harassing behaviour
(iii) Impose personal beliefs or standards on others
(iv) Become involved in a client's personal life beyond the scope of their professional function
(v) Have personal relations or accept gifts (except of nominal financial value) and/or services from current or former clients.
(a) An ongoing commitment to learning is important to ensure that program staff and board members are able to perform their duties to the highest standards of professionalism and which are consistent with evidence-based leading practices. The TRS sets out minimum training and professional competency requirements for program staff. Providers are encouraged to exceed these standards.
(b) Providers will comply with all mandatory training requirements of applicable legislation.
(c) Providers will ensure that program staff have received or will receive all required training in the identified topics and professional competencies as described under the Training Topics and Professional Competencies Matrix.
(i) Staffing categories (e.g., client support staff, dietary staff, cleaning/maintenance staff, supervisory/management staff, etc.) are defined under section 3 Defined Terms and may not align with a program staff’s title but are based on their general responsibilities or functions.
(d) Providers will maintain complete and accurate orientation and training records for all program staff and document all staff orientations and emergency drills/exercises that they participate in, with all associated dates.
(e) Providers will keep copies of all training course/curriculum descriptions, manuals or any other documentation that describes the course content, the version or revision date of the content, the training methodology and the length/duration of the training course(s) that have been completed by their program staff. This documentation may be requested by TSSS representatives during any of the reviews described under section 2.3.1 Program Reviews.
(f) Providers may accept documentation from previously completed training or course work from a designated learning institution provided that they meet the requirements of section 12.4.2 Training and Professional Competencies.
(g) Providers will ensure that program staff have received or will receive refresher training or updated mandatory training no later than every five (5) years, or within the recertification period for their training (e.g., Standard First Aid), whichever is sooner.
(h) Providers may access training content through various means (e.g., in-class, webinars, online modules, peer groups, etc.), provided that it is suitable to the learning style of the program staff being trained and that the intended learning outcomes are achieved.
(i) Providers will seek training in the identified topics and professional competencies from agencies or trainers who are qualified to deliver training on the subject matter and who can tailor the training content to a homelessness-specific context, as much as possible.
(i) ABR trainings/sessions/workshops are to be led by a facilitator with lived experience as a Black person.
(j) Providers may deliver in-house training on subjects/topics where they have the operational experience or subject matter expertise to do so effectively.
(k) Training timelines indicated in the Training Topics and Professional Competencies Matrix may be extended with prior approval from TSSS.
(a) Providers must comply with all documentation and reporting requirements of the City of Toronto, including those found in their Operating Agreement, the TRS and TSSS Directives.
(a) Providers will comply with the SMIS-related requirements found throughout the TRS, TSSS Directives, SMIS Privacy Guidelines, SMIS User Agreement and their Operating Agreement.
(b) Providers will not give students, volunteers or peer workers access to SMIS.
(c) Providers will safeguard access to SMIS, ensuring that only authorized staff have access to SMIS.
(i) Providers will remove access to SMIS to any staff who no longer require access to perform their assigned roles and responsibilities.
(d) Documentation and reporting timeframes may be extended to a maximum cumulative period of 12 hours only when SMIS is unavailable due to system interruptions (e.g., SMIS maintenance, power failure, internet access failure, etc.). At all other times documentation and reporting must be completed within established timeframes.
(i) Providers will ensure that all program staff who use SMIS are aware of the manual back-up process and the use of hard copy forms in case of system interruptions or when a SMIS module is not available.
(ii) Providers will immediately enter all manually recorded information into SMIS as soon as SMIS or the SMIS module is available.
(a) All serious occurrences will be immediately reported to TSSS.
(b) Providers will document incidents and serious occurrences in SMIS using the SMIS Incident Report module as soon as possible, but no later than six (6) hours after the serious occurrence or 24 hours after the incident (i.e., staff involved in the incident must record their reports prior to the end of their shift).
(i) Incidents that resulted in workplace violence will be required to be reviewed and approved or rejected in SMIS by a supervisory staff with SMIS Supervisor role access as soon as possible but no later than twenty-four (24) hours after the incident.
