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 4002.26 - Rest and Sleep

Universal Citation: NH Admin Rules He-C 4002.26

Current through Register No. 40, October 3, 2024

(a) Child care staff shall arrange cribs, cots, beds, mats, or playpens in a manner that ensures that:

(1) They do not block passageways and exit routes, to allow for emergency evacuation and access to each child by staff;

(2) They are spaced at least 2 feet apart while in use or separated by a solid divider on one side only, allowing for adequate supervision by staff and air circulation; and

(3) Children are placed head to toe.

(b) Full day child care programs shall provide a sleeping bag, crib, cot, bed, or mat for each child requiring a rest.

(c) Each child 12 months of age and younger shall be placed on their back to sleep in an individual crib or play pen.

(d) Child care staff shall discontinue using cribs or play pens with infants who have demonstrated the ability to climb out of them.

(e) No crib shall be used unless manufactured on or after June 28, 2011, or if manufactured prior to that date, has a Children's Product Certificate (CPC), or test report from a consumer product safety commission (CPSC) accepted third-party lab, provided by the manufacturer documenting the crib's compliance with 16 CFR 1219 as required by 16 CFR 1219 and 1220.

(f) Cribs and play pens required under (c) above shall:

(1) Not be stacked;

(2) Be free of cracked or peeling paint, splinters, and rough edges;

(3) Have no more than 2(3/s) inches between slats;

(4) Have no missing, loose, broken, or improperly installed parts, screws, brackets, baseboards, or other loose hardware, or damaged parts on the crib or mattress supports;

(5) Not have corner posts that extend more than 1/16 of an inch above the end panels;

(6) Not have holes or tears in the mesh walls or in the material that connects the walls to the bottom of the crib or play pen;

(7) Have fitted sheets designed for the size mattress, including elastic corners so that there is no excess fabric with visible folds or bunching, and that do not compress the mattress;

(8) Not have bumper pads, blankets, flat sheets, pillows, quilts, comforters, sleep positioners, or any soft items or toys with infants up to 12 months of age; and

(9) Have mattresses which are in good repair, free of rips or tears, and fit the crib or playpen so that the space between the mattress and crib or playpen is not more than 2 adult fingers wide and does not create a suffocation hazard.

(g) Pursuant to He-C 4002.33(b)(3), all child care staff in programs licensed for children 12 months and younger shall complete training on safe sleep practices prior to working with infants.

(h) Infants up to 12 months shall not nap or sleep in a car safety seat, beanbag chair, bouncy seat, infant seat, swing, jumping chair, highchair, chair, futon, moses basket, or any other type of furniture or equipment that is not a play pen or crib that meets the requirements of (f) above.

(i) If an infant up to 12 months falls asleep outside of their crib or play pen, including entering the program asleep in a car safety seat, staff shall immediately move the infant and place him or her on their back in a crib or play pen.

(j) When child care staff place infants in their crib or play pen for sleep, they shall check to ensure that the temperature in the room is comfortable for a lightly clothed adult, check the infants to ensure that they are comfortably clothed and not overheated or sweaty, and that bibs and garments with ties or hoods are removed.

(k) Children older than 3 months shall not be swaddled or placed in restrictive or weighted sleep suits or devices unless there are written medical orders from the child's primary health practitioner.

(l) In family and family group child care homes, use of an electronic monitor shall only be used to monitor sleeping children on the same level in lieu of direct supervision, in accordance with the following:

(1) There is written authorization on file from the parents of the child, indicating that they are aware of and agree to the use of the monitor;

(2) The child care staff responsible for their supervision can easily hear sounds from the monitor and respond; and

(3) Every 15 minutes, the child care staff responsible for their supervision conduct in-person checks of infants and toddlers sleeping in a crib or playpen, to ensure that each child is safe and comfortable, including a check of their faces, viewing the color of their skin and to check on their breathing.

(m) In center-based programs, use of an electronic monitor, whether only audio or both audio and visual, shall be permissible in lieu of having staff in the same room with infants and toddlers sleeping in cribs or playpens, in accordance with the following:

(1) There is written authorization on file from the parents of the child, indicating that they are aware of and agree to the use of the monitor;

(2) The child care staff responsible for their supervision are located in an adjoining room where they can easily hear sounds from the monitor and respond; and

(3) Every 15 minutes, the child care staff responsible for their supervision conduct in-person checks of infants and toddlers sleeping in a crib or playpen, to ensure that each child is safe and comfortable, including a check of their faces, viewing the color of their skin and to check on their breathing.

(n) Blankets, sleeping bags, bedding, cots, and mats shall be stored in a manner that ensures that sleeping surfaces are not touching, or the items shall be washed and sanitized before re-use if stored in a way that sleeping surfaces are touching.

(o) All bedding shall be cleaned at least once a week and more frequently if soiled.

(p) Programs shall provide children who attend for more than 5 hours with an opportunity for at least one hour of rest, relaxation, or sleep depending on the needs of each child.

(q) Programs shall consult with the parents of each child and observe children on an ongoing basis to determine each child's resting or napping needs.

(r) Programs shall accommodate the individual sleeping patterns of infants and other children who are unable to adjust to a scheduled nap or rest time.

(s) Programs shall allow children who are able to adjust to a scheduled nap or rest time to fall asleep and awaken at their own pace within a block of time set aside as nap or rest time.

(t) Programs shall provide children who do not fall asleep after 30 minutes with an opportunity to do a quiet activity.

(u) Child care staff shall not:

(1) Require that children who are awake stay on mats, sleeping bags, cots, or beds for more than 60 minutes; or

(2) Require children to sleep.

(v) For children 24 months through 5 years, during naptime, a center-based program may have one less staff person in a classroom than required to meet ratios in accordance with He-C 4002.36 through He-C 4002.38 provided that:

(1) The total number of child care staff required to maintain all ratios are on the premises of the program;

(2) The ratio of awake children to staff in the classroom shall be no more than half the number of children as stated in He-C 4002.36 through He-C 4002.38;

(3) Rooms in which staff is reduced shall be equipped with a two-way communication system to allow for immediate contact with other staff for assistance and response; and

(4) There is a safety plan on file for review by the department, child care staff, and parents which includes plans or procedures for:
a. Evacuation;

b. Supervision;

c. Environment;

d. Schedule;

e. Naptime policy; and

f. Staff training and support;

(5) The program provides parents with written notice of the reduction of staff; and

(6) Documentation of the written notice in (5) above, in the form of a posted document, a policy statement that is signed by each parent, or other method of documentation is kept in the child's record for review by department staff during visits.

(w) During rest and sleep, programs shall always maintain ratios for children under 24 months, in accordance with He-C 4002.36 and 4002.37, except as specified in (x) below.

(x) Ratios for children under 24 months in mixed age groups with children 24 months and older shall be based on the average age of the children in each group during naptime, in accordance with (w) above.

(y) Programs shall base the staff to child ratio on the average age of the children in each group in accordance with (x) above when there are mixed age groups in the same room.

(z) No child shall wear a necklace during nap time or during sleep, unless the necklace is fused or has a fixed knot such that it cannot be removed.

#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 (from He-C 4002.28)

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