of BQA 98-021 (PDF, 12 KB)
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DATE: June 5, 1998 DSL-BQA
TO: Adult Family Homes AFH 03
FROM: Judy Fryback, Director, Bureau of Quality Assurance
DHS 88.10(3)(L), Wisconsin Administrative
Code (exit DHS), states that persons residing in adult
family homes have the right to
a safe environment in which to live. The adult family home shall safeguard
residents who cannot fully guard themselves from environmental hazards to which they are
likely to be exposed, including conditions which would be hazardous to anyone and
conditions which would be or are hazardous to a particular resident because of the
residents condition or handicap."
One of the dangers to which residents might be exposed is water that is too hot. The
elderly and individuals with mental and physical handicaps may have neurological
conditions that prevent instant recoil from hot water. Because they do not instantly react
to water that is too hot, they are particularly at risk for injury.
Hot water can cause
scalding, i.e. second and third degree burns in which the skin blisters and swells. Skin
does not return to normal but forms scar tissue on healing. Such burns may lead to
permanent disability. In recent months, we know of three residents in community-based
residential facilities and of one resident in an adult family home in Wisconsin who were
seriously injured by too-hot water.
Second and third-degree hot water burns can occur at the following rates at the
110 degrees F. 13 minutes
120 degrees F. 10 minutes
127 degrees F. 1 minute
130 degrees F. 30 seconds
140 degrees F. 6 seconds
158 degrees F. 1 second
This is to advise you of the necessity for checking the temperature of the hot water at
the sinks, tubs, and showers used by residents. The temperature should be adjusted
according to the types of residents you serve and the degree of independence they have in
using sinks, showers, and tubs. We recommend a temperature of 110 to 120 degrees F.
Licensing specialists who find temperatures above this range may issue a citation at
88.10(3)(L), Wis. Adm. Code, for creating an environment that is not safe for residents.
Compliance with the requirements at DHS 88.10(3)(L) may be obtained and maintained by:
Other ways adult family homes may meet the requirement for safe water temperatures
include the following. Each of these options, if not used in combination with a mixing
valve, requires the installation of devices at each individual sink, tub, and
shower that is used by residents.
Installing a shower valve at each shower used by residents, that complies with the
intent of the "fail safe" system. The Department of Commerce has currently
approved one such valve the Chicago 2500 TempShield Tub and Shower faucet valve.
This valve controls water temperatures at the tub and shower and shuts off the water if
the temperature exceeds 110 degrees. It does not control water temperatures at the sinks
and there is not an approved counterpart for installation at the sink. Another method will
be required to control water temperatures at the sinks.
Installing a faucet with an adjustable hot-limit safety stop at each sink used by
residents. Safety stops keep water at the faucets at a pre-set temperature by blending the
amount of cold and hot water. If the water heater malfunctions, however, and heats the
water even higher than where it had been set, a safety stop will still continue blending
the same amount of hot and cold water. As a result, water temperatures at the faucet will
be hotter than what is expected and burns could occur.
- Installing at each sink, shower, and tub used by residents, a temperature-actuated flow
reduction valve. Depending on the faucet, these valves cost between $6 and $30 and can be
easily retrofitted onto each shower, tub, and sink fixture. These valves reduce the flow
of water to a trickle when the water temperature is approximately 115 degrees F. or above.
We cannot recommend brand names; however, such valves are available at local plumbing or
hardware stores. Because we do not have experience with the reliability of these valves,
we suggest that you monitor the temperature of water coming from faucets on which these
devices have been installed.
If you have questions, please contact the Regional Field Operations Director assigned
to your home. Their names and phone numbers are [in Regional
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