Nebraska Administrative Code, Chapter 4, Section 391-4-006 - STANDARDS OF OPERATION AND CARE | Nebraska Administrative Code

006.01 Licensee Requirements:

The licensee must:

1. Ensure that the center is administered and managed appropriately;

2. Maintain compliance with all applicable state statutes and school-age-only center regulations;

3. Permit announced and unannounced inspections by agency representatives during the hours of operation;

4. Either manage the day-to-day operations of the center or designate a director who is responsible for the day-to-day management of the center and define the duties and responsibilities of the director in writing; and

5. Ensure that the center has sufficient resources to provide a safe, healthy, and nurturing environment to all children enrolled in the center.

006.02 Director Requirements:

The director is responsible for managing the day-today operations of the school-age-only center. The director must report to the licensee all matters related to the maintenance, operation, and management of the center and be directly responsible to the licensee or to a person delegated governing authority by the licensee. The director must:

1. Be responsible for the center's compliance with rules and regulations;

2. Be within the child care area a sufficient number of hours to permit adequate attention to the management of the center;

3. When not in the child care area, designate another staff to act in his or her absence who will be responsible and accountable for management of the center;

4. Provide written personnel policies and policies and procedures specific to:

a. Job descriptions and responsibilities; and

b. Position qualifications, skills, knowledge, abilities and physical demands of the job.

5. Assess his/her own ability and the ability of all staff to provide care for children with special needs while meeting the needs of other children enrolled;

6. Provide orientation for new staff, including training on school-age-only center regulations;

7. Schedule training and continuing education for all staff and ensure that records are maintained including the date, topic, and length of time for each training entry;

8. Ensure that center staff identify and review incidents, accidents, complaints, and concerns, and monitor patterns and trends in overall operation and take action to alleviate problems;

9. Develop and implement written procedures that require the reporting of any evidence of physical abuse, neglect, or sexual abuse of any child in care at the school-age-only center;

10. Immediately file a report with the Child Abuse-Neglect Hotline ( 1-800-652-1999) and/or appropriate local law enforcement agency when s/he has reason to believe child abuse, neglect or sexual abuse may be occurring in the school-age-only center, in the child's home, or elsewhere, or ensure that a report is filed;

11. Not knowingly allow any individual who is a registered sex offender on the premises, except that a parent who is a registered sex offender may be allowed on the premises only to pick up and drop off his/her child;

12. Ensure that the maximum capacity of the school-age-only center is not exceeded at any time;

13. Ensure that staff-to-child ratios are met at all times;

14. Ensure that parents have access to their children at all times that children are in care; and

15. Develop and use written criteria to assess the ability of staff to give or apply medication safely.

006.03 Background Checks, Health Information, and Employment Limitations:

4-006.03A Criminal History Record Check: The applicant/licensee, if an individual or an individual in a partnership, must complete a pre-employment criminal history record check on him/herself, on each staff member and volunteer age 19 or older, and on each household member age 19 or older if the center is located in a private residence. Documentation must be kept and available for review by the Department.

The check must be conducted through the Nebraska State Patrol or through one or more local law enforcement agencies, as appropriate to the individual's residence(s). If an individual has lived in Nebraska less than 12 months, the applicant/licensee must obtain documentation of a criminal history record check from the previous state(s) of residence.

4-006.03A1 Permanent Child Care Disqualification: An individual is permanently disqualified from holding a child care license or working as a staff member or volunteer in a school-age-only center if s/he has a criminal history that includes conviction of any unlawful act endangering the health or safety of another individual. Such convictions include crimes against a child or vulnerable adult, crimes involving intentional bodily harm, crimes involving the sale, distribution or procurement of a controlled substance, or crimes involving moral turpitude on the part of the individual. These crimes include, but are not limited to:

1. Aggravated or armed robbery;

2. Assault, first or second degree;

3. Child abandonment;

4. Child abuse;

5. Child molestation or debauching a minor;

6. Child neglect;

7. Commercial sexual exploitation of a minor;

8. Domestic violence;

9. Exploitation of a minor involving drug offenses or conviction of drug offenses that involved a minor;

10. Felony controlled substances offenses, other than possession;

11. Felony violation of custody;

12. Incest;

13. Kidnapping;

14. Murder, first or second degree;

15. Sexual abuse of a minor;

16. Sexual assault;

17. Sexual exploitation of a minor, including child pornography; or

18. Voluntary manslaughter.

4-006.03A2 Twenty-Year Disqualification: An individual is disqualified from holding a child care license or working as a staff member or a volunteer in a school-age-only center if s/he has a criminal history that includes conviction in the last 20 years of:

1. Arson;

2. Criminal non-support;

3. Felony possession of controlled substance offences;

4. Felony theft; or

5. Robbery.

The 20-year disqualification begins the date the conviction became final. Any time the individual is incarcerated, either in jail or a state or federal correctional facility, is not included in the calculation of the 20-year period of disqualification. If the individual has more than one conviction, the 20-year disqualification begins the date the most recent conviction became final.

4-006.03A3 Five-Year Disqualification: An individual is disqualified from holding a child care license or working as a staff member or a volunteer in a school-age-only center if s/he has a criminal history that includes conviction in the last five years of:

1. Burglary;

2. Driving under the influence: two or more convictions;

3. Felony bad check writing;

4. Misdemeanor controlled substances offenses;

5. Misdemeanor contributing to the delinquency of a child; or

6. Misdemeanor theft.

The five-year disqualification begins the date the conviction became final. Any time the individual is incarcerated, either in jail or a state or federal correctional facility, is not included in the calculation of the five-year period of disqualification. If the individual has more than one conviction, the five-year disqualification begins the date the most recent conviction became final.

