Current through Register Vol. 50, No. 6, December 1, 2023
RELATES TO: KRS Chapter 151, 158.030, Chapter 186, 189.125,
199.011(3), 199.894(1), 199.8951, 199.896(2), (18), (19), 199.8962, 199.898,
211.350-211.380, Chapter 217, 311.646, 314.011(5), Chapter 318, 527.070(1),
620.030,
7 C.F.R.
226.20, 16 C.F.R. 1219, 1220, 1221,
45
C.F.R. 98.2,
49 C.F.R.
571.213,
20
U.S.C. 6081-6084,
42 U.S.C.
9857-9858q
NECESSITY, FUNCTION, AND CONFORMITY:
KRS
194A.050(1) requires the
Secretary of the Cabinet for Health and Family Services to promulgate
administrative regulations necessary to operate programs and fulfill the
responsibilities vested in the cabinet, qualify for the receipt of federal
funds, and cooperate with other state and federal agencies for the proper
administration of the cabinet and its programs.
KRS
199.896(2) authorizes the
Cabinet for Health and Family Services to promulgate administrative regulations
and standards for child-care centers. KRS 199.8962(2) requires the Cabinet for
Health and Family Services to promulgate administrative regulations to
establish the requirements and procedures for the implementation of standards
contained therein. This administrative regulation establishes health and safety
standards for child-care centers.
Section
1. Definitions.
(1) "Cabinet" is
defined by
KRS
199.011(3) and
199.894(1).
(2) "Corporal physical discipline" is defined
by
KRS
199.896(18).
(3) "Developmentally appropriate" means
suitable for the specific age range and abilities of a child.
(4) "Director" means an individual:
(a) Who meets the education and training
requirements as specified in 922 KAR 2:090, Section 10;
(b) Whose primary full-time job
responsibilities are to ensure compliance with 922 KAR 2:090, 922 KAR 2:280,
and this administrative regulation; and
(c) Who is responsible for directing the
program and managing the staff at the child-care center.
(5) "Health professional" means a person
currently licensed as a:
(a)
Physician;
(b) Physician
assistant;
(c) Advanced practice
registered nurse; or
(d) Registered
nurse as defined by
KRS
314.011(5) under the
supervision of a physician or advanced practice registered nurse.
(6) "Infant" means a child who is
less than twelve (12) months of age.
(7) "Licensee" means the owner or operator of
a child-care center to include:
(a) Sole
proprietor;
(b)
Corporation;
(c) Limited liability
company;
(d) Partnership;
(e) Association; or
(f) Organization, such as:
1. Board of education;
2. Private school;
3. Faith-based organization;
4. Government agency; or
5. Institution.
(8) "Nontraditional hours" means
the hours of:
(a) 7 p.m. through 5 a.m.
Monday through Friday; or
(b) 7
p.m. on Friday until 5 a.m. on Monday.
(9) "Parent" is defined by
45
C.F.R. 98.2.
(10) "Premises" means the building and
contiguous property in which child care is licensed.
(11) "Preschool-age" means a child who is
older than a toddler and younger than school-age.
(12) "Protective surface" means loose
surfacing material not installed over concrete, which includes:
(a) Wood mulch;
(b) Double shredded bark mulch;
(c) Uniform wood chips;
(d) Fine sand;
(e) Coarse sand;
(f) Pea gravel, except for areas used by
children under three (3) years of age;
(g) Certified shock absorbing resilient
material; or
(h) Other material
approved by the cabinet or designee, based on recommendation from a nationally
recognized source.
(13)
"Related" means having one (1) of the following relationships with the operator
of the child-care center:
(a)
Child;
(b) Grandchild;
(c) Niece;
(d) Nephew;
(e) Sibling;
(f) Stepchild; or
(g) Child in legal custody of the
operator.
(14)
"School-age" means a child who meets the age requirements of
KRS
158.030 or who attends kindergarten,
elementary, or secondary education.
(15) "Toddler" means a child between the age
of twelve (12) months and thirty-six (36) months.
(16) "Transition" means the changing from one
(1) child care arrangement to another.
(17) "Transition plan" means a document
outlining the process to be used in moving a child from one (1) child care
arrangement to another.
(18) "Type
I child-care center" means a child-care center licensed to regularly provide
child care services for:
(a) Four (4) or more
children in a nonresidential setting; or
(b) Thirteen (13) or more children in a
residential setting with designated space separate from the primary residence
of a licensee.
(19)
"Type II child-care center" means the primary residence of the licensee in
which child care is regularly provided for at least seven (7), but not more
than twelve (12), children including children related to the
licensee.
Section 2.
Child Care Services.
(1) Services established
in this administrative regulation shall be maintained during all hours of
operation that child care is provided.
(2) For an operating child-care center,
minimum staff-to-child ratios and group size shall be maintained as established
in the table established in this subsection.
Age of Children
|
Ratio
|
Maximum Group Size*
|
Infant
|
1 staff for 5 children
|
10
|
Toddler 12 to 24 months
|
1 staff for 6 children
|
12
|
Toddler 24 to 36 months
|
1 staff for 10 children
|
20
|
Preschool-age 3 to 4 years
|
1 staff for 12 children
|
24
|
Preschool-age 4 to 5 years
|
1 staff for 14 children
|
28
|
School-age 5 to 7 years
|
1 staff for 15 children
|
30
|
School-age 7 and older
|
1 staff for 25 children (for before and after
school)
|
30
|
1 staff for 20 children (full day of care)
|
30 |
*Maximum Group Size shall be applicable only to Type
I child-care centers.
|
(a) In a Type I
child-care center, a group size shall:
1. Be
separately maintained in a defined area unique to the group; and
2. Have specific staff assigned to, and
responsible for, the group.
(b) The age of the youngest child in the
group shall determine the:
1. Staff-to-child
ratio; and
2. Maximum group
size.
(c) This
subsection and subsection (10) of this section shall not apply during
traditional school hours to a center:
1.
