New Hampshire Code of Administrative Rules
He - Department of Health and Human Services
Subtitle He-C - Commissioner, Department of Health and Human Services
Chapter He-C 4000 - CHILD CARE LICENSING RULES
Part He-C 4002 - NH CHILD CARE PROGRAM LICENSING RULES
Section He-C 4002.20 - Prevention and Management of Injuries

Universal Citation: NH Admin Rules He-C 4002.20

Current through Register No. 40, October 3, 2024

(a) Child care staff shall supervise every child in care at all times.

(b) In center-based programs, staff shall position themselves to:

(1) Be able to hear all children younger than school age at all times, continuously scan the entire environment to know where children are and what they are doing, and be able to physically respond immediately;

(2) Know the whereabouts and activities of all school age children in their care at all times when children are briefly out of sight, such as when transitioning from one area to another or using the bathroom, and shall be able to physically respond immediately;

(3) Allow for visual supervision of all children while children are eating, and shall be able to physically respond immediately to any child that may be choking; and

(4) Know the number of and identity of children in their care.

(d) The only exception to (b)(1) above shall be children 4 years and older may leave the classroom to use a bathroom located on the same level as the classroom, provided that child care staff are aware of each child leaving the classroom to use the bathroom and the level of the building that the bathroom is located on is used exclusively by the child care program.

(e) In family child care homes, family child care providers shall supervise children in accordance with the following:

(1) The family child care provider or family child care worker may step away from the children to meet basic care needs throughout the day so long that:

a. It shall be time limited; and

b. The family child care provider or family child care worker shall be able to hear all children, preschool age and younger, at all times and be able to physically respond immediately, if necessary, with the exception of needing to step away to meet their own basic needs;

(2) The family child care provider or family child care worker shall know the whereabouts and activities of all school age children at all times and shall be able to physically respond immediately;

(3) The family child care provider or family child care worker may allow school-age children 6 years of age and older to play outside when the provider or worker are inside, with written parental permission; and

(4) When children are eating, the family child care provider or family child care worker shall be positioned to allow for visual supervision of all children and shall be able to physically respond immediately to any child that may be choking.

(f) Child care staff shall not carry a child while stepping over a low wall, gate, or other similar barrier.

(g) The program shall obtain the following documents from the parents of each child with a food allergy or other allergy, which results in a serious reaction:

(1) A written care plan that includes instructions regarding food(s) or other allergens to which the child is allergic and steps for child care staff to take to avoid the allergens; and

(2) A written treatment plan, detailing the treatment to be implemented in the event of an allergic reaction, which shall include:

a. The names, doses, and methods of prompt administration of any medications, where the medication needs to be stored in relation to the child, taking into consideration the storage requirements in He-C 4002.21(o)(2), and instructions on how to administer the prescribed medication; and

b. Specific symptoms that would indicate the need to administer one or more medications.

(h) At all times, at least one child care staff supervising a child with an allergy care plan shall have completed the training specified in He-C 4002.33(b)(5).

(i) The program shall post each allergy care plan in accordance with the posting requirements in He-C 4002.14.

(j) All child care staff responsible for food preparation and food service, and all child care staff responsible for supervising children with an allergy, including staff covering breaks, shall read and familiarize themselves with the care plans and treatment plans, to ensure that no child is accidentally exposed to an allergen.

(k) Programs shall be equipped with a telephone that is operable and accessible to all child care staff during all operating hours for incoming and outgoing calls. The phone may be a cellular phone or a landline.

(l) Child care staff shall report any occurrence of a missing child to emergency services, as soon as child care staff have determined that the child cannot be promptly located on the premises of the child care program.

(m) The center director, site director, family child care provider, and all staff used to meet staff to child ratios shall:

(1) Be certified in pediatric cardiopulmonary resuscitation (CPR) and first aid within 90 days of the first date of employment;

(2) Obtain certification in (m)(1) above by the American Red Cross, American Heart Association, Emergency Care and Safety Institute, National Safety Council, or other nationally recognized organization; and

(3) Maintain current certifications required in (m)(1) above.

(n) During all operating hours, on and off premises, there shall be at least one staff person who is trained and currently certified as specified in (m) above, with all children.

(o) CPR and first aid training as specified in (m) above may be received via correspondence or on-line, provided a skill test is required to be performed prior to becoming certified.

(p) Programs shall maintain on file, available for review by the department, copies of current CPR and first aid certificates and licenses.

(q) Programs shall have on the premises and on all field trips, a selection of non-expired first aid supplies adequate to meet the needs of the children.

(r) Programs shall store the first aid supplies required under (q) above in a portable container, in a location that is easily accessible by staff and out of the reach of children if the contents present a danger to children.

#4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (He-C 4002.22 )

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