4-006.03A4 An applicant, licensee, staff member, volunteer, or household member, must not have had his/her rights as a parent terminated by a Court because of a finding of abuse or neglect of a child or inability to care for a child.

4-006.03A5 Department Determination: An individual may hold a child care license or work as a staff member or a volunteer in a school-age-only center with a pending complaint or indictment or conviction for other crimes if the Department determines the individual has the present character and fitness to work with children. In making this determination the Department may consider the following factors:

1. The age of the individual at the time of the conduct;

2. The recency of the conduct;

3. The seriousness of the conduct;

4. The factors underlying the conduct;

5. The cumulative effect of the conduct;

6. The evidence of rehabilitation;

7. The individual's positive social contributions since the conduct;

8. The individual's honesty in providing information; and

9. The materiality of any omissions or misrepresentations.

The Department may deny or take action against a license if an individual is found to have a criminal history that includes conviction or substantial evidence of committing or permitting, or aiding or abetting another to commit, any unlawful act endangering the health or safety of another individual or a history of convictions or behavior that shows an inability or unwillingness to comply with laws or regulations. This applies to the applicant/licensee, household members who reside at the place where the child care program will be/is provided, volunteers, and employees of the applicant/licensee.

4-006.03B Registry Checks: The applicant/licensee, if an individual or an individual in a partnership, staff, volunteers, and household members if the center is located in a private residence, must not be listed as a perpetrator of abuse or neglect on the Nebraska:

1. Child abuse/neglect central register, if the individual is age 13 or older;

2. Adult protective services (APS) central registry if the individual is age 18 or older; or

3. State Patrol sex offender registry.

The individual must provide enough information for an accurate check of the registries and must authorize the release of registry information. The Department will conduct the child and adult registry checks and provide the results to the applicant/licensee.

The applicant/licensee must conduct the State Patrol sex offender registry check. All registry checks must be completed before the individual assumes responsibility for the care and supervision of children.

Any individual who is listed on any of the registries must not be on the premises during the hours of operation, except that a parent listed as a perpetrator may be allowed on the premises only to pick up or drop off his/her child.

4-006.03C Reports of Law Enforcement Contact: The applicant/licensee must complete a Report of Law Enforcement Contact for him/herself if an individual or an individual in a partnership, and must obtain a completed report for each staff member and volunteer age 19 or older and each household member age 19 or older if the center is located in a private residence. The report must:

1. Be updated, signed, and dated annually;

2. Be updated any time one of these individuals is arrested, issued a citation other than a minor traffic violation, or charged with or convicted of any felony, misdemeanor, or infraction;

3. List all previous and pending criminal charges and arrests, both felony and misdemeanor, regardless of prosecution;

4. List any record of felony and/or misdemeanor charges and arrests related to crimes against children;

5. List any record of felony and/or misdemeanor convictions;

6. List any current or past parole or probation status, including diversion or court supervision; and

7. List details, dates, county and state of the contact, arrest, charge, conviction, and disposition, if any.

4-006.03D Notification of Law Enforcement Contact: As soon as the licensee/director becomes aware of the occurrence, s/he must notify the Department of any arrest, misdemeanor ticket other than a traffic violation, pending criminal charges, and any felony or misdemeanor convictions of him/herself, staff, volunteers, or household members if the center is located in a private residence. The licensee/director must request a criminal history record check on the individual within five working days. Failure to notify the Department of law enforcement contacts as described may result in disciplinary action.

4-006.03E Investigations and Repeat Registry Checks

1. Any time the licensee/director has reason to believe that a staff member or volunteer is being or has been investigated for abuse, neglect, or sexual abuse of a child or vulnerable adult, the licensee/director must submit the name of that individual to the Department for a check with the child abuse/neglect or adult protective services registry.

2. Any individual who is under investigation for abuse, neglect, or sexual abuse of a child or vulnerable adult must not be left alone with children until the investigation is completed and the findings are determined.

4-006.03F Health Information Report: The applicant, if an individual or an individual in a partnership, must submit a completed Health Information Report on a form provided by the Department for him/herself as part of the initial application. All staff who are responsible for the care and supervision of children for more than 20 hours per week must complete the report within 30 days of hiring. The Health Information Report must be completed annually.

The Health Information Report must include an assessment by a health professional of the individual and any health conditions that could negatively affect his/her ability to care for children. If the information indicates that the individual has, or has had, a health condition that could negatively affect his/her ability to care for children, the Department may request additional information.

006.04 Director Qualifications:

The director must be at least 19 years of age and of good moral character, and must meet one of the following requirements:

1. Hold a bachelor's degree from an accredited college or university in early childhood education, education or child/youth development;

2. Hold a bachelor's degree from an accredited college or university and at least six credit hours in early childhood education, education or child/youth development;

3. Have an associate degree from an accredited college or university in early childhood education, education or child/youth development;

4. Have a Child Development Associate Credential;

5. Have successfully completed six credit hours or 36 clock hours of Department-approved training in administration, early childhood education, education, or child/youth development. Business courses may be included, not to exceed one-half of the credit or clock hour requirements; or

6. Have a high school diploma or GED and 3000 clock hours of verifiable experience in organized group activities for school-age children as indicated by a positive reference from a former employer or supervisor.

006.05 Teacher Qualifications:

4-006.05A Certificated Teachers: An individual who holds a valid Nebraska Teaching Certificate and who is employed as a staff member or used as a volunteer at a licensed school-age-only center that is on the premises of an accredited or approved school will be considered to have met the qualifications, background checks, health information, and training requirements in these regulations.