Providing early childhood education to mixed-age groups of children whose ages
range from thirty (30) months to six (6) years; and
2. Accredited by or affiliated with a
nationally-recognized education association that has criteria for group size
and staff-to-child ratios contrary to the requirements of this
subsection.
(d) If a
child related to the director, employee, or person under the supervision of the
licensee is receiving care in the center, the child shall be included in the
staff-to-child ratio.
(3)
(a)
Each center shall maintain a child-care program that assures each child shall
be:
1. Provided with adequate supervision at
all times by a qualified staff person who ensures the child is:
a. Within scope of vision and range of voice;
or
b. For a school-age child,
within scope of vision or range of voice; and
2. Protected from abuse and
neglect.
(b) The program
shall include:
1. A procedure to ensure
compliance with and inform child care staff of the laws of the Commonwealth
pertaining to child abuse or neglect set forth in
KRS
620.030; and
2. Written policy that states that the
procedures that were taught at the orientation training shall be implemented by
each child-care center staff member.
(4) The child-care center shall provide a
daily planned program:
(a) Posted in writing
in a conspicuous location with each age group and followed;
(b) Of activities that are individualized and
developmentally appropriate for each child served;
(c) That provides experience to promote the
individual child's physical, emotional, social, and intellectual growth and
well-being; and
(d) Unless the
child-care center is a before- or after-school program that operates part day
or less, that offers a variety of creative activities including:
1. Art or music;
2. Math or numbers;
3. Dramatic play;
4. Stories and books;
5. Science or nature;
6. Block building or stacking;
7. Tactile or sensory activity;
8. Multi-cultural exposure;
9. Indoor and outdoor play in which a child
makes use of both small and large muscles;
10. A balance of active and quiet play,
including group and individual activity;
11. An opportunity for a child to:
a. Have some free choice of
activities;
b. If desired, play
apart from the group at times; and
c. Practice developmentally appropriate
self-help procedures in respect to:
(i)
Clothing;
(ii) Toileting;
(iii) Hand-washing; and
(iv) Eating; and
12. The use of screen time,
electronic viewing, and listening devices if the:
a. Material is developmentally appropriate to
the child using the equipment;
b.
Material is not a replacement for active play or a substitute for engagement
and interaction with other children and adults;
c. Material does not include any violence,
adult content viewing, or inappropriate language;
d. Child is over twenty-four (24) months of
age;
e. Viewing or listening is
discussed with parents beforehand; and
f. Viewing or listening is designed as an
educational tool used to help children explore, create, problem solve,
interact, and learn with and from one another.
(5) Screen time shall be:
(a) Utilized for:
1. A maximum of thirty (30) minutes per day
in a half-day program;
2. A maximum
of sixty (60) minutes per day in a full-day program; or
3. The time needed for school-age children to
complete assigned non-traditional instruction; and
(b) Prohibited for a child under twenty-four
(24) months of age.
(6)
A child who does not wish to use an electronic device during the planned
program shall be offered other appropriate activities.
(7) Regularity of routines shall be
implemented to afford the child familiarity with the daily schedule of
activity.
(8) Sufficient time shall
be allowed for an activity so that a child may progress at his or her own
developmental rate.
(9) A child
shall not be required to stand or sit for a prolonged period of time:
(a) During an activity;
(b) While waiting for an activity to start;
or
(c) As discipline.
(10) If school-age care is
provided:
(a) A separate area or room shall
be provided in a Type I child-care center; and
(b) Each child shall be provided a snack
after school.
(11) A
child shall not be subjected to:
(a) Corporal
physical discipline pursuant to
KRS
199.896(18);
(b) Loud, profane, threatening, frightening,
humiliating, or abusive language; or
(c) Discipline that is associated with:
1. Rest;
2. Toileting;
3. Play time; or
4. Food.
(12) If nontraditional hours of care are
provided:
(a) Including time spent in school,
a child shall not be permitted to spend more than sixteen (16) hours in the
child-care center during one (1) twenty-four (24) hour period;
(b) At least one (1) staff member shall be
assigned responsibility for each sleeping room;
(c) A child present for an extended period of
time during waking hours shall receive a program of well-balanced and
constructive activity that is developmentally appropriate for the
child;
(d) A child sleeping three
(3) hours or more shall sleep in:
1. Pajamas;
or
2. A nightgown;
(e) A child who attends school
from the child-care center shall be offered breakfast prior to leaving for
school; and
(f) Staff shall:
1. If employed by a Type I child-care center,
remain awake while on duty; or
2.
If employed by or is the operator of a Type II child-care center, remain awake
until every child in care is asleep.
(13)
(a)
Care for a child with a special need shall be consistent with the nature of the
need as documented by the child's health professional.
(b) A child may include a person eighteen
(18) years of age if the person has a special need for which child care is
required.
Section
3. General Requirements.
(1)
Screen time, electronic viewing, and listening devices shall only be used in
the center as a part of the child's planned program of activity as established
in Section 2(4) and (5) of this administrative regulation.
(2) Activity areas, equipment, and materials
shall be arranged so that the child's activity is adequately supervised by
staff.
(3) Computer equipment shall
be equipped with a monitoring device that limits access by a child to items
inappropriate for a child to view or hear.
(4) A child shall:
(a) Be helped with personal care and
cleanliness based upon his or her developmental skills;
(b) Except as established in paragraph (c) of
this subsection, wash his or her hands with liquid soap and warm running water:
1.
a. Upon
arrival at the center; or
b. Within
thirty (30) minutes of arrival for school-age children;
2. Before and after eating or handling
food;
3. After toileting or diaper
change;
4. After handling
animals;
5. After touching an item
or an area of the body soiled with body fluids or wastes; and
6. After outdoor or indoor play time;
and
(c) Use hand
sanitizer or hand-sanitizing wipes if liquid soap and warm running water are
not available in accordance with paragraph (b) of this subsection. The child
shall wash the child's hands as soon as practicable once liquid soap and warm
running water are available.
