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: Early Care and Education and School-Age Centers Regulation 32, 41 & 62 https://education.delaware.gov/wp-content/uploads/2022/09/DELACARE- Regulations-for-Early-Care-and-Education-and-School-Age-Centers-22.pdf 32. Orientation A. A licensee shall document that all staff members, all substitutes, and volunteers working at least five days or 40 hours a year receive training in the following topics before working with children: Orientation Requirements: • DELACARE Regulations (related to job duties); • Personnel and administrative policies; • Release of children including procedures for situations listed in Section 23; • Positive behavior supports; • Child accident and injury procedures; • Administration of medication certification, within two months of hire, if administering medication to children; • Child care goals and program for children; • Recordkeeping, including documenting children and their own attendance; • Family involvement; • Food and nutrition services, including proper handling, storage, preparation, and feeding of breast milk and formula, if applicable; • Safety and sanitation procedures; • Physical activity; • Screen time as described in subsection 76.D; • Photographing or videotaping children; • Transporting children, if applicable; • Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, reporting requirements; and • Information on federal and State laws or regulations applicable to children and families in care, including non-discrimination. B. The orientation must include the opportunity for staff members to ask questions and receive clarification on their job functions, licensing regulations, and center policies. When information is revised, a licensee shall ensure staff members are informed of the changes. C. A licensee shall ensure all staff members, all substitutes, and volunteers working at least five days or 40 hours a year complete OCCL's approved Health and Safety Training for Child Care Professionals before working with children. This training provides professional development training hours and includes the following topics: Health and Safety Training Topics: • Emergency preparedness and response planning, disaster and evacuation plans and procedures • Safe sleep practices, including prevention of sudden infant death syndrome; • Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; Health and Safety Training Topics: • Routine and emergency health care including health exclusions, prevention, and recognition of the symptoms of childhood illnesses, including reportable communicable diseases and immunizations; • Prevention of and response to emergencies due to food and allergic reactions; • Building and physical premises safety; • Handling and storage of hazardous materials and proper disposal of bio- contaminants; • Safety measures in transporting children, and • Administration of medication. 41. Child Health Appraisal A. A licensee shall ensure that within one month of starting care, each child’s file has a health appraisal that includes an immunization record. A health care provider shall have conducted this health appraisal within the last 12 months. A licensee does not need a child’s health appraisal if other federal or State laws, such as specified in the McKinney-Vento Homeless Assistance Act, require the center to admit a child without one. Health appraisals and immunization records must be updated every 13 months. A licensee shall keep the most recent health appraisal on file and it must include: Health Appraisal Requirements: • A health history; • Physical examination; • Growth and development; • Age-appropriate immunization as described in Appendix IV; • Proof of blood lead screening for children at or around ages 12 months and 24 months; • Proof of blood lead screening after age 24 months for all children including school-age, if blood lead tests were not conducted at or around ages 12 months and 24 months; • Medical information for treatment in case of emergency; and • Recommendations regarding required medication, allergies, restrictions or modifications of the child's activities, diet, or care, if applicable. B. A licensee is not required to update health appraisals for children in grades kindergarten or higher after receiving one completed after the child began kindergarten or a higher grade. C. A licensee shall ensure a child whose parent or guardian objects to immunizations on a religious basis or whose health care provider certifies that the immunization may be harmful to the child’s health will be exempt from the immunization requirement. 1. A notarized statement or documentation from a health care provider is required for this exemption. 2. A licensee shall place this documentation in the child’s file. D. A licensee shall ensure a child whose parent or guardian objects to blood lead screening due to a sincere religious belief will be exempt from this blood screening requirement. 1. A certificate signed by the parent or guardian stating that the screening is contrary to the parent’s or guardian’s religious beliefs is required for this exemption. 62. Child Health Exclusions A. A licensee may not permit a child who has symptoms of illness listed below to be admitted or remain at the center. The child may only return when the symptoms are gone or with documentation from a health care provider, stating the child has been diagnosed and the illness or symptoms pose no serious health risk to the child or to other children. The symptoms for exclusion must include, but not be limited to, the following: Symptoms of Illness for Exclusion Includes: • Temperature of 100°F or higher without medication even if there has not been a change in behavior for infants four months old and younger; • Temperature of 101°F or higher without medication accompanied by behavior changes or symptoms of illness for children older than four months; • Symptoms of possible severe illness, such as unusual tiredness, uncontrolled coughing, unexplained irritability, persistent crying, difficulty breathing, wheezing, or other unusual signs; • Diarrhea; two or more times of loose stool during the past 24 hours, or if diarrhea is accompanied by fever, exclude for 48 hours after the symptoms end; • Blood in stools not due to change in diet, medication, or hard stools; • Vomiting; two or more times in the past 24 hours, or one time if accompanied by a fever until 48 hours after the symptoms end or until a health care provider determines the vomiting is not contagious and the child is not in danger of dehydration; • Ongoing stomach pain (more than two hours) or off-and-on pain due to a fever or other symptom; Symptoms of Illness for Exclusion Includes: • Mouth sores with drooling; • Rash with fever or behavior change; • Purulent conjunctivitis ￿pink eye￿ (defined as pink or red conjunctiva with white or yellow eye discharge), until 24 hours after starting antibiotic treatment; • Scabies, until 24 hours after starting treatment; • Pediculosis ￿head lice￿ or nits, until 24 hours after starting treatment; • Tuberculosis, as directed by DPH; • Impetigo, until 24 hours after starting antibiotic treatment and sores are dry; • Strep throat or other streptococcal infection, until 24 hours after starting antibiotic treatment; • Varicella-Zoster ￿chicken pox,￿ until all sores have crusted and are dry (usually six days); • Shingles, only if sores cannot be covered by clothing or a bandage; if not, exclude until sores have crusted and are dry; • Pertussis, until completing five days of antibiotic treatment; • Mumps, until five days after onset of glandular swelling; • Hepatitis A virus, until one week after onset of jaundice, or as directed by DPH; • Measles, until four days after arrival of rash; • Rubella, until seven days after arrival of rash; • Herpetic gingivostomatitis ￿cold sores,￿ if the child is too young to have control of saliva; or • Unspecified short-term illness, not chronic illness, if the child is unable to participate in activities or the center cannot provide care for this child and the other children. B. Temperatures for children under three years old must be taken using a non- glass thermometer under the arm or by a forehead scan. Oral temperatures may be taken on children ages three and older when a digital thermometer is used. Rectal and ear temperatures may be taken only by a licensed health care professional. C. A licensee shall ensure that if a child shows signs of ill health, as listed above, the licensee will remove the child from the group of well children to a separate area as described in Section 52. D. A licensee may permit a child to return to the center when the symptoms are gone, documentation from the child’s health care provider states the child has been diagnosed and the illness or symptoms poses no serious health risk to the child or to other children, or the child does not have symptoms for exclusion as listed in the center’s written health exclusion policy. E. A licensee shall ensure parents or guardians are notified when their child has been exposed to a contagious disease or condition. F. A licensee shall report a reportable communicable disease to DPH. For information on these diseases, the licensee shall contact DPH or refer to their website (currently listed as https://dhss.delaware.gov/dhss/dph/dpc/rptdisease.html.) G. A licensee may not permit a child with a reportable communicable disease to be admitted to or remain at the center, unless the child's health care provider documents the child has been evaluated and the disease poses no health risk to the child or to others or DPH has advised that the child is not a health risk to others. If the health care provider states the child may return and DPH says the child cannot return, the licensee shall follow DPH’s instructions. H. When a health care provider diagnosed a child as having a reportable vaccine- preventable communicable disease, a licensee shall exclude all children who were not immunized against the disease following DPH’s instructions. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Family and Large Family Child Care Homes Regulation 7A, 15D, 23 & 41 https://education.delaware.gov/wp-content/uploads/2022/08/DELACARE-FCCH- LFCCH-Regulations-August-2022.pdf 7. Procedures for Initial Licensure A. An applicant shall complete the following steps and submit the following information to OCCL when seeking a license: 1. Attend OCCL's information session and orientation to learn the application process and regulations; 2. Submit a completed Family Child Care Home Initial License Application (see Appendix I) or a Large Family Child Care Home Initial License Application (see Appendix II), as applicable, which includes: Required Application Information: • Applicant’s name, address, email, and phone numbers; • Applicant’s references: for corporations contact information for officers; for LLCs contact information for managing member; • Previous licensure information, if applicable; • Program information (including ages of children to be served); • Household members; and • Certifications that include: o Agreement to comply with federal and State laws and regulations including, but not limited to, the Americans with Disabilities Act and Delaware Equal Accommodations Law; o Statement that information supplied is true and correct; and o Acknowledgment that OCCL is required to make a thorough investigation of the applicant. 3. Submit the following items to OCCL: Items to be Submitted: • Proof of compliance with zoning codes, and, if applicable, other codes, regulations, guidelines, or laws, such as those from Division of Revenue, Department of Natural Resources and Environmental Control for septic systems, and Office of Drinking Water for well water; Items to be Submitted: • Documentation that the home is free of lead-based paint hazards. Homes constructed in or after 1978 are exempt from lead-paint risk assessments and testing; o If the home were constructed before 1978, an applicant or licensee shall provide a lead-paint risk assessment performed by an environmental testing firm certified by DPH showing the home to be free of lead-paint hazards. o If lead paint is identified but intact (i.e. not chipping, flaking, or peeling), the licensee shall monitor the identified areas at least every six months and document that the lead-based paint is intact (in good repair and not deteriorated). Lead-based paint is not regarded as a hazard if it is intact or not present in an accessible surface, a friction surface, or an impact surface that could result in an adverse human health effect. • If lead-paint hazards are identified in the risk assessment, the applicant or licensee shall remedy the hazards by hiring a lead-safe contractor (lead abatement or renovation firm) certified by DPH to make the repairs. o Once the repairs are made, a lead-dust clearance inspection must be performed by an environmental testing firm certified by DPH to confirm the home is free of lead-based paint hazards. o An applicant or licensee shall provide the lead-dust clearance testing results to OCCL within five business days to confirm the home is free of lead-based paint hazards. o Children may not be present during repairs and the home must stay closed until the results of the dust clearance test are at appropriate levels and the lead-safe contractor states it is safe for the home to be open. • If any lead-based paint identified in a risk assessment becomes deteriorated or if lead-based paint is located in an area to be remodeled, a licensee shall retain a contractor certified by DPH to work using lead-safe work practices (lead abatement or lead renovator) to perform any renovation or repair in a pre-1978 child-occupied facility; o Records of any renovation or repair work must be forwarded to OCCL within five business days. o Children may not be present during repairs or renovation until a lead dust clearance test is obtained and the lead-safe contractor states it is safe for the home to be open. • Evidence showing each room used for child care to be free of radon hazards using the Environmental Protection Agency’s guidelines; o Testing may be performed by the property owner or an inspector certified by the American Association of Radon Scientists, the National Radon Safety Board, or any organization recognized by the EPA or State of Delaware Radon Program. o If testing indicates a radon level over 4.0 pCi/L, radon mitigation according to industry standards must occur or a long-term radon test (90-120 days) must indicate a level less than 4.0 pCi/L. • Electrical inspection of the home conducted by a State fire marshal recognized electrical inspection agency; Items to be Submitted: • Current certifications in CPR including a skills demonstration and first aid for the ages of the children in care. Applicants for large family homes are exempt from this requirement if not serving as a staff member; • The names, addresses, phone numbers, and email addresses for three references who are familiar with, but not related to, the applicant and can describe the applicant's interactions with children; • Release of employment form that allows OCCL to collect service letters as per 19 Del.C. §708. The form will list the applicant's current or most recent employer and all health care and child care facilities where the applicant worked within the past five years. If an applicant has no former employer, the applicant shall provide information for two more references; • Comprehensive background checks for the applicant, adult household members, substitutes, staff members, and adult volunteers including State and federal fingerprint checks. o In addition to the Delaware fingerprinting, applicants, adult household members, substitutes, staff members, and adult volunteers who currently reside outside of Delaware must contact their state of residence and complete a fingerprinted state criminal history search and a name-based child abuse and neglect search. o Applicants, adult household members, substitutes, staff members, and adult volunteers who have resided outside of Delaware in the last five years must contact each state of residence, and request a criminal history search and a child abuse and neglect search. o After the out-of-state searches are completed, the applicant must submit the results immediately to CHU. o The person may not be alone with children until CHU notifies the licensee of the person’s eligibility after completing the comprehensive background check. o When OCCL has a reason to believe the health, safety, or welfare of a child in care may be at risk, OCCL may request parent or guardian permission for a comprehensive background check on a child household member and other medical, psychological, counseling, school, and probation records. OCCL may obtain information from the Department of Services for Children, Youth and Their Families; • Documentation of any case where the applicant gave up or lost custody of a child, if applicable; • Health appraisals for the applicant, all adult household members, and the substitute completed within one year before the application date that includes a tuberculosis (TB) test or medical professional risk assessment that verifies the person does not pose a threat of transmitting tuberculosis to children or others. The TB test or medical professional risk assessment must be completed within one year before the application date. This appraisal must confirm the person's health and document medical or physical conditions that pose a direct threat to the health and safety of children or others and any reasonable accommodations that may be required. This documentation shall be provided to OCCL for the purposes of determining whether the health condition creates a significant risk to children; • Health appraisals for child household members; • State business license or verification of tax-exempt status; • Sample two-week menu, if providing meals or snacks (if using a catering service, a copy of the caterer’s food establishment permit); and Items to be Submitted: • Documentation of completion of pre-service training in the following topics, if the applicant will work with children: o Six hours of quality-assured child development; o Three hours of quality-assured positive behavior supports or social-emotional development; o Prevention and control of infectious diseases, including immunization; o OCCL’s approved Health and Safety Training for Child Care Professionals that includes the following topics: ￿ Prevention and control of communicable diseases including immunization; ￿ Safe sleep practices, including prevention of sudden infant death syndrome; ￿ Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; ￿ Prevention of and response to emergencies due to food and allergic reactions; ￿ Building and physical grounds safety; ￿ Emergency preparedness and response planning; ￿ Handling and storage of hazardous materials and proper disposal of bio- contaminants; ￿ Administration of medication; and ￿ Safety measures in transporting children. o Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements (certificate required); • Landlord approval, if renting; • Emergency plan; and • Large family applicants shall complete the additional requirements for large family homes as listed in Sections 60 through 70. 15D. A licensee shall document on the form provided by OCCL that substitutes used for non-emergency situations receive training in the following topics before working with children: Training Requirements for Non-Emergency-Use Substitutes: • DELACARE Regulations; • Policies and procedures of the home; • Emergency preparedness and disaster and evacuation plans; o OCCL’s approved Health and Safety Training for Child Care Professionals that includes the following topics: ￿ Safe sleep practices, including prevention of sudden infant death syndrome; ￿ Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; ￿ Prevention of and response to emergencies due to food and allergic reactions; ￿ Prevention and control of communicable diseases, including immunization; ￿ Building and physical grounds safety; ￿ Handling and storage of hazardous materials and proper disposal of bio- contaminants; ￿ Administration of medication; and ￿ Safety measures in transporting children. o Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements (certificate required); • CPR and first aid certifications; and • Administration of medication. 23. Children's Health Appraisal A. A licensee shall ensure that within one month of starting care, each child's file contains a health appraisal that includes an immunization record. A health care provider shall have conducted this appraisal within the last 12 months. A licensee does not need a child’s health appraisal if other federal or State laws require the home to admit a child without an appraisal. Health appraisals must be updated every 13 months. A licensee shall keep the most recent appraisal on file and it must include: Health Appraisal Requirements: • A health history; • Physical examination; • Growth and development; • Age-appropriate immunizations as described in Appendix VIII; • Proof of blood lead screening for children at or around age 12 months and at or around 24 months; • Proof of single blood lead screening after age 24 months for all children including school-age, if blood lead tests were not conducted at or around age 12 months and at or around age 24 months; • Medical information for treatment in case of emergency; and • Recommendations regarding required medication, allergies, restrictions or modifications of the child's activities, diet, or care, if applicable. B. A licensee is not required to update health appraisals for children in grades kindergarten or higher after receiving one completed after the child began kindergarten or a higher grade. C. A licensee shall ensure a child whose parent or guardian objects to immunizations on a religious basis or whose health care provider certifies that immunizations may be harmful to the child's health will be exempt from the immunization requirement. 1. A notarized affidavit of religious belief or documentation from a health care provider is required for this exemption. 2. A licensee shall place this documentation in the child's file. D. A licensee shall ensure a child whose parent or guardian objects to blood lead screening due to a sincere religious belief will be exempt from this blood screening requirement. 1. A notarized affidavit of religious belief is required for this exemption. 2. A licensee shall place this documentation in the child’s file. 41. Child Health Exclusions A. A licensee may not permit a child who has symptoms listed below to enter or remain at the home. The child may only return when the symptoms are gone or with documentation from a health care provider stating the illness or symptoms pose no serious health risk to anyone. The documentation must be written or include a written follow-up if communicated verbally. The symptoms for exclusion must include, but not be limited to, the following: Symptoms of Illness for Exclusion Includes: • Temperature of 100°F or higher without medication even if there has not been a change in behavior for infants four months old and younger; • Temperature of 101°F or higher without medication accompanied by behavior changes or symptoms of illness for children older than four months; Symptoms of Illness for Exclusion Includes: • Symptoms of possible severe illness, such as unusual tiredness, uncontrolled coughing, unexplained irritability, persistent crying, difficulty breathing, wheezing, or other unusual signs; • Diarrhea; two or more times of loose stool during the past 24 hours, or if diarrhea is accompanied by fever, exclude for 48 hours after the symptoms end; • Blood in stools not due to change in diet, medication, or hard stools; • Vomiting; two or more times in the past 24 hours, or one time if accompanied by a fever until 48 hours after the symptoms end or until a health care provider determines the vomiting is not contagious and the child is not in danger of dehydration; • Ongoing stomach pain (more than two hours) or off-and-on pain due to a fever or other symptom; • Mouth sores with drooling; • Rash with fever or behavior change; • Purulent conjunctivitis ￿pink eye￿ (defined as pink or red conjunctiva with white or yellow eye discharge), until 24 hours after starting antibiotic treatment; • Scabies, until 24 hours after starting treatment; • Pediculosis ￿head lice￿ or nits, until 24 hours after starting treatment; • Tuberculosis, as directed by DPH; • Impetigo, until 24 hours after starting antibiotic treatment and sores are dry; • Strep throat or other streptococcal infection, until 24 hours after starting antibiotic treatment; • Varicella-Zoster ￿chicken pox,￿ until all sores have crusted and are dry (usually six days); • Shingles, only if sores cannot be covered by clothing or a bandage; if not, exclude until sores have crusted and are dry; • Pertussis, until completing five days of antibiotic treatment; • Mumps, until five days after onset of glandular swelling; • Hepatitis A virus, until one week after onset of jaundice, or as directed by DPH; • Measles, until four days after arrival of rash; • Rubella, until seven days after arrival of rash; • Herpetic gingivostomatitis ￿cold sores,￿ if the child is too young to have control of saliva; or • Unspecified short-term illness, not chronic illness if the child is unable to participate in activities or the facility cannot provide care for this child and the other children. B. A licensee shall ensure temperatures for children under three years old are taken with a non-glass thermometer under the arm or by forehead scan. 1. A digital oral thermometer may be used for children three years and older. 2. Rectal and ear temperatures may not be taken. C. A licensee shall ensure that if a child shows signs of ill health as listed above, the child's rest, comfort, food, drink, and activity needs are met until the child is picked up from the home. D. A licensee shall notify parent or guardians when their child has been exposed to a contagious disease or condition. E. A licensee shall report reportable communicable diseases to DPH. For information on these diseases, a licensee shall call DPH or refer to their website (currently listed as htttps://www.dhss.delaware.gov/dph/dpc/rptdisease.html). F. A licensee may not allow a child with a reportable communicable disease to be admitted to or remain at the home unless a health care provider documents that the illness poses no serious health risk to anyone or DPH tells the licensee that the child is not a health risk to others. If the health care provider states the child may return and DPH says the child cannot return, follow DPH's instructions. G. When a health care provider diagnosed a child with a reportable vaccine- preventable communicable disease, a licensee shall exclude all children who are not immunized against the disease following DPH's instructions. iii. All CCDF-eligible licensed in-home care. Provide the standard: Not Applicable to the Office of Child Care Licensing. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Not Applicable to the Office of Child Care Licensing. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Not Applicable to the Office of Child Care Licensing. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: This is not applicable. Relative Care providers are the only exempt category that can provide care in the child’s own home, but it is care provided by a relative only. Relative Care providers are required to participate in a Relative Orientation on program rules and regulations. They are also required to participate in 28 hours of CCDF approved training and 3 hours of a health and safety refresher training annually. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Youth Camps Regulation 24, 33 & 37 https://education.delaware.gov/wp-content/uploads/2021/10/Delacare- Regulations-For-Youth-Camps.pdf 24. Orientation A. A licensee shall document that all staff members working directly with children receive training in the following topics before working with children: Orientation Requirements: • DELACARE Regulations (related to job duties); • Emergency preparedness, disaster and evacuation plans and procedures; • Procedures for identifying and reporting suspicious behavior or concerns within the camp; • Release of children including procedures for situations listed in Section 21; • Positive behavior management; • Routine and emergency health care including health exclusions, prevention and recognition of the symptoms of childhood illnesses, including reportable communicable diseases; • Prevention and response to emergencies due to food allergies; • Building and physical premises safety; • Handling and storage of hazardous materials and proper disposal of bio contaminants; • Child accident and injury procedures; • Administration of medication; • Recordkeeping, including documenting children’s attendance and their own attendance; • Sanitation and safety procedures, including procedures to restrict access to children by unauthorized persons; • Photographing or videotaping children; • Transporting children, if applicable; • Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law and reporting requirements, and the camp’s procedures to report abuse and neglect; and • Information on federal and State laws or regulations applicable to children and families in care, including non-discrimination. B. The orientation must include the opportunity for staff members to ask questions and receive clarification on their job functions, licensing regulations, and camp policies. When information is revised, a licensee shall ensure staff members are informed of the changes. 33. Child Health Appraisal A. A licensee shall ensure that before beginning camp, each child’s file has a health appraisal conducted within the last 12 months that includes: Health Appraisal Requirements: • A health history; • Physical examination; • Growth and development; • Age-appropriate immunization as described in Appendix IV and V; • Medical information for treatment in case of emergency; and • Recommendations regarding required medication, allergies, restrictions or modifications of the child's activities, diet, or care, if applicable. B. A licensee shall ensure a child whose parent/guardian objects to immunizations on a religious basis or whose health care provider certifies that the immunization may be harmful to the child’s health will be exempt from the immunization requirement. 1. A notarized statement or documentation from a health care provider is required for an exemption related to an immunization being harmful to a child’s health. 2. A licensee shall place this documentation in the child’s file. 37. Child Health Exclusions A. A licensee may not permit a child who has symptoms of illness listed below to be admitted to or remain at the camp. The child may only return when the symptoms are gone or with documentation from a health care provider, stating the child has been diagnosed and the illness or symptoms pose no serious health risk to the child or to other children. The symptoms for exclusion must include, but not be limited to, the following: Symptoms of Illness for Exclusion Includes: • Temperature of 101 °F or higher without medication accompanied by behavior changes or symptoms of illness; Symptoms of Illness for Exclusion Includes: • Symptoms of possible severe illness, such as unusual tiredness, uncontrolled coughing, unexplained irritability, persistent crying, difficulty breathing, wheezing, or other unusual signs; • Diarrhea; two or more times of loose stool during the past 24 hours, or if diarrhea is accompanied by fever, exclude for 48 hours after the symptoms end; • Blood in stools not due to change in diet, medication, or hard stools; • Vomiting; two or more times in the past 24 hours, or one time if accompanied by a fever until 48 hours after the symptoms end or until a health care provider determines the vomiting is not contagious and the child is not in danger of dehydration; • Ongoing stomach pain (more than two hours) or off-and-on pain due to a fever or other symptom; • Mouth sores with drooling; • Rash with fever or behavior change; • Purulent conjunctivitis ￿pink eye￿ (defined as pink or red conjunctiva with white or yellow eye discharge), until 24 hours after starting antibiotic treatment; • Scabies, until 24 hours after starting treatment; • Pediculosis ￿head lice￿ or nits, until 24 hours after starting treatment; • Tuberculosis, as directed by DPH; • Impetigo, until 24 hours after starting antibiotic treatment and sores are dry; • Strep throat or other streptococcal infection, until 24 hours after starting antibiotic treatment; • Varicella-Zoster ￿chicken pox,￿ until all sores have crusted and are dry (usually six days); • Shingles, only if sores cannot be covered by clothing or a bandage; if not, exclude until sores have crusted and are dry; • Pertussis, until completing five days of antibiotic treatment; • Mumps, until five days after onset of glandular swelling; • Hepatitis A virus, until one week after onset of jaundice, or as directed by DPH; • Measles, until four days after arrival of rash; • Rubella, until seven days after arrival of rash; • Herpetic gingivostomatitis ￿cold sores,￿ if the child is too young to have control of saliva; or • Unspecified short-term illness, not chronic illness, if the child is unable to participate in activities or the camp cannot provide care for this child and the other children. B. Temperatures for children must be taken using a non-glass thermometer orally or under the arm or by forehead scan. Rectal and ear temperatures may be taken only by a licensed health care professional. C. A licensee shall ensure that if a child shows signs of ill health, as listed above, the licensee will remove the child from the group of well children to a separate area. 1. A licensee shall ensure the child’s individual needs for rest, comfort, food, drink, and activity are met until a parent/guardian picks up the child or a health care provider/consultant determines that the illness or symptoms pose no serious health risk to the child or to other children. 2. A licensee shall ensure all items used by an ill child, including rest equipment, bedding, utensils, and toys are cleaned with soap and water and then disinfected before being used by another child. D. A licensee may permit a child to return to the camp when the symptoms are gone, documentation from the child’s health care provider states the child has been diagnosed and the illness or symptoms poses no serious health risk to the child or to other children, or the child does not have symptoms for exclusion as listed in the camp’s written health exclusion policy. E. A licensee shall ensure parents/guardians are notified when their child has been exposed to a contagious disease or condition. F. A licensee shall report a reportable communicable disease to DPH. For information on these diseases, the licensee shall contact DPH or refer to their website (currently listed as http://www.dhss.delaware.gov/dhss/dph/dpc/rptdisease.html). G. A licensee may not permit a child with a reportable communicable disease to be admitted to or remain at the camp, unless the child's health care provider documents the child has been evaluated and the disease poses no health risk to the child or to others or DPH has advised that the child is not a health risk to others. If the health care provider states the child may return and DPH says the child cannot return, the licensee shall follow DPH’s instructions. H. When a health care provider diagnosed a child as having a reportable vaccine- preventable communicable disease, a licensee shall exclude all children not immunized against the disease following DPH’s instructions. 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: Early Care and Education and School-Age Centers Regulation 41 & 62 https://education.delaware.gov/wp-content/uploads/2022/09/DELACARE- Regulations-for-Early-Care-and-Education-and-School-Age-Centers-22.pdf 41. Child Health Appraisal A. A licensee shall ensure that within one month of starting care, each child’s file has a health appraisal that includes an immunization record. A health care provider shall have conducted this health appraisal within the last 12 months. A licensee does not need a child’s health appraisal if other federal or State laws, such as specified in the McKinney-Vento Homeless Assistance Act, require the center to admit a child without one. Health appraisals and immunization records must be updated every 13 months. A licensee shall keep the most recent health appraisal on file and it must include: Health Appraisal Requirements: • A health history; • Physical examination; • Growth and development; • Age-appropriate immunization as described in Appendix IV; • Proof of blood lead screening for children at or around ages 12 months and 24 months; • Proof of blood lead screening after age 24 months for all children including school-age, if blood lead tests were not conducted at or around ages 12 months and 24 months; • Medical information for treatment in case of emergency; and • Recommendations regarding required medication, allergies, restrictions or modifications of the child's activities, diet, or care, if applicable. B. A licensee is not required to update health appraisals for children in grades kindergarten or higher after receiving one completed after the child began kindergarten or a higher grade. C. A licensee shall ensure a child whose parent or guardian objects to immunizations on a religious basis or whose health care provider certifies that the immunization may be harmful to the child’s health will be exempt from the immunization requirement. 1. A notarized statement or documentation from a health care provider is required for this exemption. 2. A licensee shall place this documentation in the child’s file. D. A licensee shall ensure a child whose parent or guardian objects to blood lead screening due to a sincere religious belief will be exempt from this blood screening requirement. 1. A certificate signed by the parent or guardian stating that the screening is contrary to the parent’s or guardian’s religious beliefs is required for this exemption. 62. Child Health Exclusions A. A licensee may not permit a child who has symptoms of illness listed below to be admitted or remain at the center. The child may only return when the symptoms are gone or with documentation from a health care provider, stating the child has been diagnosed and the illness or symptoms pose no serious health risk to the child or to other children. The symptoms for exclusion must include, but not be limited to, the following: Symptoms of Illness for Exclusion Includes: • Temperature of 100°F or higher without medication even if there has not been a change in behavior for infants four months old and younger; • Temperature of 101°F or higher without medication accompanied by behavior changes or symptoms of illness for children older than four months; • Symptoms of possible severe illness, such as unusual tiredness, uncontrolled coughing, unexplained irritability, persistent crying, difficulty breathing, wheezing, or other unusual signs; • Diarrhea; two or more times of loose stool during the past 24 hours, or if diarrhea is accompanied by fever, exclude for 48 hours after the symptoms end; • Blood in stools not due to change in diet, medication, or hard stools; • Vomiting; two or more times in the past 24 hours, or one time if accompanied by a fever until 48 hours after the symptoms end or until a health care provider determines the vomiting is not contagious and the child is not in danger of dehydration; • Ongoing stomach pain (more than two hours) or off-and-on pain due to a fever or other symptom; Symptoms of Illness for Exclusion Includes: • Mouth sores with drooling; • Rash with fever or behavior change; • Purulent conjunctivitis ￿pink eye￿ (defined as pink or red conjunctiva with white or yellow eye discharge), until 24 hours after starting antibiotic treatment; • Scabies, until 24 hours after starting treatment; • Pediculosis ￿head lice￿ or nits, until 24 hours after starting treatment; • Tuberculosis, as directed by DPH; • Impetigo, until 24 hours after starting antibiotic treatment and sores are dry; • Strep throat or other streptococcal infection, until 24 hours after starting antibiotic treatment; • Varicella-Zoster ￿chicken pox,￿ until all sores have crusted and are dry (usually six days); • Shingles, only if sores cannot be covered by clothing or a bandage; if not, exclude until sores have crusted and are dry; • Pertussis, until completing five days of antibiotic treatment; • Mumps, until five days after onset of glandular swelling; • Hepatitis A virus, until one week after onset of jaundice, or as directed by DPH; • Measles, until four days after arrival of rash; • Rubella, until seven days after arrival of rash; • Herpetic gingivostomatitis ￿cold sores,￿ if the child is too young to have control of saliva; or • Unspecified short-term illness, not chronic illness, if the child is unable to participate in activities or the center cannot provide care for this child and the other children. B. Temperatures for children under three years old must be taken using a non- glass thermometer under the arm or by a forehead scan. Oral temperatures may be taken on children ages three and older when a digital thermometer is used. Rectal and ear temperatures may be taken only by a licensed health care professional. C. A licensee shall ensure that if a child shows signs of ill health, as listed above, the licensee will remove the child from the group of well children to a separate area as described in Section 52. D. A licensee may permit a child to return to the center when the symptoms are gone, documentation from the child’s health care provider states the child has been diagnosed and the illness or symptoms poses no serious health risk to the child or to other children, or the child does not have symptoms for exclusion as listed in the center’s written health exclusion policy. E. A licensee shall ensure parents or guardians are notified when their child has been exposed to a contagious disease or condition. F. A licensee shall report a reportable communicable disease to DPH. For information on these diseases, the licensee shall contact DPH or refer to their website (currently listed as https://dhss.delaware.gov/dhss/dph/dpc/rptdisease.html.) G. A licensee may not permit a child with a reportable communicable disease to be admitted to or remain at the center, unless the child's health care provider documents the child has been evaluated and the disease poses no health risk to the child or to others or DPH has advised that the child is not a health risk to others. If the health care provider states the child may return and DPH says the child cannot return, the licensee shall follow DPH’s instructions. H. When a health care provider diagnosed a child as having a reportable vaccine- preventable communicable disease, a licensee shall exclude all children who were not immunized against the disease following DPH’s instructions. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Family and Large Family Child Care Homes Regulation 23 & 41 https://education.delaware.gov/wp-content/uploads/2022/08/DELACARE-FCCH- LFCCH-Regulations-August-2022.pdf 23. Children's Health Appraisal A. A licensee shall ensure that within one month of starting care, each child's file contains a health appraisal that includes an immunization record. A health care provider shall have conducted this appraisal within the last 12 months. A licensee does not need a child’s health appraisal if other federal or State laws require the home to admit a child without an appraisal. Health appraisals must be updated every 13 months. A licensee shall keep the most recent appraisal on file and it must include: Health Appraisal Requirements: • A health history; • Physical examination; • Growth and development; • Age-appropriate immunizations as described in Appendix VIII; • Proof of blood lead screening for children at or around age 12 months and at or around 24 months; • Proof of single blood lead screening after age 24 months for all children including school-age, if blood lead tests were not conducted at or around age 12 months and at or around age 24 months; • Medical information for treatment in case of emergency; and • Recommendations regarding required medication, allergies, restrictions or modifications of the child's activities, diet, or care, if applicable. B. A licensee is not required to update health appraisals for children in grades kindergarten or higher after receiving one completed after the child began kindergarten or a higher grade. C. A licensee shall ensure a child whose parent or guardian objects to immunizations on a religious basis or whose health care provider certifies that immunizations may be harmful to the child's health will be exempt from the immunization requirement. 1. A notarized affidavit of religious belief or documentation from a health care provider is required for this exemption. 2. A licensee shall place this documentation in the child's file. D. A licensee shall ensure a child whose parent or guardian objects to blood lead screening due to a sincere religious belief will be exempt from this blood screening requirement. 1. A notarized affidavit of religious belief is required for this exemption. 2. A licensee shall place this documentation in the child’s file. 41. Child Health Exclusions A. A licensee may not permit a child who has symptoms listed below to enter or remain at the home. The child may only return when the symptoms are gone or with documentation from a health care provider stating the illness or symptoms pose no serious health risk to anyone. The documentation must be written or include a written follow-up if communicated verbally. The symptoms for exclusion must include, but not be limited to, the following: Symptoms of Illness for Exclusion Includes: • Temperature of 100°F or higher without medication even if there has not been a change in behavior for infants four months old and younger; • Temperature of 101°F or higher without medication accompanied by behavior changes or symptoms of illness for children older than four months; Symptoms of Illness for Exclusion Includes: • Symptoms of possible severe illness, such as unusual tiredness, uncontrolled coughing, unexplained irritability, persistent crying, difficulty breathing, wheezing, or other unusual signs; • Diarrhea; two or more times of loose stool during the past 24 hours, or if diarrhea is accompanied by fever, exclude for 48 hours after the symptoms end; • Blood in stools not due to change in diet, medication, or hard stools; • Vomiting; two or more times in the past 24 hours, or one time if accompanied by a fever until 48 hours after the symptoms end or until a health care provider determines the vomiting is not contagious and the child is not in danger of dehydration; • Ongoing stomach pain (more than two hours) or off-and-on pain due to a fever or other symptom; • Mouth sores with drooling; • Rash with fever or behavior change; • Purulent conjunctivitis ￿pink eye￿ (defined as pink or red conjunctiva with white or yellow eye discharge), until 24 hours after starting antibiotic treatment; • Scabies, until 24 hours after starting treatment; • Pediculosis ￿head lice￿ or nits, until 24 hours after starting treatment; • Tuberculosis, as directed by DPH; • Impetigo, until 24 hours after starting antibiotic treatment and sores are dry; • Strep throat or other streptococcal infection, until 24 hours after starting antibiotic treatment; • Varicella-Zoster ￿chicken pox,￿ until all sores have crusted and are dry (usually six days); • Shingles, only if sores cannot be covered by clothing or a bandage; if not, exclude until sores have crusted and are dry; • Pertussis, until completing five days of antibiotic treatment; • Mumps, until five days after onset of glandular swelling; • Hepatitis A virus, until one week after onset of jaundice, or as directed by DPH; • Measles, until four days after arrival of rash; • Rubella, until seven days after arrival of rash; • Herpetic gingivostomatitis ￿cold sores,￿ if the child is too young to have control of saliva; or • Unspecified short-term illness, not chronic illness if the child is unable to participate in activities or the facility cannot provide care for this child and the other children. B. A licensee shall ensure temperatures for children under three years old are taken with a non-glass thermometer under the arm or by forehead scan. 1. A digital oral thermometer may be used for children three years and older. 2. Rectal and ear temperatures may not be taken. C. A licensee shall ensure that if a child shows signs of ill health as listed above, the child's rest, comfort, food, drink, and activity needs are met until the child is picked up from the home. D. A licensee shall notify parent or guardians when their child has been exposed to a contagious disease or condition. E. A licensee shall report reportable communicable diseases to DPH. For information on these diseases, a licensee shall call DPH or refer to their website (currently listed as htttps://www.dhss.delaware.gov/dph/dpc/rptdisease.html). F. A licensee may not allow a child with a reportable communicable disease to be admitted to or remain at the home unless a health care provider documents that the illness poses no serious health risk to anyone or DPH tells the licensee that the child is not a health risk to others. If the health care provider states the child may return and DPH says the child cannot return, follow DPH's instructions. G. When a health care provider diagnosed a child with a reportable vaccine- preventable communicable disease, a licensee shall exclude all children who are not immunized against the disease following DPH's instructions. 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: Not Applicable to the Office of Child Care Licensing. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Not Applicable to the Office of Child Care Licensing. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: This is not applicable. Relative Care providers are the only exempt category that can provide care in the child’s own home, but it is care provided by a relative only. Relative Care providers are required to participate in a Relative Orientation on program rules and regulations. They are also required to participate in 28 hours of CCDF approved training and 3 hours of a health and safety refresher training annually. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Youth Camps Regulation 33 & 37 https://education.delaware.gov/wp-content/uploads/2021/10/Delacare- Regulations-For-Youth-Camps.pdf 33. Child Health Appraisal A. A licensee shall ensure that before beginning camp, each child’s file has a health appraisal conducted within the last 12 months that includes: Health Appraisal Requirements: • A health history; • Physical examination; • Growth and development; • Age-appropriate immunization as described in Appendix IV and V; • Medical information for treatment in case of emergency; and • Recommendations regarding required medication, allergies, restrictions or modifications of the child's activities, diet, or care, if applicable. B. A licensee shall ensure a child whose parent/guardian objects to immunizations on a religious basis or whose health care provider certifies that the immunization may be harmful to the child’s health will be exempt from the immunization requirement. 1. A notarized statement or documentation from a health care provider is required for an exemption related to an immunization being harmful to a child’s health. 2. A licensee shall place this documentation in the child’s file. 37. Child Health Exclusions A. A licensee may not permit a child who has symptoms of illness listed below to be admitted to or remain at the camp. The child may only return when the symptoms are gone or with documentation from a health care provider, stating the child has been diagnosed and the illness or symptoms pose no serious health risk to the child or to other children. The symptoms for exclusion must include, but not be limited to, the following: Symptoms of Illness for Exclusion Includes: • Temperature of 101 °F or higher without medication accompanied by behavior changes or symptoms of illness; Symptoms of Illness for Exclusion Includes: • Symptoms of possible severe illness, such as unusual tiredness, uncontrolled coughing, unexplained irritability, persistent crying, difficulty breathing, wheezing, or other unusual signs; • Diarrhea; two or more times of loose stool during the past 24 hours, or if diarrhea is accompanied by fever, exclude for 48 hours after the symptoms end; • Blood in stools not due to change in diet, medication, or hard stools; • Vomiting; two or more times in the past 24 hours, or one time if accompanied by a fever until 48 hours after the symptoms end or until a health care provider determines the vomiting is not contagious and the child is not in danger of dehydration; • Ongoing stomach pain (more than two hours) or off-and-on pain due to a fever or other symptom; • Mouth sores with drooling; • Rash with fever or behavior change; • Purulent conjunctivitis ￿pink eye￿ (defined as pink or red conjunctiva with white or yellow eye discharge), until 24 hours after starting antibiotic treatment; • Scabies, until 24 hours after starting treatment; • Pediculosis ￿head lice￿ or nits, until 24 hours after starting treatment; • Tuberculosis, as directed by DPH; • Impetigo, until 24 hours after starting antibiotic treatment and sores are dry; • Strep throat or other streptococcal infection, until 24 hours after starting antibiotic treatment; • Varicella-Zoster ￿chicken pox,￿ until all sores have crusted and are dry (usually six days); • Shingles, only if sores cannot be covered by clothing or a bandage; if not, exclude until sores have crusted and are dry; • Pertussis, until completing five days of antibiotic treatment; • Mumps, until five days after onset of glandular swelling; • Hepatitis A virus, until one week after onset of jaundice, or as directed by DPH; • Measles, until four days after arrival of rash; • Rubella, until seven days after arrival of rash; • Herpetic gingivostomatitis ￿cold sores,￿ if the child is too young to have control of saliva; or • Unspecified short-term illness, not chronic illness, if the child is unable to participate in activities or the camp cannot provide care for this child and the other children. B. Temperatures for children must be taken using a non-glass thermometer orally or under the arm or by forehead scan. Rectal and ear temperatures may be taken only by a licensed health care professional. C. A licensee shall ensure that if a child shows signs of ill health, as listed above, the licensee will remove the child from the group of well children to a separate area. 1. A licensee shall ensure the child’s individual needs for rest, comfort, food, drink, and activity are met until a parent/guardian picks up the child or a health care provider/consultant determines that the illness or symptoms pose no serious health risk to the child or to other children. 2. A licensee shall ensure all items used by an ill child, including rest equipment, bedding, utensils, and toys are cleaned with soap and water and then disinfected before being used by another child. D. A licensee may permit a child to return to the camp when the symptoms are gone, documentation from the child’s health care provider states the child has been diagnosed and the illness or symptoms poses no serious health risk to the child or to other children, or the child does not have symptoms for exclusion as listed in the camp’s written health exclusion policy. E. A licensee shall ensure parents/guardians are notified when their child has been exposed to a contagious disease or condition. F. A licensee shall report a reportable communicable disease to DPH. For information on these diseases, the licensee shall contact DPH or refer to their website (currently listed as http://www.dhss.delaware.gov/dhss/dph/dpc/rptdisease.html). G. A licensee may not permit a child with a reportable communicable disease to be admitted to or remain at the camp, unless the child's health care provider documents the child has been evaluated and the disease poses no health risk to the child or to others or DPH has advised that the child is not a health risk to others. If the health care provider states the child may return and DPH says the child cannot return, the licensee shall follow DPH’s instructions. H. When a health care provider diagnosed a child as having a reportable vaccine- preventable communicable disease, a licensee shall exclude all children not immunized against the disease following DPH’s instructions. 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: Early Care and Education and School-Age Centers Regulation 32 & 56 32. Orientation A. A licensee shall document that all staff members, all substitutes, and volunteers working at least five days or 40 hours a year receive training in the following topics before working with children: Orientation Requirements: • DELACARE Regulations (related to job duties); • Personnel and administrative policies; • Release of children including procedures for situations listed in Section 23; • Positive behavior supports; • Child accident and injury procedures; • Administration of medication certification, within two months of hire, if administering medication to children; • Child care goals and program for children; • Recordkeeping, including documenting children and their own attendance; • Family involvement; • Food and nutrition services, including proper handling, storage, preparation, and feeding of breast milk and formula, if applicable; • Safety and sanitation procedures; • Physical activity; • Screen time as described in subsection 76.D; • Photographing or videotaping children; • Transporting children, if applicable; • Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, reporting requirements; and • Information on federal and State laws or regulations applicable to children and families in care, including non-discrimination. B. The orientation must include the opportunity for staff members to ask questions and receive clarification on their job functions, licensing regulations, and center policies. When information is revised, a licensee shall ensure staff members are informed of the changes. C. A licensee shall ensure all staff members, all substitutes, and volunteers working at least five days or 40 hours a year complete OCCL's approved Health and Safety Training for Child Care Professionals before working with children. This training provides professional development training hours and includes the following topics: Health and Safety Training Topics: • Emergency preparedness and response planning, disaster and evacuation plans and procedures • Safe sleep practices, including prevention of sudden infant death syndrome; • Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; Health and Safety Training Topics: • Routine and emergency health care including health exclusions, prevention, and recognition of the symptoms of childhood illnesses, including reportable communicable diseases and immunizations; • Prevention of and response to emergencies due to food and allergic reactions; • Building and physical premises safety; • Handling and storage of hazardous materials and proper disposal of bio- contaminants; • Safety measures in transporting children, and • Administration of medication. 56. Sleeping Accommodations and Safe Sleep Environments A. A licensee shall ensure the program includes times for rest or sleep appropriate to each child's individual physical needs. 1. A quiet activity must be provided for children who have rested or slept for 30 minutes and do not seem to need or want more rest. 2. Preschool children are not required to rest or sleep. 3. Full staff-to-child ratios must be maintained during quiet play when children do not nap or sleep. B. Rest or sleep equipment must meet the safety standards required by CPSC or other recognized authority approved by OCCL and kept in a safe condition. C. A licensee shall ensure each child, except children who do not sleep at the center, has clean, safe, age-appropriate rest equipment. This may be a crib, playpen, pack-and-play (without ripped mesh), cot, bed, or mat. 1. Each child under 18 months old who does not walk must sleep in a crib, playpen, or pack-and-play. 2. Each child between 12 and 18 months old who walks may sleep on a cot, bed, or mat with written permission from the child’s parent or guardian. 3. Preschool-age and school-age children who do not nap at the center do not need sleep equipment. D. A licensee shall ensure a child's rest equipment is labeled with the child's name or assigned chart number and used only by that child while attending the program. 