4-006.05B Non-Certificated Teachers: To be employed as a teacher in a licensed school-age-only center, an individual who is not a certificated teacher must be at least 18 years of age and of good moral character, and must meet one of the following requirements:

1. Hold a bachelor's degree from an accredited college or university in early childhood education, education or child/youth development;

2. Hold an associate degree from an accredited college or university in early childhood education, education or child/youth development;

3. Have a Child Development Associate Credential; or

4. Have a high school diploma or GED; and

(1) 1500 verified clock hours of experience in organized group activities for school-age children as indicated by a positive reference from a former employer or supervisor; or

(2) Submit a written plan for Department approval to acquire at least three credit hours or 45 clock hours of training in administration, early childhood education, education, or child/youth development, in a period not to exceed six months. The licensee must maintain a copy of the written plan and Department approval for Department review.

006.06 Substitute, Support Staff, Volunteer, and Parent Helper Qualifications:

1. The director may hire substitute staff. The substitute must meet the age requirement for the position s/he is assuming and be of good moral character. If the substitute works over 20 hours per week and is counted in the staff-to-child ratio, the substitute must meet the staff requirements for the position s/he is assuming.

2. The director may hire support staff to assist in the care of children. Support staff must be at least 16 years of age and be of good moral character. A teacher must be in the room with support staff at all times when children are in care.

3. The director may use volunteers and uncompensated parent helpers. Volunteers and uncompensated parent helpers are not counted in the staff-to-child ratio. Volunteers and uncompensated parent helpers must be supervised by the director or a teacher at all times and must not be left alone with any children other than their own.

006.07 Director Orientation and Training:

When a new center director is employed, that individual must complete Department-approved director orientation within 30 days of starting employment. The director must also complete:

4-006.07A Safety Training: The director must complete training developed by the Early Childhood Training Center on child abuse/neglect and reporting. Any proposed equivalent training must be approved by the Department.

1. In centers licensed on or after the operative date of these regulations, the director must complete the training within three years of the date of provisional licensure and every five years thereafter.

2. In centers licensed before the operative date of these regulations, the director must complete the training within three years of that operative date and every five years thereafter.

3. This training counts toward the annual training requirement.

006.08 Teacher Training:

The licensee must ensure that teachers employed at the center complete the following training:

4-006.08A Safety Training: Teachers must complete training developed by the Early Childhood Training Center on child abuse/neglect and reporting. Any proposed equivalent training must be approved by the Department.

1. Beginning three years after the operative date of these regulations, 50% of all teachers employed by the center must have completed this training.

2. This training counts toward the annual training requirement.

4-006.08B Evidence of Teacher Training: The director must maintain a list of all teachers for each calendar year that identifies which individuals have completed:

1. Orientation training;

2. Safety training;

3. Clock hours of annual training; and

4. CPR and First Aid training.

006.09 Staff and Volunteer Orientation and Training:

4-006.09A Orientation: When new staff or volunteers are employed, those individuals must be provided with orientation prior to their having direct responsibility for the care of children. The orientation must include:

1. Job duties and responsibilities;

2. Infection control practices including proper hand washing techniques, personal hygiene, and disposal of infectious material;

3. Information on abuse, neglect and sexual abuse of children and the state's reporting requirements;

4. School-age-only center regulations;

5. Evacuation plans in the event of fire;

6. Safety plans in the event of a tornado;

7. Emergency preparedness in the event of a natural or man made disaster; and

8. The center's method of interacting with children and discipline policies.

4-006.09B Nutrition and Food Safety Training: When meals are served, all staff responsible for menu planning, food preparation, and food safety must be provided at least four clock hours of training in nutrition and food safety within 30 days of employment and annually thereafter.

4-006.09C Transportation Training: Individuals who transport children on behalf of a school-age only center must:

1. Receive and maintain a valid certificate of completion of the "Safe Kids Buckle Up" program within 90 days of employment and every five years thereafter. Individuals who transport children who were employed before the operative date of these regulations must receive and maintain a valid certificate of completion for "Safe Kids Buckle Up" within one year and every five years thereafter. Any proposed equivalent training must be approved by the Department.

2. Maintain valid certificates for Cardiopulmonary Resuscitation (CPR) and First Aid Training. Individuals who transport children who were employed before the operative date of these regulations must complete CPR and First Aid Training within one year and maintain valid certificates thereafter.

4-006.09D Annual Training: Each staff member, not including substitutes or volunteers, who provides direct care to children must obtain a minimum of 12 clock hours of training annually. Staff who work 20 hours or less each week must complete six hours of training annually.

4-006.09D1 Training must include but is not limited to the following topics:

1. Safe Environments;

2. Healthy Environments;

3. Learning Environments;

4. Physical Development;

5. Cognitive Learning;

6. Communication;

7. Creative Learning;

8. Self-Esteem;

9. Social Development;

10. Guidance;

11. Family Relationships;

12. Program Management; and

13. Professionalism.

Audio, video, and reading material specific to one or more of these training topics will count toward the annual training requirement only if an Independent Learning Summary is completed on a form provided by the Department. The actual length of audio and video material will be counted, and 50 pages of text will be considered equal to one clock hour of training.

Two hours of CPR and one hour of First Aid will be counted toward the annual training requirement in the year each is taken.

4-006.09D2 Each clock hour spent participating in any of the following types of activities counts toward the annual training requirement:

1. Center-sponsored training;

2. Workshops and conferences;

3. College courses;

4. Non-credit course work; and

5. Adult education courses.

4-006.09E CPR and First Aid Training

1. CPR training must be obtained from an entity that has been approved by the Nebraska Board of Emergency Medical Services. The Department will provide the program with information about approved CPR courses.

2. At least one staff member with current CPR and First Aid training must be on the premises at all times during the hours/days of operation.