(5) Staff shall:
(a) Maintain personal cleanliness;
(b) Conform to hygienic practices while on
duty;
(c) Except as established in
paragraph (d) of this subsection, wash their hands with liquid soap and running
water:
1. Upon arrival at the
center;
2. After toileting or
assisting a child in toileting;
3.
Before and after diapering each child;
4. After wiping or blowing a child's or own
nose;
5. After handling
animals;
6. After caring for a sick
child;
7. Before and after feeding
a child or eating;
8. Before
dispensing medication;
9. After
smoking or vaping; and
10. If
possible, before administering first aid; and
(d) Use hand sanitizer or hand-sanitizing
wipes if liquid soap and warm running water are not available in accordance
with paragraph (c) of this subsection. The staff shall wash the staff's hands
as soon as practicable once liquid soap and warm running water are
available.
(6) A staff
person suspected of being infected with a communicable disease shall:
(a) Not perform duties that could allow for
the transmission of the disease until the infectious condition can no longer be
transmitted; and
(b) Provide a
statement of fitness to return to work from a health professional, if
requested.
(7) The
following shall be inaccessible to a child in care:
(a) Toxic cleaning supplies, poisons, and
insecticides;
(b) Matches,
cigarettes, lighters, and flammable liquids; and
(c) Personal belongings and medications of
staff.
(8) The following
shall be inaccessible to a child in care unless under direct supervision and
part of planned program of instruction:
(a)
Knives and sharp objects;
(b)
Litter and rubbish;
(c) Bar soap;
and
(d) Plastic bags not used for
personal belongings.
(9)
In accordance with
KRS
527.070(1), firearms and
ammunition shall be stored separately from each other in a locked area outside
of the designated child care area.
(10) Smoking or vaping shall:
(a) Be permitted in accordance with local
ordinances;
(b) Be allowed only in
outside designated areas; and
(c)
Not be permitted in the presence of a child.
(11) While bottle feeding a child, the:
(a) Child shall be held; and
(b) Bottle or beverage container shall not
be:
1. Propped;
2. Left in the mouth of a sleeping child;
or
3. Heated in a
microwave.
(12) A fire drill shall be:
(a) Conducted during hours of operation at
least monthly; and
(b)
Documented.
(13) An
earthquake drill, shelter-in-place or lockdown drill, and tornado drill shall
be:
(a) Conducted during hours of operation
at least quarterly; and
(b)
Documented.
Section
4. Premises Requirements.
(1) The
premises shall be:
(a) Suitable for the
purpose intended;
(b) Kept clean
and in good repair; and
(c)
Equipped with:
1. A working telephone
accessible to a room used by a child; and
2. A list of emergency numbers posted by the
telephone or maintained in the telephone's contact, including numbers for the:
a. Police department;
b. Fire department;
c. Emergency medical care and rescue squad;
and
d. Poison control
center.
(2) A child-care center shall be in
compliance with the codes administered by the Kentucky Fire Marshal and the
local zoning laws.
(3) Fire and
emergency exits shall be kept clear of debris.
(4) A working carbon monoxide detector shall
be required in a licensed child-care center that is in a home if the home:
(a) Uses fuel burning appliances;
or
(b) Has an attached
garage.
(5) The building
shall be constructed to ensure the:
(a)
Building is:
1. Dry;
2. Ventilated; and
3. Well lit, including clean light fixtures
that are:
a. In good repair in all areas;
and
b. Shielded or have
shatter-proof bulbs installed; and
(b) Following are protected:
1. Windows;
2. Doors;
3. Stoves;
4. Heaters;
5. Furnaces;
6. Pipes; and
7. Stairs.
(6) Exclusive of the kitchen, bathroom,
hallway, and storage area, there shall be a minimum of thirty-five (35) square
feet of space per child.
(7)
Measures shall be utilized to control the presence of:
(a) Rodents;
(b) Flies;
(c) Roaches; and
(d) Other vermin.
(8) An opening to the outside shall be
effectively protected against the entrance of vermin by:
(a) Self-closing doors;
(b) Closed windows;
(c) Screening;
(d) Controlled air current; or
(e) Other effective means.
(9) Floors, walls, and ceilings
shall be smooth, in good repair, and constructed to be easily
cleaned.
(10) The water supply
shall be:
(a) Potable;
(b) Protected from contamination;
(c) Adequate in quality and volume;
(d) Under sufficient pressure to permit
unrestricted use; and
(e) Obtained
from an approved public water supply or a source approved by the local health
department.
(11)
Groundwater supplies for a child-care center caring for:
(a) More than twenty-five (25) children shall
comply with requirements of the Energy and Environment Cabinet, Division of
Water, established in KRS Chapter 151 and 401 KAR Chapter 8, as applicable;
or
(b) Twenty-five (25) children or
less shall secure approval from the:
1.
Energy and Environment Cabinet; or
2. Local health department.
(12) Sewage shall be
properly disposed by a method approved by the:
(a) Energy and Environment Cabinet;
or
(b) Cabinet.
(13) All plumbing shall comply
with the State Plumbing Code established in KRS Chapter 318.
(14) Solid waste shall be kept in a suitable
receptacle in accordance with local, county, and state law, as governed by
KRS
211.350 to
211.380.
(15) If a portion of the building is used for
a purpose other than child care:
(a)
Necessary provisions shall be made to avoid interference with the child-care
program; and
(b) A separate
restroom shall be provided for use only by those using the building for its
child care purpose.
(16)
The temperature of the indoor area of the premises shall be sixty-five (65) to
eighty-two (82) degrees Fahrenheit.
(17) Outdoor activity shall be restricted
based upon:
(a) Temperature;
(b) Weather conditions;
(c) Weather alerts, advisories, and warnings
issued by the National Weather Service; or
(d) Age or temperament of the
child.
(18) A kitchen
shall not be required if:
(a) The only food
served is an afternoon snack to school-age children; and
(b) Adequate refrigeration is
maintained.
(19) The
Department of Housing, Buildings and Construction, the Kentucky Fire Marshal's
Office, and cabinet shall be contacted concerning a planned new building,
addition, or major renovation prior to construction.
