5.3 Health and Safety Standards for CCDF Providers

Lead Agencies must have health and safety standards for providers serving children receiving CCDF assistance relating to the required health and safety topics as appropriate to the provider setting and age of the children served. This requirement is applicable to all child care programs receiving CCDF funds regardless of licensing status (i.e., licensed or license-exempt). The only exception to this requirement is for relative providers, as defined by CCDF. Lead Agencies have the option of exempting certain relatives from any or all CCDF health and safety requirements. Exemptions for relative providers’ standards requirements will be addressed in question 5.8.1. Describe the following health and safety standards for programs serving children receiving CCDF assistance on the following topics (note that monitoring and enforcement will be addressed in subsection 5.5): 5.3.1 Prevention and control of infectious diseases (including immunizations) health and safety standard a. Provide the standards, appropriate to the provider setting and age of children, that address the prevention and control of infectious diseases for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed center care and are found in Rules and Regulations for Child Care Learning Centers. Bathrooms 591-1-1-.06(1) Required Facilities. Flush toilets and hand washing sinks with running water shall be provided in the following minimum ratios for the use of all children: Number of Children Toilets and Sinks * 1-12 1 13-25 2 26-50 3 51-75 4 76-100 5 101-125 6 126-150 7 151-175 8 591-1-1-.06(4) Ventilation. In Centers first licensed after March 1, 1991, and Centers that remodel or add to existing plumbing facilities, the bathroom area shall be fully enclosed and ventilated to the outside of the building with either an open screened window or functioning exhaust fan and duct system. Centers without fully enclosed bathrooms shall ensure that there is adequate ventilation to control odors and adequate sanitation measures to prevent the spread of contagious diseases. 591-1-1-.06(7) Cleanliness. Bathrooms shall be cleaned daily with a disinfectant. Children’s Health 591-1-1-.07(1) Exclusion of Sick Children. A child shall not be accepted nor allowed to remain at the Center if the child has the equivalent of a one hundred one (101) degrees Fahrenheit or higher oral temperature and another contagious symptom, such as but not limited to, a rash, diarrhea or a sore throat. When a child shows symptoms of illness during the day, the child shall be moved to a quiet area away from other children where the child shall be supervised and provided the necessary attention until such time as the child leaves the Center or is able to return to the child's group. 591-1-1-.07(2) Parental Notification. Parents must be notified of incidents, illnesses or injuries as follows: Immediately notify Parent(s) and obtain specific instructions until child can be picked up or returned to group: When professional medical attention is required, or When child experiences symptoms of moderate discomfort such as elevated temperature, vomiting or diarrhea, or When child is involved in an incident that puts their health and/or safety at risk (e.g., missing from program, left on vehicle, escaped from building/playground, etc.) 591-1-1-.07(3) Communicable Diseases. The Department's current communicable disease chart of recommendations for exclusion of sick children from the Center and their readmission shall be followed. Parents of all children enrolled shall be notified in writing of the occurrence of any of the illnesses on the most current version of the communicable disease chart, as found on the Department’s website, or any cases or suspected cases of viruses or illnesses (COVID-19, etc.) identified during a public health emergency, within twenty-four (24) hours after the Center becomes aware of the illness or the next working day. Children’s Records 591-1-1-.08(2) The file shall also contain evidence of age-appropriate immunizations or a signed affidavit against such immunizations. The items shall be maintained for each child enrolled in the Center on a form approved by the Department, and no child shall continue enrollment in the Center for more than thirty (30) days without such evidence. Diapering 591-1-1-.10(1) Ventilation. For Centers first licensed after March 1, 1991, and for Centers that are renovated after March 1, 1991, the diapering areas shall be ventilated by functioning exhaust fans and a duct system or by the required amount of window space provided by operable windows when open. 591-1-1-.10(2) Hand Washing Sink. In Centers first licensed after March 1, 1991, and Centers that renovate existing plumbing facilities, a hand washing sink with running heated water shall be located adjacent to the diapering area. Flush sinks shall not be used for hand washing. Cleansing procedures in other facilities shall be approved by the Department. 591-1-1-.10(3) Changing Diapers. Diapers shall be changed in the child's own crib or on a diaper changing surface that is used for no purposes other than changing clothes in each room where infants or any other children wearing diapers are served. 591-1-1-.10(4) If diapers are changed on a diaper changing surface, the surface shall be smooth, nonporous, and equipped with a guard or rails to prevent falls. Between each diaper change, the diaper changing surface shall be cleaned with a disinfectant and dried with a single-use disposable towel. 591-1-1-.10(7) Supplies. The following items shall also be provided at the diapering area: liquid soap, individually dispensed, single-use hand towels, single- use wash cloths, and covered storage container for soiled items. 591-1-1-.10(8) Hygiene. Staff with diaper changing responsibilities shall not be simultaneously assigned to kitchen food preparation duties. 591-1-1-.10(9) Location of Diapering Area. The area used for diapering shall not be used for food preparation. It must be clear of formulas, food, food utensils and food preparation items. Equipment and Toys 591-1-1-.12(2) Equipment and Furniture. Equipment and furniture shall be free from hazardous conditions such as, but not limited to, sharp rough edges or toxic paint and shall be kept clean. 591-1-1-.12(8) Toys for Children Under Three. Toys for children under three (3) years of age shall also be age-appropriate. Those toys shall be: non-toxic and lead- free; too large to be swallowed by a child and not capable of causing asphyxiation or strangulation; free of sharp pieces, edges or points; free of small parts which may be pried off by a child; free of rust; and easily cleaned with a disinfectant daily. Food Service and Nutrition 591-1-1-.15(3) Baby Bottles and Formula. All baby bottles shall be clearly labeled with the individual child's name. Formula or breast milk shall be supplied by the Parent daily in bottles. Only the current day's formula or breast milk shall be served. Bottles shall be refrigerated at a temperature of forty (40) degrees Fahrenheit or less. If formula must be provided by the Center, only commercially prepared, ready-to-feed formula shall be used. Refrigerated or frozen breast milk shall only be heated or thawed under warm running water or in a container of warm water. 591-1-1-.15(4) Feeding Chairs. A feeding chair or similar equipment designed for feeding children shall be provided for the use of each child being fed who is capable of sitting up but who is unable to sit unassisted at a table. The chair or similar equipment must be cleaned with a disinfectant after each use. Such chair or similar equipment shall have a broad base to prevent tipping; a surface that the child cannot raise; a strap or other device which prevents the child from sliding out of the chair; and a feeding surface free of cracks. 591-1-1-.15(6)(a) Meal Service. Children shall be served all meals and snacks scheduled for the period during which they are present. In those Centers where the Parent(s) of children enrolled provide the meals and snacks, the Center shall ensure that no child remains at the Center without receiving the scheduled nutritious meals and snacks. There shall be a period of at least two (2) hours between each required meal or snack. The following meals and snacks shall be scheduled and served by the Center when appropriate: breakfast or a morning snack, lunch, an afternoon snack, supper if a Center operates evening care and an evening snack prior to bed time if a Center operates night time care. Hygiene 591-1-1-.17(4) Contagious Diseases. Children, Parents, Staff, or any other persons being supervised by the Staff, shall not be allowed in the Center who knowingly have or present symptoms of a contagious communicable disease (such as fever, coughing, fatigue, muscle aches, diarrhea, etc.) or any virus or illness (such as COVID-19, etc.) identified during a public health emergency. 591-1-1-.17(7) Handwashing, Children. Children's hands shall be washed with liquid soap and warm running water: immediately upon arrival for care, when moving from one child care group to another and upon re-entering the child care area after outside play; before and after eating meals and snacks, handling or touching food, or playing in water; after toileting and diapering, playing in sand, touching animals or pets, contact with bodily fluids such as, but not limited to, mucus, saliva, vomit or blood and after contamination by any other means. 591-1-1-.17(7)(a) Washcloth handwashing is permitted for infants when the infant is too heavy to hold for handwashing or cannot stand safely to wash hands at a sink and for children with special needs who are not capable of washing their own hands. An individual washcloth shall be used only once for each child before laundering. 591-1-1-.17(8) Handwashing, Staff. Personnel shall wash their hands with liquid soap and warm running water: immediately upon arrival for the day, when moving from one child care group to another, and upon re-entering the child care area after outside play; before and after diapering each child, dispensing medication, applying topical medications, ointments, creams or lotions, handling and preparing food, eating, drinking, preparing bottles, feeding each child, and assisting children with eating and drinking; after toileting or assisting children with toileting, using tobacco products, handling garbage and organic waste, touching animals or pets, handling bodily fluids, such as, but not limited to, mucus, saliva, vomit or blood and after contamination by any other means. 591-1-1-.17(10) Potty Chairs. If used, toilet potty chairs shall after each use be emptied by disposal in a flush toilet, cleaned with a disinfectant, and stored in the bathroom. If a sink is used, the sink shall also be disinfected. 591-1-1-.17(11) Soiled Containers and Items. Separate containers shall be used for storing soiled disposable items, such as disposable diapers, disposable washcloths and soiled nondisposable items, such as cloth diapers, washcloths and bed linens. Such containers shall be waterproof or equipped with a leakproof disposable liner, covered, easily cleaned and maintained in such a manner so as the contents of the container are never accessible to the children. Kitchen Operations 591-1-1-.18(1) Food. Food shall be in sound condition, free from spoilage and contamination and safe for human consumption. Eggs, pork, pork products, poultry and fish shall be thoroughly cooked. All raw fruits and vegetables shall be washed thoroughly before being cooked or served. Foods not subject to further washing or cooking before serving shall be stored in such a manner as to be protected against contamination. Meats, poultry, fish, dairy products and processed foods shall have been inspected under an official regulatory program. Hot foods shall be maintained at a temperature of one hundred forty (140) degrees Fahrenheit or above except during serving. Food and drinks shall be prepared as close to serving time as possible to protect children and Personnel from foodborne illness. 591-1-1-.18(2) Food Preparation Areas. Each Center shall have a designated space for food preparation separate from rooms used by children and in an area not used for diaper changing. The area shall be kept clean and free of accumulation of dust, dirt, food particles and grease deposits. Food preparation surface areas shall be nonporous with no unsealed cracks or seams. 591-1-1-.18(5) Refrigeration. All perishable and potentially hazardous foods shall be refrigerated at a temperature of forty (40) degrees Fahrenheit or below and served promptly after cooking. Freezer temperature shall be maintained at zero (0) degrees Fahrenheit or below. 591-1-1-.18(6) Dishwashing. Non-disposable dishes, glasses and silverware shall be properly cleaned by pre-rinsing, or scraping, washing, sanitizing and air drying. A three (3) compartment sink or a dishwasher with a sani-cycle or capability of maintaining a rinse water temperature of a minimum of one hundred fifty (150) degrees Fahrenheit and a two (2) compartment sink shall be available. Dishes, glasses and silverware shall be rinsed in the approved dishwasher or rinsed in a chemical sanitizer and air dried. 591-1-1-.18(7) Storage Areas. Each Center shall have a designated space for storage of food and kitchen items. The area shall be kept clean and free of accumulation of dust, dirt, food particles and grease deposits. 591-1-1-.18(8) Containers of food shall be stored above the floor on clean surfaces protected from splash and other contamination. Containers for food storage other than the original container or package in which the food was obtained, shall be impervious and non-absorbent, have tight-fitting lids or covers and labeled as to contents. 591-1-1-.18(10) Garbage. Garbage shall be stored in trash containers with lids. Containers shall be emptied and cleaned as needed. Acceptable facilities, including water and detergent or steam, shall be provided and used for cleaning containers. Areas around outside containers shall be kept clean. 591-1-1-.18(11) Hygiene. Kitchen Staff shall wash their hands and arms thoroughly with liquid soap and warm running water before starting food service work and shall wash hands during work hours as often as may be necessary to remove soil and contamination as well as after visiting the toilet room. Operational Policies & Procedures 591-1-1-.21(1)(g) A Center shall establish and implement written policies and procedures which shall be kept current, be consistent with applicable laws, regulations and these rules, made available to the Parent(s) and used to govern the operations of the Center. (1) The policies and procedures shall include the following: (g) A description of parental notification when a notifiable communicable disease is present (see rule .07 about children's health); Physical Plant 591-1-1-.25(3) Cleanliness. The Center and surrounding premises shall be kept clean, free of debris and in good repair. Hygienic measures such as, but not limited to, screened windows and proper waste disposal procedures shall be utilized to minimize the presence of rodents, flies, roaches and other vermin at the Center. Posted Notices 591-1-1-.27 Each Center shall post in a designated area for public viewing near the front entrance the following: the Center's current License or Permit; a copy of these rules; a copy of the current communicable disease chart; a statement allowing Parent(s) access to all child care areas upon notifying any staff member of his or her presence; names of persons responsible for the administration of the Center in the administrator's absence; the dated current week's menu for meals and snacks; emergency plans for severe weather, fire, and other emergency situations; a statement requiring visitors to check in with Staff when entering the Center; no smoking signs; and a notice provided by the Department which advises Parents of their right to review a copy of the Center's most recent licensure evaluation report upon request to the Center Director. The Center shall provide any Parent with a copy of this evaluation report upon request. Required Reporting 591-1-1-.29(2) Communicable Diseases. The Director or designated person-in- charge shall report or cause to be reported any cases or suspected cases of notifiable communicable diseases (COVID-19, Tuberculosis, Measles, etc.) or any viruses or illnesses identified during a public health emergency, immediately to the Department and to the local County Health Department as required by the rules of the Georgia Department of Public Health, Rule 511-2-1, Notification of Disease. Safe Sleeping and Resting Requirements 591-1-1-.30(1)(d) Arrangement of Sleeping and Resting Equipment. All sleeping and resting equipment shall be arranged to avoid obstructing access to exit doors, to provide the caregivers access to each child, and to prevent children's access to cords hanging from window treatments and other hazardous objects. To reduce the transfer of airborne diseases, sleeping and resting equipment shall be arranged as follows. There shall be a minimum of twenty-four inch (24") corridor between each row of sleeping or resting equipment. There shall be a minimum of twelve inches (12") between each piece of sleeping or resting equipment in each row of equipment. Children shall be placed on cots and mats so that one child's head is toward another child's feet in the same row. 591-1-1-.30(4) Storage. If cots and mats are stored in the children's activity room or area, they shall be stored to prevent children's access to them and to allow maximum use of play space. When storage is available and used for the storage of cots and mats that allows the cots, mats and any bedding to be stored without touching any other cots, mats or bedding, the bedding may be left on the cot or mat. When such storage is not available for the cots and mats, each child's bedding shall be kept separate from other children's bedding and stored in containers marked for individual use, such as, but not limited to, bins, cubbies, or bags. Staff Training 591-1-1-.33(1) Center Orientation. Prior to assignment to children or task, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial Center orientation. 591-1-1-.33(2)The initial Center orientation must include the following subjects: (a) the Center's policies and procedures; (b) the portions of these rules dealing with the care, health and safety of children; (d) reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; (h) the administration of medicine; (j) hand washing; (m) prevention of HIV/AIDS and blood borne pathogens. 591-1-1-.33(3)Health and Safety Orientation. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (a) prevention and control of infectious diseases (including immunization); (c) administration of medication, consistent with standards for parental consent; (h) handling and storage of hazardous materials and the appropriate disposal of bio contaminants; 591-1-1-.33(4) Food Preparation and Nutrition Training. Within the first year of employment, the Director and the person primarily responsible for food preparation shall receive four (4) clock hours of training in food nutrition planning, preparation, serving, proper dish washing and food storage. 591-1-1-.33(5)Annual Training. (a) Every calendar year after the first year of employment, all supervisory and caregiver Personnel, except independent contractors, Students-in-Training and volunteers, shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department- approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (i) Child development (e.g., developmental domains (cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; approaches to play and learning), discipline and guidance techniques, children with special needs); (ii) Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); (iv) Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). ii. All CCDF-eligible licensed family child care homes. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school- age children in all CCDF-eligible licensed family child care homes and are found in Rules and Regulations for Family Child Care Learning Homes. Staffing & Supervision 290-2-3-.07(5) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. 290-2-3-.07(6)The initial program orientation must include the following subjects: (a) the Home's policies and procedures; (b) the portions of these rules dealing with the care, health and safety of children; (e) communicable diseases and serious injuries; (i) the administration of medicine; (k) hand washing; (n) prevention of HIV/AIDS and blood borne pathogens. 290-2-3-.07(7) Health and Safety Orientation. The Provider, Employees and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (a) prevention and control of infectious diseases (including immunization); (c) administration of medication, consistent with standards for parental consent; (h) handling and storage of hazardous materials and the appropriate disposal of bio contaminants; 290-2-3-.07(9) Annual Training. (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (i) Child development (e.g., developmental domains (cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; approaches to play and learning), discipline and guidance techniques, children with special needs); (ii) Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); (iv) Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). Children’s Records 290-2-3-.08(2) Such records shall include evidence of age appropriate immunizations, or a signed affidavit certifying that the required immunizations conflict with the religious belief of the Parent or a physician statement that immunization is contraindicated. Evidence of immunizations or required documentation shall be on file for each Child upon admission to the Home or within 30 days thereafter. 290-2-3-.08(8)(b)(4) Policies and Procedures. Each Family Child Care Learning Home shall establish policies and procedures, which shall be kept current, be consistent with applicable laws, including but not limited to the Americans with Disabilities Act, regulations and these rules, made available to the Parents, and used to govern the operations of the Family Child Care Learning Home. (b)(4) The policies and procedures shall also include written procedures for the following: Notifying Parent(s) in writing of their Child's: illness, injury, and exposure to a notifiable communicable disease or any cases or suspected cases of viruses or illnesses (COVID-19, etc.) identified during a public health emergency, within twenty-four (24) hours after the Home becomes aware of the illness or the next working day. 290-2-3-.08(8)(b)(6-7) Policies and Procedures. Each Family Child Care Learning Home shall establish policies and procedures, which shall be kept current, be consistent with applicable laws, including but not limited to the Americans with Disabilities Act, regulations and these rules, made available to the Parents, and used to govern the operations of the Family Child Care Learning Home. (b)(6-7) The policies and procedures shall also include written procedures for the following: Exclusion of sick children; Exclusion and readmission of children with communicable diseases, as defined on the most current version of the communicable disease chart, as found on the Department’s website, or with cases or suspected cases of viruses or illnesses (COVID-19, etc.) identified during a public health emergency. Nutrition and Food Services 290-2-3-.10(3)(c) Feeding of Infants and Children. A signed written feeding plan for children less than one (1) year of age shall be obtained from Parent(s). Instructions from the Parent(s) shall be updated regularly as new foods are added or other dietary changes are made. The feeding plan shall be posted in the main child care area and must include the child's feeding schedule, the amount of formula or breast milk to be given, instructions for the introduction of solid foods, the amount of food to be given and notation of any type(s) of commercially premixed formula which may not be used in an emergency because of food allergies. (c)Age-appropriate solid foods (including cereal) shall not be given to infants or children less than one (1) year of age until recommended as developmentally appropriate by the child’s primary care physician and indicated in writing by the Parent(s). As soon as the feeding plan indicates that a child is ready for solid foods, the child shall be fed from individual spoons and individual containers or dishes. A child shall not be fed directly from the original baby food container if the contents are to be fed to the child at more than one (1) meal or to more than one (1) child. 290-2-3-.10(4) Baby Bottles and Formula. All baby bottles shall be clearly labeled with the individual child's name. Formula or breast milk shall be supplied by the Parent daily in bottles. Only the current day's formula or breast milk shall be served. Bottles shall be refrigerated at a temperature of forty (40) degrees Fahrenheit or less. If formula must be provided by the Home, only commercially prepared, ready-to-feed formula shall be used. Refrigerated or frozen breast milk shall only be heated or thawed under warm running water or in a container of warm water. 290-2-3-.10(5) Feeding Chairs. A feeding chair or similar equipment designed for feeding children shall be provided for the use of each child being fed who is capable of sitting up but who is unable to sit unassisted at a table. The chair or similar equipment must be cleaned with a disinfectant after each use. Such chair or similar equipment shall have a broad base to prevent tipping; a surface that the child cannot raise; a strap or other device which prevents the child from sliding out of the chair; and a feeding surface free of cracks. 290-2-3-.10(7)(b) Meal Service. Food and beverages shall be served in individual plates or bowls and with individual glasses or cups, that are not chipped or cracked. 290-2-3-.10(10) Unconsumed Food. Any portions of food or drink which are served to children or placed on the table for service and are not consumed at that meal or snack by the children to whom the portions are served shall be thrown away. Any formula or breast milk remaining one hour from the beginning of the feeding shall be discarded or returned to Parent(s). 290-2-3-.10(11) Food. Food shall be in sound condition, free from spoilage and contamination and safe for human consumption. Eggs, pork, pork products, poultry and fish shall be thoroughly cooked. All raw fruits and vegetables shall be washed thoroughly before being cooked or served. Foods not subject to further washing or cooking before serving shall be stored in such a manner as to be protected against contamination. Meats, poultry, fish, dairy products and processed foods shall have been inspected under an official regulatory program. Hot foods shall be maintained at a temperature of one hundred forty (140) degrees Fahrenheit or above except during serving. Food and drinks shall be prepared as close to serving time as possible to protect children and Personnel from foodborne illness. 290-2-3-.10(12) Food Preparation Areas. The Home shall have a designated space for food preparation and in an area not used for diaper changing. The area shall be kept clean and free of accumulation of dust, dirt, food particles and grease deposits. Food preparation surface areas shall be nonporous with no unsealed cracks or seams. 290-2-3-.10(13) Refrigeration. All perishable and potentially hazardous foods shall be refrigerated at a temperature of forty (40) degrees Fahrenheit or below and served promptly after cooking. Freezer temperature shall be maintained at zero (0) degrees Fahrenheit or below. 290-2-3-.10(14) Storage Areas. The Home shall have a designated space for storage of food and kitchen items. The area shall be kept clean and free of accumulation of dust, dirt, food particles and grease deposits. 290-2-3-.10(15) Containers of food shall be stored above the floor on clean surfaces protected from splash and other contamination. Containers for food storage other than the original container or package in which the food was obtained, shall be impervious and non-absorbent, have tight-fitting lids or covers and labeled as to contents. 290-2-3-.10(17) Garbage. Garbage shall be stored in trash containers with lids and emptied and cleaned as needed. Areas around outdoor containers shall be kept clean. 290-2-3-.10(18) Hygiene. The person preparing meals shall wash their hands and arms thoroughly with soap and warm water before starting food service work and as often as necessary during food preparation and serving to remove soil and contamination. 290-2-3-.10(19) Dishwashing. Non-disposable dishes and silverware shall be properly cleaned by pre-rinsing, or scraping, washing, sanitizing and air drying. Health, Safety, and Discipline 290-2-3-.11(1)(a-b) Health. (a) Children, Parents, Staff, or any other persons being supervised by the Staff, shall not be allowed in the Home who knowingly have or present symptoms of a contagious communicable disease (such as fever, coughing, fatigue, muscle aches, diarrhea, etc.) or any virus or illness (such as COVID-19, etc.) identified during a public health emergency. (b) Parental Notification. Parents must be notified of incidents, illnesses, or injuries as follows: Immediately notify Parent(s) and obtain specific instructions until child can be picked up or returned to group: When professional medical attention is required, or When child experiences symptoms of moderate discomfort such as elevated temperature, vomiting or diarrhea, or When child is involved in an incident that puts their health and/or safety at risk (e.g., missing from program, left on vehicle, escaped from building/playground, etc.) 290-2-3-.11(1)(e-k) (e)The Home and any vehicle used by the Home for transportation of Children shall have a first aid kit which shall at least contain: scissors, tweezers, gauze pads, thermometer, adhesive tape, band-aids, insect-sting preparation, antiseptic cleaning solution, antibacterial ointment, bandages, disposable rubber gloves, protective eyewear, facemask, and cold pack. The first aid kit, together with a first aid instruction manual which must be kept with the kit at all times, shall be stored in a central location so that it is not accessible to Children but is easily accessible to the Provider and Staff. The Home must also maintain written directions for the use of universal precautions for handling blood and bodily fluids. The directions on the use of universal precautions must be kept with the first aid kit at all times. (f) Diapers shall be changed in the Child's own crib or on a nonporous surface which is cleaned with a disinfectant and dried with a single use disposable towel after each diaper change. (g) Soiled diapers and linens shall be disposed of in a closed container. (h) If used, toilet potty chairs shall after each use be emptied by disposal in a flush toilet, cleaned with a disinfectant, and stored in the bathroom. If a sink is used, it shall be disinfected after each use. (i) Personnel shall wash their hands with liquid soap and warm running water: immediately before and after each diaper change; immediately upon the first Child's arrival in the Home for care and upon re-entering the Home after outside play; before and after dispensing oral medications and applying topical medications, ointments, creams or lotions, handling and preparing food, eating, drinking, preparing bottles, feeding or assisting children with eating and drinking; after toileting or helping children with toileting, using tobacco products, handling garbage and organic waste, touching animals or pets, handling bodily fluids such as, but not limited to, mucus, saliva, vomit or blood and after contamination by any other means. (j) Children's hands shall be washed with liquid soap and warm running water: immediately upon arrival for the day and re-entering the child care area after outside play; before and after eating meals and snacks, handling or touching food, and playing in water; after toileting and diapering, playing in sand, touching animals or pets, contact with bodily fluids such as, but not limited to, mucus, saliva, vomit or blood, and after contamination by any other means. (k) Washcloth handwashing is permitted for infants when the infant is too heavy to hold for handwashing or cannot stand safely to wash hands at a sink and for children with special needs who are not capable of washing their own hands. An individual washcloth shall be used only once for each child before laundering. Equipment and Supplies 290-2-3-.12(3) Furniture and equipment shall be kept clean and in a safe usable condition. 290-2-3-.12(5) All indoor and outdoor furniture, activity materials, and equipment shall be free from hazardous conditions such as, but not limited to, sharp rough edges or toxic paint and kept clean. 290-2-3-.12(12) Toys for children under three (3) years of age shall be non-toxic and lead free; too large to be swallowed by a child and not capable of causing asphyxiation or strangulation; free of sharp pieces, edges or points; free of small parts which may be pried off by a child; free of rust and easily cleaned with a disinfectant daily. Building and Grounds 290-2-3-.13(1) The Home's building shall be kept clean and free from obvious hazards to the children's health and safety. Reporting 290-2-3-.14(4) Communicable Diseases. The Provider or designated person-in- charge shall report or cause to be reported any cases or suspected cases of notifiable communicable diseases (COVID-19, Tuberculosis, Measles, etc.) or any viruses or illnesses identified during a public health emergency, immediately to the Department and to the local County Health Department as required by the rules of the Georgia Department of Public Health, Rule 511-2-1, Notification of Disease. Safe Sleeping and Resting Requirements 290-2-3-.19(1)(a) Sleeping and Resting Equipment. (a) Cribs and Other Approved Sleep Equipment. The Home shall provide either a safety approved crib or other equipment that is approved for infant sleep for each infant who cannot climb out of the crib or other approved equipment. Each crib shall be safety approved in compliance with Consumer Product Safety Commission (CPSC) and American Society of Testing and Materials International (ASTM) safety standards; any other equipment, such as, but not limited to, a portable crib, playpen, play yard or bassinet, shall be in compliance with current ASTM Standard Consumer Safety Specifications for Non-Full-Size Baby Cribs/Play Yards. ("Infant" refers to any child under the age of twelve (12) months or any child who is under eighteen (18) months of age who is not walking.) 290-2-3-.19(1)(d) Arrangement of Sleeping and Resting Equipment. All sleeping and resting equipment shall be arranged to avoid obstructing access to exit doors, to provide the caregivers access to each child, and to prevent children's access to cords hanging from window treatments and other hazardous objects. To reduce the transfer of airborne diseases, sleeping and resting equipment shall be arranged as follows. There shall be a minimum of twenty-four inch (24") corridor between each row of sleeping or resting equipment. There shall be a minimum of twelve inches (12") between each piece of sleeping or resting equipment in each row of equipment. Children shall be placed on cots and mats so that one child's head is toward another child's feet in the same row. 290-2-3-.19(4) Storage. If cots and mats are stored in the children's activity room or area, they shall be stored to prevent children's access to them and to allow maximum use of play space. When storage is available and used for the storage of cots and mats that allows the cots, mats and any bedding to be stored without touching any other cots, mats or bedding, the bedding may be left on the cot or mat. When such storage is not available for the cots and mats, each child's bedding shall be kept separate from other children's bedding and stored in containers marked for individual use, such as, but not limited to, bins, cubbies, or bags. iii. All CCDF-eligible licensed in-home care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible regulated (but not licensed) informal in-home care providers and are found in the Health & Safety Standards for Informal Providers Appendix HH. B. Bathrooms (1) Required Facilities. One (1) Flush toilet and one (1) hand washing sink with running water shall be provided for the use of all children. (3) Supplies. Bathrooms shall be within easy reach of children and equipped with soap, toilet tissue and single-use towels or cloth towels used only once between launderings. (4) Cleanliness. Bathrooms shall be cleaned daily with a disinfectant. F. Equipment and Toys (2) All equipment and furniture shall be used only by the age-appropriate group of children. Equipment and furniture shall be: (b) Kept clean; H. Hygiene (1) Handwashing, Children. Children's hands shall be washed with liquid soap and warm running water: (a) Before and after eating meals and snacks, and handling or touching food; and (b) After toileting and diapering. (2) Handwashing, Staff. Staff shall wash their hands with liquid soap and warm running water: (a) Before and after eating meals and snacks, and handling or touching food; (b) After diapering each child; and (c) After toileting or assisting children with toileting. J. Policies and Procedures (1) The Informal Provider shall have a written policy regarding the following: (a) Exclusion of children with contagious illnesses; (b) Notification to parents in the event their child becomes ill while at the Program; (c) Notification to all parents of enrolled children when a reportable contagious illness is present at the Program; (f) The handling and appropriate disposal of bodily fluids and storage of hazardous materials (soiled clothing and bedding) (2) Emergency preparedness and response. A written plan for handling emergencies, including but not limited to severe weather, loss of electrical power or water and death, serious injury or loss of a child, a threatening event, or natural disaster which may occur at the Program. The Provider will have in place procedures for evacuation, relocation, shelter-in-place, lock-down, communication and reunification with families, and continuity of operations. The plan must apply to all children in care and will include specific accommodations for infants and toddlers, children with disabilities, and children with chronic medical conditions. Such plan shall include assurance that no Personnel will impede in any way the delivery of emergency care or services to a child by licensed or certified emergency health care professionals. O. Staff Training (1) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. The initial program orientation must include the following subjects: the program's policies and procedures; the portions of these rules dealing with the care, health and safety of children; the Staff person’s assigned duties and responsibilities; reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; emergency weather plans; the program’s emergency preparedness plan; childhood injury control; the administration of medicine; reducing the risk of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS); hand washing; fire safety; water safety; and prevention of HIV/AIDS and blood borne pathogens. (2) Health and Safety Orientation. Each Informal Provider, Employees, and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required annual training hours. The training must address the following health and safety topics: (a) Prevention and control of infectious diseases; (c) Administration of medication, consistent with standards for parental consent; (h) Handling and storage of hazardous materials and the appropriate disposal of bio contaminants; (3) Ongoing Training (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: i. Child development (e.g., developmental domains (cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; approaches to play and learning), discipline and guidance techniques, children with special needs); ii. Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); iii. Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); iv. Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). S. Required Reporting (1) The Informal Provider shall report or cause to be reported the following to the Department within twenty-four (24) hours or the next work day: (b) Communicable Diseases. Any cases or suspected cases of notifiable communicable diseases (COVID-19, Tuberculosis, Measles, etc.) or any viruses or illnesses identified during a public health emergency, immediately to the Department and to the local County Health Department as required by the rules of the Georgia Department of Public Health, 511-2-1 Notification of Disease. (d) Serious illness or injury requiring hospitalization or professional medical attention other than first aid of a child while in the care of the program. T. Diapering (1) Handwashing Sink. A hand washing sink with running heated water shall be located adjacent to the diapering area. (2) Diaper Changing Surface. If diapers are changed on a diaper changing table/surface, the surface shall be smooth, nonporous, and equipped with a guard or rails to prevent falls. Between each diaper change, the diaper change surface shall be cleaned with a disinfectant and dried with a single-use disposable towel. Infants and children shall not be left unattended while being diapered or having their clothes changed on the diaper changing surface. (3) Location of Diapering Area. The area used for diapering shall not be used for food preparation. It must be clear of formulas, food, food utensils and food preparation items. U. Safe Sleep Requirements (2) Crib Mattress. A mattress shall be provided for each crib and shall be firm, tight-fitting without gaps, at least two inches (2") thick and covered with waterproof, washable material. Before a change of occupant, each mattress shall be cleaned with a disinfectant. (3) Crib Sheet. Each crib shall have only an individual, tight-fitting sheet which is changed daily or more often as needed and prior to a change of occupant. CAPS Policy Manual 6.6 Child’s Immunization Requirements (1) Current immunizations are required for children to receive CAPS. (3) A Certificate of Immunization is required to be kept in the CAPS case record for all non-school aged children who are receiving care through an informal provider. DPH Rules and Regulations: Chapter 511-2-2.02 (a) Except as otherwise provided, immunization against the following diseases shall be required of all children entering a school or childcare facility operating in the state: (1) Diphtheria; (2) Haemophilus influenzae type B (not required on or after the fifth birthday); (3) Hepatitis A; (4) Hepatitis B; (5) Measles; (6) Meningitis; (7) Mumps; (8) Pertussis; (9) Pneumococcal disease (not required on or after the fifth birthday); (10) Poliomyelitis; (11) Rubella (German measles); (12) Tetanus; and (13) Varicella (chickenpox). (b) A parent or guardian must submit a valid Certificate of Immunization for any child entering a school or childcare facility in the state of Georgia for the first time. (c) School or childcare facility officials may allow a child without a valid certificate of immunization to attend for no more than 90 calendar days after the first day of attendance, provided that the parent or legal guardian either shows that that the child is in the process of completing required immunizations and that immunizations are being scheduled with the shortest intervals recommended in the current Official Immunization Schedules, or presents an affidavit of religious objection as provided in DPH Rule 511-2-2-.07. (d) Effective July 1, 2014, for entrance into Georgia school grades kindergarten through twelve, students must have a total of two doses of measles vaccine, two doses of mumps vaccine, one dose of rubella vaccine and a total of two doses of varicella vaccine. (e) Children attending any childcare facility must show evidence of protection against pneumococcal disease. (f) Children born on or after January 1, 2006 who are attending any childcare facility or school must have proof of protection against hepatitis A disease (vaccination or serology). (g) Requirements for hepatitis A, hepatitis B, measles, mumps, rubella, and varicella vaccines may be waived with serologic proof of immunity. Requirements for varicella vaccine may be waived also with a healthcare provider diagnosis of varicella disease or healthcare provider verification of history of varicella disease. (h) Effective July 1, 2014, children born on or after January 1, 2002 who are attending seventh grade, and children who are new entrants into a Georgia school in grades eight through twelve, must have received one dose of Tdap vaccine. (i) Effective July 1, 2014, children born on or after January 1, 2002 who are attending seventh grade, and children who are new entrants into a Georgia school in grades eight through twelve, must have received one dose of meningococcal conjugate vaccine. (j) Effective July 1, 2020, children sixteen years of age and older who are attending eleventh grade must receive a booster dose of meningococcal conjugate vaccine, unless their initial dose was administered on or after their sixteenth birthday. [ ] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible license-exempt center care and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. B. Bathrooms (1) Flush toilets and lavatories (hand washing sinks) with running water shall be provided in the following minimum ratios for the use of all children: Number of Children Toilets and Sinks * 1-12 1 13-25 2 26-50 3 51-75 4 76-100 5 101-125 6 126-150 7 151-175 8 Each additional group of twenty-five (25) children shall require one (1) additional toilet and lavatory. * For children being potty-trained, at least one (1) flush toilet shall be provided. If used, nursery potty chairs may not be substituted for a required flush toilet. (2) Location of Bathrooms. Bathrooms shall be located on each floor in or adjacent to child care areas and rooms. (3) In lieu of the requirements set forth in subparagraphs (1) and (2) above, School-age only facilities shall provide at least one (1) toilet and (1) lavatory for each group of twenty-five (25) children on the premises. (4) Supplies. Bathrooms shall be within easy reach of children and equipped with soap, toilet tissue and single-use towels or cloth towels used only once between launderings. (5) Cleanliness. Bathrooms shall be cleaned daily with a disinfectant. F. Equipment and Toys (2) All equipment and furniture shall be used only by the age-appropriate group of children. Equipment and furniture shall be: (b) Kept clean; H. Hygiene (1) Handwashing, Children. Children's hands shall be washed with liquid soap and warm running water: (a) Upon arrival for care; (b) When moving from one child care group to another; (c) Upon re-entering the child care area after outside play; (d) Before and after eating meals and snacks, and handling or touching food; (e) After toileting and diapering; and (f) After playing in sand, touching animals or pets, and contact with bodily fluids, and after contamination by any other means. (2) Handwashing, Staff. Staff shall wash their hands with liquid soap and warm running water: (a) Before and after eating meals and snacks, and handling or touching food; (b) After diapering each child; and (c) After toileting or assisting children with toileting. J. Policies and Procedures (1) The Program shall establish and implement written policies and procedures that describe the Program's operations as follows: (a) The exclusion of children with contagious illness, (b) Notification of parents in the event their child becomes ill while at the facility, (c) The notification