[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.

Corrected Corrected by Mar 7, 2025

Category: supervision. 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 Mar 7, 2025

Category: ratio. Marked corrected in the state record.

[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 Mar 7, 2025

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

[19a-79-7a(c)(2)] · 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.

Corrected Corrected by Mar 7, 2025

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

[19a-79-7a(e)(10)] · Potentially hazardous substances and materials in the child care centers and group child care homes shall be stored in a labeled container identifying the exact contents and dilutions, used according to the manufacturer’s instructions and for the intended purpose, handled in a safe manner and inaccessible to children.

Corrected Corrected by Mar 7, 2025

Category: other. Marked corrected in the state record.

[19a-79-9a(a)(2-3)] · 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.

Corrected Corrected by Mar 7, 2025

Category: health medication. 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 Mar 7, 2025

Category: ratio. Marked corrected in the state record.

[19a-79-10(k)(5)] · Each child's bottle shall be individually identified with the child's name.

Corrected Corrected by Apr 9, 2024

Category: other. 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 9, 2024

Category: ratio. 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 Apr 9, 2024

Category: other. Marked corrected in the state record.

[19a-79-3a(b)(8)(B)] · The operator shall document that the techniques used to manage child behaviors in the facility have been discussed with the child's parent(s) prior to enrollment and reviewed as needed during the period of the child's enrollment.

Corrected Corrected by Apr 9, 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 9, 2024

Category: health medication. 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 9, 2024

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

[19a-79-7a(e)(10)] · Potentially hazardous substances in the child care centers and group child care homes shall be stored in a separate locked area.

Corrected Corrected by Apr 9, 2024

Category: other. Marked corrected in the state record.

[19a-79-7a(g)(4) and/or 19a-79-7a(h)] · Hardware such as air conditioners, water heaters or fuse boxes shall be inaccessible to children. The playground shall be free of glass, debris, holes and other hazards.

Corrected Corrected by Apr 9, 2024

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

[19a-79-7a(h)(2)] · Where swings, seesaws or climbing apparatus are used, the surface in the space shall be protected with a minimum of eight (8) inches of impact absorbing materials.

Corrected Corrected by Apr 9, 2024

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

[19a-79-9a(a)(2)] · 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.

Corrected Corrected by Apr 9, 2024

Category: ratio. Marked corrected in the state record.

[19a-79-9a(a)(3)] · 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).

Corrected Corrected by Apr 9, 2024

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

[19a-79-9a(b)(3) and/or 19a-79-9a(b)(4)] · 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.

Corrected Corrected by Apr 9, 2024

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

[19a-79-10(d)(1)] · In child care centers that serve children under three years of age, there shall be a sink with hot and cold running water designated for diaper changing and hand washing of staff and children in the program space. Visual contact with all other children shall be maintained while changing diapers or using the sink. Child care centers which staff three (3) adults to a group size of eight (8) infants or toddlers may use an accessible diaper changing facility if it is immediately adjoining the program area. Separate sinks shall be available for purposes other than hand washing after diaper changing within child care centers. Group child care homes shall have a sink accessible for hand washing other than the sink used for food preparation.

Corrected Corrected by Mar 20, 2023

Category: ratio. Marked corrected in the state record.

[19a-79-5a(a)(1)(A)-(C)] · 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. The record shall include enrollment information and permission forms signed and dated by the parent(s).

Corrected Corrected by Mar 20, 2023

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 Mar 20, 2023

Category: health medication. 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 Mar 20, 2023

Category: other. Marked corrected in the state record.

[19a-79-7a(g)(2)] · Adequate equipment for rest shall be provided. When cots are shared, they shall be washed and disinfected and linens changed between children.

Corrected Corrected by Mar 20, 2023

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

[19a-79-7a(h)(2)] · Where swings, seesaws or climbing apparatus are used, the surface in the space shall be protected with a minimum of eight (8) inches of impact absorbing materials.

Corrected Corrected by Mar 20, 2023

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

[19a-79-9a(b)(3) and/or 19a-79-9a(b)(4)] · 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.

Corrected Corrected by Mar 20, 2023

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

[19a-79-10(k)(1)] · A written statement specifying the formula, breast milk or other liquids and the feeding schedule for infants shall be obtained from the parent(s).

Corrected Corrected by May 9, 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 May 9, 2022

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 May 9, 2022

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 May 9, 2022

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 May 9, 2022

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