(ii) Incidents that resulted in an issuance of a service restriction 30 days or greater require the completion of the SMIS Incident Report module as soon as possible but no later than six (6) hours after the service restriction has been issued. Providers will complete and submit an incident report in a manner that complies with the requirements of section 12.5.2 Incident Reporting.
(c) If SMIS or the SMIS Incident Report module is not available, the incident or serious occurrence must be documented in the hard copy version of the SMIS Incident Report form or in in another manner that captures the same information as reported in the SMIS Incident Report form.
(i) Completed incident report forms must be entered in SMIS once SMIS or the or the SMIS Incident Report module becomes available.
(d) The death of a client is a type of serious occurrence and will be reported immediately to TSSS, in accordance with the reporting requirements found in the Reporting the Death of a Shelter Resident Guidebook.
(a) Providers will immediately notify TSSS of any and all planned or unplanned service disruptions to provide information about the service disruption and the anticipated or actual impacts on program access and support services delivery.
(b) Providers will submit a completed Service Disruption Notification form to TSSS within 24 hours of notifying TSSS.
(c) If the reason for the service disruption involves a serious occurrence, Providers will complete and submit an incident report in a manner that complies with the requirements of Section 12.5.2 Incident Reporting.
(d) Providers will post a notice of the disruption to advise clients and the public of limitations to services.
(e) Providers will immediately inform TSSS when the service disruption has ended, and services have returned to normal functioning.
(a) Providers will treat a client’s personal information, including physical and mental health documentation, and client files as confidential information.
(b) Providers will comply with all TSSS instructions and requirements in relation to the City’s obligations under Municipal Freedom of Information and Protection of Privacy Act, 1990 and the City’s policies in respect of the security, handling, storage and disclosure of any data, information, or documents as applicable.
(c) Providers will
(i) Have a policy and procedures for ensuring client information is accurate, complete and up to date.
(ii) Have a policy and procedures regarding the collection, storage, use, retention, removal, disclosure and disposal of a client's personal information, including physical and mental health documentation that at a minimum, will include a breach of privacy protocol and requirements of sections 12.6.2 Collection of Client Information, 12.6.3 Storage of Client Information, 12.6.4 Sharing/Disclosure of Client Information and 12.6.5 Retention and Disposal of Client Information.
(iii) Designate a staff responsible for access to information and protection of privacy issues and the implementation of any instructions given by the City regarding the handling of client information
(d) Providers will have a media policy and notify clients and TSSS of any media presence on site and/or any media requests for interviews or information as soon as known, and prior to any scheduled media presence. Programs will not permit filming or photography without a client’s signed consent (release).
(a) Providers will inform clients of the SMIS Notice of Collection, and will
(i) Post it (and bring it to the client's attention) in conspicuous areas where client information is regularly displayed (e.g., intake/admission area, counsellor or case worker office, etc.)
(ii) Verbally review the SMIS Notice of Collection and ensure the client understands it before entering client data into SMIS
(b) Providers will inform clients of the SMIS BRASS Notice of Collection and will
(i) Post it in conspicuous areas where client information is regularly displayed (e.g., intake/admission area, counselor or case worker office).
(ii) Verbally review the BRASS Notice of Collection and ensure the client understands that incidents of workplace violence, where their behaviour resulted in physical injury or threatened physical injury, will be recorded in SMIS and shared with other shelter programs to preserve the health and safety of workers.
(c) Providers will not use immigration status as a basis to deny clients access to services. Immigration status information will not be requested or collected in order to determine service eligibility at intake/assessment or admission process, unless approved by TSSS.
(i) Immigration status will be collected to facilitate suitable placement and supports.
(d) Providers may request and collect immigration status information to assist clients to obtain or replace identification or determine eligibility for social assistance programs (e.g., housing subsidy programs, GIS, OW/ODSP, OAS, CPP) or services (e.g., Housing Help, health care) that require this information.
(e) Providers will use the SMIS Consent Form to obtain consent from clients to share information with relevant support services and health care providers as described in section 12.6.4 Sharing/Disclosure of Client Information.
