N.Y. Comp. Codes R. & Regs. Tit. 18 § 416.11 - Health and infection control
(a)
Child enrollment requirements for
children not enrolled in kindergarten or a higher grade.
(1) No child may be accepted for care in a
child care program unless the program has been furnished with a written
statement signed by a health care provider verifying that the child is able to
participate in child care and currently appears to be free from contagious or
communicable diseases. A child's medical statement must have been completed
within the 12 months preceding the date of enrollment.
(2) The written medical statement from the
health care provider must also state whether the child is a child with special
health care needs and, if so, what special provisions, if any, will be
necessary in order for the child to participate in child day care. When the
written statement from the health care provider advises the day care program
that the child being enrolled is a child with special health care needs, the
day care program must work together with the parent and the child's health care
provider to develop a reasonable health care plan for the child while the child
is in the child day care program. The health care plan for the child must also
address how the day care program will obtain or develop any additional
competencies that the caregivers will need to have in order to carry out the
health care plan for the child.
(3)
The program must keep documentation of immunizations the child has received to
date, in accordance with New York Public Health Law.
(4) A program may admit any child not yet
immunized provided the child's immunizations are in process, and the parent
gives the program specific appointment dates for required immunizations in
accordance with the requirements of New York Public Health Law.
(5) [Reserved].
(6) Any child who is missing one or more of
the required immunizations may be admitted if a physician licensed to practice
medicine in New York State furnishes the program with a signed, completed
medical exemption form issued by the New York State Department of Health or New
York City Department of Education. The medical exemption must be reissued
annually.
(7) With the exception of
children meeting the criteria of paragraph (6) of this subdivision, children
enrolled in child day care must remain current with their immunizations in
accordance with the current schedule for required immunizations established in
the New York Public Health Law.
(8)
The caregivers' children receiving care in the home must meet the health and
immunization requirements of this section.
(9) The program must try to obtain a copy of
a lead screening certificate for each child under the age of six years. If the
parent does not have one, the program may not exclude the child from child day
care, but must give the parent information on lead poisoning and prevention,
and refer the parent to the child's health care provider or the local health
department for a lead blood screening test.
(b)
Provider, assistant, substitute,
and household member health requirements.
(1) The provider, assistant(s), and
substitute(s), must each submit a medical statement on forms furnished by the
office or an approved equivalent from a health care provider:
(i) at the time of initial group family day
care application;
(ii) before such
person has any involvement in child care work.
(2) Thereafter a medical statement will be
required when an event or condition reasonably calls into question a
caregiver's ability to provide safe and suitable child care.
(3) Initial medical statements sent in with
the application or as a result of a new hire must be dated within 12 months
preceding the date of application or hiring date.
(4) The medical statement must give
satisfactory evidence that the individual is physically fit to provide child
day care and has no diagnosed psychiatric or emotional disorder which would
preclude such individual from providing child day care.
(5) All providers, assistants, substitutes
and household members must be free from communicable disease unless his/her
health care provider has indicated that the presence of the communicable
disease does not pose a risk to the health and safety of the children in
care.
(6) The initial medical
statement for providers, assistants, and substitutes must include the results
of a Mantoux tuberculin test or other federally approved tuberculin test
performed within the 12 months preceding the date of the application.
Thereafter, tuberculin tests are only required at the discretion of the
employee's health care provider or at the start of new employment in a
different child care program.
(7)
The program must retain on file in the program a medical statement, on forms
furnished by the office or approved equivalents, from a health care provider
for each person residing in the home.
(i) Such
medical statement must be completed before the person begins to reside in the
child care home, and must be dated within 12 months preceding the date of the
application or the date the person takes up residency at the home and must
state that the person has no health conditions which would endanger the health
of children receiving day care in the home.
(ii) Thereafter a medical statement for a
household member will be required when an event or condition involving the
household member reasonably calls into question the health or safety of
children receiving care in the home.
(8) Consumption of, or being under the
influence of alcohol by any caregiver, volunteer or employee is prohibited
during child day care hours.
(9)
Consumption of or being under the influence of an illegal drug by any
caregiver, volunteer or employee is prohibited during child day care
hours.
