[19a-79-3a(b)(7)(C)] · The operator and staff shall not engage in, nor allow, abusive, neglectful, physical, corporal, humiliating or frightening treatment or punishment, and shall not tie nor bind children and shall not physically restrain children except for the protection and safety of the child or others, using least restrictive methods, as appropriate.

Corrected Corrected by Dec 9, 2025

Category: other. Marked corrected in the state record.

[19a-79-3a(d)(2)-(7)] · 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.

Corrected Corrected by Dec 9, 2025

Category: supervision. Marked corrected in the state record.

[19a-79-3a(b)(7)(C)] · The operator and staff shall not engage in, nor allow, abusive, neglectful, physical, corporal, humiliating or frightening treatment or punishment, and shall not tie nor bind children and shall not physically restrain children except for the protection and safety of the child or others, using least restrictive methods, as appropriate.

Corrected Corrected by Aug 8, 2025

Category: other. Marked corrected in the state record.

[19a-79-3a(b)(7)(A)] · The operator and program staff shall manage child behavior using techniques based on developmentally appropriate practice, including positive guidance, redirection and setting clear limits that encourage children to develop self-control, self-discipline and positive self-esteem and communicate acceptable techniques to all staff.

Corrected Corrected by Aug 8, 2025

Category: other. Marked corrected in the state record.

[19a-79-7a(g)(5)] · All manufacturer guidelines shall be followed for furniture, equipment and any toy that is used by, or around, children. Any furniture, equipment and toy that has been identified by the United States Consumer Product Safety Commission as unsafe or subject to recall shall be removed or repaired as indicated.

Corrected Corrected by Jun 27, 2025

Category: physical safety. Marked corrected in the state record.

[19a-79-4a(i)(1-2)(H), (F)] · 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.

Corrected Corrected by Feb 3, 2025

Category: supervision. Marked corrected in the state record.

[19a-79-7a(c)(2)] · 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.

Corrected Corrected by Feb 3, 2025

Category: physical safety. Marked corrected in the state record.

[19a-79-10(d)(1)(A-C)] · 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.

Corrected Corrected by Feb 3, 2025

Category: nutrition. Marked corrected in the state record.

[19a-79-10(e)(1-10)] · 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.

Corrected Corrected by Feb 3, 2025

Category: recordkeeping. Marked corrected in the state record.

[19a-79-10(j)-(k)(1-5)] · 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.

Corrected Corrected by Feb 3, 2025

Category: health medication. Marked corrected in the state record.

[19a-79-3a(c)(1-4)] · 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.

Corrected Corrected by Feb 3, 2025

Category: other. Marked corrected in the state record.

[19a-79-5a(a)(1)(A)-(C)] · 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 signed and dated by the parent(s) that shall include, but not be limited to: the child’s name, address, date of birth and date enrolled, the residence, business address(es) and telephone number(s) of the parent(s) and the name and telephone number of the child’s physician or other primary health care provider.

Corrected Corrected by Feb 3, 2025

Category: health medication. Marked corrected in the state record.

[19a-79-5a(a)(1)(D)(i-iv)] · 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, authorizing one responsible person other than the parent(s) who can remove the child from the child care center or group child care home, authorizing any activity away from the premises, and authorizing transportation services.

Corrected Corrected by Feb 3, 2025

Category: health medication. Marked corrected in the state record.

[19a-79-5a(a)(2)(E)] · 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.

Corrected Corrected by Feb 3, 2025

Category: health medication. Marked corrected in the state record.

[19a-79-6a(c)] · The first aid kit shall contain at least the following items assorted sizes of non medicated adhesive strips; sterile, individually wrapped, three or four inch gauze squares; two inch gauze roller bandage; one roll of adhesive tape (hypoallergenic); scissors; tweezers; two instant cold packs; a non-glass thermometer to measure a child’s temperature; disposable, nonporous gloves; and a cardiopulmonary resuscitation mouth barrier.

Corrected Corrected by Feb 3, 2025

Category: health medication. Marked corrected in the state record.

[19a-79-7a(b)(1-5)] · Plans for new construction, expansion or renovation, indicating the proposed use and accompanied by a written narrative shall be submitted to the Office prior to the start of construction, expansion, or renovation. Completed plans and specifications shall be submitted to and reviewed by the Office on the basis of compliance with the Public Health Code. Written approval by the local building inspector, local director of health or designee, local zoning and local fire marshal shall be submitted to the Office, upon request of the Office. Approval by Office is required prior to the use of any space that has been newly constructed, expanded or renovated. All construction, expansions, renovation, repairs or alterations of structures shall be done in such a manner to prevent hazards or unsafe physical or environmental conditions during periods of operation.

Corrected Corrected by Feb 3, 2025

Category: ratio. Marked corrected in the state record.

[19a-79-7a(d)(10)(A-H)] · 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.

Corrected Corrected by Feb 3, 2025

Category: supervision. Marked corrected in the state record.

[19a-79-7a(e)(5)] · 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.

Corrected Corrected by Feb 3, 2025

Category: other. Marked corrected in the state record.

[19a-79-7a(h)(1-9)] · 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.