1. A licensee shall ensure chart numbers and assignments are documented and kept current. 2. Children must use their assigned equipment while enrolled in the center. 3. A licensee may assign a crib or pack-and-play to two children who attend on different days if it is cleaned and sanitized each day. E. Mattresses and sleep equipment must be non-absorbent and cleanable. 1. Cots, mats, and crib mattresses must be cleaned with soap and water and then sanitized weekly and when soiled or wet. 2. Mats must be stored so there is no contact with the sleep surface of another mat or cleaned and disinfected after each use. 3. Sleep equipment and bedding must be cleaned and sanitized before being assigned to another child. F. Children over age one must be provided with top and bottom covers. 1. Sheets and blankets or other bedding must be cleaned at least weekly and when soiled or wet. 2. Bedding must be stored so there is no contact with another child’s bedding. G. A licensee shall ensure sleep equipment is placed at least 1½ feet apart while in use. H. The rest area must provide enough light to allow the children to be seen. I. A licensee shall follow Safe Sleep Practices for Infants. Safe Sleep Practices Include the Following: • A licensee shall ensure cribs meet the current standards of CPSC or other safety authority recognized by OCCL. • Cribs must not be stacked while in use. • Cribs must not have gaps larger than 2 3/8 inches between the slats. • Infants must sleep only in cribs, pack-and-plays, and playpens. o The use of soft surfaces, such as soft mattresses, pillows, sofas, and waterbeds, are prohibited as infant sleep surfaces. o A licensee shall ensure infants who fall asleep in car seats, swings, seats, or other equipment are immediately moved to cribs, pack-and-plays, or playpens. Safe Sleep Practices Include the Following: • Cribs, pack-and-plays, and playpens must have top rails at least 20 inches above the mattresses. o The mattress must be set at its lowest position. o Latches on cribs, pack-and-plays, or playpens must be safe, secured, and hazard-free. • Crib mattresses must be firm and tight fitting to the frame and covered with a tight-fitting bottom sheet only. • Pillows, bibs, blankets, bumper pads, cloth diapers other than those worn by an infant, comforters, top sheets, quilts, sheepskin, stuffed toys, sleep positioning devices (except as described below), stuffed toys, and other items are prohibited in a crib, pack-and-play, and playpen. o Infants may use pacifiers in a crib. o Toys or objects attached to cribs, pack-and-plays, or playpens are prohibited. • Swaddling of infants requires written parent or guardian permission. Blankets are prohibited for swaddling when laying an infant down to sleep. However, swaddle-blanket sleepers may be used. • Infants must be placed on their backs when laid down to sleep as recommended by the American Academy of Pediatrics. o OCCL allows an exception if the infant's health care provider documents that a physical or medical condition requires a different sleeping position or use of a sleep-positioning device. o The health care provider must document the new sleep position or the device and how to use it. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Family and Large Family Child Care Homes Regulation 7A, 15D & 35 7. Procedures for Initial Licensure A. An applicant shall complete the following steps and submit the following information to OCCL when seeking a license: 1. Attend OCCL's information session and orientation to learn the application process and regulations; 2. Submit a completed Family Child Care Home Initial License Application (see Appendix I) or a Large Family Child Care Home Initial License Application (see Appendix II), as applicable, which includes: Required Application Information: • Applicant’s name, address, email, and phone numbers; • Applicant’s references: for corporations contact information for officers; for LLCs contact information for managing member; • Previous licensure information, if applicable; • Program information (including ages of children to be served); • Household members; and • Certifications that include: o Agreement to comply with federal and State laws and regulations including, but not limited to, the Americans with Disabilities Act and Delaware Equal Accommodations Law; o Statement that information supplied is true and correct; and o Acknowledgment that OCCL is required to make a thorough investigation of the applicant. 3. Submit the following items to OCCL: Items to be Submitted: • Proof of compliance with zoning codes, and, if applicable, other codes, regulations, guidelines, or laws, such as those from Division of Revenue, Department of Natural Resources and Environmental Control for septic systems, and Office of Drinking Water for well water; Items to be Submitted: • Documentation that the home is free of lead-based paint hazards. Homes constructed in or after 1978 are exempt from lead-paint risk assessments and testing; o If the home were constructed before 1978, an applicant or licensee shall provide a lead-paint risk assessment performed by an environmental testing firm certified by DPH showing the home to be free of lead-paint hazards. o If lead paint is identified but intact (i.e. not chipping, flaking, or peeling), the licensee shall monitor the identified areas at least every six months and document that the lead-based paint is intact (in good repair and not deteriorated). Lead-based paint is not regarded as a hazard if it is intact or not present in an accessible surface, a friction surface, or an impact surface that could result in an adverse human health effect. • If lead-paint hazards are identified in the risk assessment, the applicant or licensee shall remedy the hazards by hiring a lead-safe contractor (lead abatement or renovation firm) certified by DPH to make the repairs. o Once the repairs are made, a lead-dust clearance inspection must be performed by an environmental testing firm certified by DPH to confirm the home is free of lead-based paint hazards. o An applicant or licensee shall provide the lead-dust clearance testing results to OCCL within five business days to confirm the home is free of lead-based paint hazards. o Children may not be present during repairs and the home must stay closed until the results of the dust clearance test are at appropriate levels and the lead-safe contractor states it is safe for the home to be open. • If any lead-based paint identified in a risk assessment becomes deteriorated or if lead-based paint is located in an area to be remodeled, a licensee shall retain a contractor certified by DPH to work using lead-safe work practices (lead abatement or lead renovator) to perform any renovation or repair in a pre-1978 child-occupied facility; o Records of any renovation or repair work must be forwarded to OCCL within five business days. o Children may not be present during repairs or renovation until a lead dust clearance test is obtained and the lead-safe contractor states it is safe for the home to be open. • Evidence showing each room used for child care to be free of radon hazards using the Environmental Protection Agency’s guidelines; o Testing may be performed by the property owner or an inspector certified by the American Association of Radon Scientists, the National Radon Safety Board, or any organization recognized by the EPA or State of Delaware Radon Program. o If testing indicates a radon level over 4.0 pCi/L, radon mitigation according to industry standards must occur or a long-term radon test (90-120 days) must indicate a level less than 4.0 pCi/L. • Electrical inspection of the home conducted by a State fire marshal recognized electrical inspection agency; Items to be Submitted: • Current certifications in CPR including a skills demonstration and first aid for the ages of the children in care. Applicants for large family homes are exempt from this requirement if not serving as a staff member; • The names, addresses, phone numbers, and email addresses for three references who are familiar with, but not related to, the applicant and can describe the applicant's interactions with children; • Release of employment form that allows OCCL to collect service letters as per 19 Del.C. §708. The form will list the applicant's current or most recent employer and all health care and child care facilities where the applicant worked within the past five years. If an applicant has no former employer, the applicant shall provide information for two more references; • Comprehensive background checks for the applicant, adult household members, substitutes, staff members, and adult volunteers including State and federal fingerprint checks. o In addition to the Delaware fingerprinting, applicants, adult household members, substitutes, staff members, and adult volunteers who currently reside outside of Delaware must contact their state of residence and complete a fingerprinted state criminal history search and a name-based child abuse and neglect search. o Applicants, adult household members, substitutes, staff members, and adult volunteers who have resided outside of Delaware in the last five years must contact each state of residence, and request a criminal history search and a child abuse and neglect search. o After the out-of-state searches are completed, the applicant must submit the results immediately to CHU. o The person may not be alone with children until CHU notifies the licensee of the person’s eligibility after completing the comprehensive background check. o When OCCL has a reason to believe the health, safety, or welfare of a child in care may be at risk, OCCL may request parent or guardian permission for a comprehensive background check on a child household member and other medical, psychological, counseling, school, and probation records. OCCL may obtain information from the Department of Services for Children, Youth and Their Families; • Documentation of any case where the applicant gave up or lost custody of a child, if applicable; • Health appraisals for the applicant, all adult household members, and the substitute completed within one year before the application date that includes a tuberculosis (TB) test or medical professional risk assessment that verifies the person does not pose a threat of transmitting tuberculosis to children or others. The TB test or medical professional risk assessment must be completed within one year before the application date. This appraisal must confirm the person's health and document medical or physical conditions that pose a direct threat to the health and safety of children or others and any reasonable accommodations that may be required. This documentation shall be provided to OCCL for the purposes of determining whether the health condition creates a significant risk to children; • Health appraisals for child household members; • State business license or verification of tax-exempt status; • Sample two-week menu, if providing meals or snacks (if using a catering service, a copy of the caterer’s food establishment permit); and Items to be Submitted: • Documentation of completion of pre-service training in the following topics, if the applicant will work with children: o Six hours of quality-assured child development; o Three hours of quality-assured positive behavior supports or social-emotional development; o Prevention and control of infectious diseases, including immunization; o OCCL’s approved Health and Safety Training for Child Care Professionals that includes the following topics: ￿ Prevention and control of communicable diseases including immunization; ￿ Safe sleep practices, including prevention of sudden infant death syndrome; ￿ Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; ￿ Prevention of and response to emergencies due to food and allergic reactions; ￿ Building and physical grounds safety; ￿ Emergency preparedness and response planning; ￿ Handling and storage of hazardous materials and proper disposal of bio- contaminants; ￿ Administration of medication; and ￿ Safety measures in transporting children. o Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements (certificate required); • Landlord approval, if renting; • Emergency plan; and • Large family applicants shall complete the additional requirements for large family homes as listed in Sections 60 through 70. 15D. A licensee shall document on the form provided by OCCL that substitutes used for non-emergency situations receive training in the following topics before working with children: Training Requirements for Non-Emergency-Use Substitutes: • DELACARE Regulations; • Policies and procedures of the home; • Emergency preparedness and disaster and evacuation plans; o OCCL’s approved Health and Safety Training for Child Care Professionals that includes the following topics: ￿ Safe sleep practices, including prevention of sudden infant death syndrome; ￿ Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; ￿ Prevention of and response to emergencies due to food and allergic reactions; ￿ Prevention and control of communicable diseases, including immunization; ￿ Building and physical grounds safety; ￿ Handling and storage of hazardous materials and proper disposal of bio- contaminants; ￿ Administration of medication; and ￿ Safety measures in transporting children. o Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements (certificate required); • CPR and first aid certifications; and • Administration of medication. 35. Sleeping Accommodations and Safe Sleep Environments A. A licensee shall ensure the program includes times for rest or sleep appropriate to each child's individual physical needs. 1. A quiet activity must be provided for children who have rested for 30 minutes and do not seem to need or want more rest. 2. Preschool children not needing to rest or sleep must have at least 30 minutes of quiet play daily. B. Rest or sleep equipment must meet the safety standards required by CPSC or other recognized authority approved by OCCL and kept in a safe condition. C. A licensee shall ensure each child, except children who do not sleep at the home, has clean, safe, age-appropriate sleep equipment. This may be a crib, playpen, pack-and-play (without ripped mesh), cot, bed, or mat. 1. Each child under 18 months old who does not walk must sleep in a crib, playpen, or pack-and-play. 2. A child between 12 and 18 months old who walks may sleep on a cot, mat, or bed with written parent or guardian permission. 3. Preschool-age and school-age children who do not nap at the home do not need sleep equipment. D. A licensee shall ensure a child's rest equipment is labeled with the child's name or assigned chart number unless cleaned and disinfected after each use. 1. A licensee shall document chart numbers and assignments and keep them current. 2. Children must use only their assigned equipment while enrolled in the home. E. Mattresses and sleep equipment must be non-absorbent and cleanable. 1. Cots, mats, and crib mattresses must be cleaned with soap and water and then sanitized weekly and when soiled or wet. 2. Mats must be stored so there is no contact with the sleep surface of another mat or cleaned and disinfected after each use. 3. Sleep equipment and bedding must be cleaned and sanitized before being assigned to another child. F. Children over age one must be provided with top and bottom covers. 1. Sheets and blankets or other bedding must be cleaned at least weekly and when soiled or wet. 2. Bedding must be stored so there is no contact with another child’s bedding. G. A licensee shall ensure sleep equipment is placed at least 1½ feet apart while in use. H. The rest area must provide enough light to allow the children to be seen. I. A licensee shall follow Safe Sleep Practices for Infants. Safe Sleep Practices Include the Following: • A licensee shall ensure cribs meet the current standards of CPSC or other safety authority recognized by OCCL. • Infants must sleep only in cribs, pack-and-plays, and playpens. o The use of soft surfaces, such as soft mattresses, pillows, sofas, and waterbeds, are prohibited as infant sleep surfaces. o A licensee shall ensure infants who fall asleep in car seats, swings, seats, or other equipment are immediately moved to cribs, pack and-plays, or playpens. • Cribs must not be stacked while in use. • Cribs must not have gaps larger than 2 3/8 inches between the slats. • Cribs, pack-and-plays, and playpens must have top rails at least 20 inches above the mattresses. o The mattress must be set at its lowest position. o Latches on cribs, pack-and-plays, or playpens must be safe, secured, and hazard-free. • Crib mattresses must be firm and tight fitting to the frame and covered with a tight-fitting bottom sheet only. • Pillows, bibs, blankets, bumper pads, cloth diapers other than those worn by an infant, comforters, top sheets, quilts, sheepskin, stuffed toys, sleep positioning devices (except as described below), and other items are prohibited in a crib, pack-and-play, and playpen. o Infants may use pacifiers in a crib. o Toys or objects attached to cribs, pack-and-plays, or playpens are prohibited. • Swaddling of infants requires written parent or guardian permission. Blankets are prohibited for swaddling when laying an infant down to sleep. However, swaddle-blanket sleepers may be used. • Infants must be placed on their backs when laid down to sleep as recommended by the American Academy of Pediatrics. o OCCL allows an exception if the infant's health care provider documents that a physical or medical condition requires a different sleeping position or use of a sleep-positioning device. o The health care provider must document the new sleep position or the device and how to use it. J. The licensee may allow a maximum of two children in care under age two to sleep in other areas with written parent permission and documented sleep checks every 15 minutes. 1. The other area must be on the same level of the home where care is provided. 2. If the area or room has a door, it must remain open when a child is using the area. K. The licensee may allow children over age two to sleep alone in other areas as long as the area is on the same level of the home where care is provided. If the area or room has a door, it must remain open when a child is using the area. L. Household children may sleep in their own bedroom as long as it is on the same level of the home where care is provided. iii. All CCDF-eligible licensed in-home care. Provide the standard: Not Applicable to the Office of Child Care Licensing. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Not Applicable to the Office of Child Care Licensing. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Not Applicable to the Office of Child Care Licensing. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: This is not applicable. Relative Care providers are the only exempt category that can provide care in the child’s own home, but it is care provided by a relative only. Relative Care providers are required to participate in a Relative Orientation on program rules and regulations. They are also required to participate in 28 hours of CCDF approved training and 3 hours of a health and safety refresher training annually. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Not applicable to this age group. 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: Early Care and Education and School-Age Centers Regulation 32 & 63 32. Orientation A. A licensee shall document that all staff members, all substitutes, and volunteers working at least five days or 40 hours a year receive training in the following topics before working with children: Orientation Requirements: • DELACARE Regulations (related to job duties); • Personnel and administrative policies; • Release of children including procedures for situations listed in Section 23; • Positive behavior supports; • Child accident and injury procedures; • Administration of medication certification, within two months of hire, if administering medication to children; • Child care goals and program for children; • Recordkeeping, including documenting children and their own attendance; • Family involvement; • Food and nutrition services, including proper handling, storage, preparation, and feeding of breast milk and formula, if applicable; • Safety and sanitation procedures; • Physical activity; • Screen time as described in subsection 76.D; • Photographing or videotaping children; • Transporting children, if applicable; • Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, reporting requirements; and • Information on federal and State laws or regulations applicable to children and families in care, including non-discrimination. B. The orientation must include the opportunity for staff members to ask questions and receive clarification on their job functions, licensing regulations, and center policies. When information is revised, a licensee shall ensure staff members are informed of the changes. C. A licensee shall ensure all staff members, all substitutes, and volunteers working at least five days or 40 hours a year complete OCCL's approved Health and Safety Training for Child Care Professionals before working with children. This training provides professional development training hours and includes the following topics: Health and Safety Training Topics: • Emergency preparedness and response planning, disaster and evacuation plans and procedures • Safe sleep practices, including prevention of sudden infant death syndrome; • Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; Health and Safety Training Topics: • Routine and emergency health care including health exclusions, prevention, and recognition of the symptoms of childhood illnesses, including reportable communicable diseases and immunizations; • Prevention of and response to emergencies due to food and allergic reactions; • Building and physical premises safety; • Handling and storage of hazardous materials and proper disposal of bio- contaminants; • Safety measures in transporting children, and • Administration of medication. 63. Administration of Medication A. A licensee shall ensure a trained staff member, who has received a valid administration of medication certificate from OCCL, is present at all times to provide both scheduled and emergency medications to children in care. A certified staff member shall be present during field trips and routine program outings to administer medication when needed. The administration of medication certificate must be on file at the center for each certified staff member. 1. OCCL only allows staff members who are at least 18 years old to be certified to give medication to children. This certification includes passing OCCL's designated test on the information in the Administration of Medication Self-Study Training Guide as described in Appendix V. Health care providers, nurses, or other qualified medical health personnel are permitted to administer medication to children in a center. 2. Written permission from the child's parent or guardian for each medication to be administered is required. 3. Unused medication must be returned to the parent or guardian when no longer needed by the child. 4. A licensee has discretion to designate which staff members shall administer medication. B. A licensee shall ensure that the parent or guardian of a child provides the following information for each medication given: Information Required for Administering Medication: • The name and birth date of the child; • Medication allergies; • Doctor name and phone number; • Pharmacy name and phone number; • Name of medication; • Dosage (amount given); • Time or frequency (when given); • Route of administration, such as oral, eye, nose, mouth, topical, inhalation, injection; • Medication expiration date; • End date (when to stop giving); • Reason for medication; and • Special directions. C. A licensee shall ensure all prescription medication is given as prescribed. Prescription medication must be: Prescription Medication Must be: • Stored securely and out of children's reach; • Refrigerated, if applicable, in a closed container separate from food; • In its original container and labeled with directions on how to give or use it; • Current and has not expired; • Given only to the child who has been prescribed the medication, verified by the child’s name on the container; and • Given to the child according to the dosage and administration instructions on the medication container. If no dosage or administration information is listed on the container, such information must be provided in writing by the child’s health care provider. D. A licensee shall ensure the following requirements are followed when non- prescribed medication is given: Non-prescription Medication Must be: • Stored securely and out of children's reach; • Refrigerated, if applicable, in a closed container separate from food; • In its original container and properly labeled with directions on how to give or use it; • Current and has not expired; • Labeled with the child's name; and • Given as written on the container's instructions, or as otherwise instructed in writing by the child’s health care provider. E. A licensee shall keep a written record of medication administered to children recorded on the Medication Administration Record (MAR) including each medication dosage, time administered, by whom administered, adverse effects observed, and medication errors. 1. Medication errors include giving the wrong medication, giving the wrong dose, failing to give the medication at the correct time or at all, giving medication to the wrong child, giving the medication by the wrong route, or giving medication without documenting the administration. 2. Adverse effects or errors in administering must be immediately reported to the parent or guardian. 3. When known, a licensee shall notify OCCL when unwanted effects or errors in administering medication result in death or medical treatment as described in subsection 14.D. 4. Documentation of administration of medication must be placed in the child’s file or in a central administration of medication log and kept while the child is enrolled in the center. F. A licensee may administer medication to a child who has a medical need during child care hours that requires the administration of medication by a non- intravenous injection. In addition to the requirements in subsection 63.B, the parent or guardian shall provide the licensee with the following information, when medication is administered by non-intravenous injection: 1. Written parent or guardian permission for the center to provide the requested medical care; and 2. A written statement from the child’s health care provider stating: a. The specific medication by injection needed by the child; b. That for the child’s health, the requested medication by injection must be administered during the hours the child attends the center; c. That the requested medication by injection may be appropriately administered at the center by non-medical child care staff; and d. Whether any additional training is necessary for non-medical staff members to administer the medication or medical care appropriately. If additional training is required, the health care provider shall provide instructions including information about: the type of training, who may provide such training (which may include the child’s parent or guardian), and any other instructions needed to provide the requested medication by injection. 1) If additional training is required, the licensee shall identify staff members who are certified to administer medication and have them complete the additional training specified by the child’s health care provider. Such training must be completed in a reasonable time based on the availability of such training. 2) The licensee shall keep documentation of this training with the child’s MAR and inform the parent or guardian in writing which staff members are authorized and trained to perform the requested medication by injection. This information must be updated as needed. 3) The licensee shall ensure that at least one staff member, who is trained as required by 63.F.2.d.1, to provide the requested medical care, is present at the center at all times while the child is present. e. A licensee shall ensure this information is reviewed with the child’s parent or guardian and health care provider yearly, and as needed. Reviews and changes must be written, dated, agreed upon by all parties, and kept with the MAR. f. A school-age child may self-administer medical care, as described in Section 63 with written parent or guardian permission and written health care provider permission. These permissions must indicate the child is able to safely self-administer the prescribed medical care, identify and select the correct medicine and dosage, if applicable, and administer the medical care at the correct time and frequency. The licensee shall keep documentation of these permissions with the child’s MAR. A staff member with a current administration of medication certificate shall be present during the self-administration and document all information required on the MAR, including that the medication was self-administered by the child. G. The administration of medication may be required under State and federal laws including but not limited to the Americans with Disabilities Act and the Delaware Equal Accommodations Law. If an agency, administrative body, court, or other entity responsible for enforcing Federal, State, and local laws and regulations makes a finding that the refusal of a licensee to administer medication is a violation of the law, OCCL shall take appropriate enforcement action consistent with subsection 12.E, due to licensee’s failure to comply with subsection 15.B. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Family and Large Family Child Care Homes Regulation 7A, 15D, & 42 7. Procedures for Initial Licensure A. An applicant shall complete the following steps and submit the following information to OCCL when seeking a license: 1. Attend OCCL's information session and orientation to learn the application process and regulations; 2. Submit a completed Family Child Care Home Initial License Application (see Appendix I) or a Large Family Child Care Home Initial License Application (see Appendix II), as applicable, which includes: Required Application Information: • Applicant’s name, address, email, and phone numbers; • Applicant’s references: for corporations contact information for officers; for LLCs contact information for managing member; • Previous licensure information, if applicable; • Program information (including ages of children to be served); • Household members; and • Certifications that include: o Agreement to comply with federal and State laws and regulations including, but not limited to, the Americans with Disabilities Act and Delaware Equal Accommodations Law; o Statement that information supplied is true and correct; and o Acknowledgment that OCCL is required to make a thorough investigation of the applicant. 3. Submit the following items to OCCL: Items to be Submitted: • Proof of compliance with zoning codes, and, if applicable, other codes, regulations, guidelines, or laws, such as those from Division of Revenue, Department of Natural Resources and Environmental Control for septic systems, and Office of Drinking Water for well water; Items to be Submitted: • Documentation that the home is free of lead-based paint hazards. Homes constructed in or after 1978 are exempt from lead-paint risk assessments and testing; o If the home were constructed before 1978, an applicant or licensee shall provide a lead-paint risk assessment performed by an environmental testing firm certified by DPH showing the home to be free of lead-paint hazards. o If lead paint is identified but intact (i.e. not chipping, flaking, or peeling), the licensee shall monitor the identified areas at least every six months and document that the lead-based paint is intact (in good repair and not deteriorated). Lead-based paint is not regarded as a hazard if it is intact or not present in an accessible surface, a friction surface, or an impact surface that could result in an adverse human health effect. • If lead-paint hazards are identified in the risk assessment, the applicant or licensee shall remedy the hazards by hiring a lead-safe contractor (lead abatement or renovation firm) certified by DPH to make the repairs. o Once the repairs are made, a lead-dust clearance inspection must be performed by an environmental testing firm certified by DPH to confirm the home is free of lead-based paint hazards. o An applicant or licensee shall provide the lead-dust clearance testing results to OCCL within five business days to confirm the home is free of lead-based paint hazards. o Children may not be present during repairs and the home must stay closed until the results of the dust clearance test are at appropriate levels and the lead-safe contractor states it is safe for the home to be open. • If any lead-based paint identified in a risk assessment becomes deteriorated or if lead-based paint is located in an area to be remodeled, a licensee shall retain a contractor certified by DPH to work using lead-safe work practices (lead abatement or lead renovator) to perform any renovation or repair in a pre-1978 child-occupied facility; o Records of any renovation or repair work must be forwarded to OCCL within five business days. o Children may not be present during repairs or renovation until a lead dust clearance test is obtained and the lead-safe contractor states it is safe for the home to be open. • Evidence showing each room used for child care to be free of radon hazards using the Environmental Protection Agency’s guidelines; o Testing may be performed by the property owner or an inspector certified by the American Association of Radon Scientists, the National Radon Safety Board, or any organization recognized by the EPA or State of Delaware Radon Program. o If testing indicates a radon level over 4.0 pCi/L, radon mitigation according to industry standards must occur or a long-term radon test (90-120 days) must indicate a level less than 4.0 pCi/L. • Electrical inspection of the home conducted by a State fire marshal recognized electrical inspection agency; Items to be Submitted: • Current certifications in CPR including a skills demonstration and first aid for the ages of the children in care. Applicants for large family homes are exempt from this requirement if not serving as a staff member; • The names, addresses, phone numbers, and email addresses for three references who are familiar with, but not related to, the applicant and can describe the applicant's interactions with children; • Release of employment form that allows OCCL to collect service letters as per 19 Del.C. §708. The form will list the applicant's current or most recent employer and all health care and child care facilities where the applicant worked within the past five years. If an applicant has no former employer, the applicant shall provide information for two more references; • Comprehensive background checks for the applicant, adult household members, substitutes, staff members, and adult volunteers including State and federal fingerprint checks. o In addition to the Delaware fingerprinting, applicants, adult household members, substitutes, staff members, and adult volunteers who currently reside outside of Delaware must contact their state of residence and complete a fingerprinted state criminal history search and a name-based child abuse and neglect search. o Applicants, adult household members, substitutes, staff members, and adult volunteers who have resided outside of Delaware in the last five years must contact each state of residence, and request a criminal history search and a child abuse and neglect search. o After the out-of-state searches are completed, the applicant must submit the results immediately to CHU. o The person may not be alone with children until CHU notifies the licensee of the person’s eligibility after completing the comprehensive background check. o When OCCL has a reason to believe the health, safety, or welfare of a child in care may be at risk, OCCL may request parent or guardian permission for a comprehensive background check on a child household member and other medical, psychological, counseling, school, and probation records. OCCL may obtain information from the Department of Services for Children, Youth and Their Families; • Documentation of any case where the applicant gave up or lost custody of a child, if applicable; • Health appraisals for the applicant, all adult household members, and the substitute completed within one year before the application date that includes a tuberculosis (TB) test or medical professional risk assessment that verifies the person does not pose a threat of transmitting tuberculosis to children or others. The TB test or medical professional risk assessment must be completed within one year before the application date. This appraisal must confirm the person's health and document medical or physical conditions that pose a direct threat to the health and safety of children or others and any reasonable accommodations that may be required. This documentation shall be provided to OCCL for the purposes of determining whether the health condition creates a significant risk to children; • Health appraisals for child household members; • State business license or verification of tax-exempt status; • Sample two-week menu, if providing meals or snacks (if using a catering service, a copy of the caterer’s food establishment permit); and Items to be Submitted: • Documentation of completion of pre-service training in the following topics, if the applicant will work with children: o Six hours of quality-assured child development; o Three hours of quality-assured positive behavior supports or social-emotional development; o Prevention and control of infectious diseases, including immunization; o OCCL’s approved Health and Safety Training for Child Care Professionals that includes the following topics: ￿ Prevention and control of communicable diseases including immunization; ￿ Safe sleep practices, including prevention of sudden infant death syndrome; ￿ Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; ￿ Prevention of and response to emergencies due to food and allergic reactions; ￿ Building and physical grounds safety; ￿ Emergency preparedness and response planning; ￿ Handling and storage of hazardous materials and proper disposal of bio- contaminants; ￿ Administration of medication; and ￿ Safety measures in transporting children. o Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements (certificate required); • Landlord approval, if renting; • Emergency plan; and • Large family applicants shall complete the additional requirements for large family homes as listed in Sections 60 through 70. 15D. A licensee shall document on the form provided by OCCL that substitutes used for non-emergency situations receive training in the following topics before working with children: Training Requirements for Non-Emergency-Use Substitutes: • DELACARE Regulations; • Policies and procedures of the home; • Emergency preparedness and disaster and evacuation plans; o OCCL’s approved Health and Safety Training for Child Care Professionals that includes the following topics: ￿ Safe sleep practices, including prevention of sudden infant death syndrome; ￿ Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; ￿ Prevention of and response to emergencies due to food and allergic reactions; ￿ Prevention and control of communicable diseases, including immunization; ￿ Building and physical grounds safety; ￿ Handling and storage of hazardous materials and proper disposal of bio- contaminants; ￿ Administration of medication; and ￿ Safety measures in transporting children. o Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements (certificate required); • CPR and first aid certifications; and • Administration of medication. 42. Administration of Medication A. A licensee shall ensure a trained staff member, who has received a valid administration of medication certificate from OCCL is present at all times to provide both scheduled and emergency medications to children in care. A certified staff member shall be present during field trips and routine program outings to administer medication when needed. The administration of medication certificate must be on file at the home for each certified staff member. 1. OCCL only allows staff members who are at least 18 years old to be certified to give medication to children. This certification includes passing OCCL's designated test on the information in the Administration of Medication Self-Study Training Guide as described in Appendix IX. Health care providers, nurses, or other qualified medical health personnel may also give medication to children. 2. The licensee has discretion to designate which staff members shall administer medication. 3. Written parent or guardian permission for each needed medication is required. 4. A licensee shall return medication to the parent or guardian when it is no longer needed. B. A licensee shall ensure the parent or guardian provides the following information for each medication given: Information Required for Administering Medication: • The name and birth date of the child; • Medication allergies; • Doctor name and phone number; • Pharmacy name and phone number; • Name of medication; • Dosage (amount given); • Time or frequency (when given); • Route of administration, such as oral, eye, nose, mouth, topical, inhalation, injection; Information Required for Administering Medication: • Medication expiration date; • End date (when to stop giving); • Reason for medication; and • Special directions. C. A licensee shall ensure all prescription medication is given as prescribed. Prescription Medication must be: • Stored securely and out of children's reach; • Refrigerated, if applicable, in a closed container separate from food; • In its original container and labeled with directions on how to give or use it; • Current and has not expired; • Given only to the child who has been prescribed the medication, verified by the child’s name on the container; and • Given to the child according to the dosage and administration instructions on the medication container. If no dosage or administration information is listed on the container, such information must be provided in writing by the child’s health care provider. D. A licensee shall ensure the following requirements are followed when non prescribed medication is given. Non-Prescription Medication must be: • Stored securely and out of children's reach; • Refrigerated, if applicable, in a closed container separate from food; • In its original container and properly labeled with directions on how to give or use it; • Current and has not expired; • Labeled with the child's name; and • Given as written on the container's instructions, or as otherwise instructed in writing by the child’s health care provider. E. A licensee shall keep a written record of medication given to children on the Medication Administration Record (MAR) including each medication dosage, time given, who gave it, unwanted effects observed, and medication errors. 1. Medication errors include giving the wrong medication, giving the wrong dose, failing to give the medication at the correct time or at all, giving medication to the wrong child, giving the medication by the wrong route, or giving medication without documenting the administration. 2. Unwanted effects or errors in administering must be immediately reported to the parent or guardian. 3. When known, a licensee shall notify OCCL when unwanted effects or errors in administering medication result in death or medical treatment as described in Section 16. 4. A licensee shall keep the MAR in the child's file. F. A licensee may administer medication to a child who has a medical need during child care hours that requires the administration of medication by a non- intravenous injection. In addition to the requirements in subsection 42.B, the parent or guardian shall provide the licensee with the following information, when medication is administered by non-intravenous injection: 1. Written parent or guardian permission for the home to provide the requested medical care; and 2. A written statement from the child’s health care provider stating: a. The specific medication by injection needed by the child; b. That for the child’s health, the requested medication by injection must be administered during the hours the child attends the home; c. That the requested medication by injection may be appropriately administered at the home by non-medical child care staff; and d. Whether any additional training is necessary for non-medical staff to administer the medication by injection appropriately. If additional training is required, the health care provider shall provide instructions including information about the type of training, who may provide such training (which may include the child’s parent or guardian), and any other instructions needed to provide the requested medication by injection. 1) If additional training is required, the staff members who are certified to administer medication shall complete the additional training specified by the child’s health care provider. Such training must be completed in a reasonable period of time based on the availability of such training. 2) The licensee shall keep documentation of this training with the child’s MAR and inform the parent or guardian in writing who is authorized and trained to perform the requested medication by injection. This information must be updated as needed. 3) The licensee shall ensure that at least one staff member who is trained as required by subsection 42.F.2.d.1) to provide the requested medication by injection, is present at the home at all times while the child is present. e. A licensee shall ensure the requirements of subsection 42.F.2 are reviewed with the child’s parent or guardian and health care provider yearly, and as needed. Reviews and changes must be written, dated, agreed upon by all parties, and kept with the MAR. G. A school-age child may self-administer medical care, as described in subsections 42.B through 42.F, with written parent or guardian permission and written health care provider permission. These permissions must indicate the child is able to safely self-administer the prescribed medical care, identify and select the correct medicine and dosage, if applicable, and administer the medical care at the correct time and frequency. The licensee shall keep documentation of these permissions with the child’s MAR. A staff member with a current administration of medication certificate shall be present during the self-administration and document all information required on the MAR, including that the medication was self-administered by the child. H. The administration of medication may be required under State and federal laws, including but not limited to the Americans with Disabilities Act and the Delaware Equal Accommodations Law. If an agency, administrative body, court, or other entity responsible for enforcing Federal, State, and local laws and regulations makes a finding that the refusal of a licensee to administer medication is a violation of the law, OCCL shall take appropriate enforcement action consistent with subsection 11.E, due to licensee’s failure to comply with subsection 7.A.2. iii. All CCDF-eligible licensed in-home care. Provide the standard: Not Applicable to the Office of Child Care Licensing. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Not Applicable to the Office of Child Care Licensing. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Not Applicable to the Office of Child Care Licensing. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: This is not applicable. Relative Care providers are the only exempt category that can provide care in the child’s own home, but it is care provided by a relative only.. Relative Care providers are required to participate in a Relative Orientation on program rules and regulations. They are also required to participate in 28 hours of CCDF approved training and 3 hours of a health and safety refresher training annually. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Youth Camps Regulation 38 38. Administration of Medication A. A licensee shall ensure a trained staff member, who has received a valid administration of medication certificate from OCCL, is present at all times to provide both scheduled and emergency medications to children in care. A certified staff member shall be present during field trips to administer medication when needed. The administration of medication certificate must be on file at the camp for each certified staff member. 1. OCCL only allows staff members who are at least 18 years old to be certified to give medication to children. This certification includes passing OCCL's designated test on the information in the Administration of Medication Self-Study Training Guide as described in Appendix VI. Health care providers, nurses, or other qualified medical health personnel are permitted to administer medication to children in a camp without this certification. 2. Written permission from the child's parent/guardian for each medication to be administered is required. 3. Unused medication must be returned to the parent/guardian when no longer needed by the child. 4. A licensee has discretion to designate which staff members shall administer medication. B. A licensee shall ensure that the parent/guardian of a child provides the following information for each medication given: Information Required for Administering Medication: • The name and birth date of the child; • Medication allergies; • Doctor name and phone number; • Pharmacy name and phone number; • Name of medication; • Dosage (amount given); • Time or frequency (when given); • Route of administration, such as oral, eye, nose, mouth, topical, inhalation, injection; • Medication expiration date; • End date (when to stop giving); • Reason for medication; and • Special directions. C. A licensee shall ensure all prescription medication is given as prescribed. Prescription Medication Must be: • Stored securely and out of children's reach; • Refrigerated, if applicable, in a closed container separate from food; • In its original container and labeled with directions on how to give or use it; • Current and has not expired; • Given only to the child who has been prescribed the medication, verified by the child’s name on the container; and • Given to the child according to the dosage and administration instructions on the medication container. If no dosage or administration information is listed on the container, such information must be provided in writing by the child’s health care provider. D. A licensee shall ensure non-prescription medication is given as written on the container's instructions, or as otherwise instructed in writing by the child’s health care provider. Non-prescription Medication Must be: • Stored securely and out of children's reach; • Refrigerated, if applicable, in a closed container separate from food; • In its original container and properly labeled with directions on how to give or use it; • Current and has not expired; and • Labeled with the child's name. E. A licensee shall keep a written record of medication administered to children recorded on the Medication Administration Record (MAR) including each medication dosage, time administered, by whom administered, adverse effects observed, and medication errors. 1. Medication errors include giving the wrong medication, giving the wrong dose, failing to give the medication, giving medication to the wrong child, giving the medication by the wrong route, or accidental spills of medication. 2. Adverse effects or errors in administering must be immediately reported to the parent/guardian. 3. When known, a licensee shall notify OCCL when unwanted effects or errors in administering medication result in death or medical treatment as described in subsection 11.A. 4. Documentation of administration of medication must be placed in the child’s file or in a central administration of medication log and kept while the child is enrolled in the camp. F. A licensee may administer medication to a child who has a medical need during child care hours that requires the administration of medication by a non- intravenous injection. In addition to the requirements in subsection 38.B, the parent/guardian shall provide the licensee with the following information, when medication is administered by non-intravenous injection: 1. Written parent/guardian permission for the camp to provide the requested medical care; and 2. A written statement from the child’s health care provider stating: a. The specific medication by injection needed by the child; b. That for the child’s health, the requested medication by injection must be administered during the hours the child attends the camp; c. That the requested medication by injection may be appropriately administered at the camp by non-medical child care staff; and d. Whether any additional training is necessary for non-medical staff members to administer the medication or medical care appropriately. If additional training is required, the health care provider shall provide instructions including information about: the type of training, who may provide such training (which may include the child’s parent/guardian), and any other instructions needed to provide the requested medication by injection. 1) If additional training is required, the licensee shall identify staff members who are certified to administer medication and have them complete the additional training specified by the child’s health care provider. Such training must be completed in a reasonable time based on the availability of such training. 2) The licensee shall keep documentation of this training with the child’s MAR and inform the parent/guardian in writing which staff members are authorized and trained to perform the requested medication by injection. This information must be updated as needed. 3) The licensee shall ensure that at least one staff member, who is trained as required by 38.F.2.d.1 to provide the requested medical care, is present at the camp at all times while the child is present. e. A school-age child may self-administer medical care as described in Section 38, with written parent/guardian permission and written health care provider permission. These permissions must indicate the child is able to safely self-administer the prescribed medical care, identify and select the correct medicine and dosage, if applicable, and administer the medical care at the correct time and frequency. The licensee shall keep documentation of these permissions with the child’s MAR. A staff member with a current administration of medication certificate shall be present during the self-administration and document all information required on the MAR, including that the medication was self-administered by the child. G. The administration of medication may be required under State and federal laws, including but not limited to the Americans with Disabilities Act and the Delaware Equal Accommodations Law. If an agency, administrative body, court, or other entity responsible for enforcing Federal, State, and local laws and regulations makes a finding that the refusal of a licensee to administer medication is a violation of the law, OCCL shall take appropriate enforcement action consistent with Section 10, due to licensee’s failure to comply with subsection 12.B. 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: Early Care and Education and School-Age Centers Regulation 63 63. Administration of Medication A. A licensee shall ensure a trained staff member, who has received a valid administration of medication certificate from OCCL, is present at all times to provide both scheduled and emergency medications to children in care. A certified staff member shall be present during field trips and routine program outings to administer medication when needed. The administration of medication certificate must be on file at the center for each certified staff member. 1. OCCL only allows staff members who are at least 18 years old to be certified to give medication to children. This certification includes passing OCCL's designated test on the information in the Administration of Medication Self-Study Training Guide as described in Appendix V. Health care providers, nurses, or other qualified medical health personnel are permitted to administer medication to children in a center. 2. Written permission from the child's parent or guardian for each medication to be administered is required. 3. Unused medication must be returned to the parent or guardian when no longer needed by the child. 4. A licensee has discretion to designate which staff members shall administer medication. B. A licensee shall ensure that the parent or guardian of a child provides the following information for each medication given: Information Required for Administering Medication: • The name and birth date of the child; • Medication allergies; • Doctor name and phone number; • Pharmacy name and phone number; • Name of medication; • Dosage (amount given); • Time or frequency (when given); • Route of administration, such as oral, eye, nose, mouth, topical, inhalation, injection; • Medication expiration date; • End date (when to stop giving); • Reason for medication; and • Special directions. C. A licensee shall ensure all prescription medication is given as prescribed. Prescription medication must be: Prescription Medication Must be: • Stored securely and out of children's reach; • Refrigerated, if applicable, in a closed container separate from food; • In its original container and labeled with directions on how to give or use it; • Current and has not expired; • Given only to the child who has been prescribed the medication, verified by the child’s name on the container; and • Given to the child according to the dosage and administration instructions on the medication container. If no dosage or administration information is listed on the container, such information must be provided in writing by the child’s health care provider. D. A licensee shall ensure the following requirements are followed when non- prescribed medication is given: Non-prescription Medication Must be: • Stored securely and out of children's reach; • Refrigerated, if applicable, in a closed container separate from food; • In its original container and properly labeled with directions on how to give or use it; • Current and has not expired; • Labeled with the child's name; and • Given as written on the container's instructions, or as otherwise instructed in writing by the child’s health care provider. E. A licensee shall keep a written record of medication administered to children recorded on the Medication Administration Record (MAR) including each medication dosage, time administered, by whom administered, adverse effects observed, and medication errors. 1. Medication errors include giving the wrong medication, giving the wrong dose, failing to give the medication at the correct time or at all, giving medication to the wrong child, giving the medication by the wrong route, or giving medication without documenting the administration. 2. Adverse effects or errors in administering must be immediately reported to the parent or guardian. 3. When known, a licensee shall notify OCCL when unwanted effects or errors in administering medication result in death or medical treatment as described in subsection 14.D. 4. Documentation of administration of medication must be placed in the child’s file or in a central administration of medication log and kept while the child is enrolled in the center. F. A licensee may administer medication to a child who has a medical need during child care hours that requires the administration of medication by a non- intravenous injection. In addition to the requirements in subsection 63.B, the parent or guardian shall provide the licensee with the following information, when medication is administered by non-intravenous injection: 1. Written parent or guardian permission for the center to provide the requested medical care; and 2. A written statement from the child’s health care provider stating: a. The specific medication by injection needed by the child; b. That for the child’s health, the requested medication by injection must be administered during the hours the child attends the center; c. That the requested medication by injection may be appropriately administered at the center by non-medical child care staff; and d. Whether any additional training is necessary for non-medical staff members to administer the medication or medical care appropriately. If additional training is required, the health care provider shall provide instructions including information about: the type of training, who may provide such training (which may include the child’s parent or guardian), and any other instructions needed to provide the requested medication by injection. 