(10) Consumption of or being
under the influences of a controlled substance by any caregiver, volunteer or
employee is prohibited during day care hours, unless the controlled substance
is prescribed by a health care provider is being taken as directed, and does
not interfere with the person's ability to perform his or her child day care
functions.
(11) Smoking in indoor
or outdoor areas in use by children and in vehicles when children are occupying
the vehicles is prohibited.
(12)
All caregivers must have knowledge of and access to children's medical records
and all emergency information.
(13)
Caregivers must be aware of each child's special health care needs identified
in the child's individual health care plan. This includes, but is not limited
to, allergies, disabilities and medical conditions.
(14) Caregivers must obtain assistance as
identified in the child's individual health care plan if the child has a
medical emergency.
(c)
The health care plan.
(1) The
licensee must prepare a health care plan on forms furnished by the office. Such
plan must protect and promote the health of children. The health care plan must
be on site, followed by all caregivers and available upon demand by a parent or
the office. In those instances in which the program will administer
medications, the health care plan must also be approved by the program's health
care consultant unless the only medications to be administered are:
(i) over-the-counter topical ointments,
lotions and creams, sprays, including sunscreen products and topically applied
insect repellant; and/or
(ii)
epinephrine auto injectors, diphenhydramine in combination with the auto
injector, asthma inhalers and nebulizers.
(2) The health care plan must describe the
following:
(i) how a daily health check of
each child for any indication of illness, injury, abuse or maltreatment will be
conducted and documented;
(ii) how
a record of each child's illnesses, injuries and signs of suspected abuse or
maltreatment will be maintained;
(iii) how professional assistance will be
obtained in emergencies;
(iv) the
advance arrangements for the care of any child who has or develops symptoms of
illness or is injured, including notifying the child's parent;
(v) which designated caregivers will be
administering medication. The plan must state that only a trained, designated
caregiver may administer medications to children, except in those programs in
which the only administration of medications offered will be the administration
of over-the-counter topical ointments, lotions, creams, and sprays including
sunscreen products and topically applied insect repellant.
(vi) the contents of the first aid
kit;
(vii) that the trained
designated caregiver may only administer medications to children if the
designated caregiver is:
(a) at least 18
years of age;
(b) possesses a
current certification in first aid and cardio-pulmonary resuscitation (CPR)
appropriate to the ages of the children in care; and
(c) has completed the Medication
Administration Training (MAT) pursuant to subdivision (e) of this section or in
the case of administering epinephrine auto injectors, Diphenhydramine in
combination with the auto injector, asthma inhalers and nebulizers has received
training on its use from the parent, health care provider or a health care
consultant;
(viii) the
designation of the health care consultant of record for programs, as indicated
in paragraph (1) of this subdivision; and
(ix) when a health care consultant is
required to approve a health care plan the schedule of visits by a health care
consultant to programs administering medications, must occur at least once
every two years and must include a review of the health care policies and
procedures and a review of the documentation.
(d)
Health care consultant.
(1) Programs must demonstrate to the health
care consultant how medications are administered in the program. A program is
not required to schedule a visit with a health care consultant or include a
schedule of visits by a health care consultant in their health care plan when:
(i) only over-the-counter topical ointments,
lotions, creams and sprays, including sunscreen products and topically applied
insect repellant are administered; and/or
(ii) epinephrine auto injectors,
diphenhydramine in combination with the auto injector, and asthma inhalers and
nebulizers are the only medications administered in the program.
(2) Should the health care
consultant determine, after a visit to the day care program, that the approved
health care plan is not being reasonably followed by the program, the health
care consultant may revoke his or her approval of the plan. If the health care
consultant revokes his or her approval of the health care plan, the health care
consultant must immediately notify the licensee and the licensee must
immediately notify the office, no longer than 24 hours later. In that instance,
the health care consultant may also notify the office directly if he or she so
desires.
(3) A program authorized
to administer medications, which has had the authorization to administer
medications revoked, or otherwise loses the ability to administer medications,
must advise the parent of every child in care before the next day the program
operates that the program no longer has the ability to administer
medications.
