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(v) Restraints must be discontinued as soon as the child demonstrates compliance or is no longer deemed dangerous. (b) At a minimum, the restraint training curriculum that is utilized shall include the following: (i) Techniques for de-escalating problem behavior including child and staff debriefings; (ii) Appropriate use of emergency safety interventions; (iii) Recognizing aggressive behavior that may be related to a medical condition; (iv) Awareness of physiological impact of a restraint on the child; (v) Recognizing signs and symptoms of positional and compression asphyxia and restraint associated cardiac arrest; (vi) Instructions as to how to monitor the breathing, verbal responsiveness, and motor control of a child who is the subject of an emergency safety intervention; (vii) Appropriate self-protection techniques; (viii) Policies and procedures relating to using manual holds, including the prohibition of any technique that would potentially impair a child’s ability to breathe; (ix) Camp policies and reporting requirements; (x) Alternatives to restraint; (xi) Avoiding power struggles; (xii) Escape and evasion techniques; (xiii) Time limits for the use of restraint; (xiv) Process for obtaining approval for continual restraints; (xv) Procedures to address problematic restraints; (xvi) Documentation; (xvii) Investigation of injuries and complaints; (xviii) Monitoring physical signs of distress and obtaining medical assistance; and (xix) Legal issues. (c) Wilderness therapeutic camps shall submit to the Department of Social Services Group Home Licensing Unit electronically or by facsimile a report in a format acceptable to the Agency at the conclusion of each month whenever the following conditions apply: (i) For any wilderness therapeutic camp with a licensed capacity of 20 children or more, any 30-day period in which three or more instances of restraints of a specific child occurred and/or whenever the wilderness therapeutic camp has had a total of 15 restraints for all children in care within the 30-day period; and (ii) For any wilderness therapeutic camp with a licensed capacity of less than 20 children, any 30-day period in which three or more instances of restraints of a specific child occurred and/or whenever the wilderness therapeutic camp has had a total of 10 instances for all children in care within the 30-day period. (d) At least once per quarter, the wilderness therapeutic camp, utilizing a master restraint log and the child’s case record, shall review the use of all restraints for each child and staff member, including the type of intervention used and the length of time of each use, to determine whether there was a clinical basis for the intervention, whether the use of the restraint was warranted, whether any alternatives were considered or employed, the effectiveness of the intervention or alternative, and the need for additional training. Written documentation of all such reviews shall be maintained. Where the wilderness therapeutic camp identifies opportunities for improvement as a result of such reviews or otherwise, the wilderness therapeutic camp shall implement these changes through an effective quality improvement plan. (6) Family Relationships/Visitation. (a) Unless a child has been removed from the custody of his/her own family and visitation is specifically prohibited by a court order or other legal document, every effort shall be made (in coordination with the referral agency when one is involved) to strengthen family relationships and