(1) Staffing
(a) Required ratios shall be maintained at
all times.
1. Staff-child ratio shall be:
Age
|
Staff to Child
Ratio
|
0 up to 18 months
|
1 to 5
|
18 months up to 21/2 years
|
1 to 7
|
24 months up to 36 months
|
1 to 8
|
21/2 years up to 4 years
|
1 to 11
|
4 years up to school age*
|
1 to 18
|
School age* up to 8 years
|
1 to 21
|
8 years and older
|
1 to 22
|
* The term "school age" Includes children who are five
(5) years of age on or before September 1. This definition corresponds with the
minimum age at which a child is entitled to admission to public school
kindergarten.
2.
Children younger than age 21/2 years shall be grouped separately from children
older than 21/2 years of age. An exception for a group of children, ages 24
months to 36 months, with the ratios indicated above is allowed. Other
exceptions may be permitted with written approval from the Department
representative. Such exceptions would allow children to be grouped based on
individual children's needs.
3.
When children of different ages are grouped together (multiple age grouping),
staff-child ratio shall be according to the age of the youngest child in the
group if more than 20% of the children are in the youngest age category. If
children in the youngest age category make up 20% or less of the group,
staff-child ratio shall be according to the next highest age
category.
4. A staff person shall
be counted in the staff-child ratio only if he/she meets child
care worker qualifications and he/she is giving full attention to the direct
supervision of the children.
(b) Staff Coverage shall be determined by the
following:
1. All children shall have staff
supervision at all times.
2. Each
staff person giving care to infants and toddlers shall be assigned the
responsibility of caring for the same infants/toddlers daily, except in the
absence of the regularly assigned child care worker.
3. When a regular staff person is absent,
there shall be a substitute present in order to maintain the required
staff-child ratios.
4. The name of
the staff person in charge shall be posted in a conspicuous place in the
facility.
5. At least one staff
person meeting child care worker qualifications shall be present in each room
where children are napping/resting. The staff person shall be able to see all
the children in the room.
6.
Staff-child ratio during
napping/resting time shall be as follows:
Ages
|
Staff to Child
Ratio
|
0 up to 18 months
|
1 to 5
|
18 months up to 2 1/2 years
|
1 to 14
|
2 1/2 years and older
|
1 to 36
|
7. At
least two staff who are at least 18 years of age, who meet child care worker
qualifications and have a current Infant-Child (Pediatric) Cardiopulmonary
Resuscitation Certificate (CPR) and a current First Aid Certificate, shall be
present during all hours of operation.
8. There shall be a second staff person, age
18 or older available in the facility building or on the premises, whenever
seven (7) or more children are present. Required staff-child ratios shall be
met at all times. Children younger than age 21/2 years shall be grouped
separately from children older than 21/2 years of age.
9. No staff person shall be on duty with the
children for more than eight (8) continuous hours, on a regular
basis.
10. Staff persons shall be
free from all other duties during the hours they are working directly with the
children.
(2)
Infant/Toddler Daily Program.
(a)
Learning/growth activities
1. Infants/toddlers
shall spend time outdoors daily, when weather permits.
(i) Infants (birth-12 months) should be taken
outside two (2) to three (3) times daily as tolerated.
(ii) Toddlers (13 months - 2 years) should be
allowed 60 to 90 minutes of outdoor play daily.
2. Infants/toddlers shall have daily indoor
opportunities for freedom of movement outside their cribs, in an open,
uncluttered space.
3. In accordance
with recommendations from the American Academy of Pediatrics, each infant
younger than twelve (12) months shall be placed in a prone (front) position
part of the time he/she is awake and observed. "Tummy time" helps muscle
development and reduces the tendency of back positioning to flatten the back of
the infant's head.
4. Infants
should not be seated for more than 15 minutes at a time, except during meals
and snacks. Infant equipment such as swings, stationary activity centers,
infant seats (i.e. bouncers) and molded seats should only be used for short
period at a time. The last restrictive environments should always be
encouraged.
5. Cries of
infants/toddlers or other signs of distress shall be investigated
immediately.
6. Infants/toddlers
shall be handled gently. Staff shall support each infant's head while lifting
and holding the infant. Rough or harsh handling is prohibited, including but
not limited to: shaking; lifting or jerking by one or both arms; pushing;
pulling; forcing or restricting movement; lifting or moving by grasping
clothing; covering an infant's/toddler's mouth, face, or head, etc.