(4) A child care
program, whose health care consultant terminates his or her relationship with
the program, will be granted a 60 day grace period to hire another health care
consultant, obtain approval of a health care plan from the new health care
consultant and submit the plan to the office without the child care program
losing the ability to administer medications as long as:
(i) the former health care consultant did not
revoke his or her approval prior to terminating the relationship with the child
care program;
(ii) Caregivers who
have been trained in medication administration are available to continue
administration of medications as per the health care plan;
(iii) the child care program follows the
approved health care plan, as currently written, for the 60-day
period;
(iv) the child care program
notifies the office, within 24 hours, of the termination of the relationship
with the health care consultant; and
(v) the child care program has the newly
hired health care consultant review and approve the health care plan and sends
the signed approved health care plan to the office before the 60-day window
expires.
(5) Once the
60-day period has expired if no health care plan approval is issued, the child
care program will be issued a new license, which will state that it is no
longer able to administer medications other than over-the-counter topical
medications and emergency medications.
(e)
Training for the administration of
medications.
(1) All caregivers,
except those excluded pursuant to paragraph (5) of this subdivision,
subdivision (f), and paragraph (h)(5) of this section who have agreed to
administer medication must complete the office-approved medication
administration training or an office-approved equivalent before administering
medications to children in day care. The certification of training in the
administration of medications to children in day care shall be effective for a
period of three-years from the date of issuance. The caregiver must complete a
recertification training approved by the office in order to extend the
certification for each additional three year period. Where a certification
lapses, the caregiver may not be recertified unless the caregiver completes the
initial medication administration training or the recertification training, as
required by the office. Where enforcement action has been taken against the
licensee based on a failure by the program to comply with requirements for the
administration of medications set forth in this section, the office may require
retraining or may prohibit a caregiver from being involved in the
administration of medications.
(2)
Caregivers who will be responsible for administering medications must receive
training in the methods of administering medications prior to administering any
medications in a child day care setting. Upon completion of the training, the
caregiver must receive a written certificate from the trainer that indicates
that the trainee has successfully completed this training program, as required,
and demonstrated competency in the administration of medications in a day care
setting.
(i) In order to be trained in the
administration of medications in a day care setting, a caregiver must be
literate in the language or languages in which health care instructions from
parents and health care providers will be received.
(ii) Persons who receive training in the
administration of medications in day care settings pursuant to this section may
not otherwise administer medications or represent themselves as being able to
administer medications except to the extent such persons may be able to do so
in accordance with the relevant provisions of the Education Law.
(3) The training in the
administration of medications must be provided by a health care provider or
registered nurse who has been certified by the office to administer the office
approved curriculum.
(4) The
training must be documented and must include, but need not be limited to the
following:
(i) training objectives;
(ii) a description of the methods of
administration including principles and techniques of application and
dispensation of oral, topical, medication patches and inhalant medication,
including the use of nebulizers, and the use of epinephrine auto-injector
devices when necessary to prevent anaphylaxis in emergency situations with
respect to the various age groups of children;
(iii) administering medication to an
uncooperative child;
(iv) an
evaluation of whether the trainee demonstrates competency in:
(a) understanding orders from the health care
professional or licensed authorized prescriber;
(b) the ability to correctly carry out the
orders given by the health care provider or licensed authorized
prescriber;
(c) recognition of
common side effects of medications and ability to follow written directions
regarding appropriate follow-up action;
(d) avoidance of medication errors and what
action to take if an error occurs;
(e) understanding relevant commonly used
abbreviations;
(f) maintaining
required documentation including the parent's permission, written orders from
health care professionals and licensed authorized prescribers, and the record
of administration of medications;
(g) safe handling of medications, including
receiving medications from a parent;
(h) proper storage of medications, including
controlled substances; and
(i) safe
disposal of medications.
(5) A person who can produce a valid New York
State license as a physician, physician's assistant, registered nurse, nurse
practitioner, licensed practical nurse or advanced emergency medical technician
will not be required to attend the training required by this subdivision in
order to administer medications in a day care program. Documentation
establishing the person's credentials in one of the above fields will be
required and a copy of the documentation must be provided to the
office.
(f)
Administration of medication.
(1) Caregivers may administer medication only
in accordance with the following:
(i) All
programs that choose to administer medications other than epinephrine auto
injectors, diphenhydramine in combination with the auto injector, asthma
inhalers and nebulizers, topical ointments, lotions, creams and sprays to
children must have a health care consultant of record and must address the
administration of medications in the health care plan in accordance with the
requirements of this section.
