Chapter Review Date (a) A center's total staffing for nursing services must be maintained, at a minimum, in the ratios described in subsection (d)(2) of this section. If only one staff member is on duty, that member must be an RN.(b) The staffing ratio is based on the number of minors on the center's actual census that are receiving nursing services from the center.(c) A center must not include direct care staff who qualify under §550.409(a)(3)(D) of this division (relating to Direct Care Staff Qualifications) in the staffing ratio until the staff complete the training program and demonstrate competency as described in §550.409(b)(1) and (2) of this division.(d) A center must maintain documentation to support compliance with this section and §550.803 of this subchapter (relating to Census). Documentation must include:(1) each change in the number of minors on the center's actual census that are receiving nursing services from the center; and(2) the increase or decrease in the number of RNs, LVNs, and direct care staff in accordance with this section as changes in the number of minors on the center's actual census that are receiving nursing services from the center occurs.Attached Graphic