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: KAR 28-4-128(b) Each applicant, applicant with a temporary permit, and each licensee shall ensure that each staff member complies with the following standard precautions when handling blood and other bodily fluids or waste: (1) Each staff member shall avoid coming into direct contact with blood and other bodily fluids or waste. (2) Each staff member shall wear single-use gloves in the following situations: (A) When cleaning contaminated surfaces or areas; (B) before dressing a cut or sore that is leaking body fluids; and (C) when cleaning up each spill, including urine, feces, blood, saliva, vomit, and tissue discharge. (3) Each contaminated surface or area on which a spill occurs shall be cleaned by removing any visible spill from the surface or area with a water-saturated disposable paper towel or wipe. After the surface or area has been cleaned, the surface or area shall be sanitized by wetting the entire surface or area with a disinfectant solution of chlorine bleach mixed according to the directions on the label, or an appropriate commercial disinfectant used according to the directions. KAR 28-4-132(d) Hands shall be washed using soap and warm running water and dried with an individual towel or disposable product. When cloth towels and washcloths are used, they shall be labeled with the child’s name, and shall be laundered at least weekly. When soap and running water are not readily available, an alcohol-based hand sanitizer may be used only by adults and, under adult supervision, by children two years of age and older. (1) Each individual caring for children shall wash that individual’s hands as needed when hands are soiled and when each of the following occurs: (A) At the start of the hours of operation or when first arriving at the facility; (B) returning from being outdoors; (C) after toileting, diapering, assisting a child with toileting, or handling any bodily fluids; (D) before preparing each snack and each meal and before and after eating each snack and each meal; (E) before and after administrating any medication; and (F) after feeding or handling any animal. (2) Each individual caring for children shall ensure each child washes that child’s hands or be assisted in washing that child’s hands as needed when hands are soiled and when each of the following occurs: (A) First arriving at the facility; (B) returning from being outdoors; (C) after toileting, being diapered, or changing wet or soiled clothing; (D) before and after eating each snack and each meal; and (E) after feeding or handling any animal. KAR 28-4-132(g)(8) Washable diapers or training pants shall not be rinsed out. They shall be stored in 46 a labeled covered container or plastic bag and returned to the parent or legal guardian. (9) Disposable diapers and disposable training pants shall be placed in a covered container or plastic bag which shall be emptied daily, or more frequently as necessary for odor control. Each covered container used for disposable diapers and disposable training pants shall be cleaned and disinfected at the end of each day. (10) Each diaper-changing surface shall be cleaned and disinfected after each use. The surface shall be cleaned by removing any visible soil from the surface with a water saturated disposable paper towel or wipe. After the surface has been cleaned, the surface shall be disinfected. KAR 28-4-423(e)(7) Individual towels or disposable products, and toilet paper shall be provided for each child. The use of common towels and washcloths shall be prohibited. When cloth towels and washcloths are used, they shall be labeled with the child's name, and laundered at least weekly. Hand soap shall be readily accessible in each bathroom. KAR 28-4-423(d)(2) Separate areas shall be provided for soiled and clean items. KAR 28-4-427(b)(8) Toys and other items used by children shall be clean and be washed and disinfected before being used by another child if contaminated by saliva or other bodily fluids. KAR 28-4-430(a)(7) Each licensee shall provide information to the parents of children in care about the benefits of annual, well-child health assessments for children under six years of age, and biennial health assessments for children six years of age and older. Each licensee shall also provide information about the importance of seeking medical advice when a child exhibits health problems. This information may be either given on a form provided by the department to the parent at the time the child is enrolled or posted in a conspicuous place, with copies of the form available to parents on request. KAR 28-4-430(c)(1) If a child is absent due to a communicable disease, staff shall inform all parents or legal guardians of the nature of the illness without disclosing the child’s identity. (2) Each communicable disease shall be reported to the local health department. KAR 28-4-430(c)(5) A quiet area shall be provided for any sick children. Sick children shall be supervised at all times. KAR 28-4-436(c)(1) Clean, individual bedding shall be provided for each child. There shall be a complete change of bedding after each five uses, immediately when wet or soiled, and always upon a change in the child utilizing the sleeping surface. Blankets shall be laundered monthly. (2) Each surface used for napping and sleeping shall be kept clean, of safe