Corrected Corrected by Feb 3, 2025

Category: physical safety. Marked corrected in the state record.

[19a-79-9a(b)(3)(A-B)] · 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.

Corrected Corrected by Feb 3, 2025

Category: ratio. Marked corrected in the state record.

- · -

Corrected Corrected by Jan 14, 2025

Category: other. Marked corrected in the state record.

[19a-79-3a(b)(8)(C)] · The operator and staff shall not engage in, nor allow, abusive, neglectful, physical, corporal, humiliating or frightening treatment or punishment, and shall not tie nor bind children and shall not physically restrain children except for the protection and safety of the child or others, using least restrictive methods, as appropriate.

Corrected Corrected by Jan 14, 2025

Category: other. Marked corrected in the state record.

[19a-79-3a(d)(2) thru (8) &/or19a-79-7a(d)(11)(A)] · 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.

Corrected Corrected by Jan 14, 2025

Category: supervision. Marked corrected in the state record.

19a-79-4a(c)(4)(D) · The operator shall be responsible for assuring the supervision of the children at all times while the children are at the facility, indoors or outdoors, or on field trips. At no time shall a child be left unsupervised.

Corrected Corrected by Jan 14, 2025

Category: supervision. Marked corrected in the state record.

Violation

Corrected Corrected by Jan 14, 2025

Category: other. Marked corrected in the state record.

[19a-79-3a(b)(8)(A)] · 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.

Corrected Corrected by Sep 30, 2024

Category: other. Marked corrected in the state record.

- · -

Corrected Corrected by Jul 23, 2024

Category: other. Marked corrected in the state record.

[19a-79-4a(c)(5)(A) &/or 19a-79-4a(c)(5)(B)] · The group size shall not exceed twenty children. When there is a mixed age group, the smaller required group size shall prevail.

Corrected Corrected by Jul 23, 2024

Category: ratio. Marked corrected in the state record.

[19a-79-10(e)(8) and/or 19a-79-10(e)(10)] · Diapering and hand washing policies and procedures shall be posted in each diapering area. When cloth diapers or training pants are used, a plan for their use and care shall be submitted to and approved by the Office of Early Childhood prior to implementation of the plan.

Corrected Corrected by Feb 6, 2024

Category: recordkeeping. Marked corrected in the state record.

[19a-79-3a(e)(4)] · The operator shall post a food service certificate as required by the local director of health in a conspicuous place, accessible to the public.

Corrected Corrected by Feb 6, 2024

Category: nutrition. Marked corrected in the state record.

[19a-6a(c) and/or 19a-6a(d)] · The facility shall maintain at least one (1) portable, readily available first aid kit wherever children are in care, including field trips, outdoor play areas and one to remain at the facility if all the children do not attend the field trip. Each kit shall be a closed container for storing first aid supplies, accessible to staff at all times but out of the reach of children. The first aid kit shall contain specified items and be restocked after use, and an inventory shall be conducted at least monthly.

Corrected Corrected by Feb 6, 2024

Category: health medication. Marked corrected in the state record.

[19a-79-5a(a)(2)(E)] · 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.

Corrected Corrected by Feb 6, 2024

Category: health medication. Marked corrected in the state record.

[19a-79-6a and/or 19a-79-7a] · 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.

Corrected Corrected by Feb 6, 2024

Category: health medication. Marked corrected in the state record.

[19a-79-7a(a) and/or 19a-79-7a(c)(3)] · 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.

Corrected Corrected by Feb 6, 2024

Category: health medication. Marked corrected in the state record.

[19a-79-7a(e)(5)] · Walls, ceilings, floors and rugs shall be maintained in a state of good repair and be washable or easily cleanable.

Corrected Corrected by Feb 6, 2024

Category: other. Marked corrected in the state record.

[19a-79-7a(g)(4) and/or 19a-79-7a(h)] · 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.

Corrected Corrected by Feb 6, 2024

Category: physical safety. Marked corrected in the state record.

[19a-79-9a(b)(5)(D) and/or 19a-79-9a(b)(5)(E)] · 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.

Corrected Corrected by Feb 6, 2024

Category: health medication. Marked corrected in the state record.

[19a-79-4a(h)(2)(G)] · 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.

Corrected Corrected by Feb 1, 2023

Category: other. Marked corrected in the state record.

[19a-79-6a and/or 19a-79-7a] · 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.

Corrected Corrected by Feb 1, 2023

Category: health medication. Marked corrected in the state record.

[19a-79-9a(b)(3) and/or 19a-79-9a(b)(4)] · 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.

Corrected Corrected by Feb 1, 2023

Category: health medication. Marked corrected in the state record.

[19a-79-9a(b)(5)(D) and/or 19a-79-9a(b)(5)(E)] · 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.

Corrected Corrected by Feb 1, 2023

Category: health medication. Marked corrected in the state record.

[19a-79-5a(a)(2)(E)] · 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.

Corrected Corrected by Feb 1, 2022

Category: health medication. Marked corrected in the state record.

[19a-79-7a(e)(10)] · Potentially hazardous substances in the child care centers and group child care homes shall be stored in a separate locked area.

Corrected Corrected by Feb 1, 2022

Category: other. Marked corrected in the state record.