of all parents of enrolled children when a reportable contagious illness is present in the facility, (e) Emergency preparedness and response. A written plan for handling emergencies, including but not limited to severe weather, loss of electrical power or water and death, serious injury or loss of a child, a threatening event, or natural disaster which may occur at the program. The program will have in place procedures for evacuation, relocation, shelter-in-place, lock-down, communication and reunification with families, and continuity of operations. The plan must apply to all children in care and will include specific accommodation for infants and toddlers, children with disabilities, and children with chronic medical conditions. Such plan shall include assurance that no Personnel will impede in any way the delivery of emergency care or services to a child by licensed or certified emergency health care professionals, (f) The handling and appropriate disposal of bodily fluids and storage of hazardous materials (soiled clothing and bedding), L. Physical Plant (4) The Program and surrounding premises must be kept clean, free of debris and in good repair. Hygienic measures such as, but not limited to, screened windows and proper waste disposal procedures shall be utilized to minimize the presence of rodents, flies, roaches and other vermin at the Program. P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (a) The program's policies and procedures; (b) The portions of these standards dealing with the care, health and safety of children; (d) Reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; (g) The administration of medicine; (i) Hand washing; (l) Prevention of HIV/Aids and blood borne pathogens. (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (a) Prevention and control of infectious diseases; (c) Administration of medication, consistent with standards for parental consent; (h) Handling and storage of hazardous materials and the appropriate disposal of bio contaminants; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (i) Child development (e.g., developmental domains (cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; approaches to play and learning), discipline and guidance techniques, children with special needs); (ii) Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); (iv) Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). T. Required Reporting (1) The Administrator or designated person-in-charge shall report or cause to be reported the following incidents to the Department within twenty-four (24) hours or the next work day: b. Communicable Diseases. Any cases or suspected cases of notifiable communicable diseases (COVID-19, Tuberculosis, Measles, etc.) or any viruses or illnesses identified during a public health emergency, immediately to the Department and to the local County Health Department as required by the rules of the Georgia Department of Public Health, 511-2-1, Notification of Disease. d. Serious illness or injury requiring hospitalization or professional medical attention other than first aid of a child while in the care of the program. U. Diapering (1) Handwashing Sink. A hand washing sink with running heated water shall be located adjacent to the diapering area. (2) Diaper Changing Surface. If diapers are changed on a diaper changing table/surface, the surface shall be smooth, nonporous, and equipped with a guard or rails to prevent falls. Between each diaper change, the diaper change surface shall be cleaned with a disinfectant and dried with a single-use disposable towel. (3) Child Unattended on Diapering Area. Requires Staff to not leave infants or children unattended while being diapered or having their clothes changed on the diaper changing surface. (4) Location of Diapering Area. The area used for diapering shall not be used for food preparation. It must be clear of formulas, food, food utensils and food preparation items. V. Safe Sleep Requirements (2) Crib Mattress. A mattress shall be provided for each crib and shall be firm, tight-fitting without gaps, at least two inches (2") thick and covered with waterproof, washable material. Before a change of occupant, each mattress shall be cleaned with a disinfectant. (3) Crib Sheet. Each crib shall have only an individual, tight-fitting sheet which is changed daily or more often as needed and prior to a change of occupant. CAPS Policy Manual 6.6 Child’s Immunization Requirements (1) Current immunizations are required for children to receive CAPS. (3) A Certificate of Immunization is required to be kept in the CAPS case record for all non-school aged children who are receiving care through an informal provider. DPH Rules and Regulations: Chapter 511-2-2.02 (a) Except as otherwise provided, immunization against the following diseases shall be required of all children entering a school or childcare facility operating in the state: (1) Diphtheria; (2) Haemophilus influenzae type B (not required on or after the fifth birthday); (3) Hepatitis A; (4) Hepatitis B; (5) Measles; (6) Meningitis; (7) Mumps; (8) Pertussis; (9) Pneumococcal disease (not required on or after the fifth birthday); (10) Poliomyelitis; (11) Rubella (German measles); (12) Tetanus; and (13) Varicella (chickenpox). (b) A parent or guardian must submit a valid Certificate of Immunization for any child entering a school or childcare facility in the state of Georgia for the first time. (c) School or childcare facility officials may allow a child without a valid certificate of immunization to attend for no more than 90 calendar days after the first day of attendance, provided that the parent or legal guardian either shows that that the child is in the process of completing required immunizations and that immunizations are being scheduled with the shortest intervals recommended in the current Official Immunization Schedules, or presents an affidavit of religious objection as provided in DPH Rule 511-2-2-.07. (d) Effective July 1, 2014, for entrance into Georgia school grades kindergarten through twelve, students must have a total of two doses of measles vaccine, two doses of mumps vaccine, one dose of rubella vaccine and a total of two doses of varicella vaccine. (e) Children attending any childcare facility must show evidence of protection against pneumococcal disease. (f) Children born on or after January 1, 2006 who are attending any childcare facility or school must have proof of protection against hepatitis A disease (vaccination or serology). (g) Requirements for hepatitis A, hepatitis B, measles, mumps, rubella, and varicella vaccines may be waived with serologic proof of immunity. Requirements for varicella vaccine may be waived also with a healthcare provider diagnosis of varicella disease or healthcare provider verification of history of varicella disease. (h) Effective July 1, 2014, children born on or after January 1, 2002 who are attending seventh grade, and children who are new entrants into a Georgia school in grades eight through twelve, must have received one dose of Tdap vaccine. (i) Effective July 1, 2014, children born on or after January 1, 2002 who are attending seventh grade, and children who are new entrants into a Georgia school in grades eight through twelve, must have received one dose of meningococcal conjugate vaccine. (j) Effective July 1, 2020, children sixteen years of age and older who are attending eleventh grade must receive a booster dose of meningococcal conjugate vaccine, unless their initial dose was administered on or after their sixteenth birthday. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The following standards are applicable to school-age children in all CCDF-eligible out-of-school programs and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. Out- of-school programs includes (1) day camps and (2) government-owned and operated providers. B. Bathrooms (1) Flush toilets and lavatories (hand washing sinks) with running water shall be provided in the following minimum ratios for the use of all children: Number of Children Toilets and Restrooms * 1-12 1 13-25 2 26-50 3 51-75 4 76-100 5 101-125 6 126-150 7 151-175 8 Each additional group of twenty-five (25) children shall require one (1) additional toilet and lavatory. * For children being potty-trained, at least one (1) flush toilet shall be provided. If used, nursery potty chairs may not be substituted for a required flush toilet. (2) Location of Bathrooms. Bathrooms shall be located on each floor in or adjacent to child care areas and rooms. (3) In lieu of the requirements set forth in subparagraphs (1) and (2) above, School-age only facilities shall provide at least one (1) toilet and (1) lavatory for each group of twenty-five (25) children on the premises. (4) Supplies. Bathrooms shall be within easy reach of children and equipped with soap, toilet tissue and single-use towels or cloth towels used only once between launderings. (5) Cleanliness. Bathrooms shall be cleaned daily with a disinfectant. F. Equipment and Toys (2) All equipment and furniture shall be used only by the age-appropriate group of children. Equipment and furniture shall be: (b) Kept clean; H. Hygiene (1) Handwashing, Children. Children's hands shall be washed with liquid soap and warm running water: (a) Upon arrival for care; (b) When moving from one child care group to another; (c) Upon re-entering the child care area after outside play; (d) Before and after eating meals and snacks, and handling or touching food; (e) After toileting and diapering; and (f) After playing in sand, touching animals or pets, and contact with bodily fluids, and after contamination by any other means. (2) Handwashing, Staff. Staff shall wash their hands with liquid soap and warm running water: (a) Before and after eating meals and snacks, and handling or touching food; (b) After diapering each child; and (c) After toileting or assisting children with toileting. J. Policies and Procedures (1) The Program shall establish and implement written policies and procedures that describe the Program's operations as follows: (a) The exclusion of children with contagious illness, (b) Notification of parents in the event their child becomes ill while at the facility, (c) The notification of all parents of enrolled children when a reportable contagious illness is present in the facility, (e) Emergency preparedness and response. A written plan for handling emergencies, including but not limited to severe weather, loss of electrical power or water and death, serious injury or loss of a child, a threatening event, or natural disaster which may occur at the program. The program will have in place procedures for evacuation, relocation, shelter-in-place, lock-down, communication and reunification with families, and continuity of operations. The plan must apply to all children in care and will include specific accommodation for infants and toddlers, children with disabilities, and children with chronic medical conditions. Such plan shall include assurance that no Personnel will impede in any way the delivery of emergency care or services to a child by licensed or certified emergency health care professionals, (f) The handling and appropriate disposal of bodily fluids and storage of hazardous materials (soiled clothing and bedding), L. Physical Plant (4) The Program and surrounding premises must be kept clean, free of debris and in good repair. Hygienic measures such as, but not limited to, screened windows and proper waste disposal procedures shall be utilized to minimize the presence of rodents, flies, roaches and other vermin at the Program. P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (a) The program's policies and procedures; (b) The portions of these standards dealing with the care, health and safety of children; (d) Reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; (g) The administration of medicine; (i) Hand washing; (l) Prevention of HIV/Aids and blood borne pathogens. (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (a) Prevention and control of infectious diseases; (c) Administration of medication, consistent with standards for parental consent; (h) Handling and storage of hazardous materials and the appropriate disposal of bio contaminants; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (i) Child development (e.g., developmental domains (cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; approaches to play and learning), discipline and guidance techniques, children with special needs); (ii) Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); (iv) Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). T. Required Reporting (1) The Administrator or designated person-in-charge shall report or cause to be reported the following incidents to the Department within twenty-four (24) hours or the next work day: b. Communicable Diseases. Any cases or suspected cases of notifiable communicable diseases (COVID-19, Tuberculosis, Measles, etc.) or any viruses or illnesses identified during a public health emergency, immediately to the Department and to the local County Health Department as required by the rules of the Georgia Department of Public Health, 511-2-1, Notification of Disease. d. Serious illness or injury requiring hospitalization or professional medical attention other than first aid of a child while in the care of the program. U. Diapering (1) Handwashing Sink. A hand washing sink with running heated water shall be located adjacent to the diapering area. (2) Diaper Changing Surface. If diapers are changed on a diaper changing table/surface, the surface shall be smooth, nonporous, and equipped with a guard or rails to prevent falls. Between each diaper change, the diaper change surface shall be cleaned with a disinfectant and dried with a single-use disposable towel. (3) Child Unattended on Diapering Area. Requires Staff to not leave infants or children unattended while being diapered or having their clothes changed on the diaper changing surface. (4) Location of Diapering Area. The area used for diapering shall not be used for food preparation. It must be clear of formulas, food, food utensils and food preparation items. CAPS Policy Manual 6.6 Child’s Immunization Requirements (1) Current immunizations are required for children to receive CAPS. (3) A Certificate of Immunization is required to be kept in the CAPS case record for all non-school aged children who are receiving care through an informal provider. DPH Rules and Regulations: Chapter 511-2-2.02 (a) Except as otherwise provided, immunization against the following diseases shall be required of all children entering a school or childcare facility operating in the state: (1) Diphtheria; (2) Haemophilus influenzae type B (not required on or after the fifth birthday); (3) Hepatitis A; (4) Hepatitis B; (5) Measles; (6) Meningitis; (7) Mumps; (8) Pertussis; (9) Pneumococcal disease (not required on or after the fifth birthday); (10) Poliomyelitis; (11) Rubella (German measles); (12) Tetanus; and (13) Varicella (chickenpox). (b) A parent or guardian must submit a valid Certificate of Immunization for any child entering a school or childcare facility in the state of Georgia for the first time. (c) School or childcare facility officials may allow a child without a valid certificate of immunization to attend for no more than 90 calendar days after the first day of attendance, provided that the parent or legal guardian either shows that that the child is in the process of completing required immunizations and that immunizations are being scheduled with the shortest intervals recommended in the current Official Immunization Schedules, or presents an affidavit of religious objection as provided in DPH Rule 511-2-2-.07. (d) Effective July 1, 2014, for entrance into Georgia school grades kindergarten through twelve, students must have a total of two doses of measles vaccine, two doses of mumps vaccine, one dose of rubella vaccine and a total of two doses of varicella vaccine. (e) Children attending any childcare facility must show evidence of protection against pneumococcal disease. (f) Children born on or after January 1, 2006 who are attending any childcare facility or school must have proof of protection against hepatitis A disease (vaccination or serology). (g) Requirements for hepatitis A, hepatitis B, measles, mumps, rubella, and varicella vaccines may be waived with serologic proof of immunity. Requirements for varicella vaccine may be waived also with a healthcare provider diagnosis of varicella disease or healthcare provider verification of history of varicella disease. (h) Effective July 1, 2014, children born on or after January 1, 2002 who are attending seventh grade, and children who are new entrants into a Georgia school in grades eight through twelve, must have received one dose of Tdap vaccine. (i) Effective July 1, 2014, children born on or after January 1, 2002 who are attending seventh grade, and children who are new entrants into a Georgia school in grades eight through twelve, must have received one dose of meningococcal conjugate vaccine. (j) Effective July 1, 2020, children sixteen years of age and older who are attending eleventh grade must receive a booster dose of meningococcal conjugate vaccine, unless their initial dose was administered on or after their sixteenth birthday. b. Provide the standards, appropriate to the provider setting and age of children, that address that children attending child care programs under CCDF are age-appropriately immunized, according to the latest recommendation for childhood immunizations of the respective State public health agency, for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed center care and are found in Rules and Regulations for Child Care Learning Centers. Children’s Records 591-1-1-.08(2) The file shall also contain evidence of age-appropriate immunizations or a signed affidavit against such immunizations. The items shall be maintained for each child enrolled in the Center on a form approved by the Department, and no child shall continue enrollment in the Center for more than thirty (30) days without such evidence. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school- age children in all CCDF-eligible licensed family child care homes and are found in Rules and Regulations for Family Child Care Learning Homes. Children’s Records 290-2-3-.08(2) Such records shall include evidence of age appropriate immunizations, or a signed affidavit certifying that the required immunizations conflict with the religious belief of the Parent or a physician statement that immunization is contraindicated. Evidence of immunizations or required documentation shall be on file for each Child upon admission to the Home or within 30 days thereafter. iii. All CCDF-eligible licensed in-home care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible regulated (but not licensed) informal in-home care providers and are found in the Health & Safety Standards for Informal Providers Appendix HH. C. Children’s Records (1) Informal Providers must maintain a file for each child while such child is in care and for a period of one (1) year after such child is no longer enrolled. The file shall contain emergency contact information including, but not limited to, the following: (d) Such records shall include evidence of age-appropriate immunizations, or a signed affidavit certifying that the required immunizations conflict with the religious belief of the Parent or a physician statement that immunization is contraindicated. Evidence of immunizations or required documentation shall be on file for each Child upon admission to the Provider or within 30 days thereafter. CAPS Policy Manual 6.6(1-5) Child’s Immunization Requirements (1) Current immunizations are required for children to receive CAPS. (2) A Certificate of Immunization is not required to be present in the CAPS record for children enrolled in school settings, children receiving Temporary Assistance for Needy Families (TANF), or children receiving care in licensed child care providers since these requirements are already met based on school/licensing and TANF requirements. (3) A Certificate of Immunization is required to be kept in the CAPS case record for all non-school aged children who are receiving care through an informal provider. (4) Families may receive an additional 45 calendar days to verify immunization requirements. The 45 calendar days granted will not postpone the eligibility determination. However, if immunization is not verified by the end of the 45-day period, the child for whom immunization cannot be verified will be determined ineligible for on-going child care assistance. (5) Exceptions to Immunizations Through Georgia law, the Department of Public Health allows for two types of exemptions from the immunization requirements: medical and religious. Each child must have one of two items on file either a valid Georgia Immunization Certificate (Form 3231) or a signed, notarized statement, which is called an affidavit of religious exemption. DPH Rules and Regulations: Chapter 511-2-2.02 (a) Except as otherwise provided, immunization against the following diseases shall be required of all children entering a school or childcare facility operating in the state: (1) Diphtheria; (2) Haemophilus influenzae type B (not required on or after the fifth birthday); (3) Hepatitis A; (4) Hepatitis B; (5) Measles; (6) Meningitis; (7) Mumps; (8) Pertussis; (9) Pneumococcal disease (not required on or after the fifth birthday); (10) Poliomyelitis; (11) Rubella (German measles); (12) Tetanus; and (13) Varicella (chickenpox). (b) A parent or guardian must submit a valid Certificate of Immunization for any child entering a school or childcare facility in the state of Georgia for the first time. (c) School or childcare facility officials may allow a child without a valid certificate of immunization to attend for no more than 90 calendar days after the first day of attendance, provided that the parent or legal guardian either shows that that the child is in the process of completing required immunizations and that immunizations are being scheduled with the shortest intervals recommended in the current Official Immunization Schedules, or presents an affidavit of religious objection as provided in DPH Rule 511-2-2-.07. (d) Effective July 1, 2014, for entrance into Georgia school grades kindergarten through twelve, students must have a total of two doses of measles vaccine, two doses of mumps vaccine, one dose of rubella vaccine and a total of two doses of varicella vaccine. (e) Children attending any childcare facility must show evidence of protection against pneumococcal disease. (f) Children born on or after January 1, 2006 who are attending any childcare facility or school must have proof of protection against hepatitis A disease (vaccination or serology). (g) Requirements for hepatitis A, hepatitis B, measles, mumps, rubella, and varicella vaccines may be waived with serologic proof of immunity. Requirements for varicella vaccine may be waived also with a healthcare provider diagnosis of varicella disease or healthcare provider verification of history of varicella disease. (h) Effective July 1, 2014, children born on or after January 1, 2002 who are attending seventh grade, and children who are new entrants into a Georgia school in grades eight through twelve, must have received one dose of Tdap vaccine. (i) Effective July 1, 2014, children born on or after January 1, 2002 who are attending seventh grade, and children who are new entrants into a Georgia school in grades eight through twelve, must have received one dose of meningococcal conjugate vaccine. (j) Effective July 1, 2020, children sixteen years of age and older who are attending eleventh grade must receive a booster dose of meningococcal conjugate vaccine, unless their initial dose was administered on or after their sixteenth birthday. [ ] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible license-exempt center care and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. C. Children’s Records (2) Requires the Program Staff to maintain a file for each child that includes evidence of age-appropriate immunizations or a signed affidavit against such immunizations for each child enrolled in the Program on a form approved by the Department, and to allow no child to continue enrollment in the Program for more than 30 days without such evidence. CAPS Policy Manual 6.6(1-5) Child’s Immunization Requirements (1) Current immunizations are required for children to receive CAPS. (2) A Certificate of Immunization is not required to be present in the CAPS record for children enrolled in school settings, children receiving Temporary Assistance for Needy Families (TANF), or children receiving care in licensed child care providers since these requirements are already met based on school/licensing and TANF requirements. (3) A Certificate of Immunization is required to be kept in the CAPS case record for all non-school aged children who are receiving care through an informal provider. (4) Families may receive an additional 45 calendar days to verify immunization requirements. The 45 calendar days granted will not postpone the eligibility determination. However, if immunization is not verified by the end of the 45-day period, the child for whom immunization cannot be verified will be determined ineligible for on-going child care assistance. (5) Exceptions to Immunizations Through Georgia law, the Department of Public Health allows for two types of exemptions from the immunization requirements: medical and religious. Each child must have one of two items on file either a valid Georgia Immunization Certificate (Form 3231) or a signed, notarized statement, which is called an affidavit of religious exemption. DPH Rules and Regulations: Chapter 511-2-2.02 (a) Except as otherwise provided, immunization against the following diseases shall be required of all children entering a school or childcare facility operating in the state: (1) Diphtheria; (2) Haemophilus influenzae type B (not required on or after the fifth birthday); (3) Hepatitis A; (4) Hepatitis B; (5) Measles; (6) Meningitis; (7) Mumps; (8) Pertussis; (9) Pneumococcal disease (not required on or after the fifth birthday); (10) Poliomyelitis; (11) Rubella (German measles); (12) Tetanus; and (13) Varicella (chickenpox). (b) A parent or guardian must submit a valid Certificate of Immunization for any child entering a school or childcare facility in the state of Georgia for the first time. (c) School or childcare facility officials may allow a child without a valid certificate of immunization to attend for no more than 90 calendar days after the first day of attendance, provided that the parent or legal guardian either shows that that the child is in the process of completing required immunizations and that immunizations are being scheduled with the shortest intervals recommended in the current Official Immunization Schedules, or presents an affidavit of religious objection as provided in DPH Rule 511-2-2-.07. (d) Effective July 1, 2014, for entrance into Georgia school grades kindergarten through twelve, students must have a total of two doses of measles vaccine, two doses of mumps vaccine, one dose of rubella vaccine and a total of two doses of varicella vaccine. (e) Children attending any childcare facility must show evidence of protection against pneumococcal disease. (f) Children born on or after January 1, 2006 who are attending any childcare facility or school must have proof of protection against hepatitis A disease (vaccination or serology). (g) Requirements for hepatitis A, hepatitis B, measles, mumps, rubella, and varicella vaccines may be waived with serologic proof of immunity. Requirements for varicella vaccine may be waived also with a healthcare provider diagnosis of varicella disease or healthcare provider verification of history of varicella disease. (h) Effective July 1, 2014, children born on or after January 1, 2002 who are attending seventh grade, and children who are new entrants into a Georgia school in grades eight through twelve, must have received one dose of Tdap vaccine. (i) Effective July 1, 2014, children born on or after January 1, 2002 who are attending seventh grade, and children who are new entrants into a Georgia school in grades eight through twelve, must have received one dose of meningococcal conjugate vaccine. (j) Effective July 1, 2020, children sixteen years of age and older who are attending eleventh grade must receive a booster dose of meningococcal conjugate vaccine, unless their initial dose was administered on or after their sixteenth birthday. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The following standards are applicable to school-age children in all CCDF-eligible out-of-school programs and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. Out- of-school programs includes (1) day camps and (2) government-owned and operated providers. C. Children’s Records (2) Requires the Program Staff to maintain a file for each child that includes evidence of age-appropriate immunizations or a signed affidavit against such immunizations for each child enrolled in the Program on a form approved by the Department, and to allow no child to continue enrollment in the Program for more than 30 days without such evidence. CAPS Policy Manual 6.6(1-5) Child’s Immunization Requirements (1) Current immunizations are required for children to receive CAPS. (2) A Certificate of Immunization is not required to be present in the CAPS record for children enrolled in school settings, children receiving Temporary Assistance for Needy Families (TANF), or children receiving care in licensed child care providers since these requirements are already met based on school/licensing and TANF requirements. (3) A Certificate of Immunization is required to be kept in the CAPS case record for all non-school aged children who are receiving care through an informal provider. Families may receive an additional 45 calendar days to verify immunization requirements. The 45 calendar days granted will not postpone the eligibility determination. However, if immunization is not verified by the end of the 45-day period, the child for whom immunization cannot be verified will be determined ineligible for on-going child care assistance. (5) Exceptions to Immunizations Through Georgia law, the Department of Public Health allows for two types of exemptions from the immunization requirements: medical and religious. Each child must have one of two items on file either a valid Georgia Immunization Certificate (Form 3231) or a signed, notarized statement, which is called an affidavit of religious exemption. DPH Rules and Regulations: Chapter 511-2-2.02 (a) Except as otherwise provided, immunization against the following diseases shall be required of all children entering a school or childcare facility operating in the state: (1) Diphtheria; (2) Haemophilus influenzae type B (not required on or after the fifth birthday); (3) Hepatitis A; (4) Hepatitis B; (5) Measles; (6) Meningitis; (7) Mumps; (8) Pertussis; (9) Pneumococcal disease (not required on or after the fifth birthday); (10) Poliomyelitis; (11) Rubella (German measles); (12) Tetanus; and (13) Varicella (chickenpox). (b) A parent or guardian must submit a valid Certificate of Immunization for any child entering a school or childcare facility in the state of Georgia for the first time. (c) School or childcare facility officials may allow a child without a valid certificate of immunization to attend for no more than 90 calendar days after the first day of attendance, provided that the parent or legal guardian either shows that that the child is in the process of completing required immunizations and that immunizations are being scheduled with the shortest intervals recommended in the current Official Immunization Schedules, or presents an affidavit of religious objection as provided in DPH Rule 511-2-2-.07. (d) Effective July 1, 2014, for entrance into Georgia school grades kindergarten through twelve, students must have a total of two doses of measles vaccine, two doses of mumps vaccine, one dose of rubella vaccine and a total of two doses of varicella vaccine. (e) Children attending any childcare facility must show evidence of protection against pneumococcal disease. (f) Children born on or after January 1, 2006 who are attending any childcare facility or school must have proof of protection against hepatitis A disease (vaccination or serology). (g) Requirements for hepatitis A, hepatitis B, measles, mumps, rubella, and varicella vaccines may be waived with serologic proof of immunity. Requirements for varicella vaccine may be waived also with a healthcare provider diagnosis of varicella disease or healthcare provider verification of history of varicella disease. (h) Effective July 1, 2014, children born on or after January 1, 2002 who are attending seventh grade, and children who are new entrants into a Georgia school in grades eight through twelve, must have received one dose of Tdap vaccine. (i) Effective July 1, 2014, children born on or after January 1, 2002 who are attending seventh grade, and children who are new entrants into a Georgia school in grades eight through twelve, must have received one dose of meningococcal conjugate vaccine. (j) Effective July 1, 2020, children sixteen years of age and older who are attending eleventh grade must receive a booster dose of meningococcal conjugate vaccine, unless their initial dose was administered on or after their sixteenth birthday. 5.3.2 Prevention of sudden infant death syndrome and the use of safe-sleep practices health and safety standard Provide the standards, appropriate to the provider setting and age of children, that address the prevention of sudden infant death syndrome and use of safe sleeping practices for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed center care and are found in Rules and Regulations for Child Care Learning Centers. Operational Policies and Procedures 591-1-1-.21(1)(q) The policies and procedures shall include the following: A description of the safe sleep practices followed by the Center that includes the following information: the initial placement of infants on their backs to sleep; no cover or other soft items in crib; appropriate sleep clothing for infants to be provided by Parent; individual crib, cot or mat and bedding provided and changing and cleaning practices for these items; infants who fall asleep in other equipment, on the floor or elsewhere will be moved to a crib to sleep; and no swaddling or positioning devices used. 591-1-1-.21(2) The Center shall have written documentation signed by the Parent(s) in each child's file that the Director or designee has: provided to the Parent(s) a copy of the Center's policies and procedures required by this rule; advised the Parent(s) of the safe sleep practices followed by the Center; advised the Parent(s) of the child's progress, issues relating to the child's care and individual practices concerning the child's special needs; and encouraged participation by Parent(s) in Center activities. Safe Sleeping and Resting Equipment 591-1-1-.30(1)(a)(1-3) Sleeping and Resting Equipment. (a) Cribs. A crib that is safety approved in compliance with Consumer Product Safety Commission (CPSC) and American Society of Testing and Materials International (ASTM) safety standards shall be provided for each infant. ("Infant" refers to any child under the age of twelve (12) months or any child who is under eighteen (18) months of age who is not walking.) 1. Crib Construction. Cribs shall be in good repair and free of hazards. Stack cribs and cribs with drop sides shall not be used. 2. Crib Mattress. A mattress shall be provided for each crib and shall be firm, tight-fitting without gaps, at least two inches (2") thick and covered with waterproof, washable material. Before a change of occupant, each mattress shall be cleaned with a disinfectant. 3. Crib Sheet. Each crib shall have only an individual, tight-fitting sheet which is changed daily or more often as needed and prior to a change of occupant. 591-1-1-.30(2) Sleeping and Resting Environment for Infants. A Center shall provide a safe sleep environment in accordance with American Academy of Pediatrics (AAP), Consumer Product Safety Commission (CPSC) and American Society for Testing and Materials (ASTM) recommendations as listed in these rules for all infants. Center Staff shall place an infant to sleep on the infant's back unless the Parent has provided a physician's written statement authorizing another sleep position for that particular infant that includes how the infant shall be placed to sleep and a time frame that the instructions are to be followed. When an infant can easily turn over from back to front and back again, Staff shall continue to put the infant to sleep initially on the infant's back but allow the infant to roll over into his or her preferred position and not re-position the infant. Sleepers, sleep sacks and wearable blankets that fit according to the commercial manufacturer's guidelines and will not slide up around the infant's face may be used when necessary for the comfort of the sleeping infant, however swaddling shall not be used unless the Center has been provided a physician's written statement authorizing its use for a particular infant that includes instructions and a time frame for swaddling the infant. Staff shall not place objects or allow objects to be placed in or on the crib with an infant such as but not limited to toys, pillows, quilts, comforters, bumper pads, sheepskins, stuffed toys, or other soft items and shall not attach objects or allow objects to be attached to a crib with a sleeping infant such as but not limited to crib gyms, toys, mirrors and mobiles. 591-1-1-.30(2)(a-c) (a) Center shall maintain the infant's sleeping area to be comfortable for a lightly clothed adult within a temperature range of sixty-five (65) to eighty-five (85) degrees depending upon the season. There shall be lighting adequate to see each sleeping infant's face to view the color of the infant's skin and check on the infant's breathing. (b) Wedges, other infant positioning devices and monitors shall not be used unless the Parent provides a physician's written statement authorizing its use that includes how to use the device and a time frame for using the device is provided for that particular infant. (c) Infants shall not sleep in equipment other than safety-approved cribs, such as, but not limited to, a car safety seat, bouncy seat, highchair, or swing. Infants who arrive at the Center asleep or fall asleep in such equipment, on the floor or elsewhere, shall be transferred to a safety-approved crib. Staff Training 591-1-1-.33(1) Center Orientation. Prior to assignment to children or task, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial Center orientation. 591-1-1-.33(2) The initial Center orientation must include the following subjects: (a) the Center's policies and procedures; (b) the portions of these rules dealing with the care, health and safety of children; (i) reducing the risk of Sudden Unexpected Infant Death (SUID), which includes Sudden Infant Death Syndrome (SIDS); 591-1-1-.33(3) Health and Safety Orientation. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (b) prevention of sudden infant death syndrome and use of safe sleeping practices; 591-1-1-.33(5) Annual Training. (a) Every calendar year after the first year of employment, all supervisory and caregiver Personnel, except independent contractors, Students-in-Training and volunteers, shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department- approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); ii. All CCDF-eligible licensed family child care homes. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school- age children in all CCDF-eligible licensed family child care homes and are found in Rules and Regulations for Family Child Care Learning Homes. Staffing & Supervision 290-2-3-.07(5) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. 290-2-3-.07(6) The initial program orientation must include the following subjects: (a) the Home's policies and procedures; (b) the portions of these rules dealing with the care, health and safety of children; (j) reducing the risk of Sudden Unexpected Infant Death (SUID) which includes Sudden 290-2-3-.07(7) Health and Safety Orientation. The Provider, Employees and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (b) prevention of sudden infant death syndrome and use of safe sleeping practices; 290-2-3-.07(9) Annual Training. (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); Children’s Records 290-2-3-.08(8)(b)(16) Policies and Procedures. Each Family Child Care Learning Home shall establish policies and procedures, which shall be kept current, be consistent with applicable laws, including but not limited to the Americans with Disabilities Act, regulations and these rules, made available to the Parents, and used to govern the operations of the Family Child Care Learning Home. The policies and procedures shall also include written procedures for the following: Notification of infant sleep position practices. The Provider must notify Parent(s) of Sudden Infant Death Syndrome (SIDS) risk reduction practices, sleep positioning policies, and arrangements for placing all infants on their backs for sleep. Safe Sleeping and Resting Requirements 290-2-3-.19(1)(a)(1-3) Sleeping and Resting Equipment. (a) Cribs and Other Approved Sleep Equipment. The Home shall provide either a safety approved crib or other equipment that is approved for infant sleep for each infant who cannot climb out of the crib or other approved equipment. Each crib shall be safety approved in compliance with Consumer Product Safety Commission (CPSC) and American Society of Testing and Materials International (ASTM) safety standards; any other equipment, such as, but not limited to, a portable crib, playpen, play yard or bassinet, shall be in compliance with current ASTM Standard Consumer Safety Specifications for Non-Full-Size Baby Cribs/Play Yards. ("Infant" refers to any child under the age of twelve (12) months or any child who is under eighteen (18) months of age who is not walking.) 1. Crib Construction. Cribs and other equipment approved for infant sleep shall be in good repair and free of hazards. Stack cribs and cribs with drop sides shall not be used. 2. Crib Mattress. A mattress shall be provided for each crib and other equipment approved for infant sleep and shall be firm, tight-fitting, at least two inches (2") thick and covered with waterproof, washable material. Before a change of occupant, each mattress shall be cleaned with a disinfectant. 3. Crib Sheet. Each crib and other equipment approved for infant sleep shall have only an individual, tight-fitting sheet which is changed daily or more often as needed and prior to a change of occupant. 290-2-3-.19(2)(a-c) Environment. A Family Child Care Learning Home shall provide a safe sleep environment in accordance with American Academy of Pediatrics (AAP), Consumer Product Safety Commission (CPSC) and American Society for Testing and Materials (ASTM) recommendations as listed in these rules for all infants and one-year-old children when placed for sleep in a safety approved crib or in any other type of equipment approved for infant sleep. Staff shall place an infant to sleep on the infant's back unless the Parent has provided a physician's written statement authorizing another sleep position for that particular infant that includes how the infant shall be placed to sleep and a time frame that the instructions are to be followed. When an infant can easily turn over from back to front and back again, Staff shall continue to put the infant to sleep initially on the infant's back, but allow the infant to roll over into his or her preferred position and not re-position the infant. Sleepers, sleep sacks and wearable blankets that fit according to the commercial manufacturer's guidelines and will not slide up around the infant's face may be used when necessary for the comfort of the sleeping infant, however swaddling shall not be used unless the Home has been provided a physician's written statement authorizing its use for a particular infant that includes instructions and a time frame for swaddling the infant. Staff shall not place objects or allow objects to be placed in or on the crib with an infant such as but not limited to toys, pillows, quilts, comforters, bumper pads, sheepskins, stuffed toys, or other soft items and shall not attach objects or allow objects to be attached to a crib with a sleeping infant such as but not limited to crib gyms, toys, mirrors and mobiles. (a) The Home shall maintain the infant's sleeping area to be comfortable for a lightly clothed adult within a temperature range of sixty-five (65) to eighty-five (85) degrees depending upon the season. There shall be lighting adequate to see each sleeping infant's face to view the color of the infant's skin and check on the infant's breathing. (b) Wedges, other infant positioning devices and monitors shall not be used unless the Parent provides a physician's written statement authorizing its use that includes how to use the device and a time frame for using the device for that particular infant. (c) Infants shall only sleep in a safety approved crib or other equipment approved for infant sleep as described in 290-2-3-.19 (1)(a) and shall not sleep in any other equipment, such as, but not limited to, a car safety seat, bouncy seat, highchair, or swing. Infants who arrive at the facility asleep or fall asleep in such equipment or on the floor shall be transferred to a safety approved crib or other equipment approved for infant sleep. iii. All CCDF-eligible licensed in-home care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible regulated (but not licensed) informal in-home care providers and are found in the Health & Safety Standards for Informal Providers Appendix HH. O. Staff Training (1) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. The initial program orientation must include the following subjects: the program's policies and procedures; the portions of these rules dealing with the care, health and safety of children; the Staff person’s assigned duties and responsibilities; reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; emergency weather plans; the program’s emergency preparedness plan; childhood injury control; the administration of medicine; reducing the risk of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS); hand washing; fire safety; water safety; and prevention of HIV/AIDS and blood borne pathogens. (2) Health and Safety Orientation. Each Informal Provider, Employees, and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required annual training hours. The training must address the following health and safety topics: (b) Prevention of sudden infant death syndrome and use of safe sleeping practices; (3) Ongoing Training (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of diverse training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: iii. Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); U. Safe Sleep Requirements (1) Cribs. A crib and other approved sleep equipment that are safety approved in compliance with Consumer Product Safety Commission (CPSC) and American Society of Testing and Materials International (ASTM) safety standards shall be provided for each infant. (￿Infant￿ refers to any child under the age of twelve (12) months or any child who is under eighteen (18) months of age who is not walking.) (2) Crib Mattress. A mattress shall be provided for each crib and shall be firm, tight-fitting without gaps, at least two inches (2") thick and covered with waterproof, washable material. Before a change of occupant, each mattress shall be cleaned with a disinfectant. (3) Crib Sheet. Each crib shall have only an individual, tight-fitting sheet which is changed daily or more often as needed and prior to a change of occupant. (4) Infant Sleep Position. Informal Provider shall place an infant to sleep on the infant’s back in a crib unless the Provider has been provided a physician’s written statement authorizing another sleep position for that particular infant that includes how the infant shall be placed to sleep and a time frame that the instructions are to be followed. (5) The Provider shall provide a safe sleep environment in accordance with the American Academy of Pediatrics (AAP), Consumer Product Safety Commission (CPSC) and American Society for Testing and Materials (ASTM). Sleepers, sleep sacks and wearable blankets that fit according to the commercial manufacturer’s guidelines and will not slide up around the infant’s face may be used when necessary for the comfort of the sleeping infant. Swaddling shall not be used unless the Provider has been provided a physician’s written statement authorizing its use for a particular infant that includes instructions and a time frame for swaddling the infant. The Provider shall not place objects or allow objects to be placed in or on the crib with an infant such as but not limited to toys, pillows, quilts, comforters, bumper pads, sheepskins, stuffed toys, or other soft items and shall not attach objects or allow objects to be attached to a crib with a sleeping infant, such as, but not limited to, crib gyms, toys, mirrors and mobile. [ ] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible license-exempt center care and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (a) The program's policies and procedures; (b) The portions of these standards dealing with the care, health and safety of children; (h) Reducing the risk of Sudden Unexpected Infant Death (SUID), which includes Sudden Infant Death Syndrome (SIDS); (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (b) Prevention of sudden infant death syndrome and use of safe sleeping practices; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); V. Safe Sleep Requirements. (1) Cribs. A crib that is safety approved in compliance with Consumer Product Safety Commission (CPSC) and American Society of Testing and Materials International (ASTM) safety standards shall be provided for each infant. (￿Infant￿ refers to any child under the age of twelve (12) months or any child who is under eighteen (18) months of age who is not walking.) (2) Crib Mattress. A mattress shall be provided for each crib and shall be firm, tight-fitting without gaps, at least two inches (2") thick and covered with waterproof, washable material. Before a change of occupant, each mattress shall be cleaned with a disinfectant. (3) Crib Sheet. Each crib shall have only an individual, tight-fitting sheet which is changed daily or more often as needed and prior to a change of occupant. (4) Infant Sleep Position. The Program shall provide a safe sleep environment in accordance with American Academy of Pediatrics (AAP), Consumer Product Safety Commission (CPSC) and American Society for Testing and Materials (ASTM) recommendations as listed in these standards for all infants. Program Staff shall place an infant to sleep on the infant’s back in a crib unless the Program has been provided a physician’s written statement authorizing another sleep position for that particular infant that includes how the infant shall be placed to sleep and a time frame that the instructions are to be followed. When an infant can easily turn over from back to front and back again, Staff shall continue to put the infant to sleep initially on the infant’s back but allow the infant to roll over into his or her preferred position and not re-position the infant. Sleepers, sleep sacks and wearable blankets that fit according to the commercial manufacturer’s guidelines and will not slide up around the infant’s face may be used when necessary for the comfort of the sleeping infant. Swaddling shall not be used unless the Program has been provided a physician’s written statement authorizing its use for a particular infant that includes instructions and a time frame for swaddling the infant. (5) Objects in Cribs. Staff shall not place objects or allow objects to be placed in or on the crib with an infant such as but not limited to toys, pillows, quilts, comforters, bumper pads, sheepskins, stuffed toys, or other soft items. Staff shall not attach objects or allow objects to be attached to a crib with a sleeping infant, such as, but not limited to, crib gyms, toys, mirrors and mobiles v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The following standards are applicable to school-age children in all CCDF-eligible out-of-school programs and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. Out- of-school programs includes (1) day camps and (2) government-owned and operated providers. P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (a) The program's policies and procedures; (b) The portions of these standards dealing with the care, health and safety of children; (h) Reducing the risk of Sudden Unexpected Infant Death (SUID), which includes Sudden Infant Death Syndrome (SIDS); (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (b) Prevention of sudden infant death syndrome and use of safe sleeping practices; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); 5.3.3 Administration of medication, consistent with standards for parental consent health and safety standard a. Provide the standards, appropriate to the provider setting and age of children, that address the administration of medication for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed center care and are found in Rules and Regulations for Child Care Learning Centers Discipline 591-1-1-.11(2) Personnel shall not: physically or sexually abuse a child or engage or permit others to engage in sexually overt conduct in the presence of any child enrolled in the Center; inflict corporal/physical punishment upon a child; shake, jerk, pinch or handle a child roughly; verbally abuse or humiliate a child which includes, but is not limited to, the use of threats, profanity or belittling remarks about a child or his family; isolate a child in a dark room, closet or unsupervised area; use mechanical or physical restraints or devices to discipline children; use medication to discipline or control children's behavior without written medical authorization issued by a licensed professional and given with the parent's written consent; restrict unreasonably a child from going to the bathroom; punish toileting accidents; force-feed a child or withhold feeding a child regularly scheduled meals and/or snacks; force or withhold naps; allow children to discipline or humiliate other children; and confine a child for disciplinary purposes to a swing, highchair, infant carrier, walker or jumpseat. Medications 591-1-1-.20(2) Dispensing Medication. Written authorization to dispense medications shall be limited to two (2) weeks unless otherwise prescribed by a physician or authorized under Georgia law. Medication shall only be dispensed out of its original container which must be labeled with the child's name or as authorized under Georgia law. 591-1-1-.20(3) Dispensing Records. The Center shall maintain a record of all medications dispensed to children by Personnel to include the date, time and amount of medication that was administered; any noticeable adverse reactions to the medication; and the signature or initials of the person administering the medication. 591-1-1-.20(5) Unused Medication. Medicines which are no longer to be dispensed shall be returned to the child's Parent(s) immediately. 591-1-1-.20(6) Non-Emergency Injections. Non-emergency injections shall only be administered by appropriately licensed persons unless the Parent and physician of the child sign a written authorization for the child to self-administer the injection. Operational Policies and Procedures 591-1-1-.21(1)(e) A Center shall establish and implement written policies and procedures which shall be kept current, be consistent with applicable laws, regulations and these rules, made available to the Parent(s) and used to govern the operations of the Center. (1) The policies and procedures shall include the following: A description of handling administration of medication (see rule .20 about medications), and notifying Parent(s) of noticeable adverse reactions to prescribed medications; Staff Training 591-1-1-.33(2) The initial Center orientation must include the following subjects: (a) the Center's policies and procedures; (b) the portions of these rules dealing with the care, health and safety of children; (h) the administration of medicine; 591-1-1-.33(3)Health and Safety Orientation. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (c) administration of medication, consistent with standards for parental consent; 591-1-1-.33(5)Annual Training. (a) Every calendar year after the first year of employment, all supervisory and caregiver Personnel, except independent contractors, Students-in-Training and volunteers, shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department- approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); ii. All CCDF-eligible licensed family child care homes. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school- age children in all CCDF-eligible licensed family child care homes and are found in Rules and Regulations for Family Child Care Learning Homes. Staffing & Supervision 290-2-3-.07(5) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. 290-2-3-.07(6) The initial program orientation must include the following subjects: (a) the Home's policies and procedures; (b) the portions of these rules dealing with the care, health and safety of children; (i) the administration of medicine; 290-2-3-.07(7) Health and Safety Orientation. The Provider, Employees and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (c) administration of medication, consistent with standards for parental consent; 290-2-3-.07(9) Annual Training. (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); Children’s Records 290-2-3-.08(5) Such records shall include documentation of any medications given as required by these rules. 290-2-3-.08(8)(b)(3) Policies and Procedures. Each Family Child Care Learning Home shall establish policies and procedures, which shall be kept current, be consistent with applicable laws, including but not limited to the Americans with Disabilities Act, regulations and these rules, made available to the Parents, and used to govern the operations of the Family Child Care Learning Home. The policies and procedures shall also include written procedures for the following: Administering medication and recording noticeable adverse reactions to medication. 290-2-3-.08(8)(b)(5) Policies and Procedures. Each Family Child Care Learning Home shall establish policies and procedures, which shall be kept current, be consistent with applicable laws, including but not limited to the Americans with Disabilities Act, regulations and these rules, made available to the Parents, and used to govern the operations of the Family Child Care Learning Home. The policies and procedures shall also include written procedures for the following: Noticeable adverse reaction to medication(s). Health, Safety, and Discipline 290-2-3-.11(1)(b) Health. Parental Notification. Parents must be notified of incidents, illnesses, or injuries as follows: Immediately notify Parent(s) and obtain specific instructions until child can be picked up or returned to group: When professional medical attention is required, or When child experiences symptoms of moderate discomfort such as elevated temperature, vomiting or diarrhea, or When child is involved in an incident that puts their health and/or safety at risk (e.g., missing from program, left on vehicle, escaped from building/playground, etc.) Notify Parent(s) by the end of the day: When professional medical attention is not required, or When child experiences symptoms of less than moderate discomfort, or When child experiences an adverse reaction to prescribed medication which does not constitute moderate discomfort. 290-2-3-.11(1)(d) Health. Except for first aid and as authorized under Georgia law, personnel shall not dispense prescription or nonprescription medications to a Child without specific written authorization from the Child's physician or Parent. All medications shall be stored as authorized under Georgia law or in accordance with the prescription or label instructions and kept in places that are inaccessible to children. Each dose of medication given to a Child shall be documented showing the Child's name, name of medication, date and time given, and the name of the person giving the medication. 290-2-3-.11(3)(a) Discipline. Disciplinary actions used to correct a Child's behavior, guidance techniques and any activities in which the Children participate or observe at the Home shall not be detrimental to the physical or mental health of any child. (a) A Provider or a Home's Provisional Employees or Employees shall not: physically or sexually abuse a child, or engage in or permit others to engage in sexually overt conduct in the presence of any Child enrolled in the Home; inflict corporal/physical punishment upon a Child; shake, jerk, pinch or handle roughly a Child; verbally abuse or humiliate a Child which includes, but is not limited to, the use of threats, profanity, or belittling remarks about a Child or his family; isolate a Child in a dark room, closet, or unsupervised area; use mechanical or physical restraints or devices to discipline Children; use medication to discipline a Child or to control Children's behavior without written medical authorization issued by a licensed professional and given with the Parent's written consent; or discipline a Child by unreasonably restricting a Child from going to the bathroom; or by punishing toileting accidents; or by force feeding a Child; or by not feeding a Child regularly scheduled meals and/or snacks; or by forcing or withholding naps; or by allowing children to discipline or humiliate other Children; or by confining a Child for disciplinary purposes to a swing, high chair, infant carrier, walker or jump seat. iii. All CCDF-eligible licensed in-home care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible regulated (but not licensed) informal in-home care providers and are found in the Health & Safety Standards for Informal Providers Appendix HH. E. Discipline (1) Disciplinary actions used to correct a child's behavior, guidance techniques and any activities in which the children participate or observe at the program shall not be detrimental to the physical or mental health of any child. (2) Personnel shall not: (g) Use medication to discipline or control children's behavior without written medical authorization issued by a licensed professional and given with the parent's written consent; I. Medications (1) Parental Authorization. Except for first aid or as authorized under Georgia law, Personnel shall not dispense prescription or non-prescription medications to a child without specific written authorization from the child's physician or parent. Such authorization will include when applicable, date; full name of the child; name of the medication; prescription number, if any; dosage; the dates to be given; the time of day to be dispensed; and signature of parent. (2) Dispensing Records. The Informal Provider shall maintain a record of all medications dispensed to children by Personnel to include the date, time and amount of medication that was administered; any noticeable adverse reactions to the medication; and the signature or initials of the person administering the medication. (3) Storage. Medications shall be kept in a locked storage cabinet or container which is not accessible to the children and stored separate from cleaning chemicals, supplies or poisons. Medications requiring refrigeration shall be placed in a leakproof container in a refrigerator that is not accessible to the children. O. Staff Training (1) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. The initial program orientation must include the following subjects: the program's policies and procedures; the portions of these rules dealing with the care, health and safety of children; the Staff person’s assigned duties and responsibilities; reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; emergency weather plans; the program’s emergency preparedness plan; childhood injury control; the administration of medicine; reducing the risk of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS); hand washing; fire safety; water safety; and prevention of HIV/AIDS and blood borne pathogens. (2) Health and Safety Orientation. Each Informal Provider, Employees, and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required annual training hours. The training must address the following health and safety topics: (c) Administration of medication, consistent with standards for parental consent; (3) Ongoing Training (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: iii. Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); [ ] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible license-exempt center care and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. E. Discipline (1) Disciplinary actions used to correct a child's behavior, guidance techniques and any activities in which the children participate or observe at the program shall not be detrimental to the physical or mental health of any child. (2) Personnel shall not: (g) Use medication to discipline or control children's behavior without written medical authorization issued by a licensed professional and given with the parent's written consent; I. Medications (1) Parental Authorization. Except for first aid or as authorized under Georgia law, Personnel shall not dispense prescription or non-prescription medications to a child without specific written authorization from the child's physician or parent. Such authorization will include when applicable, date; full name of the child; name of the medication; prescription number, if any; dosage; the dates to be given; the time of day to be dispensed; and signature of parent. (2) Dispensing Records. The program shall maintain a record of all medications dispensed to children by Personnel to include the date, time and amount of medication that was administered; any noticeable adverse reactions to the medication; and the signature or initials of the person administering the medication. (3) Storage. Medications shall be kept in a locked storage cabinet or container which is not accessible to the children and stored separate from cleaning chemicals, supplies or poisons. Medications requiring refrigeration shall be placed in a leakproof container in a refrigerator that is not accessible to the children. P. Staff Training. (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (a) The program's policies and procedures; (b) The portions of these standards dealing with the care, health and safety of children; (g) The administration of medicine; (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (c) Administration of medication, consistent with standards for parental consent; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The following standards are applicable to school-age children in all CCDF-eligible out-of-school programs and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. Out- of-school programs includes (1) day camps and (2) government-owned and operated providers. E. Discipline (1) Disciplinary actions used to correct a child's behavior, guidance techniques and any activities in which the children participate or observe at the program shall not be detrimental to the physical or mental health of any child. (2) Personnel shall not: (g) Use medication to discipline or control children's behavior without written medical authorization issued by a licensed professional and given with the parent's written consent; I. Medications (1) Parental Authorization. Except for first aid or as authorized under Georgia law, Personnel shall not dispense prescription or non-prescription medications to a child without specific written authorization from the child's physician or parent. Such authorization will include when applicable, date; full name of the child; name of the medication; prescription number, if any; dosage; the dates to be given; the time of day to be dispensed; and signature of parent. (2) Dispensing Records. The program shall maintain a record of all medications dispensed to children by Personnel to include the date, time and amount of medication that was administered; any noticeable adverse reactions to the medication; and the signature or initials of the person administering the medication. (3) Storage. Medications shall be kept in a locked storage cabinet or container which is not accessible to the children and stored separate from cleaning chemicals, supplies or poisons. Medications requiring refrigeration shall be placed in a leakproof container in a refrigerator that is not accessible to the children. P. Staff Training. (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (a) The program's policies and procedures; (b) The portions of these standards dealing with the care, health and safety of children; (g) The administration of medicine; (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (c) Administration of medication, consistent with standards for parental consent; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); b. Provide the standards, appropriate to the provider setting and age of children, that address obtaining permission from parents to administer medications to children for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed center care and are found in Rules and Regulations for Child Care Learning Centers. Discipline 591-1-1-.11(2) Personnel shall not: physically or sexually abuse a child or engage or permit others to engage in sexually overt conduct in the presence of any child enrolled in the Center; inflict corporal/physical punishment upon a child; shake, jerk, pinch or handle a child roughly; verbally abuse or humiliate a child which includes, but is not limited to, the use of threats, profanity or belittling remarks about a child or his family; isolate a child in a dark room, closet or unsupervised area; use mechanical or physical restraints or devices to discipline children; use medication to discipline or control children's behavior without written medical authorization issued by a licensed professional and given with the parent's written consent; restrict unreasonably a child from going to the bathroom; punish toileting accidents; force-feed a child or withhold feeding a child regularly scheduled meals and/or snacks; force or withhold naps; allow children to discipline or humiliate other children; and confine a child for disciplinary purposes to a swing, highchair, infant carrier, walker or jumpseat. Medications 591-1-1-.20(1) Parental Authorization. Except for first aid or as authorized under Georgia law, Personnel shall not dispense prescription or non-prescription medications to a child without specific written authorization from the child's physician or Parent. Such authorization will include when applicable, date; full name of the child; name of the medication; prescription number, if any; dosage; the dates to be given; the time of day to be dispensed; and signature of Parent. 591-1-1-.20(6) Non-Emergency Injections. Non-emergency injections shall only be administered by appropriately licensed persons unless the Parent and physician of the child sign a written authorization for the child to self-administer the injection. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school- age children in all CCDF-eligible licensed family child care homes and are found in Rules and Regulations for Family Child Care Learning Homes. Health, Safety, and Discipline 290-2-3-.11(1)(d) Except for first aid and as authorized under Georgia law, personnel shall not dispense prescription or nonprescription medications to a Child without specific written authorization from the Child's physician or Parent. All medications shall be stored as authorized under Georgia law or in accordance with the prescription or label instructions and kept in places that are inaccessible to children. Each dose of medication given to a Child shall be documented showing the Child's name, name of medication, date and time given, and the name of the person giving the medication. 290-2-3-.11(3)(a) Discipline. Disciplinary actions used to correct a Child's behavior, guidance techniques and any activities in which the Children participate or observe at the Home shall not be detrimental to the physical or mental health of any child. (a) A Provider or a Home's Provisional Employees or Employees shall not: physically or sexually abuse a child, or engage in or permit others to engage in sexually overt conduct in the presence of any Child enrolled in the Home; inflict corporal/physical punishment upon a Child; shake, jerk, pinch or handle roughly a Child; verbally abuse or humiliate a Child which includes, but is not limited to, the use of threats, profanity, or belittling remarks about a Child or his family; isolate a Child in a dark room, closet, or unsupervised area; use mechanical or physical restraints or devices to discipline Children; use medication to discipline a Child or to control Children's behavior without written medical authorization issued by a licensed professional and given with the Parent's written consent; or discipline a Child by unreasonably restricting a Child from going to the bathroom; or by punishing toileting accidents; or by force feeding a Child; or by not feeding a Child regularly scheduled meals and/or snacks; or by forcing or withholding naps; or by allowing children to discipline or humiliate other Children; or by confining a Child for disciplinary purposes to a swing, high chair, infant carrier, walker or jump seat. iii. All CCDF-eligible licensed in-home care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible regulated (but not licensed) informal in-home care providers and are found in the Health & Safety Standards for Informal Providers Appendix HH. E. Discipline (1) Disciplinary actions used to correct a child's behavior, guidance techniques and any activities in which the children participate or observe at the program shall not be detrimental to the physical or mental health of any child. (2) Personnel shall not: (g) Use medication to discipline or control children's behavior without written medical authorization issued by a licensed professional and given with the parent's written consent; I. Medications (1) Parental Authorization. Except for first aid or as authorized under Georgia law, Personnel shall not dispense prescription or non-prescription medications to a child without specific written authorization from the child's physician or parent. Such authorization will include when applicable, date; full name of the child; name of the medication; prescription number, if any; dosage; the dates to be given; the time of day to be dispensed; and signature of parent. [ ]Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible license-exempt center care and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. E. Discipline (1) Disciplinary actions used to correct a child's behavior, guidance techniques and any activities in which the children participate or observe at the program shall not be detrimental to the physical or mental health of any child. (2) Personnel shall not: (g) Use medication to discipline or control children's behavior without written medical authorization issued by a licensed professional and given with the parent's written consent; I. Medications (1) Parental Authorization. Except for first aid or as authorized under Georgia law, Personnel shall not dispense prescription or non-prescription medications to a child without specific written authorization from the child's physician or parent. Such authorization will include when applicable, date; full name of the child; name of the medication; prescription number, if any; dosage; the dates to be given; the time of day to be dispensed; and signature of parent. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The following standards are applicable to school-age children in all CCDF-eligible out-of-school programs and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. Out-of-school programs includes (1) day camps and (2) government-owned and operated providers. E. Discipline (1) Disciplinary actions used to correct a child's behavior, guidance techniques and any activities in which the children participate or observe at the program shall not be detrimental to the physical or mental health of any child. (2) Personnel shall not: (g) Use medication to discipline or control children's behavior without written medical authorization issued by a licensed professional and given with the parent's written consent; I. Medications (1) Parental Authorization. Except for first aid or as authorized under Georgia law, Personnel shall not dispense prescription or non-prescription medications to a child without specific written authorization from the child's physician or parent. Such authorization will include when applicable, date; full name of the child; name of the medication; prescription number, if any; dosage; the dates to be given; the time of day to be dispensed; and signature of parent. 5.3.4 Prevention of and response to emergencies due to food and allergic reactions health and safety standard a. Provide the standards, appropriate to the provider setting and age of children, that address the prevention of emergencies due to food and allergic reactions for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed center care and are found in Rules and Regulations for Child Care Learning Centers. Children’s Records 591-1-1-.08(1) A Center must maintain a file for each child while such child is in care at the Center and for a period of one (1) year after such child is no longer in care at the Center. In order for the file to be complete, the file shall contain the following: identifying information about the child to include: name, date of birth, sex, address, living arrangement if not with both Parents, name of school, if applicable; identifying information about the Parent(s) to include: names of both Parents, if applicable, home and work addresses, and home and work telephone numbers; name(s) and addresses of the person(s) to whom the child may be released. Such information shall contain the authorized person's address, telephone numbers, relationship to child and to Parent(s) and other identifying information; identifying information about the person(s) to contact in emergencies when the Parent cannot be reached to include name(s) and telephone number(s); identifying information about the child's primary source of health care to include physician's or clinic's name and telephone number; and a statement regarding known allergies or other physical problems, mental health disorders, intellectual disabilities or developmental disabilities which would limit the child's participation in the Center's program and activities. Field Trips 591-1-1-.13(6) Emergency Medical Information. Emergency medical information on each child to include allergies; special medical needs and conditions; current prescribed medications that the child is required to take on a daily basis for a chronic condition; the name and phone number of the child's doctor; the local medical facility that the Center uses in the area where the Center is located; and the telephone numbers where the Parent(s) can be reached shall be left at the Center as well as be taken on the trip in the possession of the adult in charge of the trip. Food Service and Nutrition 591-1-1-.15(2) Feeding of Infants and Children. A signed written feeding plan for children less than one (1) year of age shall be obtained from Parent(s). Instructions from the Parent(s) shall be updated regularly as new foods are added or other dietary changes are made. The feeding plan shall be posted in the child's assigned room and must include the child's feeding schedule, the amount of formula or breast milk to be given, instructions for the introduction of solid foods, the amount of food to be given and notation of any type(s) of commercially premixed formula which may not be used in an emergency because of food allergies. 591-1-1-.15(2)(g) Center Personnel shall ensure that children do not have excessive amounts of food in their mouths while eating and are chewing their food appropriately to prevent instances of choking. Children shall always be seated when eating and shall not be allowed to lie down or be put to sleep while food is present in their mouths. 591-1-1-.15(7) Restrictions. Food shall be served according to manufacturer’s instructions and recommendations. Foods that are associated with young children’s choking incidents, such as, but not limited to, peanuts, hot dogs, raw carrots, popcorn, fish with bones, cheese cubes, grapes and any other food that is of similar shape and size of the trachea/windpipe shall not be served to the children less than four (4) years of age. Children older than four (4) years of age may be served these foods provided that the foods are cut in such a way as to minimize choking. Food shall not be accessible or served to children until it has been chopped, diced, cut or mashed and is appropriate for each child’s age and individual eating, chewing and swallowing ability. Staff: Child Ratios and Supervision 591-1-1-.32(7) Supervision. Children shall be supervised at all times appropriate to the individual age, needs and capabilities of each child. Such supervision must include, but not be limited to, indoor and outdoor activities, mealtimes, naptime, transportation, field trips, and transitions between activities. "Supervision" means that the appropriate number of Staff members are physically present in the area where children are being cared for and are providing watchful oversight to the children, volunteers and Students-in-Training. The persons supervising in the child care area must be alert, positioned to maximize their ability to hear and see the children at all times, and able to respond promptly to the needs and actions of the children being supervised, as well as the actions of the volunteers and Students- in-Training, and provide timely attention to the children's actions and needs. Staff shall be attentive and participating with all children during mealtimes and shall be seated within an arm’s length away from children thirty-six (36) months of age and younger. Staff Training 591-1-1-.33(3)Health and Safety Orientation. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (d) prevention of and response to emergencies due to food and allergic reactions; 591-1-1-.33(5)Annual Training. (a) Every calendar year after the first year of employment, all supervisory and caregiver Personnel, except independent contractors, Students-in-Training and volunteers, shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department- approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (ii) Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); Transportation 591-1-1-.36(7)(b) Transportation Plan. For all transportation conducted by the Center or on behalf of the Center, the following requirements shall be met: Emergency Medical Information. An emergency medical information record must be maintained in the vehicle for each child being transported. The emergency medical information record for each child shall include a listing of the child's full name, date of birth, allergies, special medical needs and conditions, current prescribed medications that the child is required to take on a daily basis for a chronic condition, the name and phone number of the child's doctor, the local medical facility that the Center uses in the area where the Center is located and the telephone numbers where the Parent(s) can be reached. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school- age children in all CCDF-eligible licensed family child care homes and are found in Rules and Regulations for Family Child Care Learning Homes. Staffing & Supervision 290-2-3-.07(7) Health and Safety Orientation. The Provider, Employees and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (d) prevention of and response to emergencies due to food and allergic reactions; 290-2-3-.07(9) Annual Training. (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (ii) Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); 290-2-3-.07(18) At least one Staff person with a satisfactory Comprehensive Records Check Determination shall supervise Children at all times appropriate to the individual age, needs and capabilities of each child. Such supervision must include, but not be limited to, indoor and outdoor activities, mealtimes, naptime, transportation, field trips, and transitions between activities. "Supervision" means Staff members are providing watchful oversight to the children, volunteers and Students-in-Training. The person(s) supervising in the child care area must be alert, positioned to maximize their ability to hear and see the children at all times, and able to respond promptly to the needs and actions of the children being supervised, as well as the actions of the volunteers and Students-in-Training, and provide timely attention to the children's actions and needs. Staff shall be attentive and participating with all children during mealtimes and shall be seated within an arm’s length away from children thirty-six (36) months of age and younger. Plans shall be made to obtain additional Staff help in cases of emergencies. Children’s Records 290-2-3-.08(4) Such records shall include a record of any allergies and other known medical problems. Nutrition & Food Services 290-2-3-.10(3) Feeding of Infants and Children. A signed written feeding plan for children less than one (1) year of age shall be obtained from Parent(s). Instructions from the Parent(s) shall be updated regularly as new foods are added or other dietary changes are made. The feeding plan shall be posted in the main child care area and must include the child's feeding schedule, the amount of formula or breast milk to be given, instructions for the introduction of solid foods, the amount of food to be given and notation of any type(s) of commercially premixed formula which may not be used in an emergency because of food allergies. 290-2-3-.10(3)(g) The Home shall ensure that children do not have excessive amounts of food in their mouths while eating and are chewing their food appropriately to prevent instances of choking. Children shall always be seated when eating and shall not be allowed to lie down or be put to sleep while food is present in their mouths. 290-2-3-.10(8) Restrictions. Food shall be served according to manufacturer’s instructions and recommendations. Foods that are associated with young children’s choking incidents, such as, but not limited to, peanuts, hot dogs, raw carrots, popcorn, fish with bones, cheese cubes, grapes and any other food that is of similar shape and size of the trachea/windpipe shall not be served to the children less than four (4) years of age. Children older than four (4) years of age may be served these foods provided that the foods are cut in such a way as to minimize choking. Food shall not be accessible or served to children until it has been chopped, diced, cut or mashed and is appropriate for each child’s age and individual eating, chewing and swallowing ability. iii. All CCDF-eligible licensed in-home care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible regulated (but not licensed) informal in-home care providers and are found in the Health & Safety Standards for Informal Providers Appendix HH. J. Policies and Procedures (1) The Informal Provider shall have a written policy regarding the following: (d)The prevention of and response to food and allergic reactions O. Staff Training (2) Health and Safety Orientation. Each Informal Provider, Employees, and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required annual training hours. The training must address the following health and safety topics: (d) Prevention of and response to emergencies due to food and allergic reactions; (3) Ongoing Training (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: ii. Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); R. Field Trips (3) Emergency Medical Information. Emergency medical information on each child to include allergies; special medical needs and conditions; current prescribed medications that the child is required to take on a daily basis for a chronic condition; the name and phone number of the child's doctor; the local medical facility that the Provider uses in the area where the Provider is located; and the telephone numbers where the Parent(s) can be reached shall be left at the program as well as be taken on the trip in the possession of the adult in charge of the trip. [ ] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible license-exempt center care and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. C. Children’s Records (1) Programs must maintain a file for each child while such child is in care and for a period of one (1) year after such child is no longer enrolled. The file shall contain emergency contact information including, but not limited to, the following: (d) Identifying information about the child's primary source of health care to include physician's or clinic's name and telephone number; and a statement regarding known allergies or other physical problems, mental health disorders, or developmental disabilities which would limit the child's participation in the program or any of the program’s activities. J. Policies and Procedures (1) Program shall have a written policy regarding the following: (d) The prevention of and response to food and allergic reactions P. Staff Training (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (d) Prevention of and response to emergencies due to food and allergic reactions; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (ii) Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); R. Transportation (7) Transportation Plan. For all transportation conducted by the Program or on behalf of the Program, the following requirements shall be met: (b) Emergency Medical Information. An emergency medical information record must be maintained in the vehicle for each child being transported. The emergency medical information record for each child shall include a listing of the child's full name, date of birth, allergies, special medical needs and conditions, current prescribed medications that the child is required to take on a daily basis for a chronic condition, the name and phone number of the child's doctor, the local medical facility that the Program uses in the area where the Program is located and the telephone numbers where the Parent(s) can be reached. S. Field Trips (3) Emergency Medical Information. Emergency medical information on each child to include allergies; special medical needs and conditions; current prescribed medications that the child is required to take on a daily basis for a chronic condition; the name and phone number of the child's doctor; the local medical facility that the program uses in the area where the program is located; and the telephone numbers where the Parent(s) can be reached shall be left at the program as well as be taken on the trip in the possession of the adult in charge of the trip. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The following standards are applicable to school-age children in all CCDF-eligible out-of-school programs and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. Out- of-school programs includes (1) day camps and (2) government-owned and operated providers. C. Children’s Records (1) Programs must maintain a file for each child while such child is in care and for a period of one (1) year after such child is no longer enrolled. The file shall contain emergency contact information including, but not limited to, the following: (d) Identifying information about the child's primary source of health care to include physician's or clinic's name and telephone number; and a statement regarding known allergies or other physical problems, mental health disorders, or developmental disabilities which would limit the child's participation in the program or any of the program’s activities. J. Policies and Procedures (1) Program shall have a written policy regarding the following: (d)The prevention of and response to food and allergic reactions P. Staff Training (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (d) Prevention of and response to emergencies due to food and allergic reactions; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (ii) Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); R. Transportation (7) Transportation Plan. For all transportation conducted by the Program or on behalf of the Program, the following requirements shall be met: (b) Emergency Medical Information. An emergency medical information record must be maintained in the vehicle for each child being transported. The emergency medical information record for each child shall include a listing of the child's full name, date of birth, allergies, special medical needs and conditions, current prescribed medications that the child is required to take on a daily basis for a chronic condition, the name and phone number of the child's doctor, the local medical facility that the Program uses in the area where the Program is located and the telephone numbers where the Parent(s) can be reached. S. Field Trips (3) Emergency Medical Information. Emergency medical information on each child to include allergies; special medical needs and conditions; current prescribed medications that the child is required to take on a daily basis for a chronic condition; the name and phone number of the child's doctor; the local medical facility that the program uses in the area where the program is located; and the telephone numbers where the Parent(s) can be reached shall be left at the program as well as be taken on the trip in the possession of the adult in charge of the trip. b. Provide the standards, appropriate to the provider setting and age of children, that address the response to emergencies due to food and allergic reactions for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed center care and are found in Rules and Regulations for Child Care Learning Centers. Children’s Health 591-1-1-.07(2) Parental Notification. Parents must be notified of incidents, illnesses or injuries as follows: Immediately notify Parent(s) and obtain specific instructions until child can be picked up or returned to group: When professional medical attention is required, or When child experiences symptoms of moderate discomfort such as elevated temperature, vomiting or diarrhea, or When child is involved in an incident that puts their health and/or safety at risk (e.g., missing from program, left on vehicle, escaped from building/playground, etc.) Notify Parent(s) by the end of the day: When professional medical attention is not required, or When child experiences symptoms of less than moderate discomfort, or When child experiences an adverse reaction to prescribed medication which does not constitute moderate discomfort. 