3. The CPR card and documentation of First Aid training must be available upon request.

006.10 Employee Records Requirements:

The licensee must ensure the following employee records are maintained, updated as needed, and made available to the Department upon request. Records must be maintained for at least one year after an employee leaves the center.

4-006.10A Staff: Records for all staff, except substitutes and volunteers, must include:

1. Name;

2. Address and telephone number;

3. Social Security Number;

4. Date of hire/termination;

5. A completed Report of Law Enforcement Contact;

6. Documentation of a criminal history record check;

7. A completed Health Information Report;

8. Documentation of Nebraska registry checks with no adverse findings;

9. Documentation that the individual has met the qualifications for the position;

10. Documentation of orientation training and required ongoing training; and

11. Documentation that the individual has read and understands these regulations.

4-006.10B Substitutes: Records for each substitute must include:

1. Name;

2. Address and telephone number;

3. Social Security number;

4. A completed Report of Law Enforcement Contact;

5. Documentation of a criminal history record check;

6. Documentation of Nebraska registry checks with no adverse findings;

7. Documentation that the individual has met the qualifications for the position; and

8. Documentation that the individual has read and understands these regulations.

4-006.10C Volunteers: Records for each volunteer must include:

1. Name;

2. Address and telephone number;

3. Start date;

4. A completed Report of Law Enforcement Contact;

5. Documentation of Nebraska registry checks with no adverse findings; and

6. A written schedule that includes the hours and days of the week the individual serves as a volunteer.

006.11 Child's Record:

A Child's Record must be completed before the child's enrollment. The record must be kept current and available for review upon request by the Department. A Child's Record form may be used or a form may be created and must contain the following information for each child:

1. Name of child;

2. Birthdate of child;

3. Enrollment date;

4. Date care ceased, if applicable;

5. Parent or guardian's home address and telephone number;

6. Parent or guardian's employment address and telephone number;

7. Individual to whom the child may be released by the caregiver;

8. Individual who will take responsibility for the child in an emergency when the parent or guardian cannot be reached;

9. Consent to contact a physician in an emergency;

10. Current health status of the child; and

11. List of child's allergies and intolerance to food, insect bites, or stings, or other factors that result in a medical reaction, and clear instructions in the event of an exposure to the factor.

006.12 Parent Information Brochure:

At the time of enrollment, the licensee must give the parent(s) of each enrolled child a Parent Information Brochure provided by the Department. The licensee must maintain receipts signed and dated by the parent and make the receipts available for review by the Department.

006.13 Description of Center Services and Policies:

The licensee must ensure that the school-age-only center has a written description of center services and written policies, and that they are available to the Department. Copies of both must be given to all staff and the parents of all enrolled children, except that the center is not required to give parents the center's personnel policies. The licensee must maintain receipts signed and dated by the staff and parent and make the receipts available for review by the Department.

4-006.13A Description of Services: The center must have a written description of the range of services available. The written description must include:

1. Ages of children served;

2. Days and hours of operation;

3. A description of the center's child development program;

4. Special services provided;

5. What is expected of parents;

6. Name, address, and phone number of the center's owner or authorized representative; and

7. Information provided by the Department that describes how regulations can be accessed, how child care licensing staff can be contacted, and how complaints can be made.

4-006.13B Center Policies: The center must have written policies on:

1. Exclusion of ill children;

2. Conditions for suspending and terminating care;

3. Fees/contract information for parents;

4. Verifying the identification of individuals approved to remove children from the center;

5. Parent grievances, questions, or concerns; and

6. Personnel policies, including:

a. Staff qualifications;

b. Staff training requirements;

c. Staff discipline procedures; and

d. Staff immunization and exclusion of ill staff.

006.14 Licensed Capacity, Staffing Requirements, and Staff-to-Child Ratio:

4-006.14A Licensed Capacity: The number of children in care at any one time must not exceed the center's licensed capacity. Licensed capacity will be determined by the Department based on available space and the capacity authorized by the State Fire Marshal or delegated authority. Whichever number is smaller will be the licensed capacity of the center.

In determining whether the licensed capacity has been exceeded, any children over age 13 receiving care for compensation and any adults receiving care and supervision are included in the count. All children are counted except:

1. Children who have left the center for an activity and will not be returning that day; and

2. Children who are enrolled in the center and in attendance at school.

4-006.14B Staffing Requirements

1. All staff must be awake and alert to the needs of the children at all times, including napping/sleeping times.

2. Each room where children are receiving care must have a teacher who is involved with the direct care of children.

3. During naptime, at least one teacher must be in the room where children are napping, as long as the staff-to-child ratio is maintained center-wide.

4. At least two staff members must be on the premises at all times, except when the number of children in care is 15 or fewer.

4-006.14C Staff-to-Child Ratio: The center must maintain accurate staff and daily attendance records to verify compliance with staff-to-child ratios. Compliance with staff-to-child ratios is determined on a center-wide basis. Only staff involved in the direct care of children are counted. The following staff-to-child ratio must be met at all times.

Age of Children	Number of Children in Care	Number of Staff Required
School-age	15	1

006.15 Communicable Diseases:

The Department will provide the center with information about communicable diseases to assist the center in carrying out its responsibilities.

4-006.15A Notification to Parents: The licensee/director must notify parents of all enrolled children of any case of any reportable communicable disease on the same day the licensee is informed of or observes the illness, unless otherwise directed by the health authority. The health authority is the local health department for the area. Proper notification includes:

1. Notification to parents of children in attendance;

2. Notification to parents of enrolled children who are not in attendance on that day; and

3. Posting notice of the outbreak in a conspicuous place.

4-006.15B Confidentiality: Names of ill children must not be released to anyone except health authorities, unless parents have given their permission.