1) If additional training is required, the licensee shall identify staff members who are certified to administer medication and have them complete the additional training specified by the child’s health care provider. Such training must be completed in a reasonable time based on the availability of such training. 2) The licensee shall keep documentation of this training with the child’s MAR and inform the parent or guardian in writing which staff members are authorized and trained to perform the requested medication by injection. This information must be updated as needed. 3) The licensee shall ensure that at least one staff member, who is trained as required by 63.F.2.d.1, to provide the requested medical care, is present at the center at all times while the child is present. e. A licensee shall ensure this information is reviewed with the child’s parent or guardian and health care provider yearly, and as needed. Reviews and changes must be written, dated, agreed upon by all parties, and kept with the MAR. f. A school-age child may self-administer medical care, as described in Section 63 with written parent or guardian permission and written health care provider permission. These permissions must indicate the child is able to safely self-administer the prescribed medical care, identify and select the correct medicine and dosage, if applicable, and administer the medical care at the correct time and frequency. The licensee shall keep documentation of these permissions with the child’s MAR. A staff member with a current administration of medication certificate shall be present during the self-administration and document all information required on the MAR, including that the medication was self-administered by the child. G. The administration of medication may be required under State and federal laws including but not limited to the Americans with Disabilities Act and the Delaware Equal Accommodations Law. If an agency, administrative body, court, or other entity responsible for enforcing Federal, State, and local laws and regulations makes a finding that the refusal of a licensee to administer medication is a violation of the law, OCCL shall take appropriate enforcement action consistent with subsection 12.E, due to licensee’s failure to comply with subsection 15.B. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Family and Large Family Child Care Homes Regulation 42 42. Administration of Medication A. A licensee shall ensure a trained staff member, who has received a valid administration of medication certificate from OCCL is present at all times to provide both scheduled and emergency medications to children in care. A certified staff member shall be present during field trips and routine program outings to administer medication when needed. The administration of medication certificate must be on file at the home for each certified staff member. 1. OCCL only allows staff members who are at least 18 years old to be certified to give medication to children. This certification includes passing OCCL's designated test on the information in the Administration of Medication Self-Study Training Guide as described in Appendix IX. Health care providers, nurses, or other qualified medical health personnel may also give medication to children. 2. The licensee has discretion to designate which staff members shall administer medication. 3. Written parent or guardian permission for each needed medication is required. 4. A licensee shall return medication to the parent or guardian when it is no longer needed. B. A licensee shall ensure the parent or guardian provides the following information for each medication given: Information Required for Administering Medication: • The name and birth date of the child; • Medication allergies; • Doctor name and phone number; • Pharmacy name and phone number; • Name of medication; • Dosage (amount given); • Time or frequency (when given); • Route of administration, such as oral, eye, nose, mouth, topical, inhalation, injection; Information Required for Administering Medication: • Medication expiration date; • End date (when to stop giving); • Reason for medication; and • Special directions. C. A licensee shall ensure all prescription medication is given as prescribed. Prescription Medication must be: • Stored securely and out of children's reach; • Refrigerated, if applicable, in a closed container separate from food; • In its original container and labeled with directions on how to give or use it; • Current and has not expired; • Given only to the child who has been prescribed the medication, verified by the child’s name on the container; and • Given to the child according to the dosage and administration instructions on the medication container. If no dosage or administration information is listed on the container, such information must be provided in writing by the child’s health care provider. D. A licensee shall ensure the following requirements are followed when non prescribed medication is given. Non-Prescription Medication must be: • Stored securely and out of children's reach; • Refrigerated, if applicable, in a closed container separate from food; • In its original container and properly labeled with directions on how to give or use it; • Current and has not expired; • Labeled with the child's name; and • Given as written on the container's instructions, or as otherwise instructed in writing by the child’s health care provider. E. A licensee shall keep a written record of medication given to children on the Medication Administration Record (MAR) including each medication dosage, time given, who gave it, unwanted effects observed, and medication errors. 1. Medication errors include giving the wrong medication, giving the wrong dose, failing to give the medication at the correct time or at all, giving medication to the wrong child, giving the medication by the wrong route, or giving medication without documenting the administration. 2. Unwanted effects or errors in administering must be immediately reported to the parent or guardian. 3. When known, a licensee shall notify OCCL when unwanted effects or errors in administering medication result in death or medical treatment as described in Section 16. 4. A licensee shall keep the MAR in the child's file. F. A licensee may administer medication to a child who has a medical need during child care hours that requires the administration of medication by a non- intravenous injection. In addition to the requirements in subsection 42.B, the parent or guardian shall provide the licensee with the following information, when medication is administered by non-intravenous injection: 1. Written parent or guardian permission for the home to provide the requested medical care; and 2. A written statement from the child’s health care provider stating: a. The specific medication by injection needed by the child; b. That for the child’s health, the requested medication by injection must be administered during the hours the child attends the home; c. That the requested medication by injection may be appropriately administered at the home by non-medical child care staff; and d. Whether any additional training is necessary for non-medical staff to administer the medication by injection appropriately. If additional training is required, the health care provider shall provide instructions including information about the type of training, who may provide such training (which may include the child’s parent or guardian), and any other instructions needed to provide the requested medication by injection. 1) If additional training is required, the staff members who are certified to administer medication shall complete the additional training specified by the child’s health care provider. Such training must be completed in a reasonable period of time based on the availability of such training. 2) The licensee shall keep documentation of this training with the child’s MAR and inform the parent or guardian in writing who is authorized and trained to perform the requested medication by injection. This information must be updated as needed. 3) The licensee shall ensure that at least one staff member who is trained as required by subsection 42.F.2.d.1) to provide the requested medication by injection, is present at the home at all times while the child is present. e. A licensee shall ensure the requirements of subsection 42.F.2 are reviewed with the child’s parent or guardian and health care provider yearly, and as needed. Reviews and changes must be written, dated, agreed upon by all parties, and kept with the MAR. G. A school-age child may self-administer medical care, as described in subsections 42.B through 42.F, with written parent or guardian permission and written health care provider permission. These permissions must indicate the child is able to safely self-administer the prescribed medical care, identify and select the correct medicine and dosage, if applicable, and administer the medical care at the correct time and frequency. The licensee shall keep documentation of these permissions with the child’s MAR. A staff member with a current administration of medication certificate shall be present during the self-administration and document all information required on the MAR, including that the medication was self-administered by the child. H. The administration of medication may be required under State and federal laws, including but not limited to the Americans with Disabilities Act and the Delaware Equal Accommodations Law. If an agency, administrative body, court, or other entity responsible for enforcing Federal, State, and local laws and regulations makes a finding that the refusal of a licensee to administer medication is a violation of the law, OCCL shall take appropriate enforcement action consistent with subsection 11.E, due to licensee’s failure to comply with subsection 7.A.2. iii. All CCDF-eligible licensed in-home care. Provide the standard: Not Applicable to the Office of Child Care Licensing. [x]Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Not Applicable to the Office of Child Care Licensing. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Not Applicable to the Office of Child Care Licensing. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Relative Care providers are the only exempt category that can provide care in the child’s own home, but it is care provided by a relative only.. Relative Care providers are required to participate in a Relative Orientation on program rules and regulations. They are also required to participate in 28 hours of CCDF approved training and 3 hours of a health and safety refresher training annually. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Youth Camps Regulation 38 38. Administration of Medication A. A licensee shall ensure a trained staff member, who has received a valid administration of medication certificate from OCCL, is present at all times to provide both scheduled and emergency medications to children in care. A certified staff member shall be present during field trips to administer medication when needed. The administration of medication certificate must be on file at the camp for each certified staff member. 1. OCCL only allows staff members who are at least 18 years old to be certified to give medication to children. This certification includes passing OCCL's designated test on the information in the Administration of Medication Self-Study Training Guide as described in Appendix VI. Health care providers, nurses, or other qualified medical health personnel are permitted to administer medication to children in a camp without this certification. 2. Written permission from the child's parent/guardian for each medication to be administered is required. 3. Unused medication must be returned to the parent/guardian when no longer needed by the child. 4. A licensee has discretion to designate which staff members shall administer medication. B. A licensee shall ensure that the parent/guardian of a child provides the following information for each medication given: Information Required for Administering Medication: • The name and birth date of the child; • Medication allergies; • Doctor name and phone number; • Pharmacy name and phone number; • Name of medication; • Dosage (amount given); • Time or frequency (when given); • Route of administration, such as oral, eye, nose, mouth, topical, inhalation, injection; • Medication expiration date; • End date (when to stop giving); • Reason for medication; and • Special directions. C. A licensee shall ensure all prescription medication is given as prescribed. Prescription Medication Must be: • Stored securely and out of children's reach; • Refrigerated, if applicable, in a closed container separate from food; • In its original container and labeled with directions on how to give or use it; • Current and has not expired; • Given only to the child who has been prescribed the medication, verified by the child’s name on the container; and • Given to the child according to the dosage and administration instructions on the medication container. If no dosage or administration information is listed on the container, such information must be provided in writing by the child’s health care provider. D. A licensee shall ensure non-prescription medication is given as written on the container's instructions, or as otherwise instructed in writing by the child’s health care provider. Non-prescription Medication Must be: • Stored securely and out of children's reach; • Refrigerated, if applicable, in a closed container separate from food; • In its original container and properly labeled with directions on how to give or use it; • Current and has not expired; and • Labeled with the child's name. E. A licensee shall keep a written record of medication administered to children recorded on the Medication Administration Record (MAR) including each medication dosage, time administered, by whom administered, adverse effects observed, and medication errors. 1. Medication errors include giving the wrong medication, giving the wrong dose, failing to give the medication, giving medication to the wrong child, giving the medication by the wrong route, or accidental spills of medication. 2. Adverse effects or errors in administering must be immediately reported to the parent/guardian. 3. When known, a licensee shall notify OCCL when unwanted effects or errors in administering medication result in death or medical treatment as described in subsection 11.A. 4. Documentation of administration of medication must be placed in the child’s file or in a central administration of medication log and kept while the child is enrolled in the camp. F. A licensee may administer medication to a child who has a medical need during child care hours that requires the administration of medication by a non-intravenous injection. In addition to the requirements in subsection 38.B, the parent/guardian shall provide the licensee with the following information, when medication is administered by non-intravenous injection: 1. Written parent/guardian permission for the camp to provide the requested medical care; and 2. A written statement from the child’s health care provider stating: a. The specific medication by injection needed by the child; b. That for the child’s health, the requested medication by injection must be administered during the hours the child attends the camp; c. That the requested medication by injection may be appropriately administered at the camp by non-medical child care staff; and d. Whether any additional training is necessary for non-medical staff members to administer the medication or medical care appropriately. If additional training is required, the health care provider shall provide instructions including information about: the type of training, who may provide such training (which may include the child’s parent/guardian), and any other instructions needed to provide the requested medication by injection. 1) If additional training is required, the licensee shall identify staff members who are certified to administer medication and have them complete the additional training specified by the child’s health care provider. Such training must be completed in a reasonable time based on the availability of such training. 2) The licensee shall keep documentation of this training with the child’s MAR and inform the parent/guardian in writing which staff members are authorized and trained to perform the requested medication by injection. This information must be updated as needed. 3) The licensee shall ensure that at least one staff member, who is trained as required by 38.F.2.d.1 to provide the requested medical care, is present at the camp at all times while the child is present. e. A school-age child may self-administer medical care as described in Section 38, with written parent/guardian permission and written health care provider permission. These permissions must indicate the child is able to safely self-administer the prescribed medical care, identify and select the correct medicine and dosage, if applicable, and administer the medical care at the correct time and frequency. The licensee shall keep documentation of these permissions with the child’s MAR. A staff member with a current administration of medication certificate shall be present during the self-administration and document all information required on the MAR, including that the medication was self-administered by the child. G. The administration of medication may be required under State and federal laws, including but not limited to the Americans with Disabilities Act and the Delaware Equal Accommodations Law. If an agency, administrative body, court, or other entity responsible for enforcing Federal, State, and local laws and regulations makes a finding that the refusal of a licensee to administer medication is a violation of the law, OCCL shall take appropriate enforcement action consistent with Section 10, due to licensee’s failure to comply with subsection 12.B. 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: Early Care and Education and School-Age Centers Regulation 70, 71, & 72 70. Water A licensee shall ensure drinking water is always available to children in their classrooms and outdoors and supplied to them on their request or available for self-service as appropriate. 71. Meals and Snacks A. A licensee shall ensure meals and snacks are served on the following schedule depending on the number of hours the child is present: Number of Hours Meals and Snacks Required 2 hours - 4 hours 1 snack 4 hours - 6 hours 1 meal and 1 snack 7 hours ￿ 11 hours 2 meals and 1 snack or 2 snacks and 1 meal based on time of child's arrival 12 hours or more 3 meals and 2 snacks B. A licensee shall ensure meals and snacks are provided by a center except when: 1. The parent or guardian chooses to provide the child’s food and provides a signed statement stating this choice. The center must keep the statement on file; 2. The center does not provide meals or snacks and informs the parent or guardian at the time of enrollment that meals or snacks are to be provided by the parent or guardian. The center must inform the parent or guardian of the importance of sending nutritional meals or snacks; or 3. The center has a field trip or a specific activity requiring special meal arrangements. C. A licensee shall encourage adults to eat healthy foods when eating with children. D. A licensee shall ensure staff members responsible for food service have knowledge of nutrition, sanitary food preparation, storage, and cleaning, and follow the center’s policy on food service. E. A licensee shall ensure staff members’ responsibilities for food service do not reduce staff-to-child ratios, interfere with the center's program, or lessen supervision of children. F. A licensee shall ensure meals and snacks provided by the center: 1. Follow the meal pattern requirements (see Appendix VI and Appendix VII) which are appropriate to the child’s age; 2. May include 100% unsweetened juice, not a juice drink or cocktail; 3. May include powdered milk used only for cooking and not instead of liquid milk for drinking; and 4. Are planned on a menu, dated, and posted in a noticeable place. a. Menus listing food served must be kept for 30 days. b. Changes to the food served on a particular date must be written on the menu on or before that date. G. A licensee shall ensure that special, therapeutic diets are prepared and served by staff members only upon written instructions by a health care provider. A health care provider’s written permission is required for a change in meal patterns. H. A licensee shall ensure when a parent or guardian requests a change of meal patterns due to a family’s food preferences or religious beliefs, the parent or guardian provides the center with a list of the foods that are unacceptable and the substitutions allowed. I. Meal Components for Toddlers and Older Children 1. As described in Appendix VI, a licensee shall ensure a breakfast provided and served by a center has at least one age-appropriate serving-size item each from the milk, fruit and vegetable, and grain food groups. 2. As described in Appendix VI, a licensee shall ensure lunch or dinner provided and served by a center has one age-appropriate serving-size item from each of the milk, meat or meat alternate, and grain food groups and two items from the fruit and vegetable food group. 3. As described in Appendix VI, a licensee shall ensure that a snack provided and served by a center has at least one age-appropriate serving-size item from two of the food groups. If milk or 100% juice is not included with a snack provided and served by the center, water must be served with that snack. J. For foods prepared and served by the center, a licensee shall introduce a variety of food textures, finger foods, and a cup and utensils for self-feeding. If needed, a licensee shall ensure food is cut to prevent choking. K. A licensee shall ensure each child has utensils, such as a fork, spoon, knife, dish, cup or bottle, as appropriate to the child’s age. This equipment may not be shared with another child or adult during feeding. L. All single-service dinnerware or utensils provided by the center for meals or snacks must be thrown away immediately after use. M. Staff members shall encourage the use of a cup when a child is at least one year old and is developmentally able to drink from or hold a cup. 72. Feeding of Infants A. As described in Appendix VII, a licensee shall ensure a breakfast provided and served by a center has at least one age-appropriate serving-size item from each of the required food groups including breast milk or formula. B. As described in Appendix VII, a licensee shall ensure lunch or dinner provided and served by a center has one age-appropriate serving-size item from each of the required food groups including breast milk or formula. C. As described in Appendix VII, a licensee shall ensure that a snack provided and served by a center has at least one age-appropriate serving-size item from each of the required food groups including breast milk or formula, grain, and fruit and vegetable food groups. D. A licensee shall ensure an infant is given foods and drinks on demand or according to the infant’s eating habits using the following guidelines: Infant Feeding Requirements: • A parent or guardian provides a written feeding statement listing the foods and drinks, including specific formula or breast milk, an infant eats or drinks. This schedule must be updated monthly and as needed; • Mixing prepared formula or breast milk in a bottle with anything else requires written permission from an infant’s health care provider; • A written record of each infant’s food intake must be shared with the parent or guardian daily. Feeding problems must be discussed with the parent or guardian before the infant leaves that day; • An infant must be held for bottle-feeding. When an infant is able to hold a bottle or does not want to be held while fed, the infant may be placed in a high chair or at a feeding table; and • Introduction to all new foods and beverages must be made only with the parent’s or guardian’s permission. E. Infants must be allowed to take breaks during feedings. Infants must be observed for signs of fullness and must be allowed to stop a feeding when full unless documentation from an infant’s health care provider requires the feeding to continue; F. Parent or guardian permission is needed to feed formula to an infant receiving only breast milk; G. A staff member shall hold only one infant at a time while bottle-feeding; H. An infant must never be placed in sleeping or relaxing equipment with a bottle or have a bottle propped for feeding; I. Bottles and infant foods must be warmed for no more than five minutes under running warm tap water or by placing them in a container of water that is no warmer than 120°F. They may not be warmed or thawed in a microwave oven; J. For infants age four months or older, semi-solid foods may be fed as requested by the parent or guardian and are required once an infant is eight months old unless the parent or guardian provides documentation from the infant’s health care provider stating otherwise; K. Foods for infants must be a texture and consistency that helps them eat safely. Puréed foods must be served from a dish unless serving the entire contents of the jar; L. Cow’s milk may not be served to infants; M. Juice may not be fed to infants; N. Bottles and nipples kept by center must be washed and sanitized before each use; O. Each infant’s bottle must be labeled with the infant’s name and refrigerated immediately after preparation by center staff members or on arrival if prepared by a parent or guardian; P. Unused bottles must also be dated as to when prepared if not returned to the parent or guardian at the end of each day; Q. Unused portions of formula must be thrown away after each feeding that exceeds one hour; R. Formula must be prepared from a factory-sealed container; S. Refrigerated, unused, prepared formula must be thrown away after 48 hours; and T. Breast milk must be fed only to the infant it was intended for. 1. Frozen breast milk must be thawed under running cold water or in the refrigerator and used within 24 hours. 2. Thawed, previously frozen breast milk may be kept at room temperature for one to two hours. 3. Breast milk must be used within two hours after a feeding has finished. 4. Expressed breast milk must be returned to the parent if it is in an unsanitary bottle, partially used, or if it has been unrefrigerated for more than four hours at room temperature or within two hours after a feeding has finished. 5. Refrigerated, unused, freshly expressed breast milk that was never frozen must be returned to the parent after four days. 6. Breast milk that was frozen and stored in a freezer at 0°F must be thrown away after six months. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Family and Large Family Child Care Homes Regulation 49, 50, & 51 49. Water A licensee shall ensure drinking water is always available to children indoors and outdoors and supplied to them on their request or available for self-service as appropriate. 50. Meals and Snacks A. A licensee shall ensure meals and snacks are served on the following schedule depending on the number of hours the child is present: Number of Hours: Meal or Snacks Required: 2 hours - 4 hours 1 snack 4 hours - 6 hours 1 meal and 1 snack 7 hours ￿ 11 hours 2 meals and 1 snack or 2 snacks and 1 meal based on time of child's arrival 12 hours or more 3 meals and 2 snacks B. A licensee shall encourage adults to eat healthy foods when eating with children. A child shall be encouraged but not forced to eat. C. A licensee shall ensure nutritious food is prepared and served to children. Children must be supervised during food preparation. D. A licensee shall ensure meals and snacks provided by the child care home: 1. Follow the meal pattern requirements (see Appendix X and Appendix XI) appropriate to the child's age; 2. May include 100% unsweetened juice, not a juice drink or cocktail; 3. May include powdered milk used only for cooking and not instead of liquid milk for drinking; and 4. Are planned on a menu, dated, and posted in a noticeable place. a. Menus listing foods served must be kept for 30 days. b. Changes to the food served on a certain date must be written on the menu on or before that date. E. A licensee shall ensure when a parent or guardian requests a change of meal patterns due to a medical need, such as food intolerance or allergies, the parent or guardian provides the home with written health care provider permission for the change. F. A licensee shall ensure when a parent or guardian requests a change of meal patterns due to a family's food preferences or religious belief, the parent or guardian provides the home with a list of the foods to remove and the foods to substitute. G. Meal Components for Toddlers and Older Children: 1. When foods are provided by the parent or guardian, a licensee shall ensure the foods are refrigerated as needed and not shared. There are no meal pattern requirements for foods provided by parents or guardians. A licensee shall have a plan for providing food to a child who has not brought foods to eat. 2. As described in Appendix X, a licensee shall ensure a breakfast provided and served by a home has at least one age-appropriate serving-size item each from the milk, fruit and vegetable, and grain food groups. 3. As described in Appendix X, a licensee shall ensure lunch or dinner provided and served by a home has one age-appropriate serving-size item from each of the milk, meat or meat alternate, and grain food groups and two items from the fruit and vegetable food group. 4. As described in Appendix X, a licensee shall ensure that a snack provided and served by a home has at least one age-appropriate serving-size item from two of the food groups. If milk or 100% juice is not included with a snack provided and served by the home, water must be served with that snack. H. For foods prepared and served by the home, a licensee shall introduce a variety of food textures, finger foods, and a cup and utensils for self-feeding. If needed, a licensee shall ensure food is cut to prevent choking. I. A licensee shall ensure each child has individual utensils, such as a fork, spoon, knife, dish, cup or bottle, as appropriate to the child’s age. This equipment may not be shared with another child or adult during feeding. J. All single-service dinnerware or utensils provided by the home for meals or snacks must be thrown away immediately after use. K. Staff members shall encourage the use of a cup when a child is at least one year old and is developmentally able to drink from or hold a cup. 51. Feeding of Infants A. A licensee shall ensure an infant is given foods and drinks on demand or according to the infant’s eating habits using the following guidelines: Infant Feeding Requirements: • A parent or guardian provides a written feeding statement listing the foods and drinks, including specific formula or breast milk, an infant eats or drinks. This schedule must be updated monthly and as needed; • Mixing prepared formula or breast milk in a bottle with anything else requires written permission from an infant’s health care provider; • A written record of each infant’s food intake must be shared with the parent or guardian daily. Feeding problems must be discussed with the parent or guardian before the infant leaves that day; Infant Feeding Requirements: • An infant must be held for bottle-feeding. When an infant is able to hold a bottle or does not want to be held while fed, the infant may be placed in a high chair or at a feeding table; and • Introduction to all new foods and beverages must be made only with the parent’s or guardian’s permission. B. Infants are allowed to take breaks during feedings. Infants must be observed for signs of fullness and must be allowed to stop a feeding when full unless documentation from an infant’s health care provider requires the feeding to continue; C. Parent or guardian permission is needed to feed formula to an infant receiving only breast milk; D. A staff member shall hold only one infant at a time while bottle feeding; E. An infant must never be placed in sleeping or relaxing equipment with a bottle or have a bottle propped for feeding; F. Bottles and infant foods must be warmed for no more than five minutes under running warm tap water or by placing them in a container of water that is no warmer than 120° F. They must not be warmed or thawed in a microwave oven; G. Semi-solid foods may be fed as requested by the parent or guardian once an infant is six months old and developmental ready unless the parent or guardian provides documentation from the infant's health care provider stating otherwise; H. Foods for infants must be a texture and consistency that helps them eat safely. Puréed foods must be served from a dish unless serving the entire contents of the jar; I. Cow’s milk may not be served to infants; J. Juice may not be fed to infants; K. Bottles and nipples kept by the home must be washed and sanitized before each use; L. All bottles of formula prepared from a powder must be labeled with the child’s name, and date and time of preparation; 1. All bottles of formula prepared from a powder, must be used within two hours of preparation, unless refrigerated immediately after preparation or on arrival if prepared by a parent or guardian; 2. Refrigerated, unused, prepared powder formula must be thrown away after 24 hours; M. All bottles of formula prepared from a concentrate or ready-to-feed formula must be labeled with the child’s name, and date and time of opening or preparation; 1. All bottles of formula prepared from a concentrate or ready-to-feed formula must be used within two hours of preparation, unless refrigerated immediately after preparation or on arrival if prepared by a parent or guardian; 2. Refrigerated, unused, prepared concentrate or ready-to-feed formula must be thrown away after 48 hours of opening the concentrate or ready-to-feed formula’s bottle or can; N. Unused portions of any formula must be thrown away after each feeding that exceeds one hour; O. Formula must be prepared from a factory-sealed container; P. Prepared bottles of formula must be covered when stored in the refrigerator; and Q. Breast milk must be fed only to the infant it was intended for. 1. Frozen breast milk must be thawed under running cold water or in the refrigerator and used within 24 hours. 2. Thawed, previously frozen breast milk may be kept at room temperature for one to two hours. 3. Breast milk must be used within two hours after a feeding has finished. 4. Expressed breast milk must be returned to the parent if it is in an unsanitary bottle, partially used, or if it has been unrefrigerated for more than four hours, or if it is more than two hours after a feeding has ended at room temperature. 5. Refrigerated, unused, freshly expressed breast milk that was never frozen must be returned to the parent after 4 days. 6. Breast milk that was frozen and stored in a freezer at 0° F must be thrown away after six months. R. As described in Appendix XI, a licensee shall ensure a breakfast provided and served by a home has at least one age-appropriate serving-size item from each of the required food groups including breast milk or formula. S. As described in Appendix XI, a licensee shall ensure lunch or dinner provided and served by a home has one age-appropriate serving-size item from each of the required food groups including breast milk or formula. T. As described in Appendix XI, a licensee shall ensure that a snack provided and served by a home has at least one age-appropriate serving-size item from each of the required food groups including the breast milk or formula, grain, and fruit and vegetable food groups. iii. All CCDF-eligible licensed in-home care. Provide the standard: Not Applicable to the Office of Child Care Licensing. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Not Applicable to the Office of Child Care Licensing. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Not Applicable to the Office of Child Care Licensing. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: This is not applicable. Relative Care providers are the only exempt category that can provide care in the child’s own home, but it is care provided by a relative only. Relative Care providers are required to participate in a Relative Orientation on program rules and regulations. They are also required to participate in 28 hours of CCDF approved training and 3 hours of a health and safety refresher training annually. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Youth Camps Regulation 17 & 18 17. Food Service Policy A. A licensee shall have and follow a written policy concerning food service. This policy must be given to a parent/guardian at enrollment and when updated. This policy must include: 1. Approximate times of snacks and meals; 2. Procedures to address food allergies, religious dietary restrictions, and other dietary requests or restrictions for foods provided by the camp or parents/guardians; and 3. A description of whether the camp or parent/guardian will provide meals and snacks. B. A licensee shall ensure when a parent/guardian provides meals and snacks, the food service policy includes: 1. Statements that meals or snacks may not be shared with others; 2. Statements that foods must be clean, safe, and comply with the camp’s written policy concerning the types of foods provided by a parent/guardian; 3. Written procedures to be followed to prevent spoilage of foods brought from home; and 4. Procedures that the camp will follow to provide a meal or snack to a child who has not brought one or both. 18. Meals and Snacks A. A licensee shall ensure meals and snacks are served on the following schedule depending on the number of hours the child is present: Number of Hours: Meals/Snacks Required: 3 hours - 4 hours 1 snack 4 hours - 6 hours 1 meal and 1 snack 7 hours ￿ 11 hours 2 meals and 1 snack or 2 snacks and 1 meal based on time of child's arrival 12 hours or more 3 meals and 2 snacks B. A licensee shall provide meals and snacks except when: 1. The parent/guardian chooses to provide the child’s food and provides a signed statement stating this choice. 2. The camp does not provide meals or snacks and informs the parent/guardian at the time of enrollment that the parent/guardian provides the meals or snacks. 3. The camp has a field trip or a specific activity requiring special meal arrangements. C. A licensee shall ensure staff members responsible for food service have knowledge of nutrition, sanitary food preparation, storage, and cleaning, and follow the camp’s policy on food service. D. A licensee shall ensure meals and snacks provided by the camp: 1. Follow the meal pattern requirements (see Appendix III) which are appropriate to the child’s age; 2. May include 100% unsweetened juice, not a juice drink or cocktail; 3. May include powdered milk used only for cooking and not instead of liquid milk for drinking; and 4. Are planned on a menu, dated, and posted in a noticeable place and kept for at least 10 business days. E. A licensee shall ensure that staff members prepare and serve special, therapeutic diets only upon written instructions by a health care provider. A health care provider’s written permission is required for a change in meal patterns. F. A licensee shall ensure when a parent/guardian requests a change of meal patterns due to a family’s food preferences or religious beliefs, the parent/guardian provides the camp with a list of the foods that are unacceptable and the substitutions allowed. G. Meal Components 1. As described in Appendix III, a licensee shall ensure a breakfast provided and served by a camp has at least one age-appropriate serving-size item each from the milk, fruit and vegetable, and grain food groups. 2. As described in Appendix III, a licensee shall ensure lunch or dinner provided and served by a camp has one age-appropriate serving-size item from each of the milk, meat or meat alternate, and grain food groups and two items from the fruit and vegetable food group. 3. As described in Appendix III, a licensee shall ensure that a snack provided and served by a camp has at least one age-appropriate serving-size item from two of the food groups. If milk or 100% juice is not included with a snack provided and served by the camp, water must be served with that snack. H. A licensee shall ensure each child has utensils, such as a fork, spoon, knife, or dish. This equipment may not be shared with another child or adult during feeding. I. All single-service dinnerware or utensils provided by the camp for meals or snacks must be thrown away immediately after use. 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: Early Care and Education and School-Age Centers Regulation 63 63. Administration of Medication A. A licensee shall ensure a trained staff member, who has received a valid administration of medication certificate from OCCL, is present at all times to provide both scheduled and emergency medications to children in care. A certified staff member shall be present during field trips and routine program outings to administer medication when needed. The administration of medication certificate must be on file at the center for each certified staff member. 1. OCCL only allows staff members who are at least 18 years old to be certified to give medication to children. This certification includes passing OCCL's designated test on the information in the Administration of Medication Self-Study Training Guide as described in Appendix V. Health care providers, nurses, or other qualified medical health personnel are permitted to administer medication to children in a center. 2. Written permission from the child's parent or guardian for each medication to be administered is required. 3. Unused medication must be returned to the parent or guardian when no longer needed by the child. 4. A licensee has discretion to designate which staff members shall administer medication. B. A licensee shall ensure that the parent or guardian of a child provides the following information for each medication given: Information Required for Administering Medication: • The name and birth date of the child; • Medication allergies; • Doctor name and phone number; • Pharmacy name and phone number; • Name of medication; • Dosage (amount given); • Time or frequency (when given); • Route of administration, such as oral, eye, nose, mouth, topical, inhalation, injection; • Medication expiration date; • End date (when to stop giving); • Reason for medication; and • Special directions. C. A licensee shall ensure all prescription medication is given as prescribed. Prescription medication must be: Prescription Medication Must be: • Stored securely and out of children's reach; • Refrigerated, if applicable, in a closed container separate from food; • In its original container and labeled with directions on how to give or use it; • Current and has not expired; • Given only to the child who has been prescribed the medication, verified by the child’s name on the container; and • Given to the child according to the dosage and administration instructions on the medication container. If no dosage or administration information is listed on the container, such information must be provided in writing by the child’s health care provider. D. A licensee shall ensure the following requirements are followed when non- prescribed medication is given: Non-prescription Medication Must be: • Stored securely and out of children's reach; • Refrigerated, if applicable, in a closed container separate from food; • In its original container and properly labeled with directions on how to give or use it; • Current and has not expired; • Labeled with the child's name; and • Given as written on the container's instructions, or as otherwise instructed in writing by the child’s health care provider. E. A licensee shall keep a written record of medication administered to children recorded on the Medication Administration Record (MAR) including each medication dosage, time administered, by whom administered, adverse effects observed, and medication errors. 1. Medication errors include giving the wrong medication, giving the wrong dose, failing to give the medication at the correct time or at all, giving medication to the wrong child, giving the medication by the wrong route, or giving medication without documenting the administration. 2. Adverse effects or errors in administering must be immediately reported to the parent or guardian. 3. When known, a licensee shall notify OCCL when unwanted effects or errors in administering medication result in death or medical treatment as described in subsection 14.D. 4. Documentation of administration of medication must be placed in the child’s file or in a central administration of medication log and kept while the child is enrolled in the center. F. A licensee may administer medication to a child who has a medical need during child care hours that requires the administration of medication by a non- intravenous injection. In addition to the requirements in subsection 63.B, the parent or guardian shall provide the licensee with the following information, when medication is administered by non-intravenous injection: 1. Written parent or guardian permission for the center to provide the requested medical care; and 2. A written statement from the child’s health care provider stating: a. The specific medication by injection needed by the child; b. That for the child’s health, the requested medication by injection must be administered during the hours the child attends the center; c. That the requested medication by injection may be appropriately administered at the center by non-medical child care staff; and d. Whether any additional training is necessary for non-medical staff members to administer the medication or medical care appropriately. If additional training is required, the health care provider shall provide instructions including information about: the type of training, who may provide such training (which may include the child’s parent or guardian), and any other instructions needed to provide the requested medication by injection. 1) If additional training is required, the licensee shall identify staff members who are certified to administer medication and have them complete the additional training specified by the child’s health care provider. Such training must be completed in a reasonable time based on the availability of such training. 2) The licensee shall keep documentation of this training with the child’s MAR and inform the parent or guardian in writing which staff members are authorized and trained to perform the requested medication by injection. This information must be updated as needed. 3) The licensee shall ensure that at least one staff member, who is trained as required by 63.F.2.d.1, to provide the requested medical care, is present at the center at all times while the child is present. e. A licensee shall ensure this information is reviewed with the child’s parent or guardian and health care provider yearly, and as needed. Reviews and changes must be written, dated, agreed upon by all parties, and kept with the MAR. f. A school-age child may self-administer medical care, as described in Section 63 with written parent or guardian permission and written health care provider permission. These permissions must indicate the child is able to safely self-administer the prescribed medical care, identify and select the correct medicine and dosage, if applicable, and administer the medical care at the correct time and frequency. The licensee shall keep documentation of these permissions with the child’s MAR. A staff member with a current administration of medication certificate shall be present during the self-administration and document all information required on the MAR, including that the medication was self-administered by the child. G. The administration of medication may be required under State and federal laws including but not limited to the Americans with Disabilities Act and the Delaware Equal Accommodations Law. If an agency, administrative body, court, or other entity responsible for enforcing Federal, State, and local laws and regulations makes a finding that the refusal of a licensee to administer medication is a violation of the law, OCCL shall take appropriate enforcement action consistent with subsection 12.E, due to licensee’s failure to comply with subsection 15.B. Reg 21. Food Service Policy A. A licensee shall have and follow a written policy concerning food service. This policy must be given to a parent or guardian at enrollment and when updated. This policy must include: 1. A statement that children are encouraged but not forced to eat; 2. Approximate times of snacks and meals; 3. Procedures to address food allergies (for foods provided by the center or parents or guardians); and 4. A description of which food services will be provided by the licensee or by a parent or guardian. B. A licensee shall ensure when meals or snacks are provided by the center the food service policy includes: 1. Procedures to address religious dietary requirements and other dietary requests or restrictions; and 2. A policy on whether additional servings of foods will be served to a child who has been fed and is still hungry. C. A licensee shall ensure when meals and snacks are provided by a parent or guardian the food service policy includes: 1. Statements that meals or snacks may not be shared with others; 2. Statements that foods must be clean and safe and comply with the center’s written policy concerning the content of foods provided by a parent or guardian; 3. Written procedures to be followed to prevent spoilage of foods brought from home; and 4. Procedures that the center will follow to provide a meal or snack to a child who has not brought one or both. Reg 30 requires staff to complete Health & Safety training (Prevention of and response to emergencies due to food and allergic reactions) ii. All CCDF-eligible licensed family child care homes. Provide the standard: Family and Large Family Child Care Homes Regulation 42 42. Administration of Medication A. A licensee shall ensure a trained staff member, who has received a valid administration of medication certificate from OCCL is present at all times to provide both scheduled and emergency medications to children in care. A certified staff member shall be present during field trips and routine program outings to administer medication when needed. The administration of medication certificate must be on file at the home for each certified staff member. 1. OCCL only allows staff members who are at least 18 years old to be certified to give medication to children. This certification includes passing OCCL's designated test on the information in the Administration of Medication Self-Study Training Guide as described in Appendix IX. Health care providers, nurses, or other qualified medical health personnel may also give medication to children. 2. The licensee has discretion to designate which staff members shall administer medication. 3. Written parent or guardian permission for each needed medication is required. 4. A licensee shall return medication to the parent or guardian when it is no longer needed. B. A licensee shall ensure the parent or guardian provides the following information for each medication given: Information Required for Administering Medication: • The name and birth date of the child; • Medication allergies; • Doctor name and phone number; • Pharmacy name and phone number; • Name of medication; • Dosage (amount given); • Time or frequency (when given); • Route of administration, such as oral, eye, nose, mouth, topical, inhalation, injection; Information Required for Administering Medication: • Medication expiration date; • End date (when to stop giving); • Reason for medication; and • Special directions. C. A licensee shall ensure all prescription medication is given as prescribed. Prescription Medication must be: • Stored securely and out of children's reach; • Refrigerated, if applicable, in a closed container separate from food; • In its original container and labeled with directions on how to give or use it; • Current and has not expired; • Given only to the child who has been prescribed the medication, verified by the child’s name on the container; and • Given to the child according to the dosage and administration instructions on the medication container. If no dosage or administration information is listed on the container, such information must be provided in writing by the child’s health care provider. D. A licensee shall ensure the following requirements are followed when non- prescribed medication is given. Non-Prescription Medication must be: • Stored securely and out of children's reach; • Refrigerated, if applicable, in a closed container separate from food; • In its original container and properly labeled with directions on how to give or use it; • Current and has not expired; • Labeled with the child's name; and • Given as written on the container's instructions, or as otherwise instructed in writing by the child’s health care provider. E. A licensee shall keep a written record of medication given to children on the Medication Administration Record (MAR) including each medication dosage, time given, who gave it, unwanted effects observed, and medication errors. 1. Medication errors include giving the wrong medication, giving the wrong dose, failing to give the medication at the correct time or at all, giving medication to the wrong child, giving the medication by the wrong route, or giving medication without documenting the administration. 2. Unwanted effects or errors in administering must be immediately reported to the parent or guardian. 3. When known, a licensee shall notify OCCL when unwanted effects or errors in administering medication result in death or medical treatment as described in Section 16. 4. A licensee shall keep the MAR in the child's file. F. A licensee may administer medication to a child who has a medical need during child care hours that requires the administration of medication by a non- intravenous injection. In addition to the requirements in subsection 42.B, the parent or guardian shall provide the licensee with the following information, when medication is administered by non-intravenous injection: 1. Written parent or guardian permission for the home to provide the requested medical care; and 2. A written statement from the child’s health care provider stating: a. The specific medication by injection needed by the child; b. That for the child’s health, the requested medication by injection must be administered during the hours the child attends the home; c. That the requested medication by injection may be appropriately administered at the home by non-medical child care staff; and d. Whether any additional training is necessary for non-medical staff to administer the medication by injection appropriately. If additional training is required, the health care provider shall provide instructions including information about the type of training, who may provide such training (which may include the child’s parent or guardian), and any other instructions needed to provide the requested medication by injection. 1) If additional training is required, the staff members who are certified to administer medication shall complete the additional training specified by the child’s health care provider. Such training must be completed in a reasonable period of time based on the availability of such training. 2) The licensee shall keep documentation of this training with the child’s MAR and inform the parent or guardian in writing who is authorized and trained to perform the requested medication by injection. This information must be updated as needed. 3) The licensee shall ensure that at least one staff member who is trained as required by subsection 42.F.2.d.1) to provide the requested medication by injection, is present at the home at all times while the child is present. e. A licensee shall ensure the requirements of subsection 42.F.2 are reviewed with the child’s parent or guardian and health care provider yearly, and as needed. Reviews and changes must be written, dated, agreed upon by all parties, and kept with the MAR. G. A school-age child may self-administer medical care, as described in subsections 42.B through 42.F, with written parent or guardian permission and written health care provider permission. These permissions must indicate the child is able to safely self-administer the prescribed medical care, identify and select the correct medicine and dosage, if applicable, and administer the medical care at the correct time and frequency. The licensee shall keep documentation of these permissions with the child’s MAR. A staff member with a current administration of medication certificate shall be present during the self-administration and document all information required on the MAR, including that the medication was self-administered by the child. H. The administration of medication may be required under State and federal laws, including but not limited to the Americans with Disabilities Act and the Delaware Equal Accommodations Law. If an agency, administrative body, court, or other entity responsible for enforcing Federal, State, and local laws and regulations makes a finding that the refusal of a licensee to administer medication is a violation of the law, OCCL shall take appropriate enforcement action consistent with subsection 11.E, due to licensee’s failure to comply with subsection 7.A.2. Reg #7 Health & Safety Training required (Prevention of and response to emergencies due to food and allergic reactions) Reg #20 policies required in parent handbook (Food and nutrition policy, including a statement that children are encouraged but not forced to eat; approximate times of snacks and meals; how food allergies and other dietary requirements are handled; and whether a licensee or parent or guardian will provide food) Reg #50 Meals and Snacks E. A licensee shall ensure when a parent or guardian requests a change of meal patterns due to a medical need, such as food intolerance or allergies, the parent or guardian provides the home with written health care provider permission for the change. iii. All CCDF-eligible licensed in-home care. Provide the standard:: Not Applicable to the Office of Child Care Licensing. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Not Applicable to the Office of Child Care Licensing. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Not Applicable to the Office of Child Care Licensing. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: This is not applicable. Relative Care providers are the only exempt category that can provide care in the child’s own home, but it is care provided by a relative only. Relative Care providers are required to participate in a Relative Orientation on program rules and regulations. They are also required to participate in 28 hours of CCDF approved training and 3 hours of a health and safety refresher training annually. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Youth Camps Regulation 38 38. Administration of Medication A. A licensee shall ensure a trained staff member, who has received a valid administration of medication certificate from OCCL, is present at all times to provide both scheduled and emergency medications to children in care. A certified staff member shall be present during field trips to administer medication when needed. The administration of medication certificate must be on file at the camp for each certified staff member. 1. OCCL only allows staff members who are at least 18 years old to be certified to give medication to children. This certification includes passing OCCL's designated test on the information in the Administration of Medication Self-Study Training Guide as described in Appendix VI. Health care providers, nurses, or other qualified medical health personnel are permitted to administer medication to children in a camp without this certification. 2. Written permission from the child's parent/guardian for each medication to be administered is required. 3. Unused medication must be returned to the parent/guardian when no longer needed by the child. 