Current through Register Vol. 28, No. 3, September 1, 2024
63.1 A licensee shall ensure a trained staff member, who has received a valid administration of medication certificate from OCCL, is present at all times to provide both scheduled and emergency medications to children in care. A certified staff member shall be present during field trips and routine program outings to administer medication when needed. The administration of medication certificate must be on file at the center for each certified staff member.
63.1.1 OCCL only allows staff members who are at least 18 years old to be certified to give medication to children. This certification includes passing OCCL's designated test on the information in the Administration of Medication Self-Study Training Guide as described in Appendix V. Health care providers, nurses, or other qualified medical health personnel are permitted to administer medication to children in a center.
63.1.2 Written permission from the child's parent or guardian for each medication to be administered is required.
63.1.3 Unused medication must be returned to the parent or guardian when no longer needed by the child.
63.1.4 A licensee has discretion to designate which staff members shall administer medication.
63.2 A licensee shall ensure that the parent or guardian of a child provides the following information for each medication given:
63.2.1 The name and birth date of the child;
63.2.2 Medication allergies;
63.2.3 Doctor's name and phone number;
63.2.4 Pharmacy name and phone number;
63.2.5 Name of medication;
63.2.6 Dosage (amount given);
63.2.7 Time or frequency (when given);
63.2.8 Route of administration (oral, eye, nose, mouth, topical, inhalation);
63.2.9 Medication expiration date;
63.2.10 End date (when to stop giving);
63.2.11 Reason for medication; and
63.2.12 Special directions.
63.3 A licensee shall ensure all prescription medication is given as prescribed. Prescription medication must be:
63.3.1 Stored securely and out of children's reach;
63.3.2 Refrigerated, if applicable, in a closed container separate from food;
63.3.3 In its original container and properly labeled with directions for its administration;
63.3.4 Current and not expired;
63.3.5 Given only to the child who has been prescribed the medication, verified by the child's name on the container; and
63.3.6 Given to the child according to the dosage and administration instructions on the medication container. If no dosage or administration information is listed on the container, such information must be provided in writing by the child's health care provider.
63.4 A licensee shall ensure the following requirements are followed when non-prescribed medication is given. Non-prescription medication must be:
63.4.1 Stored securely and out of children's reach;
63.4.2 Refrigerated, if applicable, in a closed container separate from food;
63.4.3 Stored in its original container and properly labeled with directions for its administration;
63.4.4 Current and not expired;
63.4.5 Labeled with the child's name; and
63.4.6 Given as written on the container's instructions or as otherwise instructed in writing by the child's health care provider.
63.5 A licensee shall keep a written record of medication administered to children recorded on the Medication Administration Record "MAR" including each medication dosage, time administered, by whom administered, adverse effects observed, and medication errors.
63.5.1 Medication errors include giving the wrong medication, giving the wrong dose, failing to give the medication at the correct time or at all, giving medication to the wrong child, giving the medication by the wrong route, or giving medication without documenting the administration.
63.5.2 Adverse effects or errors in administering must be immediately reported to the parent/guardian.
63.5.3 When known, a licensee shall notify OCCL when unwanted effects or errors in administering medication result in death or medical treatment as described in subsection 14.4.
63.5.4 Documentation of administration of medication must be placed in the child's file or in a central administration of medication log and kept while the child is enrolled in the center.
63.6 A licensee may administer medication to a child who has a medical need during child care hours that requires the administration of medication by a non-intravenous injection. In addition to the requirements in subsection 63.2, the parent or guardian shall provide the licensee with the following information, when medication is administered by non-intravenous injection:
63.6.1 Written parent or guardian permission for the center to provide the requested medical care; and
63.6.2 A written statement from the child's health care provider stating:
63.6.2.1 The specific medication by injection needed by the child;
63.6.2.2 That for the child's health, the requested medication by injection must be administered during the hours the child attends the center;
63.6.2.3 That the requested medication by injection may be appropriately administered at the center by non-medical child care staff; and
63.6.2.4 Whether any additional training is necessary for non-medical staff members to administer the medication or medical care appropriately. If additional training is required, the health care provider shall provide instructions including information about: the type of training, who may provide such training (which may include the child's parent or guardian), and any other instructions needed to provide the requested medication by injection.
63.6.2.4.1 If additional training is required, the licensee shall identify staff members who are certified to administer medication and have them complete the additional training specified by the child's health care provider. Such training must be completed in a reasonable time based on the availability of such training.
63.6.2.4.2 The licensee shall keep documentation of this training with the child's MAR and inform the parent or guardian in writing which staff members are authorized and trained to perform the requested medication by injection. This information must be updated as needed.
63.6.2.4.3 The licensee shall ensure that at least one staff member, who is trained as required by subsection 63.6.2.4.1, to provide the requested medical care, is present at the center at all times while the child is present.
63.6.2.5 A licensee shall ensure this information is reviewed with the child's parent/guardian and health care provider yearly, and as needed. Reviews and changes must be written, dated, agreed upon by all parties, and kept with the MAR.
63.7 A school-age child may self-administer medical care, as described in Section 63.0, with written parent or guardian permission and written health care provider permission. These permissions must indicate the child is able to safely self-administer the prescribed medical care, identify and select the correct medicine and dosage, if applicable, and administer the medical care at the correct time and frequency. The licensee shall keep documentation of these permissions with the child's MAR. A staff member with a current administration of medication certificate shall be present during the self-administration and document all information required on the MAR, including that the medication was self-administered by the child.
63.8 The administration of medication may be required under State and federal laws including but not limited to the Americans with Disabilities Act and the Delaware Equal Accommodations Law. If an agency, administrative body, court, or other entity responsible for enforcing Federal, State, and local laws and regulations makes a finding that the refusal of a licensee to administer medication is a violation of the law, OCCL shall take appropriate enforcement action consistent with subsection 12.5, due to licensee's failure to comply with subsection 15.2.