4-006.15C Health Authority: The center must follow all directives given to the licensee by the health authority in the event of a communicable disease outbreak.

006.16 Children Excluded Due to Illness:

The center must have a written policy that identifies the circumstances under which children would be excluded from child care due to illness. To assist in writing the policy, the Department will provide the licensee with materials that will include recommendations on:

1. Exclusion based on specific conditions such as fever, diarrhea, vomiting, etc.; and

2. Exclusion based on specific contagious and infectious diseases such as chickenpox, measles, mumps, etc.

The center must enforce its own exclusion policy and make it available to the Department and to the parents of enrolled children.

006.17 Immunizations:

If a school-age-only center is located on the premises of a school and the staff have access to the school's child immunization records, copies of immunization records are not required.

For all other centers, within 30 days of a child's enrollment, the licensee/director must obtain a copy of the child's immunization record. Immunization records must be available for review upon request by the Department and updated each time the child receives additional immunizations. Each child's immunization record must include:

1. Documentation of age-appropriate immunization;

2. Certification by a physician, advanced practice registered nurse, or physician assistant that immunization is not appropriate for a stated medical reason; or

3. A written statement that the parent or guardian does not wish to have the child immunized and the reasons for that decision.

006.18 Supervision of Children:

Adequate and appropriate supervision must be provided to children at all times children are in attendance, including during outdoor play. Ultimate responsibility for supervision rests with the licensee.

4-006.18A Permission for Off-Premises Supervision: The licensee must ensure that parents are informed and give written permission when children will be outside the premises of the center and supervised by center staff. Written permission must be available to the Department on request.

4-006.18B Permission for Child to Leave Premises: If children participate in activities that are not provided or supervised by center staff and are outside the premises of the center, the licensee must ensure written permission is obtained from the parent. The written permission must be available to the Department upon request and must indicate the following:

1. The parent gives permission for their child(ren) to leave the center premises; and

2. The parent understands the licensee is not responsible for supervision while children participate in activities outside the center premises or outside the supervision of center staff.

006.19 Discipline:

When parents are not present, the responsibility for the discipline of children in care lies only with the licensee/director or the designated substitute.

4-006.19A Prohibited Forms of Discipline: The following actions are prohibited as a form of discipline:

1. Spanking;

2. Slapping;

3. Pinching;

4. Punching;

5. Shaking;

6. Striking with any object;

7. Use of soap, hot sauce, or other unpleasant food and non-food items;

8. Isolating a child in a locked or closed room or closet;

9. Handling roughly;

10. Biting;

11. Denial of food;

12. Forced napping;

13. Subjecting children to derogatory remarks about the child or the child's family;

14. Abusive or profane language directed at children;

15. Yelling or screaming at children;

16. Threats of physical punishment; or

17. Mechanical restraints.

4-006.19B Child Behavior That Cannot Be Disciplined: Children must not be disciplined for:

1. Toileting accidents;

2. Refusal to take medication; or

3. Refusal to eat.

4-008.19C Use of Time Out: Separation from the group, if used, must be brief and appropriate for the child's age. The time out period must:

1. Take place within a safe, lighted, and well-ventilated area;

2. Occur within direct vision of staff; and

3. Not exceed more than one minute for each year of the child's age. If the time a child spends in time out is extended, it must be carried out as indicated by a behavioral management plan developed and monitored by a licensed or certified professional qualified to identify the special needs of a child, as having a physical, emotional, or social developmental delay or impairment.

4-006.19D Use of Physical Hold: Center staff may restrict a child's movement by the use of a physical hold. A physical hold may be used only:

1. When the child is hurting him/herself, others, or property;

2. When the hold does not prevent the child from breathing or speaking; and

3. Until the child is calm and able to demonstrate reasonable control of his/her behavior.

4-006.19D1 Notification and Documentation: The licensee/director must notify the child's parents within 24 hours of the physical hold when a physical hold is used on their child. Written documentation of each use of a physical hold must be available for review by the parents of the child involved in the physical hold and the Department. The documentation must include:

1. Child's name;

2. Date of the incident;

3. Description of the incident; and

4. Names of the staff involved.

4-006.19E Use of Restraints: The use of restraints is prohibited except under the following conditions:

1. All staff who participate in restraining a child must have received prior training in de-escalation and the use of restraints;

2. The training curriculum must be accepted by the Department;

3. The training must be taught by a certified trainer; and

4. Written documentation of each use of restraint must be available for review by the parents of the child involved in the restraint and the Department. The documentation must include:

a. Child's name;

b. Date of the incident;

c. Description of the incident; and

d. Names of the staff involved.

006.20 Prohibited Language, Materials, and Actions:

Children of any age must not be exposed to:

1. Profanity used by staff;

2. Sexually explicit material;

3. Acts of violence toward a person or animal; or

4. Acts of racism.

006.21 Child Development Program:

The licensee must provide an age-appropriate program designed to promote the cognitive, social, emotional, and physical development of children in care. Information about the program must be given to parents and the Department upon request. The program must include:

1. Indoor activities;

2. Outdoor activities;

3. Rest periods and other quiet times;

4. Opportunities for individual and group times;

5. Opportunities for children to read and explore books;

6. Opportunities for socialization; and

7. Fostering language and social development by talking and interacting with children and modeling appropriate language and behavior.

4-006.21A Children's Equipment and Materials: The licensee must provide a sufficient number of age-appropriate equipment and reading materials so that, at any one time, each child can be individually involved.