4. A licensee has discretion to designate which staff members shall administer medication. B. A licensee shall ensure that the parent/guardian of a child provides the following information for each medication given: Information Required for Administering Medication: • The name and birth date of the child; • Medication allergies; • Doctor name and phone number; • Pharmacy name and phone number; • Name of medication; • Dosage (amount given); • Time or frequency (when given); • Route of administration, such as oral, eye, nose, mouth, topical, inhalation, injection; • Medication expiration date; • End date (when to stop giving); • Reason for medication; and • Special directions. C. A licensee shall ensure all prescription medication is given as prescribed. Prescription Medication Must be: • Stored securely and out of children's reach; • Refrigerated, if applicable, in a closed container separate from food; • In its original container and labeled with directions on how to give or use it; • Current and has not expired; • Given only to the child who has been prescribed the medication, verified by the child’s name on the container; and • Given to the child according to the dosage and administration instructions on the medication container. If no dosage or administration information is listed on the container, such information must be provided in writing by the child’s health care provider. D. A licensee shall ensure non-prescription medication is given as written on the container's instructions, or as otherwise instructed in writing by the child’s health care provider. Non-prescription Medication Must be: • Stored securely and out of children's reach; • Refrigerated, if applicable, in a closed container separate from food; • In its original container and properly labeled with directions on how to give or use it; • Current and has not expired; and • Labeled with the child's name. E. A licensee shall keep a written record of medication administered to children recorded on the Medication Administration Record (MAR) including each medication dosage, time administered, by whom administered, adverse effects observed, and medication errors. 1. Medication errors include giving the wrong medication, giving the wrong dose, failing to give the medication, giving medication to the wrong child, giving the medication by the wrong route, or accidental spills of medication. 2. Adverse effects or errors in administering must be immediately reported to the parent/guardian. 3. When known, a licensee shall notify OCCL when unwanted effects or errors in administering medication result in death or medical treatment as described in subsection 11.A. 4. Documentation of administration of medication must be placed in the child’s file or in a central administration of medication log and kept while the child is enrolled in the camp. F. A licensee may administer medication to a child who has a medical need during child care hours that requires the administration of medication by a non- intravenous injection. In addition to the requirements in subsection 38.B, the parent/guardian shall provide the licensee with the following information, when medication is administered by non-intravenous injection: 1. Written parent/guardian permission for the camp to provide the requested medical care; and 2. A written statement from the child’s health care provider stating: a. The specific medication by injection needed by the child; b. That for the child’s health, the requested medication by injection must be administered during the hours the child attends the camp; c. That the requested medication by injection may be appropriately administered at the camp by non-medical child care staff; and d. Whether any additional training is necessary for non-medical staff members to administer the medication or medical care appropriately. If additional training is required, the health care provider shall provide instructions including information about: the type of training, who may provide such training (which may include the child’s parent/guardian), and any other instructions needed to provide the requested medication by injection. 1) If additional training is required, the licensee shall identify staff members who are certified to administer medication and have them complete the additional training specified by the child’s health care provider. Such training must be completed in a reasonable time based on the availability of such training. 2) The licensee shall keep documentation of this training with the child’s MAR and inform the parent/guardian in writing which staff members are authorized and trained to perform the requested medication by injection. This information must be updated as needed. 3) The licensee shall ensure that at least one staff member, who is trained as required by 38.F.2.d.1 to provide the requested medical care, is present at the camp at all times while the child is present. e. A school-age child may self-administer medical care as described in Section 38, with written parent/guardian permission and written health care provider permission. These permissions must indicate the child is able to safely self-administer the prescribed medical care, identify and select the correct medicine and dosage, if applicable, and administer the medical care at the correct time and frequency. The licensee shall keep documentation of these permissions with the child’s MAR. A staff member with a current administration of medication certificate shall be present during the self-administration and document all information required on the MAR, including that the medication was self-administered by the child. G. The administration of medication may be required under State and federal laws, including but not limited to the Americans with Disabilities Act and the Delaware Equal Accommodations Law. If an agency, administrative body, court, or other entity responsible for enforcing Federal, State, and local laws and regulations makes a finding that the refusal of a licensee to administer medication is a violation of the law, OCCL shall take appropriate enforcement action consistent with Section 10, due to licensee’s failure to comply with subsection 12.B. 17. Food Service Policy A. A licensee shall have and follow a written policy concerning food service. This policy must be given to a parent/guardian at enrollment and when updated. This policy must include: 1. Approximate times of snacks and meals; 2. Procedures to address food allergies, religious dietary restrictions, and other dietary requests or restrictions for foods provided by the camp or parents/guardians; and 3. A description of whether the camp or parent/guardian will provide meals and snacks. B. A licensee shall ensure when a parent/guardian provides meals and snacks, the food service policy includes: 1. Statements that meals or snacks may not be shared with others; 2. Statements that foods must be clean, safe, and comply with the camp’s written policy concerning the types of foods provided by a parent/guardian; 3. Written procedures to be followed to prevent spoilage of foods brought from home; and 4. Procedures that the camp will follow to provide a meal or snack to a child who has not brought one or both. Reg #24 Staff Orientation requires - Prevention and response to emergencies due to food allergies; 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: Early Care and Education and School-Age Centers Regulations 45 ￿ 49 & 50, 57 & 58 45. Hazardous Materials A. A licensee shall ensure the center is free of unacceptable exposure to hazardous materials. B. An applicant and licensee shall ensure the center is free of lead-based paint hazards. Buildings constructed in or after 1978 are exempt from lead-paint risk assessments and testing. 1. If the buildings were constructed before 1978, an applicant or licensee shall provide to OCCL a lead-paint risk assessment performed by an environmental testing firm certified by DPH showing the center to be free of lead-based paint hazards. a. Before license renewal, unless previously submitted to OCCL, a licensee shall submit this risk assessment. b. If lead paint is identified but intact (i.e. not chipping, flaking, or peeling), the licensee shall monitor the identified areas at least every six months and document that the lead-based paint is intact (in good repair and not deteriorated). Lead-based paint is not regarded as a hazard if it is intact, not present in an accessible surface, a friction surface, or an impact surface that could result in an adverse human health effect. 2. If lead-paint hazards are identified in the risk assessment, the applicant or licensee shall remedy the hazards by hiring a lead-safe contractor (lead abatement or renovation firm) certified by DPH to make the repairs. a. Once the repairs are made, a lead-dust clearance inspection must be performed by an environmental testing firm certified by DPH to confirm the center is free of lead-based paint hazards. b. The applicant or licensee shall provide the lead-dust clearance testing results to OCCL within five business days to confirm the center is free of lead-based paint hazards. c. Children may not be present during repairs and the center must stay closed until the results of the lead dust clearance are at appropriate levels and the lead-safe contractor states it is safe for the center to be open. 3. If any lead-based paint identified in a risk assessment in a pre-1978 child- occupied facility becomes deteriorated or if lead-based paint is located in an area to be remodeled, a licensee shall retain a contractor certified by DPH to work using lead-safe work practices (lead abatement or lead renovator) to perform any renovation or repair. a. Records of this renovation or repair work must be forwarded to OCCL within five business days. b. Children may not be present during repairs or renovation until a lead-dust clearance test is obtained and the lead-safe contractor states it is safe for the center to be open. C. A licensee shall ensure radon testing is performed in each room used for child care once every five years between the months of October and March and within six months after any remodeling, renovations, or construction. 1. This testing may be performed by the property owner or an inspector certified by the American Association of Radon Scientists, the National Radon Safety Board, or any organization recognized by the EPA or State of Delaware Radon Program. 2. If testing indicates a radon level over 4.0 pCi/L, a licensee shall ensure acceptable radon mitigation occurs or a long-term radon test (90-120 days) indicates a level less than 4.0 pCi/L. 3. A licensee shall ensure copies of radon testing results are sent to OCCL within five business days of receiving the results. D. A licensee shall ensure containers of poisonous, toxic, or hazardous materials are: 1. Labeled with the contents; 2. Used only in the manner and under the conditions that will not contaminate food or constitute a hazard to children or to staff; and 3. Stored in a locked storage space accessible only to staff. E. Materials required for routine cleaning and maintenance must be stored out of children’s reach and used in a safe manner. F. The storage of flammable liquids and gases is not be permitted except as allowed by the Office of the Fire Marshal. G. A licensee shall ensure the center is free from illegal drugs. 46. Air Quality and Windows A. A licensee shall ensure a center is ventilated to ensure the air quality provides a healthy environment for children and adults. Painting and remodeling projects may not affect the air quality during hours of operation. B. A licensee shall ensure screening, on windows, doors, or openings to the outside used for ventilation, is in good repair. C. If a ventilation system is not provided, a center must have window area equal, at a minimum, to 4.5% of the floor area of the center. Half of this window area must be operable. D. A center located in a building that previously contained or currently contains a dry cleaner, nail salon, or any other use that may result in an unacceptable indoor air quality, will not be licensed or have a license renewed, unless the applicant or licensee obtains indoor air sampling as required per 7 DE Admin. Code 1375 that shows there is no impact to the center. 47. Smoking and Vaping A licensee shall inform staff members and others at the facility that smoking and vaping are prohibited inside the center, in the outdoor play area, while transporting children, in the presence of children, and during field trips or routine program outings. 48. Heating and Cooling A. A licensee shall ensure heating and cooling equipment, hot water pipes, or radiators are safely shielded or insulated to prevent the injury of children. B. Heating, cooling, and plumbing equipment must be properly installed, cleaned, and maintained to operate safely. C. Floor or window fans and cords must be inaccessible to children and have a safety certification mark from a nationally recognized testing laboratory such as Underwriters Laboratories or Electro-Technical Laboratory. D. Portable space heaters are prohibited. E. A licensee shall ensure that temperatures in rooms used by children are kept at a minimum temperature of 68°F and a maximum of 82°F measured three feet above floor level unless there is conflict with federal and State energy laws. 1. A licensee shall use air conditioning during hot weather to keep rooms used by children within the required temperature range. 2. Except as stated below, a licensee shall be required to inform OCCL and close temporarily if the minimum or maximum room temperature cannot be maintained. 3. OCCL allows an exception if a room temperature drops within the range of 60°F - 67°F or rises within the range of 83°F - 90°F, and a licensee can return the proper temperature within the next four hours. a. If the room temperature cannot be restored within four hours or the temperature is below 60°F or above 90°F, the center must close unless children are moved to another approved area of the center that has the proper temperature. b. When the center closes because the proper temperature cannot be maintained, the center must remain closed until the heating or cooling problem is resolved and the correct temperature is maintained. c. A licensee shall ensure OCCL is informed when closing is necessary. 49. Indoor Space A. A licensee shall show evidence of security procedures that ensures access to children is limited to authorized people. A licensee shall ensure visitors who are not touring the center, attending a special event, visiting children, or not providing a service to the center that requires access to children, remain outside of areas where children are located. B. A licensee shall ensure the center is constructed, used, furnished, maintained, and equipped in compliance with all applicable requirements established by federal, State, local and municipal regulatory bodies. A licensee shall have written certification of compliance from the appropriate regulatory bodies governing zoning, building construction, safety, sanitation, and fire safety including Department of Natural Resources and Environmental Control for air quality and radon testing and Department of Health and Social Services Office of Drinking Water for well water. C. A licensee shall keep all areas, furnishings, and equipment of the center in a clean, hazard-free, and safe condition. Floors, walls, counter surfaces, toilets, and surfaces or finishes must be cleanable and in good repair. D. A licensee shall ensure a center has enough lighting to allow for the supervision of children in areas where children’s activities occur. E. A licensee shall ensure interior space designated for children’s use is available to children when the center is in operation. 1. This space must be arranged to allow each child adequate space for free movement and active play. 2. A center must have at least 35 square feet of usable floor space for each child in each area or room used by children. a. Measurements are from wall to wall excluding areas that are not used by children. b. Toilet rooms, kitchen areas, isolation areas for ill children, offices, storage spaces, hallways, furnace rooms, gymnasiums, and other areas not used as classroom space will not be counted in determining a center’s capacity. F. A licensee shall provide children with individual storage space so personal belongings, clothing, or bedding does not touch another child’s belongings. This storage space must be labeled with the child’s name. G. A licensee shall ensure all unused electrical outlets accessible to children including unused power strips are covered. Child-resistant ground-fault circuit- interrupter ￿GFCI￿ type is exempt from being covered. H. A licensee shall ensure every exit, exit access, and exit discharge is free of obstruction at all times. All closets must be provided with doors that can be readily opened from both sides. I. A licensee shall ensure glass doors and windows within 36 inches of the floor have a vision strip or decal at children’s eye level. J. A licensee shall keep the center rodent-free and free of insect infestation. If pesticides are used, a licensee shall ensure they are used according to the instructions listed on the label. K. A licensee shall ensure the following: Plumbing Requirements: • The water temperature does not exceed 120°F from faucets and other sources accessible to children; • All sinks supply hot and cold water under pressure at all times; • All plumbing complies with State and local plumbing codes; and • Portable sinks are prohibited. L. A licensee shall ensure garbage and trash are stored securely in non- combustible, covered containers. 1. Recyclable paper may be in uncovered containers. 2. Indoor containers must be emptied at least daily to an outdoor receptacle and kept clean. 3. Outdoor trash and garbage containers must be inaccessible to children, emptied at least weekly, and, with the exception of dumpsters, cleaned as needed. M. A licensee shall ensure firearms or ammunition are not within the center’s premises. This regulation does not apply to law enforcement officers in the performance of their official duties. N. A licensee shall prohibit the burning of candles or incense and the use of air fresheners. 50. Kitchen and Food Preparation A. A licensee shall obtain a Food Establishment Permit only when the center provides food to members of the general public. DPH will assist in reviewing food transportation operations between locations owned by the same licensee. B. A licensee shall not change the center’s approved type of food operation without notifying OCCL and receiving approval. C. A licensee shall ensure a kitchen or food preparation area is provided with the necessary operable equipment to prepare, store, serve, and clean-up all meals and snacks for children and staff. Dishes and utensils must be air-dried. 1. A center that does not prepare food on-site is exempt from subsections 50.C through 50.F. a. There may be no food preparation in the facility, except for heating in the microwave foods brought from children’s homes. b. When food preparation is not permitted, a licensee shall ensure utensils and dishware are single-service and discarded after each use. D. The kitchen requirements for centers that prepare and serve meals and snacks are, but not limited to: Kitchen Requirements to Serve Meals and Snacks: • One Refrigerator; • Three-compartment sink; or • Two-compartment sink and sanitizing basin; or • Two-compartment sink and dishwasher; and • Separate hand-washing sink; • Range or cooktop; • Oven or microwave; and • Food storage areas. E. The kitchen requirements for centers that prepare and serve only snacks are: Kitchen Requirements to Serve Only Snacks: • Refrigerator; • Three-compartment sink; or • Two-compartment sink and sanitizing basin; or • Two-compartment sink and dishwasher; and • Separate hand-washing sink. F. A licensee shall ensure a kitchen or food preparation area has floors, walls, and counter surfaces that are easily cleanable and non-porous. G. A licensee shall ensure a center has a refrigerator to keep perishable food, including lunches prepared at home, cold at 41°F or colder, and food stored in a freezer frozen at 0°F or colder. 1. A working thermometer must be in refrigerators and freezers. 2. Unused freezer compartments in mini-refrigerators do not need a thermometer. H. A licensee shall ensure food provided and prepared by the center complies with the center’s written policy on nutritional quality. I. A licensee shall ensure the food is clean, wholesome, free from spoilage and contamination, and safe to eat. 1. Prepared food items must be correctly labeled with the contents and date of preparation. 2. Prepared food that is served to a child and not eaten must be thrown away and not given to another child. J. Food storage areas and appliances must be cleanable and free of food particles, dust, and debris. 1. All food items must be stored off the floor 2. Food must be stored separately from cleaning materials. 3. Food must be stored in closed or sealed containers that are labeled with the contents and expiration date. K. A licensee shall ensure the kitchen or food preparation area is constructed and supervised to prevent children’s access unless a staff member is conducting an educational activity within this area. 57. Equipment A. A licensee shall provide developmentally-appropriate equipment and materials for a variety of indoor and outdoor activities. There must be enough equipment and materials for all children to use. Materials and equipment must help provide many experiences and choices that support all children’s social-emotional, language and literacy, intellectual, and physical development. B. A licensee shall ensure that for children less than 24 months old, developmentally-appropriate supplies or equipment are provided in quantities as described in subsection 57.A in each of the following categories: Equipment Requirements for Children Less than 24 Months Old: • Sensory, such as teething toys, busy boxes, baby mirrors, rattles, melody chimes, squeeze toys; or other similar items; • Language and dramatic play, such as picture books, toy telephones, CDs, hand puppets, washable stuffed animals and dolls, photographs, or other similar items; • Manipulative, such as squeeze and grip toys, boxes, sorting and stacking toys, three- or four-piece wooden inlay puzzles, puzzle blocks, simple threading toys, mobile pull toys, balls, or other similar items; Equipment Requirements for Children Less than 24 Months Old: • Building, such as soft lightweight blocks, toy cars, trains or boats, figures of animals and people, stacking rings or cups, nesting toys, or other similar items; • Large muscle, such as low climbers, slides, riding or rocking toys, foam or soft plastic balls, gym mats, play tunnels, or other similar items; and • Music, such as rhythm instruments, a CD player and CDs, toys with musical tones, musical mobiles or busy boxes, drums, xylophones or pianos, or other similar items. C. A licensee shall ensure for children over 24 months old to school-age, developmentally-appropriate supplies or equipment are provided in quantities as described in subsection 57.A in each of the following categories: Equipment Requirements for Children Over 24 Months Old: • Language and literacy, such as books, flannel board, upper and lower case letters, pictures for discussion, materials for recognition, identification, or classification, poetry, puppets, audio-visual materials, show and tell items, or other similar items; • Science and math, such as plants and gardening equipment, aquarium with fish or other appropriate live animals, water table with supplies, sand table with supplies, cooking supplies, weather chart or thermometer, counting equipment, balance scale, or other similar items; • Manipulative, such as puzzles, pegs and pegboards, lacing boards, building toys, stencils, dominoes, pounding bench, lotto games, or other similar items; • Large muscle such as rocking boat, wheel toys, climbers, slides, balance beam, barrels or large cartons, parachute, balls and beanbags, outdoor play equipment, gym mats, or other similar items; • Building activities, such as unit blocks (minimum of four sizes), transportation toys, farm animals, play people, work bench and tools, building toys, building logs, or other similar items; • Art, such as crayons, tempera paint, large brushes and newsprint, finger paint and finger paint paper, construction paper in assorted colors, paste or glue, blunt scissors, collage materials, non-toxic felt tip markers, easels, clay or play dough, or other similar items; • Music, such as a CD player and CDs, piano or organ, guitar, rhythm sticks, drums, cymbals and bells, or other similar items; and • Dramatic play, such as toy dishes, ironing board, telephones, occupational props or uniforms, dress-up clothes, housekeeping area (stove, sink, refrigerator), cradle or doll bed, doll carriage, dolls, puppets, play grocery store, post office or hospital, or other similar items. D. A licensee shall ensure furniture is durable and child-sized or adapted to children’s use. Tables must be at waist height of the intended child-user and the child’s feet must reach a firm surface while the child is seated. E. A licensee shall ensure equipment and materials are selected or adapted to allow all children, including a child with disabilities or other special needs, to benefit from the program. F. A licensee shall ensure equipment and supplies are relevant to the cultural background and community of all children and raise awareness of other cultures and communities. G. A licensee shall prohibit toys that explode or shoot objects. H. A licensee shall ensure toys and equipment used by the children are sturdy, safely assembled, hazard-free, and not recalled. Toys and equipment may not cause children to become trapped or have rough edges, sharp corners, pinch and crush points, splinters, or exposed bolts. Equipment in poor condition must be repaired, removed. or made inaccessible to children. I. A licensee shall take the following measures to prevent hazards to children in care: Hazard Prevention: • To prevent cuts, abrasions, and punctures, equipment, materials, and other objects on the premises that have sharp edges, protruding nails, bolts, or other dangers must be repaired, removed, or made inaccessible to children. Sharp edges on natural wooden equipment must be sanded; • To prevent burns, equipment, materials, or products that may be hot enough to injure a child must be made inaccessible to children; • To prevent sheering, crushing, or pinching, broken or cracked equipment, materials, and objects must be repaired, removed, or made inaccessible to children; • To prevent entrapment, freezers, refrigerators, washers, dryers, compost bins, and other entrapment dangers must be inaccessible to children unless being actively supervised; • To prevent tripping, uneven indoor and outdoor walkways, damaged flooring or carpeting, or other tripping hazards must be removed or repaired; • To prevent injuries and death, large objects that pose a risk of falling or tipping must be securely anchored. Large objects include, but are not limited to, televisions, dressers, bookshelves, wall cabinets, sideboards or hutches, and wall units; and • To prevent injuries, equipment in poor condition (rusty parts, flaking paint, or other dangers) must be repaired, removed, or made inaccessible to children. 58. Sanitation A. A licensee shall ensure that areas and equipment listed in subsection 58.B are washed with soap and water and then disinfected as required. For sanitizing and disinfecting, a licensee shall ensure one of the following is used: an EPA-registered product, a commercially prepared product, or a bleach and water solution. 1. A licensee shall follow the manufacturer's instructions for use. 2. These products must be labeled with the contents. 3. Their instructions for use must be available at all times. B. A licensee shall ensure staff members wash with a soap and water solution and then disinfect the following equipment, items, or surfaces, as listed below: After Each Use: At Least Daily: • Potty-chairs that have first been emptied into a toilet • Toilet and toilet seats • Sinks and faucets used for hand washing after the sink has been used for rinsing a potty-chair • Sinks and faucets • Diapering surfaces, as required in subsection 61.F • Diaper pails and lids • Food preparation and eating surfaces such as counters, tables, and high chair trays • Drinking fountains • Toys mouthed by children • Water table and water play equipment • Mops used for cleaning must be rinsed, disinfected, wrung dry, and hung to dry • Play tables • Plastic bibs (cloth bibs may be used only once before laundering) • Rest mats that are not stored separately as listed in these regulations • Thermometers • Cleanable, non-absorbent activity mats such as those used for infant tummy time • Smooth surfaced non-porous floors C. At least weekly, a licensee shall ensure non-porous toys and play equipment are washed with a soap and water solution and then disinfected. D. At least weekly, a licensee shall ensure stuffed animals are laundered. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Family and Large Family Child Care Homes Regulations 27 ￿ 31 27. Hazardous Materials A. Before license renewal, unless previously submitted to OCCL, a licensee shall provide a lead-paint risk assessment performed by an environmental testing firm certified by DPH showing the home to be free of lead-based paint hazards if the home were built before 1978. 1. If lead paint is identified but intact (i.e. not chipping, flaking, or peeling), a licensee shall monitor the areas as described in subsection 7.A.3. 2. If lead-paint hazards are identified in the risk assessment, a license shall remedy these hazards as described in subsection 7.A.3. B. A licensee shall ensure radon testing is performed in each room used for child care once every five years between the months of October and March and within six months after any remodeling, renovation, or construction. 1. This testing may be performed by the property owner or an inspector certified by the American Association of Radon Scientists, the National Radon Safety Board, or any organization recognized by the EPA or State of Delaware Radon Program. 2. If testing indicates a radon level over 4.0 pCi/L, a licensee shall ensure acceptable radon mitigation occurs or a long-term radon test (90-120 days) indicates a level less than 4.0 pCi/L. 3. Copies of radon testing results shall be sent to OCCL within five business days of receiving the results. C. A licensee shall ensure matches, lighters, medicines, drugs, alcohol, cleaning products, detergents, aerosol cans, plastic bags, cords and strings from window blinds, firearms, ammunition, and other similar items are stored safely in areas out of children's reach. D. A licensee shall ensure containers of poisonous, toxic, or hazardous materials are: 1. Labeled with the contents; 2. Used only in the manner and under the conditions that will not contaminate food or constitute a hazard to children or to staff; and 3. Stored in a locked storage space accessible only to staff. E. Materials required for routine cleaning and maintenance must be stored out of children’s reach and used in a safe manner. 28. Heating and Cooling A. A licensee shall ensure screens are in good repair on all windows, doors, or openings to the outside used for venting the home. B. A licensee shall ensure that temperatures in rooms used by the children are kept at a minimum temperature of 68°F and a maximum of 82°F unless there is a conflict with federal and State energy laws. 1. OCCL allows an exception if a room temperature drops within the range of 60° F - 67° F or rises within the range of 83° F - 90° F and a licensee can return that room to the proper temperature within the next four hours. a. If the room temperature cannot be restored within four hours or the temperature is below 60°F or above 90°F, the home must close. b. The home must remain closed until the heating or cooling problem is resolved and the correct temperature is maintained. 2. A licensee shall inform OCCL when closing is necessary. C. A licensee shall use air conditioning during hot weather to keep rooms used by children within the required temperature range. D. A licensee shall ensure all floor or window fans and cords are out of children's reach and have a safety certification mark from a nationally recognized testing laboratory such as Underwriters Laboratories or Electro-Technical Laboratory. E. The licensee shall ensure heating and cooling equipment prevents injury to children by having safety shielding. 1. Fire code prohibits the use of unvented, fuel-fired heating equipment such as portable kerosene heaters. 2. Hot water pipes, steam radiators, electric space heaters, and wood burning stoves must be out of children's reach to protect children against burns. 3. Electric space heaters must be stable and have a safety certification mark from a nationally recognized testing laboratory. 4. A licensee shall securely screen or equip fireplaces with protective guards while in use. F. Heating, cooling, and plumbing equipment must be properly installed, cleaned, and maintained to operate safely. 29. Indoor space A. A licensee shall ensure there are no health or safety hazards in the home. B. A licensee shall keep the home, its furnishings, and equipment in a clean, hazard-free, and safe condition. Floors, walls, counter surfaces, toilets, and surfaces or finishes must be cleanable and in good repair. C. A licensee shall ensure stairways over four steps used by children, indoors and outdoors, have handrails at a maximum height of 38 inches. D. A licensee shall use securely installed safety gates, such as those approved by the American Society for Testing and Materials (ASTM), at the top, bottom, or both locations of stairways where infants and toddlers are in care to prevent falls and access to the stairs. 1. Gates must have latching devices that adults, but not children, can open easily. 2. Pressure or accordion gates may not be used in any area of the home. 3. If a licensee cannot set up a safety gate as stated in the manufacturer's instructions because of the home's design, then a licensee shall safely prevent infants and toddlers from accessing stairways in another way. E. A licensee shall ensure that raised areas at the home other than stairways, over two feet, such as porches, elevated walkways, and elevated play areas, have walls or barriers to prevent falls over the open side. The walls or barriers must be at least 36 inches tall. F. A licensee shall ensure door locks or latches in rooms used by children can open from either side of the door and the opening device or key is available to a licensee and staff members. G. A licensee shall have a bathroom with a working toilet and sink. A licensee shall ensure toilet paper is available for children to use in the bathroom at all times. The sink must have hot and cold running water. Children may use a bathroom that is not on the child care level if it is the only bathroom in the house. H. A licensee may not allow children to use rooms or spaces reachable only by ladder, folding stairs, or through a trap door. I. A licensee shall keep the home free from rodent and insect infestation. If pesticides are used, they must be used according to the instructions listed on the label. J. A licensee shall ensure a working flashlight is available in the home. K. A licensee shall cover all electrical outlets that children can reach, including unused power strips. L. A licensee shall ensure glass doors and windows within 36 inches of the floor have a vision strip or decal at children's eye level. M. A licensee shall ensure a State fire marshal recognized electrical inspection agency conducts an electrical inspection of the home and approves the home every three years. N. A licensee shall keep any guns and ammunition stored in the home in a locked container or locked closet. A licensee shall store ammunition separate from guns. O. A licensee shall keep trash in covered trashcans. 1. Recyclable paper may be in uncovered containers. 2. Trash must be removed daily from rooms used by children and weekly from the home. P. A licensee shall prohibit smoking, vaping, and burning candles and incense, and use of air fresheners in the home during child care hours and in the presence of children. Q. A licensee shall ensure the water temperature does not exceed 120° F from faucets and other sources accessible to children in care. R. A licensee shall ensure all sinks supply hot and cold water under pressure at all times and all plumbing complies with State and local plumbing codes. Portable sinks are prohibited. 30. Fire Safety A. A licensee shall ensure that all paths of egress, including stairways, hallways, windows, and doorways are functional and not blocked. B. A licensee shall care for children on the ground level of the home or use another level only after meeting the conditions of the designated fire marshal. C. A licensee shall ensure each exit door is at least 28 inches wide. D. A licensee shall at least have a properly installed, battery-operated working smoke alarm. 1. This alarm must have a safety certification mark from a nationally recognized testing laboratory. 2. A licensee shall place smoke alarms on the ceiling or six to 12 inches below the ceiling on each level of the home, basement, and all enclosed sleeping areas. a. A licensee shall test these alarms monthly and document these tests in a log. b. A licensee shall replace the batteries at least yearly. E. A licensee shall ensure fire safety codes and on-going procedures as required by the designated fire marshal are followed. F. A licensee shall ensure a working carbon monoxide alarm is near any sleeping area used by children when the home has an attached garage or equipment using fuels such as gas, oil, propane, wood, or kerosene. This includes an oven, furnace, water heater, or fireplace. 1. The alarm must have a safety certification mark from a nationally recognized testing laboratory. 2. The alarm must be installed as stated in the manufacturer's instructions. a. A licensee shall test these alarms monthly and document these tests in a log. b. A licensee shall replace the batteries at least yearly. G. A licensee shall complete a monthly fire prevention inspection and post the current report in a visible space. H. When a family home changes from Level I to Level II or a child care home moves to a new address, a licensee shall submit plans to the designated fire marshal for review and approval. 1. The licensee shall follow the fire safety codes of the designated fire marshal. 2. A licensee shall receive fire marshal and OCCL approval before offering services. I. A licensee shall provide a clearly visible, readily accessible, charged, portable dry chemical fire extinguisher rated 2A-10BC or greater. 1. Fire extinguishers must not be mounted in a closet or cabinet except when using a wall mounted fire extinguisher cabinet that was manufactured specifically for that purpose. 2. Fire extinguishers must be mounted at least 4 inches above the finished floor. a. Fire extinguishers weighing 40 pounds or less must be mounted so that the top of the extinguisher is not more than 60 inches above the finished floor. b. Fire extinguishers weighing more than 40 pounds must be mounted so that the top of the extinguisher is not more than 42 inches above the finished floor. c. A fire extinguisher contractor licensed by the Office of the State Fire Marshal shall inspect the fire extinguisher annually. 31. Kitchen and Food Preparation A. A licensee shall keep the kitchen, food preparation, storage, serving areas, appliances, and utensils clean and sanitary. B. A licensee shall ensure the kitchen has at least one sink with hot and cold running water. Large family homes need an additional hand-washing sink. C. A licensee shall ensure the home has a refrigerator to keep perishable food cold at 41°F or colder, and food stored in a freezer frozen at 0°F or colder. A licensee shall have a working thermometer in refrigerators and freezers used to store children's food. D. A licensee shall ensure food provided and prepared by the home complies with the home’s written policy on food and nutrition quality. E. A licensee shall ensure the food is clean, wholesome, free from spoilage and contamination, and safe to eat. 1. Prepared food items must be correctly labeled with the contents and date of preparation. 2. Prepared food that is served to a child and not eaten must be thrown away and not given to another child. F. Food storage areas and appliances must be cleanable and free of food particles, dust, and dirt. 1. All food items must be stored off the floor. 2. Food must be stored separately from cleaning materials. 3. Food must be stored in closed or sealed containers that are labeled with the contents and expiration date. G. A licensee shall ensure that children are supervised during meal preparation to prevent injuries. H. A licensee shall ensure dishes and utensils are air-dried unless sanitized and dried in a dishwasher. I. A licensee shall ensure no dishes, cups, or glasses used by children are broken or defective. J. A licensee shall ensure age-appropriate utensils, dishes, cups, glasses, or bottles are available for each child and not shared with another child during feeding iii. All CCDF-eligible licensed in-home care. Provide the standard: Not Applicable to the Office of Child Care Licensing. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Not Applicable to the Office of Child Care Licensing. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Not Applicable to the Office of Child Care Licensing. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: This is not applicable. Relative Care providers are the only exempt category that can provide care in the child’s own home, but it is care provided by a relative only. Relative Care providers are required to participate in a Relative Orientation on program rules and regulations. They are also required to participate in 28 hours of CCDF approved training and 3 hours of a health and safety refresher training annually. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Youth Camps Regulation 20, 40 - 43 20. Smoking and Vaping A licensee shall inform staff members and others at the facility that smoking and vaping are prohibited at the camp. Smoking and vaping are prohibited in the outdoor play area, while transporting children, in the presence of children, and during field trips. 40. Hazardous Materials, Maintenance Supplies, and Garbage A. A licensee shall ensure containers of poisonous, toxic, or hazardous materials are: 1. Labeled with the contents; 2. Used only in the manner and under the conditions that will not contaminate food or constitute a hazard to children or to staff; and 3. Stored in a locked storage space accessible only to staff. B. A licensee shall ensure materials required for routine cleaning and maintenance are stored out of children’s reach and used in a safe manner. C. The storage of flammable liquids and gases is not to be permitted except as allowed by the Office of the Fire Marshal. D. A licensee shall ensure saws, power tools, lawn mowers, toilet plungers, toilet brushes, and other maintenance and janitorial equipment are inaccessible to children. E. A licensee shall ensure the buildings, structures, and the campsites are free of an infestation of rodents, insects, or vermin. 1. If pesticides are used, a licensee shall ensure they are used according to the instructions listed on the label. 2. Children may not be present when pesticides are applied. F. A licensee shall ensure garbage and trash are stored securely in non combustible, covered containers. 1. Indoor containers must be emptied at least daily to an outdoor receptacle and kept clean. 2. Outdoor trash/garbage containers that do not contain a plastic liner must be inaccessible to children, emptied at least weekly, and, with the exception of dumpsters, cleaned as needed. 41. Equipment A. A licensee shall provide developmentally-appropriate equipment and materials for activities. 1. There must be enough supplies and equipment to allow children the opportunity to choose activities or materials. 2. There must be a system of sharing high demand items, such as computers, when they cannot be supplied to all children. B. A licensee shall ensure toys and equipment used by the children are sturdy, safely assembled, hazard-free, and not recalled. Toys and equipment may not cause children to become trapped or have rough edges, sharp corners, pinch and crush points, splinters, or exposed bolts. C. A licensee shall take the following measures to prevent hazards to children in care: 1. To prevent cuts, abrasions, and punctures, equipment, materials, and other objects on the premises that have sharp edges, protruding nails, bolts, or other dangers must be repaired, removed, or made inaccessible to children. Sharp edges on natural wooden equipment must be sanded; 2. To prevent burns, equipment, materials, or products that may be hot enough to injure a child must be made inaccessible to children; 3. To prevent sheering, crushing, or pinching, broken or cracked equipment, materials, and objects must be repaired, removed, or made inaccessible to children; 4. To prevent entrapment, freezers, refrigerators, washers, dryers, compost bins, and other entrapment dangers must be inaccessible to children unless being actively supervised; 5. To prevent tripping, uneven indoor walkways, damaged flooring or carpeting, or other tripping hazards must be removed or repaired; 6. To prevent injuries and death, large objects that pose a risk of falling or tipping must be securely anchored. Large objects include, but are not limited to, televisions, dressers, bookshelves, wall cabinets, sideboards or hutches, and wall units; and 7. To prevent injuries, equipment in poor condition (rusty parts, flaking paint, or other dangers) must be repaired, removed, or made inaccessible to children. D. A licensee shall ensure equipment and materials are selected or adapted to allow all children, including a child with disabilities or other special needs, to benefit from the program. E. A licensee shall ensure screen time activities, such as watching television, using a gaming device, tablet, phone, or computer, are age-appropriate and supervised by a staff member. F. A licensee shall ensure equipment and supplies are relevant to the cultural background and community of all children and raise awareness of other cultures and communities. 42. Indoor Area A. A licensee shall ensure every building and structure is constructed, used, furnished, maintained, and equipped in compliance with all applicable requirements established by federal, State, local and municipal regulatory bodies. A licensee shall have written certification of compliance from the appropriate regulatory bodies governing zoning, building construction, safety, sanitation, fire code, and the Department of Health and Social Services’ Office of Drinking Water for well water. B. A licensee shall show evidence of security procedures that ensures access to children is limited to authorized people. C. A licensee shall ensure all building areas are in good repair and in a clean and safe condition. Floors, walls, counter surfaces, and toilets must be clean and in good repair. D. A licensee shall ensure 35 square feet of indoor usable floor space is available and used for each child during inclement weather or when participating in indoor activities, when the camp is in operation. E. A licensee shall ensure natural or artificial light is provided in each indoor area so that children can be supervised and that children can freely participate in activities. F. A licensee shall ensure every exit, exit access, and exit discharge is free of obstruction at all times. All closets must be provided with doors that can be readily opened from both sides. G. A licensee shall ensure multi-purpose (ABC) type fire extinguishers each with a minimal rating of 2A are spaced within 50 feet of all areas of a room and the building when children are using indoor space. H. A licensee shall ensure the following plumbing requirements are met: Plumbing Requirements: • The water temperature does not exceed 120 °F from faucets and other sources accessible to children; • All sinks supply hot and cold or tempered water under pressure at all times; • Use of portable sinks is prohibited; and • All plumbing complies with State and local plumbing codes. I. A licensee shall ensure heating and cooling equipment, hot water pipes, or radiators are safely shielded or insulated to prevent the injury of children. J. Heating, cooling, and plumbing equipment must be properly installed, cleaned, and maintained to operate safely. K. Floor or window fans and cords must be inaccessible to children and have a safety certification mark from a nationally recognized testing laboratory such as Underwriters Laboratories or Electro-Technical Laboratory. L. A licensee shall ensure firearms or ammunition are not on the camp’s premises. This regulation does not apply to law enforcement officers in the performance of their official duties. 43. Kitchen and Food Preparation A. If meals or snacks are prepared at the camp, a licensee shall ensure a kitchen or food preparation area is provided with the necessary operable equipment to prepare, store, serve, and clean-up all meals and snacks for children and staff. B. A camp that does not prepare meals or snacks on-site is exempt from subsections 43.C through 43.J. 1. There may be no food preparation in the facility, except for heating up foods brought from children’s homes in the microwave. 2. When food preparation is not permitted, a licensee shall ensure utensils and dishware are single-service and discarded after each use. C. The minimum kitchen requirements for camps that prepare and serve meals and snacks are: Minimum Kitchen Requirements to Prepare and Serve Meals and Snacks: • One refrigerator; • Three-compartment sink; or • Two-compartment sink and sanitizing basin; or • Automatic warewashing machine (Commercial grade dishwasher); and • Separate hand-washing sink; • Range or cooktop; • Oven or microwave; and • Food storage areas. D. The minimum kitchen requirements for camps that prepare and serve only snacks are: Minimum Kitchen Requirements to Prepare and Serve Only Snacks: • Refrigerator; • Three-compartment sink; or • Two-compartment sink and sanitizing basin; or • Automatic warewashing machine (Commercial grade dishwasher); and • Separate hand-washing sink. E. A licensee shall ensure a kitchen or food preparation area has floors, walls, and counter surfaces that are easily cleanable and non-porous. F. A licensee shall ensure a camp has a refrigerator or coolers with icepacks to keep perishable food, including meals and snacks prepared at home, cold at 41 °F or colder, and food stored in a freezer frozen at 0 °F or colder. 1. A working thermometer must be in refrigerators and freezers. 2. Unused freezer compartments in mini-refrigerators do not need a thermometer. 38 G. A licensee shall ensure food provided and prepared by the camp complies with the camp’s written policy on nutritional quality. H. A licensee shall ensure the food is clean, wholesome, free from spoilage and contamination, and safe to eat. 1. Prepared food items must be correctly labeled with the contents and date of preparation. 2. Prepared food that is served to a child and not eaten must be thrown away and not given to another child. I. Food storage areas and appliances must be cleanable and free of food particles, dust, and dirt. 1. All food items must be stored off the floor. 2. Food must be stored separately from cleaning materials. 3. Food must be stored in closed or sealed containers that are labeled with the contents and expiration date. J. A licensee shall ensure the kitchen or food preparation area is constructed and supervised to prevent children’s access unless a staff member is conducting an educational activity within this area. K. A licensee shall ensure that all food taken on a trip will not spoil without refrigeration and remains safe to eat. After four hours, a licensee shall ensure food without refrigeration is discarded. L. For a camp offering cooking classes, a licensee shall ensure the following: 1. Children’s hands are washed before they begin to prepare food and immediately after touching any raw meat, poultry, seafood, or eggs. 2. Children are not permitted to wear loose clothing, and long hair that may catch fire or get caught must be secured while cooking. 3. Pot handles are turned inwards. 4. Children are informed about the dangers of touching hot items. 5. Knives are only used by children under supervision by an adult. 6. Children do not remove items from the oven without proper oven mitts and supervision. 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: Early Care and Education and School-Age Centers Regulation 53 & 54 53. Outdoor Area A. A licensee shall ensure the following: 1. Structures, fences, equipment, and the grounds are maintained in a clean and safe condition; 2. Outdoor areas that are used while it is dark have appropriate lighting; 3. Grounds drain naturally or through installed drainage systems so there is no standing water on the premises. Standing water after a storm must drain within 48 hours; and 4. All areas determined to be unsafe including steep grades, cliffs, open pits, swimming pools, high voltage boosters, propane gas tanks, streets or roads, driveways, railroad tracks, or parking lots are fenced off or have natural barriers to protect children. B. A licensee shall ensure that raised areas on the premises, other than stairways, over two feet, such as porches, elevated walkways, and elevated play areas, have walls or barriers to prevent falls over the open side. The walls or barriers must be at least 36 inches tall. C. A licensee shall ensure stairways, over four steps indoors and outdoors, have handrails at a maximum height of 38 inches that are safe for children and adults. D. A licensee shall ensure children have access to an outdoor play area with at least 75 square feet for each child for the maximum number of children who will use the playground at one time. 1. A licensee shall ensure this play area has space suitable for moderate to vigorous physical activities, including running. 2. A licensee shall ensure this play area is large enough to accommodate at least 1/4 of the center’s licensed capacity at one time. 3. Maximum group size is not required in the outdoor play area or approved indoor play area as long as the required square footage is maintained for each child. E. A licensee shall ensure the outdoor play area for school-age children is physically separated or used at separate times from the area provided for younger children. F. A licensee shall ensure a center licensed before January 1, 2007, has access to an outdoor play area with at least 50 square feet for each child for the maximum number of children who will use the playground at one time. 1. A licensee shall ensure this play area is large enough to accommodate at least 1/4 of the center’s licensed capacity at one time. 2. If the capacity of a center licensed before January 1, 2007, increases, the licensee shall ensure the outdoor play area complies with these regulations. G. A licensee shall ensure the outdoor play area is on-site, next to, or within a close safe walking distance of the center. 1. This play area must have a shaded rest area for children. 2. Staff members shall inspect outdoor areas before children begin to play to ensure there are no hazards present and play equipment is safe for use. 3. Outdoor sandboxes or play areas containing sand must be kept in a safe and clean manner including being covered when not in use. 4. Use of trampolines at the center is prohibited. H. A licensee shall ensure the center’s outdoor play areas are fenced. Use of parks or other off-site play areas that are not fenced, but used to comply with the outdoor space regulations, requires OCCL approval. Fencing Requirements: • A licensee shall ensure fencing is sturdy, safe, and reinforced at intervals to give support, constructed to discourage climbing, and allows for viewing the children by staff. • A licensee shall ensure fencing is a minimum of four feet in height with openings no larger than 3½ inches. • A licensee shall ensure fenced areas have at least two exits, with at least one being remote from the building. If a fenced play area contains another fenced play area (to separate age groups), only one exit is required in the second play area if it is remote from the building. • A licensee shall ensure gates have self-closing and positive self-latching closure mechanisms. A licensee shall ensure the latch or securing device is high enough or made so small children cannot open it. When opened, a licensee shall ensure the gate moves freely and is not hindered by scraping the ground. A licensee shall ensure fences’ gates are not locked during the center’s hours of operation. I. For a center licensed before January 1, 2007, the existing fencing shall be acceptable as long as it is safe, free from hazards, and in good repair. When the fencing is replaced, the licensee shall ensure the new fencing fully complies with these regulations. J. A licensee shall ensure the protective surface of the outdoor play area beneath and in the fall zones of climbing equipment, slides, swings, and similar equipment is of approved resilient material, which absorbs falls. 1. A licensee shall ensure the fall zone depth and materials follow the instructions as listed in the most recent publication of the Consumer Product Safety Commission’s (CPSC’s) Handbook for Public Playground Safety regarding critical heights of tested materials located on CPSC’s website. A licensee shall ensure all materials used for protective surfaces are of a size and material that do not present a safety or choking hazard. Only pea gravel shall be acceptable as cover for the outdoor play area if using a gravel or stone-like surfacing. 2. A licensee shall ensure protective surfaces of the fall zone extend at least six feet in all directions from the equipment. For swings, a licensee shall ensure the protective surfacing extends, in back and front, twice the height of the suspending bar unless otherwise directed by the CPSC or other recognized authority on playground safety. Inches Type of Material Protects to Fall Height 6 Shredded/recycled rubber 10 feet 9 Sand 4 feet 9 Pea gravel 5 feet 9 Wood mulch 7 feet 9 Wood chips 10 feet Poured-in-place surfacing or rubber mats designed for outdoor use, if used, must be in the required fall zone and at a sufficient depth or thickness as required by manufacturer’s specifications or other approved entity. K. A licensee shall ensure outdoor play equipment is securely anchored unless portable by design. 1. A licensee shall ensure this play equipment is in good repair and placed with regard for safe use. 2. A licensee shall ensure this play equipment includes equipment for vigorous play and large muscle activity and meets the diverse needs and abilities of children served. L. When a licensee cannot meet the outdoor space requirement, the licensee shall provide a minimum of 700 square feet of open, accessible indoor play space for large muscle activity. There must be at least 75 square feet for each child who will use this area at one time. Indoor play spaces that were approved by OCCL before the effective date of these regulations will remain compliant unless the center's capacity increases. 1. This indoor play space must be on-site and is in addition to the 35 square feet per child requirement. 2. There must be a protective surface of an approved resilient material, such as rubber mats, to absorb falls beneath and in the fall zones of climbing equipment, slides, swings, and similar equipment. This material must be at a sufficient depth or thickness as required by the manufacturer's specifications or other approved entity. 3. The licensee shall have and follow a written plan approved by OCCL, which specifies how large muscle activity will be provided. M. For a center licensed before January 1, 2007, the indoor play space listed in subsection 53.L may be at a nearby facility that was previously approved by OCCL. If the capacity of the center increases allowing room for an indoor play space, the center must comply with subsection 53.L. N. A licensee shall ensure a rooftop or elevated play space above the first floor is protected by a non-climbable, secure, and hazard-free barrier that is at least seven feet in height. O. Portable sinks are prohibited in the outdoor area. 54. Pools and Swimming A licensee shall ensure an individual with current water safety instructor training or senior lifesaving training from the American Red Cross or its equivalent is on duty when children are swimming. A. Portable wading pools are prohibited. B. Permanent or built-in swimming and wading pools that are left filled when not in use must be inaccessible to children. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Family and Large Family Child Care Homes Regulation 32, 33 & 59 32. Outdoor Area A. A licensee shall ensure there are no hazards on the grounds of the home. B. A licensee shall provide active play and large muscle activities that consider the children's needs and whether they are able to participate. A licensee shall provide these activities either on the grounds or within safe walking distance of the home. C. A licensee shall remove hazards before children begin to play outside. These hazards may include animal feces, toxic plants, broken or non-secure outdoor play equipment, building supplies and equipment, glass, sharp rocks, cigarette butts, beehives and wasp nests, a lawn mower, or debris. 1. A licensee shall securely lock tool sheds, garages, and other outdoor buildings to prevent children from entering. 2. Children must be supervised while outdoors. D. For a home licensed before January 1, 2009, the existing fencing of the on-site outdoor play area is acceptable as long as it is hazard-free and in good repair. When replacing the fencing, the new fencing must fully comply with Section 59 for a family home and Section 64 for a large family home. E. A licensee shall ensure outdoor play equipment is sturdy, safe, clean, and free from rough edges, sharp corners, pinch and crush points, splinters, and exposed bolts. F. A licensee shall anchor large outdoor play equipment. A licensee cannot place stationary equipment on concrete or asphalt. G. A licensee shall use materials in the outdoor play area that do not present a safety or choking hazard. These materials must be free of unsafe contaminants such as steel wires and unhealthy residue from deterioration. H. If using gravel or stone as a ground cover for the outdoor play area, only pea gravel is acceptable. For homes licensed before January 1, 2009, the existing gravel or stone ground cover is acceptable. I. A licensee shall keep outdoor sandboxes or play areas containing sand safe, sanitary, and covered when not in use. J. The use of trampolines by children in care on-site is prohibited. K. Portable sinks are prohibited. 33. Pools and Swimming A licensee shall ensure all children are under direct supervision while wading or swimming. During a swimming activity involving infants or toddlers, these children must be within arm's reach of a licensee or staff member. A. Swimming pools and large wading pools that remain filled when not in use must be inaccessible to children. B. The water in swimming pools used by children must be treated, cleaned, and maintained according to DPH regulations. C. The pool and equipment must be kept in a safe manner and be hazard-free. D. Small portable wading pools must be cleaned and disinfected after each use. 59. Outdoor Fencing A licensee shall ensure the outdoor play area of the family home is fenced if hazards are near. Such hazards include, but are not limited to, high traffic roads, water in streams, rivers, ponds, lakes, pools, railroads, steep mounds or drop-offs, and high voltage wires or poles and towers. A. Fencing must be sturdy, safe, reinforced at intervals to give support, constructed to discourage climbing, and allow for viewing the children by the licensee or substitute. B. Fencing must be at least four feet in height with openings no larger than 3½ inches. C. Gates must have a self-closing and self-latching closure device. The latch or closure device must be high enough or made so small children cannot open it. When opened, a licensee shall ensure the gate moves freely and is not hindered by scraping the ground. D. Fenced areas must have at least two exits. At least one exit must be away from the building. iii. All CCDF-eligible licensed in-home care. Provide the standard: Not Applicable to the Office of Child Care Licensing. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Not Applicable to the Office of Child Care Licensing. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Not Applicable to the Office of Child Care Licensing. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: This is not applicable. Relative Care providers are the only exempt category that can provide care in the child’s own home, but it is care provided by a relative only. Relative Care providers are required to participate in a Relative Orientation on program rules and regulations. They are also required to participate in 28 hours of CCDF approved training and 3 hours of a health and safety refresher training annually. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Youth Camps Regulation 27H, 51, 52 & 54 27. Staffing and Qualifications H. A licensee shall ensure watercraft activities are supervised by a minimum of one counselor on the water to each 10 campers in a watercraft. This counselor shall have proof of participation in three white water canoe or raft trips totaling at least 6 hours on the water or at least six hours of practical instruction in survival and stream safety as taught by the American Red Cross or its equivalent; or one counselor must hold a current American Red Cross Small Craft Certificate. 51. Outdoor Area A. A licensee shall ensure the following: 1. Structures, fences, equipment, and the grounds are maintained in a clean and safe condition; 2. Outdoor areas that are used while it is dark have appropriate lighting; 3. Grounds drain naturally or through installed drainage systems so there is no standing water on the premises. Standing water after a storm must drain within 48 hours; 4. All areas determined to be unsafe including steep grades, cliffs, open pits, high voltage boosters, propane gas tanks, streets or roads, driveways, railroad tracks, or parking lots are fenced off, have natural barriers to protect children, or procedures to protect children when fencing or a natural barrier is not present; 5. Uncovered wells, septic tanks, wastewater, wastewater tanks, below grade storage tanks, farm manure ponds or other similar hazards are inaccessible to children using a physical barrier with a locking mechanism; 6. The growth of brush, weeds, grass and plants shall be controlled in central camp areas to prevent harborage of ticks, chiggers, and other insects of public health importance; and 7. The camp area shall be maintained to prevent growth of ragweed, poison ivy, poison oak, and other noxious plants considered detrimental to health. B. A licensee shall ensure that raised areas on the premises, other than stairways, over two feet, such as porches, elevated walkways, and elevated play areas, have walls or barriers to prevent falls over the open side. The walls or barriers must be at least 36 inches tall. C. A licensee shall ensure stairways, over four steps indoors and outdoors, have handrails at a maximum height of 38 inches that are safe for children and adults. D. A licensee shall ensure when the activity schedule includes outdoor activities children have access to an outdoor play area with at least 75 square feet per child. E. A licensee shall ensure the outdoor play area is on-site, next to, or within a close safe walking distance of the camp. 1. This play area must have a shaded rest area for children. 2. Staff members shall inspect outdoor areas before children begin to play to ensure there are no hazards present and play equipment is safe for use. 3. Outdoor sandboxes must be kept in a safe and clean manner including being covered when not in use. Other play areas containing sand must be kept in a safe and clean manner. 4. Use of outdoor trampolines at the camp is prohibited. F. A licensee shall ensure the protective surface of the outdoor play area beneath and in the fall zones of climbing equipment, slides, swings, and similar equipment is of approved resilient material, which absorbs falls. 1. A licensee shall ensure the fall zone depth and materials follow the instructions as listed in the most recent publication of the Consumer Product Safety Commission’s (CPSC’s) Handbook for Public Playground Safety regarding critical heights of tested materials located on CPSC’s website. Only pea gravel shall be acceptable as cover for the outdoor play area if using a gravel or stone-like surfacing. 2. A licensee shall ensure protective surfaces of the fall zone as listed in thr chart in this subsection extend at least six feet in all directions from the equipment. For swings, a licensee shall ensure the protective surfacing extends, in back and front, twice the height of the suspending bar unless otherwise directed by CPSC or other recognized authority on playground safety. Inches Type of Material Protects to Fall Height 6 Shredded/recycled rubber 10 feet 9 Sand 4 feet 9 Pea gravel 5 feet 9 Wood mulch 7 feet 9 Wood chips 10 feet Poured-in-place surfacing or rubber mats designed for outdoor use, if used, must be in the required fall zone and at a sufficient depth or thickness as required by manufacturer’s specifications or other approved entity. G. A licensee shall ensure outdoor play equipment is securely anchored unless portable by design. 1. A licensee shall ensure this play equipment is in good repair and placed with regard for safe use. 2. A licensee shall ensure this play equipment includes equipment for vigorous play and large muscle activity and meets the diverse needs and abilities of children served. H. A licensee shall ensure a rooftop or elevated play space above the first floor is protected by a non-climbable, secure, and hazard-free barrier that is at least seven feet in height. 52. Swimming Pools and Natural Swimming and Diving Areas A. A licensee shall ensure an individual currently certified as a Red Cross Lifeguard or a nationally recognized equivalent is on duty and supervising swimming activities. B. Non-filtered wading pools are prohibited. C. A licensee shall ensure permanent or built-in swimming pools, filtered wading pools, and hot tubs are inaccessible to children when not in use by using a physical barrier with a locking mechanism. D. A licensee shall ensure swimming, diving areas, and bathing places at the camp are operated and maintained in accordance with DPH regulations pertaining to swimming pools and bathing places. E. A licensee shall ensure life-saving equipment is readily accessible during water activities if a pool or body of water is six feet or more in any direction and two feet or more in depth. Life-saving equipment may include a ring buoy and rope, a rescue tube, or a throwing line and a shepherd's hook that will not conduct electricity. F. For a camp that uses a natural diving or swimming area, a licensee shall ensure the following: 1. Hazards are assessed and eliminated or clearly marked before a camper swims, dives, or bathes at a natural diving or swimming area; 2. Swimmers are not subjected to a dangerous condition such as a strong current, a sharp drop-off, a quicksand bottom, or rough surf; 3. Water is free from known dangerous aquatic life; 4. The bottom is free from known hazardous debris, sharp stones, and sharp shells; 5. Swimming, diving, and boating areas are clearly marked or roped off; and 6. Diving and swimming programs are conducted at separate times or in separate areas from boating programs. 54. Optional Specialized Activities A. A licensee offering archery activities shall meet the following requirements: 1. For a camp offering archery activities, a licensee shall ensure the archery range is: a. Located where a camper will not wander into the danger area while it is in use; b. Clearly marked to warn individuals away from the danger area; and c. The shooting area has at least 50 yards of clearance or an archery net behind each target. 2. A licensee shall ensure the instructor inspects bows, bowstrings, and arrows to ensure they are in good repair before use. 3. A licensee shall ensure the instructor requires archers to fire from a common firing line with a ready line marked behind it. 4. A licensee shall ensure targets are set a distance from the firing line that is appropriate to the skill level of the camper. 5. A licensee shall ensure the instructor only allows an archer who is ready to shoot on the firing line and non-shooters are behind the ready line. 6. A licensee shall ensure an individual stays behind the firing line at all times except when told by the instructor to retrieve an arrow or target. 7. A licensee shall ensure the bows and arrows are stored in a locked enclosure. 8. A licensee shall ensure the instructor requires that children: a. Do not point the bow with an arrow at someone else; b. Do not fire until directed to do so; c. Do not draw and release an empty bow; and d. Always point arrows down range. B. A licensee offering boating or other watercraft activities shall meet the following requirements: 1. A licensee shall ensure that each person wears a Personal Flotation Device approved by the U.S. Coast Guard for that particular activity while on the water. 2. A licensee shall ensure campers have at least an American Red Cross Advanced Beginner Swimming Certificate, American Red Cross Survival Swimming Certificate, or its equivalent before being allowed to participate in salt water boating activities. 3. A licensee shall ensure that each watercraft is in good repair before use. 4. A licensee shall ensure a watercraft towing a water skier, tuber, or towable has an adult observer on board in addition to the driver. a. Ropes used to tow must be at least 100 feet in length. b. A licensee shall ensure the operator keeps a safe distance from docks, other boats, bulkheads, and shorelines when towing someone behind a boat. 5. A licensee shall ensure an individual using a watercraft has been trained in boarding, debarking, and safety procedures for the craft. C. A licensee offering horseback riding activities shall meet the following requirements: 1. A licensee shall ensure a riding instructor determines a camper's riding experience and level of skill before assigning a horse and deciding whether the camper rides in a ring or on a trail. 2. A licensee shall ensure a rider wears: a. Protective headgear at all times that is properly fitted and fastened and bears the label of the American Society for Testing and Materials (ASTM); and b. Shoes with closed toes and heels or shoes with closed toes and uses closed stirrups. 3. A licensee shall ensure the instructor inspects the riding areas to ensure there is no dangerous terrain and is present during the activity. 4. A licensee shall ensure the instructor requires that: a. Children are fitted for proper saddles; and b. Children are informed that sudden unexpected movements, loud sudden noises, large crowds, other animals, wasp and other insects, and camera flashes can frighten a horse and lead to injuries by being thrown off or being kicked by a horse. D. A licensee offering rock climbing or high ropes activities shall meet the following requirements: 1. A licensee shall ensure children wear appropriately sized harnesses, close-toed shoes, and helmets to participate. 2. A licensee shall ensure the instructor inspects the course, harnesses, and helmets to ensure they are in good repair and safe for use. 3. For high ropes activities, a licensee shall ensure children are not permitted to participate if they cannot reach the top rope or cable while standing on the bottom rope or cable. E. For a camp offering any other activity not listed that could be considered high- risk of injury to children, a licensee shall contact OCCL in advance of permitting the activity to determine whether additional safety measures are required. 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: Early Care and Education and School-Age Centers Regulation 67 67. Transportation A. Use of a vehicle, other than a school bus, with a rated capacity as defined by the manufacturer, to carry more than 10 passengers in addition to the driver to transport children is prohibited. A licensee shall ensure 12-15 passenger vans are not used to transport children. Passenger includes the driver. B. A licensee shall ensure when transporting children that the driver, when volunteering or employed by the center, and vehicle, when owned or leased by the center, comply with all applicable federal and State laws. 1. The driver shall be at least 21 years old. 2. The driver shall have a valid driver’s license that authorizes the driver to operate the vehicle being driven. 3. The driver shall have a comprehensive background check confirming eligibility to be alone with children during transport. 4. The driver does not need to be qualified by DEEDS Early Learning. 5. The driver may not transport more children and adults than the vehicle’s capacity. C. A licensee shall ensure children are transported using child-safety restraints as required by State and federal laws. D. A licensee shall ensure that companies contracted by the center to provide transportation services to children follow applicable State and federal laws. E. A licensee shall ensure each child is secured in an individual safety restraint system appropriate to the age, weight, and height of the child at all times while the vehicle, other than a school bus, is in motion. 1. Safety restraints must be federally approved and labeled according to the applicable Federal Motor Vehicle Safety Standard. 2. Child safety restraints must be installed and used as determined by the manufacturer and vehicle's instruction manual. 3. Safety restraints must be kept in a safe working condition and free of recall. F. If using a school bus, children preschool-age or younger must only be transported on a school bus that is properly equipped with child safety restraints unless the licensee explains to parents or guardians in writing that while child safety restraints on school buses for children preschool-age or younger are not currently required by State law, the National Highway Traffic Administration recommends that children in this age group always be transported using child safety restraints, and the licensee receives written parent or guardian permission stating the child may be transported on a school bus unrestrained. G. A licensee shall ensure vehicles used to transport children, including parent or guardian vehicles used for field trips (unless only transporting the parent’s or guardian’s own children), have and use the following: Vehicle Requirements: • A working heater capable of keeping an interior temperature of at least 50°F; • Air-conditioning to reduce the interior temperature when it exceeds 82°F (school buses are exempt); • A working phone; • A traveling first aid kit including children's emergency contact information; and • A dry chemical fire extinguisher approved by Underwriters Laboratory. H. A licensee shall ensure children are loaded and unloaded at the vehicle's curbside or in a protected parking area or driveway. I. A licensee shall ensure all doors are locked when the vehicle is moving. J. A licensee shall have written parent or guardian permission for transportation provided by the center. 1. A licensee shall document arrangements with the parent or guardian including the pickup and drop off times when driving a child to and from the child's school. 2. A licensee shall inform the parent or guardian of the person or transportation service who is driving the vehicle and ask about special needs the child may have during the ride. K. A licensee shall ensure children are never alone in the vehicle and that the vehicle is visually checked at the final location so that no child is left behind. L. A licensee may not transport children in the open back of a truck. Center: ￿Supervision of children￿ means the correct number of staff members are physically present in the area or room, including outside, with children. Supervision includes providing watchful oversight and timely attention to children’s actions and needs. 23. Center Parent or Guardian Handbook Monitoring the entrance of the center or phone, email, or other communication methods used by the center to ensure the child is released from care when requested by the parent, guardian, or authorized release person; 27. Ratios, Group Size, and Supervision A. A licensee shall ensure supervision and direct observation of children is provided at all times. This supervision occurs through the assignment of qualified staff members who are physically present and working with children. The licensee shall maintain the minimum staff-to-child ratio, except as stated in subsection 27.E, and maximum group size for each age group as listed in the table below: 53. Outdoor Area A. A licensee shall ensure the following: 1. Structures, fences, equipment, and the grounds are maintained in a clean and safe condition; 2. Outdoor areas that are used while it is dark have appropriate lighting; 3. Grounds drain naturally or through installed drainage systems so there is no standing water on the premises. Standing water after a storm must drain within 48 hours; and 4. All areas determined to be unsafe including steep grades, cliffs, open pits, swimming pools, high voltage boosters, propane gas tanks, streets or roads, driveways, railroad tracks, or parking lots are fenced off or have natural barriers to protect children. 51. Toilet Facilities A. A licensee shall ensure a center has enclosed toilet rooms on each floor where child care has been approved. Each toilet room must have at least one sink with warm running water and one operable window or ventilation fan. All door locks, if present, must be designed to permit staff members to open the locked door readily. 67. Transportation H. A licensee shall ensure children are loaded and unloaded at the vehicle's curbside or in a protected parking area or driveway. I. A licensee shall ensure all doors are locked when the vehicle is moving. 68. Field Trips and Program Outings A. A licensee shall have and follow a plan to keep track of children at all times during field trips or routine program outings. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Family and Large Family Child Care Homes Regulation 46 46. Transportation A. A licensee shall ensure the driver and vehicle used to transport children complies with all applicable federal, State and local laws. If transporting children in a vehicle that is owned or leased by the licensee, the licensee shall have documentation of motor vehicle insurance. A licensee may not use 12-15 passenger vans to transport children. Passenger includes the driver. Use of a vehicle, other than a school bus, with a rated capacity as defined by the manufacturer, to carry more than 10 passengers in addition to the driver to transport children is prohibited. B. A licensee shall ensure the driver of a vehicle does not transport more children and adults than the vehicle's capacity determined by the manufacturer. C. A licensee shall ensure the vehicle is inspected for safety before transporting children. D. A licensee shall ensure each child is secured in an individual safety restraint system appropriate to the age, weight, and height of the child at all times while the vehicle, other than a school bus, is in motion. 1. Safety restraints must be federally approved and labeled according to the applicable Federal Motor Vehicle Safety Standard. 2. Child safety restraints must be installed and used as determined by the manufacturer and vehicle's instruction manual. 3. Safety restraints must be kept in a safe working condition and free of recall. E. A child preschool-age or younger must only be transported on a school bus that is properly equipped with child safety restraints. 1. With written parent or guardian permission, a child preschool-age or younger may be transported on a school bus unrestrained. 2. A licensee shall explain to parents or guardians in writing that while child safety restraints on school buses for children preschool-age or younger are not currently required by State law, the National Highway Traffic Administration recommends that children in this age group always be transported using child safety restraints. F. A licensee shall ensure vehicles used to transport children, including parent or guardian vehicles used for field trips (unless only transporting parent’s or guardian’s own children), have and use the following: Vehicle Requirements: • A working heater capable of keeping an interior temperature of at least 50°F; • Air-conditioning to reduce the interior temperature when it exceeds 82°F (school buses are exempt); Vehicle Requirements: • A working phone; • A traveling first aid kit including children's emergency contact information; and • A dry chemical fire extinguisher approved by Underwriters Laboratory. G. A licensee shall ensure children are loaded and unloaded at the vehicle's curbside or in a protected parking area or driveway. H. A licensee shall ensure all doors are locked when the vehicle is moving. I. A licensee shall have written parent or guardian permission for transportation provided by the home. A licensee shall document arrangements with the parent or guardian including the pickup and drop off times when driving a child to and from the child's school. A licensee shall inform the parent or guardian of the person or transportation service who is driving the vehicle and ask about special needs the child may have during the ride. J. A licensee shall ensure children are never alone in the vehicle and that the vehicle is visually checked at the final location so that no child is left behind. K. A licensee may not transport children in the open back of a truck. FCCH: "Supervision" or "direct supervision" (of children or staff members) means a licensee or staff member is physically present in the same room or area, including outside, with children or staff. Supervision of children includes providing watchful oversight and timely attention to children’s actions and needs. 29. Indoor Space F. A licensee shall ensure door locks or latches in rooms used by children can open from either side of the door and the opening device or key is available to a licensee and staff members. 46. Transportation G. A licensee shall ensure children are loaded and unloaded at the vehicle's curbside or in a protected parking area or driveway. H. A licensee shall ensure all doors are locked when the vehicle is moving. 47. Field Trips and Outings E. A licensee shall ensure children are under constant supervision whenever offsite to ensure safety. 59. Outdoor Fencing A licensee shall ensure the outdoor play area of the family home is fenced if hazards are near. Such hazards include, but are not limited to, high traffic roads, water in streams, rivers, ponds, lakes, pools, railroads, steep mounds or drop-offs, and high voltage wires or poles and towers. iii. All CCDF-eligible licensed in-home care. Provide the standard: Not Applicable to the Office of Child Care Licensing. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Not Applicable to the Office of Child Care Licensing. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Not Applicable to the Office of Child Care Licensing. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: This is not applicable. Relative Care providers are the only exempt category that can provide care in the child’s own home, but it is care provided by a relative only. Relative Care providers are required to participate in a Relative Orientation on program rules and regulations. They are also required to participate in 28 hours of CCDF approved training and 3 hours of a health and safety refresher training annually. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Youth Camps Regulation 58 58. Transportation A. Use of a vehicle, other than a school bus, with a rated capacity as defined by the manufacturer, to carry more than 10 passengers in addition to the driver to transport children is prohibited. A licensee shall ensure 12-15 passenger vans are not used to transport children. Passenger includes the driver. B. A licensee shall ensure when transporting children that the driver, when volunteering or employed by the camp, and vehicle, when owned or leased by the camp, comply with all applicable federal and State laws. 1. The driver shall be at least 21 years old. 2. The driver shall have a valid driver’s license that authorizes the driver to operate the vehicle being driven. 3. The driver shall have a comprehensive background check confirming eligibility to be alone with children during transport. 4. The driver may not transport more children and adults than the vehicle’s capacity. C. A licensee shall ensure that companies contracted by the camp to provide transportation services to children follow applicable State and federal laws. D. A licensee shall ensure each child is secured in an individual safety restraint system appropriate to the age, weight, and height of the child at all times while the vehicle, other than a school bus, is in motion. 1. Safety restraints must be federally approved and labeled according to the applicable Federal Motor Vehicle Safety Standard. 2. Child safety restraints must be installed and used as determined by the manufacturer and vehicle's instruction manual. 3. Safety restraints must be kept in a safe working condition and free of recall. E. A licensee shall ensure vehicles used to transport children have and use the following: Vehicle Requirements: • A working heater capable of keeping an interior temperature of at least 50 °F; • Air-conditioning to reduce the interior temperature when it exceeds 82 °F (school buses are exempt); • A working phone; • Flares; • Reflectors; • A first aid kit; and • A dry chemical fire extinguisher approved by Underwriters Laboratory. F. A licensee shall ensure children are loaded and unloaded at the vehicle's curbside or in a protected parking area or driveway. G. A licensee shall ensure all doors are locked when the vehicle is moving. H. A licensee shall have written parent/guardian permission for transportation provided by the camp. I. A licensee shall ensure children are never alone in the vehicle and that the vehicle is visually checked at the final location so that no child is left behind. J. A licensee shall ensure children’s heads and limbs remain inside the vehicle during transport. K. A licensee may not transport children in the open back of a truck. Youth Camp: ￿Supervision￿ (of children, staff members, and volunteers) means the correct number of staff members are physically present in the area or room, including outside, with children and staff members and volunteers who must be supervised . Supervision includes providing watchful oversight and timely attention to children, staff members, and volunteers’ actions and needs. 29. Ratios, Group Size, and Supervision A. A licensee shall ensure supervision of children is provided at all times, except as stated in subsection in subsection 29.C. of this regulation. This supervision occurs through the assignment of qualified staff members who are physically present and working with children. 42. Indoor Area B. A licensee shall show evidence of security procedures that ensures access to children is limited to authorized people. 45. Toilet Facilities A. A licensee shall ensure a camp has enclosed toilet rooms. Each toilet room must have at least one sink supplied with hot and cold or tempered water under pressure and one operable window or ventilation fan. All door locks, if present, must be designed to permit staff members to open the locked door readily. 51. Outdoor Area A. A licensee shall ensure the following: 1. Structures, fences, equipment, and the grounds are maintained in a clean and safe condition; 2. Outdoor areas that are used while it is dark have appropriate lighting; 3. Grounds drain naturally or through installed drainage systems so there is no standing water on the premises. Standing water after a storm must drain within 48 hours; 4. All areas determined to be unsafe including steep grades, cliffs, open pits, high voltage boosters, propane gas tanks, streets or roads, driveways, railroad tracks, or parking lots are fenced off, have natural barriers to protect children, or procedures to protect children when fencing or a natural barrier is not present; 5. Uncovered wells, septic tanks, wastewater, wastewater tanks, below grade storage tanks, farm manure ponds or other similar hazards are inaccessible to children using a physical barrier with a locking mechanism; 6. The growth of brush, weeds, grass and plants shall be controlled in central camp areas to prevent harborage of ticks, chiggers, and other insects of public health importance; and 7. The camp area shall be maintained to prevent growth of ragweed, poison ivy, poison oak, and other noxious plants considered detrimental to health. 58. Transportation F. A licensee shall ensure children are loaded and unloaded at the vehicle's curbside or in a protected parking area or driveway. G. A licensee shall ensure all doors are locked when the vehicle is moving. 59. Field Trips A. A licensee shall have and follow a plan to keep track of children at all times during field trips. 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: Early Care and Education and School-Age Centers Regulation 32 32. Orientation A. A licensee shall document that all staff members, all substitutes, and volunteers working at least five days or 40 hours a year receive training in the following topics before working with children: Orientation Requirements: • DELACARE Regulations (related to job duties); • Personnel and administrative policies; • Release of children including procedures for situations listed in Section 23; • Positive behavior supports; • Child accident and injury procedures; • Administration of medication certification, within two months of hire, if administering medication to children; • Child care goals and program for children; • Recordkeeping, including documenting children and their own attendance; • Family involvement; • Food and nutrition services, including proper handling, storage, preparation, and feeding of breast milk and formula, if applicable; • Safety and sanitation procedures; • Physical activity; • Screen time as described in subsection 76.D; • Photographing or videotaping children; • Transporting children, if applicable; • Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, reporting requirements; and • Information on federal and State laws or regulations applicable to children and families in care, including non-discrimination. B. The orientation must include the opportunity for staff members to ask questions and receive clarification on their job functions, licensing regulations, and center policies. When information is revised, a licensee shall ensure staff members are informed of the changes. C. A licensee shall ensure all staff members, all substitutes, and volunteers working at least five days or 40 hours a year complete OCCL's approved Health and Safety Training for Child Care Professionals before working with children. This training provides professional development training hours and includes the following topics: Health and Safety Training Topics: • Emergency preparedness and response planning, disaster and evacuation plans and procedures • Safe sleep practices, including prevention of sudden infant death syndrome; • Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; 44 Health and Safety Training Topics: • Routine and emergency health care including health exclusions, prevention, and recognition of the symptoms of childhood illnesses, including reportable communicable diseases and immunizations; • Prevention of and response to emergencies due to food and allergic reactions; • Building and physical premises safety; • Handling and storage of hazardous materials and proper disposal of bio- contaminants; • Safety measures in transporting children, and • Administration of medication. 19. Child Abuse and Neglect Reporting Requirements A. A licensee shall develop, adopt, follow, and maintain on file written policies and procedures for handling an incident of suspected child abuse or neglect that occurs while a child is in or out of the center’s care to comply with applicable laws. Allegations of Abuse or Neglect against a Staff Member 1. The licensee shall ensure children are not abused or neglected. 2. The licensee shall eliminate the factors or circumstances that may result in a continuing risk of abuse or neglect to children if the abuse or neglect occurred at the center by a staff member. 3. The licensee shall ensure the 24-Hour Child Abuse Report Line (currently listed as 1-800-292-9582) is immediately notified when suspected child abuse or neglect occurs at the center. 4. A staff member alleged to have abused or neglected a child in care may not have direct contact with any child until the completion of the incident’s investigation by the Institutional Abuse Unit. However, at the licensee’s 24 discretion, the staff member may be reassigned to other duties that do not involve contact with children. 5. If the licensee is alleged to have abused or neglected a child, the licensee may not be present in the center when children are present until the completion of the Institutional Abuse Unit's investigation. Reg #20 Positive Behavior Support F. A licensee shall ensure the following actions are prohibited: • Roughly handling a child or physical punishment inflicted on a child's body, including, but not limited to the following: shaking, grabbing, striking, hairpulling, biting, pinching, plucking, slapping, hitting, kicking, or spanking; • Yelling at, humiliating, or frightening children; • Physically or sexually abusing a child; • Making negative comments about a child's looks, ability, ethnicity, family, or other personal traits; • Denying children food, water, or toilet use because of inappropriate behavior; • Tying, taping, chaining, caging, or restraining a child by a means other than holding. The child may be held only as long as necessary for the child to regain control; o If the child or others are in imminent danger or a risk to themselves or others, physical holding for as brief as possible to remedy the risk or removing the child to a safer location is permissible. Supervision is required. o In the event physical holding is used, documentation must occur by the staff. The early childhood or school-age administrator shall be involved in monitoring and managing the situation to ensure safety of all (child and staff member). • Punishing children for a toileting accident, or for failing to fall asleep, eat food, or complete an activity; • Withholding physical activity as punishment; or • Encouraging or allowing children to hit, punish, or discipline each other. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Family and Large Family Child Care Homes Regulation 7 &15 7. Procedures for Initial Licensure A. An applicant shall complete the following steps and submit the following information to OCCL when seeking a license: 1. Attend OCCL's information session and orientation to learn the application process and regulations; 2. Submit a completed Family Child Care Home Initial License Application (see Appendix I) or a Large Family Child Care Home Initial License Application (see Appendix II), as applicable, which includes: Required Application Information: • Applicant’s name, address, email, and phone numbers; • Applicant’s references: for corporations contact information for officers; for LLCs contact information for managing member; • Previous licensure information, if applicable; • Program information (including ages of children to be served); • Household members; and • Certifications that include: o Agreement to comply with federal and State laws and regulations including, but not limited to, the Americans with Disabilities Act and Delaware Equal Accommodations Law; o Statement that information supplied is true and correct; and o Acknowledgment that OCCL is required to make a thorough investigation of the applicant. 3. Submit the following items to OCCL: Items to be Submitted: • Proof of compliance with zoning codes, and, if applicable, other codes, regulations, guidelines, or laws, such as those from Division of Revenue, Department of Natural Resources and Environmental Control for septic systems, and Office of Drinking Water for well water; Items to be Submitted: • Documentation that the home is free of lead-based paint hazards. Homes constructed in or after 1978 are exempt from lead-paint risk assessments and testing; o If the home were constructed before 1978, an applicant or licensee shall provide a lead-paint risk assessment performed by an environmental testing firm certified by DPH showing the home to be free of lead-paint hazards. o If lead paint is identified but intact (i.e. not chipping, flaking, or peeling), the licensee shall monitor the identified areas at least every six months and document that the lead-based paint is intact (in good repair and not deteriorated). Lead-based paint is not regarded as a hazard if it is intact or not present in an accessible surface, a friction surface, or an impact surface that could result in an adverse human health effect. • If lead-paint hazards are identified in the risk assessment, the applicant or licensee shall remedy the hazards by hiring a lead-safe contractor (lead abatement or renovation firm) certified by DPH to make the repairs. o Once the repairs are made, a lead-dust clearance inspection must be performed by an environmental testing firm certified by DPH to confirm the home is free of lead based paint hazards. o An applicant or licensee shall provide the lead-dust clearance testing results to OCCL within five business days to confirm the home is free of lead-based paint hazards. o Children may not be present during repairs and the home must stay closed until the results of the dust clearance test are at appropriate levels and the lead-safe contractor states it is safe for the home to be open. • If any lead-based paint identified in a risk assessment becomes deteriorated or if lead-based paint is located in an area to be remodeled, a licensee shall retain a contractor certified by DPH to work using lead-safe work practices (lead abatement or lead renovator) to perform any renovation or repair in a pre-1978 child-occupied facility; o Records of any renovation or repair work must be forwarded to OCCL within five business days. o Children may not be present during repairs or renovation until a lead dust clearance test is obtained and the lead-safe contractor states it is safe for the home to be open. • Evidence showing each room used for child care to be free of radon hazards using the Environmental Protection Agency’s guidelines; o Testing may be performed by the property owner or an inspector certified by the American Association of Radon Scientists, the National Radon Safety Board, or any organization recognized by the EPA or State of Delaware Radon Program. o If testing indicates a radon level over 4.0 pCi/L, radon mitigation according to industry standards must occur or a long-term radon test (90-120 days) must indicate a level less than 4.0 pCi/L. • Electrical inspection of the home conducted by a State fire marshal recognized electrical inspection agency; Items to be Submitted: • Current certifications in CPR including a skills demonstration and first aid for the ages of the children in care. Applicants for large family homes are exempt from this requirement if not serving as a staff member; • The names, addresses, phone numbers, and email addresses for three references who are familiar with, but not related to, the applicant and can describe the applicant's interactions with children; • Release of employment form that allows OCCL to collect service letters as per 19 Del.C. §708. The form will list the applicant's current or most recent employer and all health care and child care facilities where the applicant worked within the past five years. If an applicant has no former employer, the applicant shall provide information for two more references; • Comprehensive background checks for the applicant, adult household members, substitutes, staff members, and adult volunteers including State and federal fingerprint checks. o In addition to the Delaware fingerprinting, applicants, adult household members, substitutes, staff members, and adult volunteers who currently reside outside of Delaware must contact their state of residence and complete a fingerprinted state criminal history search and a name-based child abuse and neglect search. o Applicants, adult household members, substitutes, staff members, and adult volunteers who have resided outside of Delaware in the last five years must contact each state of residence, and request a criminal history search and a child abuse and neglect search. o After the out-of-state searches are completed, the applicant must submit the results immediately to CHU. o The person may not be alone with children until CHU notifies the licensee of the person’s eligibility after completing the comprehensive background check. o When OCCL has a reason to believe the health, safety, or welfare of a child in care may be at risk, OCCL may request parent or guardian permission for a comprehensive background check on a child household member and other medical, psychological, counseling, school, and probation records. OCCL may obtain information from the Department of Services for Children, Youth and Their Families; • Documentation of any case where the applicant gave up or lost custody of a child, if applicable; • Health appraisals for the applicant, all adult household members, and the substitute completed within one year before the application date that includes a tuberculosis (TB) test or medical professional risk assessment that verifies the person does not pose a threat of transmitting tuberculosis to children or others. The TB test or medical professional risk assessment must be completed within one year before the application date. This appraisal must confirm the person's health and document medical or physical conditions that pose a direct threat to the health and safety of children or others and any reasonable accommodations that may be required. This documentation shall be provided to OCCL for the purposes of determining whether the health condition creates a significant risk to children; • Health appraisals for child household members; • State business license or verification of tax-exempt status; • Sample two-week menu, if providing meals or snacks (if using a catering service, a copy of the caterer’s food establishment permit); and Items to be Submitted: • Documentation of completion of pre-service training in the following topics, if the applicant will work with children: o Six hours of quality-assured child development; o Three hours of quality-assured positive behavior supports or social-emotional development; o Prevention and control of infectious diseases, including immunization; o OCCL’s approved Health and Safety Training for Child Care Professionals that includes the following topics: ￿ Prevention and control of communicable diseases including immunization; ￿ Safe sleep practices, including prevention of sudden infant death syndrome; ￿ Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; ￿ Prevention of and response to emergencies due to food and allergic reactions; ￿ Building and physical grounds safety; ￿ Emergency preparedness and response planning; ￿ Handling and storage of hazardous materials and proper disposal of bio contaminants; ￿ Administration of medication; and ￿ Safety measures in transporting children. o Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements (certificate required); • Landlord approval, if renting; • Emergency plan; and • Large family applicants shall complete the additional requirements for large family homes as listed in Sections 60 through 70. B. Upon receipt of the completed application and required information, a licensing specialist shall: 1. Review the application and information, and inspect the premises to determine whether the applicant complies with these regulations; 2. Make a recommendation for licensure. If a license is granted, it will be a six-month initial provisional license; and 3. Notify the applicant as stated in subsection 12.D.2 if an initial provisional license to operate is denied. C. A licensing specialist shall conduct a compliance review at the home before the expiration of the initial provisional license. Once this review is completed, OCCL will issue a provisional or annual license depending upon whether full compliance is obtained. This license will be valid for six months. 15. Use of a Substitute A. A licensee shall arrange for a substitute who is at least 18 years old. 1. This substitute may be available to assist in non-emergency situations but must be available in case of an emergency. OCCL defines an emergency as an unplanned event, such as a serious or sudden illness, accident, or situation, requiring the immediate attention of a licensee. 2. The substitute and licensee may both be present at the home; however, a licensee shall provide the majority of the child care duties. 25 B. A licensee shall post the substitute's name and phone number in the home and provide this information to OCCL. C. A licensee shall document on the form provided by OCCL that substitutes used only for emergencies receive training in the following topics before working with children: D. A licensee shall document on the form provided by OCCL that substitutes used for non-emergency situations receive training in the following topics before working with children: Training Requirements for Non-Emergency-Use Substitutes: • DELACARE Regulations; • Policies and procedures of the home; • Emergency preparedness and disaster and evacuation plans; o OCCL’s approved Health and Safety Training for Child Care Professionals that includes the following topics: ￿ Safe sleep practices, including prevention of sudden infant death syndrome; ￿ Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; ￿ Prevention of and response to emergencies due to food and allergic reactions; ￿ Prevention and control of communicable diseases, including immunization; ￿ Building and physical grounds safety; ￿ Handling and storage of hazardous materials and proper disposal of bio- contaminants; ￿ Administration of medication; and ￿ Safety measures in transporting children. o Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements (certificate required); • CPR and first aid certifications; and • Administration of medication. E. A licensee shall keep a copy of the substitute's health appraisal, comprehensive background check results showing eligibility, and orientation record on file at the home. Also, a licensee shall ensure substitutes used for non-emergency situations have the following certificates on file: Required Certifications for Non-Emergency Substitutes: • Administration of medication; • CPR including a skills demonstration; • First aid; • OCCL's Health and Safety Training for Child Care Professionals; and Training Requirements for Emergency-Use Substitutes: • DELACARE Regulations; • Policies and procedures of the home including special health care concerns of the children in care, such as allergies; • Emergency preparedness and disaster and evacuation plans; • Safe sleep practices, including prevention of sudden infant death syndrome, if caring for infants; • Recognition of the symptoms of child abuse and neglect; and • Child abuse and neglect laws and reporting requirements. • Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements. F. A licensee shall ensure the substitute has access to each child's file, knows special or emergency information about each child, and keeps all children's information private. G. The substitute may provide care in the home in the absence of a licensee, or if applicable, the large family provider or large family assistant. A licensee does not need to inform OCCL or receive approval to use a substitute in the following situations: Permission to use a Substitute is not Required for these Situations: • Emergencies as defined in subsection 15.A.1; • Medical appointments; • School appointments; or • Time off for less than five days in a row. H. The substitute may provide care in the home in the absence of a licensee, large family provider, or large family assistant. A licensee shall inform OCCL and receive approval to use a substitute in the following situations: Permission to use a Substitute is Required for these Situations: • Training or classes held for three or more sessions; • Student teaching; • Internship or practicum to meet qualifications or annual training; or • Time off for five or more days in a row. I. Before using a substitute, a licensee shall tell the parent or guardian who the substitute is and when the substitute will be caring for the children, unless it is an emergency. J. A licensee shall record the date and times a substitute is present and is helping with the children or providing care. A licensee shall maintain this record for at least three months. Reg #18 Positive Behavior Support F. A licensee shall ensure the following actions are prohibited: • Roughly handling a child or physical punishment inflicted on a child's body, including, but not limited to the following: shaking, grabbing, striking, hairpulling, biting, pinching, plucking, slapping, hitting, kicking, or spanking; • Yelling at, humiliating, or frightening children; • Physically or sexually abusing a child; • Making negative comments about a child's looks, ability, ethnicity, family, or other personal traits; • Denying children food, water, or toilet use because of inappropriate behavior; • Tying, taping, chaining, caging, or restraining a child by a means other than holding. The child may be held only as long as necessary for the child to regain control; o If the child or others are in imminent danger or a risk to themselves or others, physical holding for as brief as possible to remedy the risk or removing the child to a safer location is permissible. Supervision is required. o In the event physical holding is used, documentation must occur by the staff. The early childhood or school-age administrator shall be involved in monitoring and managing the situation to ensure safety of all (child and staff member). • Punishing children for a toileting accident, or for failing to fall asleep, eat food, or complete an activity; • Withholding physical activity as punishment; or • Encouraging or allowing children to hit, punish, or discipline each other. 65. Personnel Policies A. A licensee shall have written personnel policies and procedures available to staff members. These policies must include, as appropriate, procedures for hiring, discipline, dismissal, suspension, and lay-off of the staff member according to applicable laws. A statement signed by the staff member on the orientation form must confirm the review of these personnel policies and procedures and that the staff member was able to ask questions and receive clarification. B. A licensee shall develop, follow, and keep on file written policies and procedures that comply with applicable laws for handling suspected child abuse or neglect that occurs while a child is in or out of the large family home's care. C. A licensee shall ensure no one abuses or neglects children. D. A licensee shall take corrective action to remove the conditions that may have caused or otherwise resulted in a risk of abuse or neglect to children, if the abuse or neglect happened at the home by a staff member. E. A licensee shall ensure a licensee or staff member accused of child abuse or neglect is prohibited from working with children until the results of an investigation are completed and OCCL clears the individual to work with children. iii. All CCDF-eligible licensed in-home care. Provide the standard: Not Applicable to the Office of Child Care Licensing. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Not Applicable to the Office of Child Care Licensing. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Not Applicable to the Office of Child Care Licensing. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Relative Care providers are the only exempt category that can provide care in the child’s own home, but it is care provided by a relative only. Relative Care providers are required to participate in a Relative Orientation on program rules and regulations. They are also required to participate in 28 hours of CCDF approved training and 3 hours of a health and safety refresher training annually. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Youth Camps Regulation 11A & 36 11. Notification to OCCL A. A licensee shall ensure a staff member calls OCCL and speaks to someone at OCCL (leaving a message is not acceptable) within one business day Monday- Friday from 8:00 AM to 4:30 PM in the event of: Notify OCCL Within One Business Day in the Event of: • Suspected abuse or neglect of a child while in care (after reporting the suspicion to the 24-Hour Child Abuse Report Line, currently listed as 1-800- 292-9582); 36. Health Observation A licensee shall ensure a staff member trained in recognizing common signs of communicable disease, physical injury, other evidence of ill health as listed in Section 37, and signs of child abuse or neglect observes each child on arrival. A. A staff member must document specific concerns and observations as well as the steps taken to assist the child and keep this information in the child’s file. B. A person who suspects child abuse or neglect shall make an immediate report to the Child Abuse Report Line. 15. Child Abuse and Neglect Reporting Requirements A. A licensee shall develop, follow, and maintain on file written policies and procedures for handling an incident of suspected child abuse or neglect that occurs while a child is in or out of the camp’s care to comply with applicable laws. B. Allegations of Abuse or Neglect against a Staff Member 1. The licensee shall ensure staff members or volunteers do not abuse or neglect children. 2. If the abuse or neglect occurred at the camp by a staff member, the licensee shall eliminate those factors or circumstances that may have increased the risk of abuse or neglect. 3. A staff member alleged to have abused or neglected a child may not have direct contact with any child until the completion of the incident’s investigation. However, at the licensee’s discretion, the licensee may reassign the staff member to other duties that do not involve contact with children. Reg #16 Positive Behavior Management D. A licensee shall ensure the following actions are prohibited: • Roughly handling a child or physical punishment inflicted on a child's body, including, but not limited to the following: shaking, grabbing, striking, hairpulling, biting, pinching, plucking, slapping, hitting, kicking, or spanking; • Yelling at, humiliating, or frightening children; • Physically or sexually abusing a child; • Making negative comments about a child's looks, ability, ethnicity, family, or other personal traits; • Denying children food, water, or toilet use because of inappropriate behavior; • Tying, taping, chaining, caging, or restraining a child by a means other than holding. The child may be held only as long as necessary for the child to regain control; o If the child or others are in imminent danger or a risk to themselves or others, physical holding for as brief as possible to remedy the risk or removing the child to a safer location is permissible. Supervision is required. o In the event physical holding is used, documentation must occur by the staff. The early childhood or school-age administrator shall be involved in monitoring and managing the situation to ensure safety of all (child and staff member). • Punishing children for a toileting accident, or for failing to fall asleep, eat food, or complete an activity; • Withholding physical activity as punishment; or • Encouraging or allowing children to hit, punish, or discipline each other. Reg #24 Staff Orientation requires - Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law and reporting requirements, and the camp’s procedures to report abuse and neglect; 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: Early Care and Education and School-Age Centers Regulation 19 19. Child Abuse and Neglect Reporting Requirements A. A licensee shall develop, adopt, follow, and maintain on file written policies and procedures for handling an incident of suspected child abuse or neglect that occurs while a child is in or out of the center’s care to comply with applicable laws. Allegations of Abuse or Neglect against a Staff Member 1. The licensee shall ensure children are not abused or neglected. 2. The licensee shall eliminate the factors or circumstances that may result in a continuing risk of abuse or neglect to children if the abuse or neglect occurred at the center by a staff member. 3. The licensee shall ensure the 24-Hour Child Abuse Report Line (currently listed as 1-800-292-9582) is immediately notified when suspected child abuse or neglect occurs at the center. 4. A staff member alleged to have abused or neglected a child in care may not have direct contact with any child until the completion of the incident’s investigation by the Institutional Abuse Unit. However, at the licensee’s 24 discretion, the staff member may be reassigned to other duties that do not involve contact with children. 