7. Eliminate screen time (TV, movies,
cellphones, video games, computers and other digital devices) for children
under two (2) years old.
8. A
variety of indoor and outdoor experiences shall be available. These experiences
must include 60 minutes of moderate and vigorous physical activity daily for
full day programs and 30 minutes for half day programs. These activities shall
increase the heart rate, breathing rate, and bone and muscle strengthening of a
child by running, climbing, dancing, skipping, and jumping.
(b) Diapering/toileting.
1. Sufficient clean, dry diapers and clothing
shall be provided for each infant/toddler.
2. Wet or soiled diapers and other clothing
shall be changed promptly.
3.
Diapers and other soiled or wet clothing shall be changed in each child's crib
or on a changing area that is cleaned and disinfected after each use.
4. No infant/toddler shall be left unattended
while being diapered.
5. No
infant/toddler shall be diapered on the floor.
6. Each child's hands shall be washed after
diapering.
7. Staff shall use
universal precautions when changing diapers or being exposed to blood, fecal
material, or urine.
8. Each staff
person shall wash his/her hands with soap and warm running water before and
immediately after diapering each child and after contact with bodily fluids,
even if gloves are used. Individual disposable paper towels shall be used for
hand drying.
9. Each staff person
shall use single-use disposable gloves for diapering each child. Clean gloves
shall be used for each diaper change. Used gloves shall be disposed of in a
covered, plastic-lined container, inaccessible to children, and shall be
disposed of daily. Each staff person shall wash his/her hands with soap and
warm running water after diapering each child. Individual disposable paper
towels shall be used for hand drying
10. Wet or soiled diapers shall be placed in
a covered, plastic-lined, container, inaccessible to children, and shall be
disposed of daily.
11. Individual,
disposable wipes shall be used at each diaper change. Soiled wipes shall be
placed in a covered, plastic-lined container, kept out of the reach of
children, and disposed of properly.
12. Potty chairs, if used, shall be emptied
and rinsed and disinfected after each use.
13. Diapering areas shall be separate from
food service and food preparation areas.
(c) Napping/resting.
1. Each infant shall be allowed to form
his/her own pattern of sleeping and waking.
2. In accordance with recommendations from
the American Academy of Pediatrics, unless the infant has a note from a
physician specifying otherwise, each infant younger than twelve (12) months,
shall be placed in a supine (on his/her back) position for sleeping to lower
the risks of Sudden Infant Death Syndrome (SIDS).
3. In accordance with recommendations from
the American Academy of Pediatrics, when an infant can easily turn over from
the supine (back) to the prone (front) position, he/she shall be put down to
sleep on his/her back, but allowed to adopt whatever position he/she prefers
for sleep.
4. In accordance with
recommendations from the American Academy of Pediatrics, unless a physician
specifies the need for a positioning device that restricts movement within the
child's bed, such devices shall not be used.
5. The staff shall recognize differing needs
of a toddler for sleep/rest and each child shall be allowed to follow his/her
own sleep/rest pattern.
6. At least
one staff person shall be present in each room where children are
napping/resting. The staff person shall be able to see all the children in the
room.
(d) Cribs, cots,
and bedding.
1. Placement of cribs shall allow
a minimum of two (2) feet of space between occupied cribs.
2. Cots shall be positioned to allow space
for staff access to the children and to allow space for safe exit in case of
emergency.
3. Cribs and cots used
by infants/toddlers shall be cleaned and disinfected and the sheets and
coverings washed before being used by another child.
4. For infants, clean bottom sheets shall be
provided daily, or more frequently as needed when wet or soiled. Crib sheets
shall fit the mattress snugly.
5.
In accordance with recommendations from the American Academy of Pediatrics,
soft materials are prohibited in the infant's sleeping environment.
(i) Soft materials or objects, such as
pillows, quilts, comforters, or sheepskins, shall not be placed under a
sleeping infant.
(ii) Soft objects,
such as pillows, quilts, comforters, bumper pads, sheepskins, stuffed toys, and
other gas-trapping objects shall be kept out of the infant's sleeping
environment.
(iii) No infant shall
be put to sleep on a sofa, soft mattress, or other soft surface.
6. For toddlers, clean bottom
sheets and top coverings shall be provided at least once each week or more
frequently as needed when wet or soiled.
(e) Feeding.