(ii)
The program must confer with a health care consultant regarding the program's
policies and procedures related to the administration of medications. This
consultation must include a review of the documentation that all caregivers
authorized to administer medications have the necessary professional license or
have completed the necessary training.
(iii) Policies regarding the administration
of medications must be explained to the parent at the time of enrollment of the
child in care and when substantive changes are made thereafter. Parents must be
made familiar with the policies of the day care program relevant to the
administration of medications.
(iv)
Nothing in this Part shall be deemed to require any caregiver to administer any
medication, treatment, or other remedy except to the extent that such
medication, treatment or remedy is required under the provisions of the
Americans with Disabilities Act.
(v) Nothing in this Part shall be deemed to
prevent a parent, or relative within the third degree of consanguinity of the
parents or step-parents of a child, even if such a person is an employee or
volunteer of the program, from administering medications to a child while the
child is attending the program even if the licensee has chosen not to
administer medications or if the caregiver designated to administer medications
is not present when the child receives the medication.
(2) If the licensee elects not to administer
medications, the caregiver must still document the dosages and time as per
paragraph (9) of this subdivision that the medications were given to the child
by the child's parent, or relative within the third degree of consanguinity of
the parents or step-parents of the child.
(i)
Relatives within the third degree of consanguinity administering medications to
the child in day care must be at least 18 years of age, unless that relative is
the parent of the child.
(ii) If
the only administration of medication in a day care program is done by a
parent, or relative within the third degree of consanguinity of the parents or
step-parents of a child, the caregivers of the program do not have to complete
the administration of medication training requirements pursuant to subdivision
(e) of this section.
(3)
No child in care will be allowed to independently administer medications,
except for those medications administered pursuant to paragraph (h)(6) of this
section, without the assistance and direct supervision of caregivers that are
authorized to administer medications pursuant to this section. Any program that
elects to offer the administration of medication to children when children who
attend the program independently administer medications or when children assist
in the administration of their own medications must comply with all the
provisions of this section.
(4)
Caregivers may administer prescription and non-prescription (over-the-counter)
medications for eyes or ears, oral medications, topical ointments, creams,
lotions, sprays and medication patches and inhaled medications in accordance
with this section.
(5) Caregivers
may not administer medications by injection, vaginally or rectally except as
follows:
(i) where the caregiver has been
certified to administer medications in a day care setting and the parent and
the child's health care provider have indicated such treatment is appropriate
and received instruction on the administration of the medication; or
(ii) for a child with special health care
needs, where the parent, day care program and the child's health care provider
have agreed on a plan pursuant to which the caregiver may administer
medications by injection, vaginally or rectally; or
(iii) where the caregiver has a valid license
as a physician, physician's assistant, registered nurse, nurse practitioner,
licensed practical nurse or advanced emergency medical technician.
(6) A caregiver authorized to
administer medication who agrees to administer medications to a child must do
so, unless they observe the circumstances, if any, specified by the health care
provider or the medication label, under which the medication must not be
administered. In such instances, the caregiver must contact the parent
immediately.
(7) Permissions needed
from parent and/or health care provider in order to administer medications.
(i) Over-the-counter products, including but
not limited to over-the-counter topical ointments, lotions, creams, sprays,
including sunscreen products and topically applied insect repellant can be
administered by a caregiver for one day only, with verbal permission of the
parent. If an over-the-counter product is to be administered on a subsequent
day or an ongoing basis, written permission from the parent must have been
provided to the caregiver.
(ii) For
children less than 18 months of age, prescription medications, oral
over-the-counter medications, medicated patches, and eye, ear, or nasal drops
or sprays, can be administered by a caregiver for one day only, with verbal
permission of the parent and verbal instructions directly from the health care
provider or licensed authorized prescriber. If prescription medications, oral
over-the-counter medications, medicated patches, and eye, ear, or nasal drops
or sprays are to be administered on a subsequent day or an ongoing basis,
written permission from the parent and written instructions from the health
care provider must have been provided to the caregiver prior to such
administration.