5. If the licensee is alleged to have abused or neglected a child, the licensee may not be present in the center when children are present until the completion of the Institutional Abuse Unit's investigation. Reg #20 Positive Behavior Support F. A licensee shall ensure the following actions are prohibited: • Roughly handling a child or physical punishment inflicted on a child's body, including, but not limited to the following: shaking, grabbing, striking, hairpulling, biting, pinching, plucking, slapping, hitting, kicking, or spanking; • Yelling at, humiliating, or frightening children; • Physically or sexually abusing a child; • Making negative comments about a child's looks, ability, ethnicity, family, or other personal traits; • Denying children food, water, or toilet use because of inappropriate behavior; • Tying, taping, chaining, caging, or restraining a child by a means other than holding. The child may be held only as long as necessary for the child to regain control; o If the child or others are in imminent danger or a risk to themselves or others, physical holding for as brief as possible to remedy the risk or removing the child to a safer location is permissible. Supervision is required. o In the event physical holding is used, documentation must occur by the staff. The early childhood or school-age administrator shall be involved in monitoring and managing the situation to ensure safety of all (child and staff member). • Punishing children for a toileting accident, or for failing to fall asleep, eat food, or complete an activity; • Withholding physical activity as punishment; or • Encouraging or allowing children to hit, punish, or discipline each other. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Family and Large Family Child Care Homes Regulation 7, 15 & 26 7. Procedures for Initial Licensure A. An applicant shall complete the following steps and submit the following information to OCCL when seeking a license: 1. Attend OCCL's information session and orientation to learn the application process and regulations; 2. Submit a completed Family Child Care Home Initial License Application (see Appendix I) or a Large Family Child Care Home Initial License Application (see Appendix II), as applicable, which includes: Required Application Information: • Applicant’s name, address, email, and phone numbers; • Applicant’s references: for corporations contact information for officers; for LLCs contact information for managing member; • Previous licensure information, if applicable; • Program information (including ages of children to be served); • Household members; and • Certifications that include: o Agreement to comply with federal and State laws and regulations including, but not limited to, the Americans with Disabilities Act and Delaware Equal Accommodations Law; o Statement that information supplied is true and correct; and o Acknowledgment that OCCL is required to make a thorough investigation of the applicant. 3. Submit the following items to OCCL: Items to be Submitted: • Proof of compliance with zoning codes, and, if applicable, other codes, regulations, guidelines, or laws, such as those from Division of Revenue, Department of Natural Resources and Environmental Control for septic systems, and Office of Drinking Water for well water; Items to be Submitted: • Documentation that the home is free of lead-based paint hazards. Homes constructed in or after 1978 are exempt from lead-paint risk assessments and testing; o If the home were constructed before 1978, an applicant or licensee shall provide a lead-paint risk assessment performed by an environmental testing firm certified by DPH showing the home to be free of lead-paint hazards. o If lead paint is identified but intact (i.e. not chipping, flaking, or peeling), the licensee shall monitor the identified areas at least every six months and document that the lead-based paint is intact (in good repair and not deteriorated). Lead-based paint is not regarded as a hazard if it is intact or not present in an accessible surface, a friction surface, or an impact surface that could result in an adverse human health effect. • If lead-paint hazards are identified in the risk assessment, the applicant or licensee shall remedy the hazards by hiring a lead-safe contractor (lead abatement or renovation firm) certified by DPH to make the repairs. o Once the repairs are made, a lead-dust clearance inspection must be performed by an environmental testing firm certified by DPH to confirm the home is free of lead based paint hazards. o An applicant or licensee shall provide the lead-dust clearance testing results to OCCL within five business days to confirm the home is free of lead-based paint hazards. o Children may not be present during repairs and the home must stay closed until the results of the dust clearance test are at appropriate levels and the lead-safe contractor states it is safe for the home to be open. • If any lead-based paint identified in a risk assessment becomes deteriorated or if lead-based paint is located in an area to be remodeled, a licensee shall retain a contractor certified by DPH to work using lead-safe work practices (lead abatement or lead renovator) to perform any renovation or repair in a pre-1978 child-occupied facility; o Records of any renovation or repair work must be forwarded to OCCL within five business days. o Children may not be present during repairs or renovation until a lead dust clearance test is obtained and the lead-safe contractor states it is safe for the home to be open. • Evidence showing each room used for child care to be free of radon hazards using the Environmental Protection Agency’s guidelines; o Testing may be performed by the property owner or an inspector certified by the American Association of Radon Scientists, the National Radon Safety Board, or any organization recognized by the EPA or State of Delaware Radon Program. o If testing indicates a radon level over 4.0 pCi/L, radon mitigation according to industry standards must occur or a long-term radon test (90-120 days) must indicate a level less than 4.0 pCi/L. • Electrical inspection of the home conducted by a State fire marshal recognized electrical inspection agency; Items to be Submitted: • Current certifications in CPR including a skills demonstration and first aid for the ages of the children in care. Applicants for large family homes are exempt from this requirement if not serving as a staff member; • The names, addresses, phone numbers, and email addresses for three references who are familiar with, but not related to, the applicant and can describe the applicant's interactions with children; • Release of employment form that allows OCCL to collect service letters as per 19 Del.C. §708. The form will list the applicant's current or most recent employer and all health care and child care facilities where the applicant worked within the past five years. If an applicant has no former employer, the applicant shall provide information for two more references; • Comprehensive background checks for the applicant, adult household members, substitutes, staff members, and adult volunteers including State and federal fingerprint checks. o In addition to the Delaware fingerprinting, applicants, adult household members, substitutes, staff members, and adult volunteers who currently reside outside of Delaware must contact their state of residence and complete a fingerprinted state criminal history search and a name-based child abuse and neglect search. o Applicants, adult household members, substitutes, staff members, and adult volunteers who have resided outside of Delaware in the last five years must contact each state of residence, and request a criminal history search and a child abuse and neglect search. o After the out-of-state searches are completed, the applicant must submit the results immediately to CHU. o The person may not be alone with children until CHU notifies the licensee of the person’s eligibility after completing the comprehensive background check. o When OCCL has a reason to believe the health, safety, or welfare of a child in care may be at risk, OCCL may request parent or guardian permission for a comprehensive background check on a child household member and other medical, psychological, counseling, school, and probation records. OCCL may obtain information from the Department of Services for Children, Youth and Their Families; • Documentation of any case where the applicant gave up or lost custody of a child, if applicable; • Health appraisals for the applicant, all adult household members, and the substitute completed within one year before the application date that includes a tuberculosis (TB) test or medical professional risk assessment that verifies the person does not pose a threat of transmitting tuberculosis to children or others. The TB test or medical professional risk assessment must be completed within one year before the application date. This appraisal must confirm the person's health and document medical or physical conditions that pose a direct threat to the health and safety of children or others and any reasonable accommodations that may be required. This documentation shall be provided to OCCL for the purposes of determining whether the health condition creates a significant risk to children; • Health appraisals for child household members; • State business license or verification of tax-exempt status; • Sample two-week menu, if providing meals or snacks (if using a catering service, a copy of the caterer’s food establishment permit); and Items to be Submitted: • Documentation of completion of pre-service training in the following topics, if the applicant will work with children: o Six hours of quality-assured child development; o Three hours of quality-assured positive behavior supports or social-emotional development; o Prevention and control of infectious diseases, including immunization; o OCCL’s approved Health and Safety Training for Child Care Professionals that includes the following topics: ￿ Prevention and control of communicable diseases including immunization; ￿ Safe sleep practices, including prevention of sudden infant death syndrome; ￿ Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; ￿ Prevention of and response to emergencies due to food and allergic reactions; ￿ Building and physical grounds safety; ￿ Emergency preparedness and response planning; ￿ Handling and storage of hazardous materials and proper disposal of bio contaminants; ￿ Administration of medication; and ￿ Safety measures in transporting children. o Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements (certificate required); • Landlord approval, if renting; • Emergency plan; and • Large family applicants shall complete the additional requirements for large family homes as listed in Sections 60 through 70. B. Upon receipt of the completed application and required information, a licensing specialist shall: 1. Review the application and information, and inspect the premises to determine whether the applicant complies with these regulations; 2. Make a recommendation for licensure. If a license is granted, it will be a six-month initial provisional license; and 3. Notify the applicant as stated in subsection 12.D.2 if an initial provisional license to operate is denied. C. A licensing specialist shall conduct a compliance review at the home before the expiration of the initial provisional license. Once this review is completed, OCCL will issue a provisional or annual license depending upon whether full compliance is obtained. This license will be valid for six months. 15. Use of a Substitute A. A licensee shall arrange for a substitute who is at least 18 years old. 1. This substitute may be available to assist in non-emergency situations but must be available in case of an emergency. OCCL defines an emergency as an unplanned event, such as a serious or sudden illness, accident, or situation, requiring the immediate attention of a licensee. 2. The substitute and licensee may both be present at the home; however, a licensee shall provide the majority of the child care duties. B. A licensee shall post the substitute's name and phone number in the home and provide this information to OCCL. C. A licensee shall document on the form provided by OCCL that substitutes used only for emergencies receive training in the following topics before working with children: D. A licensee shall document on the form provided by OCCL that substitutes used for non-emergency situations receive training in the following topics before working with children: Training Requirements for Non-Emergency-Use Substitutes: • DELACARE Regulations; • Policies and procedures of the home; • Emergency preparedness and disaster and evacuation plans; o OCCL’s approved Health and Safety Training for Child Care Professionals that includes the following topics: ￿ Safe sleep practices, including prevention of sudden infant death syndrome; ￿ Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; ￿ Prevention of and response to emergencies due to food and allergic reactions; ￿ Prevention and control of communicable diseases, including immunization; ￿ Building and physical grounds safety; ￿ Handling and storage of hazardous materials and proper disposal of bio- contaminants; ￿ Administration of medication; and ￿ Safety measures in transporting children. o Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements (certificate required); • CPR and first aid certifications; and • Administration of medication. E. A licensee shall keep a copy of the substitute's health appraisal, comprehensive background check results showing eligibility, and orientation record on file at the home. Also, a licensee shall ensure substitutes used for non-emergency situations have the following certificates on file: Required Certifications for Non-Emergency Substitutes: • Administration of medication; • CPR including a skills demonstration; • First aid; • OCCL's Health and Safety Training for Child Care Professionals; and Training Requirements for Emergency-Use Substitutes: • DELACARE Regulations; • Policies and procedures of the home including special health care concerns of the children in care, such as allergies; • Emergency preparedness and disaster and evacuation plans; • Safe sleep practices, including prevention of sudden infant death syndrome, if caring for infants; • Recognition of the symptoms of child abuse and neglect; and • Child abuse and neglect laws and reporting requirements. • Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements. F. A licensee shall ensure the substitute has access to each child's file, knows special or emergency information about each child, and keeps all children's information private. G. The substitute may provide care in the home in the absence of a licensee, or if applicable, the large family provider or large family assistant. A licensee does not need to inform OCCL or receive approval to use a substitute in the following situations: Permission to use a Substitute is not Required for these Situations: • Emergencies as defined in subsection 15.A.1; • Medical appointments; • School appointments; or • Time off for less than five days in a row. H. The substitute may provide care in the home in the absence of a licensee, large family provider, or large family assistant. A licensee shall inform OCCL and receive approval to use a substitute in the following situations: Permission to use a Substitute is Required for these Situations: • Training or classes held for three or more sessions; • Student teaching; • Internship or practicum to meet qualifications or annual training; or • Time off for five or more days in a row. I. Before using a substitute, a licensee shall tell the parent or guardian who the substitute is and when the substitute will be caring for the children, unless it is an emergency. J. A licensee shall record the date and times a substitute is present and is helping with the children or providing care. A licensee shall maintain this record for at least three months. 26. Health Observations A. A licensee shall ensure each child is observed on arrival for signs of communicable disease, injury, signs of ill health as listed in Section 41, and signs of child abuse or neglect. B. A licensee shall document concerns and steps taken to assist the child. 1. A licensee shall keep documented concerns in the child's file. 2. A person who suspects child abuse or neglect shall make a report to the Child Abuse Report Line. Reg #18 Positive Behavior Support F. A licensee shall ensure the following actions are prohibited: • Roughly handling a child or physical punishment inflicted on a child's body, including, but not limited to the following: shaking, grabbing, striking, hairpulling, biting, pinching, plucking, slapping, hitting, kicking, or spanking; • Yelling at, humiliating, or frightening children; • Physically or sexually abusing a child; • Making negative comments about a child's looks, ability, ethnicity, family, or other personal traits; • Denying children food, water, or toilet use because of inappropriate behavior; • Tying, taping, chaining, caging, or restraining a child by a means other than holding. The child may be held only as long as necessary for the child to regain control; o If the child or others are in imminent danger or a risk to themselves or others, physical holding for as brief as possible to remedy the risk or removing the child to a safer location is permissible. Supervision is required. o In the event physical holding is used, documentation must occur by the staff. The early childhood or school-age administrator shall be involved in monitoring and managing the situation to ensure safety of all (child and staff member). • Punishing children for a toileting accident, or for failing to fall asleep, eat food, or complete an activity; • Withholding physical activity as punishment; or • Encouraging or allowing children to hit, punish, or discipline each other. 65. Personnel Policies A. A licensee shall have written personnel policies and procedures available to staff members. These policies must include, as appropriate, procedures for hiring, discipline, dismissal, suspension, and lay-off of the staff member according to applicable laws. A statement signed by the staff member on the orientation form must confirm the review of these personnel policies and procedures and that the staff member was able to ask questions and receive clarification. B. A licensee shall develop, follow, and keep on file written policies and procedures that comply with applicable laws for handling suspected child abuse or neglect that occurs while a child is in or out of the large family home's care. C. A licensee shall ensure no one abuses or neglects children. D. A licensee shall take corrective action to remove the conditions that may have caused or otherwise resulted in a risk of abuse or neglect to children, if the abuse or neglect happened at the home by a staff member. E. A licensee shall ensure a licensee or staff member accused of child abuse or neglect is prohibited from working with children until the results of an investigation are completed and OCCL clears the individual to work with children. iii. All CCDF-eligible licensed in-home care. Provide the standard: Not Applicable to the Office of Child Care Licensing. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Not Applicable to the Office of Child Care Licensing. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Not Applicable to the Office of Child Care Licensing. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Relative Care providers are the only exempt category that can provide care in the child’s own home, but it is care provided by a relative only. Relative Care providers are required to participate in a Relative Orientation on program rules and regulations. They are also required to participate in 28 hours of CCDF approved training and 3 hours of a health and safety refresher training annually. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Youth Camps Regulation 11A, 15, 36 11. Notification to OCCL A. A licensee shall ensure a staff member calls OCCL and speaks to someone at OCCL (leaving a message is not acceptable) within one business day Monday- Friday from 8:00 AM to 4:30 PM in the event of: Notify OCCL Within One Business Day in the Event of: • Suspected abuse or neglect of a child while in care (after reporting the suspicion to the 24-Hour Child Abuse Report Line, currently listed as 1-800- 292-9582); 15. Child Abuse and Neglect Reporting Requirements A. A licensee shall develop, follow, and maintain on file written policies and procedures for handling an incident of suspected child abuse or neglect that occurs while a child is in or out of the camp’s care to comply with applicable laws. B. Allegations of Abuse or Neglect against a Staff Member 16 1. The licensee shall ensure staff members or volunteers do not abuse or neglect children. 2. If the abuse or neglect occurred at the camp by a staff member, the licensee shall eliminate those factors or circumstances that may have increased the risk of abuse or neglect. 3. A staff member alleged to have abused or neglected a child may not have direct contact with any child until the completion of the incident’s investigation. However, at the licensee’s discretion, the licensee may reassign the staff member to other duties that do not involve contact with children. 36. Health Observation A licensee shall ensure a staff member trained in recognizing common signs of communicable disease, physical injury, other evidence of ill health as listed in Section 37, and signs of child abuse or neglect observes each child on arrival. A. A staff member must document specific concerns and observations as well as the steps taken to assist the child and keep this information in the child’s file. B. A person who suspects child abuse or neglect shall make an immediate report to the Child Abuse Report Line. 15. Child Abuse and Neglect Reporting Requirements A. A licensee shall develop, follow, and maintain on file written policies and procedures for handling an incident of suspected child abuse or neglect that occurs while a child is in or out of the camp’s care to comply with applicable laws. B. Allegations of Abuse or Neglect against a Staff Member 1. The licensee shall ensure staff members or volunteers do not abuse or neglect children. 2. If the abuse or neglect occurred at the camp by a staff member, the licensee shall eliminate those factors or circumstances that may have increased the risk of abuse or neglect. 3. A staff member alleged to have abused or neglected a child may not have direct contact with any child until the completion of the incident’s investigation. However, at the licensee’s discretion, the licensee may reassign the staff member to other duties that do not involve contact with children. Reg #16 Positive Behavior Management D. A licensee shall ensure the following actions are prohibited: • Roughly handling a child or physical punishment inflicted on a child's body, including, but not limited to the following: shaking, grabbing, striking, hairpulling, biting, pinching, plucking, slapping, hitting, kicking, or spanking; • Yelling at, humiliating, or frightening children; • Physically or sexually abusing a child; • Making negative comments about a child's looks, ability, ethnicity, family, or other personal traits; • Denying children food, water, or toilet use because of inappropriate behavior; • Tying, taping, chaining, caging, or restraining a child by a means other than holding. The child may be held only as long as necessary for the child to regain control; o If the child or others are in imminent danger or a risk to themselves or others, physical holding for as brief as possible to remedy the risk or removing the child to a safer location is permissible. Supervision is required. o In the event physical holding is used, documentation must occur by the staff. The early childhood or school-age administrator shall be involved in monitoring and managing the situation to ensure safety of all (child and staff member). • Punishing children for a toileting accident, or for failing to fall asleep, eat food, or complete an activity; • Withholding physical activity as punishment; or • Encouraging or allowing children to hit, punish, or discipline each other. Reg #24 Staff Orientation requires - Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law and reporting requirements, and the camp’s procedures to report abuse and neglect; and 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 [ ] 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: Delaware received a preliminary notice of non-compliance standards for volunteer training and practice drills for all 3 provider types (12/13/21). FCCH: 13. General Requirements I. A licensee shall ensure an adult volunteer who is present for at least five days or 40 hours per year completes OCCL’s approved Health and Safety Training for Child Care Professionals (certificate required). Emergency Preparedness is covered in the required Health and Safety training. Center: 32. Orientation C. A licensee shall ensure all staff members, all substitutes, and volunteers working at least five days or 40 hours a year complete OCCL's approved Health and Safety Training for Child Care Professionals before working with children. This training provides professional development training hours and includes the following topics: Emergency Preparedness is covered in the required Health and Safety training. Youth Camp: Delaware will address its non-compliance for practice drills by updating the Youth Camp regulations with this requirement. Regulations revisions are currently in process with the aim to be at the public comment stage in winter 2025. The timeline for finalized regulations will be after the public comment period, at an estimated summer 2025. 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: Early Care and Education and School-Age Centers Regulation 32 & 45 32. Orientation A. A licensee shall document that all staff members, all substitutes, and volunteers working at least five days or 40 hours a year receive training in the following topics before working with children: Orientation Requirements: • DELACARE Regulations (related to job duties); • Personnel and administrative policies; • Release of children including procedures for situations listed in Section 23; • Positive behavior supports; • Child accident and injury procedures; • Administration of medication certification, within two months of hire, if administering medication to children; • Child care goals and program for children; • Recordkeeping, including documenting children and their own attendance; • Family involvement; • Food and nutrition services, including proper handling, storage, preparation, and feeding of breast milk and formula, if applicable; • Safety and sanitation procedures; • Physical activity; • Screen time as described in subsection 76.D; • Photographing or videotaping children; • Transporting children, if applicable; • Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, reporting requirements; and • Information on federal and State laws or regulations applicable to children and families in care, including non-discrimination. B. The orientation must include the opportunity for staff members to ask questions and receive clarification on their job functions, licensing regulations, and center policies. When information is revised, a licensee shall ensure staff members are informed of the changes. C. A licensee shall ensure all staff members, all substitutes, and volunteers working at least five days or 40 hours a year complete OCCL's approved Health and Safety Training for Child Care Professionals before working with children. This training provides professional development training hours and includes the following topics: Health and Safety Training Topics: • Emergency preparedness and response planning, disaster and evacuation plans and procedures • Safe sleep practices, including prevention of sudden infant death syndrome; • Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; Health and Safety Training Topics: • Routine and emergency health care including health exclusions, prevention, and recognition of the symptoms of childhood illnesses, including reportable communicable diseases and immunizations; • Prevention of and response to emergencies due to food and allergic reactions; • Building and physical premises safety; • Handling and storage of hazardous materials and proper disposal of bio- contaminants; • Safety measures in transporting children, and • Administration of medication. 45. Hazardous Materials A. A licensee shall ensure the center is free of unacceptable exposure to hazardous materials. B. An applicant and licensee shall ensure the center is free of lead-based paint hazards. Buildings constructed in or after 1978 are exempt from lead-paint risk assessments and testing. 1. If the buildings were constructed before 1978, an applicant or licensee shall provide to OCCL a lead-paint risk assessment performed by an environmental testing firm certified by DPH showing the center to be free of lead-based paint hazards. a. Before license renewal, unless previously submitted to OCCL, a licensee shall submit this risk assessment. b. If lead paint is identified but intact (i.e. not chipping, flaking, or peeling), the licensee shall monitor the identified areas at least every six months and document that the lead-based paint is intact (in good repair and not deteriorated). Lead-based paint is not regarded as a hazard if it is intact, not present in an accessible surface, a friction surface, or an impact surface that could result in an adverse human health effect. 2. If lead-paint hazards are identified in the risk assessment, the applicant or licensee shall remedy the hazards by hiring a lead-safe contractor (lead abatement or renovation firm) certified by DPH to make the repairs. a. Once the repairs are made, a lead-dust clearance inspection must be performed by an environmental testing firm certified by DPH to confirm the center is free of lead-based paint hazards. b. The applicant or licensee shall provide the lead-dust clearance testing results to OCCL within five business days to confirm the center is free of lead-based paint hazards. c. Children may not be present during repairs and the center must stay closed until the results of the lead dust clearance are at appropriate levels and the lead-safe contractor states it is safe for the center to be open. 3. If any lead-based paint identified in a risk assessment in a pre-1978 child- occupied facility becomes deteriorated or if lead-based paint is located in an area to be remodeled, a licensee shall retain a contractor certified by DPH to work using lead-safe work practices (lead abatement or lead renovator) to perform any renovation or repair. a. Records of this renovation or repair work must be forwarded to OCCL within five business days. b. Children may not be present during repairs or renovation until a lead-dust clearance test is obtained and the lead-safe contractor states it is safe for the center to be open. C. A licensee shall ensure radon testing is performed in each room used for child care once every five years between the months of October and March and within six months after any remodeling, renovations, or construction. 1. This testing may be performed by the property owner or an inspector certified by the American Association of Radon Scientists, the National Radon Safety Board, or any organization recognized by the EPA or State of Delaware Radon Program. 2. If testing indicates a radon level over 4.0 pCi/L, a licensee shall ensure acceptable radon mitigation occurs or a long-term radon test (90-120 days) indicates a level less than 4.0 pCi/L. 3. A licensee shall ensure copies of radon testing results are sent to OCCL within five business days of receiving the results. D. A licensee shall ensure containers of poisonous, toxic, or hazardous materials are: 1. Labeled with the contents; 2. Used only in the manner and under the conditions that will not contaminate food or constitute a hazard to children or to staff; and 3. Stored in a locked storage space accessible only to staff. E. Materials required for routine cleaning and maintenance must be stored out of children’s reach and used in a safe manner. F. The storage of flammable liquids and gases is not be permitted except as allowed by the Office of the Fire Marshal. G. A licensee shall ensure the center is free from illegal drugs. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Family and Large Family Child Care Homes Regulation 7, 15 & 26 7. Procedures for Initial Licensure A. An applicant shall complete the following steps and submit the following information to OCCL when seeking a license: 1. Attend OCCL's information session and orientation to learn the application process and regulations; 2. Submit a completed Family Child Care Home Initial License Application (see Appendix I) or a Large Family Child Care Home Initial License Application (see Appendix II), as applicable, which includes: Required Application Information: • Applicant’s name, address, email, and phone numbers; • Applicant’s references: for corporations contact information for officers; for LLCs contact information for managing member; • Previous licensure information, if applicable; • Program information (including ages of children to be served); • Household members; and • Certifications that include: o Agreement to comply with federal and State laws and regulations including, but not limited to, the Americans with Disabilities Act and Delaware Equal Accommodations Law; o Statement that information supplied is true and correct; and o Acknowledgment that OCCL is required to make a thorough investigation of the applicant. 3. Submit the following items to OCCL: Items to be Submitted: • Proof of compliance with zoning codes, and, if applicable, other codes, regulations, guidelines, or laws, such as those from Division of Revenue, Department of Natural Resources and Environmental Control for septic systems, and Office of Drinking Water for well water; Items to be Submitted: • Documentation that the home is free of lead-based paint hazards. Homes constructed in or after 1978 are exempt from lead-paint risk assessments and testing; o If the home were constructed before 1978, an applicant or licensee shall provide a lead-paint risk assessment performed by an environmental testing firm certified by DPH showing the home to be free of lead-paint hazards. o If lead paint is identified but intact (i.e. not chipping, flaking, or peeling), the licensee shall monitor the identified areas at least every six months and document that the lead-based paint is intact (in good repair and not deteriorated). Lead-based paint is not regarded as a hazard if it is intact or not present in an accessible surface, a friction surface, or an impact surface that could result in an adverse human health effect. • If lead-paint hazards are identified in the risk assessment, the applicant or licensee shall remedy the hazards by hiring a lead-safe contractor (lead abatement or renovation firm) certified by DPH to make the repairs. o Once the repairs are made, a lead-dust clearance inspection must be performed by an environmental testing firm certified by DPH to confirm the home is free of lead based paint hazards. o An applicant or licensee shall provide the lead-dust clearance testing results to OCCL within five business days to confirm the home is free of lead-based paint hazards. o Children may not be present during repairs and the home must stay closed until the results of the dust clearance test are at appropriate levels and the lead-safe contractor states it is safe for the home to be open. • If any lead-based paint identified in a risk assessment becomes deteriorated or if lead-based paint is located in an area to be remodeled, a licensee shall retain a contractor certified by DPH to work using lead-safe work practices (lead abatement or lead renovator) to perform any renovation or repair in a pre-1978 child-occupied facility; o Records of any renovation or repair work must be forwarded to OCCL within five business days. o Children may not be present during repairs or renovation until a lead dust clearance test is obtained and the lead-safe contractor states it is safe for the home to be open. • Evidence showing each room used for child care to be free of radon hazards using the Environmental Protection Agency’s guidelines; o Testing may be performed by the property owner or an inspector certified by the American Association of Radon Scientists, the National Radon Safety Board, or any organization recognized by the EPA or State of Delaware Radon Program. o If testing indicates a radon level over 4.0 pCi/L, radon mitigation according to industry standards must occur or a long-term radon test (90-120 days) must indicate a level less than 4.0 pCi/L. • Electrical inspection of the home conducted by a State fire marshal recognized electrical inspection agency; Items to be Submitted: • Current certifications in CPR including a skills demonstration and first aid for the ages of the children in care. Applicants for large family homes are exempt from this requirement if not serving as a staff member; • The names, addresses, phone numbers, and email addresses for three references who are familiar with, but not related to, the applicant and can describe the applicant's interactions with children; • Release of employment form that allows OCCL to collect service letters as per 19 Del.C. §708. The form will list the applicant's current or most recent employer and all health care and child care facilities where the applicant worked within the past five years. If an applicant has no former employer, the applicant shall provide information for two more references; • Comprehensive background checks for the applicant, adult household members, substitutes, staff members, and adult volunteers including State and federal fingerprint checks. o In addition to the Delaware fingerprinting, applicants, adult household members, substitutes, staff members, and adult volunteers who currently reside outside of Delaware must contact their state of residence and complete a fingerprinted state criminal history search and a name-based child abuse and neglect search. o Applicants, adult household members, substitutes, staff members, and adult volunteers who have resided outside of Delaware in the last five years must contact each state of residence, and request a criminal history search and a child abuse and neglect search. o After the out-of-state searches are completed, the applicant must submit the results immediately to CHU. o The person may not be alone with children until CHU notifies the licensee of the person’s eligibility after completing the comprehensive background check. o When OCCL has a reason to believe the health, safety, or welfare of a child in care may be at risk, OCCL may request parent or guardian permission for a comprehensive background check on a child household member and other medical, psychological, counseling, school, and probation records. OCCL may obtain information from the Department of Services for Children, Youth and Their Families; • Documentation of any case where the applicant gave up or lost custody of a child, if applicable; • Health appraisals for the applicant, all adult household members, and the substitute completed within one year before the application date that includes a tuberculosis (TB) test or medical professional risk assessment that verifies the person does not pose a threat of transmitting tuberculosis to children or others. The TB test or medical professional risk assessment must be completed within one year before the application date. This appraisal must confirm the person's health and document medical or physical conditions that pose a direct threat to the health and safety of children or others and any reasonable accommodations that may be required. This documentation shall be provided to OCCL for the purposes of determining whether the health condition creates a significant risk to children; • Health appraisals for child household members; • State business license or verification of tax-exempt status; • Sample two-week menu, if providing meals or snacks (if using a catering service, a copy of the caterer’s food establishment permit); and Items to be Submitted: • Documentation of completion of pre-service training in the following topics, if the applicant will work with children: o Six hours of quality-assured child development; o Three hours of quality-assured positive behavior supports or social-emotional development; o Prevention and control of infectious diseases, including immunization; o OCCL’s approved Health and Safety Training for Child Care Professionals that includes the following topics: ￿ Prevention and control of communicable diseases including immunization; ￿ Safe sleep practices, including prevention of sudden infant death syndrome; ￿ Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; ￿ Prevention of and response to emergencies due to food and allergic reactions; ￿ Building and physical grounds safety; ￿ Emergency preparedness and response planning; ￿ Handling and storage of hazardous materials and proper disposal of bio- contaminants; ￿ Administration of medication; and ￿ Safety measures in transporting children. o Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements (certificate required); • Landlord approval, if renting; • Emergency plan; and • Large family applicants shall complete the additional requirements for large family homes as listed in Sections 60 through 70. B. Upon receipt of the completed application and required information, a licensing specialist shall: 1. Review the application and information, and inspect the premises to determine whether the applicant complies with these regulations; 2. Make a recommendation for licensure. If a license is granted, it will be a six-month initial provisional license; and 3. Notify the applicant as stated in subsection 12.D.2 if an initial provisional license to operate is denied. C. A licensing specialist shall conduct a compliance review at the home before the expiration of the initial provisional license. Once this review is completed, OCCL will issue a provisional or annual license depending upon whether full compliance is obtained. This license will be valid for six months. 15. Use of a Substitute A. A licensee shall arrange for a substitute who is at least 18 years old. 1. This substitute may be available to assist in non-emergency situations but must be available in case of an emergency. OCCL defines an emergency as an unplanned event, such as a serious or sudden illness, accident, or situation, requiring the immediate attention of a licensee. 2. The substitute and licensee may both be present at the home; however, a licensee shall provide the majority of the child care duties. B. A licensee shall post the substitute's name and phone number in the home and provide this information to OCCL. C. A licensee shall document on the form provided by OCCL that substitutes used only for emergencies receive training in the following topics before working with children: D. A licensee shall document on the form provided by OCCL that substitutes used for non-emergency situations receive training in the following topics before working with children: Training Requirements for Non-Emergency-Use Substitutes: • DELACARE Regulations; • Policies and procedures of the home; • Emergency preparedness and disaster and evacuation plans; o OCCL’s approved Health and Safety Training for Child Care Professionals that includes the following topics: ￿ Safe sleep practices, including prevention of sudden infant death syndrome; ￿ Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; ￿ Prevention of and response to emergencies due to food and allergic reactions; ￿ Prevention and control of communicable diseases, including immunization; ￿ Building and physical grounds safety; ￿ Handling and storage of hazardous materials and proper disposal of bio- contaminants; ￿ Administration of medication; and ￿ Safety measures in transporting children. o Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements (certificate required); • CPR and first aid certifications; and • Administration of medication. E. A licensee shall keep a copy of the substitute's health appraisal, comprehensive background check results showing eligibility, and orientation record on file at the home. Also, a licensee shall ensure substitutes used for non-emergency situations have the following certificates on file: Required Certifications for Non-Emergency Substitutes: • Administration of medication; • CPR including a skills demonstration; • First aid; • OCCL's Health and Safety Training for Child Care Professionals; and Training Requirements for Emergency-Use Substitutes: • DELACARE Regulations; • Policies and procedures of the home including special health care concerns of the children in care, such as allergies; • Emergency preparedness and disaster and evacuation plans; • Safe sleep practices, including prevention of sudden infant death syndrome, if caring for infants; • Recognition of the symptoms of child abuse and neglect; and • Child abuse and neglect laws and reporting requirements. • Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements. F. A licensee shall ensure the substitute has access to each child's file, knows special or emergency information about each child, and keeps all children's information private. G. The substitute may provide care in the home in the absence of a licensee, or if applicable, the large family provider or large family assistant. A licensee does not need to inform OCCL or receive approval to use a substitute in the following situations: Permission to use a Substitute is not Required for these Situations: • Emergencies as defined in subsection 15.A.1; • Medical appointments; • School appointments; or • Time off for less than five days in a row. H. The substitute may provide care in the home in the absence of a licensee, large family provider, or large family assistant. A licensee shall inform OCCL and receive approval to use a substitute in the following situations: Permission to use a Substitute is Required for these Situations: • Training or classes held for three or more sessions; • Student teaching; • Internship or practicum to meet qualifications or annual training; or • Time off for five or more days in a row. I. Before using a substitute, a licensee shall tell the parent or guardian who the substitute is and when the substitute will be caring for the children, unless it is an emergency. J. A licensee shall record the date and times a substitute is present and is helping with the children or providing care. A licensee shall maintain this record for at least three months. 26. Health Observations A. A licensee shall ensure each child is observed on arrival for signs of communicable disease, injury, signs of ill health as listed in Section 41, and signs of child abuse or neglect. B. A licensee shall document concerns and steps taken to assist the child. 1. A licensee shall keep documented concerns in the child's file. 2. A person who suspects child abuse or neglect shall make a report to the Child Abuse Report Line. iii. All CCDF-eligible licensed in-home care. Provide the standard: Not Applicable to the Office of Child Care Licensing. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Not Applicable to the Office of Child Care Licensing. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Not Applicable to the Office of Child Care Licensing. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: This is not applicable. Relative Care providers are the only exempt category that can provide care in the child’s own home, but it is care provided by a relative only. Relative Care providers are required to participate in a Relative Orientation on program rules and regulations. They are also required to participate in 28 hours of CCDF approved training and 3 hours of a health and safety refresher training annually. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Youth Camps Regulation 40 40. Hazardous Materials, Maintenance Supplies, and Garbage A. A licensee shall ensure containers of poisonous, toxic, or hazardous materials are: 1. Labeled with the contents; 2. Used only in the manner and under the conditions that will not contaminate food or constitute a hazard to children or to staff; and 3. Stored in a locked storage space accessible only to staff. B. A licensee shall ensure materials required for routine cleaning and maintenance are stored out of children’s reach and used in a safe manner. C. The storage of flammable liquids and gases is not to be permitted except as allowed by the Office of the Fire Marshal. D. A licensee shall ensure saws, power tools, lawn mowers, toilet plungers, toilet brushes, and other maintenance and janitorial equipment are inaccessible to children. E. A licensee shall ensure the buildings, structures, and the campsites are free of an infestation of rodents, insects, or vermin. 1. If pesticides are used, a licensee shall ensure they are used according to the instructions listed on the label. 2. Children may not be present when pesticides are applied. F. A licensee shall ensure garbage and trash are stored securely in non- combustible, covered containers. 1. Indoor containers must be emptied at least daily to an outdoor receptacle and kept clean. 2. Outdoor trash/garbage containers that do not contain a plastic liner must be inaccessible to children, emptied at least weekly, and, with the exception of dumpsters, cleaned as needed. 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: Early Care and Education and School-Age Centers Regulation 32 & 45 32. Orientation A. A licensee shall document that all staff members, all substitutes, and volunteers working at least five days or 40 hours a year receive training in the following topics before working with children: Orientation Requirements: • DELACARE Regulations (related to job duties); • Personnel and administrative policies; • Release of children including procedures for situations listed in Section 23; • Positive behavior supports; • Child accident and injury procedures; • Administration of medication certification, within two months of hire, if administering medication to children; • Child care goals and program for children; • Recordkeeping, including documenting children and their own attendance; • Family involvement; • Food and nutrition services, including proper handling, storage, preparation, and feeding of breast milk and formula, if applicable; • Safety and sanitation procedures; • Physical activity; • Screen time as described in subsection 76.D; • Photographing or videotaping children; • Transporting children, if applicable; • Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, reporting requirements; and • Information on federal and State laws or regulations applicable to children and families in care, including non-discrimination. B. The orientation must include the opportunity for staff members to ask questions and receive clarification on their job functions, licensing regulations, and center policies. When information is revised, a licensee shall ensure staff members are informed of the changes. C. A licensee shall ensure all staff members, all substitutes, and volunteers working at least five days or 40 hours a year complete OCCL's approved Health and Safety Training for Child Care Professionals before working with children. This training provides professional development training hours and includes the following topics: Health and Safety Training Topics: • Emergency preparedness and response planning, disaster and evacuation plans and procedures • Safe sleep practices, including prevention of sudden infant death syndrome; • Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; Health and Safety Training Topics: • Routine and emergency health care including health exclusions, prevention, and recognition of the symptoms of childhood illnesses, including reportable communicable diseases and immunizations; • Prevention of and response to emergencies due to food and allergic reactions; • Building and physical premises safety; • Handling and storage of hazardous materials and proper disposal of bio- contaminants; • Safety measures in transporting children, and • Administration of medication. 45. Hazardous Materials A. A licensee shall ensure the center is free of unacceptable exposure to hazardous materials. B. An applicant and licensee shall ensure the center is free of lead-based paint hazards. Buildings constructed in or after 1978 are exempt from lead-paint risk assessments and testing. 1. If the buildings were constructed before 1978, an applicant or licensee shall provide to OCCL a lead-paint risk assessment performed by an environmental testing firm certified by DPH showing the center to be free of lead-based paint hazards. a. Before license renewal, unless previously submitted to OCCL, a licensee shall submit this risk assessment. b. If lead paint is identified but intact (i.e. not chipping, flaking, or peeling), the licensee shall monitor the identified areas at least every six months and document that the lead-based paint is intact (in good repair and not deteriorated). Lead-based paint is not regarded as a hazard if it is intact, not present in an accessible surface, a friction surface, or an impact surface that could result in an adverse human health effect. 2. If lead-paint hazards are identified in the risk assessment, the applicant or licensee shall remedy the hazards by hiring a lead-safe contractor (lead abatement or renovation firm) certified by DPH to make the repairs. a. Once the repairs are made, a lead-dust clearance inspection must be performed by an environmental testing firm certified by DPH to confirm the center is free of lead-based paint hazards. b. The applicant or licensee shall provide the lead-dust clearance testing results to OCCL within five business days to confirm the center is free of lead-based paint hazards. c. Children may not be present during repairs and the center must stay closed until the results of the lead dust clearance are at appropriate levels and the lead-safe contractor states it is safe for the center to be open. 3. If any lead-based paint identified in a risk assessment in a pre-1978 child- occupied facility becomes deteriorated or if lead-based paint is located in an area to be remodeled, a licensee shall retain a contractor certified by DPH to work using lead-safe work practices (lead abatement or lead renovator) to perform any renovation or repair. a. Records of this renovation or repair work must be forwarded to OCCL within five business days. b. Children may not be present during repairs or renovation until a lead-dust clearance test is obtained and the lead-safe contractor states it is safe for the center to be open. C. A licensee shall ensure radon testing is performed in each room used for child care once every five years between the months of October and March and within six months after any remodeling, renovations, or construction. 1. This testing may be performed by the property owner or an inspector certified by the American Association of Radon Scientists, the National Radon Safety Board, or any organization recognized by the EPA or State of Delaware Radon Program. 2. If testing indicates a radon level over 4.0 pCi/L, a licensee shall ensure acceptable radon mitigation occurs or a long-term radon test (90-120 days) indicates a level less than 4.0 pCi/L. 3. A licensee shall ensure copies of radon testing results are sent to OCCL within five business days of receiving the results. D. A licensee shall ensure containers of poisonous, toxic, or hazardous materials are: 1. Labeled with the contents; 2. Used only in the manner and under the conditions that will not contaminate food or constitute a hazard to children or to staff; and 3. Stored in a locked storage space accessible only to staff. E. Materials required for routine cleaning and maintenance must be stored out of children’s reach and used in a safe manner. F. The storage of flammable liquids and gases is not be permitted except as allowed by the Office of the Fire Marshal. G. A licensee shall ensure the center is free from illegal drugs. Reg #58 Sanitation A. A licensee shall ensure that areas and equipment listed in subsection 58.B are washed with soap and water and then disinfected as required. For sanitizing and disinfecting, a licensee shall ensure one of the following is used: an EPAregistered product, a commercially prepared product, or a bleach and water solution. 1. A licensee shall follow the manufacturer's instructions for use. 2. These products must be labeled with the contents. 3. Their instructions for use must be available at all times. B. A licensee shall ensure staff members wash with a soap and water solution and then disinfect the following equipment, items, or surfaces, as listed below: After Each Use: • Potty-chairs that have first been emptied into a toilet • Sinks and faucets used for hand washing after the sink has been used for rinsing a potty-chair • Diapering surfaces, as required in subsection 61.F • Food preparation and eating surfaces such as counters, tables, and high chair trays • Toys mouthed by children • Mops used for cleaning must be rinsed, disinfected, wrung dry, and hung to dry • Plastic bibs (cloth bibs may be used only once before laundering) • Thermometers At Least Daily: • Toilet and toilet seats • Sinks and faucets • Diaper pails and lids • Drinking fountains • Water table and water play equipment • Play tables • Rest mats that are not stored separately as listed in these regulations • Cleanable, non-absorbent activity mats such as those used for infant tummy time • Smooth surfaced non-porous floors C. At least weekly, a licensee shall ensure non-porous toys and play equipment are washed with a soap and water solution and then disinfected. D. At least weekly, a licensee shall ensure stuffed animals are laundered. Reg #59 Handwashing A licensee shall ensure staff members and children wash their hands with soap and running water, including when gloves have been worn, and use paper towels or a handdrying device, as follows: Before and After: • Eating or handling food • Giving medications • Caring for a child who may be sick • Using a water-play or other sensory table or container with other children • Using shared play dough or clay After: • Toileting or diapering • Coming into contact with blood, fecal matter, urine, vomit, nasal secretions, or other body secretions • Handling animals or their equipment or after coming into contact with an animal's body secretions • Playing in a sandbox • Outdoor play • Cleaning • Taking out the garbage ii. All CCDF-eligible licensed family child care homes. Provide the standard: Family and Large Family Child Care Homes Regulation 7, 15 & 26 7. Procedures for Initial Licensure A. An applicant shall complete the following steps and submit the following information to OCCL when seeking a license: 1. Attend OCCL's information session and orientation to learn the application process and regulations; 2. Submit a completed Family Child Care Home Initial License Application (see Appendix I) or a Large Family Child Care Home Initial License Application (see Appendix II), as applicable, which includes: Required Application Information: • Applicant’s name, address, email, and phone numbers; • Applicant’s references: for corporations contact information for officers; for LLCs contact information for managing member; • Previous licensure information, if applicable; • Program information (including ages of children to be served); • Household members; and • Certifications that include: o Agreement to comply with federal and State laws and regulations including, but not limited to, the Americans with Disabilities Act and Delaware Equal Accommodations Law; o Statement that information supplied is true and correct; and o Acknowledgment that OCCL is required to make a thorough investigation of the applicant. 