Current through Register Vol. 48, No. 38, September 20, 2024
a) Children under 30 months of age shall not
be permitted in bathrooms, kitchens, or other hazardous areas without the
caregiver or assistant present.
b)
To minimize the risk of Sudden Infant Death Syndrome, children shall be placed
on their backs when put down to sleep.
1)
When the infant cannot rest or sleep on his/her back due to a disability or
illness, the caregiver shall have written instructions, signed by a physician,
detailing an alternative safe sleep position and/or special sleeping
arrangements for the infant. The caregiver shall put the infant to sleep in
accordance with a physician's written instructions.
2) When an infant can easily turn over from
the back to tummy position, the infant shall be put down to sleep on his/her
back, but allowed to adopt whatever sleeping position the infant
prefers.
3) Infants unable to roll
from their stomachs to their backs, and from their backs to their stomachs,
when found facedown, shall be placed on their backs.
4) No infant shall be put to sleep on a sofa,
soft mattress, car seat or swing.
5) When an infant is awake, the infant shall
be placed on his/her tummy part of the time and observed at all
times.
c) Children under
30 months of age shall be provided a daily program that is designed to meet
their needs.
1) The caregiver shall
demonstrate warm, positive feelings toward each child through actions such as
hugging, patting, smiling, and cuddling.
2) Routines such as naps and feedings shall
be discussed with the parents and shall be consistent with the child's routine
at home.
3) Non-mobile children who
are awake shall be moved to different positions and shall be held, rocked, and
carried about.
4) The caregiver
shall frequently change the place, position, and toys available for children
who cannot move about the room.
5)
Consistent toilet training shall be undertaken at a time mutually agreed upon
by parent and caregiver in accordance with the child's age and/or stage of
development.
6) Children shall be
taken outdoors for a portion of every day, when weather permits, except when
the child is ill or unless indicated otherwise by parent or
physician.
d) Feeding
schedules and procedures shall meet the developmental needs of the children.
1) Flexible feeding schedules of children
shall be established to coordinate with parents' schedules at home and to allow
for nursing.
2) Infants shall
either be held or be fed sitting up for bottle feeding. Infants unable to sit
shall always be held for bottle feeding. When infants are able to hold their
own non-glass bottles, they may feed themselves without being held. The bottle
must be removed when the child has fallen asleep. Bottle propping and carrying
of bottles by young children throughout the day/night shall not be
permitted.
3) Bottles shall never
be warmed or defrosted in a microwave oven.
4) Children shall be allowed and encouraged
to feed themselves when they indicate a readiness to do so.
5) Safe finger foods such as those that
dissolve in the mouth may be provided.
e) Proper standards of hygiene shall be
observed in the home.
1) Hands shall be
washed with soap and running water and dried before the feeding of each
child.
2) Formula brought in by the
parent shall be labeled and placed in the refrigerator.
3) All utensils shall be washed after each
use.
4) Foods stored or prepared in
jars shall be served from a separate dish for each child. Any leftovers from
the serving dish shall be discarded. Leftovers in the jar shall be labeled with
the child's name, dated, refrigerated, and served within 24 hours or
discarded.
5) A toilet shall be
easily accessible so that the contents of reusable diapers may be disposed of
before placing the diapers in the diaper pail. Disposable diapers and their
contents shall be disposed of in accordance with the manufacturer's
instructions.
6) Persons changing
diapers shall wash hands under running water with soap after each change of
diaper. Hands shall be dried with single-use towels. Additionally, disposable,
non-permeable gloves shall be worn when changing a child who has watery or
bloody stools.
7) The child whose
diaper is being changed is to be washed on the hands and anal area if there has
been defecation or if irritation is present.
8) Children who are not toilet trained shall
be diapered in their own cribs, at a central diapering area on a surface that
is disinfected after each use, or on a disposable paper sheet that is disposed
of after each diapering.
9) The
toilet seat, if soiled, or potty shall be cleaned with germicidal solution (see
subsection (f)) after every use.
10) Soiled diapers shall be changed
promptly.
11) Sheets shall be
changed when soiled, and all sheets shall be changed routinely 2 times per
week.
12) All beds shall be wiped
clean as often as necessary.
13)
Toys and equipment shall be kept clean.
f) A germicidal solution of 1/4 cup household
chlorine bleach to one gallon of water (or one tablespoon bleach to one quart
of water) or other germicidal solution approved by the Centers for Disease
Control and Prevention shall be used to clean surfaces soiled by blood or body
fluids. The bleach solution shall be made fresh daily.
g) The equipment must be appropriate to the
developmental needs of the children in care.
1) Safe, sturdy, well-constructed individual
cribs, playpens, or port-a-cribs for infants shall be equipped with good firm,
fitting mattresses made of waterproof materials that can be washed. Washable
cots may be used for children 15 months of age and over.
2) Sleeping equipment for children under 15
months must have protection to prevent falls.
3) There shall be no more than 11/2 inches of
space between the mattress and bed frame when the mattress is pushed flush at
one corner of the crib.
4) No
positioning device that restricts movement within the child's bed shall be used
without written instructions from the child's physician. Soft bedding, bumpers,
pillows, quilts, comforters, sheepskins, stuffed toys, laundry and other soft
products shall be removed from the crib when children are napping or sleeping.
If using a blanket, put the child with feet at the foot of the crib. Tuck a
thin blanket around the crib mattress, reaching only as far as the child's
chest.
5) Bed linens used on the
cots, cribs, or playpens shall be safe, tightly fitting, and
washable.
6) Conveniently located,
washable, plastic-lined covered receptacles shall be provided for soiled
diapers and linens.
7) A toilet
seat or potty shall be provided.
h) The materials must be appropriate to the
developmental needs of the child in care.
1)
Provision shall be made for an adequate supply of individual diapers, clothing,
powder, oil, etc.
2) There shall be
a variety of toys and art materials for children under 30 months of age to
observe, grasp, pick up, and manipulate.
3) Pull toys, pounding toys, large hollow
blocks, or large balls shall be available for development of large
muscles.
4) Mobile walkers are
prohibited. Stationary exercisers may be used.
i) Equipment and play materials shall be
durable and free from characteristics that may be hazardous or injurious to
children under 30 months of age. Hazardous or injurious characteristics include
sharp, rough edges; toxic paint; and objects small enough to be
swallowed.