10A N.C. Admin. Code 09 .0606 - SAFE SLEEP PRACTICES
(a) Each center
licensed to care for infants aged 12 months or younger shall develop, adopt,
and comply with a written safe sleep policy that:
(1) specifies that caregivers shall place
infants aged 12 months or younger on their backs for sleeping, unless:
(A) for an infant aged six months or less,
the center receives a written waiver of this requirement from a health care
professional; or
(B) for an infant
older than six months, the center receives a written waiver of this requirement
from a health care professional, or a parent or a legal guardian;
(2) specifies no pillows, wedges
or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts,
sheepskins, loose bedding, towels and washcloths, or other objects may be
placed with a sleeping infant aged 12 months or younger;
(3) specifies that children shall not be
swaddled;
(4) specifies that
nothing shall be placed over the head or face of an infant aged 12 months or
younger when the infant is laid down to sleep;
(5) specifies that the temperature in the
room where infants aged 12 months or younger are sleeping does not exceed
75° F;
(6) specifies that
caregivers shall visually check, in person, sleeping infants aged 12 months or
younger at least every 15 minutes;
(7) specifies how caregivers shall document
compliance with visually checking on sleeping infants aged 12 months or
younger;
(8) specifies that
pacifiers that attach to infant clothing shall not be used with sleeping
infants;
(9) specifies that infants
aged 12 months or younger sleep alone in a crib, bassinet, play pen, mat, or
cot;
(10) specifies that infants
aged 12 months or younger are prohibited from sleeping in sitting devices,
including car safety seats, strollers, swings, and infant carriers. Infants
that fall asleep in sitting devices shall be moved to a crib, bassinet, play
pen, mat, or cot; and
(11)
specifies any other steps the center shall take to provide a safe sleep
environment for infants aged 12 months or younger.
(b) The center shall post a copy of its safe
sleep policy about infant safe sleep practices in a prominent place in the
infant room where parents and caregivers are able to view daily.
(c) A copy of the center's safe sleep policy
shall be given and explained to the parents of an infant aged 12 months or
younger on or before the first day the infant attends the center. The parent
shall sign a statement acknowledging the receipt and explanation of the policy.
The acknowledgement shall contain:
(1) the
infant's name;
(2) the date the
infant first attended the center;
(3) the date the center's safe sleep policy
was given and explained to the parent; and
(4) the date the parent signed the
acknowledgement.
The center shall retain the acknowledgement in the child's record as long as the child is enrolled at the center.
(d) If a center amends its safe
sleep policy, it shall give written notice of the amendment to the parents of
all enrolled infants aged 12 months or younger at least 14 days before the
amended policy is implemented. Each parent shall sign a statement acknowledging
the receipt and explanation of the amendment. The center shall retain the
acknowledgement in the child's record as long as the child is enrolled at the
center.
(e) A caregiver shall place
a child age 12 months or younger on the child's back for sleeping, unless for a
child age 6 months or younger, the operator obtains a written waiver from a
health care professional; or for a child older than 6 months, the operator
obtains a written waiver from a health care professional or parent. Waivers
shall include the following:
(1) the infant's
name and birth date;
(2) the
signature and date of the infant's health care professional or
parent;
(3) if a wedge is needed
specify why it is needed and how it is to be used; and
(4) the infant's authorized sleep positions.
The center shall retain the waiver in the child's record as long as the child is enrolled at the center.
(f) For each infant with a waiver on file at
the center as specified in Paragraph (e) of this Rule, a notice shall be posted
for quick reference near the infant's crib, bassinet, play pen, cot or mat that
shall include:
(1) the infant's
name;
(2) the infant's authorized
sleep position; and
(3) the
location of the signed waiver.
No confidential medical information, including an infant's medical diagnosis, shall be shown on the notice.
(g) Documents that verify staff member's
compliance with visual checks on infants shall be maintained for a minimum of
one month.
(h) A bed, crib, or cot,
equipped with a firm waterproof mattress at least four inches thick and a
fitted sheet shall be provided for each child who remains in the center after
midnight. The top of bunk beds shall be used by school-age children
only.
(i) A caregiver shall not
place anything over the face of a child during rest time.
Notes
Eff. May 1, 2004;
Amended Eff. July 1, 2010;
Readopted Eff. October 1, 2017;
Amended Eff. February 1, 2021.
Eff. May 1, 2004;
Amended Eff. July 1, 2010.
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