(20) An outdoor play area shall be:
(a) Except for an after-school child-care
program, located on the premises of a public or state-accredited nonpublic
school, fenced for the safety of the children;
(b) A minimum of sixty (60) square feet per
child, separate from and in addition to the thirty-five (35) square feet
minimum pursuant to subsection (6) of this section;
(c) Free from:
1. Litter;
2. Glass;
3. Rubbish; and
4. Flammable materials;
(d) Safe from foreseeable hazard;
(e) Well drained;
(f) Well maintained;
(g) In good repair; and
(h) Visible to staff at all times.
(21) A protective surface shall:
(a) Be provided for outdoor play equipment
used to:
1. Climb;
2. Swing; and
3. Slide; and
(b) Have a fall zone equal to the height of
the equipment.
(22) If a
child-care center does not have access to an outdoor play area, an indoor space
shall:
(a) Be used as a play area;
(b) Have a minimum of sixty (60) square feet
per child, separate from and in addition to the thirty-five (35) square feet
minimum pursuant to subsection (6) of this section;
(c) Include equipment for gross motor skills;
and
(d) Have a protective surface
of at least two (2) inches thick around equipment intended for
climbing.
(23) While
attending, a child shall:
(a) Have moderate
to vigorous activity each day, including active play that:
1. Includes outdoor play unless unavailable
pursuant to subsections (17) or (22) of this section;
2. Shall occur for a minimum of;
a. Thirty (30) minutes per day in a half-day
program; or
b. Sixty (60) minutes
per day in a full-day program; and
3. May be broken into smaller increments of
time throughout a day; and
(b) Not be punished or rewarded in regards to
play time.
(24) Fences
shall be:
(a) Constructed of safe
material;
(b) Stable; and
(c) In good condition.
(25) Supports for climbing apparatus and
large equipment shall be securely fastened to the ground.
(26) Crawl spaces, such as tunnels, shall be
short and wide enough to permit access by adults.
(27) A sandbox shall be:
(a) Constructed to allow for
drainage;
(b) Covered while not in
use;
(c) Kept clean; and
(d) Checked for vermin prior to
use.
(28) Bodies of
water that shall not be utilized include:
(a)
Portable wading pools;
(b) Natural
bodies of water; and
(c)
Unfiltered, nondisinfected containers.
(29) A child-care center shall have enough
toys, play apparatus, and developmentally appropriate materials to provide each
child with a variety of activities during the day, as specified in Section 2 of
this administrative regulation.
(30) Storage space shall be provided:
(a) In the form of:
1. Shelves; or
2. Other storage device accessible to the
children; and
(b) In
sufficient quantity for each child's personal belongings.
(31) Supplies shall be stored so that the
adult can reach them without leaving a child unattended.
Section 5. Infant and Toddler Play
Requirements.
(1) Indoor areas for infants
and toddlers under twenty-four (24) months of age shall:
(a) Be separate from an area used by an older
child;
(b) Not be an exit or
entrance; and
(c) Have adequate
crawling space for an infant or toddler away from general traffic patterns of
the center.
(2) While
awake, an infant shall have short periods of supervised tummy time throughout
each day.
(3) Except in accordance
with subsection (4) of this section or Section 2(2)(c) of this administrative
regulation, an infant or toddler under twenty-four (24) months of age shall not
participate in an activity with an older child for more than one (1) hour per
day.
(4) If a toddler is
developmentally appropriate for a transition to a preschool age group, a
toddler may participate in an activity with an older child for more than one
(1) hour per day if:
(a) Space for the
toddler is available in the preschool-age group;
(b) The staff-to-child ratios and group sizes
are maintained based on the age of the youngest child;
(c) The center has a procedure for listing a
transitioning toddler on attendance records, including a specific day and time
the toddler is with either age group; and
(d) The child care center has obtained the
signature and approval of the toddler's parent on the toddler's transition
plan.
(5) If a
child-care center provides an outdoor play area for an infant or toddler under
twenty-four (24) months of age, the outdoor area shall be:
(a) Shaded; and
(b) In a separate area or scheduled at a
different time than an older child.
(6) Playpens and play yards shall:
(a) Meet federal standards as issued by the
Consumer Product Safety Commission, including 16 C.F.R. 1221;
(b) Be manufactured for commercial use;
and
(c) Not be used for sleeping or
napping.
Section
6. Sleeping and Napping Requirements.
(1) An infant shall sleep or nap on the
infant's back unless the infant's health professional signs a waiver that
states the infant requires an alternate sleeping position.
(2) Rest time shall be provided for each
child who is not school-age and who is in care for more than four (4)
hours.
(3) Rest time shall occur in
an adequate space according to the child's age as follows:
(a) For an infant:
1. An individual non-tiered crib that meets
Consumer Product Safety Commission standards established in 16 C.F.R.
1219-1220;
2. A firm crib mattress
in good repair with a clean tight-fitted sheet that shall be changed:
a. Weekly; or
b. Immediately if it is soiled or
wet;
3. No bedding other
than a clean tight-fitted sheet; and
4. No toys or other items except the infant's
pacifier; or
(b) For a
toddler or preschool-age child:
1. An
individual bed, a two (2) inch thick waterproof mat, or cot in good repair;
and
2. Bedding that is in good
repair and is changed:
a. Weekly;
or
b. Immediately if it is soiled
or wet.
(4) Rest time shall not exceed two (2) hours
for a preschool-age child unless the child is attending the child-care center
during nontraditional hours.
(5) A
child who does not sleep shall be permitted to play quietly and shall be
visually supervised.
(6) Cots,
equipment, and furnishings used for sleeping and napping shall be spaced twelve
(12) inches apart to allow free and safe movement by a person.
(7) If cots or mats are used, floors shall be
free from:
(a) Drafts;
(b) Liquid substances;
(c) Dirt; and
(d) Dampness.
(8)
(a)
Cots or mats not labeled for individual use by a child shall be cleaned after
each use.
(b) Cots or mats labeled
for individual use by a child shall be:
1.