3. Submit the following items to OCCL: Items to be Submitted: • Proof of compliance with zoning codes, and, if applicable, other codes, regulations, guidelines, or laws, such as those from Division of Revenue, Department of Natural Resources and Environmental Control for septic systems, and Office of Drinking Water for well water; Items to be Submitted: • Documentation that the home is free of lead-based paint hazards. Homes constructed in or after 1978 are exempt from lead-paint risk assessments and testing; o If the home were constructed before 1978, an applicant or licensee shall provide a lead-paint risk assessment performed by an environmental testing firm certified by DPH showing the home to be free of lead-paint hazards. o If lead paint is identified but intact (i.e. not chipping, flaking, or peeling), the licensee shall monitor the identified areas at least every six months and document that the lead-based paint is intact (in good repair and not deteriorated). Lead-based paint is not regarded as a hazard if it is intact or not present in an accessible surface, a friction surface, or an impact surface that could result in an adverse human health effect. • If lead-paint hazards are identified in the risk assessment, the applicant or licensee shall remedy the hazards by hiring a lead-safe contractor (lead abatement or renovation firm) certified by DPH to make the repairs. o Once the repairs are made, a lead-dust clearance inspection must be performed by an environmental testing firm certified by DPH to confirm the home is free of lead-based paint hazards. o An applicant or licensee shall provide the lead-dust clearance testing results to OCCL within five business days to confirm the home is free of lead-based paint hazards. o Children may not be present during repairs and the home must stay closed until the results of the dust clearance test are at appropriate levels and the lead-safe contractor states it is safe for the home to be open. • If any lead-based paint identified in a risk assessment becomes deteriorated or if lead-based paint is located in an area to be remodeled, a licensee shall retain a contractor certified by DPH to work using lead-safe work practices (lead abatement or lead renovator) to perform any renovation or repair in a pre-1978 child-occupied facility; o Records of any renovation or repair work must be forwarded to OCCL within five business days. o Children may not be present during repairs or renovation until a lead dust clearance test is obtained and the lead-safe contractor states it is safe for the home to be open. • Evidence showing each room used for child care to be free of radon hazards using the Environmental Protection Agency’s guidelines; o Testing may be performed by the property owner or an inspector certified by the American Association of Radon Scientists, the National Radon Safety Board, or any organization recognized by the EPA or State of Delaware Radon Program. o If testing indicates a radon level over 4.0 pCi/L, radon mitigation according to industry standards must occur or a long-term radon test (90-120 days) must indicate a level less than 4.0 pCi/L. • Electrical inspection of the home conducted by a State fire marshal recognized electrical inspection agency; Items to be Submitted: • Current certifications in CPR including a skills demonstration and first aid for the ages of the children in care. Applicants for large family homes are exempt from this requirement if not serving as a staff member; • The names, addresses, phone numbers, and email addresses for three references who are familiar with, but not related to, the applicant and can describe the applicant's interactions with children; • Release of employment form that allows OCCL to collect service letters as per 19 Del.C. §708. The form will list the applicant's current or most recent employer and all health care and child care facilities where the applicant worked within the past five years. If an applicant has no former employer, the applicant shall provide information for two more references; • Comprehensive background checks for the applicant, adult household members, substitutes, staff members, and adult volunteers including State and federal fingerprint checks. o In addition to the Delaware fingerprinting, applicants, adult household members, substitutes, staff members, and adult volunteers who currently reside outside of Delaware must contact their state of residence and complete a fingerprinted state criminal history search and a name-based child abuse and neglect search. o Applicants, adult household members, substitutes, staff members, and adult volunteers who have resided outside of Delaware in the last five years must contact each state of residence, and request a criminal history search and a child abuse and neglect search. o After the out-of-state searches are completed, the applicant must submit the results immediately to CHU. o The person may not be alone with children until CHU notifies the licensee of the person’s eligibility after completing the comprehensive background check. o When OCCL has a reason to believe the health, safety, or welfare of a child in care may be at risk, OCCL may request parent or guardian permission for a comprehensive background check on a child household member and other medical, psychological, counseling, school, and probation records. OCCL may obtain information from the Department of Services for Children, Youth and Their Families; • Documentation of any case where the applicant gave up or lost custody of a child, if applicable; • Health appraisals for the applicant, all adult household members, and the substitute completed within one year before the application date that includes a tuberculosis (TB) test or medical professional risk assessment that verifies the person does not pose a threat of transmitting tuberculosis to children or others. The TB test or medical professional risk assessment must be completed within one year before the application date. This appraisal must confirm the person's health and document medical or physical conditions that pose a direct threat to the health and safety of children or others and any reasonable accommodations that may be required. This documentation shall be provided to OCCL for the purposes of determining whether the health condition creates a significant risk to children; • Health appraisals for child household members; • State business license or verification of tax-exempt status; • Sample two-week menu, if providing meals or snacks (if using a catering service, a copy of the caterer’s food establishment permit); and Items to be Submitted: • Documentation of completion of pre-service training in the following topics, if the applicant will work with children: o Six hours of quality-assured child development; o Three hours of quality-assured positive behavior supports or social-emotional development; o Prevention and control of infectious diseases, including immunization; o OCCL’s approved Health and Safety Training for Child Care Professionals that includes the following topics: ￿ Prevention and control of communicable diseases including immunization; ￿ Safe sleep practices, including prevention of sudden infant death syndrome; ￿ Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; ￿ Prevention of and response to emergencies due to food and allergic reactions; ￿ Building and physical grounds safety; ￿ Emergency preparedness and response planning; ￿ Handling and storage of hazardous materials and proper disposal of bio- contaminants; ￿ Administration of medication; and ￿ Safety measures in transporting children. o Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements (certificate required); • Landlord approval, if renting; • Emergency plan; and • Large family applicants shall complete the additional requirements for large family homes as listed in Sections 60 through 70. B. Upon receipt of the completed application and required information, a licensing specialist shall: 1. Review the application and information, and inspect the premises to determine whether the applicant complies with these regulations; 2. Make a recommendation for licensure. If a license is granted, it will be a six-month initial provisional license; and 3. Notify the applicant as stated in subsection 12.D.2 if an initial provisional license to operate is denied. C. A licensing specialist shall conduct a compliance review at the home before the expiration of the initial provisional license. Once this review is completed, OCCL will issue a provisional or annual license depending upon whether full compliance is obtained. This license will be valid for six months. 15. Use of a Substitute A. A licensee shall arrange for a substitute who is at least 18 years old. 1. This substitute may be available to assist in non-emergency situations but must be available in case of an emergency. OCCL defines an emergency as an unplanned event, such as a serious or sudden illness, accident, or situation, requiring the immediate attention of a licensee. 2. The substitute and licensee may both be present at the home; however, a licensee shall provide the majority of the child care duties. B. A licensee shall post the substitute's name and phone number in the home and provide this information to OCCL. C. A licensee shall document on the form provided by OCCL that substitutes used only for emergencies receive training in the following topics before working with children: D. A licensee shall document on the form provided by OCCL that substitutes used for non-emergency situations receive training in the following topics before working with children: Training Requirements for Non-Emergency-Use Substitutes: • DELACARE Regulations; • Policies and procedures of the home; • Emergency preparedness and disaster and evacuation plans; o OCCL’s approved Health and Safety Training for Child Care Professionals that includes the following topics: ￿ Safe sleep practices, including prevention of sudden infant death syndrome; ￿ Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; ￿ Prevention of and response to emergencies due to food and allergic reactions; ￿ Prevention and control of communicable diseases, including immunization; ￿ Building and physical grounds safety; ￿ Handling and storage of hazardous materials and proper disposal of bio- contaminants; ￿ Administration of medication; and ￿ Safety measures in transporting children. o Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements (certificate required); • CPR and first aid certifications; and • Administration of medication. E. A licensee shall keep a copy of the substitute's health appraisal, comprehensive background check results showing eligibility, and orientation record on file at the home. Also, a licensee shall ensure substitutes used for non-emergency situations have the following certificates on file: Required Certifications for Non-Emergency Substitutes: • Administration of medication; • CPR including a skills demonstration; • First aid; • OCCL's Health and Safety Training for Child Care Professionals; and Training Requirements for Emergency-Use Substitutes: • DELACARE Regulations; • Policies and procedures of the home including special health care concerns of the children in care, such as allergies; • Emergency preparedness and disaster and evacuation plans; • Safe sleep practices, including prevention of sudden infant death syndrome, if caring for infants; • Recognition of the symptoms of child abuse and neglect; and • Child abuse and neglect laws and reporting requirements. • Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements. F. A licensee shall ensure the substitute has access to each child's file, knows special or emergency information about each child, and keeps all children's information private. G. The substitute may provide care in the home in the absence of a licensee, or if applicable, the large family provider or large family assistant. A licensee does not need to inform OCCL or receive approval to use a substitute in the following situations: Permission to use a Substitute is not Required for these Situations: • Emergencies as defined in subsection 15.A.1; • Medical appointments; • School appointments; or • Time off for less than five days in a row. H. The substitute may provide care in the home in the absence of a licensee, large family provider, or large family assistant. A licensee shall inform OCCL and receive approval to use a substitute in the following situations: Permission to use a Substitute is Required for these Situations: • Training or classes held for three or more sessions; • Student teaching; • Internship or practicum to meet qualifications or annual training; or • Time off for five or more days in a row. I. Before using a substitute, a licensee shall tell the parent or guardian who the substitute is and when the substitute will be caring for the children, unless it is an emergency. J. A licensee shall record the date and times a substitute is present and is helping with the children or providing care. A licensee shall maintain this record for at least three months. 26. Health Observations A. A licensee shall ensure each child is observed on arrival for signs of communicable disease, injury, signs of ill health as listed in Section 41, and signs of child abuse or neglect. B. A licensee shall document concerns and steps taken to assist the child. 1. A licensee shall keep documented concerns in the child's file. 2. A person who suspects child abuse or neglect shall make a report to the Child Abuse Report Line. Reg #37 Sanitation A. To prevent injuries, equipment in poor condition (rusty parts, flaking paint, or other dangers) must be repaired, removed, or made inaccessible to children. A licensee shall ensure areas and equipment listed in subsections 37.B and 37.C are washed with soap and water and then disinfected as required. For sanitizing and disinfecting, a licensee shall ensure one of the following is used: an EPA-registered product, a commercially prepared product, or a bleach and water solution. 1. A licensee shall follow the manufacturer's instructions for use. 2. These products must be labeled with the contents. 3. Their instructions for use must be available at all times. B. A licensee shall ensure the following items or surfaces are cleaned after each use with a soap and water solution and then disinfected as follows: Clean and Disinfect - After Each Use: • Potty-chairs, after being emptied into a toilet; • Sinks and faucets used for hand washing after the sink was used for rinsing a potty-chair; • Diapering surfaces, as required in subsection 40.F; • Food preparation and eating surfaces, such as counters, tables, and high chair trays; • Toys children put in their mouths; • Mops used for cleaning must be rinsed, disinfected, wrung, and hung to dry; • Plastic bibs (cloth bibs may only be used once before washing); and • Thermometers (that make contact with skin or mouth). Clean and Disinfect - At Least Daily: • Toilet and toilet seats; • Sinks and faucets; • Diaper pails and lids; • Drinking fountains; • Water table and water play equipment; • Play tables; • Rest mats that are stored touching each other; • Waterproof activity mats; and • Smooth waterproof floors. C. A licensee shall limit germs and disease passing among children in the home by: 1. Using washable toys with diapered children; and 2. Washing items children lick or chew after they fall to the floor or ground. D. At least weekly, a licensee shall ensure non-porous toys and play equipment are washed with a soap and water solution and then disinfected. E. At least weekly, a licensee shall ensure stuffed animals are laundered. Reg #38 Handwashing A. A licensee shall ensure staff and children's hands are washed with liquid soap and running water, even if gloves were worn, and paper towels or a mechanical hand dryer are used, as follows: 1. Before and after: eating or handling food, giving medications, caring for a child who may be sick, using a water-play or other sensory table or container with other children, and using shared play dough or clay; and 2. After: toileting or diapering, touching blood, feces, urine, vomit, nasal or other body fluids, handling animals or their equipment, or after coming into contact with an animal's body fluids, playing in a sandbox, outdoor play, cleaning, and taking out the garbage. B. A licensee shall ensure liquid soap, paper towels, and single-use towels or a mechanical hand dryer, are available at all times in the bathroom. iii. All CCDF-eligible licensed in-home care. Provide the standard: Not Applicable to the Office of Child Care Licensing. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Not Applicable to the Office of Child Care Licensing. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Not Applicable to the Office of Child Care Licensing. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: This is not applicable. Relative Care providers are the only exempt category that can provide care in the child’s own home, but it is care provided by a relative only. Relative Care providers are required to participate in a Relative Orientation on program rules and regulations. They are also required to participate in 28 hours of CCDF approved training and 3 hours of a health and safety refresher training annually. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Youth Camps Regulation 40 40. Hazardous Materials, Maintenance Supplies, and Garbage A. A licensee shall ensure containers of poisonous, toxic, or hazardous materials are: 1. Labeled with the contents; 2. Used only in the manner and under the conditions that will not contaminate food or constitute a hazard to children or to staff; and 3. Stored in a locked storage space accessible only to staff. B. A licensee shall ensure materials required for routine cleaning and maintenance are stored out of children’s reach and used in a safe manner. C. The storage of flammable liquids and gases is not to be permitted except as allowed by the Office of the Fire Marshal. D. A licensee shall ensure saws, power tools, lawn mowers, toilet plungers, toilet brushes, and other maintenance and janitorial equipment are inaccessible to children. E. A licensee shall ensure the buildings, structures, and the campsites are free of an infestation of rodents, insects, or vermin. 1. If pesticides are used, a licensee shall ensure they are used according to the instructions listed on the label. 2. Children may not be present when pesticides are applied. F. A licensee shall ensure garbage and trash are stored securely in non- combustible, covered containers. 1. Indoor containers must be emptied at least daily to an outdoor receptacle and kept clean. 2. Outdoor trash/garbage containers that do not contain a plastic liner must be inaccessible to children, emptied at least weekly, and, with the exception of dumpsters, cleaned as needed. Youth Camp ￿ 46. Soiled Clothing A. The licensee shall keep a supply of extra clothing available for campers when needed if not provided by a parent/guardian. B. A licensee shall ensure soiled or wet clothing is placed in a sealed plastic bag that is labeled with the child's name and sent home with the child at the end of the day. Reg #47 Sanitation A. A licensee shall ensure that areas and equipment listed in subsection 47.B are washed with soap and water and then disinfected as required. For sanitizing and disinfecting, a licensee shall ensure one of the following is used: an EPAregistered product, a commercially prepared product, or a bleach and water solution. If a bleach and water solution is used, it must be prepared daily. 1. A licensee shall follow the manufacturer's instructions for use. 2. These products must be labeled with the contents. 3. Their instructions for use must be available at all times. B. A licensee shall ensure staff members wash with a soap and water solution and then disinfect the following equipment, items, or surfaces, as listed in the table in this subsection: After Each Use: • Food preparation and eating surfaces such as counters and non-porous tables; • Thermometers. At Least Daily: • Toilet and toilet seats; • Sinks and faucets; • Drinking fountains; • Water table and water play equipment; • Play tables; and • Smooth surfaced non-porous floors. At Least Weekly: • non-porous toys; and • indoor play equipment. C. A licensee shall ensure that after each use, mops are rinsed, disinfected, wrung dry, and hung to dry. 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: Early Care and Education and School-Age Centers Regulation 67 67. Transportation A. Use of a vehicle, other than a school bus, with a rated capacity as defined by the manufacturer, to carry more than 10 passengers in addition to the driver to transport children is prohibited. A licensee shall ensure 12-15 passenger vans are not used to transport children. Passenger includes the driver. B. A licensee shall ensure when transporting children that the driver, when volunteering or employed by the center, and vehicle, when owned or leased by the center, comply with all applicable federal and State laws. 1. The driver shall be at least 21 years old. 2. The driver shall have a valid driver’s license that authorizes the driver to operate the vehicle being driven. 3. The driver shall have a comprehensive background check confirming eligibility to be alone with children during transport. 4. The driver does not need to be qualified by DEEDS Early Learning. 5. The driver may not transport more children and adults than the vehicle’s capacity. C. A licensee shall ensure children are transported using child-safety restraints as required by State and federal laws. D. A licensee shall ensure that companies contracted by the center to provide transportation services to children follow applicable State and federal laws. E. A licensee shall ensure each child is secured in an individual safety restraint system appropriate to the age, weight, and height of the child at all times while the vehicle, other than a school bus, is in motion. 1. Safety restraints must be federally approved and labeled according to the applicable Federal Motor Vehicle Safety Standard. 2. Child safety restraints must be installed and used as determined by the manufacturer and vehicle's instruction manual. 3. Safety restraints must be kept in a safe working condition and free of recall. F. If using a school bus, children preschool-age or younger must only be transported on a school bus that is properly equipped with child safety restraints unless the licensee explains to parents or guardians in writing that while child safety restraints on school buses for children preschool-age or younger are not currently required by State law, the National Highway Traffic Administration recommends that children in this age group always be transported using child safety restraints, and the licensee receives written parent or guardian permission stating the child may be transported on a school bus unrestrained. G. A licensee shall ensure vehicles used to transport children, including parent or guardian vehicles used for field trips (unless only transporting the parent’s or guardian’s own children), have and use the following: Vehicle Requirements: • A working heater capable of keeping an interior temperature of at least 50°F; • Air-conditioning to reduce the interior temperature when it exceeds 82°F (school buses are exempt); • A working phone; • A traveling first aid kit including children's emergency contact information; and • A dry chemical fire extinguisher approved by Underwriters Laboratory. H. A licensee shall ensure children are loaded and unloaded at the vehicle's curbside or in a protected parking area or driveway. I. A licensee shall ensure all doors are locked when the vehicle is moving. J. A licensee shall have written parent or guardian permission for transportation provided by the center. 1. A licensee shall document arrangements with the parent or guardian including the pickup and drop off times when driving a child to and from the child's school. 2. A licensee shall inform the parent or guardian of the person or transportation service who is driving the vehicle and ask about special needs the child may have during the ride. K. A licensee shall ensure children are never alone in the vehicle and that the vehicle is visually checked at the final location so that no child is left behind. L. A licensee may not transport children in the open back of a truck. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Family and Large Family Child Care Homes Regulation 46 46. Transportation A. A licensee shall ensure the driver and vehicle used to transport children complies with all applicable federal, State and local laws. If transporting children in a vehicle that is owned or leased by the licensee, the licensee shall have documentation of motor vehicle insurance. A licensee may not use 12-15 passenger vans to transport children. Passenger includes the driver. Use of a vehicle, other than a school bus, with a rated capacity as defined by the manufacturer, to carry more than 10 passengers in addition to the driver to transport children is prohibited. B. A licensee shall ensure the driver of a vehicle does not transport more children and adults than the vehicle's capacity determined by the manufacturer. C. A licensee shall ensure the vehicle is inspected for safety before transporting children. D. A licensee shall ensure each child is secured in an individual safety restraint system appropriate to the age, weight, and height of the child at all times while the vehicle, other than a school bus, is in motion. 1. Safety restraints must be federally approved and labeled according to the applicable Federal Motor Vehicle Safety Standard. 2. Child safety restraints must be installed and used as determined by the manufacturer and vehicle's instruction manual. 3. Safety restraints must be kept in a safe working condition and free of recall. E. A child preschool-age or younger must only be transported on a school bus that is properly equipped with child safety restraints. 1. With written parent or guardian permission, a child preschool-age or younger may be transported on a school bus unrestrained. 2. A licensee shall explain to parents or guardians in writing that while child safety restraints on school buses for children preschool-age or younger are not currently required by State law, the National Highway Traffic Administration recommends that children in this age group always be transported using child safety restraints. F. A licensee shall ensure vehicles used to transport children, including parent or guardian vehicles used for field trips (unless only transporting parent’s or guardian’s own children), have and use the following: Vehicle Requirements: • A working heater capable of keeping an interior temperature of at least 50°F; • Air-conditioning to reduce the interior temperature when it exceeds 82°F (school buses are exempt); Vehicle Requirements: • A working phone; • A traveling first aid kit including children's emergency contact information; and • A dry chemical fire extinguisher approved by Underwriters Laboratory. G. A licensee shall ensure children are loaded and unloaded at the vehicle's curbside or in a protected parking area or driveway. H. A licensee shall ensure all doors are locked when the vehicle is moving. I. A licensee shall have written parent or guardian permission for transportation provided by the home. A licensee shall document arrangements with the parent or guardian including the pickup and drop off times when driving a child to and from the child's school. A licensee shall inform the parent or guardian of the person or transportation service who is driving the vehicle and ask about special needs the child may have during the ride. J. A licensee shall ensure children are never alone in the vehicle and that the vehicle is visually checked at the final location so that no child is left behind. K. A licensee may not transport children in the open back of a truck. iii. All CCDF-eligible licensed in-home care. Provide the standard: Not Applicable to the Office of Child Care Licensing. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Not Applicable to the Office of Child Care Licensing. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Not Applicable to the Office of Child Care Licensing. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: This is not applicable. Relative Care providers are the only exempt category that can provide care in the child’s own home, but it is care provided by a relative only. Relative Care providers are required to participate in a Relative Orientation on program rules and regulations. They are also required to participate in 28 hours of CCDF approved training and 3 hours of a health and safety refresher training annually. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Youth Camps Regulation 58 58. Transportation A. Use of a vehicle, other than a school bus, with a rated capacity as defined by the manufacturer, to carry more than 10 passengers in addition to the driver to transport children is prohibited. A licensee shall ensure 12-15 passenger vans are not used to transport children. Passenger includes the driver. B. A licensee shall ensure when transporting children that the driver, when volunteering or employed by the camp, and vehicle, when owned or leased by the camp, comply with all applicable federal and State laws. 1. The driver shall be at least 21 years old. 2. The driver shall have a valid driver’s license that authorizes the driver to operate the vehicle being driven. 3. The driver shall have a comprehensive background check confirming eligibility to be alone with children during transport. 4. The driver may not transport more children and adults than the vehicle’s capacity. C. A licensee shall ensure that companies contracted by the camp to provide transportation services to children follow applicable State and federal laws. D. A licensee shall ensure each child is secured in an individual safety restraint system appropriate to the age, weight, and height of the child at all times while the vehicle, other than a school bus, is in motion. 1. Safety restraints must be federally approved and labeled according to the applicable Federal Motor Vehicle Safety Standard. 2. Child safety restraints must be installed and used as determined by the manufacturer and vehicle's instruction manual. 3. Safety restraints must be kept in a safe working condition and free of recall. E. A licensee shall ensure vehicles used to transport children have and use the following: Vehicle Requirements: • A working heater capable of keeping an interior temperature of at least 50 °F; • Air-conditioning to reduce the interior temperature when it exceeds 82 °F (school buses are exempt); • A working phone; • Flares; • Reflectors; • A first aid kit; and • A dry chemical fire extinguisher approved by Underwriters Laboratory. F. A licensee shall ensure children are loaded and unloaded at the vehicle's curbside or in a protected parking area or driveway. G. A licensee shall ensure all doors are locked when the vehicle is moving. H. A licensee shall have written parent/guardian permission for transportation provided by the camp. I. A licensee shall ensure children are never alone in the vehicle and that the vehicle is visually checked at the final location so that no child is left behind. J. A licensee shall ensure children’s heads and limbs remain inside the vehicle during transport. K. A licensee may not transport children in the open back of a truck. 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: Early Care and Education and School-Age Centers Regulation 35 35. First Aid and CPR Training A. Unless a staff member is currently certified, a licensee shall ensure all staff members, except for early childhood aides and school-age aides, complete certifications in first aid and in cardiopulmonary resuscitation (CPR) within two months of hire. 1. The certifications must be appropriate to the ages of the children in care. 2. CPR classes must include a "hands-on" skill demonstration. 3. Once staff members become qualified as an early childhood or school-age intern, they must complete CPR and first aid certifications within two months. 4. Certifications must be kept current. B. At least one staff member certified in first aid and CPR, applicable to the ages of the children, must be present when children are present, including the beginning and end of the day and during off-site activities. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Family and Large Family Child Care Homes Regulation 56 & 70A 56. Training A. A licensee and substitute used for planned, non-emergency situations as stated in Section 15 shall complete certifications in first aid and in CPR. The CPR certification must include a skills demonstration and be appropriate to the ages of the children in care. Certifications must be kept current. B. A family provider shall successfully complete at least 12-clock-hours of annual training including one hour of health or safety training as accepted by OCCL. Annual training must be in at least three of the following areas: • Child development; • Developmental curriculum planning or environment and curriculum; • Observation and assessment; • Positive behavior management or social-emotional development; • Health, safety, physical activity, and nutrition; • Family and community; • Professionalism; • Disability non-discrimination, accommodations, or modifications; and • Management and administration related to running a child care facility. Annual training may be within one or two areas if a college or university course was successfully completed or a training was six or more clock hours in length. C. A family provider shall complete annual training at least 30 days before the expiration date of the license. Training taken during the month the license expires will be counted toward the following year's annual training requirements. 70. Training A. A licensee shall ensure that within two months of hire, staff members and the non-emergency substitute have certifications in first aid and CPR. The CPR certification must include a skills demonstration and be appropriate to the ages of the children in care. A licensee shall ensure certifications are current. The large family provider must have these certifications to open a large family home. iii. All CCDF-eligible licensed in-home care. Provide the standard: Not Applicable to the Office of Child Care Licensing. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Not Applicable to the Office of Child Care Licensing. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Not Applicable to the Office of Child Care Licensing. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: This is not applicable. Relative Care Providers must complete CPR and First Aid training every two years. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Youth Camps Regulation 25 25. First Aid and CPR Training A licensee shall ensure all adult staff members have current certifications in first aid and in cardiopulmonary resuscitation (CPR). 1. The certifications must be appropriate to the ages of the children in care. 2. Online certifications are acceptable. 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: Early Care and Education and School-Age Centers Regulation 35 35. First Aid and CPR Training A. Unless a staff member is currently certified, a licensee shall ensure all staff members, except for early childhood aides and school-age aides, complete certifications in first aid and in cardiopulmonary resuscitation (CPR) within two months of hire. 1. The certifications must be appropriate to the ages of the children in care. 2. CPR classes must include a "hands-on" skill demonstration. 3. Once staff members become qualified as an early childhood or school-age intern, they must complete CPR and first aid certifications within two months. 4. Certifications must be kept current. B. At least one staff member certified in first aid and CPR, applicable to the ages of the children, must be present when children are present, including the beginning and end of the day and during off-site activities. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Family and Large Family Child Care Homes Regulation 56 & 70A 56. Training A. A licensee and substitute used for planned, non-emergency situations as stated in Section 15 shall complete certifications in first aid and in CPR. The CPR certification must include a skills demonstration and be appropriate to the ages of the children in care. Certifications must be kept current. B. A family provider shall successfully complete at least 12-clock-hours of annual training including one hour of health or safety training as accepted by OCCL. Annual training must be in at least three of the following areas: • Child development; • Developmental curriculum planning or environment and curriculum; • Observation and assessment; • Positive behavior management or social-emotional development; • Health, safety, physical activity, and nutrition; • Family and community; • Professionalism; • Disability non-discrimination, accommodations, or modifications; and • Management and administration related to running a child care facility. Annual training may be within one or two areas if a college or university course was successfully completed or a training was six or more clock hours in length. C. A family provider shall complete annual training at least 30 days before the expiration date of the license. Training taken during the month the license expires will be counted toward the following year's annual training requirements. 70. Training A. A licensee shall ensure that within two months of hire, staff members and the non-emergency substitute have certifications in first aid and CPR. The CPR certification must include a skills demonstration and be appropriate to the ages of the children in care. A licensee shall ensure certifications are current. The large family provider must have these certifications to open a large family home. iii. All CCDF-eligible licensed in-home care. Provide the standard: Not Applicable to the Office of Child Care Licensing. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Not Applicable to the Office of Child Care Licensing. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Not Applicable to the Office of Child Care Licensing. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: This is not applicable. Relative Care Providers must complete CPR and First Aid training every two years. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Youth Camps Regulation 25 25. First Aid and CPR Training A licensee shall ensure all adult staff members have current certifications in first aid and in cardiopulmonary resuscitation (CPR). 1. The certifications must be appropriate to the ages of the children in care. 2. Online certifications are acceptable. 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: Early Care and Education and School-Age Centers Regulation 19 19. Child Abuse and Neglect Reporting Requirements A. A licensee shall develop, adopt, follow, and maintain on file written policies and procedures for handling an incident of suspected child abuse or neglect that occurs while a child is in or out of the center’s care to comply with applicable laws. B. Allegations of Abuse or Neglect against a Staff Member 1. The licensee shall ensure children are not abused or neglected. 2. The licensee shall eliminate the factors or circumstances that may result in a continuing risk of abuse or neglect to children if the abuse or neglect occurred at the center by a staff member. 3. The licensee shall ensure the 24-Hour Child Abuse Report Line (currently listed as 1-800-292-9582) is immediately notified when suspected child abuse or neglect occurs at the center. 4. A staff member alleged to have abused or neglected a child in care may not have direct contact with any child until the completion of the incident’s investigation by the Institutional Abuse Unit. However, at the licensee’s discretion, the staff member may be reassigned to other duties that do not involve contact with children. 5. If the licensee is alleged to have abused or neglected a child, the licensee may not be present in the center when children are present until the completion of the Institutional Abuse Unit's investigation. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Family and Large Family Child Care Homes Regulation 7, 15 & 26 7. Procedures for Initial Licensure A. An applicant shall complete the following steps and submit the following information to OCCL when seeking a license: 1. Attend OCCL's information session and orientation to learn the application process and regulations; 2. Submit a completed Family Child Care Home Initial License Application (see Appendix I) or a Large Family Child Care Home Initial License Application (see Appendix II), as applicable, which includes: Required Application Information: • Applicant’s name, address, email, and phone numbers; • Applicant’s references: for corporations contact information for officers; for LLCs contact information for managing member; • Previous licensure information, if applicable; • Program information (including ages of children to be served); • Household members; and • Certifications that include: o Agreement to comply with federal and State laws and regulations including, but not limited to, the Americans with Disabilities Act and Delaware Equal Accommodations Law; o Statement that information supplied is true and correct; and o Acknowledgment that OCCL is required to make a thorough investigation of the applicant. 3. Submit the following items to OCCL: Items to be Submitted: • Proof of compliance with zoning codes, and, if applicable, other codes, regulations, guidelines, or laws, such as those from Division of Revenue, Department of Natural Resources and Environmental Control for septic systems, and Office of Drinking Water for well water; Items to be Submitted: • Documentation that the home is free of lead-based paint hazards. Homes constructed in or after 1978 are exempt from lead-paint risk assessments and testing; o If the home were constructed before 1978, an applicant or licensee shall provide a lead-paint risk assessment performed by an environmental testing firm certified by DPH showing the home to be free of lead-paint hazards. o If lead paint is identified but intact (i.e. not chipping, flaking, or peeling), the licensee shall monitor the identified areas at least every six months and document that the lead-based paint is intact (in good repair and not deteriorated). Lead-based paint is not regarded as a hazard if it is intact or not present in an accessible surface, a friction surface, or an impact surface that could result in an adverse human health effect. • If lead-paint hazards are identified in the risk assessment, the applicant or licensee shall remedy the hazards by hiring a lead-safe contractor (lead abatement or renovation firm) certified by DPH to make the repairs. o Once the repairs are made, a lead-dust clearance inspection must be performed by an environmental testing firm certified by DPH to confirm the home is free of lead-based paint hazards. o An applicant or licensee shall provide the lead-dust clearance testing results to OCCL within five business days to confirm the home is free of lead-based paint hazards. o Children may not be present during repairs and the home must stay closed until the results of the dust clearance test are at appropriate levels and the lead-safe contractor states it is safe for the home to be open. • If any lead-based paint identified in a risk assessment becomes deteriorated or if lead-based paint is located in an area to be remodeled, a licensee shall retain a contractor certified by DPH to work using lead-safe work practices (lead abatement or lead renovator) to perform any renovation or repair in a pre-1978 child-occupied facility; o Records of any renovation or repair work must be forwarded to OCCL within five business days. o Children may not be present during repairs or renovation until a lead dust clearance test is obtained and the lead-safe contractor states it is safe for the home to be open. • Evidence showing each room used for child care to be free of radon hazards using the Environmental Protection Agency’s guidelines; o Testing may be performed by the property owner or an inspector certified by the American Association of Radon Scientists, the National Radon Safety Board, or any organization recognized by the EPA or State of Delaware Radon Program. o If testing indicates a radon level over 4.0 pCi/L, radon mitigation according to industry standards must occur or a long-term radon test (90-120 days) must indicate a level less than 4.0 pCi/L. • Electrical inspection of the home conducted by a State fire marshal recognized electrical inspection agency; Items to be Submitted: • Current certifications in CPR including a skills demonstration and first aid for the ages of the children in care. Applicants for large family homes are exempt from this requirement if not serving as a staff member; • The names, addresses, phone numbers, and email addresses for three references who are familiar with, but not related to, the applicant and can describe the applicant's interactions with children; • Release of employment form that allows OCCL to collect service letters as per 19 Del.C. §708. The form will list the applicant's current or most recent employer and all health care and child care facilities where the applicant worked within the past five years. If an applicant has no former employer, the applicant shall provide information for two more references; • Comprehensive background checks for the applicant, adult household members, substitutes, staff members, and adult volunteers including State and federal fingerprint checks. o In addition to the Delaware fingerprinting, applicants, adult household members, substitutes, staff members, and adult volunteers who currently reside outside of Delaware must contact their state of residence and complete a fingerprinted state criminal history search and a name-based child abuse and neglect search. o Applicants, adult household members, substitutes, staff members, and adult volunteers who have resided outside of Delaware in the last five years must contact each state of residence, and request a criminal history search and a child abuse and neglect search. o After the out-of-state searches are completed, the applicant must submit the results immediately to CHU. o The person may not be alone with children until CHU notifies the licensee of the person’s eligibility after completing the comprehensive background check. o When OCCL has a reason to believe the health, safety, or welfare of a child in care may be at risk, OCCL may request parent or guardian permission for a comprehensive background check on a child household member and other medical, psychological, counseling, school, and probation records. OCCL may obtain information from the Department of Services for Children, Youth and Their Families; • Documentation of any case where the applicant gave up or lost custody of a child, if applicable; • Health appraisals for the applicant, all adult household members, and the substitute completed within one year before the application date that includes a tuberculosis (TB) test or medical professional risk assessment that verifies the person does not pose a threat of transmitting tuberculosis to children or others. The TB test or medical professional risk assessment must be completed within one year before the application date. This appraisal must confirm the person's health and document medical or physical conditions that pose a direct threat to the health and safety of children or others and any reasonable accommodations that may be required. This documentation shall be provided to OCCL for the purposes of determining whether the health condition creates a significant risk to children; • Health appraisals for child household members; • State business license or verification of tax-exempt status; • Sample two-week menu, if providing meals or snacks (if using a catering service, a copy of the caterer’s food establishment permit); and Items to be Submitted: • Documentation of completion of pre-service training in the following topics, if the applicant will work with children: o Six hours of quality-assured child development; o Three hours of quality-assured positive behavior supports or social-emotional development; o Prevention and control of infectious diseases, including immunization; o OCCL’s approved Health and Safety Training for Child Care Professionals that includes the following topics: ￿ Prevention and control of communicable diseases including immunization; ￿ Safe sleep practices, including prevention of sudden infant death syndrome; ￿ Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; ￿ Prevention of and response to emergencies due to food and allergic reactions; ￿ Building and physical grounds safety; ￿ Emergency preparedness and response planning; ￿ Handling and storage of hazardous materials and proper disposal of bio contaminants; ￿ Administration of medication; and ￿ Safety measures in transporting children. o Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements (certificate required); • Landlord approval, if renting; • Emergency plan; and • Large family applicants shall complete the additional requirements for large family homes as listed in Sections 60 through 70. B. Upon receipt of the completed application and required information, a licensing specialist shall: 1. Review the application and information, and inspect the premises to determine whether the applicant complies with these regulations; 2. Make a recommendation for licensure. If a license is granted, it will be a six-month initial provisional license; and 3. Notify the applicant as stated in subsection 12.D.2 if an initial provisional license to operate is denied. C. A licensing specialist shall conduct a compliance review at the home before the expiration of the initial provisional license. Once this review is completed, OCCL will issue a provisional or annual license depending upon whether full compliance is obtained. This license will be valid for six months. 15. Use of a Substitute A. A licensee shall arrange for a substitute who is at least 18 years old. 1. This substitute may be available to assist in non-emergency situations but must be available in case of an emergency. OCCL defines an emergency as an unplanned event, such as a serious or sudden illness, accident, or situation, requiring the immediate attention of a licensee. 2. The substitute and licensee may both be present at the home; however, a licensee shall provide the majority of the child care duties. B. A licensee shall post the substitute's name and phone number in the home and provide this information to OCCL. C. A licensee shall document on the form provided by OCCL that substitutes used only for emergencies receive training in the following topics before working with children: D. A licensee shall document on the form provided by OCCL that substitutes used for non-emergency situations receive training in the following topics before working with children: Training Requirements for Non-Emergency-Use Substitutes: • DELACARE Regulations; • Policies and procedures of the home; • Emergency preparedness and disaster and evacuation plans; o OCCL’s approved Health and Safety Training for Child Care Professionals that includes the following topics: ￿ Safe sleep practices, including prevention of sudden infant death syndrome; ￿ Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; ￿ Prevention of and response to emergencies due to food and allergic reactions; ￿ Prevention and control of communicable diseases, including immunization; ￿ Building and physical grounds safety; ￿ Handling and storage of hazardous materials and proper disposal of bio- contaminants; ￿ Administration of medication; and ￿ Safety measures in transporting children. o Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements (certificate required); • CPR and first aid certifications; and • Administration of medication. E. A licensee shall keep a copy of the substitute's health appraisal, comprehensive background check results showing eligibility, and orientation record on file at the home. Also, a licensee shall ensure substitutes used for non-emergency situations have the following certificates on file: Required Certifications for Non-Emergency Substitutes: • Administration of medication; • CPR including a skills demonstration; • First aid; • OCCL's Health and Safety Training for Child Care Professionals; and Training Requirements for Emergency-Use Substitutes: • DELACARE Regulations; • Policies and procedures of the home including special health care concerns of the children in care, such as allergies; • Emergency preparedness and disaster and evacuation plans; • Safe sleep practices, including prevention of sudden infant death syndrome, if caring for infants; • Recognition of the symptoms of child abuse and neglect; and • Child abuse and neglect laws and reporting requirements. • Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements. F. A licensee shall ensure the substitute has access to each child's file, knows special or emergency information about each child, and keeps all children's information private. G. The substitute may provide care in the home in the absence of a licensee, or if applicable, the large family provider or large family assistant. A licensee does not need to inform OCCL or receive approval to use a substitute in the following situations: Permission to use a Substitute is not Required for these Situations: • Emergencies as defined in subsection 15.A.1; • Medical appointments; • School appointments; or • Time off for less than five days in a row. H. The substitute may provide care in the home in the absence of a licensee, large family provider, or large family assistant. A licensee shall inform OCCL and receive approval to use a substitute in the following situations: Permission to use a Substitute is Required for these Situations: • Training or classes held for three or more sessions; • Student teaching; • Internship or practicum to meet qualifications or annual training; or • Time off for five or more days in a row. I. Before using a substitute, a licensee shall tell the parent or guardian who the substitute is and when the substitute will be caring for the children, unless it is an emergency. J. A licensee shall record the date and times a substitute is present and is helping with the children or providing care. A licensee shall maintain this record for at least three months. 26. Health Observations A. A licensee shall ensure each child is observed on arrival for signs of communicable disease, injury, signs of ill health as listed in Section 41, and signs of child abuse or neglect. B. A licensee shall document concerns and steps taken to assist the child. 1. A licensee shall keep documented concerns in the child's file. 2. A person who suspects child abuse or neglect shall make a report to the Child Abuse Report Line. iii. All CCDF-eligible licensed in-home care. Provide the standard: Not Applicable to the Office of Child Care Licensing. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Not Applicable to the Office of Child Care Licensing. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Not Applicable to the Office of Child Care Licensing. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: This is not applicable. Relative Care providers are the only exempt category that can provide care in the child’s own home, but it is care provided by a relative only. Relative Care providers are required to participate in a Relative Orientation on program rules and regulations. They are also required to participate in 28 hours of CCDF approved training and 3 hours of a health and safety refresher training annually. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Youth Camps Regulation 11A, 15, 36 11. Notification to OCCL A. A licensee shall ensure a staff member calls OCCL and speaks to someone at OCCL (leaving a message is not acceptable) within one business day Monday- Friday from 8:00 AM to 4:30 PM in the event of: Notify OCCL Within One Business Day in the Event of: • Suspected abuse or neglect of a child while in care (after reporting the suspicion to the 24-Hour Child Abuse Report Line, currently listed as 1-800- 292-9582); 15. Child Abuse and Neglect Reporting Requirements A. A licensee shall develop, follow, and maintain on file written policies and procedures for handling an incident of suspected child abuse or neglect that occurs while a child is in or out of the camp’s care to comply with applicable laws. B. Allegations of Abuse or Neglect against a Staff Member 1. The licensee shall ensure staff members or volunteers do not abuse or neglect children. 2. If the abuse or neglect occurred at the camp by a staff member, the licensee shall eliminate those factors or circumstances that may have increased the risk of abuse or neglect. 3. A staff member alleged to have abused or neglected a child may not have direct contact with any child until the completion of the incident’s investigation. However, at the licensee’s discretion, the licensee may reassign the staff member to other duties that do not involve contact with children. 36. Health Observation A licensee shall ensure a staff member trained in recognizing common signs of communicable disease, physical injury, other evidence of ill health as listed in Section 37, and signs of child abuse or neglect observes each child on arrival. A. A staff member must document specific concerns and observations as well as the steps taken to assist the child and keep this information in the child’s file. B. A person who suspects child abuse or neglect shall make an immediate report to the Child Abuse Report Line. 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: Early Care and Education and School-Age Centers Regulation 19 19. Child Abuse and Neglect Reporting Requirements A. A licensee shall develop, adopt, follow, and maintain on file written policies and procedures for handling an incident of suspected child abuse or neglect that occurs while a child is in or out of the center’s care to comply with applicable laws. B. Allegations of Abuse or Neglect against a Staff Member 1. The licensee shall ensure children are not abused or neglected. 2. The licensee shall eliminate the factors or circumstances that may result in a continuing risk of abuse or neglect to children if the abuse or neglect occurred at the center by a staff member. 3. The licensee shall ensure the 24-Hour Child Abuse Report Line (currently listed as 1-800-292-9582) is immediately notified when suspected child abuse or neglect occurs at the center. 4. A staff member alleged to have abused or neglected a child in care may not have direct contact with any child until the completion of the incident’s investigation by the Institutional Abuse Unit. However, at the licensee’s discretion, the staff member may be reassigned to other duties that do not involve contact with children. 5. If the licensee is alleged to have abused or neglected a child, the licensee may not be present in the center when children are present until the completion of the Institutional Abuse Unit's investigation. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Family and Large Family Child Care Homes Regulation 7, 15 & 26 7. Procedures for Initial Licensure A. An applicant shall complete the following steps and submit the following information to OCCL when seeking a license: 1. Attend OCCL's information session and orientation to learn the application process and regulations; 2. Submit a completed Family Child Care Home Initial License Application (see Appendix I) or a Large Family Child Care Home Initial License Application (see Appendix II), as applicable, which includes: Required Application Information: • Applicant’s name, address, email, and phone numbers; • Applicant’s references: for corporations contact information for officers; for LLCs contact information for managing member; • Previous licensure information, if applicable; • Program information (including ages of children to be served); • Household members; and • Certifications that include: o Agreement to comply with federal and State laws and regulations including, but not limited to, the Americans with Disabilities Act and Delaware Equal Accommodations Law; o Statement that information supplied is true and correct; and o Acknowledgment that OCCL is required to make a thorough investigation of the applicant. 