Current through 2024-13, March 27, 2024
A.
Immunization. Immunization records must be maintained to ensure
proper medical treatment is determined and given in the event of a disease
outbreak or public health emergency.
1. All
Children in care must meet the following requirements:
a. The Provider must have a current record of
immunization on file for each child, which clearly documents each child's
present immunization status based on the Department's Day Care Immunization
Standards (available at
http://www.maine.gov/dhhs/mecdc/infectious-disease/immunization/family/
and published in September 2019), within 30 days of the child's first admission
to the child care and updated as needed thereafter or,
b. A blood test documenting immunity to
measles, mumps, rubella and varicella (chickenpox), placed in the Child's
record and updated in a timely manner.
c. No Child may be required to be immunized
if religious, philosophical or medical reasons are documented. Effective
September 1, 2021, exemption from immunization requirements are limited to
medical reasons. The Child's physician, nurse practitioner, or physician
assistant must provide documentation that immunization is medically
inadvisable.
2.
Unimmunized Children, Provider and Staff Members. The Family Child Care
Provider must maintain a list of all unimmunized persons, regardless of age. In
the event of a disease outbreak as defined by CDC reporting standards, a Child
not immunized must be excluded from the Family Child Care in accordance with
CDC guidance or until the Child receives the necessary immunization or proof of
immunity is on record.
3.
Immunization records. The Family Child Care Provider must make immunization
records available to the Department of Health and Human Services, Maine Center
for Disease Control and Prevention, upon request.
B.
Evaluation requirements. When
the Department has reasonable cause to believe that an Applicant, Provider or
Staff Member may be unable to provide safe care for Children, the Department
may request a report from a qualified professional or an appropriate official
that includes the evaluator's determination of the person's ability to safely
care for Children.
1. A physical examination
or other evaluation is not required if the Applicant, Provider, or Staff Member
states in writing that it is contrary to the person's religious teachings and
practice.
2. If the Applicant,
Provider, or Staff Member refuses to be evaluated, the Department shall
determine whether sufficient evidence exists to ensure that the person can
safely care for Children.
C.
Health care consultation.
1. The Provider must have a manual of written
guidelines for the prevention and control of communicable diseases and other
appropriate health practices for childcare.
2. The Provider must ensure that the manual
be available to and read by all Staff Members.
D.
Health monitoring. The
Provider must observe Children in care each day at the time of arrival and
throughout the Child's stay for obvious signs of illness such as fever,
diarrhea, vomiting, or skin rashes. In the event of an apparent illness of a
Child, the Provider must comply with the guidance in the manual described in
Section
14(C)(1) below.
When a Provider knows or suspects that a Child has contracted
a notifiable disease or condition, the Provider must notify the Maine Center
for Disease Control and Prevention (MECDC). The Provider must notify the MECDC
immediately by phone for Category 1 conditions, and within 48 hours for
Category 2 conditions. MECDC contacts: Phone: 1-800-821-5821 (24 hours a day);
FAX: 1-800-293-7534 (24 hours a day); or TTY: Maine relay 711 (24 hours a day).
For a list of Category 1 and 2 notifiable diseases and conditions, see 10-144
CMR Chapter 258, Rules for the Control of Notifiable Conditions, Chapter 2(I).
http://www.maine.gov/sos/cec/rules/10/144/144c258.doc
E.
Dismissal of children due to
illness. When a Child becomes ill, but does not require immediate
medical help, the provider must determine if the Child should be sent home. The
provider must notify the Parent/Legal Guardian of the Child who has symptoms
that require exclusion.
F.
Illness, serious injury, incidents, and accidents.
1. The Provider or a Staff Member must
immediately notify the Child's Parent or Legal Guardian of any illness, serious
injury, or Incident involving their Child. An Adult designated by the Parent or
Legal Guardian must be notified immediately should the Parent or Legal Guardian
be unavailable.
2. The Provider
must document all Accidents, injuries, Incidents, or emergencies in the Child's
record on the day of the occurrence and the Parent or Legal Guardian must
review and sign the document within two business days.
G.
First aid. The Provider must
have a first aid kit and a current first aid manual.
1. A complete first-aid kit must be readily
available to the Provider during all Field Trips, and while transporting
Children. A complete first aid kit includes, but is not limited to, adhesive
tape, band aids, gauze pads, gauze roller bandage, disposable gloves, instant
cold pack, scissors, tweezers, thermometer, CPR mask, and antiseptic wipes. The
first aid kit must not contain any expired materials.
2. The first aid kit must be kept in a clean
and sanitary condition, be stored in an easily accessible, designated location
known to all providers, and be kept out of the reach of Children.
H.
Medication
administration. A Provider may give a Child prescription medication only
when the Provider has written, signed, and dated permission from a Parent.
1. The Provider must only give Medication
prescribed for the specified Child, according to the label instructions on the
original container.
2. The Provider
must not give any nonprescription Medications to a Child without written
permission from the Parent. Telephone, text, or email permission is allowed in
emergencies, if the provider documents giving the Medication and obtains
written permission from the Parent as soon as possible.
3. The provider must keep a written record,
noting each time a prescription and nonprescription Medication is given to a
Child.
4. All Medications,
refrigerated or non-refrigerated, must be:
a.
Completely inaccessible to Children,
b. Stored at the proper temperature,
and
c. Discarded upon
expiration.
I.
Handwashing. Handwashing must be done with soap and running water.
The provider must ensure that all Adults and all Children wash their hands in
at least the following circumstances:
1.
Immediately before and after eating snacks and meals, including washing the
hands of all Infants and toddlers before all feedings;
2. After each diaper change or
toileting;
3. Before and after
handling food; and
4. Before and
after administering Medication.
J.
Prevention of exposure to blood and
body fluids. The Provider must take measures to prevent exposure to
blood and other potentially infectious fluids, which may include use of
disposable gloves. When touching blood, body fluids, secretions, excretions,
mucous membranes, or non-intact skin, providers must:
1. Wash their hands after contact, even if
gloves are worn;
2. Ensure safe
waste management by immediately discarding contaminated single use items; and
3. Immediately Clean and disinfect
surfaces and reusable equipment.
K.
Emergency procedures.
Providers must have a procedure for responding to situations when an immediate
emergency medical response is required. Staff-Child ratio must be maintained
during all medical emergencies. Staff Members may be called in as necessary to
maintain the required ratio. Every Staff Member must be trained to manage an
emergency until emergency medical care becomes available.
