Current through Register Vol. 51, No. 19, September 20, 2024
A. Unless a child is temporarily admitted to or retained in care pursuant to §L of this Regulation, the provider shall maintain written records, on forms provided or approved by the office, that meet the requirements of this Regulation for each child admitted to or continuing in care.
B. Each child's written records shall be:
(1) Readily accessible to each staff member providing care to the child; and
(2) Kept on file at the child care home during the period of a child's enrollment and for 2 years after the child's disenrollment.
C. The provider shall obtain and maintain emergency information from the child's parent that:
(1) Includes the child's name and date of birth;
(2) Includes the parent's full name, current address, and telephone contact information;
(3) Includes the name and telephone number of the individual who is authorized to pick up the child each day;
(4) Includes the name and telephone number of at least one individual who is authorized to pick up the child in an emergency;
(5) Includes the name, address, and telephone number of the child's physician or other health care provider;
(6) If the child has a special health condition, includes emergency medical instructions for that condition;
(7) Is signed and dated by the child's parent;
(8) Is updated as needed, but at least annually; and
(9) Is readily accessible to each staff member supervising the child, including during an off-site activity.
D. Unless a parent objects to a child's medical examination because of bona fide religious beliefs and practices, a health assessment of the child shall be provided by the child's parent that:
(1) Includes a parental statement of the child's health status;
(2) If applicable, includes a statement of allergies; and
(3) Includes a medical evaluation, signed and dated by a physician that states the child is medically cleared to attend child care and is based on an examination completed by the physician within the last:
(a) 2 months before admission for a child younger than 9 months old;
(b) 3 months before admission for a child between 9 and 24 months old; or
(c) 12 months before admission for a child 2 years old or older.
E. As required by COMAR 10.11.04, there shall be evidence that the child has received:
(1) An appropriate lead screening for a child younger than 6 years old and born prior to January 1, 2015; or
(2) A lead test at age 12 months and again when the child is 24 months regardless of where the child resides, for any child born on or after January 1, 2015.
F. A medical evaluation and, if applicable, documentation of an appropriate lead screening or test that are transferred directly from another registered child care home, a licensed child care center, or a public or nonpublic school in Maryland may be accepted as meeting the requirements of §§D(3) and E of this regulation.
G. There shall be an immunization record showing that:
(1) The child has had immunizations appropriate for the child's age which meet the immunization guidelines set by the Maryland Department of Health and Mental Hygiene;
(2) The child has had at least one dose of each vaccine appropriate for the child's age before entry and is scheduled to complete the required immunizations;
(3) A registered physician or a health officer has determined that immunization is medically contraindicated according to accepted medical standards; or
(4) The parent objects to the child's immunization because it conflicts with the parent's bona fide religious beliefs and practices.
H. If a parent objects to a child's immunization or medical examination, or both, because of the parent's bona fide religious beliefs and practices, the provider shall require the parent to provide a health history of the child and sign a statement indicating that to the best of the parent's knowledge and belief, the child is in satisfactory health and free from any communicable disease.
I. The provider shall record or maintain on file:
(1) Each incidence of acute illness requiring exclusion of the child from care pursuant to COMAR 13A.18.11.01B;
(2) Each injury or accident required by Regulation .06C and D of this chapter to be reported;
(3) Child medication records required by COMAR 13A.18.11.04D;
(4) If the child requires a modified diet, the prescription from the child's health practitioner or the written instructions from the child's parent, pursuant to COMAR 13A.18.12.02D;
(5) If program activities away from the child care home are provided, prior written permission from the child's parent to take the child to those activities; and
(6) If applicable, documentation that the parent of a child who is 12 months old or older, but younger than 2 years old, has requested a crib for the child's rest periods.
J. Written information about the child's individual needs that is supplied by the parent by the time of the child's admission to care shall be reviewed by the provider and the parent at least every 12 months after the child's admission to care.
K. A provider shall maintain daily records of the amounts and kinds of liquids and solid food consumed by each child younger than 2 years old. These records shall be:
(1) Dated and kept on file for at least 4 weeks;
(2) Available in the area where children younger than 2 years old are fed; and
(3) Made available to the child's parent.
L. Temporary Admission.
(1) A provider may temporarily admit or retain a child in care if the child's parent or guardian is unable to provide the health-related records specified in §§D-H of this Regulation.
(2) For a child to be temporarily admitted or retained in care, the parent or guardian shall present evidence of the child's appointment with a health care provider or local health department to:
(a) Receive a medical evaluation to include, if applicable, a lead screening or test,
(b) Receive a required immunization;
(c) Acquire evidence of age-appropriate immunizations on a form approved by the office; or
(d) Reconstruct a lost record.
(3) The date of appointment, set pursuant to §L(2) of this Regulation, may not be later than 20 calendar days following the date the child was temporarily admitted or retained in care.
(4) A provider shall exclude from care a child who has been temporarily admitted or retained in care if the parent fails to provide evidence of the required medical evaluation, immunization, or health record within 3 business days after the date of the appointment made pursuant to §L(2) of this Regulation.