1. Food.
(i)
If formula and foods for infants are provided by the facility, this shall be
planned with the infant's parent(s)/guardian(s) or by the child's physician
with the parent(s)/guardian(s) knowledge and consent.
(ii) If the facility provides formula for
infants, commercially prepared, ready-to-feed formula shall be provided. All
formula, bottles, nipples, and other equipment used in bottle preparation shall
be prepared, handled, and stored in a sanitary and sterile manner.
(iii) Bottles and food for infants shall be
served according to parental request. If a parent requests bottles to be
warmed, they should be warmed under running tap water, using a commercial
bottle warmer, a slow cooking device, or by placing them in a container of warm
water. Bottles should never be warmed in a microwave. Warming devices and
dangling cords should not be accessible to children.
(iv) Meals and snacks provided by the
facility for infants/toddlers shall comply with infant and child meal and snack
patterns.
(v) If formula is
provided by the parent(s)/ guardian(s), it shall be sent ready to feed and
labeled with the child's name and stored in the refrigerator. All bottles shall
be sent home or the contents discarded at the end of the day.
(vi) Expressed human milk should be sent in a
bottle or container that is properly labeled with the infant's full name and
date and should only be given to the child specified. Parents must provide
written instructions on how to prepare, store and use the expressed human milk.
Unused breast milk should be returned to the parent in the bottle or container.
Infant formula for a breastfed infant should only be used with parental
consent.
(vii) If food for
infants/toddlers is provided by the parent(s)/guardian(s), all jars/containers
shall be labeled with the child's name. No previously opened jars of
baby/toddler food shall be accepted by the facility. All opened jars/containers
shall be sent home or discarded at the end of the day.
(vi) As a toddler's eating patterns change
from those of an infant to those of a preschool child, the regulations for
preschool feeding shall apply.
(vii) Small hard candies and nuts shall not
be served to children younger than four years of age.
(viii) Foods with a shape and consistency
that may cause choking shall be prepared appropriately for the age and ability
of the child. The following foods shall be served only under close supervision:
peanut butter; popcorn; small pieces of raw vegetables; raisins; seeds; grapes
(cut in half); foods with bones, meats (cut in pieces small enough to prevent
choking); and hot dogs (cut length-wise, then chopped in small pieces, not cut
in circular pieces).
2.
Service and serving equipment.
(i) The feeding
schedule shall be in accordance with each infant's/toddler's needs rather than
according to the hour.
(ii) Each
infant shall be held for bottle feeding. No bottles shall be propped.
(iii) When an infant is able to sit in a
chair or feeding table, he/she shall be allowed to do so.
(iv) Each toddler shall be seated while
eating.
(v) Disposable utensils and
disposable cups shall be used only under close supervision.
(vi) Each infant's/toddler's solid foods
shall be fed/eaten from a dish.
(vii) Dishes and bottles used shall be
unbreakable.
(viii) Drinking water
with no added sweeteners or carbonation shall be readily available in indoor
and outdoor areas to each toddler throughout the day.
(ix) No infant/toddler shall be forced to
eat.
(x) Food shall not be used as
a punishment or reward.
(xi) Food
service and food preparation areas shall be separate from diapering
areas.
3. Face and hand
washing.
(i) Each child's hands shall be
washed with soap and running water before and after snacks and meals, and after
toileting and diapering.
(ii) Each
staff person shall wash his/her hands with soap and running water before food
preparation or service, after assisting with toileting, and after any contact
with bodily fluids, including wet or soiled diapers, runny noses, spit, vomit,
etc.
(iii) Each staff person shall
wash his/her hands with soap and warm running water before and after diapering
each child, even if gloves are used.
(iv) Each staff person shall use single-use
disposable gloves for diapering each child. Clean gloves shall be used for each
diaper change. Used gloves shall be disposed of in a covered, plastic-lined
container, inaccessible to children, and shall be disposed of daily.
(v) Individual paper towels shall be supplied
for each washing and drying.
(3) Preschool/School-age Children - Daily
Program.
(a) Learning/growth activities.
1. A variety of indoor and outdoor
experiences shall be available. These experiences must include 60 minutes of
moderate and vigorous physical activity daily for full day programs and 30
minutes for half day programs. These activities shall build bone and muscle
strength and increase the heart rate and breathing rate of a child by running,
climbing, dancing, skipping and jumping.
2. Preschool and school-age children shall
spend time outdoors daily when weather permits. Preschoolers should be allowed
60-90 minutes of outdoor play.