(iii) For children
18 months of age and older, prescription medications, oral over-the-counter
medications, medicated patches, and eye, ear, or nasal drops or sprays, can be
administered by a caregiver for one day only, with the oral approval of the
parent. If prescription medications, oral over-the-counter medications,
medicated patches, and eye, ear, or nasal drops or sprays are to be
administered on a subsequent day or an ongoing basis, written permission from
the parent and written instructions from the health care provider must have
been provided to the caregiver prior to such administration.
(iv) A caregiver cannot administer medication
to any child in care, if the parent's instructions differ from the instructions
on the medication's packaging, until the child care provider receives
permission from a health care provider or licensed authorized prescriber on how
to administer the medication.
(v)
The caregiver must immediately notify the parent if the caregiver will not
administer medication due to differing instructions related to the
administration of medication.
(8) Caregivers who are authorized to
administer medications must administer medication as follows:
(i) to the right child;
(ii) at the right dose;
(iii) at the right time;
(iv) with the right medication; and
(v) through the right route.
(9) Documentation of medication
administration.
(i) At the time of
administration, the caregiver must document the dosages and time that the
medications are given to the child.
(ii) All observable side effects must be
documented and communicated to the parent, and when appropriate, the child's
health care provider.
(iii)
Documentation must be made if the medication was not given and the reason for
such a decision.
(10)
The parent must be notified immediately and the office must be notified within
24 hours of any medication administration errors. Notification to the office
must be reported on a form provided by the office or on an approved
equivalent.
(11) All verbal
permissions received pursuant to this subdivision must be documented.
(12) Caregivers who are authorized to
administer medications must be literate in the language for which the
permissions and instructions for use are written.
(13) Medication must be returned to the
parent or guardian when it is no longer required by the child or, with the
permission of the parent or guardian, be properly disposed of by the
caregiver.
(14) Where the program
has received written permission of the parent and written instructions from the
health care provider authorizing administration of a specified medication if
the caregiver observes some specified condition or change of condition in the
child while the child is in care, the caregiver may administer the specified
medication, without obtaining additional authorization from the parent or
health care provider.
(15)
Prescription and over-the-counter medications must be kept in their original
bottles or containers.
(16)
Prescription medication labels must include the following information or be
available through the licensed authorized prescriber on the form provided by
the office or equivalent form:
(i) child's
first and last name;
(ii) licensed
authorized prescriber's name, telephone number, and signature;
(iii) date authorized;
(iv) name of medication and dosage;
(v) frequency the medication is to be
administered;
(vi) method of
administration;
(vii) reason for
medication (unless this information must remain confidential pursuant to
law);
(viii) most common side
effects or reactions; and
(ix)
special instructions or considerations, including but not limited to possible
interactions with other medications the child is receiving, or concerns
regarding the use of the medication as it relates to a child's age, allergies,
or any pre-existing conditions.
(17) Medications must be kept in a clean area
that is inaccessible to children.
(18) If refrigeration is required, the
medication must be stored in either a separate refrigerator or a leak-proof
container in a designated area of a food storage refrigerator, separated from
food and inaccessible to children.
(19) Day care programs must comply with all
Federal and State requirements for the storage and disposal of all types of
medications, including controlled substances.
(20) In the case of medication that needs to
be given on an ongoing, long-term basis, the authorization and consent forms
for children five years of age or older must be reauthorized at least once
every 12 months. Any changes in the medication authorization related to dosage,
time or frequency of administration shall require a program to obtain new
instructions written by the licensed authorized prescriber. All other changes
to the original medication authorization require a change in the
prescription.
(21) In the case of
medication that needs to be given on an ongoing, long-term basis, the
authorization and consent forms for children under the age of five years of age
must be reauthorized at least once every six months. Any changes in the
medication authorization related to dosage, time or frequency of administration
shall require a program to obtain new instructions written by the licensed
authorized prescriber. All other changes to the original medication
authorization require a change in the prescription.
(g)
Stocking medications.
(1) A child care program may keep a supply of
over-the-counter medications at a program site to be used in the event that a
child in the program develops symptoms while in care that indicate the need for
over-the-counter medication.
(2)
Child care programs that store and administer medication that is not labeled
for a specific child must have an over-the-counter stock medication policy in
place before beginning to store any over-the-counter medications. The
over-the-counter stock medication's policy must address the safe storage and
proper administration of the stored over-the-counter medication and must
address the need for strict infection control practices as they pertain to
stock medication.
