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. Programs shall provide changing and sanitary facilities appropriate to meet the individual needs of children who are enrolled at the facility who need assistance with toileting or who are not independent with toileting. Facilities using potty chairs in addition to the required toilets shall ensure that they are of a nonporous, synthetic product, and emptied into the toilet, cleaned and disinfected after each individual use. For programs serving children under five years of age there shall be at least one toilet and one sink with hot and cold running water for every sixteen children, or fraction thereof. For programs serving only school age children, there shall be at least one toilet and one sink with running water for every twenty-five children, or fraction thereof. Toilet facilities shall be designed in such a manner to allow individual privacy. Sinks with running water shall be readily accessible to the toilet rooms if not located within them. Toilet tissue, soap, a mechanism for individual hand drying and a waste receptacle shall be accessible to the toilets and sinks. Staff, program staff, and children shall wash their hands with soap and water after toileting. Each toilet and sink shall be located at the facility or licensed premises, as applicable, of the child care center or group child care home. Each toilet room shall be well lighted and ventilated to the outside atmosphere. In child care centers constructed or renovated after January 1, 1994, all toilet facilities shall be mechanically ventilated to the outside atmosphere.

[19a-79-7a(d)(10)(A-H)] · Corrected Dec 16, 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)(1)] · Corrected Dec 16, 2025

Indoor play equipment for climbing shall have a shock absorbing surface, under and around, that shall effectively cushion the fall of a child. Carpet is not considered a shock absorbing surface.

[19a-79-7a(g)(6)] · Corrected Dec 16, 2025

All unused or expired medication, except for controlled substances, shall be returned to the parent(s) or disposed of if it is not picked up within one 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 for three years which shall be signed by both parties.

[19a-79-9a(b)(5)(D)] · Corrected Dec 16, 2025

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.

[19a-79-5a(a)(2)(E)] · Corrected Dec 16, 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 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 Dec 16, 2025

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. Only personnel authorized to administer medication may be provided with the means to access such medication. Controlled drugs shall be stored in accordance with state law.

[19a-79-9a(b)(5)(A-B)] · Corrected Dec 16, 2025

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.

[19a-79-5a(a)(2)(A) through (E)and/or19a-79-6a(e)] · Corrected Jul 18, 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 Jul 18, 2024

Potentially hazardous substances in the child care centers and group child care homes shall be stored in a separate locked area.

[19a-79-7a(e)(10)] · Corrected Jul 18, 2024

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.

[19a-79-7a(g)(4) and/or 19a-79-7a(h)] · Corrected Jul 18, 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 Jul 18, 2024

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.

[19a-79-4a(h)(1) and/or 19a-79-4a(h)(2)] · Corrected Jul 18, 2024

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.

[19a-79-9a(b)(5)(D) and/or 19a-79-9a(b)(5)(E)] · Corrected Jul 18, 2024

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.

[19a-79-10(e)(1)(2)(3)] · Corrected Oct 23, 2023

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.

[19a-79-6a(a)(2)] · Corrected Oct 23, 2023

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 Oct 23, 2023

Electrical outlets shall be provided with safety covers or approved safety outlets. The use and maintenance of electrical cords, appliances and adaptors shall be in full compliance with state codes.

[19a-79-7a(d)(10)] · Corrected Oct 23, 2023

Potentially hazardous substances in the child care centers and group child care homes shall be stored in a separate locked area.

[19a-79-7a(e)(10)] · Corrected Oct 23, 2023

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 Oct 23, 2023

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.

[19a-79-7a(g)(4) and/or 19a-79-7a(h)] · Corrected Oct 23, 2023

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 Oct 23, 2023

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 Oct 23, 2023

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.

[19a-79-10(e)(6) and/or 19a-79-10(e)(9)] · Corrected Oct 23, 2023

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 Oct 23, 2023

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.

[19a-79-5a(a)(2)(A) through (E)and/or19a-79-6a(e)] · Corrected Oct 23, 2023

There shall be an area available for the individual storage of each child's clothing and bedding.

[19a-79-7a(d)(8)] · Corrected Oct 23, 2023

There shall be proper refrigeration of no more than forty-five (45) degrees Fahrenheit for perishable foods in all child care centers and group child care homes and on field trips. The kitchen in child care centers or group child care homes that is used for the preparation and serving of food to children shall be clean, well lighted and ventilated, protected by window screening and provided with hot and cold running water, adequate and safe storage for food and supplies and refrigeration.

[19a-79-6a(a)(3) and/or 19a-79-6a(a)6)] · Corrected Oct 23, 2023

Diapering areas shall be washed and disinfected after each use.

[19a-79-10(e)(4)] · Corrected Nov 8, 2022

Disposable paper sheets shall be used and discarded immediately after each diapering.

[19a-79-10(e)(5)] · Corrected Nov 8, 2022

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 Nov 8, 2022

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 Nov 8, 2022

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 Nov 8, 2022

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 Nov 8, 2022

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 Nov 8, 2022

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 Dec 6, 2021

There shall be proper refrigeration of no more than forty-five (45) degrees Fahrenheit for perishable foods in all child care centers and group child care homes and on field trips. The kitchen in child care centers or group child care homes that is used for the preparation and serving of food to children shall be clean, well lighted and ventilated, protected by window screening and provided with hot and cold running water, adequate and safe storage for food and supplies and refrigeration.

[19a-79-6a(a)(3) and/or 19a-79-6a(a)6)] · Corrected Dec 6, 2021