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Corrected Corrected by Aug 11, 2025

Category: other. Marked corrected in the state record.

[19a-79-10(g)(1-8)] · Infants under twelve months of age shall be placed in a supine (back) position for sleeping in a well-constructed, free standing crib or other piece of equipment designed for infant sleeping and appropriate for the particular child. A well-constructed, free standing crib or other piece of equipment shall be used designed for infant sleeping and appropriate for the particular child, with a snug fitting mattress covered by a tightly-fitted sheet. Infants under twelve months of age shall be placed in a supine (back) position for sleeping in a well-constructed, free standing crib or other piece of equipment designed for infant sleeping and appropriate for the particular child, with a snug fitting mattress covered by a tightly-fitted sheet unless the child has written documentation from a physician, physician assistant or advanced practice registered nurse specifying a medical reason for an alternative sleep position or alternate piece of equipment. When infants can easily turn over from the supine to the prone position, they shall be put down to sleep on their back, but allowed to adopt whatever position they prefer for sleep. No items including, but not limited to, pillows, soft bumpers, toys and blankets, including weighted blankets, weighted sleepers, and weighted swaddles, shall be placed with an infant in a crib or hung over the side of a crib or other piece of equipment designed for sleeping except for a pacifier without attachments unless the child has written documentation from a physician, physician assistant or advanced practice registered nurse specifying a medical reason for its use. Bibs and garments with ties or hoods shall be removed from infants that are placed to sleep. No toys or objects shall be attached to sleeping or rest equipment. No infant shall be put to sleep on a sofa, bed, couch, soft mattress, waterbed or other soft surface. No infant shall be put to sleep or allowed to remain asleep in a child restraint system intended for use in a vehicle, an infant carrier, a swing or any place that is not specifically designed to be an infant bed unless the child has written documentation from a physician, physician assistant or advanced practice registered nurse specifying a medical reason for their use. No infant shall be swaddled unless the child has written documentation from a physician, physician assistant or advanced practice registered nurse specifying instructions and a timeframe for swaddling the infant. Infants under twelve months of age shall be physically observed at least every fifteen minutes to assess the infants breathing, color, temperature and comfort. No child under three years of age shall have access to teething necklaces, teething bracelets or other jewelry that could present a choking or strangulation hazard. Written policies and procedures for sleep arrangements shall include the requirements of this subsection and shall be posted in a conspicuous place in the areas where infants under twelve months of age sleep. The operator shall document that the child’s parent(s) has been informed of the child care center or group child care home’s policies and procedures for sleep arrangements prior to enrollment and reviewed as needed during the period of the child’s enrollment.

Corrected Corrected by Aug 11, 2025

Category: physical safety. Marked corrected in the state record.

[19a-79-10(i)(1)(2A-C)] · The health consultant shall visit the facility according to the following schedule: once a week for children up to twenty-four months of age; once a week if children two to three years of age, attend five hours or more per day; and once a month if children two to three years of age attend less than five hours per day.

Corrected Corrected by Aug 11, 2025

Category: health medication. Marked corrected in the state record.

[19a-79-3a(b)(6)] · The operator shall require participation by new program staff in employee orientation.

Corrected Corrected by Aug 11, 2025

Category: other. Marked corrected in the state record.

[19a-79-3a(d)6)(C), (e)(1-6), 7a(e)(17), 10(g)(8)] · The operator shall post the following items in a conspicuous place, accessible to the public: the license, the OEC complaint procedure, menus, No Smoking signs, the plan for administrative oversight, the radon test, the OEC Inspection report (posted or available), the safe sleep policy and the OEC Developmental Milestones document.

Corrected Corrected by Aug 11, 2025

Category: other. Marked corrected in the state record.

[19a-79-4a(a)(1)] · 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, completed within 12 months before the date of employment for new program staff, and every 36 months for current program staff. Such statement shall document the presence of any known medical or emotional illness or disorder that would currently pose a risk to children.

Corrected Corrected by Aug 11, 2025

Category: health medication. Marked corrected in the state record.

[19a-79-4a(a)(2), (h)(1-2)] · 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.

Corrected Corrected by Aug 11, 2025

Category: ratio. Marked corrected in the state record.

[19a-79-4a(i)(1-2)(H), (F)] · 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.

[19a-79-5a(a)(2)(E)] · An individual plan of care for any child with special health care needs or disabilities when it is necessary that special care be taken or provided while a child is in attendance shall be developed and implemented with the child's parent(s) and health care provider and updated, as necessary. The plan shall include appropriate care of the child to prevent and respond to a medical or other emergency and shall be signed by the parent and program staff responsible for the care of the child.

Corrected Corrected by Aug 11, 2025

Category: health medication. Marked corrected in the state record.

[19a-79-7a(g)(1)] · 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.

Corrected Corrected by Aug 11, 2025

Category: physical safety. Marked corrected in the state record.

[19a-79-7a(h)(1-9)] · 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.

Corrected Corrected by Aug 11, 2025

Category: physical safety. Marked corrected in the state record.

[19a-79-9a(b)(3)(A-B)] · 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 three years after the child is no longer attending the program.

Corrected Corrected by Aug 11, 2025

Category: ratio. Marked corrected in the state record.

[19a-79-4a(a)(1) and/or 19a-79-4a(a)(2)] · 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.

Corrected Corrected by Apr 26, 2024

Category: health medication. Marked corrected in the state record.

[19a-79-4a(h)(1) and/or 19a-79-4a(h)(2)] · A written plan for consultation services shall be developed, signed annually by the consultant and implemented. These services shall include an early childhood educational consultant, a health consultant, a dentist or dental hygienist consultant, a social service consultant, and a registered dietitian consultant for those programs that serve meals. Consultative services shall include annual review of written policies, plans and procedures, annual review of education programs, availability by telecommunication for advice regarding problems, availability, in person of the consultant to the program, consulting with administration and staff about specific problems, and acting as a resource person to staff and the parents.

