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: 1. Providers shall have health policies for control for the spread of communicable diseases, handwashing procedures and a regular cleaning plan to protect the health of the children and staff members. 2. When disposable diapers are used, soiled diapers shall be placed in a plastic bag or a plastic lined receptable. 3. When cloth diapers or training pants are used, diapers or training paints soiled with stool shall not be washed at the center; using disposable plastic gloves, the diaper or training pants shall be put in a sealed plastic bag to be picked up by the child’s parent or guardian at the end of the day. 4. Training pants and cloth diapers shall be placed in a sealed bag when returning to parents. 5. Toys shall be sanitized daily for infants and toddlers. 6. Providers shall have written policies which have been developed with the assistance of the facility’s health consultant which require that staff with fever, other symptoms of illness shall not be allowed to work. 7. There shall be clean bedding for each child and ill children shall be kept isolated while providing adequate supervision. 8. Staff shall have physical and TB clearances. Immunizations: Each child shall have a health record which provides evidence of a physical clearance, T.B. and current immunizations which relate to the school entry examination requirements according to the Hawaii Department of Health. 9. The facility shall have written procedures for infection control, to use in all situations to prevent the transmission of blood-borne pathogens that may be spread through blood and body fluids. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 1. Providers shall have health policies for control for the spread of communicable diseases, handwashing procedures and a regular cleaning plan to protect the health of the children and provider. 2. When disposable diapers are used, soiled diapers shall be placed in a plastic bag or a plastic lined receptable. 3. When cloth diapers or training pants are used, diapers or training paints soiled with stool shall not be washed at the center; using disposable plastic gloves, the diaper or training pants shall be put in a sealed plastic bag to be picked up by the child’s parent or guardian at the end of the day. 4. Training pants and cloth diapers shall be placed in a sealed bag when returning to parents. 5. Toys shall be sanitized daily for infants and toddlers. 6. Providers shall have written policies which have been developed with the assistance of the facility’s health consultant which require that staff with fever, other symptoms of illness shall not be allowed to work. 7. There shall be clean bedding for each child and ill children shall be kept isolated while providing adequate supervision. 8. Staff shall have physical and TB clearances. Immunizations: Each child shall have a health record which provides evidence of a physical clearance, T.B. and current immunizations which relate to the school entry examination requirements according to the Hawaii Department of Health. iii. All CCDF-eligible licensed in-home care. Provide the standard: N/A [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: 1. Providers shall have health policies for control for the spread of communicable diseases, handwashing procedures and a regular cleaning plan. 2. When disposable diapers are used, soiled diapers shall be placed in a plastic bag or a plastic lined receptable. 3. When cloth diapers or training pants are used, diapers or training paints soiled with stool shall not be washed at the center; using disposable plastic gloves, the diaper or training pants shall be put in a sealed plastic bag to be picked up by the child’s parent or guardian at the end of the day. 4. Training pants and cloth diapers shall be placed in a sealed bag when returning to parents. 5. Toys shall be sanitized daily for infants and toddlers. 6. Providers shall have written policies which have been developed with the assistance of the facility’s health consultant which require that staff with fever, other symptoms of illness shall not be allowed to work. 7. There shall be clean bedding for each child and ill children shall be kept isolated while providing adequate supervision. 8. Staff shall have physical and TB clearances. Immunizations: Each child shall have a health record which provides evidence of a physical clearance, T.B. and current immunizations which relate to the school entry examination requirements according to the Hawaii Department of Health. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: 1. Providers shall have health policies for control for the spread of communicable diseases, handwashing procedures and a regular cleaning plan. 2. When disposable diapers are used, soiled diapers shall be placed in a plastic bag or a plastic lined receptable. 3. When cloth diapers or training pants are used, diapers or training paints soiled with stool shall not be washed at the center; using disposable plastic gloves, the diaper or training pants shall be put in a sealed plastic bag to be picked up by the child’s parent or guardian at the end of the day. 4. Training pants and cloth diapers shall be placed in a sealed bag when returning to parents. 5. Toys shall be sanitized daily for infants and toddlers. 6. Providers shall have written policies which have been developed with the assistance of the facility’s health consultant which require that staff with fever, other symptoms of illness shall not be allowed to work. 7. There shall be clean bedding for each child and ill children shall be kept isolated while providing adequate supervision. 8. Staff shall have physical and TB clearances. Immunizations: Each child shall have a health record which provides evidence of a physical clearance, T.B. and current immunizations which relate to the school entry examination requirements according to the Hawaii Department of Health. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: 1. Providers shall have health policies for control for the spread of communicable diseases, handwashing procedures and a regular cleaning plan. 2. When disposable diapers are used, soiled diapers shall be placed in a plastic bag or a plastic lined receptable. 3. When cloth diapers or training pants are used, diapers or training paints soiled with stool shall not be washed at the center; using disposable plastic gloves, the diaper or training pants shall be put in a sealed plastic bag to be picked up by the child’s parent or guardian at the end of the day. 4. Training pants and cloth diapers shall be placed in a sealed bag when returning to parents. 5. Toys shall be sanitized daily for infants and toddlers. 6. Providers shall have written policies which have been developed with the assistance of the facility’s health consultant which require that staff with fever, other symptoms of illness shall not be allowed to work. 7. There shall be clean bedding for each child and ill children shall be kept isolated while providing adequate supervision. 8. Staff shall have physical and TB clearances. Immunizations: Each child shall have a health record which provides evidence of a physical clearance, T.B. and current immunizations which relate to the school entry examination requirements according to the Hawaii Department of Health. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: 1. Providers shall have health policies for control for the spread of communicable diseases, handwashing procedures and a regular cleaning plan to protect the health of the children and staff members. 2. When disposable diapers are used, soiled diapers shall be placed in a plastic bag or a plastic lined receptable. 3. When cloth diapers or training pants are used, diapers or training paints soiled with stool shall not be washed at the center; using disposable plastic gloves, the diaper or training pants shall be put in a sealed plastic bag to be picked up by the child’s parent or guardian at the end of the day. 4. Training pants and cloth diapers shall be placed in a sealed bag when returning to parents. 5. Toys shall be sanitized daily for infants and toddlers. 6. Providers shall have written policies which have been developed with the assistance of the facility’s health consultant which require that staff with fever, other symptoms of illness shall not be allowed to work. 7. There shall be clean bedding for each child and ill children shall be kept isolated while providing adequate supervision. 8. Staff shall have physical and TB clearances. Immunizations: Each child shall have a health record which provides evidence of a physical clearance, T.B. and current immunizations which relate to the school entry examination requirements according to the Hawaii Department of Health. 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: (1) Child’s record of immunizations, or a written statement from a licensed physician certifying that the physical condition of the infant or toddler is such that immunizations would endanger the infant or toddler’s life or health, or a written statement from a parent or guardian requesting exemption from the required immunizations on the grounds that such immunizations conflict with the parent or guardian’s bona fide religious tenets and practices, in accordance with Chapter 11-157. (2) Evidence of tuberculosis clearance in accordance with Chapter 11-164.2; (3) Evidence of the child’s physical examination; and (4) The signature of a physician or health agency, signed within one (1) year prior to admission. For children experiencing homelessness or in foster care, the child care facility shall allow a grace period of three months from the child’s first day in care to obtain from the parent or guardian of each child, entering child care, a health record of the child, which complies with the provisions of Chapter 11-157, which relate to the immunization, physical examination, and Chapter 11-164.2 for tuberculosis clearance. ii. All CCDF-eligible licensed family child care homes. Provide the standard: (1) Child’s record of immunizations, or a written statement from a licensed physician certifying that the physical condition of the infant or toddler is such that immunizations would endanger the infant or toddler’s life or health, or a written statement from a parent or guardian requesting exemption from the required immunizations on the grounds that such immunizations conflict with the parent or guardian’s bona fide religious tenets and practices, in accordance with Chapter 11-157. (2) Evidence of tuberculosis clearance in accordance with Chapter 11-164.2; (3) Evidence of the child’s physical examination; and (4) The signature of a physician or health agency, signed within one (1) year prior to admission. For children experiencing homelessness or in foster care, the child care facility shall allow a grace period of three months from the child’s first day in care to obtain from the parent or guardian of each child, entering child care, a health record of the child, which complies with the provisions of Chapter 11-157, which relate to the immunization, physical examination, and Chapter 11-164.2 for tuberculosis clearance. iii. All CCDF-eligible licensed in-home care. Provide the standard: N/A [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: (1) Child’s record of immunizations, or a written statement from a licensed physician certifying that the physical condition of the infant or toddler is such that immunizations would endanger the infant or toddler’s life or health, or a written statement from a parent or guardian requesting exemption from the required immunizations on the grounds that such immunizations conflict with the parent or guardian’s bona fide religious tenets and practices, in accordance with Chapter 11-157. (2) Evidence of tuberculosis clearance in accordance with Chapter 11-164.2; (3) Evidence of the child’s physical examination; and (4) The signature of a physician or health agency, signed within one (1) year prior to admission. For children experiencing homelessness or in foster care, the child care facility shall allow a grace period of three months from the child’s first day in care to obtain from the parent or guardian of each child, entering child care, a health record of the child, which complies with the provisions of Chapter 11-157, which relate to the immunization, physical examination, and Chapter 11-164.2 for tuberculosis clearance. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: (1) Child’s record of immunizations, or a written statement from a licensed physician certifying that the physical condition of the infant or toddler is such that immunizations would endanger the infant or toddler’s life or health, or a written statement from a parent or guardian requesting exemption from the required immunizations on the grounds that such immunizations conflict with the parent or guardian’s bona fide religious tenets and practices, in accordance with Chapter 11-157. (2) Evidence of tuberculosis clearance in accordance with Chapter 11-164.2; (3) Evidence of the child’s physical examination; and (4) The signature of a physician or health agency, signed within one (1) year prior to admission. For children experiencing homelessness or in foster care, the child care facility shall allow a grace period of three months from the child’s first day in care to obtain from the parent or guardian of each child, entering child care, a health record of the child, which complies with the provisions of Chapter 11-157, which relate to the immunization, physical examination, and Chapter 11-164.2 for tuberculosis clearance. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: (1) Child’s record of immunizations, or a written statement from a licensed physician certifying that the physical condition of the infant or toddler is such that immunizations would endanger the infant or toddler’s life or health, or a written statement from a parent or guardian requesting exemption from the required immunizations on the grounds that such immunizations conflict with the parent or guardian’s bona fide religious tenets and practices, in accordance with Chapter 11-157. (2) Evidence of tuberculosis clearance in accordance with Chapter 11-164.2; (3) Evidence of the child’s physical examination; and (4) The signature of a physician or health agency, signed within one (1) year prior to admission. For children experiencing homelessness or in foster care, the child care facility shall allow a grace period of three months from the child’s first day in care to obtain from the parent or guardian of each child, entering child care, a health record of the child, which complies with the provisions of Chapter 11-157, which relate to the immunization, physical examination, and Chapter 11-164.2 for tuberculosis clearance. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: (1) Child’s record of immunizations, or a written statement from a licensed physician certifying that the physical condition of the infant or toddler is such that immunizations would endanger the infant or toddler’s life or health, or a written statement from a parent or guardian requesting exemption from the required immunizations on the grounds that such immunizations conflict with the parent or guardian’s bona fide religious tenets and practices, in accordance with Chapter 11-157. (2) Evidence of tuberculosis clearance in accordance with Chapter 11-164.2; (3) Evidence of the child’s physical examination; and (4) The signature of a physician or health agency, signed within one (1) year prior to admission. For children experiencing homelessness or in foster care, the child care facility shall allow a grace period of three months from the child’s first day in care to obtain from the parent or guardian of each child, entering child care, a health record of the child, which complies with the provisions of Chapter 11-157, which relate to the immunization, physical examination, and Chapter 11-164.2 for tuberculosis clearance. 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: All employees, household members, and volunteers of the child care facility that care for children less than one (1) year of age shall follow safe sleep practices as recommended by the American Academy of Pediatrics, practices to maintain safe sleep environments, practices to prevent the risk of sudden infant death syndrome, and complete initial and annual safe sleep training that is approved by the Department. Children that are one (1) year of age and older shall have an individual bed, crib, cot, mat, or rug and a clean sheet to use over the bed, crib, cot, mat, or rug. Sleeping areas shall be kept ventilated and at a safe temperature. When night care is provided, cribs, or beds shall be placed at least three (3) feet apart and staff shall be within hearing distance. The Basic Health and Safety Practices Child Care Provider’s Guide has additional standards that address Sudden Infant Death Syndrome (SIDS) or serious sleep- related accident. Putting an infant to sleep on the back reduces the risk of SIDS. Care providers can also support safe sleeping conditions by removing soft bedding like pillows, stuffed toys, comforters, and bumper guards from the sleeping area, ensuring that the care environment and any vehicle a child rides are smoke free, putting infants to sleep in a safety-approved crib or play yard, and not putting the child to sleep in the same bed with others. These types of actions are ways to support healthy sleep environments for infants and reduce the risk of sleep- related accidents due to smothering, suffocation, or strangulation. ii. All CCDF-eligible licensed family child care homes. Provide the standard: All employees, household members and volunteers of the child care facility that care for children less than one (1) year of age shall follow safe sleep practices as recommended by the American Academy of Pediatrics, practices to maintain safe sleep environments, practices to prevent the risk of sudden infant death syndrome, and complete initial and annual safe sleep training that is approved by the Department. Children that are one (1) year of age and older shall have an individual bed, crib, cot, mat, or rug and a clean sheet to use over the bed, crib, cot, mat, or rug. Sleeping areas shall be kept ventilated and at a safe temperature. When night care is provided, cribs, or beds shall be placed at least three (3) feet apart and staff shall be within hearing distance. The Basic Health and Safety Practices Child Care Provider’s Guide has additional standards that address Sudden Infant Death Syndrome (SIDS) or serious sleep- related accident. Putting an infant to sleep on the back reduces the risk of SIDS. Care providers can also support safe sleeping conditions by removing soft bedding like pillows, stuffed toys, comforters, and bumper guards from the sleeping area, ensuring that the care environment and any vehicle a child rides are smoke free, putting infants to sleep in a safety-approved crib or play yard, and not putting the child to sleep in the same bed with others. These types of actions are ways to support healthy sleep environments for infants and reduce the risk of sleep- related accidents due to smothering, suffocation, or strangulation. iii. All CCDF-eligible licensed in-home care. Provide the standard: N/A [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: For a child less than one year of age, the provider shall ensure the following: (1) areas where children sleep are kept ventilated and at a safe temperature; (2) That each child has a separate crib or playpen; (3) That cribs or playpens used for care have not been recalled by the United States consumer product safety commission; provided that a recalled item may be used if repaired in accordance with the manufacturer's standards, and the provider maintains a record of the repair; (4) Not allowing for any other sleeping arrangement; including bed-sharing; (5) Placing the child on his or her back to sleep, unless written instructions for an alternative sleep position are on file; (6) Moving the child to a crib or playpen for the remainder of the nap when the child falls asleep in a location or in equipment other than a crib or playpen; (7) Monitoring and periodically checking on a sleeping child; (8) The crib or playpen has a clean, tightly-fitted sheet; and (9) The crib or playpen does not have any bedding or toys placed in with a child. The Basic Health and Safety Practices Child Care Provider’s Guide has additional standards that address Sudden Infant Death Syndrome (SIDS) or serious sleep- related accident. Putting an infant to sleep on the back reduces the risk of SIDS. Care providers can also support safe sleeping conditions by removing soft bedding like pillows, stuffed toys, comforters, and bumper guards from the sleeping area, ensuring that the care environment and any vehicle a child rides are smoke free, putting infants to sleep in a safety-approved crib or play yard, and not putting the child to sleep in the same bed with others. These types of actions are ways to support healthy sleep environments for infants and reduce the risk of sleep- related accidents due to smothering, suffocation, or strangulation. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: For a child less than one year of age, the provider shall ensure the following: (1) areas where children sleep are kept ventilated and at a safe temperature; (2) That each child has a separate crib or playpen; (3) That cribs or playpens used for care have not been recalled by the United States consumer product safety commission; provided that a recalled item may be used if repaired in accordance with the manufacturer's standards, and the provider maintains a record of the repair; (4) Not allowing for any other sleeping arrangement; including bed-sharing; (5) Placing the child on his or her back to sleep, unless written instructions for an alternative sleep position are on file; (6) Moving the child to a crib or playpen for the remainder of the nap when the child falls asleep in a location or in equipment other than a crib or playpen; (7) Monitoring and periodically checking on a sleeping child; (8) The crib or playpen has a clean, tightly-fitted sheet; and (9) The crib or playpen does not have any bedding or toys placed in with a child. The Basic Health and Safety Practices Child Care Provider’s Guide has additional standards that address Sudden Infant Death Syndrome (SIDS) or serious sleep- related accident. Putting an infant to sleep on the back reduces the risk of SIDS. Care providers can also support safe sleeping conditions by removing soft bedding like pillows, stuffed toys, comforters, and bumper guards from the sleeping area, ensuring that the care environment and any vehicle a child rides are smoke free, putting infants to sleep in a safety-approved crib or play yard, and not putting the child to sleep in the same bed with others. These types of actions are ways to support healthy sleep environments for infants and reduce the risk of sleep- related accidents due to smothering, suffocation, or strangulation. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: For a child less than one year of age, the provider shall ensure the following: (1) areas where children sleep are kept ventilated and at a safe temperature; (2) That each child has a separate crib or playpen; (3) That cribs or playpens used for care have not been recalled by the United States consumer product safety commission; provided that a recalled item may be used if repaired in accordance with the manufacturer's standards, and the provider maintains a record of the repair; (4) Not allowing for any other sleeping arrangement; including bed-sharing; (5) Placing the child on his or her back to sleep, unless written instructions for an alternative sleep position are on file; (6) Moving the child to a crib or playpen for the remainder of the nap when the child falls asleep in a location or in equipment other than a crib or playpen; (7) Monitoring and periodically checking on a sleeping child; (8) The crib or playpen has a clean, tightly-fitted sheet; and (9) The crib or playpen does not have any bedding or toys placed in with a child. The Basic Health and Safety Practices Child Care Provider’s Guide has additional standards that address Sudden Infant Death Syndrome (SIDS) or serious sleep- related accident. Putting an infant to sleep on the back reduces the risk of SIDS. Care providers can also support safe sleeping conditions by removing soft bedding like pillows, stuffed toys, comforters, and bumper guards from the sleeping area, ensuring that the care environment and any vehicle a child rides are smoke free, putting infants to sleep in a safety-approved crib or play yard, and not putting the child to sleep in the same bed with others. These types of actions are ways to support healthy sleep environments for infants and reduce the risk of sleep- related accidents due to smothering, suffocation, or strangulation. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A due to age of children in care: Hawaii Administrative Rules: 17-896.1-10 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: When medication prescribed by a physician is administered at the facility: 1. Written permission from the child’s parent or guardian to administer medication is on file. 2. The medication shall be kept in the original container bearing the prescription label which shows a current date, the physician's directions for use, and the child's name; and kept out of the reach of the children. 3. Medication shall be kept out of the reach of the children and shall be returned to parents or guardians when no longer in house. When over-the-counter medication is recommended by the child or family doctor, medication shall be administered at the child care facility as directed by the doctor or parent or guardian in writing. The Basic Health and Safety Practices Child Care Provider’s Guide has additional standards that address the administration of medication. 1. Before administering medication: Ensure parent(s) have completed the Consent for the Administration of Medication Form. Check all information on consent form to ensure accuracy. Remove medication from a storage area that is inaccessible to children. Wash hands thoroughly. Wear latex-free gloves if applying topical medications or eye and ear drops. Recheck and confirm child’s name, medication expiration date, time, name of medication, dose, and physician’s directions are indicated on the medication. Administer medication to the child as prescribed. 2. After giving the medication: document the time and date the medication was given and the amount. Put medication away in storage area that is inaccessible to children. Wash hands thoroughly. Observe child’s response to the medication. If there is any reaction to the medication, document the reaction and call/inform the child’s parent(s) immediately and, if necessary, call 911. ii. All CCDF-eligible licensed family child care homes. Provide the standard: When medication prescribed by a physician is administered at the facility: 1. Written permission from the child’s parent or guardian to administer medication is on file; 2. The medication shall be kept in the original container bearing the prescription label which shows a current date, the physician's directions for use, and the child's name; and kept out of the reach of the children. 3. Medication shall be kept out of the reach of the children and shall be returned to parents or guardians when no longer in house. When over-the-counter medication is recommended by the child or family doctor, medication shall be administered at the child care facility as directed by the doctor or parent or guardian in writing. The Basic Health and Safety Practices Child Care Provider’s Guide has additional standards that address the administration of medication. 1. Before administering medication: Ensure parent(s) have completed the Consent for the Administration of Medication Form. Check all information on consent form to ensure accuracy. Remove medication from a storage area that is inaccessible to children. Wash hands thoroughly. Wear latex-free gloves if applying topical medications or eye and ear drops. Recheck and confirm child’s name, medication expiration date, time, name of medication, dose, and physician’s directions are indicated on the medication. Administer medication to the child as prescribed. 2. After giving the medication: document the time and date the medication was given and the amount. Put medication away in storage area that is inaccessible to children. Wash hands thoroughly. Observe child’s response to the medication. If there is any reaction to the medication, document the reaction and call/inform the child’s parent(s) immediately and, if necessary, call 911. iii. All CCDF-eligible licensed in-home care. Provide the standard: N/A [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: When medication prescribed by a physician is administered at the facility: 1. Written permission from the child’s parent or guardian to administer medication is on file; 2. The medication shall be kept in the original container bearing the prescription label which shows a current date, the physician's directions for use, and the child's name; and kept out of the reach of the children. 3. Medication shall be kept out of the reach of the children and shall be returned to parents or guardians when no longer in house. When over-the-counter medication is recommended by the child or family doctor, medication shall be administered at the child care facility as directed by the doctor or parent or guardian in writing. The Basic Health and Safety Practices Child Care Provider’s Guide has additional standards that address the administration of medication. 1. Before administering medication: Ensure parent(s) have completed the Consent for the Administration of Medication Form. Check all information on consent form to ensure accuracy. Remove medication from a storage area that is inaccessible to children. Wash hands thoroughly. Wear latex-free gloves if applying topical medications or eye and ear drops. Recheck and confirm child’s name, medication expiration date, time, name of medication, dose, and physician’s directions are indicated on the medication. Administer medication to the child as prescribed. 2. After giving the medication: document the time and date the medication was given and the amount. Put medication away in storage area that is inaccessible to children. Wash hands thoroughly. Observe child’s response to the medication. If there is any reaction to the medication, document the reaction and call/inform the child’s parent(s) immediately and, if necessary, call 911. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: When medication prescribed by a physician is administered at the facility: 1. Written permission from the child’s parent or guardian to administer medication is on file; 2. The medication shall be kept in the original container bearing the prescription label which shows a current date, the physician's directions for use, and the child's name; and kept out of the reach of the children. 3. Medication shall be kept out of the reach of the children and shall be returned to parents or guardians when no longer in house. When over-the-counter medication is recommended by the child or family doctor, medication shall be administered at the child care facility as directed by the doctor or parent or guardian in writing. The Basic Health and Safety Practices Child Care Provider’s Guide has additional standards that address the administration of medication. 1. Before administering medication: Ensure parent(s) have completed the Consent for the Administration of Medication Form. Check all information on consent form to ensure accuracy. Remove medication from a storage area that is inaccessible to children. Wash hands thoroughly. Wear latex-free gloves if applying topical medications or eye and ear drops. Recheck and confirm child’s name, medication expiration date, time, name of medication, dose, and physician’s directions are indicated on the medication. Administer medication to the child as prescribed. 2. After giving the medication: document the time and date the medication was given and the amount. Put medication away in storage area that is inaccessible to children. Wash hands thoroughly. Observe child’s response to the medication. If there is any reaction to the medication, document the reaction and call/inform the child’s parent(s) immediately and, if necessary, call 911. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: When medication prescribed by a physician is administered at the facility: 1. Written permission from the child’s parent or guardian to administer medication is on file; 2. The medication shall be kept in the original container bearing the prescription label which shows a current date, the physician's directions for use, and the child's name; and kept out of the reach of the children. 3. Medication shall be kept out of the reach of the children and shall be returned to parents or guardians when no longer in house. When over-the-counter medication is recommended by the child or family doctor, medication shall be administered at the child care facility as directed by the doctor or parent or guardian in writing. The Basic Health and Safety Practices Child Care Provider’s Guide has additional standards that address the administration of medication. 1. Before administering medication: Ensure parent(s) have completed the Consent for the Administration of Medication Form. Check all information on consent form to ensure accuracy. Remove medication from a storage area that is inaccessible to children. Wash hands thoroughly. Wear latex-free gloves if applying topical medications or eye and ear drops. Recheck and confirm child’s name, medication expiration date, time, name of medication, dose, and physician’s directions are indicated on the medication. Administer medication to the child as prescribed. 2. After giving the medication: document the time and date the medication was given and the amount. Put medication away in storage area that is inaccessible to children. Wash hands thoroughly. Observe child’s response to the medication. If there is any reaction to the medication, document the reaction and call/inform the child’s parent(s) immediately and, if necessary, call 911. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: When medication prescribed by a physician is administered at the facility: 1. Written permission from the child’s parent or guardian to administer medication is on file; 2. The medication shall be kept in the original container bearing the prescription label which shows a current date, the physician's directions for use, and the child's name; and kept out of the reach of the children. 3. Medication shall be kept out of the reach of the children and shall be returned to parents or guardians when no longer in house. When over-the-counter medication is recommended by the child or family doctor, medication shall be administered at the child care facility as directed by the doctor or parent or guardian in writing. The Basic Health and Safety Practices Child Care Provider’s Guide has additional standards that address the administration of medication. 1. Before administering medication: Ensure parent(s) have completed the Consent for the Administration of Medication Form. Check all information on consent form to ensure accuracy. Remove medication from a storage area that is inaccessible to children. Wash hands thoroughly. Wear latex-free gloves if applying topical medications or eye and ear drops. Recheck and confirm child’s name, medication expiration date, time, name of medication, dose, and physician’s directions are indicated on the medication. Administer medication to the child as prescribed. 2. After giving the medication: document the time and date the medication was given and the amount. Put medication away in storage area that is inaccessible to children. Wash hands thoroughly. Observe child’s response to the medication. If there is any reaction to the medication, document the reaction and call/inform the child’s parent(s) immediately and, if necessary, call 911. 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: When medication prescribed by a physician is administered at the facility, written permission from the child’s parent or guardian to administer medication is on file. When over-the- counter medication is recommended by the child or family doctor, medication shall be administered at the child care facility as directed by the doctor or parent or guardian in writing. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address obtaining permission from parents to administer medications to children. Ensure parent(s) have completed the Consent for the Administration of Medication Form. Check all information on consent form to ensure accuracy. Consent form will authorize the individual/provider to give the child the prescribed dose of medication as listed on the consent form including: Name of medication, dose, at the following time and dates, and prescribed by named doctor. Medication must be in its original container and long-term medication must be renewed every three (3) months. Consent form also includes: possible side effects if any and signature of Parent and Physician, date of prescription and name of prescription. ii. All CCDF-eligible licensed family child care homes. Provide the standard: When medication prescribed by a physician is administered at the facility, written permission from the child’s parent or guardian to administer medication is on file. When over-the-counter medication is recommended by the child or family doctor, medication shall be administered at the child care facility as directed by the doctor or parent or guardian in writing. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address obtaining permission from parents to administer medications to children. Ensure parent(s) have completed the Consent for the Administration of Medication Form. Check all information on consent form to ensure accuracy. Consent form will authorize the individual/provider to give the child the prescribed dose of medication as listed on the consent form including: Name of medication, dose, at the following time and dates, and prescribed by named doctor. Medication must be in its original container and long-term medication must be renewed every three (3) months. Consent form also includes: possible side effects if any and signature of Parent and Physician, date of prescription and name of prescription. iii. All CCDF-eligible licensed in-home care. Provide the standard: N/A [x]Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: When medication prescribed by a physician is administered at the facility, written permission from the child’s parent or guardian to administer medication is on file. When over-the-counter medication is recommended by the child or family doctor, medication shall be administered at the child care facility as directed by the doctor or parent or guardian in writing. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address obtaining permission from parents to administer medications to children. Ensure parent(s) have completed the Consent for the Administration of Medication Form. Check all information on consent form to ensure accuracy. Consent form will authorize the individual/provider to give the child the prescribed dose of medication as listed on the consent form including: Name of medication, dose, at the following time and dates, and prescribed by named doctor. Medication must be in its original container and long-term medication must be renewed every three (3) months. Consent form also includes: possible side effects if any and signature of Parent and Physician, date of prescription and name of prescription v. All CCDF-eligible license-exempt family child care homes. Provide the standard: When medication prescribed by a physician is administered at the facility, written permission from the child’s parent or guardian to administer medication is on file. When over-the-counter medication is recommended by the child or family doctor, medication shall be administered at the child care facility as directed by the doctor or parent or guardian in writing. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address obtaining permission from parents to administer medications to children. Ensure parent(s) have completed the Consent for the Administration of Medication Form. Check all information on consent form to ensure accuracy. Consent form will authorize the individual/provider to give the child the prescribed dose of medication as listed on the consent form including: Name of medication, dose, at the following time and dates, and prescribed by named doctor. Medication must be in its original container and long-term medication must be renewed every three (3) months. Consent form also includes: possible side effects if any and signature of Parent and Physician, date of prescription and name of prescription. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: When medication prescribed by a physician is administered at the facility, written permission from the child’s parent or guardian to administer medication is on file. When over-the-counter medication is recommended by the child or family doctor, medication shall be administered at the child care facility as directed by the doctor or parent or guardian in writing. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address obtaining permission from parents to administer medications to children. Ensure parent(s) have completed the Consent for the Administration of Medication Form. Check all information on consent form to ensure accuracy. Consent form will authorize the individual/provider to give the child the prescribed dose of medication as listed on the consent form including: Name of medication, dose, at the following time and dates, and prescribed by named doctor. Medication must be in its original container and long-term medication must be renewed every three (3) months. Consent form also includes: possible side effects if any and signature of Parent and Physician, date of prescription and name of prescription. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: When medication prescribed by a physician is administered at the facility, written permission from the child’s parent or guardian to administer medication is on file. When over-the-counter medication is recommended by the child or family doctor, medication shall be administered at the child care facility as directed by the doctor or parent or guardian in writing. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address obtaining permission from parents to administer medications to children. Ensure parent(s) have completed the Consent for the Administration of Medication Form. Check all information on consent form to ensure accuracy. Consent form will authorize the individual/provider to give the child the prescribed dose of medication as listed on the consent form including: Name of medication, dose, at the following time and dates, and prescribed by named doctor. Medication must be in its original container and long-term medication must be renewed every three (3) months. Consent form also includes: possible side effects if any and signature of Parent and Physician, date of prescription and name of prescription. 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: (1) Children shall not be offered foods to which they are allergic or, for religious reasons, cannot consume. Provisions shall be made to secure such information from the parent or guardian, and the parent or guardian of the child shall arrange for nutritious substitute foods. (2) A list of food items that are provided by the caregiver shall be posted in a prominent place for review by parents. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address food allergies: (1) Collect information from the family about the child’s known food allergies. (2) Ask the family to provide a care plan prepared by the child’s health care provider that includes the food(s) the child is allergic to. (3) Post a sign about individual child's food allergies prominently in your food preparation area where staff can view and/or wherever food is served. (4) Consider eliminating the offending food entirely from your site to decrease the danger of an accidental exposure. (5) Notify families of any known food allergens of the children in your care; and ask them not to bring any of the offending foods to your site. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The provider shall obtain from the parent or guardian of each child, by the child's first day entering child care, information about the health needs for each child, including any allergies. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address food allergies: (1) Collect information from the family about the child’s known food allergies. (2) Ask the family to provide a care plan prepared by the child’s health care provider that includes the food(s) the child is allergic to. (3) Post a sign about individual child's food allergies prominently in your food preparation area where staff can view and/or wherever food is served. (4) Consider eliminating the offending food entirely from your site to decrease the danger of an accidental exposure. (5) Notify families of any known food allergens of the children in your care; and ask them not to bring any of the offending foods to your site. iii. All CCDF-eligible licensed in-home care. Provide the standard: N/A [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The provider shall obtain from the parent or guardian of each child, by the child's first day entering child care, information about the health needs for each child, including any allergies. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address food allergies: (1) Collect information from the family about the child’s known food allergies. (2) Ask the family to provide a care plan prepared by the child’s health care provider that includes the food(s) the child is allergic to. (3) Post a sign about individual child's food allergies prominently in your food preparation area where staff can view and/or wherever food is served. (4) Consider eliminating the offending food entirely from your site to decrease the danger of an accidental exposure. (5) Notify families of any known food allergens of the children in your care; and ask them not to bring any of the offending foods to your site. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The provider shall obtain from the parent or guardian of each child, by the child's first day entering child care, information about the health needs for each child, including any allergies. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address food allergies: (1) Collect information from the family about the child’s known food allergies. (2) Ask the family to provide a care plan prepared by the child’s health care provider that includes the food(s) the child is allergic to. (3) Post a sign about individual child's food allergies prominently in your food preparation area where staff can view and/or wherever food is served. (4) Consider eliminating the offending food entirely from your site to decrease the danger of an accidental exposure. (5) Notify families of any known food allergens of the children in your care; and ask them not to bring any of the offending foods to your site. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The provider shall obtain from the parent or guardian of each child, by the child's first day entering child care, information about the health needs for each child, including any allergies. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address food allergies: (1) Collect information from the family about the child’s known food allergies. (2) Ask the family to provide a care plan prepared by the child’s health care provider that includes the food(s) the child is allergic to. (3) Post a sign about individual child's food allergies prominently in your food preparation area where staff can view and/or wherever food is served. (4) Consider eliminating the offending food entirely from your site to decrease the danger of an accidental exposure. (5) Notify families of any known food allergens of the children in your care; and ask them not to bring any of the offending foods to your site. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The provider shall obtain from the parent or guardian of each child, by the child's first day entering child care, information about the health needs for each child, including any allergies. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address food allergies: (1) Collect information from the family about the child’s known food allergies. (2) Ask the family to provide a care plan prepared by the child’s health care provider that includes the food(s) the child is allergic to. (3) Post a sign about individual child's food allergies prominently in your food preparation area where staff can view and/or wherever food is served. (4) Consider eliminating the offending food entirely from your site to decrease the danger of an accidental exposure. (5) Notify families of any known food allergens of the children in your care; and ask them not to bring any of the offending foods to your site. 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 Department of Human Services (DHS) is not compliant by 10/01/24 for the standard of response to emergencies due to food and allergic reactions. Preliminary of Possible Non- Compliance Rev date: 01/2023. DHS will need additional time and technical assistance from the Office of Child Care to fully implement this requirement. The Monitoring Team reported that they did not find evidence that the Lead Agency has requirements for the response to emergencies due to food or allergic reactions. The Department of Human Services plans to work on this Standard for the next round of rule amendments for Fiscal Year 2025-2027 Plan Period. The Department of Human Services requested for technical assistance on language for response to emergencies during the implementation conference. However, the Department of Human Services requires all caregivers to complete the initial training by reviewing The Basic Health and Safety Practices Child Care Provider’s Guide and completing the Assessment with 100% accuracy. The Basic Health and Safety Practices Child Care Provider’s Guide has the following standards that address the response to an allergic reaction: (1) Ask the family to provide a care plan prepared by the child’s health care provider that includes the following: Food(s) the child is allergic to, specific symptoms that would indicate the need to administer medication - names, doses, and methods of administration of any medications. (2) If the family gives you an EpiPen for administration, have the parent(s) train you on how to use it. (3) Have the family complete Consent for Administration of Medication Form. (4) Recognizing symptoms of an allergic reaction: Sit with the child during meals. Observe for signs of allergic reactions, such as sudden onset of sneezing, redness, hives, itching skin, swollen or bluish skin or lips, choking, or inability to speak. Listen and watch for cues of discomfort. A child who is verbal may tell you - My mouth feels funny - Something is poking my tongue - My tongue (or mouth) is itching (or burning) - My tongue is hot - There’s something stuck in my throat - My lips feel tight - There are bugs in my ears. (5) Treating allergic reactions: Promptly administer the prescribed medication according to the care plan. Notify the child’s parent(s) immediately if there are any suspected allergic reactions or contact with the allergen, even if a reaction did not occur. If epinephrine has been administered, contact 911 immediately. Carry the written care plan, a telephone, emergency phone numbers, and proper medications with you on field trips or any kind of transport away from your site. Contact 911, if needed. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The Department of Human Services (DHS) is not compliant by 10/01/24 for the standard of response to emergencies due to food and allergic reactions. Preliminary of Possible Non-Compliance Rev date: 01/2023. DHS will need additional time and technical assistance from the Office of Child Care to fully implement this requirement. The Monitoring Team reported that they did not find evidence that the Lead Agency has requirements for the response to emergencies due to food or allergic reactions. The Department of Human Services plans to work on this Standard for the next round of rule amendments for Fiscal Year 2025-2027 Plan Period. The Department of Human Services requested for technical assistance on language for response to emergencies during the implementation conference. However, the Department of Human Services requires all caregivers to complete the initial training by reviewing The Basic Health and Safety Practices Child Care Provider’s Guide and completing the Assessment with 100% accuracy. The Basic Health and Safety Practices Child Care Provider’s Guide has the following standards that address the response to an allergic reaction: (1) Ask the family to provide a care plan prepared by the child’s health care provider that includes the following: Food(s) the child is allergic to, specific symptoms that would indicate the need to administer medication - names, doses, and methods of administration of any medications. (2) If the family gives you an EpiPen for administration, have the parent(s) train you on how to use it. (3) Have the family complete Consent for Administration of Medication Form. (4) Recognizing symptoms of an allergic reaction: Sit with the child during meals. Observe for signs of allergic reactions, such as sudden onset of sneezing, redness, hives, itching skin, swollen or bluish skin or lips, choking, or inability to speak. Listen and watch for cues of discomfort. A child who is verbal may tell you - My mouth feels funny - Something is poking my tongue - My tongue (or mouth) is itching (or burning) - My tongue is hot - There’s something stuck in my throat - My lips feel tight - There are bugs in my ears. (5) Treating allergic reactions: Promptly administer the prescribed medication according to the care plan. Notify the child’s parent(s) immediately if there are any suspected allergic reactions or contact with the allergen, even if a reaction did not occur. If epinephrine has been administered, contact 911 immediately. Carry the written care plan, a telephone, emergency phone numbers, and proper medications with you on field trips or any kind of transport away from your site. ▫ Contact 911, if needed. iii. All CCDF-eligible licensed in-home care. Provide the standard:: N/A [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The Department of Human Services (DHS) is not compliant by 10/01/24 for the standard of response to emergencies due to food and allergic reactions. Preliminary of Possible Non-Compliance Rev date: 01/2023. DHS will need additional time and technical assistance from the Office of Child Care to fully implement this requirement. The Monitoring Team reported that they did not find evidence that the Lead Agency has requirements for the response to emergencies due to food or allergic reactions. The Department of Human Services plans to work on this Standard for the next round of rule amendments for Fiscal Year 2025-2027 Plan Period. The Department of Human Services requested for technical assistance on language for response to emergencies during the implementation conference. However, the Department of Human Services requires all caregivers to complete the initial training by reviewing The Basic Health and Safety Practices Child Care Provider’s Guide and completing the Assessment with 100% accuracy. The Basic Health and Safety Practices Child Care Provider’s Guide has the following standards that address the response to an allergic reaction: (1) Ask the family to provide a care plan prepared by the child’s health care provider that includes the following: Food(s) the child is allergic to, specific symptoms that would indicate the need to administer medication - names, doses, and methods of administration of any medications. (2) If the family gives you an EpiPen for administration, have the parent(s) train you on how to use it. (3) Have the family complete Consent for Administration of Medication Form. (4) Recognizing symptoms of an allergic reaction: Sit with the child during meals. Observe for signs of allergic reactions, such as sudden onset of sneezing, redness, hives, itching skin, swollen or bluish skin or lips, choking, or inability to speak. Listen and watch for cues of discomfort. A child who is verbal may tell you - My mouth feels funny - Something is poking my tongue - My tongue (or mouth) is itching (or burning) - My tongue is hot - There’s something stuck in my throat - My lips feel tight - There are bugs in my ears. (5) Treating allergic reactions: Promptly administer the prescribed medication according to the care plan. Notify the child’s parent(s) immediately if there are any suspected allergic reactions or contact with the allergen, even if a reaction did not occur. If epinephrine has been administered, contact 911 immediately. Carry the written care plan, a telephone, emergency phone numbers, and proper medications with you on field trips or any kind of transport away from your site. Contact 911, if needed. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The Department of Human Services (DHS) is not compliant by 10/01/24 for the standard of response to emergencies due to food and allergic reactions. Preliminary of Possible Non-Compliance Rev date: 01/2023. DHS will need additional time and technical assistance from the Office of Child Care to fully implement this requirement. The Monitoring Team reported that they did not find evidence that the Lead Agency has requirements for the response to emergencies due to food or allergic reactions. The Department of Human Services plans to work on this Standard for the next round of rule amendments for Fiscal Year 2025-2027 Plan Period. The Department of Human Services requested for technical assistance on language for response to emergencies during the implementation conference. However, the Department of Human Services requires all caregivers to complete the initial training by reviewing The Basic Health and Safety Practices Child Care Provider’s Guide and completing the Assessment with 100% accuracy. The Basic Health and Safety Practices Child Care Provider’s Guide has the following standards that address the response to an allergic reaction: (1) Ask the family to provide a care plan prepared by the child’s health care provider that includes the following: Food(s) the child is allergic to, specific symptoms that would indicate the need to administer medication - names, doses, and methods of administration of any medications. (2) If the family gives you an EpiPen for administration, have the parent(s) train you on how to use it. (3) Have the family complete Consent for Administration of Medication Form. (4) Recognizing symptoms of an allergic reaction: Sit with the child during meals. Observe for signs of allergic reactions, such as sudden onset of sneezing, redness, hives, itching skin, swollen or bluish skin or lips, choking, or inability to speak. Listen and watch for cues of discomfort. A child who is verbal may tell you - My mouth feels funny - Something is poking my tongue - My tongue (or mouth) is itching (or burning) - My tongue is hot - There’s something stuck in my throat - My lips feel tight - There are bugs in my ears. (5) Treating allergic reactions: Promptly administer the prescribed medication according to the care plan. Notify the child’s parent(s) immediately if there are any suspected allergic reactions or contact with the allergen, even if a reaction did not occur. If epinephrine has been administered, contact 911 immediately. Carry the written care plan, a telephone, emergency phone numbers, and proper medications with you on field trips or any kind of transport away from your site. Contact 911, if needed. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Department of Human Services (DHS) is not compliant by 10/01/24 for the standard of response to emergencies due to food and allergic reactions. Preliminary of Possible Non-Compliance Rev date: 01/2023. DHS will need additional time and technical assistance from the Office of Child Care to fully implement this requirement. The Monitoring Team reported that they did not find evidence that the Lead Agency has requirements for the response to emergencies due to food or allergic reactions. The Department of Human Services plans to work on this Standard for the next round of rule amendments for Fiscal Year 2025-2027 Plan Period. The Department of Human Services requested for technical assistance on language for response to emergencies during the implementation conference. However, the Department of Human Services requires all caregivers to complete the initial training by reviewing The Basic Health and Safety Practices Child Care Provider’s Guide and completing the Assessment with 100% accuracy. The Basic Health and Safety Practices Child Care Provider’s Guide has the following standards that address the response to an allergic reaction: (1) Ask the family to provide a care plan prepared by the child’s health care provider that includes the following: Food(s) the child is allergic to, specific symptoms that would indicate the need to administer medication - names, doses, and methods of administration of any medications. (2) If the family gives you an EpiPen for administration, have the parent(s) train you on how to use it. (3) Have the family complete Consent for Administration of Medication Form. (4) Recognizing symptoms of an allergic reaction: Sit with the child during meals. Observe for signs of allergic reactions, such as sudden onset of sneezing, redness, hives, itching skin, swollen or bluish skin or lips, choking, or inability to speak. Listen and watch for cues of discomfort. A child who is verbal may tell you - My mouth feels funny - Something is poking my tongue - My tongue (or mouth) is itching (or burning) - My tongue is hot - There’s something stuck in my throat - My lips feel tight - There are bugs in my ears. (5) Treating allergic reactions: Promptly administer the prescribed medication according to the care plan. Notify the child’s parent(s) immediately if there are any suspected allergic reactions or contact with the allergen, even if a reaction did not occur. If epinephrine has been administered, contact 911 immediately. Carry the written care plan, a telephone, emergency phone numbers, and proper medications with you on field trips or any kind of transport away from your site. ▫ Contact 911, if needed. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The Department of Human Services (DHS) is not compliant by 10/01/24 for the standard of response to emergencies due to food and allergic reactions. Preliminary of Possible Non-Compliance Rev date: 01/2023. DHS will need additional time and technical assistance from the Office of Child Care to fully implement this requirement. The Monitoring Team reported that they did not find evidence that the Lead Agency has requirements for the response to emergencies due to food or allergic reactions. DHS plans to work on this Standard for the next round of rule amendments for Fiscal Year 2025-2027 Plan Period. The Department of Human Services requested for technical assistance on language for response to emergencies during the implementation conference. However, the Department of Human Services requires all caregivers to complete the initial training by reviewing The Basic Health and Safety Practices Child Care Provider’s Guide and completing the Assessment with 100% accuracy. The Basic Health and Safety Practices Child Care Provider’s Guide has the following standards that address the response to an allergic reaction: (1) Ask the family to provide a care plan prepared by the child’s health care provider that includes the following: Food(s) the child is allergic to, specific symptoms that would indicate the need to administer medication - names, doses, and methods of administration of any medications. (2) If the family gives you an EpiPen for administration, have the parent(s) train you on how to use it. (3) Have the family complete Consent for Administration of Medication Form. (4) Recognizing symptoms of an allergic reaction: Sit with the child during meals. Observe for signs of allergic reactions, such as sudden onset of sneezing, redness, hives, itching skin, swollen or bluish skin or lips, choking, or inability to speak. Listen and watch for cues of discomfort. A child who is verbal may tell you - My mouth feels funny - Something is poking my tongue - My tongue (or mouth) is itching (or burning) - My tongue is hot - There’s something stuck in my throat - My lips feel tight - There are bugs in my ears. (5) Treating allergic reactions: Promptly administer the prescribed medication according to the care plan. Notify the child’s parent(s) immediately if there are any suspected allergic reactions or contact with the allergen, even if a reaction did not occur. If epinephrine has been administered, contact 911 immediately. Carry the written care plan, a telephone, emergency phone numbers, and proper medications with you on field trips or any kind of transport away from your site. Contact 911, if needed. 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 premises, both indoor and outdoor, in which a child care program is carried out shall be free of environmental hazards, shall be clean and comfortable, and provide for adequate space to meet the needs of the children as follows: 1. The outdoor space shall be fenced or have natural barriers to deter children from getting into unsafe areas which may include the adjacent parking areas or the street; free from open drainage ditches, wells or holes and have adequate drainage to prevent stagnant pools of water from collecting; and rodents and insects shall be controlled. 2. Covered containers shall be used for trash and removed often to avoid creating a health hazard or nuisance. 3. Hazardous items such as poisons, cleaning solutions, poisonous plants, and firearms shall be inaccessible by children. 4. All rooms shall be lighted and ventilated; furniture and equipment shall be sturdily constructed and lead based paint shall not be used on surfaces accessible by children. 5. Pets, animals, and fowl shall be maintained in a safe and sanitary manner at all times. 6. If a lodging house, boarding house, or other business conflicts with child care hours and responsibilities, the lodging house, the boarding house, or other business shall not be operated on the premises of the child care home 7. All parts of the buildings, building appurtenances, outdoor space, equipment, and all other parts of the facility shall be kept repaired, safe and sanitary at all times. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The premises, both indoor and outdoor, in which a child care program is carried out shall be free of environmental hazards, shall be clean and comfortable, and provide for adequate space to meet the needs of the children as follows: 1. The outdoor space shall be fenced or have natural barriers to deter children from getting into unsafe areas which may include the adjacent parking areas or the street; free from open drainage ditches, wells or holes and have adequate drainage to prevent stagnant pools of water from collecting; and rodents and insects shall be controlled. 2. Covered containers shall be used for trash and removed often to avoid creating a health hazard or nuisance. 3. Hazardous items such as poisons, cleaning solutions, poisonous plants, and firearms shall be inaccessible by children. 4. All rooms shall be lighted and ventilated; furniture and equipment shall be sturdily constructed and lead based paint shall not be used on surfaces accessible by children. 5. Pets, animals, and fowl shall be maintained in a safe and sanitary manner at all times. 6. If a lodging house, boarding house, or other business conflicts with child care hours and responsibilities, the lodging house, the boarding house, or other business shall not be operated on the premises of the child care home 7. All parts of the buildings, building appurtenances, outdoor space, equipment, and all other parts of the facility shall be kept repaired, safe and sanitary at all times. iii. All CCDF-eligible licensed in-home care. Provide the standard: N/A [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The premises, both indoor and outdoor, in which a child care program is carried out shall be free of environmental hazards, shall be clean and comfortable, and provide for adequate space to meet the needs of the children as follows: 1. The outdoor space shall be fenced or have natural barriers to deter children from getting into unsafe areas which may include the adjacent parking areas or the street; free from open drainage ditches, wells or holes and have adequate drainage to prevent stagnant pools of water from collecting; and rodents and insects shall be controlled. 2. Covered containers shall be used for trash and removed often to avoid creating a health hazard or nuisance. 3. Hazardous items such as poisons, cleaning solutions, poisonous plants, and firearms shall be inaccessible by children. 4. All rooms shall be lighted and ventilated; furniture and equipment shall be sturdily constructed and lead based paint shall not be used on surfaces accessible by children. 5. Pets, animals, and fowl shall be maintained in a safe and sanitary manner at all times. 6. If a lodging house, boarding house, or other business conflicts with child care hours and responsibilities, the lodging house, the boarding house, or other business shall not be operated on the premises of the child care home 7. All parts of the buildings, building appurtenances, outdoor space, equipment, and all other parts of the facility shall be kept repaired, safe and sanitary at all times. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The premises, both indoor and outdoor, in which a child care program is carried out shall be free of environmental hazards, shall be clean and comfortable, and provide for adequate space to meet the needs of the children as follows: 1. The outdoor space shall be fenced or have natural barriers to deter children from getting into unsafe areas which may include the adjacent parking areas or the street; free from open drainage ditches, wells or holes and have adequate drainage to prevent stagnant pools of water from collecting; and rodents and insects shall be controlled. 2. Covered containers shall be used for trash and removed often to avoid creating a health hazard or nuisance. 3. Hazardous items such as poisons, cleaning solutions, poisonous plants, and firearms shall be inaccessible by children. 4. All rooms shall be lighted and ventilated; furniture and equipment shall be sturdily constructed and lead based paint shall not be used on surfaces accessible by children. 5. Pets, animals, and fowl shall be maintained in a safe and sanitary manner at all times. 6. If a lodging house, boarding house, or other business conflicts with child care hours and responsibilities, the lodging house, the boarding house, or other business shall not be operated on the premises of the child care home 7. All parts of the buildings, building appurtenances, outdoor space, equipment, and all other parts of the facility shall be kept repaired, safe and sanitary at all times. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The premises, both indoor and outdoor, in which a child care program is carried out shall be free of environmental hazards, shall be clean and comfortable, and provide for adequate space to meet the needs of the children as follows: 1. The outdoor space shall be fenced or have natural barriers to deter children from getting into unsafe areas which may include the adjacent parking areas or the street; free from open drainage ditches, wells or holes and have adequate drainage to prevent stagnant pools of water from collecting; and rodents and insects shall be controlled. 2. Covered containers shall be used for trash and removed often to avoid creating a health hazard or nuisance. 3. Hazardous items such as poisons, cleaning solutions, poisonous plants, and firearms shall be inaccessible by children. 4. All rooms shall be lighted and ventilated; furniture and equipment shall be sturdily constructed and lead based paint shall not be used on surfaces accessible by children. 5. Pets, animals, and fowl shall be maintained in a safe and sanitary manner at all times. 6. If a lodging house, boarding house, or other business conflicts with child care hours and responsibilities, the lodging house, the boarding house, or other business shall not be operated on the premises of the child care home 7. All parts of the buildings, building appurtenances, outdoor space, equipment, and all other parts of the facility shall be kept repaired, safe and sanitary at all times. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The premises, both indoor and outdoor, in which a child care program is carried out shall be free of environmental hazards, shall be clean and comfortable, and provide for adequate space to meet the needs of the children as follows: 1. The outdoor space shall be fenced or have natural barriers to deter children from getting into unsafe areas which may include the adjacent parking areas or the street; free from open drainage ditches, wells or holes and have adequate drainage to prevent stagnant pools of water from collecting; and rodents and insects shall be controlled. 2. Covered containers shall be used for trash and removed often to avoid creating a health hazard or nuisance. 3. Hazardous items such as poisons, cleaning solutions, poisonous plants, and firearms shall be inaccessible by children. 4. All rooms shall be lighted and ventilated; furniture and equipment shall be sturdily constructed and lead based paint shall not be used on surfaces accessible by children. 5. Pets, animals, and fowl shall be maintained in a safe and sanitary manner at all times. 6. If a lodging house, boarding house, or other business conflicts with child care hours and responsibilities, the lodging house, the boarding house, or other business shall not be operated on the premises of the child care home 7. All parts of the buildings, building appurtenances, outdoor space, equipment, and all other parts of the facility shall be kept repaired, safe and sanitary at all times. 