(3) Stock
medication must be kept in a clean area that is inaccessible to children and
any stock medication must be stored separate from child specific
medication.
(4) Stock medications
must be kept in the original container and have the following information on
the label or in the package insert:
(i) name
of the medication;
(ii) reasons for
use;
(iii) directions for use,
including route of administration;
(iv) dosage instructions;
(v) possible side effects and/or adverse
reactions;
(vi) warnings or
conditions under which it is inadvisable to administer the medication;
and
(vii) expiration
date.
(5) Child care
programs that stock supplies of over-the-counter medication, which are not in
single dose packaging, must provide a separate mechanism to administer the
medication for each child that may need the medication. Once a device has been
used for a specific child in care, that specific device must be disposed of or
reused only for that specific child and must be labeled with the child's first
and last name. The program must include the procedure in the over-the-counter
stock medication policy for dispensing the stock medication from the container
to the device, or directly administering to the child, without contaminating
the stock medication.
(6) All stock
medication must be administered using best practice techniques in accordance
with the directions for use on the medication package.
(7) Group family day care programs may not
stock prescription medication.
(h) Emergency care and the administration of
epinephrine, diphenhydramine in combination with the auto injector, asthma
inhalers and nebulizers.
(1) The caregivers
must immediately call 911 for children who require emergency medical care for
children who require such care and also must:
(i) obtain written consent at the time of
admission from the parent which authorizes the provider or other caregivers to
obtain emergency health care for the child;
(ii) arrange for the transportation of any
child in need of emergency health care, and for the supervision of the children
remaining in the program;
(iii) in
the event of an accident or illness requiring immediate health care, secure
such care and notify the parent; and
(iv) advise a parent or the person authorized
to pick up the child that day, of any developing symptoms of illness or minor
injury sustained while child is in care.
(2) The home must be equipped with a portable
first aid kit which is accessible for emergency treatment. The first aid kit
must be stocked to treat a broad range of injuries and situations and must be
restocked as necessary. The first aid kit and any other first aid supplies must
be kept in a clean, covered container or cabinet inaccessible to
children.
(3) Rectal thermometers
may not be used.
(4) The caregivers
must provide a child who has or develops symptoms of illness a place to rest
quietly that is in the view of, and under the supervision of a caregiver until
the child receives medical care or the parent or approved parental designee
arrives. In the event that a child has or develops symptoms of illness, the
caregiver is responsible for immediately notifying the parent.
(5) When a caregiver has not been authorized
to administer medications in a day care setting in accordance with the
requirements of subdivision (f) of this section, such caregiver may administer
emergency care through the use of epinephrine auto-injector devices,
diphenhydramine, when prescribed in combination with the auto injector, asthma
inhaler and asthma nebulizer when necessary to prevent anaphylaxis or breathing
difficulty for an individual child but only when the parent and the child's
health care provider have indicated such treatment is appropriate. In addition:
(i) a written Individual Health Care Plan
must be developed for the child;
(ii) the child's health care provider must
issue a standing order and prescription for the medication;
(iii) the parent must approve, in writing,
the administration of the medication as prescribed by the health care provider
and keep medications current;
(iv)
all caregivers administering an emergency medication pursuant to paragraph
(g)(5) of this section, must be instructed on its use; and, the instruction
must be provided by the parent, the child's health care provider or a health
care consultant;
(v) a caregiver
who has been instructed on the use of the auto injector, diphenhydramine,
inhaler or nebulizer must be present during all hours the child with the
potential emergency condition is in care;
(vi) the caregiver administering the
auto-injector, diphenhydramine, asthma medication or nebulizer must be at least
18 years old;
(vii) the caregiver
must immediately contact 911 after administration of epinephrine;
(viii) if an inhaler or nebulizer for asthma
is administered, a caregiver must call 911 if the child's breathing does not
return to its normal functioning after its use; and
(ix) storage, documentation of the
administration of medication and labeling of the auto-injector, asthma inhaler
and asthma nebulizer must be in compliance with this section.
(6) When a program is approved to
administer an inhaler to a child with asthma or other diagnosed respiratory
condition, or an epinephrine auto injector for anaphylaxis, a school-aged child
may carry and use these devices during day care hours if the program secures
written permission of such use of a duly authorized health care provider,
parental consent and completes a special health care plan for the
child.