1. Equipment/materials and reading material must be offered to children; and

2. Equipment/materials and reading material must be replaced as needed.

4-006.21B Sleeping Surfaces: When children nap or sleep at the center, the licensee must ensure that appropriate sleeping surfaces are available for each child in care. Acceptable sleeping surfaces for school-age children are:

1. Beds;

2. Cots;

3. Sofas;

4. Washable sleeping bags; and

5. Waterproof mats which must be at least one inch thick and at least 45 inches long.

006.22 Wading and Swimming Activities:

Children must be accompanied, kept safe, and adequately supervised during wading and swimming activities while in care.

4-006.22A Prohibited Water Sources: Children must not be allowed to use the following water sources for swimming or wading activities:

1. Natural bodies of water;

2. Hot tubs, spas or saunas;

3. Livestock tanks; or

4. Decorative ponds.

4-006.22B Wading: If the licensee allows children to participate in wading or other water play activities:

1. Children must be accompanied and directly supervised; and

2. The licensee must ensure that the wading pool is drained and sanitized daily and is inaccessible to children when not in use.

4-006.22C Permission for Non-Center-Supervised Activities Off the Premises: If the licensee does not allow children to participate in swimming activities while in care, but a parent requests that their child leave the premises to go to a swimming pool, the licensee must obtain a written and signed statement from the parent that is kept on file on the premises and available to the Department upon request. The statement must indicate that the child is allowed to leave care and must acknowledge that the licensee is not responsible for supervision.

4-006.22D Permission for Center-Supervised Activities Off the Premises: If the licensee allows children in care to participate in swimming activities under the supervision of center staff but off the center's premises, the licensee must obtain a written, signed, and dated statement from the parent that is updated annually. The statement must be available to the Department upon request, and must indicate the following:

1. The parent gives permission for their child(ren) to leave the center's premises for swimming/wading;

2. The location of the pool where the child is allowed to swim; and

3. Whether the child is allowed to swim in water over his/her head.

4-006.22E Licensure of Swimming Pools: The licensee must ensure that swimming pools off the center's premises where children are taken are licensed by the Department.

4-006.22F Water Safety

1. When a swimming or non-portable pool is in use (except in the case of organized swimming lessons), the staff-child ratio in 4-006.22H3 must be maintained:

2. When the depth of a pool's water is over four feet, the licensee must ensure that someone who has satisfactorily completed a swimming water safety course is on duty at all times children in care are at the pool.

4-006.22G Pool on the Premises Not Used by Children in Care: The licensee must meet the following requirements if an above-ground or in-ground swimming pool is on the premises that children in care are not allowed to use:

1. The pool must be enclosed with a fence that is at least four feet high and flush with the ground;

2. Above-ground pools must have non-climbable side walls;

3. When a pool is covered, the cover used must be the manufacturer's recommended cover;

4. Equipment needed to rescue a child or adult must be readily accessible; and

5. Children must be accompanied and directly supervised if the pool is located in the outdoor play area.

4-006.22H Pool on the Premises Used by Children in Care: If children in care are allowed to use a pool on the premises, the licensee must meet the requirements in 4-006.22G and:

1. Have a permit issued by the Department;

2. If the depth of the water is over four feet, an individual who has satisfactorily completed a swimming water safety course must be on duty at all times children are at the pool; and

3. Maintain the following staff-to-child ratios:

Number of Children	Number of Staff Required
School-age	6	1

006.23 Transportation:

When transportation is provided for children in care, the licensee must ensure the following conditions are met:

1. No child must ever be left alone in the vehicle;

2. Smoking is prohibited in the vehicle used to transport children;

3. All doors on the vehicle must be locked when the vehicle is in motion;

4. Any individual who transports children must be at least 18 years of age, and must possess a current and valid driver's license for the type of vehicle used to transport children, as verified by the Department of Motor Vehicles;

5. The vehicle used to transport children must be properly registered and insured, and must contain a first aid kit and parent contact information for each child being transported;

6. The number of children transported must not exceed the seating capacity of the vehicle as indicated by the manufacturer;

7. All children transported must be properly secured in the appropriate restraint system as required by Neb. Rev. Stat. §§ 60-6,267 and 60-6,268;

8. All car/booster seats must be federally approved and must be the correct type for the child's age and developmental level;

9. Written permission from parents for the center to transport children must be obtained, kept on file, and made available to the Department;

10. Children must not be transported to any location without the prior knowledge of the parents, except in a medical or other emergency;

11. Children must not be transported to avoid violations of capacity or staff-to-child ratio;

12. School-age children only may be transported with no staff in addition to the driver;

13. School-age children only may be transported in buses over 10,000 pounds, unless the bus is equipped with and the children are properly secured in the appropriate restraint system as required by Neb. Rev. Stat. §§ 60-6,267 and 60-6,268; and

14. The center must have a written transportation policy that is given to all staff who transport children and is available to parents and the Department upon request. The transportation policy must describe:

a. Restraints and safety equipment;

b. Procedures to ensure children are never left alone in a vehicle at any time; and

c. Emergency procedures in the event a child becomes ill, the vehicle breaks down or is involved in an accident, or other emergencies.

006.24 Medications:

The licensee must ensure the following conditions are met when center staff give or apply medication.

4-006.24A Giving or Applying Medication: Any staff who gives or applies medication must do so in accordance with the "Five Rights" as set out in the Medication Aide Act. The Five Rights are:

1. The right drug;

2. The right recipient;

3. In the right dose;

4. By the right route; and

5. At the right time.

4-006.24B Competence to Give or Apply Medication: Parents or any licensed health care professional are responsible for determining if center staff are competent to give or apply medication. Any licensed health care professional, as directed by the prescribing health professional, is competent to give or apply medication under any circumstances as long as it is within the scope of practice of that health care professional. The center director has the responsibility to assess the ability of staff to give or apply medication.

