All equipment shall be of such design and material as to be readily cleaned and safe for children. Equipment shall not be colored or covered by any poisonous material. Equipment shall be sturdy, safely constructed and free from protruding nails, rust, toxic material and other hazards.

[19a-79-7a(g)(1)] · Corrected Jun 24, 2025

Chairs for feeding, each of which has a stable base, safety straps on all high chairs attached to the chair and a tray which locks securely.

[19a-79-10(d)(2)(C)] · Corrected Jun 24, 2025

Infants shall be removed from their cribs and held for all bottle feedings. They may be placed in chairs for all other feedings. Infants and toddlers shall be removed from their cribs or playpens at other intervals during the day for individual cuddlings and for verbal communication. They shall be allowed to crawl and toddle as age and development permit. Each infant shall be placed in a prone (front) position part of the time when awake. When food and liquids are served a written statement specifying the formula, breast milk or other liquids and the feeding schedule for infants shall be obtained from the parent(s), updated as necessary and followed by program staff. Unused portions of formula, breast milk or other liquids shall be discarded after each feeding. Clean bottles shall be provided by the parent(s) unless the facility uses disposable bottles or has a dishwasher or dishwashing system approved by the local director of health to wash bottles. Baby food shall be served from a dish unless the whole contents of the jar will be served. Each child's bottle shall be individually identified with the child's name.

[19a-79-10(j)-(k)(1-5)] · Corrected Jun 24, 2025

An education consultant shall be available to the operator and program staff for advice and support regarding the educational content and practice of the program. A person needs to apply for approval to be an education consultant. Program staff shall not serve as education consultants for programs in which they provide direct care or direct program supervision in a non-consultative role; or in a program with the same operator as a program in which they provide direct care or direct program supervision in a non-consultative role. Specific duties of the education consultant shall include, but not be limited to making, at a minimum, annual site visits to the facility, reviewing daily plans, curriculum documents, and educational policies for the developmental and age appropriate practices, observing program staff interactions, use of materials and equipment, implementation of plans and approaches to classroom management; and providing feedback on documentation review and classroom observations to the director and head teacher. A health consultant shall be available to the operator and program staff for advice regarding the health of the children and the health program. Specific duties of the health consultant shall include, but not be limited to making, at a minimum, quarterly site visits to facilities that serve children three years of age and older; or for group child care homes, facilities that operate no more than three hours per day, or facilities that enroll only school age children, semi-annual site visits. Facilities that are closed during the summer months may omit the summer quarterly visit. Site visits shall be made by the health consultant during customary business hours when the children are present at the facility. Specific duties include, but are not limited to reviewing health and immunization records of children and program staff, reviewing the contents, storage and plan for maintenance of first aid kits, observing the indoor and outdoor environments for health and safety, observing children’s general health and development, observing diaper changing and toileting areas and diaper changing, toileting and hand washing procedures, reviewing the policies, procedures and required documentation for the administration of medications, including petitions for special medication authorizations needed for programs that administer medication, assisting in the review of individual care plans for children with special health care needs or children with disabilities, as needed; and quarterly review of all injury, illness, incident and accident reports. A social service consultant shall be available to the operator and program staff for advice regarding the emotional needs, program staff support and the social service program. A registered dietitian consultant shall be available to the operator and program staff for advice regarding nutrition and food service for those programs that prepare or plan meals. A written plan for consultation services shall be developed, signed annually by the consultant and implemented. Consultative service shall include, but not be limited to an annual review of written policies, plans and procedures that relate to the services provided by the consultant, availability by telecommunication for advice regarding problems, availability, in person, of the consultant to the program, consulting with administration and program staff about specific problems, acting as a resource person to program staff and the parent(s) to include coordinating services and assisting families and program staff in identifying necessary resources, and seeking and supporting the collaboration of multiple consultants serving the program. The activities and observations required by each consultant shall be documented in a consultation log that is kept on file at the facility for two years.

All spaces occupied by people, equipment within buildings, approaches to buildings and parking lots shall have a minimum of one foot candle or equivalent of lighting per square foot. Child care centers and group child care homes shall have at least fifty foot candles or equivalent of light per square foot in rooms used by children for reading, painting and other close work. There shall be at least thirty foot candles of light or equivalent in other work or play areas. Programs that serve exclusively school age children may utilize program space with less lighting provided the lighting is bright enough to accommodate the activities with comfort. During napping and resting, lighting shall be maintained at a level that will enable children to be visible. All areas accessible to children shall have light fixtures that are shielded or shatter proof.