Cleaned at least weekly; and
2.
Disinfected immediately if it is soiled or wet.
(9) Individual bedding shall be stored in a
sanitary manner.
Section
7. First Aid and Medicine.
(1)
First aid supplies shall:
(a) Be available to
provide prompt and proper first aid treatment;
(b) Be stored out of reach of a
child;
(c) Be periodically
inventoried to ensure the supplies have not expired;
(d) If reusable, be:
1. Sanitized; and
2. Maintained in a sanitary manner;
and
(e) Include:
1. Liquid soap;
2. Adhesive bandages;
3. Sterile gauze;
4. Medical tape;
5. Scissors;
6. A thermometer;
7. Flashlight;
8. Cold pack;
9. First aid book;
10. Disposable gloves; and
11. A cardiopulmonary resuscitation
mouthpiece protector.
(2) A child showing signs of an illness or
condition that could be communicable shall not be admitted to the regular
child-care program.
(3) If a child
becomes ill while at the child-care center:
(a) The child shall be placed in a supervised
area isolated from the rest of the children;
(b) The parent shall be contacted
immediately; and
(c) Arrangements
shall be made to remove the child from the child-care center as soon as
practicable.
(4)
Prescription and nonprescription medication shall be administered to a child in
care:
(a)
1. With a written request of the child's parent or the
child's prescribing health professional; and
2. According to the directions or
instructions on the medication's label; or
(b) For epinephrine, in accordance with
KRS
199.8951 and
311.646.
(5) The child-care center shall keep a
written record of the administration of medication, including:
(a) Time of each dosage;
(b) Date;
(c) Amount;
(d) Name of staff person giving the
medication;
(e) Name of the child;
and
(f) Name of the
medication.
(6)
Medication, including refrigerated medication, shall be:
(a) Stored in a separate and locked place,
out of the reach of a child unless the medication is:
1. A first aid supply and is maintained in
accordance with subsection (1) of this section;
2. Diaper cream, sunscreen, or toothpaste.
Diaper cream, sunscreen, or toothpaste shall be inaccessible to a
child;
3. An epinephrine
auto-injector. A licensed child-care center shall comply with
KRS
199.8951 and
311.646,
including:
a. An epinephrine auto-injector
shall be inaccessible to a child;
b. A child-care center shall have at least
one (1) person onsite who has received training on the administration of an
epinephrine auto-injector if the child-care center maintains an epineph-rine
auto-injector;
c. A child-care
center shall seek emergency medical care for a child if an auto-injector is
administered to the child; and
d. A
child-care center shall report to the child's parent and the cabinet in
accordance with 922 KAR 2:090, Section 13(1)(b), if an epinephrine
auto-injector is administered to a child; or
4. An emergency or rescue medication for a
child in care, such as medication to respond to diabetic or asthmatic
condition, as prescribed by the child's physician. Emergency or rescue
medication shall be inaccessible to a child in care;
(b) Kept in the original bottle;
and
(c) Properly labeled.
(7) Medication shall not be given
to a child if the medication's expiration date has passed.
(8) Each center shall ensure that every staff
member has received training on first aid and cardiopulmonary resuscitation
(CPR).
Section 8.
Kitchen Requirements.
(1) The kitchen shall:
(a) Be clean;
(b) Be equipped for proper food:
1. Preservation;
2. Storage;
3. Preparation; and
4. Service;
(c) Be adequately ventilated to the outside
air; and
(d) Except in a Type II
child-care center when a meal is not being prepared, not be used for the
activity of a child.
(2)
A child-care center required to have a food service permit shall be in
compliance with
902 KAR 45:005
and this administrative regulation.
(3) Convenient and suitable sanitized
utensils shall be:
(a) Provided; and
(b) Used to minimize handling of food during
preparation.
(4) A
cold-storage facility used for storage of perishable food in a nonfrozen state
shall:
(a) Have an indicating thermometer or
other appropriate temperature measuring device;
(b) Be in a safe environment for
preservation; and
(c) Be forty (40)
degrees Fahrenheit or below.
(5) Frozen food shall be:
(a) Kept at a temperature of zero degrees
Fahrenheit or below; and
(b)
Thawed:
1. At refrigerator
temperatures;
2. Under cool,
potable running water;
3. As part
of the cooking process; or
4. By
another method in accordance with the Department for Public Health's food
safety standards and permits, established in KRS Chapter 217.
(6) Equipment,
utensils, and surfaces contacting food shall be:
(a) Smooth;
(b) Free of breaks, open seams, cracks, and
chips;
(c) Accessible for cleaning;
and
(d) Nontoxic.
(7) The following shall be clean
and sanitary:
(a) Eating and drinking
utensils;
(b)
Kitchenware;
(c) Food contact
surfaces of equipment;
(d) Food
storage utensils;
(e) Food storage
containers;
(f) Cooking surfaces of
equipment; and
(g) Nonfood contact
surfaces of equipment.
(8) A single-service item shall be:
(a) Stored;
(b) Handled and dispensed in a sanitary
manner; and
(c) Used only
once.
(9) Bottles shall
be:
(a) Individually labeled;
(b) Promptly refrigerated;
(c) Covered while not in use; and
(d) Consumed within one (1) hour of being
heated or removed from the refrigerator.
Section 9. Food and Drink Requirements for
All Child-Care Centers.
(1) Food shall be:
(a) Clean;
(b) Free from:
1. Spoilage;
2. Adulteration; and
3. Misbranding;
(c) Safe for human consumption;
(d) Withheld from service or discarded if the
food is hermetically sealed, nonacidic, or low-acidic food that has been
processed in a place other than a commercial food-processing
establishment;
(e) Obtained from a
source that is in compliance with the Department for Public Health's food
safety standards and permits, established in KRS Chapter 217;
(f) Acceptable if from an established
commercial food store;
(g) Served
in a quantity that is developmentally appropriate for the child with additional
portions provided upon request of the child; and
(h) Protected against contamination from:
1. Dust;
2. Flies;
3. Rodents and other vermin;
4. Unclean utensils and work
surfaces;
5. Unnecessary
handling;
6. Coughs and
sneezes;
7. Cuts in skin;
8. Communicable disease;
9. Flooding;
10. Drainage; and
11. Overhead leakage.
(2) Food shall not be:
(a) Used for reward;
(b) Used for discipline;
(c) Withheld until all other foods are
consumed; or
(d) Served while
viewing electronic devices.