4-006.24C Confidentiality: Any staff who gives or applies medication must not disclose information about a child's medication or physical or mental health condition unless such information is needed to protect the health of other children or staff. The use of a posted medication sign-in sheet does not violate confidentiality if the parent has been advised in writing that the parent has the option of using a private method of informing center staff of the child's medication needs.

4-006.24D Written Permission and Instructions: Any staff who gives or applies prescription or non-prescription medication may do so only with prior written permission and written instructions from a parent. Staff must comply with the instructions provided by the parent or inform the parent the medications will not be given or applied.

1. Any error in the giving or applying of medication must be reported to the parent.

2. The dosage must not exceed that which is printed on the label.

3. Expired medication must not be given or applied to a child and must be returned to the parent or destroyed.

4-006.24E Unusual Circumstances: The licensee must obtain a written statement from the licensed health care professional who prescribed the medication allowing center staff to give the medication when:

1. Any prescription medication is given or applied as needed (PRN); or

2. By a route other than oral, topical, inhalant, or instillation.

The written statement must describe the route and what symptoms need to exist in order for the medication to be given or applied.

4-006.24F Hand Washing: All individuals must properly wash their hands before giving or applying any medication. If handling any bodily fluids is involved, individuals must properly wash their hands after giving or applying medication.

4-006.24G Storage: All medications must be kept in proper storage. This includes:

1. All prescription and non-prescription medications must be kept in locked storage at all times children are in care;

2. Separate locked storage must be provided for medications requiring refrigeration;

3. All medications must be kept in the original container and stored according to instructions, clearly labeled for a named child, and returned to the parent when no longer needed; and

4. Over-the-counter, non-toxic topical ointment such as lip balm, petroleum jelly, sun block and diaper ointment must be kept out of the reach of children.

4-006.24H Record-Keeping: The licensee/director must maintain a record as to the time and amount of medication given or applied.

4-006.24I Children Taking/Applying Medication: With written permission of the parent, a school-age child may take or apply his/her own medications at the direction of the parent who is responsible for direction and monitoring.

006.25 Food Service:

The licensee must ensure that meals and snacks that are appropriate to the needs of the children in care are served to all children in attendance. Weekly menus must be given to parents upon request. Meals and snacks must:

1. Be appropriate to the age and development of the child;

2. Address children's allergies and food intolerance; and

3. Meet established USDA requirements regarding food groups and serving sizes. Meals and snacks provided by parents must be supplemented if USDA requirements are not met. If the child's meals are not to be supplemented due to dietary concerns, a statement from a physician must be obtained and available indicating it is acceptable for the child to be served a meal that does not meet USDA requirements.

4-006.25A The center must offer at least the following number of meals and snacks, based on how long children are present:

21/2 to 4 hours	One snack
4 to 8 hours	One snack and one meal
8 to 10 hours	Two snacks and one meal
10 or more hours	Two snacks and two meals

006.26 Food Safety:

The licensee must ensure that the center complies with the Food Code whenever food is prepared and/or served on the premises of the center. If the center serves food prepared at another location, the licensee must ensure that the individual or organization preparing the food is in compliance with the Food Code.

006.27 Emergency Preparedness:

4-006.27A Telephone: A working, non-coin operated telephone must be available on the premises at all times. Emergency telephone numbers, including fire, rescue, police (or 911) and Poison Control, must be prominently posted.

4-006.27B Fire and Tornado Drills: Fire and tornado drills must be practiced with the children and staff. Written documentation of drills, including dates conducted, must be kept and available for review by the Department.

1. Fire drills must be completed a minimum of once each month the school-age-only center is operating.

2. Tornado drills must be completed a minimum of four times per year during the months of March through September.

4-006.27C Fire and Tornado Safety Diagrams: Fire and tornado safety diagrams must:

1. Show the layout of the licensed school-age-only center area(s);

2. Be prominently posted and visible in each room where care is provided;

3. Include how the evacuation of children with special needs will be conducted;

4. Include fire evacuation routes; and

5. Include tornado safety locations.

4-006.27D Disaster Preparedness: The licensee must have a written plan that addresses:

1. Evacuating and moving children to a safe location in the event of a fire, tornado, flood or other natural or man-made disaster;

2. Notification of parents of children in care of an emergency;

3. Reunification of parents with their children in the event of an emergency that requires evacuation; and

4. How children with special needs will be safe in the event of a disaster including evacuation and reunification with the parent.

4-006.27E Notification to the Department of Emergencies: The licensee/director must notify the Department within 24 hours or next business day of the following occurrences at the center:

1. The death of a child;

2. Any accident or injury to a child which requires hospitalization or treatment at a medical facility;

3. When a child has been missing, lost, or left unsupervised on or off the premises; and/or

4. An emergency or disaster that results in damage to the School-Age-Only Center or the inability of the licensee/director to comply with regulations.

4-006.27F First Aid Kit: A first aid kit must be available on the premises. It must be inaccessible to children. If any poisons or medications are stored in the kit, it must be kept in locked storage. The kit must contain:

1. Fever thermometer;

2. Soap;

3. Bandages;

4. Sterile gauze pads;

5. First aid tape;

6. Scissors; and

7. Disposable gloves.

006.28 Environmental Services:

The licensee must ensure that child care is provided in a safe, clean, comfortable environment. Every area and building on the same premises used for child care must comply with these regulations.

4-006.28A Housekeeping and Maintenance: The licensee must ensure that the necessary housekeeping and maintenance are provided to protect the health and safety of children in care. The center and grounds must be kept clean, safe, and in good repair.

1. The center and any building on the premises in or around areas where children are present must be kept free of exposed lead-based paint surfaces that are flaking, peeling, or chipped.