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: When swimming or wading pools are part of the child care facility, equipment, or program, the swimming pools shall be constructed, maintained, and operated in accordance with building and health rules. When swimming or wading activities are a part of the child care program, the following safety practices must be observed: 1. A certified lifeguard, who may be the provider, shall be on duty at all times when swimming activities or swimming pools or beaches are in use. 2. Wading pools less than 24 inches at the deepest part shall be exempt from the requirements of subsection (b)(1). However, children shall be personally attended by a responsible adult at all times and the wading pools shall be emptied immediately after each use. 3. Legible safety rules for all types of pools, excepting for wading pools, shall be posted in a conspicuous location and read and reviewed at regular intervals. 4. Swimming pools shall be maintained in accordance with building and health rules and have a certified lifeguard when in use; and 5. Wading pools shall be filled just prior to use and emptied immediately after use. ii. All CCDF-eligible licensed family child care homes. Provide the standard: When swimming or wading pools are part of the child care facility, equipment, or program, the swimming pools shall be constructed, maintained, and operated in accordance with building and health rules. When swimming or wading activities are a part of the child care program, the following safety practices must be observed: 1. A certified lifeguard, who may be the provider, shall be on duty at all times when swimming activities or swimming pools or beaches are in use. 2. Wading pools less than 24 inches at the deepest part shall be exempt from the requirements of subsection (b)(1). However, children shall be personally attended by a responsible adult at all times and the wading pools shall be emptied immediately after each use. 3. Legible safety rules for all types of pools, excepting for wading pools, shall be posted in a conspicuous location and read and reviewed at regular intervals. 4. Swimming pools shall be maintained in accordance with building and health rules and have a certified lifeguard when in use; and 5. Wading pools shall be filled just prior to use and emptied immediately after use. iii. All CCDF-eligible licensed in-home care. Provide the standard: N/A [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: When swimming or wading pools are part of the child care facility, equipment, or program, the swimming pools shall be constructed, maintained, and operated in accordance with building and health rules. When swimming or wading activities are a part of the child care program, the following safety practices must be observed: 1. A certified lifeguard, who may be the provider, shall be on duty at all times when swimming activities or swimming pools or beaches are in use. 2. Wading pools less than 24 inches at the deepest part shall be exempt from the requirements of subsection (b)(1). However, children shall be personally attended by a responsible adult at all times and the wading pools shall be emptied immediately after each use. 3. Legible safety rules for all types of pools, excepting for wading pools, shall be posted in a conspicuous location and read and reviewed at regular intervals. 4. Swimming pools shall be maintained in accordance with building and health rules and have a certified lifeguard when in use; and 5. Wading pools shall be filled just prior to use and emptied immediately after use. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: When swimming or wading pools are part of the child care facility, equipment, or program, the swimming pools shall be constructed, maintained and operated in accordance with building and health rules. When swimming or wading activities are a part of the child care program, the following safety practices must be observed: 1. A certified lifeguard, who may be the provider, shall be on duty at all times when swimming activities or swimming pools or beaches are in use. 2. Wading pools less than 24 inches at the deepest part shall be exempt from the requirements of subsection (b)(1). However, children shall be personally attended by a responsible adult at all times and the wading pools shall be emptied immediately after each use. 3. Legible safety rules for all types of pools, excepting for wading pools, shall be posted in a conspicuous location and read and reviewed at regular intervals. 4. Swimming pools shall be maintained in accordance with building and health rules and have a certified lifeguard when in use; and 5. Wading pools shall be filled just prior to use and emptied immediately after use. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: When swimming or wading pools are part of the child care facility, equipment, or program, the swimming pools shall be constructed, maintained, and operated in accordance with building and health rules. When swimming or wading activities are a part of the child care program, the following safety practices must be observed: 1. A certified lifeguard, who may be the provider, shall be on duty at all times when swimming activities or swimming pools or beaches are in use. 2. Wading pools less than 24 inches at the deepest part shall be exempt from the requirements of subsection (b)(1). However, children shall be personally attended by a responsible adult at all times and the wading pools shall be emptied immediately after each use. 3. Legible safety rules for all types of pools, excepting for wading pools, shall be posted in a conspicuous location and read and reviewed at regular intervals. 4. Swimming pools shall be maintained in accordance with building and health rules and have a certified lifeguard when in use; and 5. Wading pools shall be filled just prior to use and emptied immediately after use. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: When swimming or wading pools are part of the child care facility, equipment, or program, the swimming pools shall be constructed, maintained, and operated in accordance with building and health rules. When swimming or wading activities are a part of the child care program, the following safety practices must be observed: 1. A certified lifeguard, who may be the provider, shall be on duty at all times when swimming activities or swimming pools or beaches are in use. 2. Wading pools less than 24 inches at the deepest part shall be exempt from the requirements of subsection (b)(1). However, children shall be personally attended by a responsible adult at all times and the wading pools shall be emptied immediately after each use. 3. Legible safety rules for all types of pools, excepting for wading pools, shall be posted in a conspicuous location and read and reviewed at regular intervals. 4. Swimming pools shall be maintained in accordance with building and health rules and have a certified lifeguard when in use; and 5. Wading pools shall be filled just prior to use and emptied immediately after use. 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 premises, both indoor and outdoor, in which a child care program is carried out shall be free of environmental hazards, shall be clean and comfortable, and provide for adequate space to meet the needs of the children as follows: The outdoor space shall be fenced or shall have natural barriers or other protective conditions to deter children from getting into unsafe areas. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The premises, both indoor and outdoor, in which a child care program is carried out shall be free of environmental hazards, shall be clean and comfortable, and provide for adequate space to meet the needs of the children as follows: 1. The outdoor space shall be fenced or shall have natural barriers or other protective conditions to deter children from getting into unsafe areas. 2. Children's access to traffic and other outdoor hazards shall be blocked or controlled for school-age children. iii. All CCDF-eligible licensed in-home care. Provide the standard: N/A [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The premises, both indoor and outdoor, in which a child care program is carried out shall be free of environmental hazards, shall be clean and comfortable, and provide for adequate space to meet the needs of the children as follows: 1. The outdoor space shall be fenced or shall have natural barriers or other protective conditions to deter children from getting into unsafe areas. 2. Children's access to traffic and other outdoor hazards shall be blocked or controlled for school-age children. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The premises, both indoor and outdoor, in which a child care program is carried out shall be free of environmental hazards, shall be clean and comfortable, and provide for adequate space to meet the needs of the children as follows: 1. The outdoor space shall be fenced or shall have natural barriers or other protective conditions to deter children from getting into unsafe areas. 2. Children’s access to traffic and other outdoor hazards shall be blocked. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The premises, both indoor and outdoor, in which a child care program is carried out shall be free of environmental hazards, shall be clean and comfortable, and provide for adequate space to meet the needs of the children as follows: 1. The outdoor space shall be fenced or shall have natural barriers or other protective conditions to deter children from getting into unsafe areas. 2. Children's access to traffic and other outdoor hazards shall be blocked. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The premises, both indoor and outdoor, in which a child care program is carried out shall be free of environmental hazards, shall be clean and comfortable, and provide for adequate space to meet the needs of the children as follows: 1. The outdoor space shall be fenced or shall have natural barriers or other protective conditions to deter children from getting into unsafe areas. 2. Children's access to traffic and other outdoor hazards shall be blocked or controlled for school-age children. 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 provider shall ensure an environment that promotes a child’s well-being. The provider shall not use physical punishment as a means of disciplining or managing children’s behavior, including but not limited to, spanking, pinching, slapping, or shaking. The provider shall not cause physical harm or neglect to the child. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address shaken baby syndrome and abusive head trauma. Extreme abuse, such as found in Abusive Head Trauma, which is a general term that includes Shaken Baby Syndrome, can cause permanent brain damage and/or death. It is caused by the shaking of a baby or young child, causing the head to flop back and forth. The child doesn’t have to be shaken hard for trauma to occur. The brain of the young child may bounce inside the skull, resulting in brain damage, hemorrhaging, blindness, or other serious injuries or death. Babies under the age of six (6) months are at the highest risk of Shaken Baby Syndrome/Abusive head Trauma, but it can affect children up to the age of three (3). Preventing Shaken Baby Syndrome (BSB)/Abusive Head Trauma (AHT): 1. SBS/AHT is a preventable form of physical child abuse. 2. Understanding why SBS/AHT occurs, how it can be prevented, and the serious outcomes of shaking a baby can reduce the risk of SBS/AHT. Reporting Suspected Child Abuse and/or Neglect 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088. 3. In cases of emergency or immediate threat or harm, call 911. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The provider shall ensure an environment that promotes a child’s well-being. The provider shall not use physical punishment as a means of disciplining or managing children’s behavior, including but not limited to, spanking, pinching, slapping or shaking. The provider shall not cause physical harm or neglect to the child. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address shaken baby syndrome and abusive head trauma. Extreme abuse, such as found in Abusive Head Trauma, which is a general term that includes Shaken Baby Syndrome, can cause permanent brain damage and/or death. It is caused by the shaking of a baby or young child, causing the head to flop back and forth. The child doesn’t have to be shaken hard for trauma to occur. The brain of the young child may bounce inside the skull, resulting in brain damage, hemorrhaging, blindness, or other serious injuries or death. Babies under the age of six (6) months are at the highest risk of Shaken Baby Syndrome/Abusive head Trauma, but it can affect children up to the age of three (3). Preventing Shaken Baby Syndrome (SBS)/Abusive Head Trauma (AHT): 1. SBS/AHT is a preventable form of physical child abuse. 2. Understanding why SBS/AHT occurs, how it can be prevented, and the serious outcomes of shaking a baby can reduce the risk of SBS/AHT. Reporting Suspected Child Abuse and/or Neglect: 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. (For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088. 3. In cases of emergency or immediate threat or harm, call 911. iii. All CCDF-eligible licensed in-home care. Provide the standard: N/A [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The provider shall ensure an environment that promotes a child’s well-being. The provider shall not use physical punishment as a means of disciplining or managing children’s behavior, including but not limited to, spanking, pinching, slapping or shaking. The provider shall not cause physical harm or neglect to the child. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address shaken baby syndrome and abusive head trauma. Extreme abuse, such as found in Abusive Head Trauma, which is a general term that includes Shaken Baby Syndrome, can cause permanent brain damage and/or death. It is caused by the shaking of a baby or young child, causing the head to flop back and forth. The child doesn’t have to be shaken hard for trauma to occur. The brain of the young child may bounce inside the skull, resulting in brain damage, hemorrhaging, blindness, or other serious injuries or death. Babies under the age of six (6) months are at the highest risk of Shaken Baby Syndrome/Abusive head Trauma, but it can affect children up to the age of three (3). Preventing Shaken Baby Syndrome (SBS)/Abusive Head Trauma (AHT): 1. SBS/AHT is a preventable form of physical child abuse. 2. Understanding why SBS/AHT occurs, how it can be prevented, and the serious outcomes of shaking a baby can reduce the risk of SBS/AHT. Reporting Suspected Child Abuse and/or Neglect: 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. (For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088. 3. In cases of emergency or immediate threat or harm, call 911. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The provider shall ensure an environment that promotes a child’s well-being. The provider shall not use physical punishment as a means of disciplining or managing children’s behavior, including but not limited to, spanking, pinching, slapping or shaking. The provider shall not cause physical harm or neglect to the child. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address shaken baby syndrome and abusive head trauma. Extreme abuse, such as found in Abusive Head Trauma, which is a general term that includes Shaken Baby Syndrome, can cause permanent brain damage and/or death. It is caused by the shaking of a baby or young child, causing the head to flop back and forth. The child doesn’t have to be shaken hard for trauma to occur. The brain of the young child may bounce inside the skull, resulting in brain damage, hemorrhaging, blindness, or other serious injuries or death. Babies under the age of six (6) months are at the highest risk of Shaken Baby Syndrome/Abusive head Trauma, but it can affect children up to the age of three (3). Preventing Shaken Baby Syndrome (SBS)/Abusive Head Trauma (AHT): 1. SBS/AHT is a preventable form of physical child abuse. 2. Understanding why SBS/AHT occurs, how it can be prevented, and the serious outcomes of shaking a baby can reduce the risk of SBS/AHT. Reporting Suspected Child Abuse and/or Neglect: 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. (For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088. 3. In cases of emergency or immediate threat or harm, call 911. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The provider shall ensure an environment that promotes a child’s well-being. The provider shall not use physical punishment as a means of disciplining or managing children’s behavior, including but not limited to, spanking, pinching, slapping or shaking. The provider shall not cause physical harm or neglect to the child. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address shaken baby syndrome and abusive head trauma. Extreme abuse, such as found in Abusive Head Trauma, which is a general term that includes Shaken Baby Syndrome, can cause permanent brain damage and/or death. It is caused by the shaking of a baby or young child, causing the head to flop back and forth. The child doesn’t have to be shaken hard for trauma to occur. The brain of the young child may bounce inside the skull, resulting in brain damage, hemorrhaging, blindness, or other serious injuries or death. Babies under the age of six (6) months are at the highest risk of Shaken Baby Syndrome/Abusive head Trauma, but it can affect children up to the age of three (3). Preventing Shaken Baby Syndrome (SBS)/Abusive Head Trauma (AHT): 1. SBS/AHT is a preventable form of physical child abuse. 2. Understanding why SBS/AHT occurs, how it can be prevented, and the serious outcomes of shaking a baby can reduce the risk of SBS/AHT. Reporting Suspected Child Abuse and/or Neglect: 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. (For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088. 3. In cases of emergency or immediate threat or harm, call 911. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The provider shall ensure an environment that promotes a child’s well-being. The provider shall not use physical punishment as a means of disciplining or managing children’s behavior, including but not limited to, spanking, pinching, slapping or shaking. The provider shall not cause physical harm or neglect to the child. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address shaken baby syndrome and abusive head trauma. Extreme abuse, such as found in Abusive Head Trauma, which is a general term that includes Shaken Baby Syndrome, can cause permanent brain damage and/or death. It is caused by the shaking of a baby or young child, causing the head to flop back and forth. The child doesn’t have to be shaken hard for trauma to occur. The brain of the young child may bounce inside the skull, resulting in brain damage, hemorrhaging, blindness, or other serious injuries or death. Babies under the age of six (6) months are at the highest risk of Shaken Baby Syndrome/Abusive head Trauma, but it can affect children up to the age of three (3). Preventing Shaken Baby Syndrome (SBS)/Abusive Head Trauma (AHT): 1. SBS/AHT is a preventable form of physical child abuse. 