591-1-1-.07(4) Medical Emergencies. A Center shall have a written plan which outlines how emergency medical services will be obtained, including place(s) the child will be taken for emergency care. When a medical emergency arises involving a child, the Center Staff shall seek prompt emergency medical treatment and provide any certified or licensed emergency medical persons with immediate access to the child. Children’s Records 591-1-1-.08(1)(b) A Center must maintain a file for each child while such child is in care at the Center and for a period of one (1) year after such child is no longer in care at the Center. In order for the file to be complete, the file shall contain the following: identifying information about the child to include: name, date of birth, sex, address, living arrangement if not with both Parents, name of school, if applicable; identifying information about the Parent(s) to include: names of both Parents, if applicable, home and work addresses, and home and work telephone numbers; name(s) and addresses of the person(s) to whom the child may be released. Such information shall contain the authorized person's address, telephone numbers, relationship to child and to Parent(s) and other identifying information; identifying information about the person(s) to contact in emergencies when the Parent cannot be reached to include name(s) and telephone number(s); identifying information about the child's primary source of health care to include physician's or clinic's name and telephone number; and a statement regarding known allergies or other physical problems, mental health disorders, intellectual disabilities or developmental disabilities which would limit the child's participation in the Center's program and activities. (b)The file shall contain parental authorizations, including, but not limited to, written authorization for the Center to obtain emergency medical care for the child when the Parent is not available. Field Trips 591-1-1-.13(6) Emergency Medical Information. Emergency medical information on each child to include allergies; special medical needs and conditions; current prescribed medications that the child is required to take on a daily basis for a chronic condition; the name and phone number of the child's doctor; the local medical facility that the Center uses in the area where the Center is located; and the telephone numbers where the Parent(s) can be reached shall be left at the Center as well as be taken on the trip in the possession of the adult in charge of the trip. Medications 591-1-1-.20(3) Dispensing Records. The Center shall maintain a record of all medications dispensed to children by Personnel to include the date, time and amount of medication that was administered; any noticeable adverse reactions to the medication; and the signature or initials of the person administering the medication. Operational Policies and Procedures 591-1-1-.21(1) A Center shall establish and implement written policies and procedures which shall be kept current, be consistent with applicable laws, regulations and these rules, made available to the Parent(s) and used to govern the operations of the Center. The policies and procedures shall include the following: (e) A description of handling administration of medication (see rule .20 about medications), and notifying Parent(s) of noticeable adverse reactions to prescribed medications. (h) A description of handling medical emergencies (see rule .07 about children's health). Transportation 591-1-1-.36(7)(b) Transportation Plan. For all transportation conducted by the Center or on behalf of the Center, the following requirements shall be met: Emergency Medical Information. An emergency medical information record must be maintained in the vehicle for each child being transported. The emergency medical information record for each child shall include a listing of the child's full name, date of birth, allergies, special medical needs and conditions, current prescribed medications that the child is required to take on a daily basis for a chronic condition, the name and phone number of the child's doctor, the local medical facility that the Center uses in the area where the Center is located and the telephone numbers where the Parent(s) can be reached. Staff Training 591-1-1-.33(3)Health and Safety Orientation. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (d) prevention of and response to emergencies due to food and allergic reactions; 591-1-1-.33(5)Annual Training. (a) Every calendar year after the first year of employment, all supervisory and caregiver Personnel, except independent contractors, Students-in-Training and volunteers, shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department- approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (ii) Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); ii. All CCDF-eligible licensed family child care homes. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school- age children in all CCDF-eligible licensed family child care homes and are found in Rules and Regulations for Family Child Care Learning Homes. Staffing & Supervision 290-2-3-.07(7) Health and Safety Orientation. The Provider, Employees and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (d) prevention of and response to emergencies due to food and allergic reactions; 290-2-3-.07(9) Annual Training. (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (ii) Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); Children’s Records 290-2-3-.08(1) The Home shall maintain current and updated individual records on each Child in care. The Home shall maintain the records outlined herein while the Child is in care and for a period of one (1) year after such Child is no longer in care at the Family Child Care Learning Home. Such records shall include: identifying information (Child's name, birth date, Parent's name, home and business addresses, telephone numbers); name, address and telephone number of persons, including Child's physician, to contact in emergencies; and name, address, telephone numbers, relationship to Child and to Parent(s) and other identifying information of person(s) to whom the Child may be released. 290-2-3-.08(4) Such records shall include a record of any allergies and other known medical problems. 290-2-3-.08(8)(b) Policies and Procedures. Each Family Child Care Learning Home shall establish policies and procedures, which shall be kept current, be consistent with applicable laws, including but not limited to the Americans with Disabilities Act, regulations and these rules, made available to the Parents, and used to govern the operations of the Family Child Care Learning Home. (b) The policies and procedures shall also include written procedures for the following: 2. Handling emergency medical care, including where the Children will be taken for emergency medical care; 3. Administering medication and recording noticeable adverse reactions to medication; Health, Safety, and Discipline 290-2-3-.11(1)(b) Parental Notification. Parents must be notified of incidents, illnesses, or injuries as follows: Immediately notify Parent(s) and obtain specific instructions until child can be picked up or returned to group: When professional medical attention is required, or When child experiences symptoms of moderate discomfort such as elevated temperature, vomiting or diarrhea, or When child is involved in an incident that puts their health and/or safety at risk (e.g., missing from program, left on vehicle, escaped from building/playground, etc.) Notify Parent(s) by the end of the day: When professional medical attention is not required, or When child experiences symptoms of less than moderate discomfort, or When child experiences an adverse reaction to prescribed medication which does not constitute moderate discomfort. iii. All CCDF-eligible licensed in-home care. Provide the standard:: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible regulated (but not licensed) informal in-home care providers and are found in the Health & Safety Standards for Informal Providers Appendix HH. I. Medications (2) Dispensing Records. The Informal Provider shall maintain a record of all medications dispensed to children by Personnel to include the date, time and amount of medication that was administered; any noticeable adverse reactions to the medication; and the signature or initials of the person administering the medication. J. Policies and Procedures (1) The Informal Provider shall have a written policy regarding the following: (d) The prevention of and response to food and allergic reactions O. Staff Training (2) Health and Safety Orientation. Each Informal Provider, Employees, and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required annual training hours. The training must address the following health and safety topics: (d) Prevention of and response to emergencies due to food and allergic reactions; (3) Ongoing Training (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: ii. Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); [ ] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible license-exempt center care and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. I. Medications (2) Dispensing Records. The program shall maintain a record of all medications dispensed to children by Personnel to include the date, time and amount of medication that was administered; any noticeable adverse reactions to the medication; and the signature or initials of the person administering the medication. J. Policies and Procedures (1) Program shall have a written policy regarding the following: (d) The prevention of and response to food and allergic reactions P. Staff Training (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (d) Prevention of and response to emergencies due to food and allergic reactions; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (ii) Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); R. Transportation (7) Transportation Plan. For all transportation conducted by the Program or on behalf of the Program, the following requirements shall be met: (b) Emergency Medical Information. An emergency medical information record must be maintained in the vehicle for each child being transported. The emergency medical information record for each child shall include a listing of the child's full name, date of birth, allergies, special medical needs and conditions, current prescribed medications that the child is required to take on a daily basis for a chronic condition, the name and phone number of the child's doctor, the local medical facility that the Program uses in the area where the Program is located and the telephone numbers where the Parent(s) can be reached. S. Field Trips (3) Emergency Medical Information. Emergency medical information on each child to include allergies; special medical needs and conditions; current prescribed medications that the child is required to take on a daily basis for a chronic condition; the name and phone number of the child's doctor; the local medical facility that the program uses in the area where the program is located; and the telephone numbers where the Parent(s) can be reached shall be left at the program as well as be taken on the trip in the possession of the adult in charge of the trip. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The following standards are applicable to school-age children in all CCDF-eligible out-of-school programs and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. Out- of-school programs includes (1) day camps and (2) government-owned and operated providers. I. Medications (2) Dispensing Records. The program shall maintain a record of all medications dispensed to children by Personnel to include the date, time and amount of medication that was administered; any noticeable adverse reactions to the medication; and the signature or initials of the person administering the medication. J. Policies and Procedures (1) Program shall have a written policy regarding the following: (d) The prevention of and response to food and allergic reactions P. Staff Training (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (d) Prevention of and response to emergencies due to food and allergic reactions; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (ii) Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); R. Transportation (7) Transportation Plan. For all transportation conducted by the Program or on behalf of the Program, the following requirements shall be met: (b) Emergency Medical Information. An emergency medical information record must be maintained in the vehicle for each child being transported. The emergency medical information record for each child shall include a listing of the child's full name, date of birth, allergies, special medical needs and conditions, current prescribed medications that the child is required to take on a daily basis for a chronic condition, the name and phone number of the child's doctor, the local medical facility that the Program uses in the area where the Program is located and the telephone numbers where the Parent(s) can be reached. S. Field Trips (3) Emergency Medical Information. Emergency medical information on each child to include allergies; special medical needs and conditions; current prescribed medications that the child is required to take on a daily basis for a chronic condition; the name and phone number of the child's doctor; the local medical facility that the program uses in the area where the program is located; and the telephone numbers where the Parent(s) can be reached shall be left at the program as well as be taken on the trip in the possession of the adult in charge of the trip. 5.3.5 Building and physical premises safety, including the identification of and protection from hazards, bodies of water, and vehicular traffic health and safety standard a. Provide the standards, appropriate to the provider setting and age of children, that address the identification of and protection from building and physical premises hazards for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed center care and are found in Rules and Regulations for Child Care Learning Centers. Animals 591-1-1-.05(1) Control of Animals. Animals shall be controlled to assure that proper sanitation of the premises is maintained and animals are not a hazard to the children, Personnel or visitors at the Center. No animals, such as but not limited to, pit bull dogs, ferrets, and poisonous snakes, which may have a vicious propensity, shall be permitted on the Center premises at any time there are children on the premises. Horses or other farm animals shall not be quartered on any property over which Center Staff exercises any control that is located within five hundred (500) feet of the building in which the Center is located. 591-1-1-.05(2) Confinement. All animals shall be confined in pens or covered areas except for specific teacher-directed learning experiences. Animal pens and confinement areas shall be kept clean. Equipment and Toys 591-1-1-.12(1) All indoor and outdoor furniture, activity materials, and equipment shall be used: in a safe and appropriate manner by each Employee and child in attendance; and in accordance with the manufacturer's instructions, recommendations, and intended use. All equipment and furniture shall be used only by the age-appropriate group of children. 591-1-1-.12(2) Equipment and Furniture. Equipment and furniture shall be free from hazardous conditions such as, but not limited to, sharp rough edges or toxic paint and shall be kept clean. 591-1-1-.12(4) Equipment and furniture shall be secured if it is of a weight or mass that could cause injury from tipping, falling, or being pulled or pushed over. Potentially unstable equipment and furniture that might injure a child if not secured include, but are not limited to, televisions, chests of drawers, bookcases, shelving, cabinets and fish tanks. Examples of items not required to be secured include, but are not limited to, child-sized tables and chairs, rocking chairs, and cribs. Kitchen Operations 591-1-1-.18(12) Exclusion of Children. Children shall not be permitted in the kitchen except as part of a planned, supervised learning experience. Physical Plant 591-1-1-.25(3) Cleanliness. The Center and surrounding premises shall be kept clean, free of debris and in good repair. Hygienic measures such as, but not limited to, screened windows and proper waste disposal procedures shall be utilized to minimize the presence of rodents, flies, roaches and other vermin at the Center. 591-1-1-.25(8) Electrical Outlets. Except in School-age Centers, all unused electrical outlets within reach of children shall have protective caps specifically designed to prohibit children from placing anything in the receptacle. Electrical outlets in use which the children can reach shall be made inaccessible to the children. 591-1-1-.25 (10) Fire Safety. A Center must be in compliance with applicable laws and regulations issued by the state fire marshal, the proper local fire marshal or state inspector, including a certificate of occupancy if required prior to receiving any children for care. 591-1-1-.25(12) Heating and Cooling Equipment. Heating and cooling equipment shall be protected to prevent children from touching it. Fans, space heaters, etc. shall be positioned or installed so as to be inaccessible to the children. 591-1-1-.25(13) Indoor Storage Areas. Potentially hazardous equipment, materials and supplies shall be stored in a locked area inaccessible to children. Examples of items to be stored include non-food related products under pressure in aerosol dispensing cans, flammable and corrosive materials, cleaning supplies, poisons, insecticides, office supplies and industrial-sized or commercial buckets with a capacity of three gallons or more or any other similar device with rigid sides which would not tip over if a toddler fell into the container head first. 591-1-1-.25 (15) Outside Storage Area. Any outside storage or equipment area shall be locked, separated from the children by a barrier or enclosure, and shall not be accessible to the children. 591-1-1-.25(16) Parking. Sufficient parking areas shall be provided to permit safe discharge and pick up of children. 591-1-1-.25(17) Plants and Shrubs. The Center premises shall be free of plants and shrubs which are poisonous or hazardous. 591-1-1-.25(21) Windows. All floor level windows or full-length glass doors shall be constructed of safety glass with decals applied at the eye level of the children or such windows or doors shall have protective devices covering the glass designed to prevent the children from getting cut by the glass should it break for any reason. Except in School-age Centers, child care rooms shall have outside windows which receive natural sunlight and equal not less than five percent (5%) of the floor area in each room, unless central heating and air conditioning are provided. Playgrounds 591-1-1-.26(3) Location. Playgrounds shall be adjacent to the Center or in an area which can be reached by a safe route or method approved by the Department. Except in School-age Centers, the playground shall have shaded areas. 591-1-1-.26(4) Fence or Approved Barriers. Playgrounds shall be protected from traffic or other hazards by a four (4) foot or higher secure fence or other barrier approved by this Department. Fencing material shall not present a hazard to children and shall be maintained so as to prevent children from leaving the playground area by any means other than through an approved access route. Fence gates shall be kept closed except when persons are entering or exiting the area. 591-1-1-.26(5) Playground Surfaces. Except in School-age Centers, the playground shall have a surface suitable for varied activities. Hard surfaces, such as gravel, concrete, or paving shall not exceed one-fourth (1/4) of the total playground area. 591-1-1-.26(6) Equipment. Playground equipment shall provide an opportunity for the children to engage in a variety of experiences and shall be age-appropriate.For example, toddlers shall not be permitted to swing in swings designed for School- age Children. The outdoor equipment shall be free of lead-based paint, sharp corners and shall be regularly maintained in such a way as to be free of rust and splinters that could pose significant safety hazard to the children. All equipment shall be arranged so as not to obstruct supervision of children. 591-1-1-.26(7) Anchoring of Certain Equipment. Climbing and swinging equipment shall be anchored. 591-1-1-.26(8) Fall Zones and Surfacing. Climbing and swinging equipment shall have a resilient surface beneath the equipment and the fall zone from such equipment must be adequately maintained by the Center to assure continuing resiliency. 591-1-1-.26(9) Safety and Upkeep of Playground. Playgrounds shall be kept clean, free from litter and free of hazards, such as but not limited to rocks, exposed tree roots and exposed sharp edges of concrete. Safe Sleeping and Resting Requirements 591-1-1-.30(1)(d) Arrangement of Sleeping and Resting Equipment. All sleeping and resting equipment shall be arranged to avoid obstructing access to exit doors, to provide the caregivers access to each child, and to prevent children's access to cords hanging from window treatments and other hazardous objects. To reduce the transfer of airborne diseases, sleeping and resting equipment shall be arranged as follows. There shall be a minimum of twenty-four inch (24") corridor between each row of sleeping or resting. Staff Training 591-1-1-.33(1) Center Orientation. Prior to assignment to children or task, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial Center orientation. 591-1-1-.33(2)The initial Center orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children; (f) the program’s emergency preparedness plan; (k) fire safety; (l) water safety; and 591-1-1-.33(3)Health and Safety Orientation. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (e) building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; 591-1-1-.33(5)Annual Training. (a) Every calendar year after the first year of employment, all supervisory and caregiver Personnel, except independent contractors, Students-in-Training and volunteers, shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department- approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); ii. All CCDF-eligible licensed family child care homes. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school- age children in all CCDF-eligible licensed family child care homes and are found in Rules and Regulations for Family Child Care Learning Homes. Staffing and Supervision 290-2-3-.07(5) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. 290-2-3-.07(6) The initial program orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children; (g) the program’s emergency preparedness plan; (l) fire safety; (m) water safety; and 290-2-3-.07(7) Health and Safety Orientation. The Provider, Employees and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (e) building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; 290-2-3-.07(9) Annual Training. (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); Children’s Records 290-2-3-.08(8)(b)(8) Policies and Procedures. Each Family Child Care Learning Home shall establish policies and procedures, which shall be kept current, be consistent with applicable laws, including but not limited to the Americans with Disabilities Act, regulations and these rules, made available to the Parents, and used to govern the operations of the Family Child Care Learning Home. (b)The policies and procedures shall also include written procedures for the following: Protection of children in the event of: severe weather, fire, and physical plant problems, such as a power failure, that affect climate control, loss of water, or structural damages; 290-2-3-.08(13) Notification of the existence of a firearm in the Family Child Care Learning Home. 290-2-3-.08(15) Notification of the existence of any pets or other animals residing in the Home or on the property of the Family Child Care Learning Home. Health, Safety, and Discipline 290-2-3-.11(1)(n-o) (n) Pets in the Home shall be vaccinated in accordance with the requirements of the local county Boards of Health. Unconfined pets shall not be permitted in child care areas when any Child is present except for supervised learning experiences. (o) Pets and all other animals shall be controlled to assure that proper sanitation of the premises is maintained and animals are not a hazard to the children, personnel or other visitors. No animal, such as but not limited to, pit bull dogs, ferrets, and poisonous snakes, which may have a vicious propensity, shall be permitted on the Family Child Care Learning Home premises at any time there are children on the premises. Horses or other farm animals shall not be quartered on any property over which the Provider exercises any control that is located within five hundred (500) feet of the building in which the Family Child Care Learning Home is located. 290-2-3-.11(2)(d-i) (d) Children shall not have access to hanging cords or other hazardous objects. (e) Clear glass doors shall be marked to avoid accidental impact. (f) Poisons, medicines, cleaning agents, razors, aerosol cans and other potential hazardous materials shall be stored out of reach of children or in locked cabinets. (g) Firearms shall be stored so they are not accessible to children. (h) At least one UL Approved smoke detector shall be on each floor of the Home and such detectors shall be maintained in working order. At least one 2- A:10-B:C fire extinguisher shall be kept in the child care area to be located no more than thirty feet from the kitchen. The extinguisher shall be maintained in working order and shall be inaccessible to the children. (i) Flammable liquids, such as gasoline or kerosene, shall not be stored inside the Home. Equipment and Supplies 290-2-3-.12(3-7) (3) Furniture and equipment shall be kept clean and in a safe usable condition. (4) All indoor and outdoor furniture, activity materials, and equipment shall be: used in a safe and appropriate manner by each Provider, Provisional Employee, Employee and child in attendance and used in accordance with the manufacturer's instructions, recommendations, and intended use. (5) All indoor and outdoor furniture, activity materials, and equipment shall be free from hazardous conditions such as, but not limited to, sharp rough edges or toxic paint and kept clean. (6) All indoor and outdoor furniture, activity materials, and equipment shall be placed so as to permit the children's freedom of movement and to minimize danger of accident and collision. (7) All indoor and outdoor furniture and equipment shall be secured if equipment and furniture is of a weight or mass that could cause injury from tipping, falling, or being pulled or pushed over. Potentially unstable equipment and furniture that might injure a child if not secured include, but are not limited to, televisions, chests of drawers, bookcases, shelving, cabinets and fish tanks. Examples of items not required to be secured include, but are not limited to, child-sized tables and chairs, rocking chairs, and cribs. Building and Grounds 290-2-3-.13(1) The Home's building shall be kept clean and free from obvious hazards to the children's health and safety. 290-2-3-.13(1)(c-f) (c) Furniture and equipment shall be arranged so as not to interfere with exits. (d) The Home shall be kept free of fire hazards and unnecessary or excessive combustible material. When in use, radiators, open fire, oil or wood burning stoves, floor furnaces and similar hazards shall have barriers or screens to prevent Children from being burned. Unvented fuel fired heaters shall not be used unless equipped with an oxygen depletion safety shut off system. (e) Multiple plugs and electric extension cords shall not be used. Electrical outlets within reach of children shall be plugged or covered. (f) Fans shall be positioned or installed so as to be inaccessible to the children. 290-2-3-.13(2)(a-d) Outside grounds and play areas shall be kept clean and free of obvious hazards to the children's health and safety. (a) Outside play areas shall be free of hazards such as, but not limited to exposed sharp edges of concrete or non-play equipment, broken glass, debris, open drainage ditches, holes and stagnant water. (b) Climbing and swinging equipment that are not portable shall be securely anchored to eliminate accidents or injuries. (c) Climbing and swinging equipment that are not portable shall have a resilient surface beneath the equipment and the fall zone from such equipment, which is adequately maintained by the Family Child Care Learning Home to assure continuing resiliency. (d) Such outside play areas shall be protected from traffic or other hazards by fencing or other barriers at least four feet in height and approved by the Department. Fencing material shall not present a hazard to children. A fence shall be provided around swimming pools to make them inaccessible when not in use. Sleeping and Resting Requirements 290-2-3-.19(1)(d) Arrangement of Sleeping and Resting Equipment. All sleeping and resting equipment shall be arranged to avoid obstructing access to exit doors, to provide the caregivers access to each child, and to prevent children's access to cords hanging from window treatments and other hazardous objects. To reduce the transfer of airborne diseases, sleeping and resting equipment shall be arranged as follows. There shall be a minimum of twenty-four inch (24") corridor between each row of sleeping or resting equipment. There shall be a minimum of twelve inches (12") between each piece of sleeping or resting equipment in each row of equipment. Children shall be placed on cots and mats so that one child's head is toward another child's feet in the same row. iii. All CCDF-eligible licensed in-home care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible regulated (but not licensed) informal in-home care providers and are found in the Health & Safety Standards for Informal Providers Appendix HH. F. Equipment and Toys (1) All indoor and outdoor furniture, activity materials, and equipment shall be used: (a) In a safe and appropriate manner by each Employee and child in attendance; and (b) In accordance with the manufacturer’s instructions, recommendations, and intended use. (2) All equipment and furniture shall be used only by the age-appropriate group of children. Equipment and furniture shall be: (a) Free from hazardous conditions such as, but not limited to, sharp rough edges or toxic paint; (c) Placed so as to permit the children’s freedom of movement and to minimize danger of accident and collision; (d) Secured if equipment and furniture is of a weight or mass that could cause injury from tipping, falling, or being pulled or pushed over. Potentially unstable equipment and furniture that might injure a child if not secured include, but are not limited to, televisions, chests of drawers, bookcases, shelving, cabinets and fish tanks. Examples of items not required to be secured include, but are not limited to, child-sized tables and chairs, rocking chairs, and cribs. J. Policies and Procedures (1) The Informal Provider shall have a written policy regarding the following: (f) The handling and appropriate disposal of bodily fluids and storage of hazardous materials (soiled clothing and bedding); L. Physical Plant (1) Indoor Storage Areas. Potentially hazardous equipment, materials and supplies shall be stored in a locked area inaccessible to children. Examples of items to be stored include non-food related products under pressure in aerosol dispensing cans, flammable and corrosive materials to include but not limited to heaters and fire places, cleaning supplies, poisons, insecticides, office supplies, weapons, and industrial-sized or commercial buckets with a capacity of three gallons or more or any other similar device with rigid sides which would not tip over if a toddler fell into the container head first. (a) At least one approved smoke detector shall be on each floor of the Home and such detectors shall be maintained and in working order, (b) At least one fire extinguisher shall be kept in the child care area. The extinguisher shall be maintained in working order and shall be inaccessible to the children. M. Playgrounds (1) Fence or Approved Barriers. Playgrounds shall be protected from traffic or other hazards by a four (4) foot or higher secure fence or other barrier. Fencing material shall not present a hazard to children and shall be maintained so as to prevent children from leaving the playground area by any means other than through an approved access route. Fence gates shall be kept closed except when persons are entering or exiting the area. (2) Equipment. Playground equipment shall provide an opportunity for the children to engage in a variety of experiences and shall be age-appropriate. The outdoor equipment shall be free from hazards such as, but not limited to, lead- based paint, sharp corners, and shall be regularly maintained in such a way as to be free of rust and splinters that could pose significant safety hazard to the children. All equipment shall be arranged so as not to obstruct supervision of children. Climbing and swinging equipment shall be anchored and have a resilient surface beneath the equipment. The fall-zone from such equipment must be adequately maintained to assure continuing resiliency. (3) Safety and Upkeep of Playground. Playgrounds shall be kept clean, free from litter and free of hazards, such as but not limited to non-resilient surfaces under the fall-zone of play equipment, rocks, exposed tree roots and exposed sharp edges of concrete or equipment. O. Staff Training (1) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. The initial program orientation must include the following subjects: the program's policies and procedures; the portions of these rules dealing with the care, health and safety of children; the Staff person’s assigned duties and responsibilities; reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; emergency weather plans; the program’s emergency preparedness plan; childhood injury control; the administration of medicine; reducing the risk of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS); hand washing; fire safety; water safety; and prevention of HIV/AIDS and blood borne pathogens. (2) Health and Safety Orientation. Each Informal Provider, Employees, and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required annual training hours. The training must address the following health and safety topics: (e) Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; (3) Ongoing Training (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: iii. Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); [ ] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible license-exempt center care and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. F. Equipment and Toys (1) All indoor and outdoor furniture, activity materials, and equipment shall be used: (a) In a safe and appropriate manner by each Employee and child in attendance; and (b) In accordance with the manufacturer’s instructions, recommendations, and intended use. (2) All equipment and furniture shall be used only by the age-appropriate group of children. Equipment and furniture shall be: (a) Free from hazardous conditions such as, but not limited to, sharp rough edges or toxic paint; (c) Placed so as to permit the children’s freedom of movement and to minimize danger of accident and collision; (d) Secured if equipment and furniture is of a weight or mass that could cause injury from tipping, falling, or being pulled or pushed over. Potentially unstable equipment and furniture that might injure a child if not secured include, but are not limited to, televisions, chests of drawers, bookcases, shelving, cabinets and fish tanks. Examples of items not required to be secured include, but are not limited to, child-sized tables and chairs, rocking chairs, and cribs. J. Policies and Procedures (1) Program shall have a written policy regarding the following: (f) The handling and appropriate disposal of bodily fluids and storage of hazardous materials (soiled clothing and bedding) L. Physical Plant (1) Required approvals. The construction of a new building or any planned structural changes to an existing program building shall obtain approval from the local zoning authorities, fire safety agencies and local building authorities. Construction and maintenance work shall take place only in areas that are not accessible to the children. (2) Fire Safety. A program must be in compliance with applicable laws and regulations issued by the state fire marshal, the proper local fire marshal or state inspector, including a certificate of occupancy if required prior to receiving any children for care. (3) Indoor Storage Areas. Potentially hazardous equipment, materials and supplies shall be stored in a locked area inaccessible to children. Examples of items to be stored include non-food related products under pressure in aerosol dispensing cans, flammable and corrosive materials, cleaning supplies, poisons, insecticides, office supplies and industrial-sized or commercial buckets with a capacity of three gallons or more or any other similar device with rigid sides which would not tip over if a toddler fell into the container head first. M. Playgrounds (1) Fence or Approved Barriers. It is recommended that playgrounds shall be protected from traffic or other hazards by a four (4) foot or higher secure fence or other barrier. Fencing material shall not present a hazard to children and shall be maintained so as to prevent children from leaving the playground area by any means other than through an approved access route. Fence gates should be kept closed except when persons are entering or exiting the area. If the outdoor play space has no fence or barrier, the program official must submit a plan to ensure children are protected from vehicular traffic, water hazards, and any other potential hazards while participating in outdoor play. (2) Equipment. Playground equipment shall provide an opportunity for the children to engage in a variety of experiences and shall be age-appropriate. The outdoor equipment shall be free from hazards such as, but not limited to, lead- based paint, sharp corners, and shall be regularly maintained in such a way as to be free of rust and splinters that could pose significant safety hazard to the children. All equipment shall be arranged so as not to obstruct supervision of children. Climbing and swinging equipment shall be anchored and have a resilient surface beneath the equipment. (3) Fall-zone and Surfacing. Requires climbing and swinging equipment to have a resilient surface beneath the equipment and the fall zone from such equipment must be adequately maintained by the program to ensure continuing resiliency. (4) Safety and Upkeep of Playground. Playgrounds shall be kept clean, free from litter and free of hazards, such as but not limited to rocks, exposed tree roots and exposed sharp edges of concrete or equipment. P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; (e) Emergency weather plans; and the program’s emergency preparedness plan; (j) Fire Safety; (k) Water Safety; (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (e) Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The following standards are applicable to school-age children in all CCDF-eligible out-of-school programs and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. Out- of-school programs includes (1) day camps and (2) government-owned and operated providers. F. Equipment and Toys (1) All indoor and outdoor furniture, activity materials, and equipment shall be used: (a) In a safe and appropriate manner by each Employee and child in attendance; and (b) In accordance with the manufacturer’s instructions, recommendations, and intended use. (2) All equipment and furniture shall be used only by the age-appropriate group of children. Equipment and furniture shall be: (a) Free from hazardous conditions such as, but not limited to, sharp rough edges or toxic paint; (c) Placed so as to permit the children’s freedom of movement and to minimize danger of accident and collision; (d) Secured if equipment and furniture is of a weight or mass that could cause injury from tipping, falling, or being pulled or pushed over. Potentially unstable equipment and furniture that might injure a child if not secured include, but are not limited to, televisions, chests of drawers, bookcases, shelving, cabinets and fish tanks. Examples of items not required to be secured include, but are not limited to, child-sized tables and chairs, rocking chairs, and cribs. J. Policies and Procedures (1) Program shall have a written policy regarding the following: (f) The handling and appropriate disposal of bodily fluids and storage of hazardous materials (soiled clothing and bedding) L. Physical Plant (1) Required approvals. The construction of a new building or any planned structural changes to an existing program building shall obtain approval from the local zoning authorities, fire safety agencies and local building authorities. Construction and maintenance work shall take place only in areas that are not accessible to the children. (2) Fire Safety. A program must be in compliance with applicable laws and regulations issued by the state fire marshal, the proper local fire marshal or state inspector, including a certificate of occupancy if required prior to receiving any children for care. (3) Indoor Storage Areas. Potentially hazardous equipment, materials and supplies shall be stored in a locked area inaccessible to children. Examples of items to be stored include non-food related products under pressure in aerosol dispensing cans, flammable and corrosive materials, cleaning supplies, poisons, insecticides, office supplies and industrial-sized or commercial buckets with a capacity of three gallons or more or any other similar device with rigid sides which would not tip over if a toddler fell into the container head first. M. Playgrounds (1) Fence or Approved Barriers. It is recommended that playgrounds shall be protected from traffic or other hazards by a four (4) foot or higher secure fence or other barrier. Fencing material shall not present a hazard to children and shall be maintained so as to prevent children from leaving the playground area by any means other than through an approved access route. Fence gates should be kept closed except when persons are entering or exiting the area. If the outdoor play space has no fence or barrier, the program official must submit a plan to ensure children are protected from vehicular traffic, water hazards, and any other potential hazards while participating in outdoor play. (3)(2) Equipment. Playground equipment shall provide an opportunity for the children to engage in a variety of experiences and shall be age-appropriate. The outdoor equipment shall be free from hazards such as, but not limited to, lead- based paint, sharp corners, and shall be regularly maintained in such a way as to be free of rust and splinters that could pose significant safety hazard to the children. All equipment shall be arranged so as not to obstruct supervision of children. Climbing and swinging equipment shall be anchored and have a resilient surface beneath the equipment. (2)(3) Fall-zone and Surfacing. Requires climbing and swinging equipment to have a resilient surface beneath the equipment and the fall zone from such equipment must be adequately maintained by the program to ensure continuing resiliency. (4) Safety and Upkeep of Playground. Playgrounds shall be kept clean, free from litter and free of hazards, such as but not limited to, rocks, exposed tree roots and exposed sharp edges of concrete or equipment. P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; (e) Emergency weather plans; and the program’s emergency preparedness plan; (j) Fire Safety; (k) Water Safety; (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (e) Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); b. Provide the standards, appropriate to the provider setting and age of children, that address the identification of and protection from bodies of water for the following CCDF- eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed center care and are found in Rules and Regulations for Child Care Learning Centers. Staff Training 591-1-1-.33(1) Center Orientation. Prior to assignment to children or task, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial Center orientation. 591-1-1-.33(2)The initial Center orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children; (l) water safety; 591-1-1-.33(3)Health and Safety Orientation. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (e) building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; 591-1-1-.33(5)Annual Training. (a) Every calendar year after the first year of employment, all supervisory and caregiver Personnel, except independent contractors, Students-in-Training and volunteers, shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department- approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); Swimming 591-1-1-.35(2) Accessibility of Pools. All swimming and wading pools shall be inaccessible to children except during supervised activities. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school- age children in all CCDF-eligible licensed family child care homes and are found in Rules and Regulations for Family Child Care Learning Homes. Staffing & Supervision 290-2-3-.07(5) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. 290-2-3-.07(6) The initial program orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children; (m) water safety; 290-2-3-.07(7) Health and Safety Orientation. The Provider, Employees and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (e) building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; 290-2-3-.07(9) Annual Training. (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); Building and Grounds 290-2-3-.13(2)(d) Outside grounds and play areas shall be kept clean and free of obvious hazards to the children's health and safety. (d) Such outside play areas shall be protected from traffic or other hazards by fencing or other barriers at least four feet in height and approved by the Department. Fencing material shall not present a hazard to children. A fence shall be provided around swimming pools to make them inaccessible when not in use. iii. All CCDF-eligible licensed in-home care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible regulated (but not licensed) informal in-home care providers and are found in the Health & Safety Standards for Informal Providers Appendix HH. O. Staff Training (1) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. The initial program orientation must include the following subjects: the program's policies and procedures; the portions of these rules dealing with the care, health and safety of children; the Staff person’s assigned duties and responsibilities; reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; emergency weather plans; the program’s emergency preparedness plan; childhood injury control; the administration of medicine; reducing the risk of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS); hand washing; fire safety; water safety; and prevention of HIV/AIDS and blood borne pathogens. (2) Health and Safety Orientation. Each Informal Provider, Employees, and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required annual training hours. The training must address the following health and safety topics: (e) Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; (3) Ongoing Training (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: iii. Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); P. Swimming Pools and Water Related Activities (1) Accessibility of Pools. All swimming and wading pools shall be adequately fenced and inaccessible to children except during supervised activities. [ ] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible license-exempt center care and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. M. Playgrounds (1) Fence or Approved Barriers. It is recommended that playgrounds shall be protected from traffic or other hazards by a four (4) foot or higher secure fence or other barrier. Fencing material shall not present a hazard to children and shall be maintained so as to prevent children from leaving the playground area by any means other than through an approved access route. Fence gates should be kept closed except when persons are entering or exiting the area. If the outdoor play space has no fence or barrier, the program official must submit a plan to ensure children are protected from vehicular traffic, water hazards, and any other potential hazards while participating in outdoor play. (3)(4) Safety and Upkeep of Playground. Playgrounds shall be kept clean, free from litter and free of hazards, such as but not limited to, rocks, exposed tree roots and exposed sharp edges of concrete or equipment. P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; (k) Water Safety; (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (e) Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); Q. Swimming Pools and Water Related Activities (1) Accessibility of Pools. All swimming and wading pools shall be adequately fenced and inaccessible to children except during supervised activities. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The following standards are applicable to school-age children in all CCDF-eligible out-of-school programs and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. Out- of-school programs includes (1) day camps and (2) government-owned and operated providers. M. Playgrounds (1) Fence or Approved Barriers. It is recommended that playgrounds shall be protected from traffic or other hazards by a four (4) foot or higher secure fence or other barrier. Fencing material shall not present a hazard to children and shall be maintained so as to prevent children from leaving the playground area by any means other than through an approved access route. Fence gates should be kept closed except when persons are entering or exiting the area. If the outdoor play space has no fence or barrier, the program official must submit a plan to ensure children are protected from vehicular traffic, water hazards, and any other potential hazards while participating in outdoor play. (4) Safety and Upkeep of Playground. Playgrounds shall be kept clean, free from litter and free of hazards, such as but not limited to, rocks, exposed tree roots and exposed sharp edges of concrete or equipment. P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; (k) Water Safety; (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (e) Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); Q. Swimming Pools and Water Related Activities (1) Accessibility of Pools. All swimming and wading pools shall be adequately fenced and inaccessible to children except during supervised activities. c. Provide the standards, appropriate to the provider setting and age of children, that address the identification of and protection from vehicular traffic hazards for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed center care and are found in Rules and Regulations for Child Care Learning Centers. Physical Plant 591-1-1-.25(16) Parking. Sufficient parking areas shall be provided to permit safe discharge and pick up of children. Playgrounds 591-1-1-.26(3) Location. Playgrounds shall be adjacent to the Center or in an area which can be reached by a safe route or method approved by the Department. Except in School-age Centers, the playground shall have shaded areas. 591-1-1-.26(4) Fence or Approved Barriers. Playgrounds shall be protected from traffic or other hazards by a four (4) foot or higher secure fence or other barrier approved by this Department. Fencing material shall not present a hazard to children and shall be maintained so as to prevent children from leaving the playground area by any means other than through an approved access route. Fence gates shall be kept closed except when persons are entering or exiting the area. Staff Training 591-1-1-.33(1) Center Orientation. Prior to assignment to children or task, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial Center orientation. 591-1-1-.33(2)The initial Center orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children; 591-1-1-.33(3)Health and Safety Orientation. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (e) building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; 591-1-1-.33(5)Annual Training. (a) Every calendar year after the first year of employment, all supervisory and caregiver Personnel, except independent contractors, Students-in-Training and volunteers, shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department- approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); Transportation 591-1-1-.36(12) Transporting vehicles shall be parked or stopped so that no child will have to cross the street in order to meet the vehicle or arrive at a destination. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school- age children in all CCDF-eligible licensed family child care homes and are found in Rules and Regulations for Family Child Care Learning Homes. Staffing and Supervision 290-2-3-.07(5) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. 290-2-3-.07(6) The initial program orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children; 290-2-3-.07(7) Health and Safety Orientation. The Provider, Employees and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (e) building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; 290-2-3-.07(9) Annual Training. (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); Building and Grounds 290-2-3-.13(2)(d) Such outside play areas shall be protected from traffic or other hazards by fencing or other barriers at least four feet in height and approved by the Department. Fencing material shall not present a hazard to children. A fence shall be provided around swimming pools to make them inaccessible when not in use. iii. All CCDF-eligible licensed in-home care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible regulated (but not licensed) informal in-home care providers and are found in the Health & Safety Standards for Informal Providers Appendix HH. M. Playgrounds (1) Fence or Approved Barriers. Playgrounds shall be protected from traffic or other hazards by a four (4) foot or higher secure fence or other barrier. Fencing material shall not present a hazard to children and shall be maintained so as to prevent children from leaving the playground area by any means other than through an approved access route. Fence gates shall be kept closed except when persons are entering or exiting the area. O. Staff Training (1) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. The initial program orientation must include the following subjects: the program's policies and procedures; the portions of these rules dealing with the care, health and safety of children; the Staff person’s assigned duties and responsibilities; reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; emergency weather plans; the program’s emergency preparedness plan; childhood injury control; the administration of medicine; reducing the risk of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS); hand washing; fire safety; water safety; and prevention of HIV/AIDS and blood borne pathogens. (2) Health and Safety Orientation. Each Informal Provider, Employees, and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required annual training hours. The training must address the following health and safety topics: (e) Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; (3) Ongoing Training (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: iii. Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); [ ] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible license-exempt center care and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. M. Playgrounds (1) Fence or Approved Barriers. It is recommended that playgrounds shall be protected from traffic or other hazards by a four (4) foot or higher secure fence or other barrier. Fencing material shall not present a hazard to children and shall be maintained so as to prevent children from leaving the playground area by any means other than through an approved access route. Fence gates should be kept closed except when persons are entering or exiting the area. If the outdoor play space has no fence or barrier, the program official must submit a plan to ensure children are protected from vehicular traffic, water hazards, and any other potential hazards while participating in outdoor play. P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (e) Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The following standards are applicable to school-age children in all CCDF-eligible out-of-school programs and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. Out- of-school programs includes (1) day camps and (2) government-owned and operated providers. M. Playgrounds (1) Fence or Approved Barriers. It is recommended that playgrounds shall be protected from traffic or other hazards by a four (4) foot or higher secure fence or other barrier. Fencing material shall not present a hazard to children and shall be maintained so as to prevent children from leaving the playground area by any means other than through an approved access route. Fence gates should be kept closed except when persons are entering or exiting the area. If the outdoor play space has no fence or barrier, the program official must submit a plan to ensure children are protected from vehicular traffic, water hazards, and any other potential hazards while participating in outdoor play. P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (e) Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); 5.3.6 Prevention of shaken baby syndrome, abusive head trauma, and maltreatment health and safety standard a. Provide the standards, appropriate to the provider setting and age of children, that address the prevention of shaken baby syndrome and abusive head trauma and indicate the age of children it applies to for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The following standards are applicable to children ages birth to two years of age in all CCDF- eligible licensed center care and are found in Rules and Regulations for Child Care Learning Centers. Discipline 591-1-1-.11(2) Personnel shall not: physically or sexually abuse a child or engage or permit others to engage in sexually overt conduct in the presence of any child enrolled in the Center; inflict corporal/physical punishment upon a child; shake, jerk, pinch or handle a child roughly; verbally abuse or humiliate a child which includes, but is not limited to, the use of threats, profanity or belittling remarks about a child or his family; isolate a child in a dark room, closet or unsupervised area; use mechanical or physical restraints or devices to discipline children; use medication to discipline or control children's behavior without written medical authorization issued by a licensed professional and given with the parent's written consent; restrict unreasonably a child from going to the bathroom; punish toileting accidents; force-feed a child or withhold feeding a child regularly scheduled meals and/or snacks; force or withhold naps; allow children to discipline or humiliate other children; and confine a child for disciplinary purposes to a swing, highchair, infant carrier, walker or jumpseat. Operational Policies and Procedures 591-1-1-.21(1) A Center shall establish and implement written policies and procedures which shall be kept current, be consistent with applicable laws, regulations and these rules, made available to the Parent(s) and used to govern the operations of the Center. The policies and procedures shall include the following: (k) Child abuse reporting law requirements. (r) A description of the practices followed by the Center to prevent shaken baby syndrome and abusive head trauma in children up to five years of age that includes the following information: how to recognize, respond to, and report the signs and symptoms of shaken baby syndrome and abusive head trauma; strategies to assist staff members in understanding how to care for infants and how to cope with a crying, fussing, or distraught child; strategies to ensure staff members understand the brain development of children up to five years of age; and a list of prohibited behaviors when dealing with children. Staff Training 591-1-1-.33(1) Center Orientation. Prior to assignment to children or task, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial Center orientation. 591-1-1-.33(2)The initial Center orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children; (d) reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; 591-1-1-.33(3)Health and Safety Orientation. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (f) prevention of shaken baby syndrome, abusive head trauma and child maltreatment; (i) precautions in transporting children; recognition and reporting of child abuse and neglect; and 591-1-1-.33(5)Annual Training. (a) Every calendar year after the first year of employment, all supervisory and caregiver Personnel, except independent contractors, Students-in-Training and volunteers, shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department- approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iv) Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). ii. All CCDF-eligible licensed family child care homes. Provide the standard: The following standards are applicable to children birth to two years of age in all CCDF-eligible licensed family child care homes and are found in Rules and Regulations for Family Child Care Learning Homes. Staffing and Supervision 290-2-3-.07(5) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. 290-2-3-.07(6) The initial program orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children; (d) reporting requirements for suspected cases of child abuse, neglect or deprivation; 290-2-3-.07(7) Health and Safety Orientation. The Provider, Employees and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (f) prevention of shaken baby syndrome, abusive head trauma and child maltreatment; (i) precautions in transporting children; recognition and reporting of child abuse and neglect; 290-2-3-.07(9) Annual Training. (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iv) Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). Health, Safety, and Discipline 290-2-3-.11(3) Discipline. Disciplinary actions used to correct a Child's behavior, guidance techniques and any activities in which the Children participate or observe at the Home shall not be detrimental to the physical or mental health of any child. 290-2-3-.11(3)(a) A Provider or a Home's Provisional Employees or Employees shall not: physically or sexually abuse a child, or engage in or permit others to engage in sexually overt conduct in the presence of any Child enrolled in the Home; inflict corporal/physical punishment upon a Child; shake, jerk, pinch or handle roughly a Child; verbally abuse or humiliate a Child which includes, but is not limited to, the use of threats, profanity, or belittling remarks about a Child or his family; isolate a Child in a dark room, closet, or unsupervised area; use mechanical or physical restraints or devices to discipline Children; use medication to discipline a Child or to control Children's behavior without written medical authorization issued by a licensed professional and given with the Parent's written consent; or discipline a Child by unreasonably restricting a Child from going to the bathroom; or by punishing toileting accidents; or by force feeding a Child; or by not feeding a Child regularly scheduled meals and/or snacks; or by forcing or withholding naps; or by allowing children to discipline or humiliate other Children; or by confining a Child for disciplinary purposes to a swing, high chair, infant carrier, walker or jump seat. iii. All CCDF-eligible licensed in-home care. Provide the standard: The following standards are applicable to children birth to two years of age in all CCDF-eligible regulated (but not licensed) informal in-home care providers and are found in the Health & Safety Standards for Informal Providers Appendix HH. A. Activities (3) Staff shall not engage in, or allow children or other adults to engage in, activities that could be detrimental to a child’s health or well-being, such as but not limited to, horse play, rough play, wrestling, and picking up a child in a manner that could cause injury. E. Discipline (1) Disciplinary actions used to correct a child's behavior, guidance techniques and any activities in which the children participate or observe at the program shall not be detrimental to the physical or mental health of any child. (2) Personnel shall not: (a) Physically or sexually abuse a child or engage or permit others to engage in sexually overt conduct in the presence of any child enrolled in the Program; (c) Shake, jerk, pinch or handle a child roughly; J. Policies and Procedures (1) The Informal Provider shall have a written policy regarding the following: (e) A description of the practices followed by the Program to prevent shaken baby syndrome and abusive head trauma in children up to five years of age that includes the following information: how to recognize, respond to, and report the signs and symptoms of shaken baby syndrome and abusive head trauma; strategies to assist staff members in understanding how to care for infants and how to cope with a crying, fussing, or distraught child; strategies to ensure staff members understand the brain development of children up to five years of age; and a list of prohibited behaviors when dealing with children, (g) Recognition and reporting of child abuse and neglect. O. Staff Training (1) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. The initial program orientation must include the following subjects: the program's policies and procedures; the portions of these rules dealing with the care, health and safety of children; the Staff person’s assigned duties and responsibilities; reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; emergency weather plans; the program’s emergency preparedness plan; childhood injury control; the administration of medicine; reducing the risk of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS); hand washing; fire safety; water safety; and prevention of HIV/AIDS and blood borne pathogens. (2) Health and Safety Orientation. Each Informal Provider, Employees, and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required annual training hours. The training must address the following health and safety topics: (f) Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; (j) Recognition and reporting of child abuse and neglect; (3) Ongoing Training (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: iv. Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). [ ] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The following standards are applicable to children birth to two years of age in all CCDF-eligible license-exempt center care and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. A. Activities (3) Staff shall not engage in, or allow children or other adults to engage in, activities that could be detrimental to a child’s health or well-being, such as but not limited to, horse play, rough play, wrestling, and picking up a child in a manner that could cause injury. E. Discipline (1) Disciplinary actions used to correct a child's behavior, guidance techniques and any activities in which the children participate or observe at the program shall not be detrimental to the physical or mental health of any child. (2) Personnel shall not: (a) Physically or sexually abuse a child or engage or permit others to engage in sexually overt conduct in the presence of any child enrolled in the Program; (c) Shake, jerk, pinch or handle a child roughly; J. Policies and Procedures (1) The Program shall establish and implement written policies and procedures that describe the Program's operations as follows: (e) Emergency preparedness and response. A written plan for handling emergencies, including but not limited to severe weather, loss of electrical power or water and death, serious injury or loss of a child, a threatening event, or natural disaster which may occur at the program. The program will have in place procedures for evacuation, relocation, shelter-in-place, lock-down, communication and reunification with families, and continuity of operations. The plan must apply to all children in care and will include specific accommodation for infants and toddlers, children with disabilities, and children with chronic medical conditions. Such plan shall include assurance that no Personnel will impede in any way the delivery of emergency care or services to a child by licensed or certified emergency health care professionals, (g) Recognition and reporting of child abuse and neglect, P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; (d) Reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (f) Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; (j) Recognition and reporting of child abuse and neglect; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iv) Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The following standards are applicable to school-age children in all CCDF-eligible out-of-school programs and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. Out- of-school programs includes (1) day camps and (2) government-owned and operated providers. A. Activities (3) Staff shall not engage in, or allow children or other adults to engage in, activities that could be detrimental to a child’s health or well-being, such as but not limited to, horse play, rough play, wrestling, and picking up a child in a manner that could cause injury. E. Discipline (1) Disciplinary actions used to correct a child's behavior, guidance techniques and any activities in which the children participate or observe at the program shall not be detrimental to the physical or mental health of any child. (2) Personnel shall not: (a) Physically or sexually abuse a child or engage or permit others to engage in sexually overt conduct in the presence of any child enrolled in the Program; (c) Shake, jerk, pinch or handle a child roughly; J. Policies and Procedures (1) The Program shall establish and implement written policies and procedures that describe the Program's operations as follows: (e) Emergency preparedness and response. A written plan for handling emergencies, including but not limited to severe weather, loss of electrical power or water and death, serious injury or loss of a child, a threatening event, or natural disaster which may occur at the program. The program will have in place procedures for evacuation, relocation, shelter-in-place, lock-down, communication and reunification with families, and continuity of operations. The plan must apply to all children in care and will include specific accommodation for infants and toddlers, children with disabilities, and children with chronic medical conditions. Such plan shall include assurance that no Personnel will impede in any way the delivery of emergency care or services to a child by licensed or certified emergency health care professionals, (g) Recognition and reporting of child abuse and neglect, P. Staff Training 1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; (d) Reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (f) Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; (j) Recognition and reporting of child abuse and neglect; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iv) Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). b. Provide the standards, appropriate to the provider setting and age of children, that address the prevention of child maltreatment and indicate the age of children it applies to for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed center care and are found in Rules and Regulations for Child Care Learning Centers. Activities 591-1-1-.03(9) Staff shall not engage in, or allow children or other adults to engage in, activities that could be detrimental to a child's health or well-being, such as but not limited to, horse play, rough play, wrestling, and picking up a child in a manner that could cause injury. Discipline 591-1-1-.11(1) Disciplinary actions used to correct a child's behavior, guidance techniques and any activities in which the children participate or observe at the Center shall not be detrimental to the physical or mental health of any child. 591-1-1-.11(2) Personnel shall not: physically or sexually abuse a child or engage or permit others to engage in sexually overt conduct in the presence of any child enrolled in the Center; inflict corporal/physical punishment upon a child; shake, jerk, pinch or handle a child roughly; verbally abuse or humiliate a child which includes, but is not limited to, the use of threats, profanity or belittling remarks about a child or his family; isolate a child in a dark room, closet or unsupervised area; use mechanical or physical restraints or devices to discipline children; use medication to discipline or control children's behavior without written medical authorization issued by a licensed professional and given with the parent's written consent; restrict unreasonably a child from going to the bathroom; punish toileting accidents; force-feed a child or withhold feeding a child regularly scheduled meals and/or snacks; force or withhold naps; allow children to discipline or humiliate other children; and confine a child for disciplinary purposes to a swing, highchair, infant carrier, walker or jumpseat. Operational Policies and Procedures 591-1-1-.21(1)(k) A Center shall establish and implement written policies and procedures which shall be kept current, be consistent with applicable laws, regulations and these rules, made available to the Parent(s) and used to govern the operations of the Center. (1) The policies and procedures shall include the following: Child abuse reporting law requirements. Staff: Child Ratios and Supervision 291-1-1-.32(7) Supervision. Children shall be supervised at all times appropriate to the individual age, needs and capabilities of each child. Such supervision must include, but not be limited to, indoor and outdoor activities, mealtimes, naptime, transportation, field trips, and transitions between activities. "Supervision" means that the appropriate number of Staff members are physically present in the area where children are being cared for and are providing watchful oversight to the children, volunteers and Students-in-Training. The persons supervising in the child care area must be alert, positioned to maximize their ability to hear and see the children at all times, and able to respond promptly to the needs and actions of the children being supervised, as well as the actions of the volunteers and Students- in-Training, and provide timely attention to the children's actions and needs. Staff shall be attentive and participating with all children during mealtimes and shall be seated within an arm’s length away from children thirty-six (36) months of age and younger. Staff Training 591-1-1-.33(1) Center Orientation. Prior to assignment to children or task, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial Center orientation. 591-1-1-.33(2)The initial Center orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children; (d) reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; 591-1-1-.33(3)Health and Safety Orientation. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (f) prevention of shaken baby syndrome, abusive head trauma and child maltreatment; (i) precautions in transporting children; recognition and reporting of child abuse and neglect; 591-1-1-.33(5)Annual Training. (a) Every calendar year after the first year of employment, all supervisory and caregiver Personnel, except independent contractors, Students-in-Training and volunteers, shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department- approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iv) Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). ii. All CCDF-eligible licensed family child care homes. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school- age children in all CCDF-eligible licensed family child care homes and are found in Rules and Regulations for Family Child Care Learning Homes. Staffing and Supervision 290-2-3-.07(5) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. 290-2-3-.07(6) The initial program orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children; (d) reporting requirements for suspected cases of child abuse, neglect or deprivation; 290-2-3-.07(7) Health and Safety Orientation. The Provider, Employees and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (f) prevention of shaken baby syndrome, abusive head trauma and child maltreatment; (i) precautions in transporting children; recognition and reporting of child abuse and neglect; 290-2-3-.07(9) Annual Training. (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iv) Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). 290-2-3-.07(1718) At least one Staff person with a satisfactory Comprehensive Records Check Determination shall supervise Children at all times appropriate to the individual age, needs and capabilities of each child. Such supervision must include, but not be limited to, indoor and outdoor activities, mealtimes, naptime, transportation, field trips, and transitions between activities. "Supervision" means Staff members are providing watchful oversight to the children, volunteers and Students-in-Training. The person(s) supervising in the child care area must be alert, positioned to maximize their ability to hear and see the children at all times, and able to respond promptly to the needs and actions of the children being supervised, as well as the actions of the volunteers and Students-in-Training, and provide timely attention to the children's actions and needs. Staff shall be attentive and participating with all children during mealtimes and shall be seated within an arm’s length away from children thirty-six (36) months of age and younger. Plans shall be made to obtain additional Staff help in cases of emergencies. Children’s Records 290-2-3-.08(8)(b)(4) Policies and Procedures. Each Family Child Care Learning Home shall establish policies and procedures, which shall be kept current, be consistent with applicable laws, including but not limited to the Americans with Disabilities Act, regulations and these rules, made available to the Parents, and used to govern the operations of the Family Child Care Learning Home. (b) The policies and procedures shall also include written procedures for the following: Notifying Parent(s) in writing of their Child's: illness, injury, and exposure to a notifiable communicable disease or any cases or suspected cases of viruses or illnesses (COVID-19, etc.) identified during a public health emergency, within twenty-four (24) hours after the Home becomes aware of the illness or the next working day. Children’s Activities 290-2-3-.09(8) The Provider shall not engage in or allow children or other adults to engage in activities that could be detrimental to a child's health or well-being such as, but not limited to, horse play, rough play, wrestling, and picking up a child in a manner that could cause injury. Health, Safety, and Discipline 290-2-3-.11(3) Discipline. Disciplinary actions used to correct a Child's behavior, guidance techniques and any activities in which the Children participate or observe at the Home shall not be detrimental to the physical or mental health of any child. 290-2-3-.11(3)(a) A Provider or a Home's Provisional Employees or Employees shall not: physically or sexually abuse a child, or engage in or permit others to engage in sexually overt conduct in the presence of any Child enrolled in the Home; inflict corporal/physical punishment upon a Child; shake, jerk, pinch or handle roughly a Child; verbally abuse or humiliate a Child which includes, but is not limited to, the use of threats, profanity, or belittling remarks about a Child or his family; isolate a Child in a dark room, closet, or unsupervised area; use mechanical or physical restraints or devices to discipline Children; use medication to discipline a Child or to control Children's behavior without written medical authorization issued by a licensed professional and given with the Parent's written consent; or discipline a Child by unreasonably restricting a Child from going to the bathroom; or by punishing toileting accidents; or by force feeding a Child; or by not feeding a Child regularly scheduled meals and/or snacks; or by forcing or withholding naps; or by allowing children to discipline or humiliate other Children; or by confining a Child for disciplinary purposes to a swing, high chair, infant carrier, walker or jump seat. iii. All CCDF-eligible licensed in-home care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible regulated (but not licensed) informal in-home care providers and are found in the Health & Safety Standards for Informal Providers Appendix HH. A. Activities (3) Staff shall not engage in, or allow children or other adults to engage in, activities that could be detrimental to a child’s health or well-being, such as but not limited to, horse play, rough play, wrestling, and picking up a child in a manner that could cause injury. E. Discipline (1) Disciplinary actions used to correct a child's behavior, guidance techniques and any activities in which the children participate or observe at the program shall not be detrimental to the physical or mental health of any child. (2) Personnel shall not: (a) Physically or sexually abuse a child or engage or permit others to engage in sexually overt conduct in the presence of any child enrolled in the Program; (b) Inflict corporal/physical punishment upon a child; (c) Shake, jerk, pinch or handle a child roughly; (d) Verbally abuse or humiliate a child which includes, but is not limited to, the use of threats, profanity or belittling remarks about a child or his family; (e) Isolate a child in a dark room, closet or unsupervised area; (f) Use mechanical or physical restraints or devices to discipline children; (g) Use medication to discipline or control children's behavior without written medical authorization issued by a licensed professional and given with the parent's written consent; (h) Restrict unreasonably a child from going to the bathroom; (i) Punish toileting accidents; (j) Force-feed a child or withhold feeding a child regularly scheduled meals and/or snacks; (k) Force or withhold naps; (l) Allow children to discipline or humiliate other children; (m) Confine a child for disciplinary purposes to a swing, highchair, infant carrier, walker or jumpseat; (n) Commit any criminal act, as defined under Georgia law which is set forth in O.C.G.A. § 16-1-1 et seq., in the presence of any child enrolled in the program. J. Policies and Procedures (1) The Informal Provider shall have a written policy regarding the following: (g) Recognition and reporting of child abuse and neglect. N. Staffing and Supervision (2) Supervision. Children shall be supervised at all times. "Supervision" means that the appropriate number of Staff members are physically present in the area where children are being cared for and are providing watchful oversight to the children. The persons supervising in the child care area must be alert, and able to respond promptly to the needs and actions of the children being supervised. O. Staff Training (1) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. The initial program orientation must include the following subjects: the program's policies and procedures; the portions of these rules dealing with the care, health and safety of children; the Staff person’s assigned duties and responsibilities; reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; emergency weather plans; the program’s emergency preparedness plan; childhood injury control; the administration of medicine; reducing the risk of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS); hand washing; fire safety; water safety; and prevention of HIV/AIDS and blood borne pathogens. (4)(3) Health and Safety Orientation. Each Informal Provider, Employees, and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required annual training hours. The training must address the following health and safety topics: (f) Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; (j) Recognition and reporting of child abuse and neglect; (3) Ongoing Training (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: iv. Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). [ ] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible license-exempt center care and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. A. Activities (3) Staff shall not engage in, or allow children or other adults to engage in, activities that could be detrimental to a child’s health or well-being, such as but not limited to, horse play, rough play, wrestling, and picking up a child in a manner that could cause injury. E. Discipline (1) Disciplinary actions used to correct a child's behavior, guidance techniques and any activities in which the children participate or observe at the program shall not be detrimental to the physical or mental health of any child. (2) Personnel shall not: (a) Physically or sexually abuse a child or engage or permit others to engage in sexually overt conduct in the presence of any child enrolled in the Program; (b) Inflict corporal/physical punishment upon a child; (c) Shake, jerk, pinch or handle a child roughly; (d) Verbally abuse or humiliate a child which includes, but is not limited to, the use of threats, profanity or belittling remarks about a child or his family; (e) Isolate a child in a dark room, closet or unsupervised area; (f) Use mechanical or physical restraints or devices to discipline children; (g) Use medication to discipline or control children's behavior without written medical authorization issued by a licensed professional and given with the parent's written consent; (h) Restrict unreasonably a child from going to the bathroom; (i) Punish toileting accidents; (j) Force-feed a child or withhold feeding a child regularly scheduled meals and/or snacks; (k) Force or withhold naps; (l) Allow children to discipline or humiliate other children; (m) Confine a child for disciplinary purposes to a swing, highchair, infant carrier, walker or jumpseat; (n) Commit any criminal act, as defined under Georgia law which is set forth in O.C.G.A. § 16-1-1 et seq., in the presence of any child enrolled in the program. (J) Policies and Procedures (1) The Program shall establish and implement written policies and procedures that describe the Program's operations as follows: (g) Recognition and reporting of child abuse and neglect. O. Staff: Child Ratios and Supervision (3) Supervision. Children shall be supervised at all times. "Supervision" means that the appropriate number of Staff members are physically present in the area where children are being cared for and are providing watchful oversight to the children. The persons supervising in the child care area must be alert, and able to respond promptly to the needs and actions of the children being supervised. P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; (d) Reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (f) Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; (j) Recognition and reporting of child abuse and neglect; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iv) Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The following standards are applicable to school-age children in all CCDF-eligible out-of-school programs and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. Out- of-school programs includes (1) day camps and (2) government-owned and operated providers. A. Activities (3) Staff shall not engage in, or allow children or other adults to engage in, activities that could be detrimental to a child’s health or well-being, such as but not limited to, horse play, rough play, wrestling, and picking up a child in a manner that could cause injury. E. Discipline (1) Disciplinary actions used to correct a child's behavior, guidance techniques and any activities in which the children participate or observe at the program shall not be detrimental to the physical or mental health of any child. (2) Personnel shall not: (a) Physically or sexually abuse a child or engage or permit others to engage in sexually overt conduct in the presence of any child enrolled in the Program; (b) Inflict corporal/physical punishment upon a child; (c) Shake, jerk, pinch or handle a child roughly; (d) Verbally abuse or humiliate a child which includes, but is not limited to, the use of threats, profanity or belittling remarks about a child or his family; (e) Isolate a child in a dark room, closet or unsupervised area; (f) Use mechanical or physical restraints or devices to discipline children; (g) Use medication to discipline or control children's behavior without written medical authorization issued by a licensed professional and given with the parent's written consent; (h) Restrict unreasonably a child from going to the bathroom; (i) Punish toileting accidents; (j) Force-feed a child or withhold feeding a child regularly scheduled meals and/or snacks; (k) Force or withhold naps; (l) Allow children to discipline or humiliate other children; (m) Confine a child for disciplinary purposes to a swing, highchair, infant carrier, walker or jumpseat; (n) Commit any criminal act, as defined under Georgia law which is set forth in O.C.G.A. § 16-1-1 et seq., in the presence of any child enrolled in the program. (J) Policies and Procedures (1) The Program shall establish and implement written policies and procedures that describe the Program's operations as follows: (g) Recognition and reporting of child abuse and neglect. O. Staff: Child Ratios and Supervision (3) Supervision. Children shall be supervised at all times. "Supervision" means that the appropriate number of Staff members are physically present in the area where children are being cared for and are providing watchful oversight to the children. The persons supervising in the child care area must be alert, and able to respond promptly to the needs and actions of the children being supervised. P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; (d) Reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (f) Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; (j) Recognition and reporting of child abuse and neglect; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iv) Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). 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 [x] Training [x] Practice drills vii. [x] Communication with families viii. [x] Reunification with families ix. [x] Continuity of operations x. Accommodation of [x] Infants [x] Toddlers [x] Children with disabilities [x] Children with chronic medical conditions xi. If any of the above are not checked, describe: 5.3.8 Handling and storage of hazardous materials and the appropriate disposal of biocontaminants health and safety standard a. Provide the standards, appropriate to the provider setting and age of children, that address the handling and storage of hazardous materials for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed center care and are found in Rules and Regulations for Child Care Learning Centers. Physical Plant 591-1-1-.25(13) Indoor Storage Areas. Potentially hazardous equipment, materials and supplies shall be stored in a locked area inaccessible to children. Examples of items to be stored include non-food related products under pressure in aerosol dispensing cans, flammable and corrosive materials, cleaning supplies, poisons, insecticides, office supplies and industrial-sized or commercial buckets with a capacity of three gallons or more or any other similar device with rigid sides which would not tip over if a toddler fell into the container head first. 591-1-1-.25(15) Outside Storage Area. Any outside storage or equipment area shall be locked, separated from the children by a barrier or enclosure, and shall not be accessible to the children. Staff Training 591-1-1-.33(1) Center Orientation. Prior to assignment to children or task, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial Center orientation. 591-1-1-.33(2)The initial Center orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children; 591-1-1-.33(3)Health and Safety Orientation. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (h) handling and storage of hazardous materials and the appropriate disposal of bio contaminants; 591-1-1-.33(5)Annual Training. (a) Every calendar year after the first year of employment, all supervisory and caregiver Personnel, except independent contractors, Students-in-Training and volunteers, shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department- approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); ii. All CCDF-eligible licensed family child care homes. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school- age children in all CCDF-eligible licensed family child care homes and are found in Rules and Regulations for Family Child Care Learning Homes. Staffing and Supervision 290-2-3-.07(5) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. 290-2-3-.07(6) The initial program orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children; 290-2-3-.07(7) Health and Safety Orientation. The Provider, Employees and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (h) handling and storage of hazardous materials and the appropriate disposal of bio contaminants; 290-2-3-.07(9) Annual Training. (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); Health, Safety, and Discipline 290-2-3-.11(2)(d) Children shall not have access to hanging cords or other hazardous objects. 290-2-3-.11(2)(f) Poisons, medicines, cleaning agents, razors, aerosol cans and other potential hazardous materials shall be stored out of reach of children or in locked cabinets. 290-2-3-.11(2)(g) Firearms shall be stored so they are not accessible to children. iii. All CCDF-eligible licensed in-home care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible regulated (but not licensed) informal in-home care providers and are found in the Health & Safety Standards for Informal Providers Appendix HH. J. Policies and Procedures (1) The Informal Provider shall have a written policy regarding the following: (f)The handling and appropriate disposal of bodily fluids and storage of hazardous materials (soiled clothing and bedding) L. Physical Plant (1) Indoor Storage Areas. Potentially hazardous equipment, materials and supplies shall be stored in a locked area inaccessible to children. Examples of items to be stored include non-food related products under pressure in aerosol dispensing cans, flammable and corrosive materials, cleaning supplies, poisons, insecticides, office supplies and industrial-sized or commercial buckets with a capacity of three gallons or more or any other similar device with rigid sides which would not tip over if a toddler fell into the container head first. O. Staff Training (1) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. The initial program orientation must include the following subjects: the program's policies and procedures; the portions of these rules dealing with the care, health and safety of children; the Staff person’s assigned duties and responsibilities; reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; emergency weather plans; the program’s emergency preparedness plan; childhood injury control; the administration of medicine; reducing the risk of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS); hand washing; fire safety; water safety; and prevention of HIV/AIDS and blood borne pathogens. (2) Health and Safety Orientation. Each Informal Provider, Employees, and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required annual training hours. The training must address the following health and safety topics: (h) Handling and storage of hazardous materials and the appropriate disposal of bio contaminants; (3) Ongoing Training (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: iii. Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); [ ] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible license-exempt center care and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. J. Policies and Procedures (1) Program shall have a written policy regarding the following: (f) The handling and appropriate disposal of bodily fluids and storage of hazardous materials (soiled clothing and bedding) L. Physical Plant (3) Indoor Storage Areas. Potentially hazardous equipment, materials and supplies shall be stored in a locked area inaccessible to children. Examples of items to be stored include non-food related products under pressure in aerosol dispensing cans, flammable and corrosive materials, cleaning supplies, poisons, insecticides, office supplies and industrial-sized or commercial buckets with a capacity of three gallons or more or any other similar device with rigid sides which would not tip over if a toddler fell into the container head first. P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (h) Handling and storage of hazardous materials and the appropriate disposal of bio contaminants; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The following standards are applicable to school-age children in all CCDF-eligible out-of-school programs and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. Out- of-school programs includes (1) day camps and (2) government-owned and operated providers. J. Policies and Procedures (1) Program shall have a written policy regarding the following: (f) The handling and appropriate disposal of bodily fluids and storage of hazardous materials (soiled clothing and bedding) L. Physical Plant (3) Indoor Storage Areas. Potentially hazardous equipment, materials and supplies shall be stored in a locked area inaccessible to children. Examples of items to be stored include non-food related products under pressure in aerosol dispensing cans, flammable and corrosive materials, cleaning supplies, poisons, insecticides, office supplies and industrial-sized or commercial buckets with a capacity of three gallons or more or any other similar device with rigid sides which would not tip over if a toddler fell into the container head first. P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (h) Handling and storage of hazardous materials and the appropriate disposal of bio contaminants; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); b. Provide the standards, appropriate to the provider setting and age of children, that address the disposal of bio contaminants for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed center care and are found in Rules and Regulations for Child Care Learning Centers. Hygiene 591-1-1-.17(6) (6) Garbage. Garbage and organic waste shall be stored in containers that are lined with plastic liners and have tight-fitting covers. Trash and garbage shall be removed from the building daily or as often as necessary to maintain the premises in a clean condition. Kitchen Operations 591-1-1-.18(10) (10) Garbage. Garbage shall be stored in trash containers with lids. Containers shall be emptied and cleaned as needed. Acceptable facilities, including water and detergent or steam, shall be provided and used for cleaning containers. Areas around outside containers shall be kept clean. Staff Training 591-1-1-.33(1) Center Orientation. Prior to assignment to children or task, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial Center orientation. 591-1-1-.33(2)The initial Center orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children; 591-1-1-.33(3)Health and Safety Orientation. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (h) handling and storage of hazardous materials and the appropriate disposal of bio contaminants; 591-1-1-.33(5)Annual Training. (a) Every calendar year after the first year of employment, all supervisory and caregiver Personnel, except independent contractors, Students-in-Training and volunteers, shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department- approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (ii) Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); ii. All CCDF-eligible licensed family child care homes. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school- age children in all CCDF-eligible licensed family child care homes and are found in Rules and Regulations for Family Child Care Learning Homes. Staffing and Supervision 290-2-3-.07(5) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. 290-2-3-.07(6) The initial program orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children; 290-2-3-.07(7) Health and Safety Orientation. The Provider, Employees and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (h) handling and storage of hazardous materials and the appropriate disposal of bio contaminants; 290-2-3-.07(9) Annual Training. (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (ii) Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); Nutrition and Food Services 290-2-3-.10(17) (17) Garbage. Garbage shall be stored in trash containers with lids and emptied and cleaned as needed. Areas around outdoor containers shall be kept clean. iii. All CCDF-eligible licensed in-home care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible regulated (but not licensed) informal in-home care providers and are found in the Health & Safety Standards for Informal Providers Appendix HH. J. Policies and Procedures (1) The Informal Provider shall have a written policy regarding the following: (f) The handling and appropriate disposal of bodily fluids and storage of hazardous materials (soiled clothing and bedding) O. Staff Training (1) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. The initial program orientation must include the following subjects: the program's policies and procedures; the portions of these rules dealing with the care, health and safety of children; the Staff person’s assigned duties and responsibilities; reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; emergency weather plans; the program’s emergency preparedness plan; childhood injury control; the administration of medicine; reducing the risk of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS); hand washing; fire safety; water safety; and prevention of HIV/AIDS and blood borne pathogens. (2) Health and Safety Orientation. Each Informal Provider, Employees, and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required annual training hours. The training must address the following health and safety topics: (h) Handling and storage of hazardous materials and the appropriate disposal of bio contaminants; (3) Ongoing Training (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: ii. Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); [ ] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible license-exempt center care and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. J. Policies and Procedures (1) Program shall have a written policy regarding the following: (f) The handling and appropriate disposal of bodily fluids and storage of hazardous materials (soiled clothing and bedding) P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (h) Handling and storage of hazardous materials and the appropriate disposal of bio contaminants; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: ii. Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The following standards are applicable to school-age children in all CCDF-eligible out-of-school programs and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. Out- of-school programs includes (1) day camps and (2) government-owned and operated providers. J. Policies and Procedures (1) Program shall have a written policy regarding the following: (f) The handling and appropriate disposal of bodily fluids and storage of hazardous materials (soiled clothing and bedding) P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (h) Handling and storage of hazardous materials and the appropriate disposal of bio contaminants; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: ii. Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); 5.3.9 Precautions in transporting children health and safety standard Provide the standards, appropriate to the provider setting and age of children, that address precautions in transporting children for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed center care and are found in Rules and Regulations for Child Care Learning Centers. Field Trips 591-1-1-.13(4) If the field trip involves transporting children, the Center must ensure it complies with the staffing requirements for transporting children. First Aid and CPR 591-1-1-.14(2)(c) During any field trip or transportation of children, there must always be a staff member present who has current evidence of the successful completion of pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid. 591-1-1-.14(3) Supplies. Each building of the Center and any vehicle used by the Center for transportation of children shall have a first aid kit which shall at least contain: scissors; tweezers; gauze pads; adhesive tape; thermometer; band-aids, assorted sizes; antibacterial ointment; insect-sting preparation; an antiseptic cleansing solution; triangular bandages; rubber gloves; protective eye wear; a protective face mask; and cold pack. The first aid kit, together with a first aid instruction manual which must be kept with the kit at all times, shall be stored so that it is not accessible to children but is easily accessible to Staff. Operational Policies and Procedures 591-1-1-.21(1)(d) A Center shall establish and implement written policies and procedures which shall be kept current, be consistent with applicable laws, regulations and these rules, made available to the Parent(s) and used to govern the operations of the Center. (1) The policies and procedures shall include the following: A description of the Center's transportation and field trip services (see rule .36 about transportation requirements). Staff: Child Ratios and Supervision 591-1-1-.32(7) Supervision. Children shall be supervised at all times appropriate to the individual age, needs and capabilities of each child. Such supervision must include, but not be limited to, indoor and outdoor activities, mealtimes, naptime, transportation, field trips, and transitions between activities. "Supervision" means that the appropriate number of Staff members are physically present in the area where children are being cared for and are providing watchful oversight to the children, volunteers and Students-in-Training. The persons supervising in the child care area must be alert, positioned to maximize their ability to hear and see the children at all times, and able to respond promptly to the needs and actions of the children being supervised, as well as the actions of the volunteers and Students- in-Training, and provide timely attention to the children's actions and needs. Staff shall be attentive and participating with all children during mealtimes and shall be seated within an arm’s length away from children thirty-six (36) months of age and younger. Staff Training 591-1-1-.33(1) Center Orientation. Prior to assignment to children or task, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial Center orientation. 591-1-1-.33(2)The initial Center orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children; 591-1-1-.33(3)Health and Safety Orientation. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (i) precautions in transporting children; recognition and reporting of child abuse and neglect; 591-1-1-.33(5)Annual Training. (a) Every calendar year after the first year of employment, all supervisory and caregiver Personnel, except independent contractors, Students-in-Training and volunteers, shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department- approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); Transportation 591-1-1-.36(1-13) (1) Transportation Requirements. The transportation requirements that follow apply to all transportation provided by the Center, including transportation provided by any person on behalf of the Center, regardless of whether the person is employed by the License Center and regardless of whether a fee is charged for this service. Non-routine transportation, such as a Parent requesting that their child be picked up at school due to the Parents' work schedule or other conflicts, is also covered by these requirements, regardless of whether a fee is charged for this service or not. (Possible scenarios include, but are not limited to: contract services hired by the Center to provide transportation or another licensed facility providing transportation on the Center's behalf.) (2) Emergency Transportation. A Center shall have available at all times both a licensed driver and a vehicle that meets the safety requirements contained in these rules or must have a plan approved by the Department for alternative emergency transportation. (3) Transportation Training. Child Care Learning Centers that provide any type of transportation shall obtain two (2) clock hours of state-approved or state- accepted transportation training, biannually, for the Director and for each Staff person responsible for or who participates in the transportation of children. The training shall include, but is not limited to, a review of the transportation rules, a review of approved transportation forms and procedures, and instruction on the usage and completion of the forms and procedures. This training may be counted as part of the annual training requirements for Staff. (a) The Director and each Staff person who is responsible for or who participates in the transportation of children shall complete two (2) clock hours of state-approved or state-accepted transportation training on or before June 30, 2015 and at least every two years thereafter. (b) Effective July 1, 2015, the Director and each Staff person who will be responsible for or participate in the transportation of children shall have completed two (2) clock hours of state-approved or state-accepted transportation training prior to assuming any duties related to the transportation of children and at least every two years thereafter. (4) Vehicle Safety. Vehicles used for transporting children shall be maintained as follows: (a) Annual Safety Check. Each vehicle shall have a satisfactory annual safety check, completed by a trained individual, of at least: tires, headlights, horn, taillights, turn signals, brake lights, brakes, suspension, exhaust system, steering, windows, windshields and windshield wipers. A copy of a standard inspection report used by the Department or an equivalent shall be kept in the Center or on the vehicle and should include evidence of any repairs and/or replacements that were identified as needed on the inspection report. (b) Interior. Interior of a transportation vehicle must be clean and in safe repair and free of hazardous items, objects and/or other non-essential items which could impede the children's access or egress from the vehicle or cause injury if the items were thrown about the vehicle as a result of a collision. (c) Fire Extinguisher. Each vehicle shall be equipped with a fire extinguisher maintained in working order and kept inaccessible to children. (d) Heater. Each vehicle must have a functioning heating system. (e) Seats. Seats must be securely fastened to the body of the vehicle. (f) Child Passenger Restraints 1. All children transported in a vehicle provided by or used by the Center shall be secured in a child passenger restraining system or seat safety belt in accordance with current state and federal laws and regulations. The child passenger restraining system and seat safety belts must be installed and used in accordance with the manufacturer's directions for such system and used in accordance with the manufacturer's directions with respect to restraining, seating or positioning the child being transported in the vehicle. 2. No vehicle used by the Center to transport children shall exceed the manufacturer's rated seating capacity for the vehicle. The Center shall maintain on file proof of the manufacturer's rated seating capacity for each vehicle used by the Center. (g) Front Seat. There shall be no more than three (3) persons in the front seat of a transporting vehicle including the driver. Centers must follow applicable state and federal laws and regulations and the vehicle manufacturer's recommendations when children are allowed to sit in the front seat. (h) Windows. No window, in a transporting vehicle, except that of the driver, shall be opened to more than fifty percent (50%) of its capacity at any time children are on board. (5) Staffing Requirements for Transportation of Children (a) Driver. Whenever the Center transports children for any reason, the driver of the vehicle shall be at least eighteen (18) years of age and possess a valid driver's license as required for the class of vehicle that the driver will be operating for the Center. (b) Additional Staff. When the Center transports children for any reason, the following Staff:child ratios shall be maintained: - Driver + One (1) Staff Members [The additional Staff must be at least eighteen (18) years of age or older]: When transporting three (3) or more children under three years of age; When seven (7) or more children under five (5) years of age occupy vehicle; When eighteen (18) or more children five (5) years of age or older occupy the vehicle. - Driver + Two (2) Staff Members [One (1) of the additional Staff members must be at least eighteen (18) years of age]: When eight (8) or more children under three (3) years of age occupy the vehicle with other children; When more than twenty (20) children under five years of age occupy the vehicle with other children. (c) Staffing Requirements When Transporting More Than Thirty-Six (36) Children. 1. When more than thirty-six (36) children under five (5) years of age occupy the vehicle, the Staff:child ratios as stated in Rules 591-1-1-.32(1) and 591-1-1- .32(2) shall be met. 2. When more than thirty-six (36) children five (5) years of age and older are transported with no children under the age of five (5) years, there shall be a minimum of two (2) Staff persons for the first thirty-six (36) children and there must be one additional Staff person for each additional twenty (20) children. This means a third Staff person would be required if transporting thirty-seven (37) to fifty-six (56) children five (5) years and older. (6) Parental Authorization. For routine transportation provided by the Center or on behalf of the Center, the child's Parent(s) must provide written authorization for the transportation and specify routine pick-up location, routine pick-up time, routine delivery location, routine delivery time and the name of any person authorized to receive the child. (7) Transportation Plan. For all transportation conducted by the Center or on behalf of the Center, the following requirements shall be met: (a) Center and Passenger Information. Each vehicle used to transport children shall contain current information including the full names of all children to be transported and each child's pick-up location, pick-up time, delivery location, alternate delivery location if a Parent is not at home and name of person authorized to receive each child. In addition, the vehicle shall contain current information identifying the Center's name and telephone number and the name of the driver of the vehicle. (b) Emergency Medical Information. An emergency medical information record must be maintained in the vehicle for each child being transported. The emergency medical information record for each child shall include a listing of the child's full name, date of birth, allergies, special medical needs and conditions, current prescribed medications that the child is required to take on a daily basis for a chronic condition, the name and phone number of the child's doctor, the local medical facility that the Center uses in the area where the Center is located and the telephone numbers where the Parent(s) can be reached. (c) Passenger Transportation Checklists. A passenger transportation checklist, provided by or in a format approved by the Department, shall be used to account for each child during transportation. A separate passenger checklist shall be used for each vehicle. 1. The first and last name of each child transported shall be documented on the passenger transportation checklist. Each child shall be listed individually; a sibling group shall not be listed as a single entry, for example, an entry of "Smith children" would be unacceptable. 2. The driver or other designated person shall immediately document in writing, with a check or other mark/symbol to account for each child listed on the passenger transportation checklist each time a child enters and exits the vehicle. The driver or other designated person shall document in writing with a different mark/symbol to account for each child listed on the passenger transportation checklist who was not present on the vehicle for any reason. An explanation shall be documented in writing whenever a child is transported to a field trip site but is not present on the return trip to the Center. 3. The driver or other designated Staff person shall also document in writing the dates and the departure/arrival times for all types of transportation on the passenger transportation checklist as follows: School Transportation - each time the vehicle departs from the Center, is loaded or unloaded at each school and when the vehicle returns to the Center. Home Transportation - each time the vehicle departs from the Center, arrives at the location where any child is picked up or dropped off and when the vehicle returns to the Center. Field Trip Transportation- each time the vehicle leaves the Center, arrives at a field trip destination, leaves a field trip destination, and returns to the Center. 4. The Staff person on the vehicle responsible for keeping the passenger transportation checklist shall give the completed passenger transportation checklist to the Director or the Director's designated Staff person at the Center as set forth below: immediately upon return to the Center at the completion of the trip once the vehicle has been checked or the next business day following the completion of the trip if the vehicle did not return to the Center at the end of the trip or if the Center was closed when the vehicle returned. 5. Passenger transportation checklists shall be maintained as Center records for one (1) year. (d)Checking the Vehicle - To ensure that all children have been unloaded from transportation vehicles, regardless of whether the vehicle is equipped with a child safety alarm devices, the vehicle shall be thoroughly checked first by a designated Staff person who was present on the vehicle during the trip and then by a second designated Staff person, who may or may not have been present on the vehicle during the trip, to ensure that two checks of the vehicle have been completed. 1. The first check shall be conducted immediately upon unloading the last child at any location including, but not limited to, a field trip destination, arrival at the Center, and the last stop during transportation to home or school. The responsible person on the vehicle shall: physically walk through the entire vehicle; visually inspect all seat surfaces, under all seats and in all compartments or recesses in the vehicle's interior; sign the passenger transportation checklist(s), indicating all of the children have exited the vehicle; and give the passenger transportation checklist(s) to the second designated Staff person. 2. The second designated Staff person shall conduct a check of the vehicle immediately upon the completion of the first check of the vehicle. The responsible person shall: physically walk through the entire vehicle; visually inspect all seat surfaces, under all seats and in all compartments or recesses in the vehicle's interior; and sign the passenger transportation checklist(s), indicating all of the children have exited the vehicle. There shall be continuous watchful oversight of the vehicle between the first check and second check. 3. If a second designated Staff person is not available to conduct a second check of the vehicle, the driver shall check the vehicle as follows: physically walk through the entire vehicle; visually inspect all seat surfaces, under all seats and in all compartments or recesses in the vehicle's interior; and sign the passenger transportation checklist(s), indicating all of the children have exited the vehicle, and then report by phone to the Director or designated Staff person that the check has been completed and no children remain on the vehicle. (Possible circumstances include, but are not limited to: the Center has closed when the driver returns with the vehicle; the driver is the only Staff person on the vehicle at the last destination during home, school or field trip transportation; the driver takes the vehicle home at the end of the day.) The time and verification of such telephone contact shall be immediately documented and signed on the passenger transportation checklist(s) by the driver. (8) Travel Restriction. Unless accompanied by his or her Parent, no child shall be required to travel more than forty-five (45) minutes on each trip between the Center and destination point, excluding field trips. (9) Center Responsibility. The Center is responsible for the child from the time and place the child is picked up until the child is delivered to his or her Parent(s) or the responsible person designated by his or her Parent(s). A child shall not be dropped off at any location if there is no one present authorized to receive the child. (10)Supervision of Vehicles. A child shall never be left unattended in a vehicle. (11)Prohibited Methods of Transportation. Children shall not be transported in vehicles, or parts thereof, which are not designed for the purpose of transporting people, such as but not limited to: truck beds, campers or any trailers attached-to a motor vehicle. (12) Transporting vehicles shall be parked or stopped so that no child will have to cross the street in order to meet the vehicle or arrive at a destination. (13) The motor shall be turned off, the brake set and the keys removed whenever the driver leaves the vehicle. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school- age children in all CCDF-eligible licensed family child care homes and are found in Rules and Regulations for Family Child Care Learning Homes. Staffing and Supervision 290-2-3-.07(5) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. 290-2-3-.07(6) The initial program orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children; 290-2-3-.07(7) Health and Safety Orientation. The Provider, Employees and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (i) precautions in transporting children; recognition and reporting of child abuse and neglect; 290-2-3-.07(9) Annual Training. (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); 290-2-3-.07(8)(c) The Provider, a Provisional Employee, or Employee with current evidence of successful completion of pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid must always be present on any field trip or during the transportation of children. 290-2-3-.07(18) At least one Staff person with a satisfactory Comprehensive Records Check Determination shall supervise Children at all times appropriate to the individual age, needs and capabilities of each child. Such supervision must include, but not be limited to, indoor and outdoor activities, mealtimes, naptime, transportation, field trips, and transitions between activities. "Supervision" means Staff members are providing watchful oversight to the children, volunteers and Students-in-Training. The person(s) supervising in the child care area must be alert, positioned to maximize their ability to hear and see the children at all times, and able to respond promptly to the needs and actions of the children being supervised, as well as the actions of the volunteers and Students-in-Training, and provide timely attention to the children's actions and needs. Staff shall be attentive and participating with all children during mealtimes and shall be seated within an arm’s length away from children thirty-six (36) months of age and younger. Plans shall be made to obtain additional Staff help in cases of emergencies. Children’s Records 290-2-3-.08(7) Such records shall include parental agreements for transportation, field trips, swimming and/or other activities away from the Home if the Child will be participating in these activities. 290-2-3-.08(8)(a) Policies and Procedures. Each Family Child Care Learning Home shall establish policies and procedures, which shall be kept current, be consistent with applicable laws, including but not limited to the Americans with Disabilities Act, regulations and these rules, made available to the Parents, and used to govern the operations of the Family Child Care Learning Home. (a) The policies and procedures shall include a written description of the services to be provided which specifies the following: ages of children served, months of operation, days of operation, hours of operation, dates the Family Child Care Learning Home will be closed, admission requirements, including parental responsibilities for supplying and maintaining accurate required record information and escorting Child to and from the Family Child Care Learning Home; standard fees, payment of fees, fees related to absences and vacations and other charges such as transportation, etc. and transportation provided, if any. 290-2-3-.08(8)(b)(9) Policies and Procedures. Each Family Child Care Learning Home shall establish policies and procedures, which shall be kept current, be consistent with applicable laws, including but not limited to the Americans with Disabilities Act, regulations and these rules, made available to the Parents, and used to govern the operations of the Family Child Care Learning Home. (b) The policies and procedures shall also include written procedures for the following: The transportation of Children to and from school or home, if provided, to include the procedure to be followed if no one is home to receive the transported Child. Health, Safety, and Discipline 290-2-3-.11(1)(e) The Home and any vehicle used by the Home for transportation of Children shall have a first aid kit which shall at least contain: scissors, tweezers, gauze pads, thermometer, adhesive tape, band-aids, insect-sting preparation, antiseptic cleaning solution, antibacterial ointment, bandages, disposable rubber gloves, protective eyewear, facemask, and cold pack. The first aid kit, together with a first aid instruction manual which must be kept with the kit at all times, shall be stored in a central location so that it is not accessible to Children but is easily accessible to the Provider and Staff. The Home must also maintain written directions for the use of universal precautions for handling blood and bodily fluids. The directions on the use of universal precautions must be kept with the first aid kit at all times. 290-2-3-.11(2)(j-m) (j) If children are transported in a vehicle by the Provider or a Home's employee, the driver shall have a current driver's license. (k) When transported in a vehicle by the Provider or a Home's employee, children shall be restrained by either individual seat belts or appropriate child restraints in accordance with current state and federal laws and regulations. (l) No child shall be left unattended in a motor vehicle. (m) If children are transported, written authorization for the Child to receive emergency medical treatment when the Parent is not available, as required by these rules, shall be maintained in the vehicle. iii. All CCDF-eligible licensed in-home care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible regulated (but not licensed) informal in-home care providers and are found in the Health & Safety Standards for Informal Providers Appendix HH. O. Staff Training (1) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. The initial program orientation must include the following subjects: the program's policies and procedures; the portions of these rules dealing with the care, health and safety of children; the Staff person’s assigned duties and responsibilities; reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; emergency weather plans; the program’s emergency preparedness plan; childhood injury control; the administration of medicine; reducing the risk of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS); hand washing; fire safety; water safety; and prevention of HIV/AIDS and blood borne pathogens. (2) Health and Safety Orientation. Each Informal Provider, Employees, and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required annual training hours. The training must address the following health and safety topics: (i) Precautions in transporting children (if applicable); (3) Ongoing Training (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: iii. Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); Q. Transportation (1) If children are transported in a vehicle, the Informal Provider shall: (a) Have a Current driver’s license. (b) Restrain children by either induvial seat belts or appropriate child restraints in accordance with current state and federal laws and regulations. (c) Obtain written authorization for the child to be transported by the Provider. (d) Obtain written authorization for the Child to receive emergency medical treatment when the Parent is not available, as required by these rules, shall be maintained in the vehicle. (2) Supervision of Vehicles. A child shall never be left unattended in a vehicle. R. Field Trips (1) Parental Permission. An Informal Provider shall obtain written permission from Parent(s) in advance of the child's participation in any field trip and such permission must be signed and dated by a Parent. (2) List of Trip Participants. A list of children and adults participating in the trip shall be left at the Informal Provider’s home as well as be taken on the trip in the possession of the adult in charge of the trip. (3) Emergency Medical Information. Emergency medical information on each child to include allergies; special medical needs and conditions; current prescribed medications that the child is required to take on a daily basis for a chronic condition; the name and phone number of the child's doctor; the local medical facility that the program uses in the area where the program is located; and the telephone numbers where the Parent(s) can be reached shall be left at the program as well as be taken on the trip in the possession of the adult in charge of the trip. [ ] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible license-exempt center care and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (i) Precautions in transporting children (if applicable); (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); R. Transportation (1) Vehicle Safety. Vehicles used for transporting children shall be maintained as follows: (a) Annual Safety Check. Each vehicle shall have a satisfactory annual safety check, completed by a trained individual, of at least: tires, headlights, horn, taillights, turn signals, brake lights, brakes, suspension, exhaust system, steering, windows, windshields and windshield wipers. A copy of a standard inspection report used by the Department or an equivalent shall be kept on file at the program or on the vehicle and should include evidence of any repairs and/or replacements that were identified as needed on the inspection report. (b) Interior. Interior of a transportation vehicle must be clean and in safe repair and free of hazardous items, objects and/or other non-essential items which could impede the children's access or egress from the vehicle or cause injury if the items were thrown about the vehicle as a result of a collision. (c) Child Passenger Restraints. All children transported in a vehicle provided by or used by the program shall be secured in a child passenger restraining system or seat safety belt in accordance with current state and federal laws and regulations. The child passenger restraining system and seat safety belts must be installed and used in accordance with the manufacturer's directions for such system and used in accordance with the manufacturer’s directions with respect to restraining, seating or positioning the child being transported in the vehicle. (2) Driver. Whenever the program transports children for any reason, the driver of the vehicle shall be at least eighteen (18) years of age and possess a valid driver's license as required for the class of vehicle that the driver will be operating for the program. (3) Pediatric CPR and First Aid Training. Either the driver or another Staff person present on the vehicle shall have current evidence of successful completion of a biennial training program in pediatric cardiopulmonary resuscitation (CPR) for infants and children and a triennial training program in pediatric first aid offered by certified or licensed health care professionals. (4) Additional Staff. When the program transports children for any reason, the following Staff:child ratios shall be maintained: - Driver + One (1) Staff Members. The additional Staff must be at least eighteen (18) years of age or older. - When transporting three (3) or more children under three years of age; - When seven (7) or more children under five (5) years of age occupy vehicle; - When eighteen (18) or more children five (5) years of age or older occupy the vehicle. - Driver + Two (2) Staff Members. One (1) of the additional Staff members must be at least eighteen (18) years of age. - When eight (8) or more children under three (3) years of age occupy the vehicle with other children; - When more than twenty (20) children under five years of age occupy the vehicle with other children. (5) Staffing Requirements When Transporting More Than Thirty-Six (36) Children. (a) When more than thirty-six (36) children under five (5) years of age occupy the vehicle, the Staff:child ratios as stated in Standard EX-HS-R(5)(a) shall be met. (b) When more than thirty-six (36) children five (5) years of age and older are transported with no children under the age of five (5) years, there shall be a minimum of two (2) Staff persons for the first thirty-six (36) children and there must be one additional Staff person for each additional twenty (20) children. This means a third Staff person would be required if transporting thirty-seven (37) to fifty-six (56) children five (5) years and older. (6) Parental Authorization. For routine transportation provided by the program or on behalf of the program, the child's Parent(s) must provide written authorization for the transportation and specify routine pick-up location, routine pick-up time, routine delivery location, routine delivery time and the name of any person authorized to receive the child. (7) Transportation Plan. For all transportation conducted by the Program or on behalf of the Program, the following requirements shall be met: (a) Program and Passenger Information. Each vehicle used to transport children shall contain current information including the full names of all children to be transported and each child's pick-up location, pick-up time, delivery location, alternate delivery location if a Parent is not at home and name of person authorized to receive each child. In addition, the vehicle shall contain current information identifying the Program’s name and telephone number and the name of the driver of the vehicle. (b) Emergency Medical Information. An emergency medical information record must be maintained in the vehicle for each child being transported. The emergency medical information record for each child shall include a listing of the child's full name, date of birth, allergies, special medical needs and conditions, current prescribed medications that the child is required to take on a daily basis for a chronic condition, the name and phone number of the child's doctor, the local medical facility that the Program uses in the area where the Program is located and the telephone numbers where the Parent(s) can be reached. (c) Passenger Transportation Checklists. A passenger transportation checklist, provided by or in a format approved by the Department, shall be used to account for each child during transportation. A separate passenger checklist shall be used for each vehicle. 1. The first and last name of each child transported shall be documented on the passenger transportation checklist. Each child shall be listed individually; a sibling group shall not be listed as a single entry, for example, an entry of ￿Smith children￿ would be unacceptable. 2. The driver or other designated person shall immediately document in writing, with a check or other mark/symbol to account for each child listed on the passenger transportation checklist each time a child enters and exits the vehicle. The driver or other designated person shall document in writing with a different mark/symbol to account for each child listed on the passenger transportation checklist who was not present on the vehicle for any reason. An explanation shall be documented in writing whenever a child is transported to a field trip site but is not present on the return trip to the Program. 3. The driver or other designated Staff person shall also document in writing the departure/arrival times for all types of transportation on the passenger transportation checklist as follows: (i) Home Transportation - Each time the vehicle departs from the Program, arrives at the location where any child is picked up or dropped off and when the vehicle returns to the Program. (ii) Field Trip Transportation- Each time the vehicle leaves the Program, arrives at a field trip destination, leaves a field trip destination, and returns to the Program. 4. The Staff person on the vehicle responsible for keeping the passenger transportation checklist shall give the completed passenger transportation checklist to the Director or the Director’s designated Staff person at the Program as set forth below: (i) Immediately upon return to the Program at the completion of the trip once the vehicle has been checked; or (ii) The next business day following the completion of the trip if the vehicle did not return to the Program at the end of the trip or if the Program was closed when the vehicle returned. 5. Passenger transportation checklists shall be maintained as Program records for one (1) year. 6. Checking the Vehicle - To ensure that all children have been unloaded from transportation vehicles, regardless of whether the vehicle is equipped with a child safety alarm devices, the vehicle shall be thoroughly checked first by a designated Staff person who was present on the vehicle during the trip and then by a second designated Staff person, who may or may not have been present on the vehicle during the trip, to ensure that two checks of the vehicle have been completed. 7. The first check shall be conducted immediately upon unloading the last child at any location including, but not limited to, a field trip destination, arrival at the Program, and the last stop during transportation to home or school. The responsible person on the vehicle shall: (i) Physically walk through the entire vehicle; (ii) Visually inspect all seat surfaces, under all seats and in all compartments or recesses in the vehicle’s interior; (iii) Sign the passenger transportation checklist(s), indicating all of the children have exited the vehicle; and give the passenger transportation checklist(s) to the second designated Staff person. The second designated Staff person shall conduct a check of the vehicle as referenced in EX-HS-R. The second check shall be conducted immediately upon the completion of the first check of the vehicle. There shall be continuous watchful oversight of the vehicle between the first check and second check. (iv) If a second designated Staff person is not available to conduct a second check of the vehicle, the driver shall check the vehicle as stated in EX-HS-R.(7) above and then report by phone to the Director or designated Staff person that the check has been completed and no children remain on the vehicle. (Possible circumstances include, but are not limited to: the Program has closed when the driver returns with the vehicle; the driver is the only Staff person on the vehicle at the last destination during home, school or field trip transportation; the driver takes the vehicle home at the end of the day.) The time and verification of such telephone contact shall be immediately documented and signed on the passenger transportation checklist(s) by the driver. (8) Supervision of Vehicles. A child shall never be left unattended in a vehicle. S. Field Trips (1) Parental Permission. A program shall obtain written permission from Parent(s) in advance of the child's participation in any field trip and such permission must be signed and dated by a Parent. (2) List of Trip Participants. A list of children and adults participating in the trip shall be left at the program as well as be taken on the trip in the possession of the adult in charge of the trip. (3) Emergency Medical Information. Emergency medical information on each child to include allergies; special medical needs and conditions; current prescribed medications that the child is required to take on a daily basis for a chronic condition; the name and phone number of the child's doctor; the local medical facility that the program uses in the area where the program is located; and the telephone numbers where the Parent(s) can be reached shall be left at the program as well as be taken on the trip in the possession of the adult in charge of the trip. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The following standards are applicable to school-age children in all CCDF-eligible out-of-school programs and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. Out- of-school programs includes (1) day camps and (2) government-owned and operated providers. P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (i) Precautions in transporting children (if applicable); (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iii) Safety (e.g., prevention of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS) and the use of safe sleeping practices, medication administration, injury control and prevention, transportation, handling and storage of hazardous materials, identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic, and emergency preparedness planning and response); R. Transportation (1) Vehicle Safety. Vehicles used for transporting children shall be maintained as follows: (a) Annual Safety Check. Each vehicle shall have a satisfactory annual safety check, completed by a trained individual, of at least: tires, headlights, horn, taillights, turn signals, brake lights, brakes, suspension, exhaust system, steering, windows, windshields and windshield wipers. A copy of a standard inspection report used by the Department or an equivalent shall be kept on file at the program or on the vehicle and should include evidence of any repairs and/or replacements that were identified as needed on the inspection report. (b) Interior. Interior of a transportation vehicle must be clean and in safe repair and free of hazardous items, objects and/or other non-essential items which could impede the children's access or egress from the vehicle or cause injury if the items were thrown about the vehicle as a result of a collision. (c) Child Passenger Restraints. All children transported in a vehicle provided by or used by the program shall be secured in a child passenger restraining system or seat safety belt in accordance with current state and federal laws and regulations. The child passenger restraining system and seat safety belts must be installed and used in accordance with the manufacturer's directions for such system and used in accordance with the manufacturer’s directions with respect to restraining, seating or positioning the child being transported in the vehicle. (2) Driver. Whenever the program transports children for any reason, the driver of the vehicle shall be at least eighteen (18) years of age and possess a valid driver's license as required for the class of vehicle that the driver will be operating for the program. (3) Pediatric CPR and First Aid Training. Either the driver or another Staff person present on the vehicle shall have current evidence of successful completion of a biennial training program in pediatric cardiopulmonary resuscitation (CPR) for infants and children and a triennial training program in pediatric first aid offered by certified or licensed health care professionals. (4) Additional Staff. When the program transports children for any reason, the following Staff:child ratios shall be maintained: - Driver + One (1) Staff Members. The additional Staff must be at least eighteen (18) years of age or older. - When transporting three (3) or more children under three years of age; - When seven (7) or more children under five (5) years of age occupy vehicle; - When eighteen (18) or more children five (5) years of age or older occupy the vehicle. - Driver + Two (2) Staff Members.One (1) of the additional Staff members must be at least eighteen (18) years of age. - When eight (8) or more children under three (3) years of age occupy the vehicle with other children; - When more than twenty (20) children under five years of age occupy the vehicle with other children. (5) Staffing Requirements When Transporting More Than Thirty-Six (36) Children. (a)When more than thirty-six (36) children under five (5) years of age occupy the vehicle, the Staff:child ratios as stated in Standard EX-HS-R.(5)(a) shall be met. (b) When more than thirty-six (36) children five (5) years of age and older are transported with no children under the age of five (5) years, there shall be a minimum of two (2) Staff persons for the first thirty-six (36) children and there must be one additional Staff person for each additional twenty (20) children. This means a third Staff person would be required if transporting thirty-seven (37) to fifty-six (56) children five (5) years and older. (6) Parental Authorization. For routine transportation provided by the program or on behalf of the program, the child's Parent(s) must provide written authorization for the transportation and specify routine pick-up location, routine pick-up time, routine delivery location, routine delivery time and the name of any person authorized to receive the child. (7) Transportation Plan. For all transportation conducted by the Program or on behalf of the Program, the following requirements shall be met: (a) Program and Passenger Information. Each vehicle used to transport children shall contain current information including the full names of all children to be transported and each child's pick-up location, pick-up time, delivery location, alternate delivery location if a Parent is not at home and name of person authorized to receive each child. In addition, the vehicle shall contain current information identifying the Program’s name and telephone number and the name of the driver of the vehicle. (b) Emergency Medical Information. An emergency medical information record must be maintained in the vehicle for each child being transported. The emergency medical information record for each child shall include a listing of the child's full name, date of birth, allergies, special medical needs and conditions, current prescribed medications that the child is required to take on a daily basis for a chronic condition, the name and phone number of the child's doctor, the local medical facility that the Program uses in the area where the Program is located and the telephone numbers where the Parent(s) can be reached. (c) Passenger Transportation Checklists. A passenger transportation checklist, provided by or in a format approved by the Department, shall be used to account for each child during transportation. A separate passenger checklist shall be used for each vehicle. 1. The first and last name of each child transported shall be documented on the passenger transportation checklist. Each child shall be listed individually; a sibling group shall not be listed as a single entry, for example, an entry of ￿Smith children￿ would be unacceptable. 2. The driver or other designated person shall immediately document in writing, with a check or other mark/symbol to account for each child listed on the passenger transportation checklist each time a child enters and exits the vehicle. The driver or other designated person shall document in writing with a different mark/symbol to account for each child listed on the passenger transportation checklist who was not present on the vehicle for any reason. An explanation shall be documented in writing whenever a child is transported to a field trip site but is not present on the return trip to the Program. 3. The driver or other designated Staff person shall also document in writing the departure/arrival times for all types of transportation on the passenger transportation checklist as follows: (i) Home Transportation - Each time the vehicle departs from the Program, arrives at the location where any child is picked up or dropped off and when the vehicle returns to the Program. (ii) Field Trip Transportation- Each time the vehicle leaves the Program, arrives at a field trip destination, leaves a field trip destination, and returns to the Program. 4. The Staff person on the vehicle responsible for keeping the passenger transportation checklist shall give the completed passenger transportation checklist to the Director or the Director’s designated Staff person at the Program as set forth below: (i) Immediately upon return to the Program at the completion of the trip once the vehicle has been checked; or (ii) The next business day following the completion of the trip if the vehicle did not return to the Program at the end of the trip or if the Program was closed when the vehicle returned. 5. Passenger transportation checklists shall be maintained as Program records for one (1) year. 6. Checking the Vehicle - To ensure that all children have been unloaded from transportation vehicles, regardless of whether the vehicle is equipped with a child safety alarm devices, the vehicle shall be thoroughly checked first by a designated Staff person who was present on the vehicle during the trip and then by a second designated Staff person, who may or may not have been present on the vehicle during the trip, to ensure that two checks of the vehicle have been completed. 7. The first check shall be conducted immediately upon unloading the last child at any location including, but not limited to, a field trip destination, arrival at the Program, and the last stop during transportation to home or school. The responsible person on the vehicle shall: (i) Physically walk through the entire vehicle; (ii) Visually inspect all seat surfaces, under all seats and in all compartments or recesses in the vehicle’s interior; (iii) Sign the passenger transportation checklist(s), indicating all of the children have exited the vehicle; and give the passenger transportation checklist(s) to the second designated Staff person. The second designated Staff person shall conduct a check of the vehicle as referenced in EX-HS-R. The second check shall be conducted immediately upon the completion of the first check of the vehicle. There shall be continuous watchful oversight of the vehicle between the first check and second check. (iv)If a second designated Staff person is not available to conduct a second check of the vehicle, the driver shall check the vehicle as stated in EX-HS-R.(7) above and then report by phone to the Director or designated Staff person that the check has been completed and no children remain on the vehicle. (Possible circumstances include, but are not limited to: the Program has closed when the driver returns with the vehicle; the driver is the only Staff person on the vehicle at the last destination during home, school or field trip transportation; the driver takes the vehicle home at the end of the day.) The time and verification of such telephone contact shall be immediately documented and signed on the passenger transportation checklist(s) by the driver. (8) Supervision of Vehicles. A child shall never be left unattended in a vehicle. S. Field Trips (1) Parental Permission. A program hall obtain written permission from Parent(s) in advance of the child's participation in any field trip and such permission must be signed and dated by a Parent. (2) List of Trip Participants. A list of children and adults participating in the trip shall be left at the program as well as be taken on the trip in the possession of the adult in charge of the trip. (3) Emergency Medical Information. Emergency medical information on each child to include allergies; special medical needs and conditions; current prescribed medications that the child is required to take on a daily basis for a chronic condition; the name and phone number of the child's doctor; the local medical facility that the program uses in the area where the program is located; and the telephone numbers where the Parent(s) can be reached shall be left at the program as well as be taken on the trip in the possession of the adult in charge of the trip. 5.3.10 Pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) health and safety standard a. Provide the standards, appropriate to the provider setting and age of children, that address pediatric first aid for all staff for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed center care and are found in Rules and Regulations for Child Care Learning Centers. First Aid and CPR 591-1-1-.14(1) Training. (a) All Staff who provide direct care to children must obtain certification in a biennial training program in pediatric cardiopulmonary resuscitation (CPR) and a triennial training program in pediatric first aid within the first 45 days of employment. Current and valid evidence of the successful completion of such training shall be maintained on the Center’s premises. The hours obtained completing this certification will not count towards the required annual training hours. (b) The training must be done by certified or licensed health care professionals or trainers and must deal with the provision of emergency care to infants and children. 591-1-1-.14(2) Staffing Requirement. (a) When any child is present on the premises, at least fifty percent (50%) of the caregiver staff present shall be trained in pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid. (b) There must always be one staff person present in each classroom where children are present that has current and valid pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid training. (c) During any field trip or transportation of children, there must always be a staff member present who has current evidence of the successful completion of pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid. (d) The Center Director must have current evidence of successful completion of pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid at all times. 591-1-1-.14(3) Supplies. Each building of the Center and any vehicle used by the Center for transportation of children shall have a first aid kit which shall at least contain: scissors; tweezers; gauze pads; adhesive tape; thermometer; band-aids, assorted sizes; antibacterial ointment; insect-sting preparation; an antiseptic cleansing solution; triangular bandages; rubber gloves; protective eye wear; a protective face mask; and cold pack. The first aid kit, together with a first aid instruction manual which must be kept with the kit at all times, shall be stored so that it is not accessible to children but is easily accessible to Staff. Staff Training 591-1-1-.33(1) Center Orientation. Prior to assignment to children or task, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial Center orientation. 591-1-1-.33(2)The initial Center orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children;(g) childhood injury control; ii. All CCDF-eligible licensed family child care homes. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school- age children in all CCDF-eligible licensed family child care homes and are found in Rules and Regulations for Family Child Care Learning Homes. Requirements for Applications and Licenses 290-2-3-.04(2)(b)(3) License Applications and Requirements (b) Pre-Service Training. Prior to the submission of the License application, the applicant who will be responsible for the day-to-day operations shall complete the pre-service training listed below that has been approved by the Department and which will include: Cardiopulmonary resuscitation (CPR) and first aid training programs offered by certified or licensed health care professionals or trainers and approved by the Department, which include emergency care for infants and children. Staffing and Supervision 290-2-3-.07(5) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. 290-2-3-.07(6) The initial program orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children; (h) childhood injury control; 290-2-3-.07(8) First Aid and CPR. (a) Every Provider, Provisional Employee and Employee with direct care responsibilities shall have current evidence of successful completion of a biennial training program in pediatric cardiopulmonary resuscitation (CPR) and a triennial training program in pediatric first aid which have been offered by certified or licensed health care professionals or trainers. Such training must be completed by the Provider prior to initial licensure. Training must be completed within 45 days from the date of hire for Provisional Employees and Employees. Current and valid evidence of the successful completion of such training shall be maintained on the Home’s Premises. (b) The Provider, a Provisional Employee or Employee with current evidence of successful completion of pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid must always be on the Home’s premises whenever any Child is present. (c) The Provider, a Provisional Employee, or Employee with current evidence of successful completion of pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid must always be present on any field trip or during the transportation of children. Health, Safety, and Discipline 290-2-3-.11(1)(e) The Home and any vehicle used by the Home for transportation of Children shall have a first aid kit which shall at least contain: scissors, tweezers, gauze pads, thermometer, adhesive tape, band-aids, insect-sting preparation, antiseptic cleaning solution, antibacterial ointment, bandages, disposable rubber gloves, protective eyewear, facemask, and cold pack. The first aid kit, together with a first aid instruction manual which must be kept with the kit at all times, shall be stored in a central location so that it is not accessible to Children but is easily accessible to the Provider and Staff. The Home must also maintain written directions for the use of universal precautions for handling blood and bodily fluids. The directions on the use of universal precautions must be kept with the first aid kit at all times. iii. All CCDF-eligible licensed in-home care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible regulated (but not licensed) informal in-home care providers and are found in the Health & Safety Standards for Informal Providers Appendix HH. G. First Aid and CPR (1) First Aid and CPR: (a) Every Provider, Provisional Employee and Employee with direct care responsibilities shall have current evidence of successful completion of a biennial training program in pediatric cardiopulmonary resuscitation (CPR) and a triennial training program in pediatric first aid which have been offered by certified or licensed health care professionals or trainers. Such training must be completed by the Provider prior to initial licensure. Training must be completed within 45 days from the date of hire for Provisional Employees and Employees. Current and valid evidence of the successful completion of such training shall be maintained on the Provider’s premises. (b) The Provider, a Provisional Employee or Employee with current evidence of successful completion of pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid must always be on the Provider’s premises whenever any Child is present. (c) The Provider, a Provisional Employee, or Employee with current evidence of successful completion of pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid must always be present on any field trip or during the transportation of children. O. Staff Training (1) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. The initial program orientation must include the following subjects: the program's policies and procedures; the portions of these rules dealing with the care, health and safety of children; the Staff person’s assigned duties and responsibilities; reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; emergency weather plans; the program’s emergency preparedness plan; childhood injury control; the administration of medicine; reducing the risk of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS); hand washing; fire safety; water safety; and prevention of HIV/AIDS and blood borne pathogens. [ ] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible license-exempt center care and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. G. First Aid and CPR (1) Training (a) All Staff who provide direct care to children must obtain certification in a biennial training program in pediatric cardiopulmonary resuscitation (CPR) and a triennial training program in pediatric first aid within the first 45 days of employment. Current and valid evidence of the successful completion of such training shall be maintained on the Program’s premises. The hours obtained completing this certification will not count towards the required annual training hours. (b) The training must be done by certified or licensed health care professionals or trainers and must deal with the provision of emergency care to infants and children. (2) Staffing Requirements (a) When any child is present on the premises, at least fifty percent (50%) of the caregiver staff present shall be trained in pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid. (b) There must always be one staff person present in each classroom where children are present that has current and valid pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid training. (c) During any field trip or transportation of children, there must always be a staff member present who has current evidence of the successful completion of pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid. (d) The Program Director must have current evidence of successful completion of pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid at all times. P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; (f) Childhood injury control; v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The following standards are applicable to school-age children in all CCDF-eligible out-of-school programs and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. Out- of-school programs includes (1) day camps and (2) government-owned and operated providers. G. First Aid and CPR (1) Training (a) All Staff who provide direct care to children must obtain certification in a biennial training program in pediatric cardiopulmonary resuscitation (CPR) and a triennial training program in pediatric first aid within the first 45 days of employment. Current and valid evidence of the successful completion of such training shall be maintained on the Program’s premises. The hours obtained completing this certification will not count towards the required annual training hours. (b) The training must be done by certified or licensed health care professionals or trainers and must deal with the provision of emergency care to infants and children. (2) Staffing Requirements (a) When any child is present on the premises, at least fifty percent (50%) of the caregiver staff present shall be trained in pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid. (b) There must always be one staff person present in each classroom where children are present that has current and valid pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid training. (c) During any field trip or transportation of children, there must always be a staff member present who has current evidence of the successful completion of pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid. (d) The Program Director must have current evidence of successful completion of pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid at all times. P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; (f) Childhood injury control; b. Provide the standards, appropriate to the provider setting and age of children, that address pediatric cardiopulmonary resuscitation for all staff for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed center care and are found in Rules and Regulations for Child Care Learning Centers. First Aid and CPR 591-1-1-.14(1) Training. (a) All Staff who provide direct care to children must obtain certification in a biennial training program in pediatric cardiopulmonary resuscitation (CPR) and a triennial training program in pediatric first aid within the first 45 days of employment. Current and valid evidence of the successful completion of such training shall be maintained on the Center’s premises. The hours obtained completing this certification will not count towards the required annual training hours. (b) The training must be done by certified or licensed health care professionals or trainers and must deal with the provision of emergency care to infants and children. 591-1-1-.14(2) Staffing Requirement. (a) When any child is present on the premises, at least fifty percent (50%) of the caregiver staff present shall be trained in pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid. (b) There must always be one staff person present in each classroom where children are present that has current and valid pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid training. (c) During any field trip or transportation of children, there must always be a staff member present who has current evidence of the successful completion of pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid. (d) The Center Director must have current evidence of successful completion of pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid at all times. Staff Training 591-1-1-.33(1) Center Orientation. Prior to assignment to children or task, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial Center orientation. 591-1-1-.33(2)The initial Center orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children; ii. All CCDF-eligible licensed family child care homes. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school- age children in all CCDF-eligible licensed family child care homes and are found in Rules and Regulations for Family Child Care Learning Homes. Requirements for Applications and Licenses 290-2-3-.04(2)(b)(3) License Applications and Requirements (b) Pre-Service Training. Prior to the submission of the License application, the applicant who will be responsible for the day-to-day operations shall complete the pre-service training listed below that has been approved by the Department and which will include: Cardiopulmonary resuscitation (CPR) and first aid training programs offered by certified or licensed health care professionals or trainers and approved by the Department, which include emergency care for infants and children. Staffing and Supervision 290-2-3-.07(5) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. 290-2-3-.07(6) The initial program orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children; 290-2-3-.07(8) First Aid and CPR. (a) Every Provider, Provisional Employee and Employee with direct care responsibilities shall have current evidence of successful completion of a biennial training program in pediatric cardiopulmonary resuscitation (CPR) and a triennial training program in pediatric first aid which have been offered by certified or licensed health care professionals or trainers. Such training must be completed by the Provider prior to initial licensure. Training must be completed within 45 days from the date of hire for Provisional Employees and Employees. Current and valid evidence of the successful completion of such training shall be maintained on the Home’s Premises. (b) The Provider, a Provisional Employee or Employee with current evidence of successful completion of pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid must always be on the Home’s premises whenever any Child is present. (c) The Provider, a Provisional Employee, or Employee with current evidence of successful completion of pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid must always be present on any field trip or during the transportation of children. iii. All CCDF-eligible licensed in-home care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible regulated (but not licensed) informal in-home care providers and are found in the Health & Safety Standards for Informal Providers Appendix HH. G. First Aid and CPR (1) First Aid and CPR: (a) Every Provider, Provisional Employee and Employee with direct care responsibilities shall have current evidence of successful completion of a biennial training program in pediatric cardiopulmonary resuscitation (CPR) and a triennial training program in pediatric first aid which have been offered by certified or licensed health care professionals or trainers. Such training must be completed by the Provider prior to initial licensure. Training must be completed within 45 days from the date of hire for Provisional Employees and Employees. Current and valid evidence of the successful completion of such training shall be maintained on the Provider’s premises. (b) The Provider, a Provisional Employee or Employee with current evidence of successful completion of pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid must always be on the Provider’s premises whenever any Child is present. (c) The Provider, a Provisional Employee, or Employee with current evidence of successful completion of pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid must always be present on any field trip or during the transportation of children. O. Staff Training (1) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. The initial program orientation must include the following subjects: the program's policies and procedures; the portions of these rules dealing with the care, health and safety of children; the Staff person’s assigned duties and responsibilities; reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; emergency weather plans; the program’s emergency preparedness plan; childhood injury control; the administration of medicine; reducing the risk of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS); hand washing; fire safety; water safety; and prevention of HIV/AIDS and blood borne pathogens. [ ] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible license-exempt center care and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. G. First Aid and CPR (1) Training (a) All Staff who provide direct care to children must obtain certification in a biennial training program in pediatric cardiopulmonary resuscitation (CPR) and a triennial training program in pediatric first aid within the first 45 days of employment. Current and valid evidence of the successful completion of such training shall be maintained on the Program’s premises. The hours obtained completing this certification will not count towards the required annual training hours. (b) The training must be done by certified or licensed health care professionals or trainers and must deal with the provision of emergency care to infants and children. (2) Staffing Requirements (a) When any child is present on the premises, at least fifty percent (50%) of the caregiver staff present shall be trained in pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid. (b) There must always be one staff person present in each classroom where children are present that has current and valid pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid training. (c) During any field trip or transportation of children, there must always be a staff member present who has current evidence of the successful completion of pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid. (d) The Program Director must have current evidence of successful completion of pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid at all times. P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The following standards are applicable to school-age children in all CCDF-eligible out-of-school programs and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. Out- of-school programs includes (1) day camps and (2) government-owned and operated providers. G. First Aid and CPR (1) Training (a) All Staff who provide direct care to children must obtain certification in a biennial training program in pediatric cardiopulmonary resuscitation (CPR) and a triennial training program in pediatric first aid within the first 45 days of employment. Current and valid evidence of the successful completion of such training shall be maintained on the Program’s premises. The hours obtained completing this certification will not count towards the required annual training hours. (b) The training must be done by certified or licensed health care professionals or trainers and must deal with the provision of emergency care to infants and children. (2) Staffing Requirements (a) When any child is present on the premises, at least fifty percent (50%) of the caregiver staff present shall be trained in pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid. (b) There must always be one staff person present in each classroom where children are present that has current and valid pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid training. (c) During any field trip or transportation of children, there must always be a staff member present who has current evidence of the successful completion of pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid. (d) The Program Director must have current evidence of successful completion of pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid at all times. P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; 5.3.11 Identification and reporting of child abuse and neglect health and safety standard a. Provide the standards, appropriate to the provider setting and age of children, that address the identification of child abuse and neglect for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed center care and are found in Rules and Regulations for Child Care Learning Centers. Operational Policies and Procedures 591-1-1-.21(1) A Center shall establish and implement written policies and procedures which shall be kept current, be consistent with applicable laws, regulations and these rules, made available to the Parent(s) and used to govern the operations of the Center. (r) A description of the practices followed by the Center to prevent shaken baby syndrome and abusive head trauma in children up to five years of age that includes the following information: how to recognize, respond to, and report the signs and symptoms of shaken baby syndrome and abusive head trauma; strategies to assist staff members in understanding how to care for infants and how to cope with a crying, fussing, or distraught child; strategies to ensure staff members understand the brain development of children up to five years of age; and a list of prohibited behaviors when dealing with children. Staff Training 591-1-1-.33(1) Center Orientation. Prior to assignment to children or task, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial Center orientation. 591-1-1-.33(2)The initial Center orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children; 591-1-1-.33(3)Health and Safety Orientation. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (i) precautions in transporting children; recognition and reporting of child abuse and neglect 591-1-1-.33(5)Annual Training. (a) Every calendar year after the first year of employment, all supervisory and caregiver Personnel, except independent contractors, Students-in-Training and volunteers, shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department- approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iv) Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). ii. All CCDF-eligible licensed family child care homes. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school- age children in all CCDF-eligible licensed family child care homes and are found in Rules and Regulations for Family Child Care Learning Homes. Staffing and Supervision 290-2-3-.07(5) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. 290-2-3-.07(6) The initial program orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children; 290-2-3-.07(7) Health and Safety Orientation. The Provider, Employees and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (i) precautions in transporting children; recognition and reporting of child abuse and neglect; 290-2-3-.07(9) Annual Training. (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iv) Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). Children’s Records 290-2-3-.08(8) Policies and Procedures. Each Family Child Care Learning Home shall establish policies and procedures, which shall be kept current, be consistent with applicable laws, including but not limited to the Americans with Disabilities Act, regulations and these rules, made available to the Parents, and used to govern the operations of the Family Child Care Learning Home. (b) The policies and procedures shall also include written procedures for the following: 17. A description of the practices followed by the Home to prevent shaken baby syndrome and abusive head trauma in children up to five years of age that includes the following information: how to recognize, respond to, and report the signs and symptoms of shaken baby syndrome and abusive head trauma; strategies to assist staff members in understanding how to care for infants and how to cope with a crying, fussing, or distraught child; strategies to ensure staff members understand the brain development of children up to five years of age; and a list of prohibited behaviors when dealing with children. iii. All CCDF-eligible licensed in-home care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible regulated (but not licensed) informal in-home care providers and are found in the Health & Safety Standards for Informal Providers Appendix HH. J. Policies and Procedures (1) The Informal Provider shall have a written policy regarding the following: (e) A description of the practices followed by the Program to prevent shaken baby syndrome and abusive head trauma in children up to five years of age that includes the following information: how to recognize, respond to, and report the signs and symptoms of shaken baby syndrome and abusive head trauma; strategies to assist staff members in understanding how to care for infants and how to cope with a crying, fussing, or distraught child; strategies to ensure staff members understand the brain development of children up to five years of age; and a list of prohibited behaviors when dealing with children. (g) Recognition and reporting of child abuse and neglect O. Staff Training (1) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. The initial program orientation must include the following subjects: the program's policies and procedures; the portions of these rules dealing with the care, health and safety of children; the Staff person’s assigned duties and responsibilities; reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; emergency weather plans; the program’s emergency preparedness plan; childhood injury control; the administration of medicine; reducing the risk of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS); hand washing; fire safety; water safety; and prevention of HIV/AIDS and blood borne pathogens. (2) Health and Safety Orientation. Each Informal Provider, Employees, and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required annual training hours. The training must address the following health and safety topics: (j) Recognition and reporting of child abuse and neglect; (3) Ongoing Training (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: iv. Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). [ ] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible license-exempt center care and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. J. Policies and Procedures (1) The Program shall establish and implement written policies and procedures that describe the Program's operations as follows: (g) Recognition and reporting of child abuse and neglect (i) A description of the practices followed by the Center to prevent shaken baby syndrome and abusive head trauma in children up to five years of age that includes the following information: how to recognize, respond to, and report the signs and symptoms of shaken baby syndrome and abusive head trauma; strategies to assist staff members in understanding how to care for infants and how to cope with a crying, fussing, or distraught child; strategies to ensure staff members understand the brain development of children up to five years of age; and a list of prohibited behaviors when dealing with children. P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (j) Recognition and reporting of child abuse and neglect; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: iv. Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The following standards are applicable to school-age children in all CCDF-eligible out-of-school programs and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. Out- of-school programs includes (1) day camps and (2) government-owned and operated providers. J. Policies and Procedures (1) The Program shall establish and implement written policies and procedures that describe the Program's operations as follows: (g) Recognition and reporting of child abuse and neglect (i) A description of the practices followed by the Center to prevent shaken baby syndrome and abusive head trauma in children up to five years of age that includes the following information: how to recognize, respond to, and report the signs and symptoms of shaken baby syndrome and abusive head trauma; strategies to assist staff members in understanding how to care for infants and how to cope with a crying, fussing, or distraught child; strategies to ensure staff members understand the brain development of children up to five years of age; and a list of prohibited behaviors when dealing with children. P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (j) Recognition and reporting of child abuse and neglect; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: iv. Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). b. Provide your standards, appropriate to the provider setting and age of children, that address the reporting of child abuse and neglect for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed center care and are found in Rules and Regulations for Child Care Learning Centers. Operational Policies and Procedures 591-1-1-.21(1)(k) A Center shall establish and implement written policies and procedures which shall be kept current, be consistent with applicable laws, regulations and these rules, made available to the Parent(s) and used to govern the operations of the Center. (1) The policies and procedures shall include the following: Child abuse reporting law requirements. Required Reporting 591-1-1-.29(1) Child Abuse, Neglect or Deprivation. Within twenty-four (24) hours or the next work day, the Director or designated person-in-charge shall report or cause to be reported any suspected incidents of child abuse, neglect or deprivation to the local County Division of Family and Children Services in accordance with state law and to the Department, notifying that such a report was made. Staff Training 591-1-1-.33(1) Center Orientation. Prior to assignment to children or task, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial Center orientation. 591-1-1-.33(2)The initial Center orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children; 591-1-1-.33(3)Health and Safety Orientation. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (i) precautions in transporting children; recognition and reporting of child abuse and neglect 591-1-1-.33(5)Annual Training. (a) Every calendar year after the first year of employment, all supervisory and caregiver Personnel, except independent contractors, Students-in-Training and volunteers, shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department- approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iv) Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). Inspections and Investigations 591-1-1-.37(a)(2) Inspections and Investigations. The Department may conduct inspections and investigations in the following instances: Upon receiving a report alleging child abuse, neglect or deprivation which occurred while the child was in the care of the Center Director, Provisional Employees or Employees. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school- age children in all CCDF-eligible licensed family child care homes and are found in Rules and Regulations for Family Child Care Learning Homes. Inspections and Investigations 290-2-3-.05(a)(2) Inspections and Investigations. The Department may conduct inspections and investigations in the following instances: Upon receiving a report alleging child abuse, neglect or deprivation which occurred while the child was in the care of the Home Provider, Provisional Employees or Employees. Staffing and Supervision 290-2-3-.07(5) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. 290-2-3-.07(6) The initial program orientation must include the following subjects: (b) the portions of these rules dealing with the care, health and safety of children; 290-2-3-.07(7) Health and Safety Orientation. The Provider, Employees and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (i) precautions in transporting children; recognition and reporting of child abuse and neglect; 290-2-3-.07(9) Annual Training. (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (iv) Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). Required Reporting 290-2-3-.14(3) Child Abuse, Neglect or Deprivation. Within twenty-four (24) hours or the next work day, the Provider or designated person-in-charge shall report or cause to be reported any suspected incident of child abuse, neglect or deprivation to the local County Division of Family and Children Services in accordance with state law and to the Department, notifying that such a report was made. iii. All CCDF-eligible licensed in-home care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible regulated (but not licensed) informal in-home care providers and are found in the Health & Safety Standards for Informal Providers Appendix HH. J. Policies and Procedures (1) The Informal Provider shall have a written policy regarding the following: (g) Recognition and reporting of child abuse and neglect O. Staff Training (1) Program Orientation. Prior to assignment to children or task, the Provider and all Employees (i.e., Volunteers, Students-in-Training, Independent Contractors, etc.) and Provisional Employees must receive initial program orientation. The initial program orientation must include the following subjects: the program's policies and procedures; the portions of these rules dealing with the care, health and safety of children; the Staff person’s assigned duties and responsibilities; reporting requirements for suspected cases of child abuse, neglect or deprivation; communicable diseases and serious injuries; emergency weather plans; the program’s emergency preparedness plan; childhood injury control; the administration of medicine; reducing the risk of Sudden Unexpected Infant Death (SUID) which includes Sudden Infant Death Syndrome (SIDS); hand washing; fire safety; water safety; and prevention of HIV/AIDS and blood borne pathogens. (2) Health and Safety Orientation. Each Informal Provider, Employees, and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state- approved training hours obtained will count toward required annual training hours. The training must address the following health and safety topics: (j) Recognition and reporting of child abuse and neglect; (3) Ongoing Training (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: iv. Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). S. Required Reporting (1) The Informal Provider shall report or cause to be reported the following to the Department within twenty-four (24) hours or the next work day: (a) Child Abuse, Neglect or Deprivation. Within twenty-four (24) hours or the next work day, suspected incidents of child abuse, neglect or deprivation shall be reported to the local County Division of Family and Children Services in accordance with state law and to the Department, notifying that such a report was made. [ ] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible license-exempt center care and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. J. Policies and Procedures (1) The Program shall establish and implement written policies and procedures that describe the Program's operations as follows: (g) Recognition and reporting of child abuse and neglect P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (j) Recognition and reporting of child abuse and neglect; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: iv. Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). T. Required Reporting (1) The Administrator or designated person-in-charge shall report or cause to be reported the following incidents to the Department within twenty-four (24) hours or the next work day: a. Child Abuse, Neglect or Deprivation. Suspected incidents of child abuse, neglect or deprivation shall be reported to the local County Division of Family and Children Services in accordance with state law and to the Department, notifying that such a report was made. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The following standards are applicable to school-age children in all CCDF-eligible out-of-school programs and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. Out- of-school programs includes (1) day camps and (2) government-owned and operated providers. J. Policies and Procedures (1) The Program shall establish and implement written policies and procedures that describe the Program's operations as follows (g) Recognition and reporting of child abuse and neglect P. Staff Training (1) Prior to assignment to children or tasks, all Employees (i.e., volunteers, students-in-training, independent contractors, etc.) and Provisional Employees must receive initial program orientation. (2) The initial program orientation must include the following subjects: (b) The portions of these standards dealing with the care, health and safety of children; (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (j) Recognition and reporting of child abuse and neglect; (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: iv. Child abuse and neglect (e.g., identification and reporting, meeting the needs of abused and/or neglected children, prevention of shaken baby syndrome, abusive head trauma and child maltreatment). T. Required Reporting (1) The Administrator or designated person-in-charge shall report or cause to be reported the following incidents to the Department within twenty-four (24) hours or the next work day: a. Child Abuse, Neglect or Deprivation. Suspected incidents of child abuse, neglect or deprivation shall be reported to the local County Division of Family and Children Services in accordance with state law and to the Department, notifying that such a report was made. 