construction, and maintained in good repair. KAR 28-4-439(q)(2)Tableware shall be maintained in sanitary condition using one of the following methods: (A) All preparation dishes, service dishes, and non- disposable dishes shall be washed and sanitized after use using one of the following: (i) A three-compartment sink supplied with hot and cold running water and a drainboard for washing, rinsing, sanitizing, and airdrying; (ii) a two- compartment sink and a basin for sanitizing the tableware and cooking utensils; or (iii) a mechanical dishwasher with a sanitizing cycle. ii. All CCDF-eligible licensed family child care homes. Provide the standard: KAR 28-4- 128(b) Each applicant, applicant with a temporary permit, and each licensee shall ensure that each staff member complies with the following standard precautions when handling blood and other bodily fluids or waste: (1) Each staff member shall avoid coming into direct contact with blood and other bodily fluids or waste. (2) Each staff member shall wear single-use gloves in the following situations: (A) When cleaning contaminated surfaces or areas; (B) before dressing a cut or sore that is leaking body fluids; and (C) when cleaning up each spill, including urine, feces, blood, saliva, vomit, and tissue discharge. (3) Each contaminated surface or area on which a spill occurs shall be cleaned by removing any visible spill from the surface or area with a water-saturated disposable paper towel or wipe. After the surface or area has been cleaned, the surface or area shall be sanitized by wetting the entire surface or area with a disinfectant solution of chlorine bleach mixed according to the directions on the label, or an appropriate commercial disinfectant used according to the directions. KAR 28-4-132(d) Hands shall be washed using soap and warm running water and dried with an individual towel or disposable product. When cloth towels and washcloths are used, they shall be labeled with the child’s name, and shall be laundered at least weekly. When soap and running water are not readily available, an alcohol-based hand sanitizer may be used only by adults and, under adult supervision, by children two years of age and older. (1) Each individual caring for children shall wash that individual’s hands as needed when hands are soiled and when each of the following occurs: (A) At the start of the hours of operation or when first arriving at the facility; (B) returning from being outdoors; (C) after toileting, diapering, assisting a child with toileting, or handling any bodily fluids; (D) before preparing each snack and each meal and before and after eating each snack and each meal; (E) before and after administrating any medication; and (F) after feeding or handling any animal. (2) Each individual caring for children shall ensure each child washes that child’s hands or be assisted in washing that child’s hands as needed when hands are soiled and when each of the following occurs: (A) First arriving at the facility; (B) returning from being outdoors; (C) after toileting, being diapered, or changing wet or soiled clothing; (D) before and after eating each snack and each meal; and (E) after feeding or handling any animal. KAR 28-4-132(g)(8) Washable diapers or training pants shall not be rinsed out. They shall be stored in 46 a labeled covered container or plastic bag and returned to the parent or legal guardian. (9) Disposable diapers and disposable training pants shall be placed in a covered container or plastic bag which shall be emptied daily, or more frequently as necessary for odor control. Each covered container used for disposable diapers and disposable training pants shall be cleaned and disinfected at the end of each day. (10) Each diaper-changing surface shall be cleaned and disinfected after each use. The surface shall be cleaned by removing any visible soil from the surface with a water saturated disposable paper towel or wipe. After the surface has been cleaned, the surface shall be disinfected. KAR 28-4-116(a)(6) (6) Toys and other items used by children shall meet the following requirements: (A) Be clean, of safe construction, and in good repair; (B) be washed and sanitized daily when used by children under 18 months of age; and (C) be washed and sanitized before being used by another child, if contaminated by saliva or other bodily fluids. KAR 28-4-116(d)(11) (11) Tableware shall be washed, rinsed, and air-dried or placed in a dishwasher after each meal. KAR 28-4-116a(c)(2) Each surface used for napping or sleeping shall be kept clean, of safe construction, and maintained in good repair. KAR 28-4-117(e) If an infant who has not been immunized against measles, mumps, rubella, and varicella because of the age of that child is enrolled and there are children in care who have not had measles, mumps, rubella, and varicella immunizations due to an exception, including the children of the provider, the parents of the infant at risk shall sign a statement that the parents have been informed of the risk to their child. This statement shall be in the infant's file at the facility. KAR 28-4-117(g) Each applicant with a temporary permit and each licensee shall provide information to parents of children about the benefits of annual well-child health assessments for children under the age of six years and biennial health assessments for children six years of age and older. Each applicant with a temporary permit and each licensee shall also provide information about the importance of seeking medical advice when children exhibit health problems. This information shall be given on a form provided by the department to the parent when the child is enrolled or be posted in a conspicuous place, with copies of the form available to parents on request. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Kansas does not have license exempt CCDF center-based child care programs. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Kansas does not have license exempt CCDF family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Kansas does not have license exempt CCDF non-relative in-home care. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: KAR 28-4-588(d)(2)(C) If bedding is used, it shall be stored in a sanitary manner. KAR 28-4-590(b)(4) Each operator and each staff member who has regular, ongoing contact with children or youth shall attest to that individual's health status on a form supplied by the department or approved by the secretary. The health status form shall indicate if the individual has been exposed to an active case of tuberculosis or has been diagnosed with suspect or confirmed active tuberculosis. Each individual shall update the health status form annually or more often if there is a change in the health status or if the individual has been exposed to an active case of tuberculosis. (5) If an operator or staff member in contact with children or youth experiences significant changes in physical, mental, or emotional health or if the individual has been exposed to an active case of tuberculosis, an assessment of the individual's current health status may be required by the secretary. A licensed health care provider qualified to diagnose and treat the condition shall conduct the health assessment. Each assessment shall be kept in the individual's file and shall be submitted to the secretary on request. KAR 28-4-590(c) (1) If an operator, program director, staff member, child, or youth is exposed to an active case of tuberculosis or if the location of the program is in an area identified by the local health department or the secretary as a high-risk area for tuberculosis exposure, that individual shall obtain a Mantoux test or a chest x-ray. (2) Each individual diagnosed with suspected or confirmed active tuberculosis shall be excluded from the program until the operator receives authorization from the secretary for the individual to return. (3) Each operator shall notify the secretary if any individual identified in paragraph (c)(1) of this regulation indicates exposure to an active case of tuberculosis, has a diagnosis of suspected or confirmed active tuberculosis, or has a positive Mantoux test or positive chest x-ray indicating active disease. KAR 28-4-590(f) (1) Hand washing. (A) Each operator shall encourage each child and youth to wash the hands with soap and water before and after eating and after toileting. (B) Each staff member shall wash the hands with soap and water before and after eating and after toileting. (C) Waterless sanitizing cleanser or sanitizing wipes shall not be used as a substitute for soap and running water. Individuals shall not share towels or washcloths. KAR 28-4-591(a)(1)(B) No individual shall be in the food preparation area who is vomiting, has diarrhea, or has other signs, symptoms, or positive laboratory tests indicative of an infectious illness that can be transmitted through food handling. (C) No individual shall handle or serve food until the individual is no longer infectious as required by K.A.R. 28-1-6. KAR 28-4-592(d) Standard precautions for handling blood and other bodily fluids or waste. Each operator shall ensure that each staff member complies with the following standard precautions when handling blood and other bodily fluids or waste: (1) Each staff member shall avoid coming into direct contact with blood and other bodily fluids or waste. (2) Each staff member shall wear single-use gloves in the following situations: (A) When cleaning contaminated surfaces or areas; (B) before dressing a cut or sore that is leaking body fluids; and (C) when cleaning up each spill, including urine, feces, blood, saliva, vomit, and tissue discharge. (3) Each contaminated surface or area on which a spill occurs shall be cleaned by removing any visible spill from the surface or area with a water-saturated disposable paper towel or wipe. After the surface or area has been cleaned, the surface or area shall be sanitized by wetting the entire surface or area with a disinfectant solution of chlorine bleach mixed according to the directions on the label, or an appropriate commercial disinfectant used according to the directions on the label. (4) Each mop used to clean up a contaminated area shall be cleaned and rinsed in a disinfecting solution, wrung as dry as possible, and hung to dry. (5) Each paper towel, sponge, or other material used for cleaning up a contaminated area shall be placed in a plastic bag with a secure tie and thrown away in a covered container. KAR 28-4-592(f)(1) If a child or youth becomes ill while attending the program, the operator shall immediately notify the parent or adult responsible for the child or youth. (2) If an operator, staff member, child, or youth in a program contracts a reportable infectious or contagious disease listed in K.A.R. 28-1-2, the operator shall report the disease to the secretary’s designee by the next working day. (3) The operator shall follow the protocol recommended by the county health department and shall cooperate fully with any investigation, disease control, or surveillance procedures initiated by the county health department or the department. 