Current through Register Vol. 49, No. 18, September 16, 2024
PURPOSE: This amendment requires group child care
homes and child care centers to implement and maintain written policies
pertaining to safe sleep for children less than one (1) year of age in
accordance with the American Academy of Pediatrics (AAP) recommendations and
provides minimum requirements for the provider's safe sleep
policy.
PUBLISHER'S NOTE: The secretary of state has
determined that the publication of the entire text of the material which is
incorporated by reference as a portion of this rule would be unduly cumbersome
or expensive. This material as incorporated by reference in this rule shall be
maintained by the agency at its headquarters and shall be made available to the
public for inspection and copying at no more than the actual cost of
reproduction. This note applies only to the reference material. The entire text
of the rule is printed here.
(1) The provider shall establish, implement,
and maintain written policies pertaining to the program goals, admission, safe
sleep practices for children less than one (1) year of age, care, and discharge
of children, and shall provide a copy to the parent(s) at the time of
enrollment.
(2) The provider's
infant safe sleep policy shall comply with section
210.223,
RSMo, and shall include, but not be limited to:
(A) The following safe sleep practices:
1. The policy shall list the licensee's
expectations regarding how and when caregivers are to be trained on safe
sleep;
2. A requirement that
children less than one (1) year of age be placed on their backs to
sleep;
3. A requirement that the
facility shall receive a written statement from the infant's licensed health
care provider stating that the infant requires alternative sleep positions or
special sleeping arrangements that differ from those set forth in
19 CSR
30-62.182(2)(C) prior to allowing the
infant to be placed in a sleep position that is not on his or her back;
and
4. Supervision of infants
during nap/sleep times, to include:
A.
Positioning of staff;
B. Lighting
in the nap room;
C. Physical checks
of the child to ensure he or she is not overheated or in distress;
and
D. Prohibitions against the use
of any equipment such as a sound machine that may interfere with the
caregiver's ability to see or hear a child who may be distressed; and
(B) The following
requirements for safe sleep environments:
1.
The policy shall state that cribs and playpens must have a firm mattress and
tight fitting sheets, be free of loose bedding, bumper pads, pillows, and soft
toys;
2. Shall require infants'
heads be uncovered during nap/sleep times;
3. Shall prohibit covering cribs or playpens
with blankets or bedding;
4. Shall
prohibit smoking in the child care home during the hours children are in care;
and
5. Shall require giving the
parent(s) or guardian(s) of each infant in care a copy of the provider's safe
sleep policy upon the child's enrollment.
(3)
The provider shall have available a copy of the Licensing Rules for Group Day
Care Homes and Child Day Care Centers in Missouri and shall advise the
parent(s) at the time of enrollment of his/her child of the availability of the
rules for review.
(4) Only children two (2) years of age and older shall
be accepted for care unless the facility has been specifically licensed to
include infant/toddler care.
(5) If infant/toddler
care is provided in a unit auxiliary to a licensed facility for older children,
the following shall apply:
(A) Placement of a
two (2) year old in either the infant/toddler unit or the unit for older
children shall be determined in consultation with the parent(s); and
(B) The infant/toddler unit shall not care
for children older than two (2) years unless the total number of children in
attendance at the time is four (4) or fewer.
(6) A
child who has a special physical, developmental, or behavioral need shall have
on file an individualized plan for specialized care from a professionally
qualified source.
(7) The provider shall assess his/her ability to
provide care for the special needs child while also meeting the needs of the
other children.
(8) The provider shall develop and implement a
procedure for admitting children which shall include:
(A) A personal interview with the parent(s)
and child to exchange information and arrive at a mutual decision about
admitting a child;
(B) A plan for
continuing communication between the child care provider and the
parent(s);
(C) Discussion of the
plan for providing for the care of the ill child as required by
19 CSR 30-62.192
Health Care;
(D) Discussion of the
parental plan for providing for the care of the school-age child on scheduled
days of school closings; and
(E)
Completion by the parent(s) of the following written information which shall be
on file before the child is accepted for care:
1. All information required by
19 CSR
30-62.222 Records and Reports;
2. Information regarding a child's personal
development, behavior patterns, habits, and individual needs;
3. A diet plan for each infant/toddler signed
by the parent(s);
4. Instructions
for action to be taken if the parent(s) or physician designated by the
parent(s) cannot be reached in an emergency and permission for emergency
medical care;
5. Information
indicating that the child has completed age-appropriate immunizations, is in
the process of completing immunizations, or is exempt from immunization
requirements as defined by
19 CSR 30-62.192
Health Care;
6. Permission for
field trips, transportation to and from school, and other
transportation;
7. Permission for
school-age children to leave the facility to participate in classes, clubs, or
other activities, naming the activity, time of leaving and returning, and the
method of transportation to and from the activity (Permission for regular
activities such as scouting may be given for the entire school term.);
and
8. Acknowledgement by the
parent(s) that-
A. They have received a copy
of the provider's policies pertaining to the admission, care, and discharge of
children;
B. They have been
informed that the Licensing Rules for Group Day Care Homes and Child Day Care
Centers in Missouri are available in the facility for their review;
C. They and the provider have agreed on a
plan for continuing communication regarding the child's development, behavior,
and individual needs;
D. They
understand and agree that the child may not be accepted for care when
ill;
E. They have received a copy
of the provider's safe sleep policy when enrolling children less than one (1)
year of age; and
F. They have been
notified that they may request notice at initial enrollment in or attendance at
the facility or upon request of whether there are children for whom an
immunization exemption has been filed currently enrolled in or attending the
facility.
(9) If care is
provided for children related to the center owner(s) or group day care home
provider, the parent(s) shall complete and sign a form which is supplied by the
department (see
19 CSR
30-61.135) . The form shall be on file at the facility
before children related to the center owner(s) or group day care home provider
are accepted for care, and shall contain the following identifying information:
(A) Each child's name, address, birthdate,
and date of admission;
(B) Each
child's relationship to the center owner(s) or group day care home provider;
and
(C) The parent's(s') name(s),
address(es), and telephone number(s).
(10) If a provider
enrolls children for irregular or intermittent care, all procedures for
admitting children shall be followed. Children enrolled on an irregular or
intermittent basis shall be accepted only by appointment and shall not cause
the facility to exceed its licensed capacity.
(11) After attempts
have been made to meet a child's individual needs, any child who demonstrates
an inability to benefit from the care offered by the child care provider or
whose presence is detrimental to other children may be discharged from the
facility.
(12) Care of a child may be discontinued if the
provider and the parent(s) cannot establish a mutually satisfactory working
relationship.
(13) Parents shall have access to the facility at any
time during child care hours.
*Original authority:210.221.1(3), RSMo 1949, amended 1955,
1987, 1993.