(7) The special health care
plan, parental consent and health care provider consent documenting permission
for a school-age child to carry an inhaler or auto injector must be maintained
on file by the program.
(i)
Infection control.
(1) Caregivers and volunteers must thoroughly
wash their hands with soap and running water at the beginning of each day,
before and after the administration of medications, when they are dirty, after
toileting or assisting children with toileting, after changing a diaper, before
and after food handling or eating, after handling pets or other animals, after
contact with any bodily secretion or fluid, and after coming in from
outdoors.
(2) Caregivers and
volunteers must ensure that children thoroughly wash their hands or assist
children with thoroughly washing their hands with soap and running water when
they are dirty, after toileting, before and after food handling or eating,
after handling pets or other animals, after contact with any bodily secretion
or fluid, and after coming in from outdoors.
(3) For diapered children, caregivers and
volunteers must ensure that adequate steps are taken to clean the child after
each change of diaper.
(4)
Caregivers must assist children in keeping clean and comfortable, and in
learning appropriate personal hygiene practices.
(5) Children in night care shall have a
routine that encourages good personal hygiene practices.
(6) Each child shall have an individual
washcloth, towel and toothbrush. When evening or night care is provided each
child shall have the opportunity to change into night clothes and wash before
bed. The caregiver will give each child a shower, bath, or sponge bath in a
manner agreed between the parent and the program.
(7) When soap and running water is not
available, hand sanitizer may be used by children and caregivers and volunteers
on visibly clean hands. Package directions must be followed including
supervision of children so that ingestion does not occur.
(i) When soap and running water is not
available and hands are visibly soiled, individual wipes may be used in
combination with hand sanitizer.
(ii) The use of hand sanitizers on children
under the age of two years is prohibited.
(8) Safety precautions relating to blood must
be observed by all caregivers and volunteers as follows:
(i) Disposable gloves must be immediately
available and worn whenever there is a possibility for contact with blood,
including but not limited to:
(a) changing
diapers where there is blood in the stool;
(b) touching blood or blood-contaminated body
fluids;
(c) treating cuts that
bleed; and
(d) wiping surfaces
stained with blood.
(ii)
In an emergency, a child's well-being must take priority. A bleeding child must
not be denied care because gloves are not immediately available.
(iii) Disposable gloves must be discarded
after each use.
(iv) If blood is
touched accidentally, the exposed skin must be thoroughly washed with soap and
running water.
(v) Clothes
contaminated with blood must be placed in a securely tied plastic bag and
returned to the parent at the end of the day.
(vi) Surfaces that have been blood stained
must be cleaned and then disinfected with an Environmental Protection Agency
(EPA) registered product that has an EPA registration number on the
label.
(9) Sufficient
and suitable clothing must be available so that children who dirty or soil
their clothing may be changed. All such clothing must be returned to parents
for washing or must be washed by the caregiver.
(10) Children must be kept clean and
comfortable at all times. Diapers must be changed when wet or soiled. The
diaper changing area must be as close as possible to a sink with soap and hot
and cold running water. This area or sink must not be used for food
preparation. Diaper changing surfaces must be cleaned and disinfected after
each use with an Environmental Protection Agency (EPA) registered product that
has an EPA registration number on the label.
(11) The program must make arrangements with
the parent to provide an adequate supply of disposable or cloth diapers. When
cloth diapers are used they must be supplied by a parent or commercial diaper
service.
(12) When disposable
diapers are used, soiled diapers must be disposed of immediately into an
outside trash disposal, or placed in a tightly covered plastic-lined trash can
inaccessible to children until outdoor disposal is possible.
(13) Non-disposable diapers must not be
laundered in the group family care home, and must be stored in a securely
covered receptacle until returned to the diaper service. When parents provide
non-disposable diapers, soiled diapers must be placed in a securely tied
plastic bag and returned to the parent at the end of the day.
(14) Toilet facilities must be kept clean at
all times, and must be supplied with toilet paper, soap and towels accessible
to the children.
(15) Toileting
equipment, such as potty chairs, appropriate to the toilet training level of
the children in the group must be provided.
