Code of Colorado Regulations
1400 - Department of Early Childhood
1402 - Division of Early Learning, Licensing, and Administration
8 CCR 1402-1 - CHILD CARE FACILITY LICENSING RULES AND REGULATIONS
HEALTH CARE
Section 8 CCR 1402-1-2.513 - MEDICATION

Universal Citation: 1400 CO Code Regs 8 CCR 1402-1-2.513

Current through Register Vol. 47, No. 17, September 10, 2024

A. Any un-expired routine medication, prescription and non-prescription (over-the-counter), must be administered only with a current written order of a health care provider with prescriptive authority and with written parent(s) or guardian(s) consent. Home remedies, including homeopathic medications, vitamins, and supplements must not be administered to children in childcare.

B. The written order by the health care provider with prescriptive authority must include:

1. Child's name and birthdate;

2. Licensed prescribing practitioner name, telephone number, and signature;

3. Date authorized;

4. Name of medication and dosage;

5. Time of day medication is to be given;

6. Route of medication;

7. Length of time the medication is to be given;

8. Reason for medication (unless this information needs to remain confidential);

9. Side effects or reactions to watch for; and

10. Special instructions.

C. Medications must be kept in the original labeled bottle or container. Prescription medications must contain the original pharmacy label.

D. Over-the-counter medication must be kept in the originally labeled container and be labeled with the child's first and last name.

E. In the case medication needs to be given on an ongoing, long-term basis, the authorization and consent forms must be reauthorized on at least an annual basis. Any changes in the original medication authorization require a new written order by the prescribing practitioner and a change in the prescription label.

F. Staff designated by the program director to give medications must complete the Department-approved medication administration training and have current annual delegation or more often as determined by the Department-approved Child Care Health Consultant. Delegation must be from the center's current Department-approved Child Care Health Consultant who must observe and document the competency of each staff member involved in medication administration. All staff administering medication must have current Department-approved Cardiopulmonary Resuscitation (CPR), first aid certification prior to administering medication with the following exceptions:

1. Staff determined by the program director, in consultation with the Department-approved Child Care Health Consultant, to be responsible for providing routine emergency medications covered in the approved Medication Administration training: Severe Allergy or Asthma. After completing the training, staff must receive delegation from their Department-approved Child Care Health Consultant for those medications only. Staff may then provide those medications to children based on the instructions from the child's individualized health care plan.

2. Staff determined by the program director, in consultation with the Department-approved Child Care Health Consultant, to be responsible for providing medications not covered in the approved medication administration training must complete training required by the Department-approved Child Care Health Consultant. After completing the training, staff must receive delegation from their Department-approved Child Care Health Consultant. Staff may administer medications and/or medical treatments such as emergency seizure medication, insulin, or oxygen based on instructions from the child's individualized health care plan.

3. Staff may be trained and delegated in the administration of a single rescue medication or rescue medical intervention by the center's Department-approved Child Care Health Consultant. Such training and delegation must qualify the staff member to provide a rescue medication or treatment for a specific child based on instructions from the child's individualized health care plan.

G. All medications, except those medications specified in the Department's approved medication administration training as emergency medications, must be locked and in an area inaccessible to children, but available to staff trained in administering medication. 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, separate from food and inaccessible to children. Controlled medications must be counted and safely secured, and specific policies regarding their handling require special attention in the centers policies. Access to these medications must be limited (see sections 27-80-210 and 12-280-134(3), C.R.S.).

1. Emergency medications must be stored in accordance with the Department-approved Child Care Health Consultant's recommendation. Emergency medications are not required to be stored in a locked area. Emergency medications may be stored in an area easily accessible and identifiable to staff but out of reach of children.

2. When away from the classroom, staff must carry emergency medications.

H. The center may, with written parent(s) or guardian(s) consent and authorization of the prescribing health care provider, permit children as defined in 26.5-5-314(4), C.R.S., who have asthma to carry their own inhalers or children who are at risk of anaphylaxis to carry their own epinephrine, and use them as directed.

1. The center must have a specific written policy on the storage and access of inhalers and epinephrine carried by school-age children. The policy must include a written contract with the parent(s) or guardian(s) and child acknowledgement assigning levels of responsibility of each individual. This contract includes orders for the medication from a health care provider, along with confirmation from the health care provider and the Department-approved Child Care Health Consultant that the student has been instructed in and is capable of self-administering the prescribed medications.

2. All staff members and Department-approved Child Care Health Consultants must be aware of which children have asthma and severe allergies, and which of those may administer their own inhaler or auto injectors.

I. Children are not allowed to bring medications to the center unless accompanied by a responsible adult.

J. If a medication is expired or left over, the parent(s) or guardian(s) are responsible for picking up the medication. If the parent(s) or guardian(s) do not respond, the center must dispose of the medications in accordance with 6 CCR 1007-2, Part 1, Regulations Pertaining to Solid Waste Sites and Facilities (March 30, 2024) and 6 CCR 1007-3, Parts 99 (June 30, 2018), 100 (July 15, 2020) and 260-265 (July 15, 2023), 266 (June 30, 2014), 267 (March 30, 2024), and 268 (July 15, 2023), and as required by the Colorado Department of Public Health and Environment (CDPHE) https://cdphe.colorado.gov/colorado-medication-take-back-program (2023), herein incorporated by reference. No later editions or amendments are incorporated. These regulations are available at no cost from CDPHE at https://www.sos.state.co.us/CCR. The recommendations are available at no cost from CDPHE at https://cdphe.colorado.gov/hm/prep-med-waste-disposal and https://cdphe.colorado.gov/colorado-medication-take-back-program. These regulations and recommendations are also available for public inspection and copying at the Colorado Department of Early Childhood, 710 S. Ash St., Denver, CO 80246, during regular business hours..

K. Topical preparations such as petroleum jelly and bug sprays may be administered to children with written parental authorization. These preparations may not be applied to open wounds or broken skin unless there is a written order by the prescribing practitioner.

L. A written medication log must be kept for each child. This log is part of the child's records. The log must contain the following:

1. Child's name and birthdate;

2. Name of the medication, dosage, and route;

3. Time medication was administered;

4. Special instructions;

5. Name and initials of the individuals giving the medication; and

6. Notation if the medication was not given and the reason.

Disclaimer: These regulations may not be the most recent version. Colorado may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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