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[-] · Corrected Feb 3, 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 Feb 3, 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 3, 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 3, 2025

Fences used to protect children from hazards shall be at least four feet in height. When there is a swimming pool or any other body of water at the facility or near enough to the facility to attract or be accessible to children at any time of the year, there shall be a sturdy fence or barrier, four feet high or higher, which totally and effectively bars access to the water by children. All entries and exits through such fence or barrier shall have self-closing, self-latching devices or locks. When an outside wall of the child care center or group child care home that serves as one side of the fence or barrier to the body of water has a doorway, such doorway shall remain locked. Decorative ponds, fishponds, fountains or similar bodies of water that do not have a fence or barrier as required in this subdivision, shall be completely covered with a childproofing grate or other barrier to prevent access to children. Locks shall be openable with a key, combination, fingerprint, magnet or other unlocking mechanism that prevents an unauthorized person from obtaining access.

[19a-79-7a(h)(7)(A-B)] · Corrected Feb 3, 2025

There shall be proper refrigeration of no more than forty-one (41) degrees Fahrenheit for perishable foods in all child care centers and group child care homes and on field trips.

[19a-79-6a(a)(3)] · Corrected Feb 3, 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.

The operator shall ensure that all program staff have completed a comprehensive background check before they have unsupervised access to children. The operator shall provide to the Office of Early Childhood any information obtained concerning substantiated child abuse or neglect records or criminal convictions upon request. The operator shall obtain from each prospective employee, who is eighteen years of age or older, for a position that requires the provision of care to a child or involves unsupervised access to a child, a listing of all employment held in the United States for an organization that provides care or services to children in the preceding five years. The operator shall take reasonable steps to contact each previous employer provided by the prospective employee to verify at a minimum the prospective employee’s job title, description of his/her regular duties, confirmation of employment dates, and whether such previous employer would recommend the prospective employee for rehire. This information shall be made accessible to the Office upon request. The operator shall not employ program staff, including volunteers, who have a record that the commissioner reasonably believes renders such program staff unsuitable to be employed in a child care center or group child care home.

[19a-79-4a(b)] · Corrected Feb 3, 2025

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[-] · Corrected May 14, 2024

For children under three years of age, there shall be at least one (1) program staff for every four (4) children or fraction thereof in attendance. 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-79-10(c)(2) and/or 19a-79-4a(c)(6)] · Corrected May 14, 2024

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 May 14, 2024

For children under three years of age, there shall be at least one (1) program staff for every four (4) children or fraction thereof in attendance. 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-79-10(c)(2) and/or 19a-79-4a(c)(6)] · Corrected May 14, 2024

For children under three years of age, there shall be a physical barrier separating each group of eight (8) children, indoors and outdoors.

[19a-79-10(c)(4)] · Corrected May 14, 2024

The operator shall be responsible for the overall management and operation of the child care center or group child care home in accordance with applicable state and local laws and regulations and shall assure annual training for all current staff on the child care center or group child care home policies, plans and procedures. 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 documentation of annual training for current staff on the child care center or group child care home policies, plans and procedures.

[19a-79-3a(b)(7) &/or 19a-79-4a(3)] · Corrected May 14, 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 May 14, 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 May 14, 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 May 14, 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 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 May 14, 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 May 14, 2024

An operator of a child care center or group child care home operating in a facility first licensed after January 1, 1986 shall provide a minimum of thirty-five (35) square feet of total indoor usable program space per child. An operator of a child care center or group child care home operating in a facility first licensed before January 1, 1986 shall provide a minimum of thirty (30) square feet of total indoor usable program space per child.

[19a-79-7a(f)(1) &/or 19a-79-7a(f)(2)] · Corrected May 14, 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 May 14, 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 May 14, 2024

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 May 14, 2024

The operator shall have on staff a designated head teacher, approved by the Office who is 20 years of age or older and has the personal qualifications needed to supervise people. 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. A program providing care for one (1) or more hours between the hours of ten (10) P.M. and five (5) A.M. shall have a person on the licensed premises designated as the person in charge who shall meet the head teacher qualifications.

[19a-79-4a(e)(2),(c)(1)-11(f) &/or19a-79-12(b)(1)] · Corrected May 14, 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 evidence that the necessary information and documentation specified by the Office of Early Childhood in order to conduct background checks has been submitted. The operator shall provide to the Office of Early Childhood any information obtained concerning substantiated child abuse or neglect records or criminal convictions upon request.

[19a-79-4a(b)] · Corrected May 14, 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 Mar 16, 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 Mar 16, 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 Mar 16, 2023

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 Mar 16, 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 Mar 16, 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 Mar 16, 2023

Plastic bags, balloons and Styrofoam objects shall not be accessible to children under three (3) years of age.

[19a-79-10(h)(2)] · Corrected Mar 16, 2023

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.

[19a-79-3a(d)(2) thru (8) &/or19a-79-7a(d)(11)(A)] · Corrected Mar 16, 2023

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 evidence that the necessary information and documentation specified by the Office of Early Childhood in order to conduct background checks has been submitted. The operator shall provide to the Office of Early Childhood any information obtained concerning substantiated child abuse or neglect records or criminal convictions upon request.

[19a-79-4a(b)] · Corrected Mar 16, 2023

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 Mar 16, 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 Mar 16, 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 Mar 16, 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 Mar 16, 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 Mar 16, 2023

The operator shall document that the techniques used to manage child behaviors in the facility have been discussed with the child's parent(s) prior to enrollment and reviewed as needed during the period of the child's enrollment.

[19a-79-3a(b)(8)(B)] · Corrected Mar 16, 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 Mar 16, 2023

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 Mar 16, 2023

The operator shall be responsible for the overall management and operation of the child care center or group child care home in accordance with applicable state and local laws and regulations and shall assure annual training for all current staff on the child care center or group child care home policies, plans and procedures. 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 documentation of annual training for current staff on the child care center or group child care home policies, plans and procedures.

[19a-79-3a(b)(7) &/or 19a-79-4a(3)] · Corrected Mar 16, 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 Mar 16, 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 Mar 16, 2023

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[-] · Corrected Mar 23, 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 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 Mar 23, 2022

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 Mar 23, 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 Mar 23, 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 Mar 23, 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 Mar 23, 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 Mar 23, 2022

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 Mar 23, 2022