(16) When more than one child in the program
is being toilet trained, potty chairs must be emptied, cleaned and then
sanitized or disinfected after each use with an Environmental Protection Agency
(EPA) registered product that has an EPA registration number on the
label.
(17) If only one child in
the program is being toilet trained, potty chairs must be emptied and rinsed
after each use and cleaned and then sanitized daily with a sanitizer or
disinfectant with an Environmental Protection Agency (EPA) registered product
that has an EPA registration number on the label.
(18) Potty chairs must not be washed out in a
hand washing sink, unless that sink is cleaned, then sanitized or disinfected
after such use.
(19) Either
disposable towels or individual cloth towels for each child must be used. If
individual cloth towels are used, they must be laundered daily.
(20) Sharing personal hygiene items, such as
washcloths, towels, toothbrushes, combs and hairbrushes, is
prohibited.
(21) All rooms,
equipment, surfaces, supplies and furnishings accessible to children must be
cleaned and then sanitized or disinfected, using an EPA registered product, as
needed to protect the health of children, and in a manner consistent with the
program's health care plan approved by the office.
(22) The premises must be kept clean and free
from dampness, odors and the accumulation of trash.
(23) The premises must be kept free of
vermin.
(24) Equipment that is
frequently used or touched by children on a daily basis must be cleaned and
then sanitized or disinfected, using an EPA registered product, when soiled and
at least once weekly.
(25) Carpets
contaminated with body fluids must be spot cleaned.
(26) Extensive cleaning, such as shampooing
carpets or washing windows and walls, must occur when children are not
present.
(27) Garbage receptacles
must be covered, and cleaned as needed after emptying.
(28) Thermometers and toys mouthed by
children must be washed and disinfected using an EPA registered product before
use by another child.
(29)
Individual drinking cups or disposable cups must be provided daily. Once a
drinking cup or eating utensils have been used by a child they may not be used
by another child unless they are washed first.
(30) Between uses, dishes and utensils must
be washed with soap and hot water and rinsed in hot running water.
(31) Linens, blankets and bedding must be
cleaned at least weekly and before use by another child. Cribs, cots, beds,
mats and mattresses must be cleaned thoroughly between uses by different
children and at least monthly.
(32)
Sanitizers and disinfectants must be used as directed on the product
label.
(j)
Pesticide use.
(1) Any
application of pesticides (as the term pesticide is defined in section 33-0101 of the Environmental
Conservation Law) shall be completed in accordance with the requirements of
section 390-c of the Social Services Law and
sections 33-1004 and 33-1005 of the Environmental Conservation Law.
(2) In addition to the requirements of
section 390-c of the Social Services Law, each day
care facility must send a notice home with each child or otherwise provide
notification to the parent of each child not less than forty-eight hours prior
to the application of pesticides. Such notice must include:
(i) the location and specific date of the
application of pesticides and may include two alternate dates in the event that
an outdoor application cannot be made due to weather conditions;
(ii) the pesticide product name and pesticide
registration number assigned by the United States Environmental Protection
Agency;
(iii) the following
statement: "This notice is to inform you of a pending pesticide application at
this facility. You may wish to discuss with a representative of the day care
facility what precautions are being taken to protect your child from exposure
to these pesticides. Further information about the product or products being
applied, including any warnings that appear on the label of the pesticide or
pesticides that are pertinent to the protection of humans, animals or the
environment, can be obtained by calling the National Pesticide Information
Center at 1-800-858-7378 or the New York State Department of Health Center for
Environmental Health Info Line at 1-800-458-1158"; and
(iv) the name of a representative of the day
care facility and contact number for additional information.
(3) Any day care program that
fails to send the appropriate notice of pesticide application as set forth in
this section, for a first such violation, shall be issued a written warning in
lieu of penalty. For a second violation, such program shall be subject to a
penalty not to exceed $100. For any subsequent violation, such program shall be
subject to a penalty not to exceed $250 for each violation. No penalty may be
assessed by the commissioner without affording the licensee with notice and an
opportunity for a hearing pursuant to section
413.5 of this
Title.
(4) Any finding by the
Department of Environmental Conservation of a violation by the program of the
requirements set forth in sections 33-1004 or 33-1005 of the Environmental
Conservation Law shall be deemed a safety hazard to children in care and a
violation of this section.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.