Corrected Corrected by Apr 26, 2024

Category: ratio. Marked corrected in the state record.

[19a-79-6a and/or 19a-79-7a] · 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.

Corrected Corrected by Apr 26, 2024

Category: health medication. Marked corrected in the state record.

[19a-79-3a(e)(7)] · The operator shall post no smoking signs at entrances in a conspicuous place, accessible to the public.

Corrected Corrected by Apr 26, 2024

Category: other. Marked corrected in the state record.

[19a-79-5a(a)(2)(A) through (E)and/or19a-79-6a(e)] · 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 a health record that shall include date of birth, a physical examination form, an immunization record, and information regarding disabilities or special health care needs.

Corrected Corrected by Apr 26, 2024

Category: health medication. Marked corrected in the state record.

[19a-79-5a(a)(2)(E)] · 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.

Corrected Corrected by Apr 26, 2024

Category: health medication. Marked corrected in the state record.

[19a-79-9a(b)(5)(D) and/or 19a-79-9a(b)(5)(E)] · All unused or expired medication shall be returned to the parent(s) or disposed of if it is not picked up within one (1) week following the termination of the order, in the presence of at least one witness. The facility shall keep a written record of the medications destroyed which shall be signed by both parties. The facility shall require the parent(s) of a child who has a prescription for an automatic prefilled cartridge injector, or similar automatic injectable equipment used to treat an allergic reaction or injectable equipment used to administer glucagon or inhalant medication to treat asthma, to provide the injector or equipment labeled with the information from the prescriber upon enrollment and attendance of such child at the facility, and replace such medication and equipment prior to its expiration date.

Corrected Corrected by Apr 26, 2024

Category: health medication. Marked corrected in the state record.

[19a-79-9a(b)(5)] · Medication shall be stored in the original child-resistant safety container and appropriately labeled. Medication shall be stored in a locked area or a locked container in a refrigerator in keeping with the label directions away from food and inaccessible to children. Controlled drugs shall be stored in accordance with state law. Equipment and medications prescribed to treat asthma, administer glucagons, or as an emergent first line of defense medication against an allergic response shall be stored in a safe manner, inaccessible to other children, to allow for quick access in an emergency.

Corrected Corrected by Apr 26, 2024

Category: health medication. Marked corrected in the state record.

[19a-79-10(e)(1)(2)(3)] · The diapering area shall be an elevated sturdy table or counter equipped with a safety rail. Infants and toddlers shall be diapered at a diapering area used only for this purpose and located in the program area. Each diapering area shall have a non-porous surface and be kept in good repair.

Corrected Corrected by Mar 27, 2023

Category: other. Marked corrected in the state record.

[19a-79-6a and/or 19a-79-7a] · 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.

Corrected Corrected by Mar 27, 2023

Category: health medication. Marked corrected in the state record.

[19a-79-7a(e)(5)] · Walls, ceilings, floors and rugs shall be maintained in a state of good repair and be washable or easily cleanable.

Corrected Corrected by Mar 27, 2023

Category: other. Marked corrected in the state record.

[19a-79-9a(b)(5)] · Medication shall be stored in the original child-resistant safety container and appropriately labeled. Medication shall be stored in a locked area or a locked container in a refrigerator in keeping with the label directions away from food and inaccessible to children. Controlled drugs shall be stored in accordance with state law. Equipment and medications prescribed to treat asthma, administer glucagons, or as an emergent first line of defense medication against an allergic response shall be stored in a safe manner, inaccessible to other children, to allow for quick access in an emergency.

Corrected Corrected by Mar 27, 2023

Category: health medication. Marked corrected in the state record.

[19a-6a(c) and/or 19a-6a(d)] · The facility shall maintain at least one (1) portable, readily available first aid kit wherever children are in care, including field trips, outdoor play areas and one to remain at the facility if all the children do not attend the field trip. Each kit shall be a closed container for storing first aid supplies, accessible to staff at all times but out of the reach of children. The first aid kit shall contain specified items and be restocked after use, and an inventory shall be conducted at least monthly.

Corrected Corrected by Jul 18, 2022

Category: health medication. Marked corrected in the state record.

[19a-79-10(e)(7) and/or 19a-79-10(e)(8)] · The hands of the staff and the children shall be washed before and after each diaper change. Diapering and hand washing policies and procedures shall be posted in each diapering area.

Corrected Corrected by Jul 18, 2022

Category: other. Marked corrected in the state record.

[19a-79-4a(a)(1) and/or 19a-79-4a(a)(2)] · 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.

Corrected Corrected by Jul 18, 2022

Category: health medication. Marked corrected in the state record.

[19a-79-4a(h)(2)(G)] · A written plan for consultation services shall be developed, signed annually by the consultant and implemented. Consultative services shall include documenting the activities and observations in a consultation log that is kept on file at the facility for two years.

Corrected Corrected by Jul 18, 2022

Category: other. Marked corrected in the state record.

[19a-79-7a(e)(1) &/or 19a-79-12(b)(8)] · Every area used by children shall be adequately ventilated and have a thermometer affixed to the wall. The ambient air temperature shall be at least sixty-five (65) degrees Fahrenheit.

Corrected Corrected by Jul 18, 2022

Category: other. Marked corrected in the state record.

[19a-79-7a(e)(5)] · Walls, ceilings, floors and rugs shall be maintained in a state of good repair and be washable or easily cleanable.

Corrected Corrected by Jul 18, 2022

Category: other. Marked corrected in the state record.

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Corrected Corrected by Jul 14, 2021

Category: other. Marked corrected in the state record.