2. Understanding why SBS/AHT occurs, how it can be prevented, and the serious outcomes of shaking a baby can reduce the risk of SBS/AHT. Reporting Suspected Child Abuse and/or Neglect: 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. (For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088. 3. In cases of emergency or immediate threat or harm, call 911. 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 provider shall ensure an environment that promotes a child’s well-being. The provider shall not use physical punishment as a means of disciplining or managing children’s behavior, including but not limited to, spanking, pinching, slapping or shaking. The provider shall not cause physical harm or neglect to the child. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address child maltreatment. Extreme abuse, such as found in Abusive Head Trauma, which is a general term that includes Shaken Baby Syndrome, can cause permanent brain damage and/or death. It is caused by the shaking of a baby or young child, causing the head to flop back and forth. The child doesn’t have to be shaken hard for trauma to occur. The brain of the young child may bounce inside the skull, resulting in brain damage, hemorrhaging, blindness, or other serious injuries or death. Babies under the age of six (6) months are at the highest risk of Shaken Baby Syndrome/Abusive Head Trauma, but it can affect children up to the age of three (3). Procedures: 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. (For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088. 3. In cases of emergency or immediate threat or harm, call 911. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The provider shall ensure an environment that promotes a child’s well-being. The provider shall not use physical punishment as a means of disciplining or managing children’s behavior, including but not limited to, spanking, pinching, slapping or shaking. The provider shall not cause physical harm or neglect to the child. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address child maltreatment. Extreme abuse, such as found in Abusive Head Trauma, which is a general term that includes Shaken Baby Syndrome, can cause permanent brain damage and/or death. It is caused by the shaking of a baby or young child, causing the head to flop back and forth. The child doesn’t have to be shaken hard for trauma to occur. The brain of the young child may bounce inside the skull, resulting in brain damage, hemorrhaging, blindness, or other serious injuries or death. Babies under the age of six (6) months are at the highest risk of Shaken Baby Syndrome/Abusive Head Trauma, but it can affect children up to the age of three (3). Procedures: 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. (For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088. 3. In cases of emergency or immediate threat or harm, call 911. iii. All CCDF-eligible licensed in-home care. Provide the standard: N/A [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The provider shall ensure an environment that promotes a child’s well-being. The provider shall not use physical punishment as a means of disciplining or managing children’s behavior, including but not limited to, spanking, pinching, slapping or shaking. The provider shall not cause physical harm or neglect to the child. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address child maltreatment. Extreme abuse, such as found in Abusive Head Trauma, which is a general term that includes Shaken Baby Syndrome, can cause permanent brain damage and/or death. It is caused by the shaking of a baby or young child, causing the head to flop back and forth. The child doesn’t have to be shaken hard for trauma to occur. The brain of the young child may bounce inside the skull, resulting in brain damage, hemorrhaging, blindness, or other serious injuries or death. Babies under the age of six (6) months are at the highest risk of Shaken Baby Syndrome/Abusive Head Trauma, but it can affect children up to the age of three (3). Procedures: 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. (For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088. 3. In cases of emergency or immediate threat or harm, call 911. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The provider shall ensure an environment that promotes a child’s well-being. The provider shall not use physical punishment as a means of disciplining or managing children’s behavior, including but not limited to, spanking, pinching, slapping or shaking. The provider shall not cause physical harm or neglect to the child. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address child maltreatment. Extreme abuse, such as found in Abusive Head Trauma, which is a general term that includes Shaken Baby Syndrome, can cause permanent brain damage and/or death. It is caused by the shaking of a baby or young child, causing the head to flop back and forth. The child doesn’t have to be shaken hard for trauma to occur. The brain of the young child may bounce inside the skull, resulting in brain damage, hemorrhaging, blindness, or other serious injuries or death. Babies under the age of six (6) months are at the highest risk of Shaken Baby Syndrome/Abusive Head Trauma, but it can affect children up to the age of three (3). Procedures: 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. (For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088. 3. In cases of emergency or immediate threat or harm, call 911. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The provider shall ensure an environment that promotes a child’s well-being. The provider shall not use physical punishment as a means of disciplining or managing children’s behavior, including but not limited to, spanking, pinching, slapping or shaking. The provider shall not cause physical harm or neglect to the child. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address child maltreatment. Extreme abuse, such as found in Abusive Head Trauma, which is a general term that includes Shaken Baby Syndrome, can cause permanent brain damage and/or death. It is caused by the shaking of a baby or young child, causing the head to flop back and forth. The child doesn’t have to be shaken hard for trauma to occur. The brain of the young child may bounce inside the skull, resulting in brain damage, hemorrhaging, blindness, or other serious injuries or death. Babies under the age of six (6) months are at the highest risk of Shaken Baby Syndrome/Abusive Head Trauma, but it can affect children up to the age of three (3). Procedures: 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. (For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088. 3. In cases of emergency or immediate threat or harm, call 911. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The provider shall ensure an environment that promotes a child’s well-being. The provider shall not use physical punishment as a means of disciplining or managing children’s behavior, including but not limited to, spanking, pinching, slapping or shaking. The provider shall not cause physical harm or neglect to the child. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address child maltreatment. Extreme abuse, such as found in Abusive Head Trauma, which is a general term that includes Shaken Baby Syndrome, can cause permanent brain damage and/or death. It is caused by the shaking of a baby or young child, causing the head to flop back and forth. The child doesn’t have to be shaken hard for trauma to occur. The brain of the young child may bounce inside the skull, resulting in brain damage, hemorrhaging, blindness, or other serious injuries or death. Babies under the age of six (6) months are at the highest risk of Shaken Baby Syndrome/Abusive Head Trauma, but it can affect children up to the age of three (3). Procedures: 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. (For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088. 3. In cases of emergency or immediate threat or harm, call 911. 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: Hazardous substances, including cleaning solutions, alcohol, and medication are inaccessible to children and in a closed contained which are clearly labeled. Cleaning materials shall be stored in a secured area away from food preparation areas during food preparation times. 1. Providers shall follow procedures for infection control, to use in all situations to prevent the transmission of blood-borne germs that may be spread through blood and body fluids that might contain blood. 2. Facilities shall have written policies for the routine cleaning and maintenance of the facility. These policies shall specify the type of disinfectant and cleaning agent used, method for cleaning, schedule for cleaning, storage of cleaning material and utensils, disposal of soiled items or spilled body fluids, and cleaning of equipment. 3. Storage of cleaning material shall be in a secured area which is inaccessible to children. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The Department of Human Services (DHS) is not compliant by 10/01/24 for the standard of handling and storage of hazardous materials. Preliminary Notice of Possible Non-Compliance Rev 01/2023. DHS will need additional time to fully implement the requirement. The Monitoring Team reported no specific reference to appropriate disposal of bio-contaminants. The Department of Human Services plans to work on this Standard for the next round of rule amendments for Fiscal Year 2025-2027 Plan Period. In the existing admin rules: Hazardous substances, including cleaning solutions, alcohol, and medication are inaccessible to children and in a closed contained which are clearly labeled. Cleaning materials shall be stored in a secured area away from food preparation areas during food preparation times. 1. Providers shall follow procedures for infection control, to use in all situations to prevent the transmission of blood-borne germs that may be spread through blood and body fluids that might contain blood. 2. Facilities shall have written policies for the routine cleaning and maintenance of the facility. These policies shall specify the type of disinfectant and cleaning agent used, method for cleaning, schedule for cleaning, storage of cleaning material and utensils, disposal of soiled items or spilled body fluids, and cleaning of equipment. 3. Storage of cleaning material shall be in a secured area which is inaccessible to children. iii. All CCDF-eligible licensed in-home care. Provide the standard: N/A [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Hazardous substances, including cleaning solutions, alcohol, and medication are inaccessible to children and in a closed contained which are clearly labeled. Cleaning materials shall be stored in a secured area away from food preparation areas during food preparation times. 1. Providers shall follow procedures for infection control, to use in all situations to prevent the transmission of blood-borne germs that may be spread through blood and body fluids that might contain blood. 2. Facilities shall have written policies for the routine cleaning and maintenance of the facility. These policies shall specify the type of disinfectant and cleaning agent used, method for cleaning, schedule for cleaning, storage of cleaning material and utensils, disposal of soiled items or spilled body fluids, and cleaning of equipment. 3. Storage of cleaning material shall be in a secured area which is inaccessible to children. 4. The provider shall establish and follow procedures for handling, storing, and disposing of bio-contaminants, to use in all situations to prevent the transmission of blood-borne germs that may be spread through blood and body fluids. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Hazardous substances, including cleaning solutions, alcohol, and medication are inaccessible to children and in a closed contained which are clearly labeled. Cleaning materials shall be stored in a secured area away from food preparation areas during food preparation times. 1. Providers shall follow procedures for infection control, to use in all situations to prevent the transmission of blood-borne germs that may be spread through blood and body fluids that might contain blood. 2. Facilities shall have written policies for the routine cleaning and maintenance of the facility. These policies shall specify the type of disinfectant and cleaning agent used, method for cleaning, schedule for cleaning, storage of cleaning material and utensils, disposal of soiled items or spilled body fluids, and cleaning of equipment. 3. Storage of cleaning material shall be in a secured area which is inaccessible to children. 4. Establish and follow procedures for handling, storing, and disposing of bio- contaminants, to use in all situations to prevent the transmission of blood-borne germs that may be spread through blood and body fluids. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The provider shall establish and follow procedures for handling, storing, and disposing of bio- contaminants, to use in all situations to prevent the transmission of blood-borne germs that may be spread through blood and body fluids. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Hazardous substances, including cleaning solutions, alcohol, and medication are inaccessible to children and in a closed contained which are clearly labeled. Cleaning materials shall be stored in a secured area away from food preparation areas during food preparation times. 1. Providers shall follow procedures for infection control, to use in all situations to prevent the transmission of blood-borne germs that may be spread through blood and body fluids that might contain blood. 2. Facilities shall have written policies for the routine cleaning and maintenance of the facility. These policies shall specify the type of disinfectant and cleaning agent used, method for cleaning, schedule for cleaning, storage of cleaning material and utensils, disposal of soiled items or spilled body fluids, and cleaning of equipment. 3. Storage of cleaning material shall be in a secured area which is inaccessible to children. 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 provider shall have written procedures for infection control, to use in all situations to prevent the transmission of blood-borne pathogens that may be spread through blood and body fluids. Basic Health and Safety Practices, Child Care Provider's Guide, Addendum - Prevention of Exposure to Blood and Body Fluids. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Following procedures for infection control, to use in all situations to prevent the transmission of blood-borne germs that may spread through blood and body fluids that might contain blood. Basic Health and Safety Practices, Child Care Provider's Guide, Addendum - Prevention of Exposure to Blood and Body Fluids. iii. All CCDF-eligible licensed in-home care. Provide the standard: N/A [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The provider shall have written procedures for infection control, to use in all situations to prevent the transmission of blood-borne pathogens that may be spread through blood and body fluids. Basic Health and Safety Practices, Child Care Provider's Guide, Addendum - Prevention of Exposure to Blood and Body Fluids. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Following procedures for infection control, to use in all situations to prevent the transmission of blood-borne germs that may spread through blood and body fluids that might contain blood. Basic Health and Safety Practices, Child Care Provider's Guide, Addendum - Prevention of Exposure to Blood and Body Fluids. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Establish and follow procedures for handling, storing, and disposing of biocontaminants, to use in all situations to prevent the transmission of blood-borne germs that may be spread through blood and body fluids. Basic Health and Safety Practices, Child Care Provider's Guide, Addendum - Prevention of Exposure to Blood and Body Fluids. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Procedures for infection control, to use in all situations to prevent the transmission of blood-borne germs that may spread through blood and body fluids that might contain blood shall be in writing. Basic Health and Safety Practices, Child Care Provider's Guide, Addendum - Prevention of Exposure to Blood and Body Fluids. 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: 1. The vehicle and driver providing transportation shall satisfy all relevant motor carrier safety rules and traffic laws of the state; 2. No more than six (6) children under the age of six (6) years shall be transported when only one (1) adult is in the vehicle; 3. Children shall be instructed in safe transportation conduct as appropriate for age and stage of development; 4. Children shall be secured in the seat of the bus or in the back seat of a personal vehicle in approved car seats or restraints; 5. Prior to transporting children, the provider shall obtain written permission form the parent or guardian that each child is allowed to be transported by the provider in a personal vehicle or by public bus; 6. A child shall not be left unattended in a vehicle; 7. The provider shall take a head count or attendance record check before and after transportation is provided; and 8. During any field trip or excursion, the provider shall have available with them a first aid kit, emergency contact phone numbers, and medical treatment release forms signed by the child’s parent or guardian. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 1. The vehicle and driver providing transportation shall satisfy all relevant motor carrier safety rules and traffic laws of the state; 2. No more than six (6) children under the age of six (6) years shall be transported when only one (1) adult is in the vehicle; 3. Children shall be instructed in safe transportation conduct as appropriate for age and stage of development; 4. Children shall be secured in the seat of the bus or in the back seat of a personal vehicle in approved car seats or restraints; 5. Prior to transporting children, the provider shall obtain written permission form the parent or guardian that each child is allowed to be transported by the provider in a personal vehicle or by public bus; 6. A child shall not be left unattended in a vehicle; 7. The provider shall take a head count or attendance record check before and after transportation is provided; and 8. During any field trip or excursion, the provider shall have available with them a first aid kit, emergency contact phone numbers, and medical treatment release forms signed by the child’s parent or guardian. iii. All CCDF-eligible licensed in-home care. Provide the standard: N/A [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: (1) The provider has written permission from the parent or guardian that each child is allowed to be transported by school bus or other means of transportation such as a personal vehicle; (2) During any field trip or excursion operated or planned by the facility, the group sizes and provider-child ratios as required in the admin rule section shall apply; (3) Children shall be instructed in safe transportation conduct; (4) Car seats and safety restraints shall be used as required by applicable laws; (5) Children shall be secured in the back seat of the vehicle; (6) Children shall not be left alone in vehicles, even with the air conditioning on or windows rolled down; and (7) The provider shall take a head count or attendance record check before and after transportation is provided. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: 1. Have written permission form the parent or guardian that each child is allowed to be transported by the provider in a personal vehicle; 2. Ensure that car seats and safety restraints are used as required by applicable laws; 3. Ensure that children are secured in the back seat of the vehicle; 4. Ensure that children are never left unattended in vehicles, even with the air conditioning on or windows rolled down. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: 1. Have written permission form the parent or guardian that each child is allowed to be transported by the provider in a personal vehicle; 2. Ensure that car seats and safety restraints are used as required by applicable laws; 3. Ensure that children are secured in the back seat of the vehicle; 4. Ensure that children are never left unattended in vehicles, even with the air conditioning on or windows rolled down. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: 1. The vehicle and driver providing transportation shall satisfy all relevant motor carrier safety rules and traffic laws of the state; 2. No more than six (6) children under the age of six (6) years shall be transported when only one (1) adult is in the vehicle; 3. Children shall be instructed in safe transportation conduct as appropriate for age and stage of development; 4. Children shall be secured in the seat of the bus or in the back seat of a personal vehicle in approved car seats or restraints; 5. Prior to transporting children, the provider shall obtain written permission form the parent or guardian that each child is allowed to be transported by the provider in a personal vehicle or by public bus; 6. A child shall not be left unattended in a vehicle; 7. The provider shall take a head count or attendance record check before and after transportation is provided; and 8. During any field trip or excursion, the provider shall have available with them a first aid kit, emergency contact phone numbers, and medical treatment release forms signed by the child’s parent or guardian. 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 Department of Human Services (DHS) is not compliant by 10/01/24 for Standards: pediatric first aid for staff. Preliminary Notice of Possible Non-Compliance Rev date: 01/2023. DHS will need additional time and technical assistance from the Office of Child Care to fully implement the requirement. The Monitoring Team did not find evidence of requirements in place for all provider staff to be trained in pediatric first-aid. The Department of Human Services plans to work on this Standard for the next round of rule amendments for Fiscal Year 2025-2027 Plan Period. The Department of Human Services requested for technical assistance on language for the standard during the implementation conference. However, the current requirement is: 1) There shall be at least one (1) adult provider who is trained in observation of symptoms of illness and with a current certificate in pediatric first aid at all times during the operational day when children are in care. 2) A current certificate means a certificate that has not expired; and 3) The current pediatric first aid certificate must be provided by the American Red Cross, American Heart Association, or any organization whose child first aid certification standards are equivalent to the American Red Cross or American Heart Association standards and be approved by the department ii. All CCDF-eligible licensed family child care homes. Provide the standard: The Department of Human Services (DHS) is not compliant by 10/01/24 for Standards: pediatric first aid for staff. Preliminary Notice of Possible Non-Compliance Rev date: 01/2023. DHS will need additional time and technical assistance from the Office of Child Care to fully implement the requirement. The Monitoring Team did not find evidence of requirements in place for all provider staff to be trained in pediatric first-aid. The Department of Human Services plans to work on this Standard for the next round of rule amendments for Fiscal Year 2025-2027 Plan Period. The Department of Human Services requested for technical assistance on language for the standard during the implementation conference. However, the current requirement is: 1) There shall be at least one (1) adult provider who is trained in observation of symptoms of illness and with a current certificate in pediatric first aid at all times during the operational day when children are in care. 2) A current certificate means a certificate that has not expired; and 3) The current pediatric first aid certificate must be provided by the American Red Cross, American Heart Association, or any organization whose child first aid certification standards are equivalent to the American Red Cross or American Heart Association standards and be approved by the department. iii. All CCDF-eligible licensed in-home care. Provide the standard: N/A [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The Department of Human Services (DHS) is not compliant by 10/01/24 for Standards: pediatric first aid for staff. Preliminary Notice of Possible Non-Compliance Rev date: 01/2023. DHS will need additional time and technical assistance from the Office of Child Care to fully implement the requirement. The Monitoring Team did not find evidence of requirements in place for all provider staff to be trained in pediatric first-aid. The Department of Human Services plans to work on this Standard for the next round of rule amendments for Fiscal Year 2025-2027 Plan Period. The Department of Human Services requested for technical assistance on language for the standard during the implementation conference. However, the current requirement is: 1) There shall be at least one (1) adult provider who is trained in observation of symptoms of illness and with a current certificate in pediatric first aid at all times during the operational day when children are in care. 2) A current certificate means a certificate that has not expired; and 3) The current pediatric first aid certificate must be provided by the American Red Cross, American Heart Association, or any organization whose child first aid certification standards are equivalent to the American Red Cross or American Heart Association standards and be approved by the department. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The Department of Human Services (DHS) is not compliant by 10/01/24 for Standards: pediatric first aid for staff. Preliminary Notice of Possible Non- Compliance Rev date: 01/2023. DHS will need additional time and technical assistance from the Office of Child Care to fully implement the requirement. The Monitoring Team did not find evidence of requirements in place for all provider staff to be trained in pediatric first-aid. The Department of Human Services plans to work on this Standard for the next round of rule amendments for Fiscal Year 2025-2027 Plan Period. The Department of Human Services requested for technical assistance on language for the standard during the implementation conference. However, the current requirement is: 1) There shall be at least one (1) adult provider who is trained in observation of symptoms of illness and with a current certificate in pediatric first aid at all times during the operational day when children are in care. 2) A current certificate means a certificate that has not expired; and 3) The current pediatric first aid certificate must be provided by the American Red Cross, American Heart Association, or any organization whose child first aid certification standards are equivalent to the American Red Cross or American Heart Association standards and be approved by the department. . vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Department of Human Services (DHS) is not compliant by 10/01/24 for Standards: pediatric first aid for staff. Preliminary Notice of Possible Non-Compliance Rev date: 01/2023. DHS will need additional time and technical assistance from the Office of Child Care to fully implement the requirement. The Monitoring Team did not find evidence of requirements in place for all provider staff to be trained in pediatric first-aid. The Department of Human Services plans to work on this Standard for the next round of rule amendments for Fiscal Year 2025-2027 Plan Period. The Department of Human Services requested for technical assistance on language for the standard during the implementation conference. However, the current requirement is: 1) There shall be at least one (1) adult provider who is trained in observation of symptoms of illness and with a current certificate in pediatric first aid at all times during the operational day when children are in care. 2) A current certificate means a certificate that has not expired; and 3) The current pediatric first aid certificate must be provided by the American Red Cross, American Heart Association, or any organization whose child first aid certification standards are equivalent to the American Red Cross or American Heart Association standards and be approved by the department. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The Department of Human Services (DHS) is not compliant by 10/01/24 for Standards: pediatric first aid for staff. Preliminary Notice of Possible Non-Compliance Rev date: 01/2023. DHS will need additional time and technical assistance from the Office of Child Care to fully implement the requirement. The Monitoring Team did not find evidence of requirements in place for all provider staff to be trained in pediatric first-aid. The Department of Human Services plans to work on this Standard for the next round of rule amendments for Fiscal Year 2025-2027 Plan Period. The Department of Human Services requested for technical assistance on language for the standard during the implementation conference. However, the current requirement is: 1) There shall be at least one (1) adult provider who is trained in observation of symptoms of illness and with a current certificate in pediatric first aid at all times during the operational day when children are in care. 2) A current certificate means a certificate that has not expired; and 3) The current pediatric first aid certificate must be provided by the American Red Cross, American Heart Association, or any organization whose child first aid certification standards are equivalent to the American Red Cross or American Heart Association standards and be approved by the department. 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 Department of Human Services (DHS) is not compliant by 10/01/24 for Standards: pediatric cardiopulmonary resuscitation for staff. Preliminary Notice of Possible Non- Compliance Rev date: 01/2023. DHS will need additional time and technical assistance from the Office of Child Care to fully implement the requirement. The Monitoring Team did not find evidence of requirements in place for all provider staff to be trained in pediatric cardiopulmonary resuscitation (CPR). The Department of Human Services plans to work on this Standard for the next round of rule amendments for Fiscal Year 2025-2027 Plan Period. The Department of Human Services requested for technical assistance on language for the standard during the implementation conference. However, the current standard for child CPR: 1) There shall be at least one (1) adult provider who is trained in child CPR and with a current certificate at all times during the operational day when children are in care. 2) A current certificate means a certificate that has not expired. 3) The child CPR course must be provided by the American Red Cross, American Heart Association, or any organization whose child CPR certification standards are equivalent to the American Red Cross or American Heart Association standards and be approved by the department. 4) When the provider accepts infant children, the CPR course shall include training in infant CPR. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The Department of Human Services (DHS) is not compliant by 10/01/24 for Standards: pediatric cardiopulmonary resuscitation for staff. Preliminary Notice of Possible Non-Compliance Rev date: 01/2023. DHS will need additional time and technical assistance from the Office of Child Care to fully implement the requirement. The Monitoring Team did not find evidence of requirements in place for all provider staff to be trained in pediatric cardiopulmonary resuscitation (CPR). The Department of Human Services plans to work on this Standard for the next round of rule amendments for Fiscal Year 2025-2027 Plan Period. The Department of Human Services requested for technical assistance on language for the standard during the implementation conference. However, the current standard for child CPR: 1) There shall be at least one (1) adult provider who is trained in child CPR and with a current certificate at all times during the operational day when children are in care. 2) A current certificate means a certificate that has not expired. 3) The child CPR course must be provided by the American Red Cross, American Heart Association, or any organization whose child CPR certification standards are equivalent to the American Red Cross or American Heart Association standards and be approved by the department. 4) When the provider accepts infant children, the CPR course shall include training in infant CPR. iii. All CCDF-eligible licensed in-home care. Provide the standard: N/A [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The Department of Human Services (DHS) is not compliant by 10/01/24 for Standards: pediatric cardiopulmonary resuscitation for staff. Preliminary Notice of Possible Non-Compliance Rev date: 01/2023. DHS will need additional time and technical assistance from the Office of Child Care to fully implement the requirement. The Monitoring Team did not find evidence of requirements in place for all provider staff to be trained in pediatric cardiopulmonary resuscitation (CPR). The Department of Human Services plans to work on this Standard for the next round of rule amendments for Fiscal Year 2025-2027 Plan Period. The Department of Human Services requested for technical assistance on language for the standard during the implementation conference. However, the current standard for child CPR: The Monitoring Team did not find evidence of requirements in place for all provider staff to be trained in pediatric cardiopulmonary resuscitation (CPR). The Department of Human Services plans to work on this Standard for the next round of rule amendments for Fiscal Year 2025-2027 Plan Period. The Department of Human Services requested for technical assistance on language for the standard during the implementation conference. However, the current standard for child CPR: 1) There shall be at least one (1) adult provider who is trained in child CPR and with a current certificate at all times during the operational day when children are in care. 2) A current certificate means a certificate that has not expired. 3) The child CPR course must be provided by the American Red Cross, American Heart Association, or any organization whose child CPR certification standards are equivalent to the American Red Cross or American Heart Association standards and be approved by the department. 4) When the provider accepts infant children, the CPR course shall include training in infant CPR. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The Department of Human Services (DHS) is not compliant by 10/01/24 for Standards: pediatric cardiopulmonary resuscitation for staff. Preliminary Notice of Possible Non-Compliance Rev date: 01/2023. DHS will need additional time and technical assistance from the Office of Child Care to fully implement the requirement. The Monitoring Team did not find evidence of requirements in place for all provider staff to be trained in pediatric cardiopulmonary resuscitation (CPR). The Department of Human Services plans to work on this Standard for the next round of rule amendments for Fiscal Year 2025-2027 Plan Period. The Department of Human Services requested for technical assistance on language for the standard during the implementation conference. However, the current standard for child CPR: The Monitoring Team did not find evidence of requirements in place for all provider staff to be trained in pediatric cardiopulmonary resuscitation (CPR). The Department of Human Services plans to work on this Standard for the next round of rule amendments for Fiscal Year 2025-2027 Plan Period. The Department of Human Services requested for technical assistance on language for the standard during the implementation conference. However, the current standard for child CPR: 1) There shall be at least one (1) adult provider who is trained in child CPR and with a current certificate at all times during the operational day when children are in care. 2) A current certificate means a certificate that has not expired. 3) The child CPR course must be provided by the American Red Cross, American Heart Association, or any organization whose child CPR certification standards are equivalent to the American Red Cross or American Heart Association standards and be approved by the department. 4) When the provider accepts infant children, the CPR course shall include training in infant CPR. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Department of Human Services (DHS) is not compliant by 10/01/24 for Standards: pediatric cardiopulmonary resuscitation for staff. Preliminary Notice of Possible Non-Compliance Rev date: 01/2023. DHS will need additional time and technical assistance from the Office of Child Care to fully implement the requirement. The Monitoring Team did not find evidence of requirements in place for all provider staff to be trained in pediatric cardiopulmonary resuscitation (CPR). The Department of Human Services plans to work on this Standard for the next round of rule amendments for Fiscal Year 2025-2027 Plan Period. The Department of Human Services requested for technical assistance on language for the standard during the implementation conference. However, the current standard for child CPR: The Monitoring Team did not find evidence of requirements in place for all provider staff to be trained in pediatric cardiopulmonary resuscitation (CPR). The Department of Human Services plans to work on this Standard for the next round of rule amendments for Fiscal Year 2025-2027 Plan Period. The Department of Human Services requested for technical assistance on language for the standard during the implementation conference. However, the current standard for child CPR: 1) There shall be at least one (1) adult provider who is trained in child CPR and with a current certificate at all times during the operational day when children are in care. 2) A current certificate means a certificate that has not expired. 3) The child CPR course must be provided by the American Red Cross, American Heart Association, or any organization whose child CPR certification standards are equivalent to the American Red Cross or American Heart Association standards and be approved by the department. 4) When the provider accepts infant children, the CPR course shall include training in infant CPR. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The Department of Human Services (DHS) is not compliant by 10/01/24 for Standards: pediatric cardiopulmonary resuscitation for staff. Preliminary Notice of Possible Non-Compliance Rev date: 01/2023. DHS will need additional time and technical assistance from the Office of Child Care to fully implement the requirement. The Monitoring Team did not find evidence of requirements in place for all provider staff to be trained in pediatric cardiopulmonary resuscitation (CPR). The Department of Human Services plans to work on this Standard for the next round of rule amendments for Fiscal Year 2025-2027 Plan Period. The Department of Human Services requested for technical assistance on language for the standard during the implementation conference. However, the current standard for child CPR: The Monitoring Team did not find evidence of requirements in place for all provider staff to be trained in pediatric cardiopulmonary resuscitation (CPR). The Department of Human Services plans to work on this Standard for the next round of rule amendments for Fiscal Year 2025-2027 Plan Period. The Department of Human Services requested for technical assistance on language for the standard during the implementation conference. However, the current standard for child CPR requirement is: 1) There shall be at least one (1) adult provider who is trained in child CPR and with a current certificate at all times during the operational day when children are in care. 2) A current certificate means a certificate that has not expired. 3) The child CPR course must be provided by the American Red Cross, American Heart Association, or any organization whose child CPR certification standards are equivalent to the American Red Cross or American Heart Association standards and be approved by the department. 4) When the provider accepts infant children, the CPR course shall include training in infant CPR. 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 facility shall have written operation policies to cover mandated reporting of suspected abuse or neglect in accordance with Chapter 350, Hawaii Revised Statutes. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address reporting suspected child abuse and/or neglect: Procedures: 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088. 3. In cases of emergency or immediate threat or harm, call 911. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The facility shall have written operation policies to cover mandated reporting of suspected abuse or neglect in accordance with Chapter 350, Hawaii Revised Statutes. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address reporting suspected child abuse and/or neglect: Procedures: 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. (For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088. 3. In cases of emergency or immediate threat or harm, call 911. iii. All CCDF-eligible licensed in-home care. Provide the standard: N/A [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: An exempt provider shall: report any suspected child abuse or neglect in accordance with section 350-1.1, Hawaii Revised Statutes. Satisfactorily complete and provide written evidence to the department to show completion of trainings as required by the department when caring for an eligible child under this chapter which includes but is not limited to: Hawaii Administrative Rules (HAR) 17-798.3- 51(c)(7)(A) An initial training in health and safety standards that is approved by the department prior to caring for an eligible child. HAR 17-798.3-51(c)(7)(c) A minimum of eight (8) hours of training within one (1) year of completion of the initial training as described in subparagraph (A), and completed annually thereafter, as prescribed by the department on at least two (2) of the following topic areas: (i) Physical care of the young child; (ii) Care of the sick child; (iii) Child nutrition; (iv) Child growth and development; (v) Learning activities and play; (vii) Family engagement; (viii) Managing challenging behaviors; (ix) Prevention of child maltreatment and abuse: (x) First aid and child cardiopulmonary resuscitation: (xi) Physical environment; (xii) Health and safety The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address reporting suspected child abuse and/or neglect: Procedures: 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088. 3. In cases of emergency or immediate threat or harm, call 911. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The license-exempt family child care home provider shall report any suspected child abuse or neglect in accordance with section 350-1.1, Hawaii Revised Statutes. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address reporting suspected child abuse and/or neglect: Procedures: 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. (For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088. 3. In cases of emergency or immediate threat or harm, call 911. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: A license- exempt in-home care provider shall: report any suspected child abuse or neglect in accordance with section 350-1.1, Hawaii Revised Statutes. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address reporting suspected child abuse and/or neglect: Procedures: 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. (For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088. 3. In cases of emergency or immediate threat or harm, call 911. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The facility shall have written operation policies to cover mandated reporting of suspected abuse or neglect in accordance with Chapter 350, Hawaii Revised Statutes. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address reporting suspected child abuse and/or neglect: Procedures: 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088. 3. In cases of emergency or immediate threat or harm, call 911. 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 facility shall have written operation policies to cover mandated reporting of suspected abuse or neglect in accordance with Chapter 350, Hawaii Revised Statutes. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address reporting suspected child abuse and/or neglect: Procedures: 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. (For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088. 3. In cases of emergency or immediate threat or harm, call 911. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The licensed family child care home’s written policies shall include mandated reporting of suspected child abuse or neglect in accordance with the Hawaii Revised Statutes. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address reporting suspected child abuse and/or neglect: Procedures: 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088. 3. In cases of emergency or immediate threat or harm, call 911. iii. All CCDF-eligible licensed in-home care. Provide the standard: N/A [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: An exempt provider shall: report any suspected child abuse or neglect in accordance with section 350-1.1, Hawaii Revised Statutes. Satisfactorily complete and provide written evidence to the department to show completion of trainings as required by the department when caring for an eligible child under this chapter which includes but is not limited to: Hawaii Administrative Rules (HAR) 17-798.3- 51(c)(7)(A) An initial training in health and safety standards that is approved by the department prior to caring for an eligible child. HAR 17-798.3-51(c)(7)(c) A minimum of eight (8) hours of training within one (1) year of completion of the initial training as described in subparagraph (A), and completed annually thereafter, as prescribed by the department on at least two (2) of the following topic areas: (i) Physical care of the young child; (ii) Care of the sick child; (iii) Child nutrition; (iv) Child growth and development; (v) Learning activities and play; (vii) Family engagement; (viii) Managing challenging behaviors; (ix) Prevention of child maltreatment and abuse: (x) First aid and child cardiopulmonary resuscitation: (xi) Physical environment; (xii) Health and safety The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address reporting suspected child abuse and/or neglect: Procedures: 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088. 3. In cases of emergency or immediate threat or harm, call 911. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: An exempt provider shall: report any suspected child abuse or neglect in accordance with section 350-1.1, Hawaii Revised Statutes. Satisfactorily complete and provide written evidence to the department to show completion of trainings as required by the department when caring for an eligible child under this chapter which includes but is not limited to: Hawaii Administrative Rules (HAR) 17-798.3- 51(c)(7)(A) An initial training in health and safety standards that is approved by the department prior to caring for an eligible child. HAR 17-798.3-51(c)(7)(c) A minimum of eight (8) hours of training within one (1) year of completion of the initial training as described in subparagraph (A), and completed annually thereafter, as prescribed by the department on at least two (2) of the following topic areas: (i) Physical care of the young child; (ii) Care of the sick child; (iii) Child nutrition; (iv) Child growth and development; (v) Learning activities and play; (vii) Family engagement; (viii) Managing challenging behaviors; (ix) Prevention of child maltreatment and abuse: (x) First aid and child cardiopulmonary resuscitation: (xi) Physical environment; (xii) Health and safety The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address reporting suspected child abuse and/or neglect: Procedures: 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088. 3. In cases of emergency or immediate threat or harm, call 911. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: An exempt provider shall: report any suspected child abuse or neglect in accordance with section 350-1.1, Hawaii Revised Statutes. Satisfactorily complete and provide written evidence to the department to show completion of trainings as required by the department when caring for an eligible child under this chapter which includes but is not limited to: Hawaii Administrative Rules (HAR) 17-798.3- 51(c)(7)(A) An initial training in health and safety standards that is approved by the department prior to caring for an eligible child. HAR 17-798.3-51(c)(7)(c) A minimum of eight (8) hours of training within one (1) year of completion of the initial training as described in subparagraph (A), and completed annually thereafter, as prescribed by the department on at least two (2) of the following topic areas: (i) Physical care of the young child; (ii) Care of the sick child; (iii) Child nutrition; (iv) Child growth and development; (v) Learning activities and play; (vii) Family engagement; (viii) Managing challenging behaviors; (ix) Prevention of child maltreatment and abuse: (x) First aid and child cardiopulmonary resuscitation: (xi) Physical environment; (xii) Health and safety The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address reporting suspected child abuse and/or neglect: Procedures: 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088. 3. In cases of emergency or immediate threat or harm, call 911. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: The facility shall have written operation policies to cover mandated reporting of suspected abuse or neglect in accordance with Chapter 350, Hawaii Revised Statutes. The Basic Health and Safety Practices Child Care Provider’s Guide has standards that address reporting suspected child abuse and/or neglect: Procedures: 1. If you see any signs of possible physical, sexual, or emotional abuse or neglect, or if a child has told you about hard that he/she has received, write down the specific information to document your observations or what the child said; note date and time. For more information on signs and symptoms of suspected child abuse and neglect, see Understanding Child Maltreatment by the Centers for Disease Control and prevention and the National Center for Injury Prevention and Control in reference list. 2. If you suspect that a child has been abused or neglected, report it to the appropriate agency right away. To make a report, call the State of Hawaii Department of Human Services: 808-832-5300 or (toll free) 1-888-380-3088 3. In cases of emergency or immediate threat or harm, call 911. 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: Infant and Toddler: (Hawaii Administrative Rules 17- 895.1-25 Program Provisions) Provisions for the promotion of physical development which shall include: (A) Opportunities for the infants and toddlers to learn about health, development, and care of their bodies including exercise, safety, nutrition and hygiene, as appropriate to their age and development. Family Child Care (FCC) (Hawaii Administrative Rules 17-891.2-25 Program Provisions): Opportunities for children to learn about the health, development, and care of the children's bodies, including exercise, nutrition and hygiene. ii. Access to physical activity. Describe: Licensed centers and registered homes shall provide activities to promote physical development by providing activities that include daily opportunities for running, climbing, and other vigorous and varied physical activities; and opportunities for children to learn about the health, development, and care of the children’s bodies, including exercise, nutrition, and hygiene. For school-age programs, at least 25% of the program must provide for gross motor activities. Infant/Toddler: provisions for the promotion of physical development, which shall include: (A) Varied, developmentally appropriate physical activities; and (B) Opportunities for the infants and toddlers to learn about the health development, and care of their bodies including exercise, safety, nutrition, and hygiene, as development to their age and development. Family Child Care (FCC): activities that promote physical development shall include: (A) Daily opportunities for running, climbing, and other vigorous and varied physical activities; and (B) Opportunities for children to learn about the health, development, and care of the children's bodies, including exercise, nutrition, and hygiene. iii. Caring for children with special needs. Describe: Hawaii Administrative Rule chapters 17-891.2-45, 17-892.2-46, 17-895.1-45, 17-896.1-45 (a) When children with special needs are admitted into a group child care center or group child care home, the facility shall provide for the special needs of each child. (b) The child with special needs shall be admitted only after consultation with the child's source of health care and the program's health consultant occurs. The consultation shall include written recommendations to cover the child's special needs or to define the child's participation in the program. (c) If the child's health care source considers it advisable, the staff of the program shall receive training related to the nature of the child's condition and the child's potential for growth and development. (d) Where the nature of the child's special needs or the number of children with special needs in the program necessitates added care, staff and equipment shall be available to cover these requirements. iv. Any other areas determined necessary to promote child development or to protect children’s health and safety. Describe: Hawaii Administrative Rule chapters 17-891.2-25, 17-892.2-25, 17-895.1-25, 17-896.1-25 Programs shall provide experiences which are aimed at promoting the individual child's intellectual, emotional and social well-being and growth: Programs to promote intellectual development shall: (A) Provide that a variety of learning materials are introduced and are available to the children; and (B) Include first-hand experiences for children to learn about the world; Programs to promote emotional development shall provide that: (A) There are opportunities for individual self-expression; (B) Each child is recognized as an individual; (C) The child is afforded constructive guidance and the setting of clear-cut limits which foster the child's ability to be self-disciplined; (D) Each child's personal privacy is respected; (E) Providers shall not use: (i) Physical punishment, abuse, or harm including but not limited to spanking, pinching, slapping, or shaking; or (ii) Methods of influencing behavior which are frightening, humiliating, damaging, neglectful, or injurious to the child's health or self-esteem; and (F) Providers shall respect each child's cultural, ethnic, and family background, as well as the child's primary language or dialect; Programs to promote social development shall provide that: (A) Children are guided in developing and working out ways of getting along with each other; (B) Providers interact with the children in ways which emphasize and foster attitudes of mutual respect between adults and children; and (C) Providers behave in ways which help the children develop attitudes of respect for all other persons as individuals and develop an appreciation of cultural and ethnic diversity;