(a) Providers will take all reasonable measures to safeguard hard-copy files containing a client’s personal or health information including, but not limited to the storage of all such files in a secure location and in a locked container (e.g., locked cabinet in a locked office, etc.) and limiting access to the files to authorized program staff who require this information to provide support services.
(b) Providers will take all reasonable measures to safeguard electronic files containing a client’s personal or health information and the storage medium for these files (e.g., computer, USB key, etc.), which may include, but is not limited to, password protecting the file, encrypting the file and limiting access to authorized program staff who require this information to provide support services.
(c) Removing confidential client files from the 24-Hour Respite Site premises or electronically transmitting a client’s personal information outside a secure network is discouraged.
(d) Providers that permit the physical removal or electronic transmission of a client’s personal information must document the exceptional circumstances requiring such movement and the safeguards taken to ensure the security, privacy and confidentiality of the information is maintained.
(e) If client information must be removed or transmitted as part of the client’s service plan, the information must be secured and moved/transmitted in a manner that will limit potential security, privacy and confidentiality breaches.
(a) Providers will not disclose a client’s personal information, including physical and mental health documentation, without first receiving the client’s signed consent, unless permitted to do so under section 12.6.4 (f).
(b) Upon the request of a client, Providers will provide information about the client’s records (e.g., hard-copy notes, SMIS information, etc.) in a manner that follows applicable laws and does not compromise the confidentiality or personal information of other clients or program staff.
(c) Disclosure of personal information, including physical and mental health documentation, about a client may only be made by, and/or provided to, the client in question, or a person who is legally authorized to act on behalf of the client.
(d) Sharing confidential client information with a service provider to which a client is referred or is receiving service, or a non-service provider (e.g., police, media, researcher, acquaintance of client who is not an authorized person acting on their behalf) is permitted with the client’s written consent or completed SMIS Client Consent form.
(e) All client consent documentation will be accurate, up-to-date and recorded in SMIS, in a manner that complies with the requirements of section 12.6.3 Storage of Client Information.
(f) Providers will permit the disclosure of a client’s personal information, including physical and mental health documentation, to relevant authorities or persons, without the client’s signed consent only when
(i) Permitted or required under applicable legislation or regulations.
(ii) Disclosure is required pursuant to a court order or subpoena
(iii) Refusing or neglecting to provide personal or health information could endanger the safety of the client or others.
(a) Providers will have a policy and procedures regarding the retention and disposal of a client’s personal information, including physical and mental health documentation that, at a minimum, includes
(i) Maintaining a written record of client personal information that is destroyed in accordance to section 12.6.1 Client Information and Files and the Operating Agreement, which includes a detailed description of the manner of such destruction
(ii) Disposing only of SMIS information accessible to and required by TSSS with the explicit approval and in accordance with instructions provided by TSSS.
(a) Providers will have a policy and procedures regarding the management, documentation and reporting of privacy breaches and unauthorized use of personal information with respect to client information.
(b) Providers will report any actual or suspected breach of confidentiality with respect to client information to TSSS as soon as possible, but no later than 24 hours after becoming aware of the actual or suspected breach.
(c) Providers will report to TSSS the following details of an actual or suspected breach of confidentiality with respect to client information that, at a minimum, includes
(i) The information breached
(ii) The time of occurrence
(iii) The manner or means of the disclosure, use or breach having occurred
(iv) The person(s) responsible, if known
(v) The steps that the Provider has taken and is intending to take to rectify, mitigate and avoid the possible adverse consequence of the unauthorized use, disclosure or breach.
Questions and Answers: December 2025 24-Hour Respite Site Standards Update
Service Restriction Client Notification Template
Poster: Client Rights & Responsibilities / Staff Code of Conduct
Poster: Principles of Services
Poster: Compliments, Complaints and Appeals
Poster: BRASS (Behavioural Risk Alert Safety System) Notice of Collection
Quick Reference: Key Space Related Standards
Quick Reference: Policies, Procedures and Plans Requirements
Quick Reference: Reporting Contact List
Quick Reference: Training Topic Matrix
Additional resources for 24-Hour Respite Site providers