3. Submit the following items to OCCL: Items to be Submitted: • Proof of compliance with zoning codes, and, if applicable, other codes, regulations, guidelines, or laws, such as those from Division of Revenue, Department of Natural Resources and Environmental Control for septic systems, and Office of Drinking Water for well water; Items to be Submitted: • Documentation that the home is free of lead-based paint hazards. Homes constructed in or after 1978 are exempt from lead-paint risk assessments and testing; o If the home were constructed before 1978, an applicant or licensee shall provide a lead-paint risk assessment performed by an environmental testing firm certified by DPH showing the home to be free of lead-paint hazards. o If lead paint is identified but intact (i.e. not chipping, flaking, or peeling), the licensee shall monitor the identified areas at least every six months and document that the lead-based paint is intact (in good repair and not deteriorated). Lead-based paint is not regarded as a hazard if it is intact or not present in an accessible surface, a friction surface, or an impact surface that could result in an adverse human health effect. • If lead-paint hazards are identified in the risk assessment, the applicant or licensee shall remedy the hazards by hiring a lead-safe contractor (lead abatement or renovation firm) certified by DPH to make the repairs. o Once the repairs are made, a lead-dust clearance inspection must be performed by an environmental testing firm certified by DPH to confirm the home is free of lead-based paint hazards. o An applicant or licensee shall provide the lead-dust clearance testing results to OCCL within five business days to confirm the home is free of lead-based paint hazards. o Children may not be present during repairs and the home must stay closed until the results of the dust clearance test are at appropriate levels and the lead-safe contractor states it is safe for the home to be open. • If any lead-based paint identified in a risk assessment becomes deteriorated or if lead-based paint is located in an area to be remodeled, a licensee shall retain a contractor certified by DPH to work using lead-safe work practices (lead abatement or lead renovator) to perform any renovation or repair in a pre-1978 child-occupied facility; o Records of any renovation or repair work must be forwarded to OCCL within five business days. o Children may not be present during repairs or renovation until a lead dust clearance test is obtained and the lead-safe contractor states it is safe for the home to be open. • Evidence showing each room used for child care to be free of radon hazards using the Environmental Protection Agency’s guidelines; o Testing may be performed by the property owner or an inspector certified by the American Association of Radon Scientists, the National Radon Safety Board, or any organization recognized by the EPA or State of Delaware Radon Program. o If testing indicates a radon level over 4.0 pCi/L, radon mitigation according to industry standards must occur or a long-term radon test (90-120 days) must indicate a level less than 4.0 pCi/L. • Electrical inspection of the home conducted by a State fire marshal recognized electrical inspection agency; Items to be Submitted: • Current certifications in CPR including a skills demonstration and first aid for the ages of the children in care. Applicants for large family homes are exempt from this requirement if not serving as a staff member; • The names, addresses, phone numbers, and email addresses for three references who are familiar with, but not related to, the applicant and can describe the applicant's interactions with children; • Release of employment form that allows OCCL to collect service letters as per 19 Del.C. §708. The form will list the applicant's current or most recent employer and all health care and child care facilities where the applicant worked within the past five years. If an applicant has no former employer, the applicant shall provide information for two more references; • Comprehensive background checks for the applicant, adult household members, substitutes, staff members, and adult volunteers including State and federal fingerprint checks. o In addition to the Delaware fingerprinting, applicants, adult household members, substitutes, staff members, and adult volunteers who currently reside outside of Delaware must contact their state of residence and complete a fingerprinted state criminal history search and a name-based child abuse and neglect search. o Applicants, adult household members, substitutes, staff members, and adult volunteers who have resided outside of Delaware in the last five years must contact each state of residence, and request a criminal history search and a child abuse and neglect search. o After the out-of-state searches are completed, the applicant must submit the results immediately to CHU. o The person may not be alone with children until CHU notifies the licensee of the person’s eligibility after completing the comprehensive background check. o When OCCL has a reason to believe the health, safety, or welfare of a child in care may be at risk, OCCL may request parent or guardian permission for a comprehensive background check on a child household member and other medical, psychological, counseling, school, and probation records. OCCL may obtain information from the Department of Services for Children, Youth and Their Families; • Documentation of any case where the applicant gave up or lost custody of a child, if applicable; • Health appraisals for the applicant, all adult household members, and the substitute completed within one year before the application date that includes a tuberculosis (TB) test or medical professional risk assessment that verifies the person does not pose a threat of transmitting tuberculosis to children or others. The TB test or medical professional risk assessment must be completed within one year before the application date. This appraisal must confirm the person's health and document medical or physical conditions that pose a direct threat to the health and safety of children or others and any reasonable accommodations that may be required. This documentation shall be provided to OCCL for the purposes of determining whether the health condition creates a significant risk to children; • Health appraisals for child household members; • State business license or verification of tax-exempt status; • Sample two-week menu, if providing meals or snacks (if using a catering service, a copy of the caterer’s food establishment permit); and Items to be Submitted: • Documentation of completion of pre-service training in the following topics, if the applicant will work with children: o Six hours of quality-assured child development; o Three hours of quality-assured positive behavior supports or social-emotional development; o Prevention and control of infectious diseases, including immunization; o OCCL’s approved Health and Safety Training for Child Care Professionals that includes the following topics: ￿ Prevention and control of communicable diseases including immunization; ￿ Safe sleep practices, including prevention of sudden infant death syndrome; ￿ Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; ￿ Prevention of and response to emergencies due to food and allergic reactions; ￿ Building and physical grounds safety; ￿ Emergency preparedness and response planning; ￿ Handling and storage of hazardous materials and proper disposal of bio- contaminants; ￿ Administration of medication; and ￿ Safety measures in transporting children. o Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements (certificate required); • Landlord approval, if renting; • Emergency plan; and • Large family applicants shall complete the additional requirements for large family homes as listed in Sections 60 through 70. B. Upon receipt of the completed application and required information, a licensing specialist shall: 1. Review the application and information, and inspect the premises to determine whether the applicant complies with these regulations; 2. Make a recommendation for licensure. If a license is granted, it will be a six-month initial provisional license; and 3. Notify the applicant as stated in subsection 12.D.2 if an initial provisional license to operate is denied. C. A licensing specialist shall conduct a compliance review at the home before the expiration of the initial provisional license. Once this review is completed, OCCL will issue a provisional or annual license depending upon whether full compliance is obtained. This license will be valid for six months. 15. Use of a Substitute A. A licensee shall arrange for a substitute who is at least 18 years old. 1. This substitute may be available to assist in non-emergency situations but must be available in case of an emergency. OCCL defines an emergency as an unplanned event, such as a serious or sudden illness, accident, or situation, requiring the immediate attention of a licensee. 2. The substitute and licensee may both be present at the home; however, a licensee shall provide the majority of the child care duties. B. A licensee shall post the substitute's name and phone number in the home and provide this information to OCCL. C. A licensee shall document on the form provided by OCCL that substitutes used only for emergencies receive training in the following topics before working with children: D. A licensee shall document on the form provided by OCCL that substitutes used for non-emergency situations receive training in the following topics before working with children: Training Requirements for Non-Emergency-Use Substitutes: • DELACARE Regulations; • Policies and procedures of the home; • Emergency preparedness and disaster and evacuation plans; o OCCL’s approved Health and Safety Training for Child Care Professionals that includes the following topics: ￿ Safe sleep practices, including prevention of sudden infant death syndrome; ￿ Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; ￿ Prevention of and response to emergencies due to food and allergic reactions; ￿ Prevention and control of communicable diseases, including immunization; ￿ Building and physical grounds safety; ￿ Handling and storage of hazardous materials and proper disposal of bio- contaminants; ￿ Administration of medication; and ￿ Safety measures in transporting children. o Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements (certificate required); • CPR and first aid certifications; and • Administration of medication. E. A licensee shall keep a copy of the substitute's health appraisal, comprehensive background check results showing eligibility, and orientation record on file at the home. Also, a licensee shall ensure substitutes used for non-emergency situations have the following certificates on file: Required Certifications for Non-Emergency Substitutes: • Administration of medication; • CPR including a skills demonstration; • First aid; • OCCL's Health and Safety Training for Child Care Professionals; and Training Requirements for Emergency-Use Substitutes: • DELACARE Regulations; • Policies and procedures of the home including special health care concerns of the children in care, such as allergies; • Emergency preparedness and disaster and evacuation plans; • Safe sleep practices, including prevention of sudden infant death syndrome, if caring for infants; • Recognition of the symptoms of child abuse and neglect; and • Child abuse and neglect laws and reporting requirements. • Recognition of the symptoms of child abuse and neglect, the child abuse and neglect law, and reporting requirements. F. A licensee shall ensure the substitute has access to each child's file, knows special or emergency information about each child, and keeps all children's information private. G. The substitute may provide care in the home in the absence of a licensee, or if applicable, the large family provider or large family assistant. A licensee does not need to inform OCCL or receive approval to use a substitute in the following situations: Permission to use a Substitute is not Required for these Situations: • Emergencies as defined in subsection 15.A.1; • Medical appointments; • School appointments; or • Time off for less than five days in a row. H. The substitute may provide care in the home in the absence of a licensee, large family provider, or large family assistant. A licensee shall inform OCCL and receive approval to use a substitute in the following situations: Permission to use a Substitute is Required for these Situations: • Training or classes held for three or more sessions; • Student teaching; • Internship or practicum to meet qualifications or annual training; or • Time off for five or more days in a row. I. Before using a substitute, a licensee shall tell the parent or guardian who the substitute is and when the substitute will be caring for the children, unless it is an emergency. J. A licensee shall record the date and times a substitute is present and is helping with the children or providing care. A licensee shall maintain this record for at least three months. 26. Health Observations A. A licensee shall ensure each child is observed on arrival for signs of communicable disease, injury, signs of ill health as listed in Section 41, and signs of child abuse or neglect. B. A licensee shall document concerns and steps taken to assist the child. 1. A licensee shall keep documented concerns in the child's file. 2. A person who suspects child abuse or neglect shall make a report to the Child Abuse Report Line. iii. All CCDF-eligible licensed in-home care. Provide the standard: Not Applicable to the Office of Child Care Licensing. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Not Applicable to the Office of Child Care Licensing. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Not Applicable to the Office of Child Care Licensing. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: This is not applicable. Relative Care providers are the only exempt category that can provide care in the child’s own home, but it is care provided by a relative only. Relative Care providers are required to participate in a Relative Orientation on program rules and regulations. They are also required to participate in 28 hours of CCDF approved training and 3 hours of a health and safety refresher training annually. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Youth Camps Regulation 11A, 15, 36 11. Notification to OCCL A. A licensee shall ensure a staff member calls OCCL and speaks to someone at OCCL (leaving a message is not acceptable) within one business day Monday- Friday from 8:00 AM to 4:30 PM in the event of: Notify OCCL Within One Business Day in the Event of: • Suspected abuse or neglect of a child while in care (after reporting the suspicion to the 24-Hour Child Abuse Report Line, currently listed as 1-800- 292-9582); 15. Child Abuse and Neglect Reporting Requirements A. A licensee shall develop, follow, and maintain on file written policies and procedures for handling an incident of suspected child abuse or neglect that occurs while a child is in or out of the camp’s care to comply with applicable laws. B. Allegations of Abuse or Neglect against a Staff Member 1. The licensee shall ensure staff members or volunteers do not abuse or neglect children. 2. If the abuse or neglect occurred at the camp by a staff member, the licensee shall eliminate those factors or circumstances that may have increased the risk of abuse or neglect. 3. A staff member alleged to have abused or neglected a child may not have direct contact with any child until the completion of the incident’s investigation. However, at the licensee’s discretion, the licensee may reassign the staff member to other duties that do not involve contact with children. 36. Health Observation A licensee shall ensure a staff member trained in recognizing common signs of communicable disease, physical injury, other evidence of ill health as listed in Section 37, and signs of child abuse or neglect observes each child on arrival. A. A staff member must document specific concerns and observations as well as the steps taken to assist the child and keep this information in the child’s file. B. A person who suspects child abuse or neglect shall make an immediate report to the Child Abuse Report Line. 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: Center ￿ Regulation 71 71. Meals and Snacks A. A licensee shall ensure meals and snacks are served on the following schedule depending on the number of hours the child is present: Number of Hours Meals and Snacks Required 2 hours - 4 hours 1 snack 4 hours - 6 hours 1 meal and 1 snack 7 hours ￿ 11 hours 2 meals and 1 snack or 2 snacks and 1 meal based on time of child's arrival 12 hours or more 3 meals and 2 snacks B. A licensee shall ensure meals and snacks are provided by a center except when: 1. The parent or guardian chooses to provide the child’s food and provides a signed statement stating this choice. The center must keep the statement on file; 2. The center does not provide meals or snacks and informs the parent or guardian at the time of enrollment that meals or snacks are to be provided by the parent or guardian. The center must inform the parent or guardian of the importance of sending nutritional meals or snacks; or 3. The center has a field trip or a specific activity requiring special meal arrangements. C. A licensee shall encourage adults to eat healthy foods when eating with children. D. A licensee shall ensure staff members responsible for food service have knowledge of nutrition, sanitary food preparation, storage, and cleaning, and follow the center’s policy on food service. E. A licensee shall ensure staff members’ responsibilities for food service do not reduce staff-to-child ratios, interfere with the center's program, or lessen supervision of children. F. A licensee shall ensure meals and snacks provided by the center: 1. Follow the meal pattern requirements (see Appendix VI and Appendix VII) which are appropriate to the child’s age; 2. May include 100% unsweetened juice, not a juice drink or cocktail; 3. May include powdered milk used only for cooking and not instead of liquid milk for drinking; and 4. Are planned on a menu, dated, and posted in a noticeable place. a. Menus listing food served must be kept for 30 days. 78 b. Changes to the food served on a particular date must be written on the menu on or before that date. G. A licensee shall ensure that special, therapeutic diets are prepared and served by staff members only upon written instructions by a health care provider. A health care provider’s written permission is required for a change in meal patterns. H. A licensee shall ensure when a parent or guardian requests a change of meal patterns due to a family’s food preferences or religious beliefs, the parent or guardian provides the center with a list of the foods that are unacceptable and the substitutions allowed. I. Meal Components for Toddlers and Older Children 1. As described in Appendix VI, a licensee shall ensure a breakfast provided and served by a center has at least one age-appropriate serving-size item each from the milk, fruit and vegetable, and grain food groups. 2. As described in Appendix VI, a licensee shall ensure lunch or dinner provided and served by a center has one age-appropriate serving-size item from each of the milk, meat or meat alternate, and grain food groups and two items from the fruit and vegetable food group. 3. As described in Appendix VI, a licensee shall ensure that a snack provided and served by a center has at least one age-appropriate serving size item from two of the food groups. If milk or 100% juice is not included with a snack provided and served by the center, water must be served with that snack. J. For foods prepared and served by the center, a licensee shall introduce a variety of food textures, finger foods, and a cup and utensils for self-feeding. If needed, a licensee shall ensure food is cut to prevent choking. K. A licensee shall ensure each child has utensils, such as a fork, spoon, knife, dish, cup or bottle, as appropriate to the child’s age. This equipment may not be shared with another child or adult during feeding. L. All single-service dinnerware or utensils provided by the center for meals or snacks must be thrown away immediately after use. M. Staff members shall encourage the use of a cup when a child is at least one year old and is developmentally able to drink from or hold a cup. FCC/LFCC ￿ Regulation 50 50. Meals and Snacks A. A licensee shall ensure meals and snacks are served on the following schedule depending on the number of hours the child is present: Number of Hours: Meal or Snacks Required: 2 hours - 4 hours 1 snack 4 hours - 6 hours 1 meal and 1 snack 7 hours ￿ 11 hours 2 meals and 1 snack or 2 snacks and 1 meal based on time of child's arrival 12 hours or more 3 meals and 2 snacks B. A licensee shall encourage adults to eat healthy foods when eating with children. A child shall be encouraged but not forced to eat. C. A licensee shall ensure nutritious food is prepared and served to children. Children must be supervised during food preparation. D. A licensee shall ensure meals and snacks provided by the child care home: 1. Follow the meal pattern requirements (see Appendix X and Appendix XI) appropriate to the child's age; 2. May include 100% unsweetened juice, not a juice drink or cocktail; 3. May include powdered milk used only for cooking and not instead of liquid milk for drinking; and 4. Are planned on a menu, dated, and posted in a noticeable place. a. Menus listing foods served must be kept for 30 days. b. Changes to the food served on a certain date must be written on the menu on or before that date. E. A licensee shall ensure when a parent or guardian requests a change of meal patterns due to a medical need, such as food intolerance or allergies, the parent or guardian provides the home with written health care provider permission for the change. F. A licensee shall ensure when a parent or guardian requests a change of meal patterns due to a family's food preferences or religious belief, the parent or guardian provides the home with a list of the foods to remove and the foods to substitute. G. Meal Components for Toddlers and Older Children: 1. When foods are provided by the parent or guardian, a licensee shall ensure the foods are refrigerated as needed and not shared. There are no meal pattern requirements for foods provided by parents or guardians. A licensee shall have a plan for providing food to a child who has not brought foods to eat. 2. As described in Appendix X, a licensee shall ensure a breakfast provided and served by a home has at least one age-appropriate serving-size item each from the milk, fruit and vegetable, and grain food groups. 3. As described in Appendix X, a licensee shall ensure lunch or dinner provided and served by a home has one age-appropriate serving-size item from each of the milk, meat or meat alternate, and grain food groups and two items from the fruit and vegetable food group. 4. As described in Appendix X, a licensee shall ensure that a snack provided and served by a home has at least one age-appropriate serving-size item from two of the food groups. If milk or 100% juice is not included with a snack provided and served by the home, water must be served with that snack. H. For foods prepared and served by the home, a licensee shall introduce a variety of food textures, finger foods, and a cup and utensils for self-feeding. If needed, a licensee shall ensure food is cut to prevent choking. I. A licensee shall ensure each child has individual utensils, such as a fork, spoon, knife, dish, cup or bottle, as appropriate to the child’s age. This equipment may not be shared with another child or adult during feeding. J. All single-service dinnerware or utensils provided by the home for meals or snacks must be thrown away immediately after use. K. Staff members shall encourage the use of a cup when a child is at least one year old and is developmentally able to drink from or hold a cup. Youth Camp - 18 18. Meals and Snacks A. A licensee shall ensure meals and snacks are served on the following schedule depending on the number of hours the child is present: Number of Hours: Meals/Snacks Required: 3 hours - 4 hours 1 snack 4 hours - 6 hours 1 meal and 1 snack 7 hours ￿ 11 hours 2 meals and 1 snack or 2 snacks and 1 meal based on time of child's arrival 12 hours or more 3 meals and 2 snacks B. A licensee shall provide meals and snacks except when: 1. The parent/guardian chooses to provide the child’s food and provides a signed statement stating this choice. 2. The camp does not provide meals or snacks and informs the parent/guardian at the time of enrollment that the parent/guardian provides the meals or snacks. 3. The camp has a field trip or a specific activity requiring special meal arrangements. C. A licensee shall ensure staff members responsible for food service have knowledge of nutrition, sanitary food preparation, storage, and cleaning, and follow the camp’s policy on food service. D. A licensee shall ensure meals and snacks provided by the camp: 1. Follow the meal pattern requirements (see Appendix III) which are appropriate to the child’s age; 2. May include 100% unsweetened juice, not a juice drink or cocktail; 3. May include powdered milk used only for cooking and not instead of liquid milk for drinking; and 4. Are planned on a menu, dated, and posted in a noticeable place and kept for at least 10 business days. E. A licensee shall ensure that staff members prepare and serve special, therapeutic diets only upon written instructions by a health care provider. A health care provider’s written permission is required for a change in meal patterns. F. A licensee shall ensure when a parent/guardian requests a change of meal patterns due to a family’s food preferences or religious beliefs, the parent/guardian provides the camp with a list of the foods that are unacceptable and the substitutions allowed. G. Meal Components 1. As described in Appendix III, a licensee shall ensure a breakfast provided and served by a camp has at least one age-appropriate serving-size item each from the milk, fruit and vegetable, and grain food groups. 19 2. As described in Appendix III, a licensee shall ensure lunch or dinner provided and served by a camp has one age-appropriate serving-size item from each of the milk, meat or meat alternate, and grain food groups and two items from the fruit and vegetable food group. 3. As described in Appendix III, a licensee shall ensure that a snack provided and served by a camp has at least one age-appropriate serving-size item from two of the food groups. If milk or 100% juice is not included with a snack provided and served by the camp, water must be served with that snack. H. A licensee shall ensure each child has utensils, such as a fork, spoon, knife, or dish. This equipment may not be shared with another child or adult during feeding. I. All single-service dinnerware or utensils provided by the camp for meals or snacks must be thrown away immediately after use. ii. Access to physical activity. Describe: Center ￿ Regulation 76 76. Activity Schedule A. A licensee shall develop and follow a schedule for each group of children that is posted for easy reference by parents or guardians and staff. 1. The schedule must list times for the following activities: learning opportunities; active or outdoor play; free choice and staff-directed activities, rest or at least 30 minutes of quiet play, meals, and snacks. 2. This schedule may be flexible based on the needs and interests of the children. B. Weather permitting, a licensee shall ensure daily outdoor play is provided for infants, toddlers, and older children when the wind chill factor is 32°F or higher or the heat index is 89°F or lower. 1. Outdoor play during periods outside this temperature range may be determined by the licensee. 2. Children must be appropriately dressed for the weather. 3. A licensee shall ensure the guidelines of the National Weather Service (currently https://www.weather.gov) are followed if an advisory regarding health or safety risks has been issued. 4. For infants, this may include riding in a stroller or carriage, but must also include opportunities for gross motor development. This may occur on a blanket or other hazard-free space. C. A licensee shall provide opportunities for physical activity for each child one year and older, according to the child’s ability. 1. For every four hours the child is in care between 7 AM and 7 PM, 30 or more minutes of moderate to vigorous physical activity indoors or outdoors must be provided. 2. Daily active play may happen in one or more blocks of time. 3. Structured physical activities must be adapted to allow inclusion of children of all abilities. D. A licensee shall ensure screen time activities, such as watching television, using a gaming device, tablet, phone, or computer, are supervised by a staff member, age-appropriate, and educational. Screen time activities require written parent or guardian permission and are limited to one hour or less per day, unless a special event occurs. Children younger than two years are prohibited from participating in screen time activities. Assistive technology is not included in screen time restrictions FCC/LFCC ￿ Regulation 52 52. Activities and Interactions A. A licensee shall interact with children at their eye level and sit on the floor with them whenever appropriate. A licensee shall offer age-appropriate activities to children throughout the day to help their development and school-readiness. B. A licensee shall provide activities and materials that reflect children's cultures and communities, including both familiar and new materials, pictures, and experiences. C. A licensee shall have and follow a schedule that is posted for easy viewing by parents or guardians and staff members. The schedule must list times for the following activities: learning opportunities, active or outdoor play, rest, meals, and snacks. This schedule may be flexible to meet the needs and interests of the children. D. A licensee shall ensure activities and materials are adapted to support all children's learning, including a child with disabilities or other special needs, to benefit from the program. 1. A licensee shall allow services to be provided at the home for a child with an IEP, IFSP, or Section 504 plan. 2. At the request of a parent or guardian, a licensee shall permit qualified professionals to complete an observation or assessment of the child while at the home. E. Weather permitting, a licensee shall ensure daily outdoor play is provided for infants, toddlers, and older children when the wind chill factor is 32° F or higher or the heat index is 89° F or lower. 1. Outdoor play during periods outside this temperature range may be determined by the licensee. 2. Children must be appropriately dressed for the weather. 3. A licensee shall ensure the guidelines of the National Weather Service (currently www.weather.gov) are followed if an advisory regarding health or safety risks has been issued. 4. For infants, this may include riding in a stroller or carriage, but must also include opportunities for gross motor development. This may occur on a blanket or other hazard-free space. F. A licensee shall provide chances for physical activity for each child according to the child's ability. For every four hours the child is in care between 7 AM and 7 PM, 30 or more minutes of physical activity must be provided. Daily active play may be divided into one or more blocks of time. It may be indoors or outdoors. G. A licensee and staff members shall interact with each child, giving attention and physical comfort. H. A licensee shall ensure children are not in cribs, pack-and-plays, swings, high chairs, seats, or stationary activity centers for more than 30 minutes at a time while awake. Toddlers and infants, as appropriate, must be provided with an activity during this time. After removing the child from the equipment, the child must be able to move freely on the floor. I. A licensee shall offer activities that meet the needs and interests of school- age children by providing age-appropriate activities, materials, and equipment. These activities must include the following: • Active physical play, such as games, sports, dancing, running, jumping, climbing, or exploring the environment; • Outdoor activities or active indoor play in bad weather; • Time to talk and interact with others; and • Time to relax or quiet activities such as board or card games, reading, homework, and studying. J. A licensee shall ensure activities, such as watching television or using a gaming device, tablet, phone, or computer, are supervised, age-appropriate, and educational. These screen time activities require written parent or guardian permission and are limited to one hour or less per day, unless a special event occurs. Assistive technology is not included in screen time restrictions. Youth Camp ￿ Regulation 54 54. Care of Children A. There is a maximum number of consecutive hours of care a licensee may provide. A licensee shall care for children no more than 17 hours within a day, with at least seven uninterrupted hours of rest. No other work may occur during the hours of rest. B. A licensee shall be present and providing child care at all times except during the limited use of a substitute. iii. Caring for children with special needs. Describe: Center ￿ Regulation 20, 23, 57, 91 20. Positive Behavior Supports A. A licensee shall have and follow an easy-to-understand written children’s behavior supports statement. The statement shall be posted in a noticeable place in the center and provided to a parent or guardian and staff. B. A licensee shall ensure that all staff use prevention strategies, appropriate redirection rather than restraint, and positive developmentally-appropriate methods of behavior supports for children, which encourage self-control, self-direction, positive self-esteem, social responsibility, and cooperation. 1. Staff shall give directions and guidance in a clear, non-threatening manner. 2. In addition, staff members shall intervene quickly to ensure the safety of children and others; redirect children by suggesting other acceptable behaviors; escort the child to a different setting when necessary and speak so children understand their feelings are important and acceptable, but their disruptive behavior is not. 3. As children develop, these methods must be modified to encourage them to control their own behavior, cooperate with others, and solve problems by developing ideas about the best possible solution. C. A licensee shall ensure staff members consult with a child’s parent or guardian and professionals, if necessary, to design effective positive behavioral supports or to make reasonable accommodations to comply with provisions in an IFSP or IEP and to adapt behavior supports or other practices for a child who has a special need or disability. D. A licensee shall ensure staff members teach by example by always being respectful when speaking to children while at the center. E. A licensee shall ensure that if ￿time-out￿ is used, it is used only as necessary to help the child gain control of behavior and feelings. It must be used as a supplement to, not a substitute for, other developmentally-appropriate methods of behavior management. 1. ￿Time-out￿ must be limited to brief periods of no more than one minute for each year of a child’s age. 2. ￿Time-out￿ may not be used for infants. 3. Before using ￿time-out￿, the staff member shall discuss the reason for the ￿time-out￿ in language appropriate to the child’s level of development and understanding. 4. A child removed from the group or room during a ￿time-out￿ must be supervised. Before rejoining the group or at another time, a staff member must talk to the child in ways that encourages the child to make better decisions in the future. F. A licensee shall ensure the following actions are prohibited: Prohibited Acts: • Roughly handling a child or physical punishment inflicted on a child's body, including, but not limited to the following: shaking, grabbing, striking, hair- pulling, biting, pinching, plucking, slapping, hitting, kicking, or spanking; • Yelling at, humiliating, or frightening children; • Physically or sexually abusing a child; • Making negative comments about a child's looks, ability, ethnicity, family, or other personal traits; • Denying children food, water, or toilet use because of inappropriate behavior; • Tying, taping, chaining, caging, or restraining a child by a means other than holding. The child may be held only as long as necessary for the child to regain control; o If the child or others are in imminent danger or a risk to themselves or others, physical holding for as brief as possible to remedy the risk or removing the child to a safer location is permissible. Supervision is required. o In the event physical holding is used, documentation must occur by the staff. The early childhood or school-age administrator shall be involved in monitoring and managing the situation to ensure safety of all (child and staff member). • Punishing children for a toileting accident, or for failing to fall asleep, eat food, or complete an activity; • Withholding physical activity as punishment; or • Encouraging or allowing children to hit, punish, or discipline each other. 23. Center Parent or Guardian Handbook A licensee shall have and follow an organized system of respectful communication with parents and guardians and provide a handbook at enrollment that includes the following information: Parent or Guardian Handbook Requirements: • Assurances that parent’s or guardian’s visits and monitoring of the program are welcomed and permitted without prior approval; • Assurances of nondiscrimination based on race, color, national origin, gender, age, sex, pregnancy, marital status, sexual orientation, gender identity or expression, religion, creed, disability, veteran’s status, or any other category protected by state or federal laws; • A statement of the center’s developmental and educational goals for children as stated in subsection 73.B including procedures for regularly informing the parent or guardian about the program and the child’s developmental and educational progress including a minimum of one annual conference between center staff and the parent or guardian; • A written explanation of the mandatory reporting of child abuse and neglect; • Information about procedures used to assess children’s accomplishments and needs and, when there are concerns, to refer the parent or guardian for additional help in the community; • Upon request, a procedure for informing the parent or guardian of the identities and contact information of the governing body members and owners, as applicable; • A procedure encouraging the parent or guardian to review current licensing regulations that are made available at the center; • A procedure for accepting and handling complaints from the parent or guardian; Parent or Guardian Handbook Requirements: • Procedures related to the release of children including: o Releasing children only to people approved by a parent or guardian including a process for the emergency release of a child; o Monitoring the entrance of the center or phone, email, or other communication methods used by the center to ensure the child is released from care when requested by the parent, guardian, or authorized release person; o Allowing school-age children to walk home or from the school bus stop to the center each with written parent or guardian permission; o Checking the identity of an unknown approved person before releasing the child and keeping documentation of this verification except for bus drivers contracted by the child’s school; o Handling situations in which a non-custodial parent attempts to claim the child without custodial parent or guardian permission; o Handling situations in which an unapproved person attempts to pick up a child; and o Handling situations when a person who seems to be intoxicated or unable to bring the child home safely requests the release of a child; • Procedures to report accidents or critical incidents involving the child and other important information relating to the child; • Procedures stating that written permission from the parent or guardian is required before disclosing or using a child’s written, electronic, or digital information except to employees of OCCL or other entities with statutory responsibilities for issues relating to the health, safety, and well-being of children; • Procedures for using a written transition plan when enrolling a child or when moving a child permanently from a particular group or room. The parent or guardian must be informed in advance; • Policies for routine and emergency health care including procedures to follow in case of illness; plans for accessing emergency services, including transportation and parent or guardian notification; illness exclusions including reportable communicable diseases; parent or guardian notification of communicable disease or condition; and administration of medication policies including reasonable accommodations for a child with disabilities; • Policies for child suspension and expulsion such as the ￿Best Practice Statement for the Prevention of Expulsion and Suspension in Delaware Early Childhood Programs,￿ that can be found on the ￿My Child DE￿ website; • Policies on positive behavior supports, food and nutrition services as described in Section 21, safety and sanitation, physical activity, screen time, photographing or videotaping children, and transporting children, as applicable; and • A typical daily schedule of the center's programs and activities. 57. Equipment A. A licensee shall provide developmentally-appropriate equipment and materials for a variety of indoor and outdoor activities. There must be enough equipment and materials for all children to use. Materials and equipment must help provide many experiences and choices that support all children’s social-emotional, language and literacy, intellectual, and physical development. B. A licensee shall ensure that for children less than 24 months old, developmentally-appropriate supplies or equipment are provided in quantities as described in subsection 57.A in each of the following categories: Equipment Requirements for Children Less than 24 Months Old: • Sensory, such as teething toys, busy boxes, baby mirrors, rattles, melody chimes, squeeze toys; or other similar items; • Language and dramatic play, such as picture books, toy telephones, CDs, hand puppets, washable stuffed animals and dolls, photographs, or other similar items; • Manipulative, such as squeeze and grip toys, boxes, sorting and stacking toys, three- or four-piece wooden inlay puzzles, puzzle blocks, simple threading toys, mobile pull toys, balls, or other similar items; Equipment Requirements for Children Less than 24 Months Old: • Building, such as soft lightweight blocks, toy cars, trains or boats, figures of animals and people, stacking rings or cups, nesting toys, or other similar items; • Large muscle, such as low climbers, slides, riding or rocking toys, foam or soft plastic balls, gym mats, play tunnels, or other similar items; and • Music, such as rhythm instruments, a CD player and CDs, toys with musical tones, musical mobiles or busy boxes, drums, xylophones or pianos, or other similar items. C. A licensee shall ensure for children over 24 months old to school-age, developmentally-appropriate supplies or equipment are provided in quantities as described in subsection 57.A in each of the following categories: Equipment Requirements for Children Over 24 Months Old: • Language and literacy, such as books, flannel board, upper and lower case letters, pictures for discussion, materials for recognition, identification, or classification, poetry, puppets, audio-visual materials, show and tell items, or other similar items; • Science and math, such as plants and gardening equipment, aquarium with fish or other appropriate live animals, water table with supplies, sand table with supplies, cooking supplies, weather chart or thermometer, counting equipment, balance scale, or other similar items; • Manipulative, such as puzzles, pegs and pegboards, lacing boards, building toys, stencils, dominoes, pounding bench, lotto games, or other similar items; • Large muscle such as rocking boat, wheel toys, climbers, slides, balance beam, barrels or large cartons, parachute, balls and beanbags, outdoor play equipment, gym mats, or other similar items; • Building activities, such as unit blocks (minimum of four sizes), transportation toys, farm animals, play people, work bench and tools, building toys, building logs, or other similar items; • Art, such as crayons, tempera paint, large brushes and newsprint, finger paint and finger paint paper, construction paper in assorted colors, paste or glue, blunt scissors, collage materials, non-toxic felt tip markers, easels, clay or play dough, or other similar items; • Music, such as a CD player and CDs, piano or organ, guitar, rhythm sticks, drums, cymbals and bells, or other similar items; and • Dramatic play, such as toy dishes, ironing board, telephones, occupational props or uniforms, dress-up clothes, housekeeping area (stove, sink, refrigerator), cradle or doll bed, doll carriage, dolls, puppets, play grocery store, post office or hospital, or other similar items. D. A licensee shall ensure furniture is durable and child-sized or adapted to children’s use. Tables must be at waist height of the intended child-user and the child’s feet must reach a firm surface while the child is seated. E. A licensee shall ensure equipment and materials are selected or adapted to allow all children, including a child with disabilities or other special needs, to benefit from the program. F. A licensee shall ensure equipment and supplies are relevant to the cultural background and community of all children and raise awareness of other cultures and communities. G. A licensee shall prohibit toys that explode or shoot objects. H. A licensee shall ensure toys and equipment used by the children are sturdy, safely assembled, hazard-free, and not recalled. Toys and equipment may not cause children to become trapped or have rough edges, sharp corners, pinch and crush points, splinters, or exposed bolts. Equipment in poor condition must be repaired, removed. or made inaccessible to children. I. A licensee shall take the following measures to prevent hazards to children in care: Hazard Prevention: • To prevent cuts, abrasions, and punctures, equipment, materials, and other objects on the premises that have sharp edges, protruding nails, bolts, or other dangers must be repaired, removed, or made inaccessible to children. Sharp edges on natural wooden equipment must be sanded; • To prevent burns, equipment, materials, or products that may be hot enough to injure a child must be made inaccessible to children; • To prevent sheering, crushing, or pinching, broken or cracked equipment, materials, and objects must be repaired, removed, or made inaccessible to children; • To prevent entrapment, freezers, refrigerators, washers, dryers, compost bins, and other entrapment dangers must be inaccessible to children unless being actively supervised; • To prevent tripping, uneven indoor and outdoor walkways, damaged flooring or carpeting, or other tripping hazards must be removed or repaired; • To prevent injuries and death, large objects that pose a risk of falling or tipping must be securely anchored. Large objects include, but are not limited to, televisions, dressers, bookshelves, wall cabinets, sideboards or hutches, and wall units; and • To prevent injuries, equipment in poor condition (rusty parts, flaking paint, or other dangers) must be repaired, removed, or made inaccessible to children. 91. Child Care Activities A licensee shall ensure that a program of indoor and outdoor activities and supplies and equipment is provided based on the ages and developmental levels of school-age children served. A licensee shall ensure that activities are adapted if necessary to accommodate a child with disabilities or other special needs. A. As described in Section 57, supplies and equipment must be adapted to suit the different ages and interests of the school-age children, including books for all reading abilities. 1. There must be enough supplies and equipment to allow children the opportunity to choose activities or materials. 2. There must be a system of sharing high demand items, such as computers, when they cannot be supplied to all children. B. Children must have the opportunity to be responsible for choosing, planning, carrying out, and evaluating their own activities depending on their ages. Children must have opportunities to experience many activities that reflect the various communities, languages, and cultures of the children in care. C. The daily schedule for school-age children must be posted and include the following opportunities: Daily Schedule Requirements for School-Age Children: • Moderate to vigorous active physical play, such as games, sports, dancing, running, jumping, climbing, or exploring the environment; • Outdoor activities or active physical indoor play when weather conditions do not permit outdoor play; and • Socialization, conversation, relaxation, and quiet activities such as board or card games, reading, homework and studying. D. In addition to the daily schedule, a licensee shall ensure a monthly activity plan is posted and shows school-age children are working on projects that require extended time to complete in such topics as science, math, social studies, language arts, cooking, drama, creative arts, or music. This monthly activity plan may be included in the daily schedule. FCC/LFCC Regulation 18, 20 & 52 18. Positive Behavior Supports A. A licensee shall have and follow an easy-to-understand written children’s behavior supports statement. This statement must be given to a parent or guardian at enrollment and staff members. B. A licensee shall ensure that all staff use prevention strategies, appropriate redirection rather than restraint, and positive developmentally-appropriate methods of behavior supports of children, which encourage self-control, self direction, positive self-esteem, social responsibility, and cooperation. 1. Staff shall give directions and guidance in a clear, non-threatening manner. 2. In addition, staff members shall intervene quickly to ensure the safety of the child and others; redirect children by suggesting other acceptable behaviors; escort the child to a different setting when necessary and speak so children understand their feelings are important and acceptable, but their disruptive behavior is not. 3. As children develop, these methods must be modified to encourage them to control their own behavior, cooperate with others, and solve problems by developing ideas about the best possible solution. C. A licensee shall consult with a child's parent or guardian and professionals, if necessary, to design effective positive behavioral supports or to make reasonable accommodations to comply with provisions in an IFSP or IEP and to adapt behavior supports and other practices for a child who has a special need or disability. D. A licensee and staff members shall teach by example by always being respectful when speaking with children and others. E. A licensee shall ensure that if ￿time-out￿, is used, it is used only as necessary to help the child gain control of behavior and feelings. It must be used as a supplement to, not a substitute for, other developmentally-appropriate methods of behavior support. 1. ￿Time-out￿ must be limited to brief periods of no more than one minute for each year of a child’s age. 2. ￿Time-out￿ may not be used for infants. 3. Before using ￿time-out￿, the staff member shall discuss the reason for the ￿time-out￿ in language appropriate to the child’s level of development and understanding. 4. A child removed from the group or room during a ￿time-out￿ must be supervised. Before rejoining the group or at another time, a staff member must talk to the child in ways that encourages the child to make better decisions in the future. F. A licensee shall ensure the following actions are prohibited: Prohibited Acts: • Roughly handling a child or physical punishment inflicted on a child's body, including, but not limited to the following: shaking, grabbing, striking, hair- pulling, biting, pinching, plucking, slapping, hitting, kicking, or spanking; • Yelling at, humiliating, or frightening children; • Physically or sexually abusing a child; • Making negative comments about a child's looks, ability, ethnicity, family, or other personal traits; • Denying children food, water, or toilet use because of inappropriate behavior; • Tying, taping, chaining, caging, or restraining a child by a means other than holding. The child may be held only as long as necessary for the child to regain control; o If the child or others are in imminent danger or a risk to themselves or others, physical holding for as brief as possible to remedy the risk or removing the child to a safer location is permissible. Supervision is required. o In the event physical holding is used, documentation must occur by the staff to ensure safety for all (child and staff member). • Punishing children for a toileting accident, or for failing to fall asleep, eat food, or complete an activity; • Withholding physical activity as punishment; or • Encouraging or allowing children to hit, punish, or discipline each other. 20. Parent or Guardian Communication A. A licensee shall discuss the following information with a parent or guardian during the enrollment process and as needed: Discuss the Following Information with a Parent or Guardian: • Explain that parent or guardian visits are welcomed; • Ask about each child's culture and community, show respect for each family and culture, and discuss how to support these child care practices, especially concerning infants and toddlers; • State that parents or guardians are most important in children's development; • Identify the ongoing needs of the child and learn parent or guardian preferences, goals, concerns, or special circumstances that may influence the child's development, behavior, and learning; o Identify if the child has an IEP or IFSP; and o Discuss with a parent or guardian and service providers, as applicable, any reasonable accommodations or modifications needed by a child with a disability to access the program or services. Discuss the Following Information with a Parent or Guardian: • Explain how infant activities, such as feeding or sleeping, will be shared at the end of each day; • Explain safety procedures for indoors and outdoors, fires, pets, first aid, and emergencies; • Explain cleaning procedures, such as disinfecting, Standard Precautions as described in Section 39, diapering, and toileting; and • Explain the program, including routine activities, equipment, and sleeping accommodations. B. A licensee shall have and follow written policies in a handbook. The handbook must be given to a parent or guardian at enrollment. The Handbook Must Include the Following Information: • A typical daily schedule; • Positive behavior supports policy; • Health policy, including the following: o Emergency health care that states how the parent or guardian will be notified, how the child will be transported, and what will happen if a parent or guardian cannot be reached; o Health exclusions listing when children are not allowed to be admitted or remain in care and what will happen when a child becomes ill and a parent or guardian cannot be reached; and o Notification and prevention of an outbreak of a communicable disease, including a list of reportable communicable diseases, and how parents or guardians will be informed if their children were exposed to a communicable disease or condition; • Food and nutrition policy, including a statement that children are encouraged but not forced to eat; approximate times of snacks and meals; how food allergies and other dietary requirements are handled; and whether a licensee or parent or guardian will provide food; • Release of children policy, including the following: o Procedures to release children only to people approved by a parent or guardian, including a process for the emergency release of a child; o Monitoring the entrance of the home, or phone, email, or other communication methods used by the home to ensure the child is released from care when requested by the parent, guardian, or authorized release person; o Allowing school-age children to walk to their home or from the school bus stop to the family or large family home each with written parent or guardian permission; o Checking the identity of an unknown approved person before releasing the child and keeping documentation of this verification; o Procedures for handling situations in which a non-custodial parent attempts to claim the child without custodial parent or guardian permission; and o Procedures to be followed when an unapproved person wants to pick up a child, or a person who seems to be intoxicated or unable to bring the child home safely requests the release of a child; • Reporting procedures for accidents, injuries, or serious incidents; • Mandatory reporting of child abuse and neglect policy; • Administration of medication policy including reasonable accommodations for a child with disabilities; The Handbook Must Include the Following Information:: • Safe sleep practices for infants, if applicable; • Description of animals or pets regardless of the location within the home; • Suspension and expulsion policies such as the ￿Best Practice Statement for the Prevention of Expulsion and Suspension in Delaware Early Childhood Programs,￿ found on the ￿My Child DE￿ website; • Non-discrimination policy assuring the child or family will not be discriminated against based on race, color, national origin, gender, age, sex, pregnancy, marital status, sexual orientation, gender identity or expression, religion, creed, disability, veteran’s status, or any other category protected by state and federal laws; and • Transportation policy, if applicable 52. Activities and Interactions A. A licensee shall interact with children at their eye level and sit on the floor with them whenever appropriate. A licensee shall offer age-appropriate activities to children throughout the day to help their development and school-readiness. B. A licensee shall provide activities and materials that reflect children's cultures and communities, including both familiar and new materials, pictures, and experiences. C. A licensee shall have and follow a schedule that is posted for easy viewing by parents or guardians and staff members. The schedule must list times for the following activities: learning opportunities, active or outdoor play, rest, meals, and snacks. This schedule may be flexible to meet the needs and interests of the children. D. A licensee shall ensure activities and materials are adapted to support all children's learning, including a child with disabilities or other special needs, to benefit from the program. 1. A licensee shall allow services to be provided at the home for a child with an IEP, IFSP, or Section 504 plan. 2. At the request of a parent or guardian, a licensee shall permit qualified professionals to complete an observation or assessment of the child while at the home. E. Weather permitting, a licensee shall ensure daily outdoor play is provided for infants, toddlers, and older children when the wind chill factor is 32° F or higher or the heat index is 89° F or lower. 1. Outdoor play during periods outside this temperature range may be determined by the licensee. 2. Children must be appropriately dressed for the weather. 3. A licensee shall ensure the guidelines of the National Weather Service (currently www.weather.gov) are followed if an advisory regarding health or safety risks has been issued. 4. For infants, this may include riding in a stroller or carriage, but must also include opportunities for gross motor development. This may occur on a blanket or other hazard-free space. F. A licensee shall provide chances for physical activity for each child according to the child's ability. For every four hours the child is in care between 7 AM and 7 PM, 30 or more minutes of physical activity must be provided. Daily active play may be divided into one or more blocks of time. It may be indoors or outdoors. G. A licensee and staff members shall interact with each child, giving attention and physical comfort. H. A licensee shall ensure children are not in cribs, pack-and-plays, swings, high chairs, seats, or stationary activity centers for more than 30 minutes at a time while awake. Toddlers and infants, as appropriate, must be provided with an activity during this time. After removing the child from the equipment, the child must be able to move freely on the floor. I. A licensee shall offer activities that meet the needs and interests of school- age children by providing age-appropriate activities, materials, and equipment. These activities must include the following: • Active physical play, such as games, sports, dancing, running, jumping, climbing, or exploring the environment; • Outdoor activities or active indoor play in bad weather; • Time to talk and interact with others; and • Time to relax or quiet activities such as board or card games, reading, homework, and studying. J. A licensee shall ensure activities, such as watching television or using a gaming device, tablet, phone, or computer, are supervised, age-appropriate, and educational. These screen time activities require written parent or guardian permission and are limited to one hour or less per day, unless a special event occurs. Assistive technology is not included in screen time restrictions. iv. Any other areas determined necessary to promote child development or to protect children’s health and safety. Describe: Not at this time