5.3 Health and Safety Standards for CCDF Providers

Lead Agencies must have health and safety standards for providers serving children receiving CCDF assistance relating to the required health and safety topics as appropriate to the provider setting and age of the children served. This requirement is applicable to all child care programs receiving CCDF funds regardless of licensing status (i.e., licensed or license-exempt). The only exception to this requirement is for relative providers, as defined by CCDF. Lead Agencies have the option of exempting certain relatives from any or all CCDF health and safety requirements. Exemptions for relative providers’ standards requirements will be addressed in question 5.8.1. Describe the following health and safety standards for programs serving children receiving CCDF assistance on the following topics (note that monitoring and enforcement will be addressed in subsection 5.5): 5.3.1 Prevention and control of infectious diseases (including immunizations) health and safety standard a. Provide the standards, appropriate to the provider setting and age of children, that address the prevention and control of infectious diseases for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The District’s child development facility licensing regulation 5A DCMR § 100 addresses the prevention and control of infectious diseases through exclusion policies for children and staff due to illness; requirements for health examinations for children and staff; requirements for hand washing and hand sanitizing for staff, volunteers, and children; and the removal or covering of shoes prior to entering an infant play area to protect infants from hazardous toxins. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The District’s child development facility licensing regulation 5A DCMR § 100 addresses the prevention and control of infectious diseases through exclusion policies for children and staff due to illness; requirements for health examinations for children and staff; requirements for hand washing and hand sanitizing for staff, volunteers, and children; and the removal or covering of shoes prior to entering an infant play area to protect infants from hazardous toxins. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Through the provider agreement, in-home caregivers are required to have a current health certificate for themselves and children in their care and are required to complete mandatory health and safety training, including on prevention and control of infectious disease. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A b. Provide the standards, appropriate to the provider setting and age of children, that address that children attending child care programs under CCDF are age-appropriately immunized, according to the latest recommendation for childhood immunizations of the respective State public health agency, for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The District’s child development facility licensing regulation 5A DCMR § 152 requires evidence of age- appropriate and up-to-date immunizations unless children are subject to a religious or medical exemption. This evidence is typically submitted in the form of a Universal Health Certificate. The District’s Department of Health (DC Health) mandates that each child must be immunized according to the required schedule of immunizations for children by age set forth in 22-B DCMR §§ 130.1 et seq., before entering the facility, unless the child has a religious or medical exemption or is within a 60-day grace period for children experiencing homelessness or children in protective services. OSSE’s licensing regulations require facilities to obtain a Certificate of Immunization Compliance, issued by DC Health, which certifies that the facility has reached the District's immunization compliance target for enrolled children and staff. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The District’s child development facility licensing regulation 5A DCMR § 152 requires evidence of age-appropriate and up-to-date immunizations unless children are subject to a religious or medical exemption. This evidence is typically submitted in the form of a Universal Health Certificate. DC Health mandates that each child must be immunized according to the required schedule of immunizations for children by age set forth in 22-B DCMR §§ 130.1 et seq., before entering the facility, unless the child has a religious or medical exemption or is within a 60-day grace period for children experiencing homelessness or children in protective services. OSSE’s licensing regulations require facilities to obtain a Certificate of Immunization Compliance, issued by DC Health, which certifies that the facility has reached the District's immunization compliance target for enrolled children and staff. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Children in license-exempt in-home care are required to have a current health certificate, which includes documentation of up-to-date immunizations or exemptions. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 5.3.2 Prevention of sudden infant death syndrome and the use of safe-sleep practices health and safety standard Provide the standards, appropriate to the provider setting and age of children, that address the prevention of sudden infant death syndrome and use of safe sleeping practices for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The District's child development facility licensing regulation 5A DCMR § 126 establishes safe sleep practices, including requiring the use of individual cribs, cots, or beds that are not shared and are clean and sanitary. It also requires compliance with the most recent recommendations of the American Academy of Pediatrics about safe sleep practices and reducing the risk of sudden infant death syndrome. Additionally, 5A DCMR § 143 requires that facilities ensure that children enrolled are provided periods of rest, not to exceed three hours per day (unless operating during non- traditional hours). The duration and schedule of activities shall be appropriate in order to prevent fatigue and to meet the physical needs of the enrolled children at the facility, taking into account the ages and developmental levels of the children. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The District's child development facility licensing regulation 5A DCMR § 126 establishes safe sleep practices, including requiring the use of individual cribs, cots, or beds that are not shared and are clean and sanitary. It also requires compliance with the most recent recommendations of the American Academy of Pediatrics about safe sleep practices and reducing the risk of sudden infant death syndrome. Additionally, 5A DCMR § 143 requires that facilities ensure that children enrolled are provided periods of rest, not to exceed three hours per day (unless operating during non-traditional hours). The duration and schedule of activities shall be appropriate in order to prevent fatigue and to meet the physical needs of the enrolled children at the facility, taking into account the ages and developmental levels of the children. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The provider agreement requires training on the prevention of sudden infant death syndrome and the use of safe sleep practices within three months of signing the agreement. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 5.3.3 Administration of medication, consistent with standards for parental consent health and safety standard a. Provide the standards, appropriate to the provider setting and age of children, that address the administration of medication for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The District's child care licensing regulation 5A DCMR § 123 sets requirements for the administration of medication, which prohibit a licensee from administering medication to a child in care, except in cases of emergency first aid, unless parental consent is given in writing; a licensed health care practitioner has approved; and the individual administering the medication has completed an approved medication training program or is a registered nurse, licensed practical nurse, or medication technician certified by the District’s Board of Nursing to administer medication to children in care. This licensing regulation also sets forth the requirements for the storage of medication in the facility, the maintenance of a medication log, and the self-administration of medication by a child. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The District's child care licensing regulation 5A DCMR § 123 sets requirements for the administration of medication, which prohibit a licensee from administering medication to a child in care, except in cases of emergency first aid, unless parental consent is given in writing; a licensed health care practitioner has approved; and the individual administering the medication has completed an approved medication training program or is a registered nurse, licensed practical nurse, or medication technician certified by the District’s Board of Nursing to administer medication to children in care. This licensing regulation also sets forth the requirements for the storage of medication in the facility, the maintenance of a medication log, and the self-administration of medication by a child. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The provider agreement requires training in the administration of medicine within three months of signing the agreement. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A b. Provide the standards, appropriate to the provider setting and age of children, that address obtaining permission from parents to administer medications to children for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The District's child care licensing regulation 5A DCMR § 153 sets forth requirements for obtaining permission to administer medications to children. The regulation states that parental permission to administer the medication or treatment is documented on a completed, signed, and dated medication authorization form that is received by the licensee before the medication or treatment is administered. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The District's child care licensing regulation 5A DCMR § 153 sets forth requirements for obtaining permission to administer medications to children. The regulation states that parental permission to administer the medication or treatment is documented on a completed, signed, and dated medication authorization form that is received by the licensee before the medication or treatment is administered. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x]Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt family child care homes. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The provider agreement requires training on the administration of medicine, including obtaining parental permission, within three months of signing the agreement. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 5.3.4 Prevention of and response to emergencies due to food and allergic reactions health and safety standard a. Provide the standards, appropriate to the provider setting and age of children, that address the prevention of emergencies due to food and allergic reactions for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The District's child development facility licensing regulation 5A DCMR § 115 sets forth requirements for the prevention of emergencies due to food and allergic reactions. A licensee must post all food allergy information near the entrance to each classroom. Facilities must also have a written care plan for each child with a food allergy prepared for the facility by the child's parent(s), guardian(s), or licensed health care practitioner, which must include a detailed treatment plan to be implemented in the event of an allergic reaction. The treatment plan includes the names, doses, and methods of administration of any medications that the child should receive in the event of a reaction. Based on the plan, staff must be trained to prevent exposure to food to which a child is allergic, recognize the symptoms of an allergic reaction, and administer appropriate treatment. Furthermore, facilities are required to maintain good air quality. The presence of dirt, moisture, and warmth encourages the growth of mold and other contaminants, which can trigger allergic reactions or asthma. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The District's child development facility licensing regulation 5A DCMR § 115 sets forth requirements for the prevention of emergencies due to food and allergic reactions. A licensee must post all food allergy information near the entrance to each classroom. Facilities must also have a written care plan for each child with a food allergy prepared for the facility by the child's parent(s), guardian(s), or licensed health care practitioner, which must include a detailed treatment plan to be implemented in the event of an allergic reaction. The treatment plan includes the names, doses, and methods of administration of any medications that the child should receive in the event of a reaction. Based on the plan, staff must be trained to prevent exposure to food to which a child is allergic, recognize the symptoms of an allergic reaction, and administer appropriate treatment. Furthermore, facilities are required to maintain good air quality. The presence of dirt, moisture, and warmth encourages the growth of mold and other contaminants, which can trigger allergic reactions or asthma. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The provider agreement requires training in the prevention of and response to emergencies due to food and allergic reactions within three months of signing the agreement. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A b. Provide the standards, appropriate to the provider setting and age of children, that address the response to emergencies due to food and allergic reactions for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The District’s child development facility licensing regulation 5A DCMR § 154 sets forth the requirements for the response to emergencies due to food and allergic reactions. A licensee shall ensure staff are trained to recognize the symptoms of and treat allergic reactions. Facilities must also have a written care plan for each child with a food allergy prepared for the facility by the child's parent(s), guardian(s), or licensed health care practitioner, which shall include a detailed treatment plan to be implemented in the event of an allergic reaction. The treatment plan includes the names, doses, and methods of administration of any medications that the child should receive in the event of a reaction. Based on the plan, staff must be trained to prevent exposure to food to which a child is allergic, recognize the symptoms of an allergic reaction, and administer appropriate treatment. Additionally, a licensee shall immediately notify the parent(s) or guardian(s) of any suspected allergic reactions of an enrolled child, as well as the ingestion of or contact with the problem food, even if a reaction did not occur. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The District’s child development facility licensing regulation 5A DCMR § 154 sets forth the requirements for the response to emergencies due to food and allergic reactions. A licensee shall ensure staff are trained to recognize the symptoms of and treat allergic reactions. Facilities must also have a written care plan for each child with a food allergy prepared for the facility by the child's parent(s), guardian(s), or licensed health care practitioner, which shall include a detailed treatment plan to be implemented in the event of an allergic reaction. The treatment plan includes the names, doses, and methods of administration of any medications that the child should receive in the event of a reaction. Based on the plan, staff must be trained to prevent exposure to food to which a child is allergic, recognize the symptoms of an allergic reaction, and administer appropriate treatment. Additionally, a licensee shall immediately notify the parent(s) or guardian(s) of any suspected allergic reactions of an enrolled child, as well as the ingestion of or contact with the problem food, even if a reaction did not occur. iii. All CCDF-eligible licensed in-home care. Provide the standard:: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The provider agreement requires training on the prevention of and response to emergencies due to food and allergic reactions within three months of signing the agreement. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 5.3.5 Building and physical premises safety, including the identification of and protection from hazards, bodies of water, and vehicular traffic health and safety standard a. Provide the standards, appropriate to the provider setting and age of children, that address the identification of and protection from building and physical premises hazards for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The District’s child development facility licensing regulations 5A DCMR §§ 122-126 require licensed providers to conform, to the extent practicable, to the National Health and Safety Performance Standards to ensure the safety and welfare of children, and the cleanliness and sanitary conditions of the facility. A licensee must ensure that every building or part that is used as a facility is constructed, used, furnished, maintained, and equipped in compliance with all applicable requirements established by District and federal laws and regulations with written certification of compliance from the appropriate regulatory bodies governing zoning, building construction and safety, sanitation, and fire safety. Additionally, these regulations detail various requirements for fire safety, lavatory space and equipment, and aspects of the indoor and outdoor environment. Regulation 5A DCMR § 125 of the licensing regulations sets forth requirements for daily inspection of each outdoor play space. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The District’s child development facility licensing regulations 5A DCMR §§ 122-126 require licensed providers to conform, to the extent practicable, to the National Health and Safety Performance Standards to ensure the safety and welfare of children, and the cleanliness and sanitary conditions of the facility. A licensee must ensure that every building or part that is used as a facility is constructed, used, furnished, maintained, and equipped in compliance with all applicable requirements established by District and federal laws and regulations with written certification of compliance from the appropriate regulatory bodies governing zoning, building construction and safety, sanitation, and fire safety. Additionally, these regulations detail various requirements for fire safety, lavatory space and equipment, and aspects of the indoor and outdoor environment. Regulation 5A DCMR § 125 of the licensing regulations sets forth requirements for daily inspection of each outdoor play space. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The provider agreement requires training on building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic within three months of signing the agreement. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A b. Provide the standards, appropriate to the provider setting and age of children, that address the identification of and protection from bodies of water for the following CCDF- eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The District's child development facility licensing regulation 5A DCMR § 157 ensures building and physical premises safety by setting forth requirements for the identification of and protection from bodies of water, including swimming and water play. A licensee must maintain constant and active supervision when any child is in or around water or ensure the inaccessibility of pools, including swimming pools, fixed-in- place wading pools, hot tubs, spas, fish ponds, or similar bodies of water by using a pool cover or by surrounding the pool with a fence. Exit and entrance points to pools or bodies of water must have self-closing, positive-latching gates with locking devices a minimum of 55 inches from the ground. If a facility chooses to utilize one or more wading pools, the licensee must ensure that such pools are cleaned, emptied, and drained daily and stored in a location that is inaccessible to the enrolled children unless qualified adults are present and supervising the children. Licensees must ensure that when children are swimming or playing in water, including baby pools, wading pools, and full-depth pools, they are supervised by at least one adult who is certified as a Lifeguard or Water Safety Instructor by the American Red Cross or by an equivalent water safety instruction and testing program, for every six children. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The District's child development facility licensing regulation 5A DCMR § 157 ensures building and physical premises safety by setting forth requirements for the identification of and protection from bodies of water, including swimming and water play. A licensee must maintain constant and active supervision when any child is in or around water or ensure the inaccessibility of pools, including swimming pools, fixed-in-place wading pools, hot tubs, spas, fish ponds, or similar bodies of water by using a pool cover or by surrounding the pool with a fence. Exit and entrance points to pools or bodies of water must have self-closing, positive- latching gates with locking devices a minimum of 55 inches from the ground. If a facility chooses to utilize one or more wading pools, the licensee must ensure that such pools are cleaned, emptied, and drained daily and stored in a location that is inaccessible to the enrolled children unless qualified adults are present and supervising the children. Licensees must ensure that when children are swimming or playing in water, including baby pools, wading pools, and full-depth pools, they are supervised by at least one adult who is certified as a lifeguard or water safety instructor by the American Red Cross or by an equivalent water safety instruction and testing program, for every six children. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The provider agreement requires training on building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic within three months of signing the agreement. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A c. Provide the standards, appropriate to the provider setting and age of children, that address the identification of and protection from vehicular traffic hazards for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The District's child development facility licensing regulation 5A DCMR § 125 ensures building and physical premises safety by requiring the identification of and protection from hazards that can cause bodily injury, including vehicular traffic. Specifically, licensees must enclose outdoor play space with a fence or natural barrier that is at least four feet high, with a space no larger than three and one-half inches between its bottom edge and the ground and designed to prevent climbing outdoor gates. Fences must have positive self-latching closure mechanisms that are at least four feet off the ground or constructed in a manner so that they cannot be opened by a preschool-age child. Additionally, § 158 provides that a licensee maintain a safe vehicle loading and unloading area for children on or adjacent to the facility’s premises. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The District's child development facility licensing regulation 5A DCMR § 125 ensures building and physical premises safety by requiring the identification of and protection from hazards that can cause bodily injury, including vehicular traffic. Specifically, licensees must enclose outdoor play space with a fence or natural barrier that is at least four feet high, with a space no larger than three and one- half inches between its bottom edge and the ground and designed to prevent climbing outdoor gates. Fences must have positive self-latching closure mechanisms that are at least four feet off the ground or constructed in a manner so that they cannot be opened by a preschool-age child. Additionally, § 158 provides that a licensee maintain a safe vehicle loading and unloading area for children on or adjacent to the facility’s premises. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The provider agreement requires training on building and physical premises safety, including identification of and protection from hazards that can cause bodily injuries such as electrical hazards, bodies of water, and vehicular traffic within three months of signing the agreement. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 5.3.6 Prevention of shaken baby syndrome, abusive head trauma, and maltreatment health and safety standard a. Provide the standards, appropriate to the provider setting and age of children, that address the prevention of shaken baby syndrome and abusive head trauma and indicate the age of children it applies to for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The District’s child care licensing regulation 5A DCMR § 147 sets forth requirements to prevent child abuse by prohibiting any staff, substitutes, volunteers, or individual residing on the premises of the facility, or any other individual connected with the facility from subjecting a child to abuse, neglect, mental injury, or injurious treatment. The standard applies to all ages of children. Additionally, regulation 5A DCMR § 127 requires a licensee to establish policies that describe procedures for identifying and preventing shaken baby syndrome and abusive head trauma in infants, if applicable. An infant is defined as an individual from birth to 12 months of age. Furthermore, regulation 5A DCMR § 141 prohibits staff members from using any of the following methods for discipline for children of any age: physical harm, including but not limited to, punching, pinching, shaking, shoving, pushing, spanking, striking, kicking, biting, yanking, strangling, kneeing, poking, or plucking. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The District’s child care licensing regulation 5A DCMR § 147 sets forth requirements to prevent child abuse by prohibiting any staff, substitutes, volunteers, or individual residing on the premises of the facility, or any other individual connected with the facility from subjecting a child to abuse, neglect, mental injury, or injurious treatment. The standard applies to all ages of children. Additionally, regulation 5A DCMR § 127 requires a licensee to establish policies that describe procedures for identifying and preventing shaken baby syndrome and abusive head trauma in infants, if applicable. An infant is defined as an individual from birth to 12 months of age. Furthermore, regulation 5A DCMR § 141 prohibits staff members from using any of the following methods for discipline for children of any age: physical harm, including but not limited to, punching, pinching, shaking, shoving, pushing, spanking, striking, kicking, biting, yanking, strangling, kneeing, poking, or plucking. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The provider agreement requires training on the prevention of shaken baby syndrome and abusive head trauma within three months of signing the agreement. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A b. Provide the standards, appropriate to the provider setting and age of children, that address the prevention of child maltreatment and indicate the age of children it applies to for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The District’s child care licensing regulation 5A DCMR § 147 sets forth requirements to prevent child abuse by prohibiting any staff, substitutes, volunteers, or individual residing on the premises of the facility, or any other individual connected with the facility from subjecting a child to abuse, neglect, mental injury, or injurious treatment. Licensees are required to use positive methods of child guidance that meet the individual needs of each child and encourage self-control, self-direction, self- esteem, and cooperation. Furthermore, regulation 5A DCMR § 141 prohibits staff members from using any of the following methods for discipline: physical harm, including but not limited to, punching, pinching, shaking, shoving, pushing, spanking, striking, kicking, biting, yanking, strangling, kneeing, poking, or plucking. These standards apply to all ages of children. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The District’s child care licensing regulation 5A DCMR § 147 sets forth requirements to prevent child abuse by prohibiting any staff, substitutes, volunteers, or individual residing on the premises of the facility, or any other individual connected with the facility from subjecting a child to abuse, neglect, mental injury, or injurious treatment. Licensees are required to use positive methods of child guidance that meet the individual needs of each child and encourage self-control, self-direction, self-esteem, and cooperation. Furthermore, regulation 5A DCMR § 141 prohibits staff members from using any of the following methods for discipline: physical harm, including but not limited to, punching, pinching, shaking, shoving, pushing, spanking, striking, kicking, biting, yanking, strangling, kneeing, poking, or plucking. These standards apply to all ages of children. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The provider agreement requires training on child abuse and neglect, prevention, detection, and reporting within three months of signing the agreement. This requirement applies to all ages of children. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 5.3.7 Emergency preparedness and response planning standard Identify by checking below that the emergency preparedness and response planning due to natural disasters and human-caused events standard includes procedures in the following areas: i. [x] Evacuation ii. [x] Relocation iii. [x] Shelter-in-place iv. [x] Lock down v. Staff emergency preparedness [x] Training [x] Practice drills vi. Volunteer emergency preparedness [ ] Training [x] Practice drills vii. [x] Communication with families viii. [x] Reunification with families ix. [x] Continuity of operations x. Accommodation of [x] Infants [x] Toddlers [x] Children with disabilities [x] Children with chronic medical conditions xi. If any of the above are not checked, describe: OSSE received a Preliminary Notice of Non-Compliance on Sept. 29, 2023, indicating that OSSE does not indicate that volunteers are included in the emergency preparedness and response planning for emergency training. OSSE affirms that it needs additional time to revise the District’s child development facility licensing regulations to require volunteers to be included in emergency preparedness training. To come into compliance, OSSE published a Notice of Proposed Rulemaking (NRPM) for the District’s child development facility licensing regulations on May 17, 2023, that adds volunteers to the existing requirements for emergency preparedness and response planning for emergency training. OSSE anticipates a Final Rule later this year. In the meantime, OSSE is reviewing and updating inspection and monitoring tools to ensure the emergency preparedness and response planning standards, policies and monitoring include the requirements for volunteers. 5.3.8 Handling and storage of hazardous materials and the appropriate disposal of biocontaminants health and safety standard a. Provide the standards, appropriate to the provider setting and age of children, that address the handling and storage of hazardous materials for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The District’s child development facility licensing regulation 5A DCMR § 124 requires proper handling and storage of hazardous materials and disposal of biocontaminants. Licensees must conform, to the extent practicable, to the National Health and Safety Performance Standards to ensure the safety and welfare of children and the cleanliness and sanitary conditions of the facility, per 5A DCMR § 142. Additionally, regulation 5A DCMR § 149 requires licensees to ensure that all cleaning and sanitizing supplies, toxic substances, paint, poisons, aerosol containers, and other items bearing warning labels are safely stored and are kept in a secure area, inaccessible to the children at all times. A licensee shall also ensure that the telephone number for the local poison control center is posted in a location where it is readily available in an emergency. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The District’s child development facility licensing regulation 5A DCMR § 124 requires proper handling and storage of hazardous materials and disposal of biocontaminants. Licensees must conform, to the extent practicable, to the National Health and Safety Performance Standards to ensure the safety and welfare of children and the cleanliness and sanitary conditions of the facility, per 5A DCMR § 142. Additionally, regulation 5A DCMR § 149 requires licensees to ensure that all cleaning and sanitizing supplies, toxic substances, paint, poisons, aerosol containers, and other items bearing warning labels are safely stored and are kept in a secure area, inaccessible to the children at all times. A licensee shall also ensure that the telephone number for the local poison control center is posted in a location where it is readily available in an emergency. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The provider agreement requires training on poison prevention, including the handling of storage of hazardous materials and the appropriate disposal of biocontaminants, within three months of signing the agreement. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A b. Provide the standards, appropriate to the provider setting and age of children, that address the disposal of bio contaminants for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The District’s child development facility licensing regulation 5A DCMR § 124 addresses the appropriate disposal of biocontaminants (which include blood, bodily fluids, or excretions that may spread infectious disease) and requires training on appropriate handling and disposal. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The District’s child development facility licensing regulation 5A DCMR § 124 addresses the appropriate disposal of biocontaminants (which include blood, bodily fluids, or excretions that may spread infectious disease) and requires training on appropriate handling and disposal. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The provider agreement requires training on poison prevention, including the handling of storage of hazardous materials and the appropriate disposal of biocontaminants, within three months of signing the agreement. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 5.3.9 Precautions in transporting children health and safety standard Provide the standards, appropriate to the provider setting and age of children, that address precautions in transporting children for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The District’s child development facility licensing regulation 5A DCMR § 134 requires that a licensee that enters into contracts with other entities for the provision of transportation services or rents, owns, operates, or maintains one or more motor vehicles used for transporting children complies with all applicable federal and District laws and regulations governing the maintenance and operation of motor vehicles and the transportation of children. The licensee must establish and implement policies and procedures intended to ensure the safe transportation of children, including traffic records checks and policies, and procedures for the training and monitoring of any person responsible for the transportation of enrolled children. Additionally, the regulations set forth safeguards for children during transportation, including minimum adult-to-child ratios shall be maintained in vehicles, maintaining proof of vehicle insurance coverage, permission from parents, seat belt restraints, and safe loading and unloading. Licensees must also maintain a transportable first aid kit for outings and when children are being transported. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The District’s child development facility licensing regulation 5A DCMR § 134 requires that a licensee that enters into contracts with other entities for the provision of transportation services or rents, owns, operates, or maintains one or more motor vehicles used for transporting children complies with all applicable federal and District laws and regulations governing the maintenance and operation of motor vehicles and the transportation of children. The licensee must establish and implement policies and procedures intended to ensure the safe transportation of children, including traffic records checks and policies, and procedures for the training and monitoring of any person responsible for the transportation of enrolled children. Additionally, the regulations set forth safeguards for children during transportation, including minimum adult-to-child ratios shall be maintained in vehicles, maintaining proof of vehicle insurance coverage, permission from parents, seat belt restraints, and safe loading and unloading. Licensees must also maintain a transportable first aid kit for outings and when children are being transported. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The provider agreement requires training on transportation safety within three months of signing the agreement. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 5.3.10 Pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) health and safety standard a. Provide the standards, appropriate to the provider setting and age of children, that address pediatric first aid for all staff for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The District’s child development facility licensing regulation 5A DCMR § 150 requires all staff members to possess current and valid first aid certification appropriate to the age of children served by the facility. Additionally, licensees must have two staff members at the premises readily available to administer first aid. Further, a quantity of first aid supplies sufficient to meet the facility's reasonably expected needs, based on the size of the facility, the ages and developmental abilities of the enrolled children, and the facility's program of activities. A licensee must maintain these supplies in a designated location that is readily available to staff and inaccessible to children. Specifically, a licensee shall maintain one first aid kit with specific supplies for every 25 children. Licensees must inspect and replenish the first aid kit and also maintain a transportable first aid kit for outings and when children are being transported. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The District’s child development facility licensing regulation 5A DCMR § 150 requires all staff members to possess current and valid first aid certification appropriate to the age of children served by the facility. Additionally, licensees must have two staff members at the premises readily available to administer first aid. Further, a quantity of first aid supplies is sufficient to meet the facility's reasonably expected needs, based on the size of the facility, the ages and developmental abilities of the enrolled children, and the facility's program of activities. A licensee must maintain these supplies in a designated location that is readily available to staff and inaccessible to children. Specifically, a licensee shall maintain one first aid kit with specific supplies for every 25 children. Licensees must inspect and replenish the first aid kit and also maintain a transportable first aid kit for outings and when children are being transported. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The provider agreement requires training on pediatric first aid within three months of signing the agreement. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A b. Provide the standards, appropriate to the provider setting and age of children, that address pediatric cardiopulmonary resuscitation for all staff for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The District’s child care licensing regulation 5A DCMR § 150 requires all staff members to possess current and valid certification in CPR appropriate to the age of children served by the facility. Additionally, licensees must have two staff members at the premises and be readily available to administer CPR. Further, the first aid kit must include a mouthpiece for giving CPR and other supplies sufficient to meet the facility's reasonably expected needs, based on the size of the facility, the ages and developmental abilities of the enrolled children, and the facility's program of activities. A licensee shall maintain these supplies in a designated location that is readily available to staff and inaccessible to children. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The District’s child care licensing regulation 5A DCMR § 150 requires all staff members to possess current and valid certification in CPR appropriate to the age of children served by the facility. Additionally, licensees must have two staff members at the premises and be readily available to administer CPR. Further, the first aid kit must include a mouthpiece for giving CPR and other supplies sufficient to meet the facility's reasonably expected needs, based on the size of the facility, the ages and developmental abilities of the enrolled children, and the facility's program of activities. A licensee shall maintain these supplies in a designated location that is readily available to staff and inaccessible to children. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The provider agreement requires training on CPR within three months of signing the agreement. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 5.3.11 Identification and reporting of child abuse and neglect health and safety standard a. Provide the standards, appropriate to the provider setting and age of children, that address the identification of child abuse and neglect for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The District’s child development facility licensing regulation 5A DCMR § 139 requires a licensed provider to provide training to all staff upon initial hire and annually thereafter regarding the facility's policies and procedures relating to child abuse, neglect, and risk to a child's health, safety, or welfare, including to whom and how to report suspected abuse, neglect, or risk to a child's health, safety, or welfare. Additionally, licensees are required to notify OSSE of any unusual incident that may adversely affect the health, safety, or welfare of any enrolled child or children by submitting an Unusual Incident Report form (5A DCMR § 128). ii. All CCDF-eligible licensed family child care homes. Provide the standard: The District’s child development facility licensing regulation 5A DCMR § 139 requires a licensed provider to provide training to all staff upon initial hire and annually thereafter regarding the facility's policies and procedures relating to child abuse, neglect, and risk to a child's health, safety, or welfare, including to whom and how to report suspected abuse, neglect, or risk to a child's health, safety, or welfare. Additionally, licensees are required to notify OSSE of any unusual incident that may adversely affect the health, safety, or welfare of any enrolled child or children by submitting an Unusual Incident Report form (5A DCMR § 128). iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The provider agreement requires annual training on child abuse and neglect, prevention, detection, and reporting within three months of signing the agreement. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A b. Provide your standards, appropriate to the provider setting and age of children, that address the reporting of child abuse and neglect for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The District’s child development licensing regulation 5-A DCMR § 147 requires all staff to immediately report and to cooperate with officials investigating alleged or actual child abuse, neglect or alleged neglect, or actual risk to an enrolled child's health, safety, or welfare. Licensees must create an encouraging and supportive environment where staff may report incidents involving alleged or actual child abuse or neglect or alleged or actual risk to an enrolled child's health, safety, or welfare without threat of retaliation, including termination of employment. Furthermore, this regulation requires that any staff member who knows or has reasonable cause to suspect that an enrolled child is, has been, or is in immediate danger of being abused or neglected make or cause to be made an immediate oral report to: the Child Protective Services Division of the Child and Family Services Agency (CFSA), via the CFSA 24-hour Child Abuse and Neglect Hotline (202- 671- SAFE); and the Metropolitan Police Department. The regulations further indicate when an oral report should be followed up with a written report and what the written report should include. Finally, 5A DCMR § 113 provides OSSE with the authority to revoke a license for failing to report suspected child abuse or neglect. Licensees are required to notify OSSE of any unusual incident that may adversely affect the health, safety, or welfare of any enrolled child or children by submitting an Unusual Incident Report form (5A DCMR § 128). ii. All CCDF-eligible licensed family child care homes. Provide the standard: The District’s child development licensing regulation 5A DCMR § 147 requires all staff to immediately report and to cooperate with officials investigating alleged or actual child abuse, neglect or alleged neglect, or actual risk to an enrolled child's health, safety, or welfare. Licensees must create an encouraging and supportive environment where staff may report incidents involving alleged or actual child abuse or neglect or alleged or actual risk to an enrolled child's health, safety, or welfare without threat of retaliation, including termination of employment. Furthermore, this regulation requires that any staff member who knows or has reasonable cause to suspect that an enrolled child is, has been, or is in immediate danger of being abused or neglected make or cause to be made an immediate oral report to: the Child Protective Services Division of CFSA, via the CFSA 24-hour Child Abuse and Neglect Hotline (202- 671-SAFE); and the Metropolitan Police Department. The regulations further indicate when an oral report should be followed up with a written report and what the written report should include. Finally, 5A DCMR § 113 provides OSSE with the authority to revoke a license for failing to report suspected child abuse or neglect. Licensees are required to notify OSSE of any unusual incident that may adversely affect the health, safety, or welfare of any enrolled child or children by submitting an Unusual Incident Report form (5A DCMR § 128). iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A. The District does not have CCDF-eligible license-exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The provider agreement requires training on child abuse and neglect, prevention, detection, and reporting within three months of signing the agreement. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A c. Confirm if child care providers must comply with the Lead Agency’s procedures for reporting child abuse and neglect as required by the Child Abuse Prevention and Treatment Act (42 U.S.C. 5106a(b)(2)(B)(i): [x] Yes, confirmed. [ ] No. If no, describe: 5.3.12 Additional optional standards In addition to the required health and safety standards, does the Lead Agency require providers to comply with the following optional standards? [x] Yes. [ ] No. If no, skip to Section 5.4 If yes, describe the standard(s). i. Nutrition. Describe: Licensed facilities that store, prepare, handle, and serve food must comply with the District’s Food Code, 25A DCMR, and shall obtain and maintain all certifications or licenses required under the applicable laws and regulations of the District. Licensees are required to have planned daily menus for foods served by the facility. Daily menus and foods are to be varied, suitable to the ages and developmental levels of the children, and consistent with the meal pattern requirements and nutrition standards specified by the Child and Adult Care Food Program (CACFP). Facilities must plan and publicly post menus for all foods served, including snacks, and modify the menus as necessary to reflect the foods actually served. Additionally, all facilities should have at least one staff member present at all times when meals are being prepared or served who is certified as a Food Protection Manager in accordance with the District’s Food Code, 25A DCMR. Staff responsibilities concerning food preparation and service should not reduce the adult-to-child ratios for staff actively supervising children or interfere with the implementation of the facility’s program of activities. No person may be involved in food preparation, service, or otherwise work in the food preparation or service area, if that person shows signs or symptoms of illness or if that person is actually or probably infected with any bacterium or virus that can be carried in food. Facilities are to annually request and obtain from a child’s parent(s) or guardian(s) all relevant information regarding dietary restrictions and food allergies for that child upon the child’s admission to the facility. The facility shall record this information in the child’s file. All staff responsible for food preparation and distribution are to be immediately informed, orally and in writing, of any dietary restrictions, food allergies, or other special dietary requirements of enrolled children at the facility. The serving of a special therapeutic diet to a child is only upon written approval from the child’s parent(s) or guardian(s), accompanied by written instructions from the child’s licensed health care practitioner. Facilities must provide and ensure that each child uses, at each meal or snack, clean and sanitary individual eating and drinking utensils. Reusable utensils must be washed and sanitized after each use. Facilities may use powdered milk or reconstituted evaporated milk for cooking but it may not be served as a substitute for fluid milk for drinking. A licensee must make drinking water continuously available to all children and serve drinking water on demand. ii. Access to physical activity. Describe: The District’s child development licensing regulation 5A DCMR § 143 requires that all facilities serving children in a full-day program shall ensure that each child, including infants, toddlers, and preschoolers, has a minimum of 2 hours of active playtime each day, including a minimum of 45 minutes of outdoor activity, weather permitting. During outdoor play, children shall be dressed appropriately for weather and temperature. Facilities are required to provide 1 hour of structured active play and guided physical activity and 1 hour of child-initiated unstructured physical activity. Children attending less than a full-day program are to be scheduled to participate in a proportionate amount of such physical activities. In inclement weather, facilities should encourage and support active play in a safe indoor play area. Additionally, children shall not be engaged in sedentary activities or activities requiring them to sit passively for more than 60 minutes continuously, except during scheduled rest or nap time. Restrictive infant equipment such as swings, stationary activity centers, infant seats, and molded seats, if used, shall only be used for a maximum of 30 minutes, twice a day. iii. Caring for children with special needs. Describe: Licensing regulations require all facilities to make reasonable efforts to determine if any child under their care is a child with any disability, as defined by the Individuals with Disabilities Education Act (IDEA) with an Individualized Family Service Plan (IFSP), and be aware of any obligations that the licensee may have pursuant to the IFSP. Facilities are to provide a child’s Strong Start service coordinator or service provider access to the facility in order to provide services pursuant to the child’s IFSP. If the child’s IFSP is implemented while in the care of the licensee, the facility must work with the child’s IFSP service coordinator or service provider to develop a plan for incorporating the IFSP goals and strategies into the child’s daily routine at the facility. When disclosing any information concerning a child with an IFSP plan to any person, including a licensed health care practitioner, who is not employed by the facility, the facility must comply with privacy and disclosure requirements under federal and local IDEA laws and regulations, including but not limited to any requirement to obtain written consent from the child’s parent or guardian before making any disclosure. Each child with a disability is to be provided with developmentally appropriate toys, materials, and play equipment that meets the requirements of the Americans with Disabilities Act (ADA). Additionally, each child with a disability should be provided appropriate assistance and attention from staff members, volunteers, and reasonable accommodations to enable the child to participate in all services and activities provided by the facility to children without a disability, including field trips. iv. Any other areas determined necessary to promote child development or to protect children’s health and safety. Describe: N/A