2. Rooms, walls, floors, and ceilings must be kept clean, dry, in good repair, and free of odor resulting from sewage, mold, mildew, or other environmental or biological hazards or unsanitary conditions.

3. Heating, ventilation, and lighting in all rooms used for child care must be adequate to protect the health of children.

4. The licensee must equip and maintain the premises to prevent the entrance, harborage, or breeding of rodents, flies and all other insects and vermin. All doors opening to the outside must be self-closing (except sliding doors) and all windows used for ventilation must be screened. The center must have effective screening of all openings to the outside when flies or other flying insects are present.

5. All garbage and rubbish must be disposed of in a manner that minimizes odor and the transmission of infectious diseases, and prevents the attraction of rodents, flies, and all other insects and vermin. This includes:

a. Using containers, both indoor and outdoor, for garbage and rubbish that are watertight, have tight fitting covers, and are fly and rodent proof;

b. Keeping all garbage and rubbish containers clean; and

c. Not burning garbage on the premises.

6. If carpeting is used in a bathroom, it must be removable, washable, and non-shag.

7. Carpeting is prohibited in the food preparation area.

8. In rooms where food is stored or prepared:

a. Walls and ceilings must be smooth, of easily cleanable construction, and finished in a light color; and

b. Walls subject to splash must have a smooth, washable surface.

4-006.28B Maintenance of Materials, Equipment, Fixtures, and Furnishings: The licensee must ensure that materials, equipment, fixtures, and furnishings used in the center are kept clean, safe, and in good repair.

1. The licensee/director must create and follow a process for routine and preventative maintenance of materials, equipment, fixtures, and furnishings so they are kept safe, in good repair, and available to meet the intended use. This includes ensuring no sharp edges, rust, or loose parts.

2. Furniture and equipment must be arranged so as not to interfere with exits.

006.29 Environmental Safety:

The licensee is responsible for maintaining a safe and hazard-free environment to protect the health and safety of children in care.

4-006.29A Smoking: Smoking anywhere indoors in a school-age-only center is prohibited at all times, unless the center is located in a private residence. If the center is located in a private residence, the licensee must ensure that:

1. No one smokes indoors during the hours of operation when one or more children who are not occupants of the residence are present; and

2. Parents are informed before enrollment if the licensee or any household member smokes.

4-006.29B Alcohol and Controlled Substances

1. If the center is located in a private residence, alcohol as defined by Neb. Rev. Stat. § 53-103 must not be consumed in any area used for child care whenever any child in care is present.

2. If the center is not located in a private residence, alcohol as defined by Neb. Rev. Stat. § 53-103 must not be present in any area used for child care during the hours of operation.

3. The unlawful use or possession of controlled substances, as defined by Neb. Rev. Stat. §§ 28-401 to 28-403 and 28-439, is prohibited. Controlled substances that have not been legally prescribed must not be on the premises.

4-006.29C Animals/Pets: The licensee must ensure that any animal at the center does not negatively affect the children. The licensee must:

1. Have all pets examined annually by a licensed veterinarian and have documentation available;

2. Complete all vaccinations recommended by the licensed veterinarian that include, at a minimum, current rabies vaccinations for dogs, household cats, and ferrets, and have documentation available;

3. Have provisions for pet care necessary to prevent the acquisition and spread of fleas, ticks and other parasites;

4. Ensure that no animals are allowed in the food preparation, food storage, or serving areas during food preparation and serving times; and

5. Comply with any state or local law or ordinance relating to the care and ownership responsibilities of pets or specific breeds identified by those laws or ordinances.

4-006.29D Prohibited Animals: Exotic or unusual animals, or any animal that has bitten or attacked anyone without provocation or has been determined by the local health authority to be dangerous, must not be allowed on the premises during the hours of operation.

4-006.29E Other Environmental Safety Requirements

1. Surfaces must be smooth and free of sharp edges, mold, or dirt, and the environment must be kept free of other conditions which may pose a potential risk.

2. All cleaning agents, medications (both prescription and nonprescription), and poisonous materials must be kept in locked storage at all times children are in care. Separate locked storage must be provided for medications requiring refrigeration.

3. All firearms, other potentially hazardous weapons, weapon accessories, and ammunition must not be on the premises of the center, unless the center is located in a private residence.

a. If the center is located in a private residence, all firearms, other potentially hazardous weapons, weapon accessories, and ammunition must be kept in locked storage. Firearms must be unloaded and ammunition must be stored separately from firearms.

4. Electrical outlets within reach of children under age six must be covered with safety caps, ground fault interrupters, or have safety outlets installed.

5. Shared use of the following items is prohibited:

a. Disposable towelettes;

b. Drinking containers, cups, or glasses;

c. Personal care items such as toothbrushes and hair brushes; and

d. Towels and washcloths.

6. The licensee must ensure storage that is:

a. Clean and adequate for all personal items of staff;

b. Clean and adequate for all personal items of children;

c. Covered and waterproof for soiled or wet clothing; and

d. For staff and children's storage, areas separate from where food and medication are kept.

7. Deep freezers that cannot be opened from the inside must be locked or stored in a locked room.

Nebraska Administrative CodeTopic - HEALTH AND HUMAN SERVICES SYSTEMTitle 391 - CHILDREN'S SERVICES LICENSINGChapter 4 - SCHOOL-AGE-ONLY CENTERSSection 391-4-006 - STANDARDS OF OPERATION AND CARE

Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 391 - CHILDREN'S SERVICES LICENSING
Chapter 4 - SCHOOL-AGE-ONLY CENTERS
Section 391-4-006 - STANDARDS OF OPERATION AND CARE