[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 May 14, 2025

Category: supervision. 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 May 14, 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 May 14, 2025

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

[19a-79-9a(b)(1)(A-F)-(2)(A-C)] · 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.

Corrected Corrected by May 14, 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 May 14, 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.

Corrected Corrected by Dec 10, 2024

Category: supervision. 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 8, 2024

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

[19a-79-6a(a)(2)] · A nutritionally adequate meal shall be provided by the child care center or group child care home, or the parent(s) whenever a child remains on the premises for five (5) hours or more. Children who stay on the premises less than five (5) hours shall have a nutritious snack. Children who stay on the premises longer than five (5) but less than eight (8) hours shall have one (1) meal and one (1) nutritious snack. Children who stay on the premises eight (8) hours or more shall have one (1) meal plus two (2) nutritious snacks, or two (2) meals plus one (1) nutritious snack.

Corrected Corrected by Apr 8, 2024

Category: nutrition. 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 8, 2024

Category: physical safety. 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 8, 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 Apr 18, 2023

Category: other. Marked corrected in the state record.

[19a-79-10(h)(2)] · Plastic bags, balloons and Styrofoam objects shall not be accessible to children under three (3) years of age.

Corrected Corrected by Apr 18, 2023

Category: other. 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 18, 2023

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 18, 2023

Category: other. 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 Jul 19, 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 19, 2022

Category: other. Marked corrected in the state record.

[19a-79-3a(d)(1)] · The operator shall implement and annually review specific written policies, plans and procedures that include daily attendance records for both children and staff showing the specific times of arrival and departure. The operator shall notify the parent(s), staff and the Office of Early Childhood within five (5) days of changes in these policies, plans and procedures.

Corrected Corrected by Aug 4, 2021

Category: recordkeeping. Marked corrected in the state record.

[19a-79-3a(d)(2) thru (8) &/or19a-79-7a(d)(11)(A)] · The operator shall implement and annually review specific written policies, plans and procedures that include, but not necessarily be limited to discipline, when a child is not picked up as planned, emergencies, supervision of children, general operating policies, and personnel policies. The operator shall notify the parent(s), staff and the Office of Early Childhood within five (5) days of changes in these policies, plans and procedures. Where toilets and sinks are shared by children and adults, a written policy shall be developed and implemented that requires supervision of children when using the shared toilet room.

Corrected Corrected by Aug 4, 2021

Category: supervision. Marked corrected in the state record.

[19a-79-4a(c)(4)(A) thru (C) &/or 19a-79-4a(c)(6)] · There shall be at least one (1) program staff person for every ten (10) children, or fraction thereof in attendance at all times. When there is a mixed age group, the lower required ratio for the age of the youngest child shall prevail. During nap time, when all of the children in the group are sleeping, the overall staff child ratios shall be maintained on the licensed premises. At no time shall a group of children be left unsupervised.

Corrected Corrected by Aug 4, 2021

Category: ratio. 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 Aug 4, 2021

Category: other. 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 Aug 4, 2021

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