Current through Register 1531, September 27, 2024
The following requirements apply to all programs, including
family child care, small group and school age and large group and school age
child care. Additional requirements for small group and school age and large
group and school age child care are found at 606 CMR 7.12(15).
(1) The licensee must design and implement a
nutrition program that meets the U.S.D.A. guidelines for the nutritional and
dietary needs and feeding requirements of each child, including those of
children with disabilities.
(2) All
educators must receive basic training in the following:
(a) in USDA recognized nutrition requirements
for the healthy growth and development of children; and
(b) in food choking hazards.
(3) Educators must follow parents'
or physicians' orders in the preparation and feeding of special diets to
children.
(4) Educators must follow
the directions of the parents and /or the child's physician regarding any food
allergies of a child.
(5)
Vitamin Supplements.
(a) Educators must follow the direction of
parents where the administration of over-the-counter vitamin supplements is
required.
(b) All over-the-counter
vitamin supplements must be provided by parents in the original manufacturer's
packaging.
(c) Educators must not
administer any vitamin supplement contrary to the directions on the original
container, unless so authorized in writing by the child's licensed health care
practitioner.
(6) The
licensee must have a method of providing nutritious meals and snacks to
children whose parents fail to send meals and/or snacks from home.
(7) If the licensee provides meals and snacks
for children:
(a) the nutrition program must
serve a variety of nutritious foods;
(b) the licensee must ensure that snacks and
meals are prepared and served in a safe and sanitary manner;
(c) the licensee must ensure that foods are
not served to children beyond their recommended dates of use;
(d) the licensee must store all food in
clean, covered containers;
(e) the
licensee must properly wash and sanitize all bottles, eating utensils, drinking
utensils, dishes, and preparation utensils after each use;
(f) the licensee must prepare and make
available to parents on request written menus, including snacks, for each
week;
(g) the licensee must keep
previous menus on file for one year.
(8) The licensee must provide refrigeration
and storage for food at not less than 32°F, nor more than 40°F for all
food requiring refrigeration. Meals and snacks provided by parents must be
stored safely. Thermometers verifying temperatures must be maintained in all
refrigerators.
(9) Eating and
drinking utensils must be free from defects, cracks and chips and appropriate
to the ages and needs of the children, including children with disabilities.
Disposable cups and plates may be used. If plastic utensils are used, they must
be heavy-duty and if reused, must be designed for this purpose and dishwasher
safe.
(10) Meal schedules must be
appropriate to the ages of the children served.
(a) In programs serving infants and toddlers:
1. A current feeding schedule must be
maintained, documenting use of either breast milk or formula, if applicable,
new foods introduced, food intolerances and preferences, voiding patterns, and
observations related to developmental changes in feeding and
nutrition.
2. Infants and toddlers
must be fed according to their individual feeding schedules or needs.
3. Infants must be held while fed a
bottle.
(b) In programs
serving preschool and school age children:
1.
The licensee must provide regular, nutritious snacks for children in care for
less than four hours;
2. The
licensee must schedule meals, in addition to snacks, for children in care four
hours or longer;
3. The licensee
must offer a nutritious substitute to a child who misses a meal or snack due to
deviations from his regular schedule (such as arriving late or leaving
early).
4. Children must be allowed
to participate in menu planning in an age-appropriate manner.
(11) During meal and
snack times educators must:
(a) be present
interacting with and assisting children;
(b) allow children to eat at a reasonable,
leisurely rate;
(c) encourage
children to serve themselves, when appropriate;
(d) ensure that each child receives an
adequate amount and variety of food;
(e) help children with disabilities to
participate in meal and snack times with their peers;
(f) encourage children to eat a well-balanced
diet;
(g) offer alternative
activities for children who have finished their snack or meal.
(12) Educators must dispose of, or
return to the parent, milk, formula or food unfinished by a child, as directed
by the parent.
(13) The licensee
must provide a source of sanitary drinking water located in or convenient to
rooms occupied by children.
(14)
Educators must offer water to children at frequent intervals and upon request
by children.
(15)
Additional Requirements for Small Group and School Age and Large
Group and School Age Child Care.
(a) The licensee must designate, according to
Department of Public Health (DPH) requirements, one person to be responsible
for the food program. This designated person shall review and approve
menus.
(b) If the licensee provides
food prepared on-site, the licensee must have a Food Service permit or evidence
of inspection from the local health department when required by DPH.
(c) If the licensee provides food that is
prepared off-site, the food must be prepared at a facility that has a Food
Service permit or evidence of inspection from the local health department and
must be transported to the program in appropriate sanitary containers and at
appropriate temperatures.
(d) If
parents provide meals or snacks for children, the licensee must provide to
parents, in writing at the time of admission, a list of nutritious items that
may be part of a lunch or snack. The program must support parent choice
regarding meals to the extent that such choice does not adversely affect a
child's health.