[19a-79-7a(e)(7-9)] · Corrected Jun 24, 2025

There shall be access to a minimum of seventy-five (75) square feet per child of outdoor space for the number of children using the space at any one time. The outdoor area shall be fenced or protected for safety. Outdoor play equipment shall have a shock absorbing surface, under and around, that shall effectively cushion the fall of a child, except where the child is sitting or standing at ground level. The shock absorbing surface shall be maintained at a depth of at least eight inches, be free of water and not allowed to become compacted. Acceptable shock absorbing surfaces may include mulch, sand, and wood chips. Synthetic material that is less than eight inches in depth, including but not limited to, rubber mats or tiles may be acceptable surfaces provided the operator maintains documentation on the licensed premises that the synthetic material is manufactured for this purpose, installed in accordance with the manufacturer’s specifications and sufficient to cushion the fall of a child. Concrete, asphalt, grass and dirt shall not be considered a shock absorbing surface. The playground shall be free of glass, debris, holes and other hazards. Nuts, bolts and screws shall be tight; and those that protrude shall be covered or protected. Outside equipment shall be anchored for stability when recommended by the manufacturer. Anchors shall be buried below ground level. The operator shall provide documentation to the Office, upon request, by a certified playground safety inspector that newly constructed playgrounds and all newly installed playground equipment that are set in position and anchored in such a way to last indefinitely are designed and installed in accordance with U.S. Consumer Product Safety Commission and the American Society for Testing and Materials Standards. Drinking water shall be available and accessible to children. Outdoor equipment shall be arranged in such a way as to avoid accidents. All play equipment, fences, and structures shall not pose a hazard.

[19a-79-7a(h)(1-9)] · Corrected Jun 24, 2025

The written permission of the parent(s) shall be required prior to the administration of the nonprescription topical medication shall be kept on file at the facility for each child administered a nonprescription topical medication. The parent(s) shall be immediately notified of any medication error, and notified of such error in writing not more than seventy two hours after the medication error occurred, and such medication error shall be documented in the child’s record. The medication shall be stored in the original container and shall contain the following information on the container or packaging indicating the individual child’s name; the name of the medication; and directions for the medication’s administration. The medication shall be stored away from food and inaccessible to children. Any unused portion of the medication shall be returned to the parent(s). Any expired medication shall be destroyed in a safe manner or returned to the parent.

[19a-79-9a(a)(2-3)] · Corrected Jun 24, 2025

Prior to the administration of any medication, the director(s), head teacher(s), program staff or group child care home provider(s) who are responsible for administering the medications shall first be trained by a pharmacist, physician, physician assistant, advanced practice registered nurse or registered nurse in the methods of administration of medications and shall receive written approval from the trainer which indicates that the trainee has successfully completed a training program as required herein. In addition to being trained in the methods of medication administration, such trained staff may administer injectable medications by a premeasured, commercially prepared auto-injector used to treat allergic reactions or other type of injectable medication and rectal medications, only after he or she has successfully completed a training program on the administration of such type of medication. After completing such training, the director, head teacher, program staff or group child care home provider shall annually have his or her skills and competency in the administration of such medication reviewed and/or validated in accordance with the regulations. The facility shall have program staff trained in the use such medications on site during all hours when a child who has orders to receive such medication is on-site. Upon completion of the required training program or the review and validation of the required training, the written training approval for staff shall be on file at the facility. Approval for the administration of oral, topical, inhalant medications, rectal medications and injectable medications other than by a premeasured commercially prepared auto-injector shall remain valid for three years. Approval for the administration of injectable medications by a premeasured commercially prepared auto-injector shall be valid for one year. A copy of the approval shall be on file at the facility for a period of three years and shall be available to Office staff upon request. The operator shall ensure that the trainer provides the trainee with an outline of the curriculum content which verifies that all mandated requirements have been included in the training program. A copy of said outline shall be on file at the facility for a period of three years for Office review. The Office may require at any time that the operator obtain the full curriculum from the trainer for review by the Office.

[19a-79-9a(b)(1)(A-F)-(2)(A-C)] · Corrected Jun 24, 2025

For programs serving children younger than school age, the building, equipment and furnishings shall be maintained in a good state of repair. A maintenance program shall be established that ensures that the interior, exterior and grounds of the building are maintained, kept clean and orderly, free from accumulations of refuse, dampness, stagnant water, dilapidated structures and other health and safety hazards.

[19a-79-7a(c)(2)] · Corrected Jun 24, 2025

Documentation of professional development for each program staff who cares for the children, including new employee orientation and annual training for current program staff on the child care center or group child care home policies, plans and procedures. Program staff, including the director, shall complete health and safety training no later than three months after the date of hire. Written verification of ongoing training that is at least one percent of the total annual hours worked. As of April 1, 2025, such annual training shall include content as defined in 45 CFR § 98.41(a)(1)(i) to (a)(1)(xi). Such education may include, but is not limited to, early education and child development, licensing and regulations, emergency preparedness, prevention and control of infectious diseases, prevention of sudden infant death syndrome and use of safe sleep practices, administration of medication, prevention and response to emergencies due to food and allergic reactions, building and physical premises safety, protection from hazards, bodies of water, and vehicular traffic; handling and storage of hazardous materials and the appropriate disposal of bio contaminants; child maltreatment, prevention of shaken baby syndrome and abusive head trauma, precautions in transporting children, pediatric first aid and cardiopulmonary resuscitation, nutrition and programming for children with disabilities or special health care needs.

[19a-79-4a(a)(2), (h)(1-2)] · Corrected Jun 24, 2025

All equipment shall be of such design and material as to be readily cleaned and safe for children. Equipment shall not be colored or covered by any poisonous material. Equipment shall be sturdy, safely constructed and free from protruding nails, rust, toxic material and other hazards.