3.
No child shall be required to watch television or videotapes. All videotapes
shall be previewed by a staff person to ensure their appropriateness for the
age of the children. Sexually explicit, violent, or frightening materials are
prohibited.
4. For children over
two (2) years old, limit screen time to less than 30 minutes per day for
children in half day programs and to less than one (1) hour per day for those
in full day programs. Screen time shall be used only for educational purposes
or physical activity.
5. Children
shall be handled gently. Rough or harsh handling is prohibited, including but
not limited to: shaking; lifting or jerking by one or both arms; pushing;
pulling; forcing or restricting movement; lifting or moving by grasping
clothing; covering a child's head or face; etc.
(b) Napping/resting.
1. The staff shall recognize differing needs
of children for sleep/rest.
2. Cots
and bedding
(i) Cots shall be cleaned and
clean bottom and top sheets/covers provided before the cot is used by another
child.
(ii) Clean sheets/covers
shall be provided at least once each week or more frequently as needed when wet
or soiled.
(iii) Cots shall be
positioned to allow space for staff access to the children and to allow space
for safe exit in case of emergency.
3. At least one (1) staff person shall be
present in each room where children are napping/resting. The staff person shall
be able to see all the children in the room.
(c) Toileting.
1. Children's toileting shall be according to
each child's needs. Each child's hands shall be washed with soap and running
water after toileting.
2. Staff
shall use universal precautions when diapering/toileting or being exposed to
blood, fecal material, or urine.
(d) Feeding
1. Food
(i)
Children in attendance shall be served breakfast or a morning snack, a
nutritious midday meal, and at least one afternoon snack.
(ii) Meal and snack components and serving
sizes shall comply with meal and snack patterns.
(iii) Breakfast, if served, shall include at
least the following: fruit or vegetable or full strength juice; bread or bread
product; and milk.
(iv) Snacks
shall include at least two of the following four choices: milk or milk
products; meat or meat alternate; fruit, vegetable or full strength juice;
bread, cereal, crackers or other bread products.
(v) Meals shall include at least the
following: meat or meat alternate; vegetables/fruits (2 vegetables or 1
vegetable and 1 fruit or 2 fruits); bread or bread product; and milk.
(vi) Fluid (liquid) milk shall be served. No
powdered milk shall be served for drinking.
(vii) No child shall be deprived of a meal or
snack if he/she is in attendance at the time the meal or snack is
served.
(viii) Meals and snacks for
children with special dietary needs shall be provided in accordance with the
child's needs and written instructions of the child's parent(s)/guardian(s) or
a licensed physician.
(ix) Menus
for meals and snacks shall be planned in advance, dated and posted where they
may be seen by the parent(s)/guardian(s). Menus shall include a variety of
foods. Food substitutions shall be noted on the menu.
(x) Meals and snacks shall be provided by the
facility.
When a parent(s)/guardian(s) chooses to provide food for their
child, a written signed statement indicating this shall be on file in the
facility.
(xi) Vending
machines shall be prohibited in areas used by the children.
(xii) Small hard candies and nuts shall not
be served to children younger than four years of age.
(xiii) Foods with a shape and consistency
that may cause choking shall be prepared appropriately for the age and ability
of each child. The following foods shall be served only under close
supervision: peanut butter; popcorn; small pieces of raw vegetables; raisins;
seeds; grapes (cut in half); foods with bones, meats (cut in pieces small
enough to prevent choking); and hot dogs (cut length-wise, then chopped in
small pieces, not cut in circular pieces).
2. Service and serving equipment.
(i) Portions of food served shall be suited
to the child's age and appetite. Second portions shall be available.
(ii) Unbreakable or single-use disposable
dinnerware shall be used.
(iii)
Single-use cups or glasses or drinking fountains shall be supplied for water
service during the day. A common drinking container shall not be
used.
(iv) Drinking water with no
added sweeteners or carbonation shall be readily available in indoor and
outdoor areas to each child throughout the day.
(v) Food shall be served on individual dishes
or napkins and shall not be placed directly on tables.
(vi) Children shall be seated while
eating.
(vii) No child shall be
forced to eat.
(viii) Children
shall not be allowed in the kitchen.
3. Face and hand washing.
(i) Each child's hands shall be washed with
soap and running water before and after meals and snacks, and after toileting
and diapering.