(3) A serving of milk shall consist of:
(a) Breast milk or iron-fortified formula for
a child:
1. Age birth to twelve (12) months;
or
2. Beyond twelve (12) months of
age as documented by the parent or the child's physician;
(b) Pasteurized unflavored whole milk for
children ages twelve (12) months to twenty-four (24) months; or
(c) Pasteurized unflavored low fat one (1)
percent or fat-free skim milk for children ages twenty-four (24) months to
school-age.
(4) Formula
or breast milk provided by the parent shall be prepared and labeled.
(5) A child-care center may participate in
the Child and Adult Care Food Program (CACFP).
(6) A serving of bread shall only consist of
whole or enriched grain.
(7)
Drinking water shall be freely available to a child throughout the
day.
(8) Food shall be stored on:
(a) Clean racks;
(b) Clean shelves;
(c) Other clean surfaces; or
(d) If maintained in a sanitary condition, in
nonabsorbent labeled containers a minimum of six (6) inches off the
floor.
(9) Fruits and
vegetables shall be washed before cooking or serving.
(10) Children shall not be served food that
has been deep-fried on-site.
(11)
Meat salads, poultry salads, and cream-filled pastries shall be:
(a) Prepared with utensils that are clean;
and
(b) Refrigerated unless served
immediately.
(12) An
individual portion of food served to a child or adult shall not be served
again.
(13) Wrapped food that is
still wholesome and has not been unwrapped may be reserved.
(14) Meals shall be:
(a) Served every two (2) to three (3) hours;
and
(b) Served to a child:
1. Seated with sufficient room to manage food
and tableware; and
2. Supplied with
individual eating utensils designed for use by a child.
(15) Drinks served to children
shall not have added sugar. Children shall drink water, milk, or 100% juice
with meals.
(16) Juice shall:
(a) Not include added sugar;
(b) Not be served more than once per
day;
(c) Not be served to children
under the age of twelve (12) months; and
(d) Serve as a fruit or vegetable meal
component replacement.
(17) A meat alternative shall include:
(a) Tofu;
(b) Soy products;
(c) Cheese, including cottage or ricotta
cheese;
(d) Eggs;
(e) Cooked dry beans;
(f) Peanut butter or soy nut
butter;
(g) Yogurt, plain or
flavored; or
(h) Peanuts, soy nuts,
tree nuts, or seeds.
(18) Cheese shall be natural and pasteurized
processed cheese. Children shall not be served cheese product, imitation
cheese, cheese food, or cheese spread as a meat alternative.
(19) For food provided by the center, all
children in the center shall be offered the same food items unless:
(a) A parent provides written authorization
to substitute the food with an alternative that meets the same component
requirement; or
(b) A physician
provides written authorization to substitute the food or the food component and
includes the food that the child shall not have and the food substitution that
the child shall have.
(20) Children shall be served all daily food
components required by Section 10 or 11 of this administrative
regulation.
Section 10.
Meal Planning Requirements for a Center that Provides Meals.
(1) Breakfast shall include the following
three (3) components:
(a) Milk;
(b) Bread or grain, which may:
1. Be exchanged for a meat or meat
alternative up to three (3) times per week; and
2. Include ready-to-eat cereal with six (6)
grams of sugar or less per dry ounce; and
(c)
1.
Fruit;
2. Vegetable; or
3. 100 percent
juice.
(2) A
snack shall include two (2) of the following components:
(a) Milk;
(b) Meat or meat alternative;
(c) Bread or grain; or
(d)
1. Fruit;
2. Vegetable; or
3. 100 percent juice.
(3) Lunch, and dinner if served,
shall include the following components:
(a)
Milk;
(b) Meat or meat
alternative;
(c) Bread or grain;
and
(d)
1. Two (2) different vegetables; or
2. One (1) fruit and one (1)
vegetable.
(4) A grain-based dessert shall not replace
the bread or grain component of a meal.
(5) Yogurt served to children shall have
twenty-three (23) grams of sugar or less per six (6) ounces.
(6) The serving size for milk shall be:
(a) Four (4) ounces for one (1) or two (2)
year old children;
(b) Six (6)
ounces for three (3) to five (5) year old children; or
(c) Eight (8) ounces for school-age
children.
(7) At least
one (1) whole grain bread or grain shall be served daily.
(8) A component shall be considered "whole
grain" if:
(a) The product is listed by any
state agency's Special Supplemental Nutrition Program for Women, Infants, and
Children as whole grain;
(b) The
product is labeled as "whole wheat" and has a Standard of Identity issued by
the U.S. Food and Drug Administration (FDA);
(c) The product includes one of the
FDA-approved whole grain health claims on its packaging, exactly as
written;
(d) The product meets the
whole grain-rich criteria under the National School Lunch Program
(NSLP);
(e) The product is
identified on the package as "whole grain," "whole wheat," or "whole
grain-rich"; or
(f) Proper
documentation from a manufacturer or standardized recipe demonstrates that
whole grains are the primary grain ingredient by weight.
(9) A weekly menu shall be:
(a) Prepared;
(b) Dated;
(c) Posted in advance in a conspicuous
place;
(d) Kept on file for thirty
(30) days; and
(e) Amended in
writing with any substitutions on the day the meal is served.
Section 11. Meal
Planning Requirements for a Center that Does Not Provide Meals.
(1) A child-care center that does not provide
meals shall serve:
(a)
1. Breakfast; or
2. A mid-morning snack;
(b)
1.
Lunch; or
2. A mid-afternoon snack;
and
(c) Dinner, if
appropriate.