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: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed center care and are found in Rules and Regulations for Child Care Learning Centers. Food Service and Nutrition 591-1-1-.15(1-3) (1) Compliance with USDA Nutritional Guidelines. Meals and snacks with serving sizes dependent upon the age of the child shall meet nutritional guidelines as established by the United States Department of Agriculture Child and Adult Care Food Program. Meals and snacks shall be varied daily, and additional servings of nutritious food shall be offered to children over and above the required daily minimum, if not contraindicated by special diet. (2) Feeding of Infants and Children. A signed written feeding plan for children less than one (1) year of age shall be obtained from Parent(s). Instructions from the Parent(s) shall be updated regularly as new foods are added or other dietary changes are made. The feeding plan shall be posted in the child's assigned room and must include the child's feeding schedule, the amount of formula or breast milk to be given, instructions for the introduction of solid foods, the amount of food to be given and notation of any type(s) of commercially premixed formula which may not be used in an emergency because of food allergies. (a) Center Personnel shall hold and feed infants less than six (6) months of age and older children who cannot hold their own bottles or sit alone. Baby bottles shall never be propped; the infant's head shall be elevated while feeding. (b) Honey shall not be served to children less than one (1) year of age. (c) Age-appropriate solid foods (including cereal) shall not be given to infants or children less than one (1) year of age until recommended as developmentally appropriate by the child’s primary care physician and indicated in writing by the Parent(s). As soon as the feeding plan indicates that a child is ready for solid foods, the child shall be fed from individual spoons and individual containers or dishes. A child shall not be fed directly from the original baby food container if the contents are to be fed to the child at more than one (1) meal or to more than one (1) child. (d) As soon as the child exhibits a desire to feed him/herself, the child shall be assisted and encouraged to use their fingers for self-feeding, eat with a spoon, and to drink from individual cups. (e) The Center shall encourage and support breastfeeding. Centers shall have a designated area set aside for breastfeeding mothers to breastfeed. (f) Food for infants or children less than one (1) year of age shall be cut into pieces one-quarter inch or smaller and food for toddlers shall be cut into pieces one-half inch or smaller to prevent choking. (g) Center Personnel shall ensure that children do not have excessive amounts of food in their mouths while eating and are chewing their food appropriately to prevent instances of choking. Children shall always be seated when eating and shall not be allowed to lie down or be put to sleep while food is present in their mouths. (3) Baby Bottles and Formula. All baby bottles shall be clearly labeled with the individual child's name. Formula or breast milk shall be supplied by the Parent daily in bottles. Only the current day's formula or breast milk shall be served. Bottles shall be refrigerated at a temperature of forty (40) degrees Fahrenheit or less. If formula must be provided by the Center, only commercially prepared, ready-to-feed formula shall be used. Refrigerated or frozen breast milk shall only be heated or thawed under warm running water or in a container of warm water. 591-1-1-.15(5) Menus. The Center shall provide a menu listing all meals and snacks to be served during the current week except for School-age Centers where the food may be provided by the Parent(s) by agreement between the School-age Center and the Parent(s). Substitutions shall be recorded on the posted menu. Menus shall be retained at the Center for six (6) months. 591-1-1-.15(6)(a) Meal Service. (a) Children shall be served all meals and snacks scheduled for the period during which they are present. In those Centers where the Parent(s) of children enrolled provide the meals and snacks, the Center shall ensure that no child remains at the Center without receiving the scheduled nutritious meals and snacks. There shall be a period of at least two (2) hours between each required meal or snack. The following meals and snacks shall be scheduled and served by the Center when appropriate: breakfast or a morning snack, lunch, an afternoon snack, supper if a Center operates evening care and an evening snack prior to bed time if a Center operates night time care. 591-1-1-.15(8-9) (8) Foods and drinks with little or no nutritional value, i.e., sweets, soft drinks, etc. shall be served only on special occasions and only in addition to the required nutritious meals and snacks. Powdered nonfat dry milk shall only be used for cooking purposes. (9) Modified Diets. When a child requires a modified diet for medical reasons, a written statement from a medical authority shall be on file. When a child requires a modified diet for religious reasons, a written statement to that effect from the child's Parent(s) shall be on file. All caregiver Personnel shall be informed of the diet restriction for the child and only food that complies with the prescribed dietary regimen but still meets the food and FFY 2025￿2027 CCDF State Plan nutrition requirements shall be served to the child. Staff Training 591-1-1-.33(4) Food Preparation and Nutrition Training. Within the first year of employment, the Director and the person primarily responsible for food preparation shall receive four (4) clock hours of training in food nutrition planning, preparation, serving, proper dish washing and food storage. 591-1-1-.33(5)Annual Training. (a) Every calendar year after the first year of employment, all supervisory and caregiver Personnel, except independent contractors, Students-in- Training and volunteers, shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (ii) Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed family child care homes and are found in Rules and Regulations for Family Child Care Learning Homes. Nutrition and Food Services 290-2-3-.10(1-4) (1) Compliance with USDA Nutritional Guidelines. Meals and snacks with serving sizes dependent upon the age of the child shall meet nutritional guidelines as established by the United States Department of Agriculture Child and Adult Care Food Program. Meals and snacks shall be varied daily, and additional servings of nutritious food shall be offered to children over and above the required daily minimum, if not contraindicated by special diet. (2) Non-nutritional Food. Foods and drinks with little or no nutritional value, i.e., sweets, soft drinks, etc. shall be served only on special occasions and only in addition to the required nutritious meals and snacks. Powdered nonfat dry milk shall not be used except for cooking purposes. (3) Feeding of Infants and Children. A signed written feeding plan for children less than one (1) year of age shall be obtained from Parent(s). Instructions from the Parent(s) shall be updated regularly as new foods are added or other dietary changes are made. The feeding plan shall be posted in the main child care area and must include the child's feeding schedule, the amount of formula or breast milk to be given, instructions for the introduction of solid foods, the amount of food to be given and notation of any type(s) of commercially premixed formula which may not be used in an emergency because of food allergies. (a) Staff shall hold and feed infants less than six (6) months of age and older children who cannot hold their own bottles or sit alone. Baby bottles shall never be propped; the infant's head shall be elevated while feeding. (b) Honey shall not be served to children less than one (1) year of age. (c) Age-appropriate solid foods (including cereal) shall not be given to infants or children less than one (1) year of age until recommended as developmentally appropriate by the child’s primary care physician and indicated in writing by the Parent(s). As soon as the feeding plan indicates that a child is ready for solid foods, the child shall be fed from individual spoons and individual containers or dishes. A child shall not be fed directly from the original baby food container if the contents are to be fed to the child at more than one (1) meal or to more than one (1) child. (e) As soon as the child exhibits a desire to feed him/herself, the child shall be assisted and encouraged to use their fingers for self-feeding, eat with a spoon, and to drink from individual cups. The Home shall encourage and support breastfeeding. The Home shall have a designated area set aside for breastfeeding mothers to breastfeed. (f) Food for infants or children less than one (1) year of age shall be cut into pieces one-quarter inch or smaller and food for toddlers shall be cut into pieces one-half inch or smaller to prevent choking. (g) The Home shall ensure that children do not have excessive amounts of food in their mouths while eating and are chewing their food appropriately to prevent instances of choking. Children shall always be seated when eating and shall not be allowed to lie down or be put to sleep while food is present in their mouths. (4) Baby Bottles and Formula. All baby bottles shall be clearly labeled with the individual child's name. Formula or breast milk shall be supplied by the Parent daily in bottles. Only the current day's formula or breast milk shall be served. Bottles shall be refrigerated at a temperature of forty (40) degrees Fahrenheit or less. If formula must be provided by the Home, only commercially prepared, ready-to-feed formula shall be used. Refrigerated or frozen breast milk shall only be heated or thawed under warm running water or in a container of warm water. 290-2-3-.10(6) Menus. The Home shall provide a menu listing all meals and snacks to be served during the current week. Substitutions shall be recorded on the posted menu. Menus shall be retained at the Home for six (6) months. 290-2-3-.10(7)(a) Meal Service. Children shall be served all meals and snacks scheduled for the period during which they are present in the Home. This includes breakfast or a morning snack, lunch, an afternoon snack, supper (if the Home offers evening care), and an evening snack prior to bedtime (if the Home offers night time care). In those Homes where the Parent(s) of children enrolled provide the meals and snacks, the Home shall ensure that no child remains at the Home without receiving the scheduled nutritious meals and snacks. There shall be a period of at least two (2) hours between each required meal or snack. 290-2-3-.10(9) Modified Diets. When a child requires a modified diet for medical reasons, a written statement from a medical authority shall be on file. When a child requires a modified diet for religious reasons, a written statement to that effect from the child's Parent(s) shall be on file. Staff shall be informed of the diet restriction for the child and only food that complies with the prescribed dietary regimen but still meets the food and nutrition requirements shall be served to the child. Staffing and Supervision 290-2-3-.07(9) Annual Training. (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (ii) Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible license-exempt center care and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. P. Staff Training (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (ii) Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); CAPS Policy Manual - 15.5 Compliance Standards for License-exempt and Informal Providers 15.5.3.4 Health and safety orientation training for license-exempt and informal providers must be completed within the first 90 days of employment and may be completed online or through instructor-led courses and must cover, at a minimum, the following topic areas: · Prevention and control of infectious diseases (including immunization) · Prevention of sudden infant death syndrome (SIDS) and use of safe sleeping practices · Administration of medication consistent with standards for parental consent · Prevention and response to emergencies due to food and allergic reactions · Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic · Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment · Emergency preparedness and response planning for emergencies resulting from a natural disaster or a human-caused event (such as violence at a child care facility) · Handling and storage of hazardous materials and the appropriate disposal of bio contaminants Precautions in transporting children · Recognition and reporting of child abuse and neglect Child development to include all major domains: cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; and approaches to play and learning The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible regulated (but not licensed) informal in-home care providers and are found in the Health & Safety Standards for Informal Providers Appendix HH. O. Staff Training (3) Ongoing Training (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: ii. Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); CAPS Policy Manual - 15.5 Compliance Standards for License-exempt and Informal Providers 15.5.3.4 Health and safety orientation training for license-exempt and informal providers must be completed within the first 90 days of employment and may be completed online or through instructor-led courses and must cover, at a minimum, the following topic areas: · Prevention and control of infectious diseases (including immunization) · Prevention of sudden infant death syndrome (SIDS) and use of safe sleeping practices · Administration of medication consistent with standards for parental consent · Prevention and response to emergencies due to food and allergic reactions · Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic · Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment · Emergency preparedness and response planning for emergencies resulting from a natural disaster or a human-caused event (such as violence at a child care facility) · Handling, storage, and disposal of hazardous materials and the appropriate disposal of bio contaminants · Precautions in transporting children Recognition and reporting of child abuse and neglect Child development to include all major domains: cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; and approaches to play and learning 237 | P a g e FFY 2025￿2027 CCDF State Plan The following standards are applicable to school-age children in all CCDF- eligible out-of-school programs and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. Out-of-school programs includes (1) day camps and (2) government-owned and operated providers. P. Staff Training (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (ii) Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); CAPS Policy Manual - 15.5 Compliance Standards for License-exempt and Informal Providers 15[OK23.1].5.3.4 Health and safety orientation training for license-exempt and informal providers must be completed within the first 90 days of employment and may be completed online or through instructor-led courses and must cover, at a minimum, the following topic areas: · Prevention and control of infectious diseases (including immunization) · Prevention of sudden infant death syndrome and use of safe sleeping practices · Administration of medication consistent with standards for parental consent · Prevention and response to emergencies due to food and allergic reactions · Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic · Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment · Emergency preparedness and response planning for emergencies resulting from a natural disaster or a human-caused event (such as violence at a child care facility) · Handling, storage, and disposal of hazardous materials and the appropriate disposal of bio contaminants · Precautions in transporting children Recognition and reporting of child abuse and neglect Child development to include all major domains: cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; and approaches to play and learning ii. Access to physical activity. Describe: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed center care and are found in Rules and Regulations for Child Care Learning Centers. Activities 591-1-1-.03(1)[SA24.1][JB24.2] The Center shall provide a daily planned program of varied and developmentally appropriate activities that promote the social, emotional, physical, cognitive, language and literacy development of each child. Center Staff shall use a variety of teaching methods to accommodate the needs of the children's different learning styles. 591-1-1-.03(5)(a)(b)(e) A variety of activities shall be planned for each group that include, but are not limited to: (a) Indoor and outdoor play; (b) A balance of quiet and active periods; (e) Large muscle activities, such as but not limited to, running, riding, climbing, balancing, jumping, throwing, or digging; 591-1-1-.03(7)(a)-(c) Outdoor Activities. Outdoor activities shall be provided daily, weather permitting, in accordance with the following: (a) Centers operating five (5) hours or more per day shall provide each child who is not an infant at least one and one-half (11/2) hours of outdoor activity per day and infants shall spend at least one (1) hour daily outdoors. (b) Centers operating less than five (5) hours per day shall provide a brief outdoor period for the children daily. (c) A child may be excused from outdoor activities for a limited period of time if there is documentation that outdoor activity is medically contraindicated or there is an occasional written request by the parent that the child be excused from outdoor activities for a very limited amount of time because of special circumstances. Playgrounds 591-1-1-.26(1)(a-b) (1) Size. (a) For Centers with a licensed capacity of 19 or more children first licensed after March 1, 1991, the Center shall provide or have ready access to an outdoor play area. The minimum size of the outdoor area must be equal to one hundred (100) square feet times one-third (1/3) of the Center's licensed capacity for children. (b) For Centers with a licensed capacity of 18 or fewer children first licensed after April 21, 1991, the Center shall provide or have ready access to an outdoor play area. The minimum size of the outdoor area must be equal to one hundred (100) square feet times the center's licensed capacity for children. Staff Training 591-1-1-.33(5)Annual Training. (a) Every calendar year after the first year of employment, all supervisory and caregiver Personnel, except independent contractors, Students-in- Training and volunteers, shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (ii) Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed family child care homes and are found in Rules and Regulations for Family Child Care Learning Homes. Children’s Activities 290-2-3-.09(1)(a)(b)(e) The Family Child Care Learning Home shall provide a variety of daily activities appropriate for the Children's chronological ages and developmental levels. Children with special needs shall be integrated into the activities provided by the Family Child Care Learning Home unless contraindicated medically or by parental agreement. Activities shall be planned for each group to allow for: (a) Indoor and outdoor play; (b) A balance of quiet and active periods; (e) Large muscle activities, such as, but not limited to, running, riding, climbing, balancing, jumping, throwing, or digging; 290-2-3-09(3) Children shall spend some time of each day outside when the children's health and the weather permits. Staffing and Supervision 290-2-3-.07(9) Annual Training. (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (ii) Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible license-exempt center care and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. A. Activities (1) Providers should provide a daily planned program of varied and developmentally appropriate activities that promote the social, emotional[SA25.1], physical, cognitive, language and literacy development of each child. Staff should use a variety of teaching methods to accommodate the needs of the children's different learning styles. P. Staff Training (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (ii) Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); CAPS Policy Manual - 15.5 Compliance Standards for License-exempt and Informal Providers 15.5.3.4 Health and safety orientation training for license-exempt and informal providers must be completed within the first 90 days of employment and may be completed online or through instructor-led courses and must cover, at a minimum, the following topic areas: · Prevention and control of infectious diseases (including immunization) · Prevention of sudden infant death syndrome and use of safe sleeping practices · Administration of medication consistent with standards for parental consent · Prevention and response to emergencies due to food and allergic reactions · Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic · Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment · Emergency preparedness and response planning for emergencies resulting a natural disaster or a human-caused event (such as violence at a child care facility) · Handling and storage of hazardous materials and the appropriate disposal of bio contaminants Precautions in transporting children Recognition and reporting of child abuse and neglect Child development to include all major domains: cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; and approaches to play and learning The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible regulated (but not licensed) informal in-home care providers and are found in the Health & Safety Standards for Informal Providers Appendix HH. A. Activities (1) Providers should provide a daily planned program of varied and developmentally appropriate activities that promote the social, emotional[SA26.1], physical, cognitive, language and literacy development of each child. Staff should use a variety of teaching methods to accommodate the needs of the children's different learning styles. O. Staff Training (3) Ongoing Training (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: ii. Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); CAPS Policy Manual - 15.5 Compliance Standards for License-exempt and Informal Providers 15[OK27.1][OK27.2].5.3.4 Health and safety orientation training for license- exempt and informal providers must be completed within the first 90 days of employment and may be completed online or through instructor-led courses and must cover, at a minimum, the following topic areas: · Prevention and control of infectious diseases (including immunization) · Prevention of sudden infant death syndrome and use of safe sleep practices · Administration of medication consistent with standards for parental consent · Prevention and response to emergencies due to food and allergic reactions · Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic · Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment · Emergency preparedness and response planning for emergencies resulting from a natural disaster or a human-caused event (such as violence at a child care facility) · Handling and storage of hazardous materials and the appropriate disposal of bio contaminants Precautions in transporting children Recognition and reporting of child abuse and neglect Child development to include all major domains: cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; and approaches to play and learning The following standards are applicable to school-age children in all CCDF-eligible out-of- school programs and are found in Health & Safety Standards for License- Exempt Providers Receiving Subsidy. Out-of-school programs includes (1) day camps and (2) government-owned and operated providers. A. Activities (1) Providers should provide a daily planned program of varied and developmentally appropriate activities that promote the social, emotional[SA28.1], physical, cognitive, language and literacy development of each child. Staff should use a variety of teaching methods to accommodate the needs of the children's different learning styles. P. Staff Training (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (ii) Health (e.g., nutrition and the support of breast feeding, physical activity, prevention and control of illnesses and infectious diseases, immunizations, prevention of and response to emergencies due to food and allergic reactions, cleanliness, sanitation, and the appropriate disposal of bio contaminants); CAPS Policy Manual - 15.5 Compliance Standards for License-exempt and Informal Providers 15.5.3.4 Health and safety orientation training for license-exempt and informal providers must be completed within the first 90 days of employment and may be completed online or through instructor-led courses and must cover, at a minimum, the following topic areas: · Prevention and control of infectious diseases (including immunization) · Prevention of sudden infant death syndrome and use of safe sleeping FFY 2025￿2027 CCDF State Plan practices · Administration of medication consistent with standards for parental consent · Prevention and response to emergencies due to food and allergic reactions · Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic · Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment · Emergency preparedness and response planning for emergencies resulting from a natural disaster or a human-caused event (such as violence at a child care facility) · Handling and storage of hazardous materials and the appropriate disposal of bio contaminants Precautions in transporting children Recognition and reporting of child abuse and neglect Child development to include all major domains: cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; and approaches to play and learning iii. Caring for children with special needs. Describe: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed center care and are found in Rules and Regulations for Child Care Learning Centers. Activities 591-1-1-.03(4) A Child with Special Needs shall be integrated into the activities provided by the Center unless contraindicated medically or by written parental agreement. Admission and Enrollment 591-1-1-.04(2) The admission of a Child with Special Needs must be in compliance with the Americans with Disabilities Act, and a reasonable effort must be made to accommodate the child's needs and to integrate the child with other children. These accommodations must be in writing and the result of a mutual agreement between the Center and the Parents of the Child with Special Needs. The agreement shall be made in connection with the child's enrollment or at the time that the special need becomes apparent to the Center or the Parents. Children’s Records 591-1-.08(1)(a) A Center must maintain a file for each child while such child is in care at the Center and for a period of one (1) year after such child is no longer in care at the Center. In order for the file to be complete, the file shall contain the following: identifying information about the child to include: name, date of birth, sex, address, living arrangement if not with both Parents, name of school, if applicable; identifying information about the Parent(s) to include: names of both Parents, if applicable, home and work addresses, and home and work telephone numbers; name(s) and addresses of the person(s) to whom the child may be released. Such information shall contain the authorized person's address, telephone numbers, relationship to child and to Parent(s) and other identifying information; identifying information about the person(s) to contact in emergencies when the Parent cannot be reached to include name(s) and telephone number(s); identifying information about the child's primary source of health care to include physician's or clinic's name and telephone number; and a statement regarding known allergies or other physical problems, mental health disorders, intellectual disabilities or developmental disabilities which would limit the child's participation in the Center's program and activities. (a) The file shall contain a description of any special procedures to be followed in caring for the child, including any special services which the Center agrees to provide to a Child with Special Needs. Operational Policies and Procedures 591-1-1-.21(2) The Center shall have written documentation signed by the Parent(s) in each child's file that the Director or designee has: provided to the Parent(s) a copy of the Center's policies and procedures required by this rule; advised the Parent(s) of the safe sleep practices followed by the Center; advised the Parent(s) of the child's progress, issues relating to the child's care and individual practices concerning the child's special needs; and encouraged participation by Parent(s) in Center activities. Staff Training 591-1-1-.33(5)Annual Training. (a) Every calendar year after the first year of employment, all supervisory and caregiver Personnel, except independent contractors, Students-in- Training and volunteers, shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (i) Child development (e.g., developmental domains (cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; approaches to play and learning), discipline and guidance techniques, children with special needs); The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed family child care homes and are found in Rules and Regulations for Family Child Care Learning Homes. Children’s Records 290-2-3-.08(8)(b)(12) Policies and Procedures. Each Family Child Care Learning Home shall establish policies and procedures, which shall be kept current, be consistent with applicable laws, including but not limited to the Americans with Disabilities Act, regulations and these rules, made available to the Parents, and used to govern the operations of the Family Child Care Learning Home. (b) The policies and procedures shall also include written procedures for the following: Any information requested by the Parent concerning the operation of the Family Child Care Learning Home or the care of the Child, including but not limited to a description of any special procedures to be followed in caring for the Child, such as any special services which the Home agrees to provide to a Child with special needs. The Parent(s) will be provided daily communication (verbal/written) regarding the care of the Child, especially with infants, toddlers and nonverbal Children. Additionally, the Provider must bring special problems or significant developments to the Parent's attention as soon as they arise. Children’s Activities 290-2-3-.09(1) The Family Child Care Learning Home shall provide a variety of daily activities appropriate for the Children's chronological ages and developmental levels. Children with special needs shall be integrated into the activities provided by the Family Child Care Learning Home unless contraindicated medically or by parental agreement. Staffing and Supervision 290-2-3-.07(9) Annual Training. (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (i) Child development (e.g., developmental domains (cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; approaches to play and learning), discipline and guidance techniques, children with special needs); The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible license-exempt center care and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. A. Activities (1) Providers should provide a daily planned program of varied and developmentally appropriate activities that promote the social, emotional[JB29.1], physical, cognitive, language and literacy development of each child. Staff should use a variety of teaching methods to accommodate the needs of the children's different learning styles. (2) Individual Attention. Personnel shall provide individual attention to each child as evidenced by: (a) Responding promptly to the child's distress signals and need for comfort. (b) Playing with and talking to the children. (c) Providing and assisting the child with personal care in a manner appropriate to the child's age level, i.e., providing the child privacy in dressing, diapering and toileting functions as the developmental age of the child dictates. P. Staff Training (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (i) Child development (e.g., developmental domains (cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; approaches to play and learning), discipline and guidance techniques, children with special needs); The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible regulated (but not licensed) informal in-home care providers and are found in the Health & Safety Standards for Informal Providers Appendix HH. A. Activities (1) Providers should provide a daily planned program of varied and developmentally appropriate activities that promote the social, emotional, [JB30.1]physical, cognitive, language and literacy development of each child. Staff should use a variety of teaching methods to accommodate the needs of the children's different learning styles. (2) Individual Attention. Personnel shall provide individual attention to each child as evidenced by: (a) Responding promptly to the child's distress signals and need for comfort. (b) Playing with and talking to the children. (c) Providing and assisting the child with personal care in a manner appropriate to the child's age level, i.e., providing the child privacy in dressing, diapering and toileting functions as the developmental age of the child dictates. O. Staff Training (3) Ongoing Training (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: i. Child development (e.g., developmental domains (cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; approaches to play and learning), discipline and guidance techniques, children with special needs); The following standards are applicable to school-age children in all CCDF- eligible out-of-school programs and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. Out-of-school programs includes (1) day camps and (2) government-owned and operated providers. A. Activities (1) Providers should provide a daily planned program of varied and developmentally appropriate activities that promote the social, emotional, [JB31.1]physical, cognitive, language and literacy development of each child. Staff should use a variety of teaching methods to accommodate the needs of the children's different learning styles. (2) Individual Attention. Personnel shall provide individual attention to each child as evidenced by: (a) Responding promptly to the child's distress signals and need for comfort. (b) Playing with and talking to the children. (c) Providing and assisting the child with personal care in a manner appropriate to the child's age level, i.e., providing the child privacy in dressing, diapering and toileting functions as the developmental age of the child dictates. P. Staff Training (5) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (i) Child development (e.g., developmental domains (cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; approaches to play and learning), discipline and guidance techniques, children with special needs); iv. Any other areas determined necessary to promote child development or to protect children’s health and safety. Describe: The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed center care and are found in Rules and Regulations for Child Care Learning Centers. Activities 591-1-1-.03(1-3) (1) The Center shall provide a daily planned program of varied and developmentally appropriate activities that promote the social, emotional[JB32.1], physical, cognitive, language and literacy development of each child. Center Staff shall use a variety of teaching methods to accommodate the needs of the children's different learning styles. (2) Current lesson plans shall be kept on site and reflect appropriate instruction practices and activities to support children's development. The Center shall have sufficient and varied play and learning equipment and materials to support the above program of activities in all developmental areas. (3) Opportunities for each child to make choices in a variety of activities shall be offered. 591-1-1-.03(5) A variety of activities shall be planned for each group that include, but are not limited to: (a) Indoor and outdoor play; (b) A balance of quiet and active periods; (c) A balance of supervised free choice and caregiver-directed activities; (d) Individual, small group and large group activities; (e) Large muscle activities, such as but not limited to, running, riding, climbing, balancing, jumping, throwing, or digging; (f) Small muscle activities, such as but not limited to, building with blocks or construction toys, use of puzzles, shapes, nesting or stacking toys, pegs, lacing, sorting beads, or clay; (g) Language experiences, such as but not limited to, listening, talking, rhymes, fingerplays, stories, use of film strips, recordings or flannel boards; (h) Arts and crafts, such as but not limited to, painting, coloring, cutting, or pasting; (i) Dramatic play, such as but not limited to, play in a home center, with dolls, puppets, or dress up; (j) Rhythm and music, such as but not limited to, listening, singing, dancing, or making music; and (k) Nature and science experiences, such as but not limited to, measuring, pouring, activities related to the "world around us" such as nature walks, plants, leaves or weather or experiences in using the five senses through sensory play. Staff Training 591-1-1-.33(3)Health and Safety Orientation. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (j) child development to include all major domains: cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; and approaches to play and learning. 591-1-1-.33(5)Annual Training. (a) Every calendar year after the first year of employment, all supervisory and caregiver Personnel, except independent contractors, Students-in- Training and volunteers, shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 1. At least two (2) hours in evidence based, developmentally appropriate language and literacy practices; 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (i) Child development (e.g., developmental domains (cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; approaches to play and learning), discipline and guidance techniques, children with special needs); The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible licensed family child care homes and are found in Rules and Regulations for Family Child Care Learning Homes. Children’s Activities 290-2-3-.09(1)(a-k); (1) The Family Child Care Learning Home shall provide a variety of daily activities appropriate for the Children's chronological ages and developmental levels. Children with special needs shall be integrated into the activities provided by the Family Child Care Learning Home unless contraindicated medically or by parental agreement. Activities shall be planned for each group to allow for: (a) Indoor and outdoor play; (b) A balance of quiet and active periods; (c) A balance of supervised free choice and caregiver-directed activities; (d) Individual, small group, and large group activities; (e) Large muscle activities, such as, but not limited to, running, riding, climbing, balancing, jumping, throwing, or digging; (f) Small muscle activities, such as, but not limited to, building with blocks or construction toys, use of puzzles, nesting or stacking toys, pegs, lacing, sorting beads, or clay; (g) Language experiences, such as, but not limited to, listening, talking, rhymes, finger plays, stories, use of film strips, recordings or flannel boards; (h) Arts and crafts, such as, but not limited to, painting, coloring, cutting, or pasting; (i) Dramatic play, such as, but not limited to, play in a home center, with dolls, puppets, or dress up; (j) Rhythm and music, such as, but not limited to, listening, singing, dancing, or making music; and (k) Nature and science experiences, such as, but not limited to, measuring, pouring, activities related to the "world around us" such as nature walks, plants, leaves or weather, or experiences in using the five senses through sensory play. Staffing and Supervision 290-2-3-.07(7) Health and Safety Orientation. The Provider, Employees and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: (j) child development to include all major domains: cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; and approaches to play and learning. 290-2-3-.07(9) Annual Training. (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 1. At least two (2) hours in evidence based, developmentally appropriate language and literacy practices; 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (i) Child development (e.g., developmental domains (cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; approaches to play and learning), discipline and guidance techniques, children with special needs); The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible license-exempt center care and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. A. Activities (1) Providers should provide a daily planned program of varied and developmentally appropriate activities that promote the social, emotional, [JB33.1]physical, cognitive, language and literacy development of each child. Staff should use a variety of teaching methods to accommodate the needs of the children's different learning styles. FFY 2025￿2027 CCDF State Plan (2) Individual Attention. Personnel shall provide individual attention to each child as evidenced by: (a) Responding promptly to the child's distress signals and need for comfort. (b) Playing with and talking to the children. (c) Providing and assisting the child with personal care in a manner appropriate to the child's age level, i.e., providing the child privacy in dressing, diapering and toileting functions as the developmental age of the child dictates. P. Staff Training (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (k) Child Development to include all major domains: cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; and approaches to play and learning. (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 1. At least two (2) hours in evidence based, developmentally appropriate language and literacy practices. 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (i) Child development (e.g., developmental domains (cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; approaches to play and learning), discipline and guidance techniques, children with special needs); The following standards are applicable to infants, toddlers, preschoolers, and school-age children in all CCDF-eligible regulated (but not licensed) informal in-home care providers and are found in the Health & Safety Standards for Informal Providers Appendix HH. A. Activities (1) Providers should provide a daily planned program of varied and developmentally appropriate activities that promote the social, emotional, [JB34.1]physical, cognitive, language and literacy development of each child. Staff should use a variety of teaching methods to accommodate the needs of the children's different learning styles. (2) Individual Attention. Personnel shall provide individual attention to each child as evidenced by: (a) Responding promptly to the child's distress signals and need for comfort. (b) Playing with and talking to the children. (c) Providing and assisting the child with personal care in a manner appropriate to the child's age level, i.e., providing the child privacy in dressing, diapering and toileting functions as the developmental age of the child dictates. O. Staff Training (2) Health and Safety Orientation. Each Informal Provider, Employees, and Provisional Employees with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required annual training hours. The training must address the following health and safety topics: (k) Child Development to include all major domains: cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; and approaches to play and learning. (3) Ongoing Training (a) Every calendar year after the first year of employment, the Provider, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 1. At least two (2) hours in evidence based, developmentally appropriate language and literacy practices; 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: i. Child development (e.g., developmental domains (cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; approaches to play and learning), discipline and guidance techniques, children with special needs); The following standards are applicable to school-age children in all CCDF- eligible out-of-school programs and are found in Health & Safety Standards for License-Exempt Providers Receiving Subsidy. Out-of-school programs includes (1) day camps and (2) government-owned and operated providers. A. Activities (1) Providers should provide a daily planned program of varied and developmentally appropriate activities that promote the social, emotional, [JB35.1]physical, cognitive, language and literacy development of each child. Staff should use a variety of teaching methods to accommodate the needs of the children's different learning styles. (2) Individual Attention. Personnel shall provide individual attention to each child as evidenced by: (a) Responding promptly to the child's distress signals and need for comfort. (b) Playing with and talking to the children. (c) Providing and assisting the child with personal care in a manner appropriate to the child's age level, i.e., providing the child privacy in dressing, diapering and toileting functions as the developmental age of the child dictates. P. Staff Training (3) Health & Safety Orientation training. Each staff member with direct care responsibilities shall complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics. The training must address the following health and safety topics: (k) Child Development to include all major domains: cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; and approaches to play and learning. (4) Annual training. (a) Every calendar year after the first year of employment, the Director, Provisional Employees and Employees shall attend ten (10) clock hours of various training which is offered by an accredited college, university or vocational program or other Department-approved source. (b) The annual ten (10) clock hours of training shall include the following: 1. At least two (2) hours in evidence based, developmentally appropriate language and literacy practices. 2. At least two (2) hours in on-going child development and health and safety related topics, which could include, but not be limited to: (i) Child development (e.g., developmental domains (cognitive; social and emotional; physical development and motor skills; communication, language, and literacy; approaches to play and learning), discipline and guidance techniques, children with special needs);