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 May 26, 2026

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, multi-hazard and medical emergencies, supervision of children, general operating policies, administrative oversight 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.

[19a-79-3a(d)(2)-(7)] · Corrected Jan 16, 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 May 6, 2025

Every area used by children shall be adequately ventilated and programs serving children younger than school age shall have a non-mercury thermometer affixed to the wall. The ambient air temperature shall be at least sixty-five degrees Fahrenheit as measured three feet from the floor. Programs that serve exclusively school age children may utilize program space with the ambient air temperature less than sixty-five degrees Fahrenheit provided the temperature is warm enough to accommodate the activities with comfort. When the temperature exceeds eighty degrees Fahrenheit, the operator shall provide more fluids and increase ventilation.

[19a-79-7a(e)(1-2)] · Corrected May 6, 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 6, 2025

A child care center or group child care home with a preschool endorsement may deem a child who is thirty-two to thirty-six months of age, inclusive, to be three years of age for purposes of enrolling such child in a preschool program provided such child care center or group child care home receives written authorization from such child’s parent and the director to so enroll such child in the preschool program. The written authorization shall be kept on file at the child care center or group child care home and available to the Office upon request.

[19a-79-3a(l)] · Corrected May 6, 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 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 6, 2025

Infants under twelve months of age shall be placed in a supine (back) position for sleeping in a well-constructed, free standing crib or other piece of equipment designed for infant sleeping and appropriate for the particular child. A well-constructed, free standing crib or other piece of equipment shall be used designed for infant sleeping and appropriate for the particular child, with a snug fitting mattress covered by a tightly-fitted sheet. Infants under twelve months of age shall be placed in a supine (back) position for sleeping in a well-constructed, free standing crib or other piece of equipment designed for infant sleeping and appropriate for the particular child, with a snug fitting mattress covered by a tightly-fitted sheet unless the child has written documentation from a physician, physician assistant or advanced practice registered nurse specifying a medical reason for an alternative sleep position or alternate piece of equipment. When infants can easily turn over from the supine to the prone position, they shall be put down to sleep on their back, but allowed to adopt whatever position they prefer for sleep. No items including, but not limited to, pillows, soft bumpers, toys and blankets, including weighted blankets, weighted sleepers, and weighted swaddles, shall be placed with an infant in a crib or hung over the side of a crib or other piece of equipment designed for sleeping except for a pacifier without attachments unless the child has written documentation from a physician, physician assistant or advanced practice registered nurse specifying a medical reason for its use. Bibs and garments with ties or hoods shall be removed from infants that are placed to sleep. No toys or objects shall be attached to sleeping or rest equipment. No infant shall be put to sleep on a sofa, bed, couch, soft mattress, waterbed or other soft surface. No infant shall be put to sleep or allowed to remain asleep in a child restraint system intended for use in a vehicle, an infant carrier, a swing or any place that is not specifically designed to be an infant bed unless the child has written documentation from a physician, physician assistant or advanced practice registered nurse specifying a medical reason for their use. No infant shall be swaddled unless the child has written documentation from a physician, physician assistant or advanced practice registered nurse specifying instructions and a timeframe for swaddling the infant. Infants under twelve months of age shall be physically observed at least every fifteen minutes to assess the infants breathing, color, temperature and comfort. No child under three years of age shall have access to teething necklaces, teething bracelets or other jewelry that could present a choking or strangulation hazard. Written policies and procedures for sleep arrangements shall include the requirements of this subsection and shall be posted in a conspicuous place in the areas where infants under twelve months of age sleep. The operator shall document that the child’s parent(s) has been informed of the child care center or group child care home’s policies and procedures for sleep arrangements prior to enrollment and reviewed as needed during the period of the child’s enrollment.

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[-] · Corrected May 6, 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 Apr 2, 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 Apr 2, 2024

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 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

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

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 2, 2024

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.

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

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- · Corrected Mar 18, 2024

The operator shall be responsible for managing child behavior using techniques based on developmentally appropriate practice and communicate acceptable techniques to all staff. These techniques shall include positive guidance, redirection and setting clear limits that encourage children to develop self-control, self-discipline and positive self-esteem.

[19a-79-3a(b)(8)(A)] · Corrected Mar 18, 2024

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.

[19a-79-4a(c)(4)(A) thru (C) &/or 19a-79-4a(c)(6)] · Corrected Mar 18, 2024

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.

[19a-79-4a(a)(1) and/or 19a-79-4a(a)(2)] · Corrected Apr 11, 2023

Toys used for infants shall be kept separate, washed and disinfected at least daily. Toys for toddlers, including floor and riding toys, shall be washed and disinfected at least weekly and as needed.

[19a-79-10(h)(1)] · Corrected Apr 11, 2023

Toys and other objects with a diameter of less than one and one-quarter (1 1/4) inches, objects with removable parts that have a diameter of less than one and one-quarter (1 1/4) inches shall not be accessible to children under three (3) years of age.

[19a-79-10(h)(2)] · Corrected Apr 11, 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 specific written permission forms signed by the parent(s) authorizing the operator to use the programs emergency policies which shall accompany the child on trips away from the premises.

[19a-79-5a(a)(1)(D)(i)] · Corrected Apr 11, 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 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 11, 2023

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 Apr 11, 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 specific written permission forms signed by the parent(s) authorizing one responsible person other than the parent(s) who can remove the child from the child care center or group child care home.

[19a-79-5a(a)(1)(D)(ii)] · Corrected Apr 11, 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. The record shall include enrollment information and permission forms signed and dated by the parent(s).

[19a-79-5a(a)(1)(A)-(C)] · Corrected Apr 11, 2023

Toys and other objects with a diameter of less than one and one-quarter (1 1/4) inches, objects with removable parts that have a diameter of less than one and one-quarter (1 1/4) inches shall not be accessible to children under three (3) years of age.

[19a-79-10(h)(2)] · Corrected Jun 21, 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 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 Jun 21, 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 Jun 21, 2022

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 Jun 21, 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. The record shall include enrollment information and permission forms signed and dated by the parent(s).

[19a-79-5a(a)(1)(A)-(C)] · Corrected Oct 12, 2021

When a child care center or group child care home provides either meals or snacks, menus shall be prepared at least one (1) week in advance, dated and copies posted in a conspicuous place, accessible to the public. Changes shall be documented by the end of the program day. A copy of what was served shall be kept on file for three (3) months.

[19a-79-3a(e)(5) and/or 19a-79-6a(a)(4)] · Corrected Oct 12, 2021

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 12, 2021