[19a-79-7a(g)] · Corrected Apr 17, 2024

A file shall be kept on the licensed premises for each employee of the child care center or group child care home which shall include evidence that the necessary information and documentation specified by the Office of Early Childhood in order to conduct background checks has been submitted. The operator shall provide to the Office of Early Childhood any information obtained concerning substantiated child abuse or neglect records or criminal convictions upon request.

[19a-79-4a(b)] · Corrected Apr 17, 2024

The operator of a child care center or group child care home is responsible for maintaining on the licensed premises a current record for each child enrolled. A copy of the record shall be available and provided upon request to the Office of Early Childhood, the child's parent(s) and the local health director. It shall include an individual plan of care for any child with special health care needs or disabilities, developed with the child's parent(s) and health care provider and updated, as necessary.

[19a-79-5a(a)(2)(E)] · Corrected Apr 17, 2024

Nonprescription Topical Medications shall be stored in the original container and shall be appropriately labeled and shall be stored away from food and inaccessible to children. Any unused portion of the medication shall be returned to the parent(s).

[19a-79-9a(a)(3)] · Corrected Apr 17, 2024

A written statement specifying the formula, breast milk or other liquids and the feeding schedule for infants shall be obtained from the parent(s).

[19a-79-10(k)(1)] · Corrected Apr 17, 2024

At least every two (2) years, the local health director shall make unannounced visits, inspections or investigations of the licensed child care center or group child care home.

[19a-79-2a(c)(7)] · Corrected Apr 17, 2024

Water supply, food service and sewage disposal facilities shall be in compliance with all applicable sections of the Public Health Code. All water supplies shall be tested every two (2) years for lead content and the results submitted to the local and state health departments. Whenever water is obtained from other than a Department of Public Health-approved public water supply, it shall be of a safe and sanitary quality and tested every two (2) years for bacterial and chemical quality and the results submitted to the local and state health departments.

[19a-79-7a(a) and/or 19a-79-7a(c)(3)] · Corrected Apr 17, 2024

Walls, ceilings, floors and rugs shall be maintained in a state of good repair and be washable or easily cleanable.

[19a-79-7a(e)(5)] · Corrected Apr 17, 2024

The written permission of the parent(s) shall be required prior to the administration of the nonprescription topical medication and a medication administration record shall be written in ink and kept on file at the facility for each child administered a nonprescription topical medication.

[19a-79-9a(a)(2)] · Corrected Apr 17, 2024

A file shall be kept on the licensed premises for each employee of the child care center or group child care home which shall include documentation of professional development for each program staff person who cares for the children, including new employee orientation and annual training for current staff on programs policies, plans and procedures. Professional development for program staff shall be required for one (1) per cent of the total annual hours worked. The operator of the child care center or group child care home shall develop, implement and maintain a written plan for professional development in child care. The operator shall have documentation of a professional development plan for each program staff member which shall be maintained on site at the facility and made available for review.

[19a-79-4a(a)(3) and/or 19a-79-4a(g)] · Corrected Apr 17, 2024

While children are in attendance at the program the operator and staff shall not engage in, nor allow, abusive, neglectful, physical, corporal, humiliating or frightening treatment or punishment, and shall not tie nor bind children and shall not physically restrain children except for the protection and safety of the child or others, using least restrictive methods, as appropriate.

[19a-79-3a(b)(8)(C)] · Corrected Sep 19, 2023

The operator shall maintain a staff adequate for the number, ages and developmental needs of the children to be accommodated. A designated head teacher shall be on site for sixty percent (60%) of the time the child care center or group child care home is in operation on a weekly basis. There shall be at least two (2) staff eighteen (18) years of age or older on the premises when one (1) or more children are in attendance. The staff shall be available to care for the children. All staff in the child care center and group child care home shall have the personal qualities necessary to care for and work with children, relate to adults, and relate to the parent(s).

[19a-79-4a(c)] · Corrected Sep 19, 2023

A file shall be kept on the licensed premises for each employee of the child care center or group child care home which shall include an acceptable medical statement and a written report of a negative tuberculin test.

[19a-79-4a(a)(1) and/or 19a-79-4a(a)(2)] · Corrected May 25, 2023

Except for nonprescription topical medications, no medication shall be administered to a child without the written order of an authorized prescriber and the written permission of the child's parent(s) which shall be on file at the facility. Individual written medication administration records for each child shall be written in ink, reviewed prior to administering each dose of medication and kept on file at the facility for at least two (2) years after the child is no longer attending the program.

[19a-79-9a(b)(3) and/or 19a-79-9a(b)(4)] · Corrected May 25, 2023

The building, equipment and services shall be maintained in a good state of repair. A maintenance program shall be established that ensures that the interior, exterior and grounds of the building are maintained, kept clean and orderly, free from accumulations of refuse, dampness, stagnant water, dilapidated structures and other health and safety hazards.

[19a-79-6a and/or 19a-79-7a] · Corrected Jun 23, 2022