(ii) Each staff
person shall wash his/her hands with soap and running water before food
preparation or service, after assisting with toileting, and after any contact
with bodily fluids, including wet or soiled diapers, runny noses, spit, vomit,
etc.
(iii) Each staff person shall
wash his/her hands with soap and warm running water before and after diapering
each child, even if gloves are used.
(iv) Each staff person shall use single-use
disposable gloves for diapering each child. Clean gloves shall be used for each
diaper change. Used gloves shall be disposed of in a covered, plastic-lined
container, inaccessible to children, and shall be disposed of daily.
(v) Individual paper towels shall be supplied
for each washing and drying.
4. When food service is catered, the plan
shall be approved in writing by the county health department, if such approval
is available. Meals and snacks that are catered shall meet the meal and snack
patterns provided.
(4) Disciplinary Practices
(a) Discipline shall be appropriate to the
age and developmental level of each child.
(b) Disciplinary practices, including but not
limited to the following, are prohibited:
1.
The use of corporal or physical punishment is prohibited, including but not
limited to: spanking; shaking; slapping; kicking; pushing; biting; pinching;
hitting; thumping; hair pulling; ear pulling; exclusive physical exercise,
excessive rest, or strenuous bizarre posture;
2. The use of verbal abuse is prohibited,
including but not limited to: yelling; shouting; name calling; shaming; making
derogatory remarks about a child or a child's family; using language that
threatens, humiliates, or frightens a child;
3. The use of discipline associated with
food, naps, or bathroom procedures is prohibited, including but not limited to:
withholding food as punishment; use of food such as hot sauce, lemon juice,
vinegar, etc., or soap, as punishment; punishment for lapses in toilet
training; punishment for not sleeping during nap/rest time;
4. The use of physical restraint as
punishment is prohibited;
5.
Punishment administered by another child is prohibited.
6. Rough or harsh handling of children,
whether associated with discipline or not, is prohibited, including but not
limited to: shaking; lifting or jerking by one or both arms; pushing; pulling;
forcing or restricting movement; lifting or moving by grasping clothing;
covering a child's head; etc.
7.
physical activity/outdoor time taken away as punishment is
prohibited.
(6)
Emergency Preparedness and Response Plans. The Center shall develop a written
disaster plan and make is available to all child care staff members and
employees. This plan shall be posted in a conspicuous place. This emergency
preparedness plan must be submitted to the Department and copies provided to
all parents/guardians.
(a) The plan shall
include procedures that will be used to prepare for and respond to the
following types of emergency or disaster situations:
1. Weather emergencies and natural disasters
which include severe thunderstorms, tornadoes, flash flooding, major snowfall,
blizzards, ice storms, or earthquakes;
2. Emergency outdoor or indoor lockdown or
evacuation due to threats of violence which includes active shooter,
bioterrorism or terrorism;
3.
Emergency or disaster evacuations due to hazardous materials and spills, gas
leaks or bomb threats;
4.
Outbreaks, epidemics, or other infectious disease emergencies;
5. Loss of power, water or heat;
6. Other threatening situations that may pose
a health or safety hazard to the children in the center.
(b) The disaster plan shall include details
for:
1. Shelter in place or evacuation, how
the center will care for and account for the children until they can be
reunited with the parent;
2.
Assisting infants and children with special needs and/or health
conditions;
3. Reunification with
parents; center,
(i) Emergency contact
information for the parents and the center,
(ii) Procedures for notifying and
communicating with parents regarding the location of the children if
evacuated,
(iii) Procedures of
communicating with parents during loss of communications (no phone or internet
service available),
4.
The location of supplies and procedures for gathering necessary supplies for
staff and children if required to shelter in place;
5. What to do if a disaster occurs during the
transport of children, or when on a field trip or routine trip;
6. Training of staff or reassignment of staff
duties as appropriate;
7. Updating
the plan on a yearly basis;
8.
Contact with local emergency management officials;
(c) The plan should also be inclusive of:
1. Current emergency plans and
procedures;
2. Location and use of
fire extinguishers;
3. Location on
the first aid and emergency supply kits;
4. Phones for on-site and off-site
use;
5. Drills including but not
limited to fire, tornado, lock-down, and relocation.
(d) Emergency procedures shall be practiced
at least once each quarter so that children are familiar with the types of
procedures and are able to be engaged, and not overwhelmed by the fear of an
event. The recommended schedule is to rotate one or more types of drill each
month so that all drills are practiced each quarter (4 times per
year).