(2)
Breakfast shall include three (3) of the following components:
(a) Milk;
(b) Bread or grain;
(c) Meat or meat alternative; or
(d)
1.
Fruit;
2. Vegetable; or
3. 100 percent
juice.
(3) A
snack shall include two (2) of the following components:
(a) Milk;
(b) Bread or grain;
(c) Meat or meat alternative; or
(d)
1.
Fruit;
2. Vegetable; or
3. 100 percent juice.
(4) Lunch, and dinner if served,
shall include:
(a) Milk;
(b) Bread or grain;
(c) Meat or meat alternative; and
(d)
1. Two
(2) different vegetables; or
2. One
(1) fruit and one (1) vegetable.
Section 12. Toilet, Diapering, and Toiletry
Requirements.
(1) A child-care center shall
have a minimum of one (1) toilet and one (1) lavatory for each twenty (20)
children. Urinals may be substituted for up to one-half (1/2) of the number of
toilets required for a male toilet room.
(2) A toilet room shall:
(a)
1. Be
provided for each gender; or
2. A
plan shall be implemented to use the same toilet room at separate
times;
(b) Have a supply
of toilet paper; and
(c) Be cleaned
and disinfected daily.
(3) A sink shall be:
(a) Located in or immediately adjacent to
toilet rooms;
(b) Equipped with hot
and cold running water that allows for hand washing;
(c) Equipped with hot water at a minimum
temperature of ninety (90) degrees Fahrenheit and a maximum of 120 degrees
Fahrenheit;
(d) Equipped with
liquid soap;
(e) Equipped with
hand-drying blower or single use disposable hand drying material;
(f) Equipped with an easily cleanable waste
receptacle; and
(g) Immediately
adjacent to a changing area used for infants and toddlers.
(4) Each toilet shall:
(a) Be kept in clean condition;
(b) Be kept in good repair;
(c) Be in a lighted room; and
(d) Have ventilation to outside
air.
(5) Toilet training
shall be coordinated with the child's parent.
(6) An adequate quantity of freshly laundered
or disposable diapers and clean clothing shall be available.
(7) If a toilet training chair is used, the
chair shall be:
(a) Used over a surface that
is impervious to moisture;
(b) Out
of reach of other toilets or toilet training chairs;
(c) Emptied promptly; and
(d) Disinfected after each use.
(8) Diapers or clothing shall be:
(a) Changed when soiled or wet;
(b) Stored in a covered container
temporarily; and
(c) Washed or
disposed of at least once a day.
(9) The proper methods of diapering and
hand-washing shall be posted at each diaper changing area.
(10) When a child is diapered, the child
shall:
(a) Not be left unattended;
and
(b) Be placed on a surface that
is:
1. Clean;
2. Padded;
3. Free of holes, rips, tears, or other
damage;
4. Nonabsorbent;
5. Easily cleaned; and
6. Free of any items not used for diaper
changing.
(11) Unless the child is allergic, individual
disposable washcloths shall be used to thoroughly clean the affected area of
the child.
(12) Staff shall
disinfect the diapering surface after each child is diapered.
(13) If staff wears disposable gloves, the
gloves shall be changed and disposed after each child is diapered.
(14) Combs, towels or washcloths, brushes,
and toothbrushes used by a child shall be:
(a) Individually stored in separate
containers; and
(b) Plainly labeled
with the child's name.
(15) Toothbrushes shall be:
(a) Individually identified;
(b) Allowed to air dry; and
(c) Protected from contamination.
(16) Toothpaste used by multiple
children shall be dispensed onto an intermediate surface, such as waxed paper,
to avoid cross contamination.
Section
13. Toys and Furnishings.
(1)
All toys and furniture contacted by a child shall be:
(a) Kept clean and in good repair;
and
(b) Free of peeling, flaking,
or chalking paint.
(2)
Indoor and outdoor equipment shall:
(a) Be
clean, safe, and in good repair;
(b) Meet the physical, developmental needs,
and interests of children of different age groups;
(c) Be free from sharp points or corners,
splinters, protruding nails or bolts, loose or rusty parts, hazardous small
parts, lead-based paint, poisonous material, and flaking or chalking paint;
and
(d) Be designed to guard
against entrapment or situations that may cause strangulation.
(3) Toys shall be:
(a) Used according to the manufacturer's
safety specifications;
(b) Durable;
and
(c) Without sharp points or
edges.
(4) A toy or
another item that is considered a mouth contact surface by a child not toilet
trained shall be sanitized daily by:
(a)
1. Scrubbing in warm, soapy water using a
brush to reach into crevices;
2.
Rinsing in clean water;
3.
Submerging in a sanitizing solution for at least two (2) minutes; and
4. Air dried; or
(b) Cleaning in a dishwasher if the toy or
other item is dishwasher safe.
(5) Tables and chairs shall be of suitable
size for children.
(6) Chairs
appropriate for staff shall be provided to use while feeding, holding, or
playing with a child.
Section
14. Transportation.
(1) A center
shall document compliance with KRS Chapter 186 and
603 KAR
5:072 pertaining to:
(a) Vehicles;
(b) Drivers; and
(c) Insurance.
(2) A center providing or arranging
transportation service shall:
(a) Be licensed
and approved by the cabinet or its designee prior to transporting a
child;
(b) Have a written plan that
details the type of transportation, staff schedule, transportation schedule,
and transportation route; and
(c)
Have written policies and procedures, including emergency procedures practiced
monthly by staff who transports children.
(3) Prior to transporting a child, a center
providing transportation services of a child shall notify the cabinet or its
designee in writing of the:
(a) Type of
transportation offered;
(b) Type of
vehicle used for transportation;
(c) Plan for ensuring staff perform duties
relating to transportation properly;
(d) Full insurance coverage for each
vehicle;
(e) Agency policy and
procedures relating to an emergency plan for evacuating the vehicle;
(f) Contracts, agreements, or documents
detailing arrangements with any third party for services; and
(g) Safety procedures for:
1. Transporting a child;
2. Loading and unloading a child;
and
3. Providing adequate
supervision of a child.
