Walls, ceilings, floors and rugs shall be maintained in a state of good repair and be washable or easily cleanable. Rugs, if used, shall not present a tripping or slipping hazard.

[19a-79-7a(e)(5)] · Corrected Mar 17, 2026

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 Apr 14, 2026

Infants shall be removed from their cribs and held for all bottle feedings. They may be placed in chairs for all other feedings. Infants and toddlers shall be removed from their cribs or playpens at other intervals during the day for individual cuddlings and for verbal communication. They shall be allowed to crawl and toddle as age and development permit. Each infant shall be placed in a prone (front) position part of the time when awake. When food and liquids are served a written statement specifying the formula, breast milk or other liquids and the feeding schedule for infants shall be obtained from the parent(s), updated as necessary and followed by program staff. Unused portions of formula, breast milk or other liquids shall be discarded after each feeding. Clean bottles shall be provided by the parent(s) unless the facility uses disposable bottles or has a dishwasher or dishwashing system approved by the local director of health to wash bottles. Baby food shall be served from a dish unless the whole contents of the jar will be served. Each child's bottle shall be individually identified with the child's name.

[19a-79-10(j)-(k)(1-5)] · Corrected Apr 14, 2026

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 Apr 14, 2026

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 Apr 14, 2026

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.

[19a-79-10(i)(1)(2A-C)] · Corrected Apr 14, 2026

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 Apr 14, 2026

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.

[19a-79-7a(c)(2)] · Corrected Apr 14, 2026

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.

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[-] · Corrected Feb 25, 2025

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 Feb 25, 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(2)(C) · Corrected Feb 25, 2025

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 Feb 25, 2025

Plastic bags, not in use, shall be stored out of reach and inaccessible to children under three years of age. Plastic bags, while in use, may be stored within reach of children under three years of age provided access to such bags is only under direct and immediate supervision.

[19a-79-10(h)(2)] · Corrected Feb 25, 2025

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.

[19a-79-7a(c)(2)] · Corrected Feb 25, 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 Feb 25, 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 Feb 25, 2025

The operator shall notify the Office of Early Childhood, the parent(s) and staff of any changes in programs or services. Notification of personnel changes shall be made within five (5) business days after the change. If the change is for a head teacher, a plan for interim head teacher coverage shall be submitted to the Office of Early Childhood. A qualified head teacher or a plan approved by the commissioner shall be in place within thirty (30) days of change of a qualified head teacher. Notification of changes related to the licensed capacity, fees, services or voluntary closing shall be made at least thirty (30) days prior to the effective date of the proposed change. A change of location, change of operator or a change of ownership requires a new initial application.

[19a-79-3a(c)(1-4)] · Corrected Feb 25, 2025

A designated head teacher shall be on site for sixty percent (60%) of the time the child care center or group child care home is in operation on a weekly basis. The head teacher shall be approved by the Office.

[19a-79-4a(d)(1)-(e)(2)] · Corrected Feb 25, 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 Feb 25, 2025

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.

[19a-79-7a(h)(1-9)] · Corrected Feb 25, 2025

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 ventilated and protected by window screening. All windows that open to the outside and are used for ventilation shall be equipped with 16 mesh screening...and to prevent the entrance of vectors. There shall be effective measures taken to prevent vermin from entering or breeding in the facility.

[19-79-6a(a)(6) and/or 19a-79-7a(d)(4)] · Corrected Jul 23, 2024

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

[19a-79-3a(e)(6)] · Corrected Nov 27, 2023

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.

[19a-79-7a(e)(1) &/or 19a-79-12(b)(8)] · Corrected Nov 27, 2023

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 Nov 27, 2023

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 Dec 12, 2022

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 Dec 12, 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 Dec 12, 2022

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 4, 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 Apr 4, 2022

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.

[19a-79-7a(e)(1) &/or 19a-79-12(b)(8)] · Corrected Apr 4, 2022

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 Apr 4, 2022

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 Apr 4, 2022

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 Apr 4, 2022