In child care centers there shall be a sink with hot and cold running water designated for diaper changing and hand washing of program staff and children. This sink shall be located in the program space. Child care centers which have three program staff for a group of 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.

[19a-79-10(d)(1)(A-C)] · Corrected May 9, 2025

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. Diapering areas shall be washed and disinfected after each use. Disposable paper sheets shall be used and discarded immediately after each diapering. A covered washable lined waste receptacle shall be available and located in a convenient place for soiled waste material. These materials shall be removed to an exterior waste storage area at least daily. Disposable diapers shall be discarded in a covered receptacle immediately after diapering. The hands of the program staff and the children shall be washed after each diaper change. Diapering and hand washing policies and procedures shall be posted in each diapering area and followed. When cloth diapers or training pants are used, a written plan for their use and care shall be developed and implemented. This plan shall include, but not be limited to, these procedures: placing soiled clothing and diapers in a sealed air tight container; removing soiled clothing and diapers from the child care center or group child care home daily; and cleaning and sanitizing the container daily.

[19a-79-10(e)(1-10)] · Corrected May 9, 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.

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 signed physical examination form including the child's date of birth, a statement about the child's general health and the presence of any known medical or emotional illness or disorder that would currently pose a risk to other children or which would currently affect this child’s functional ability to participate safely in a child care setting.

[19a-79-5a(a)(2)(A)-(E)] · Corrected May 9, 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 May 9, 2025

If the child care center or group child care home uses the basement level or the first floor of a building, a minimum of one radon test shall be conducted using a device or service listed by one of the national radon proficiency programs. This test shall be completed during the months of November through April and the results posted with the license. Radon testing shall occur in the lowest level of the facility where child care services are provided. The Office and Department of Public Health shall be notified of the results. When results of radon gas in the air are equal to or greater than 4.0 (pCi/L), the operator shall ensure that the radon gas is reduced to below 4.0 pCi/L. A qualified residential mitigation service provider shall be hired to reduce the level of radon gas in the air.

[19a-79-7a(e)(17)] · Corrected May 9, 2025

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.

[19a-79-9a(b)(3)(A-B)] · Corrected May 9, 2025

Emergency telephone numbers shall be posted in an area adjacent to the phone.

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

The operator shall post emergency plans in a conspicuous place, accessible to the public.

[19a-79-3a(e)(6)] · Corrected Apr 2, 2024

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.

[19a-79-4a(h)(2)(G)] · Corrected Apr 2, 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 2, 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 2, 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 2, 2024

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 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. A director(s), head teacher(s), program staff or group child care home provider(s) trained and approved to administer medication shall be present whenever a child who has orders to receive medication is present at the facility. The training in the administration of medications shall be documented. A copy of the approval shall be on file at the facility where the director, head teacher, program staff or group child care home provider is employed and shall be available to Office of Early Childhood staff upon request.

[19a-79-9a(b)(1) &/or 19a-79-9a(b)(2)] · Corrected Apr 2, 2024

Upon completion of the required medication administration training program, the training approval and an outline of the curriculum content shall be on file at the facility.

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

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.

[19a-79-9a(b)(5)] · Corrected Apr 2, 2024

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 Apr 2, 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 2, 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 Oct 18, 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 Oct 18, 2023

The operator shall post emergency plans in a conspicuous place, accessible to the public.

[19a-79-3a(e)(6)] · Corrected Oct 18, 2023