(4) A vehicle used to transport children
shall be equipped with:
(a) A fire
extinguisher;
(b) First aid
supplies as established in Section 7 of this administrative
regulation;
(c) Emergency
reflective triangles; and
(d) A
device to cut the restraint system, if necessary.
(5) Transportation provided by licensed
public transportation or a school bus shall comply with subsections (1) and (2)
of this section.
(6) A vehicle used
to transport children shall comply with the requirements established in
paragraphs (a) through (d) of this subsection.
(a) For a twelve (12) or more passenger
vehicle, the child-care center shall maintain a current certification of
inspection from the Transportation Cabinet.
(b) A vehicle that requires traffic to stop
while loading and unloading a child shall be equipped with a system of:
1. Signal lamps;
2. Identifying colors; and
3. Cautionary words.
(c) A vehicle shall be equipped with seat
belts for each occupant to be individually secured.
(d) A vehicle shall not transport children
and hazardous materials at the same time.
(7) The appropriate car safety seat meeting
federal and state motor vehicle safety standards in
49 C.F.R.
571.213 and
KRS
189.125 shall be used for each
child.
(8) A daily inspection of
the vehicle shall be performed prior to the vehicle's use and documented for:
(a) Tire inflation consistent with tire
manufacturer's recommended air pressure;
(b) Working lights, signals, mirrors, gauges,
and wiper blades;
(c) Working
safety restraints;
(d) Adequate
fuel level; and
(e) Cleanliness and
good repair.
(9)
(a) The staff-to-child ratios set forth in
Section 2(2) of this administrative regulation shall apply to vehicle
transport, if not inconsistent with special requirements or exceptions in this
section.
(b) An individual who is
driving with a child in the vehicle shall supervise no more than four (4)
children under the age of five (5).
(10) Each child shall:
(a) Have a seat;
(b) Be individually belted or harnessed in
the seat; and
(c) Remain seated
while the vehicle is in motion.
(11) A child shall not be left unattended:
(a) At the site of aftercare delivery;
or
(b) In a vehicle.
(12) If the parent or designee is
unavailable, a prearranged written plan shall be completed to designate where
the child can be picked up.
(13) A
child shall not be picked up or delivered to a location that requires crossing
the street or highway unless accompanied by an adult.
(14) A vehicle transporting a child shall
have the headlamps on.
(15) If a
vehicle needs to be refueled, it shall be refueled only while not being used to
transport a child. If emergency refueling or repair is necessary during
transporting, all children shall be removed and supervised by an adequate
number of adults while refueling or repair is occurring.
(16) If the driver is not in the driver's
seat, the:
(a) Engine shall be turned
off;
(b) Keys shall be removed;
and
(c) Emergency brake shall be
set.
(17) Transportation
services provided shall:
(a) Be recorded in
writing and include:
1. The first and last
name of the child transported; and
2. The time each child gets on and the time
each child gets off;
(b)
Be completed by a staff member other than the driver; and
(c) Be kept for five (5) years.
(18) A driver of a vehicle
transporting a child for a center shall:
(a)
Be at least twenty-one (21) years old;
(b) Complete:
1. The background checks as described in 922
KAR 2:280; and
2. An annual check
of the:
a. Kentucky driver history records in
accordance with
KRS
186.018; or
b. Driver history records through the state
transportation agency that issued the driver's license;
(c) Hold a current driver's
license that has not been suspended or revoked during the last five (5) years;
and
(d) Not caused an accident that
resulted in the death of a person.
(19) Firearms, ammunition, alcohol, or
illegal substances shall not be transported in a vehicle transporting
children.
(20)
(a) Based on the harm, threat, or danger to a
child's health, safety, and welfare, the cabinet shall revoke a center's
privilege to transport a child or pursue an adverse action in accordance with
Section 15, 16, 17, or 18 of 922 KAR 2:090:
1. For a violation of this section;
or
2. If the center:
a. Fails to report an accident in accordance
with 922 KAR 2:090, Section 13; or
b. Transports more passengers than the
vehicle's seating capacity and safety restraints can accommodate.
(b) Revocation of a
center's privilege to provide transportation services in accordance with
paragraph (a) of this subsection shall:
1.
Apply to each site listed under the licensee; and
2. Remain effective for no less than a twelve
(12) month period.
(21) A parent may use the parent's vehicle to
transport the parent's child during a field trip.
Section 15. Animals.
(1) An animal shall not be allowed in the
presence of a child in care:
(a) Unless:
1. The animal is under the supervision and
control of an adult;
2. Written
parental consent has been obtained; and
3. The animal is certified as vaccinated
against rabies; or
(b)
Except in accordance with subsection (3) of this section.
(2) A parent shall be notified in writing if
a child has been bitten or scratched by an animal.
(3) An animal that is considered
undomesticated, wild, or exotic shall not be allowed at a child-care center
unless the animal is:
(a) A part of a planned
program activity led by an animal specialist affiliated with a zoo or nature
conservatory; and
(b) In accordance
with
301 KAR
2:081 and
301 KAR
2:082.
(4) This section shall not apply to wild
animals on the outer property of the child-care center that are expected to be
found outdoors, such as squirrels and birds, if they are not:
(a) Disturbed; or
(b) Brought indoors.
20 Ky.R. 256; 562;
812; eff. 10-13-1993; Recodified from 905 KAR 2:120, 10-30-1998; 27 Ky.R. 2932;
28 Ky.R. 116; 404; eff. 8-15-2001; TAm eff. 10-29-2004; 34 Ky.R. 1261; 2010;
2170; eff. 3-19-2008; 39 Ky.R. 898; 1724; eff. 3-8-2013; 39 Ky.R. 2261; 40
Ky.R. 564; eff. 9-18-2013; 44 Ky.R. 2129, 2533; 45 Ky.R. 43; eff 7-18-2018; 47
Ky.R.1145, 1787; eff. 6-16-2021.
STATUTORY AUTHORITY:
KRS
194A.050(1),
199.896(2),
199.8962(2)