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: KSA 65-508(g) Each child cared for in a child care facility, including children of the person maintaining the facility, shall be required to have current such immunizations as the secretary of 8 health and environment considers necessary. The person maintaining a child care facility shall maintain a record of each child's immunizations and shall provide to the secretary of health and environment such information relating thereto, in accordance with rules and regulations of the secretary, but the person maintaining a child care facility shall not have such person's license revoked solely for the failure to have or to maintain the immunization records required by this subsection. KAR 28-1-20. Immunizations; schools, child care facilities, and preschool or child care programs operated by a school. (a) Definition. For the purposes of this regulation, "susceptible child" shall mean either of the following if, for that individual, there is no history of the disease that has been documented by a physician, no laboratory documentation of immunity, or no documentation acceptable to the secretary that demonstrates current vaccination against the disease: (1) Any individual who attends school as defined in K.S.A. 72-6261, and amendments thereto; or (2) any individual who is enrolled, is placed, or resides in a child care facility as defined in K.S.A. 65-503, and amendments thereto, or a preschool or child care program operated by a school. (b) Required vaccinations. Except as provided in K.S.A. 72-6262 and amendments thereto, each susceptible child shall be required to receive the following vaccinations before enrolling in any school: (1) Diphtheria; (2) hepatitis A; (3) hepatitis B; (4) measles (rubeola); (5) meningitis; (6) mumps; (7) pertussis (whooping cough); (8) poliomyelitis; (9) rubella (German measles); (10) tetanus; and (11) varicella (chickenpox). (c) Immunization record for school entry. The immunization record of each individual who attends school shall document that the individual has received the vaccinations specified in subsection (b) from a physician or local health department or is not a susceptible child, on forms provided by the department of health and environment. (d) Immunizations required for a child in a child care facility or preschool or child care program operated by a school. Each susceptible child, including a child under 16 years of age of a child care provider who is enrolled, is placed, or resides in a child care facility or a preschool or child care program operated by a school, shall be required to receive the following immunizations as medically appropriate: (1) Diphtheria; (2) Haemophilus influenzae type B; (3) hepatitis A; (4) hepatitis B; (5) measles (rubeola); (6) mumps; (7) pertussis (whooping cough); (8) pneumococcal disease; (9) poliomyelitis; (10) rubella; (11) tetanus; and (12) varicella (chickenpox). (e) Immunization records for a child care facility. Each child's immunization record shall be maintained on the forms provided by the department of health and environment. KAR 28-4-430(a)(5) Immunizations for each child in care shall be current as medically appropriate and shall be maintained current for protection from the diseases specified in K.A.R. 28-1-20(d). A record of each child's immunizations shall be maintained on the child's medical record form. ii. All CCDF-eligible licensed family child care homes. Provide the standard: KSA 65- 508(g) Each child cared for in a child care facility, including children of the person maintaining the facility, shall be required to have current such immunizations as the secretary of 8 health and environment considers necessary. The person maintaining a child care facility shall maintain a record of each child's immunizations and shall provide to the secretary of health and environment such information relating thereto, in accordance with rules and regulations of the secretary, but the person maintaining a child care facility shall not have such person's license revoked solely for the failure to have or to maintain the immunization records required by this subsection. KAR 28-1-20. Immunizations; schools, child care facilities, and preschool or child care programs operated by a school. (a) Definition. For the purposes of this regulation, "susceptible child" shall mean either of the following if, for that individual, there is no history of the disease that has been documented by a physician, no laboratory documentation of immunity, or no documentation acceptable to the secretary that demonstrates current vaccination against the disease: (1) Any individual who attends school as defined in K.S.A. 72-6261, and amendments thereto; or (2) any individual who is enrolled, is placed, or resides in a child care facility as defined in K.S.A. 65-503, and amendments thereto, or a preschool or child care program operated by a school. (b) Required vaccinations. Except as provided in K.S.A. 72-6262 and amendments thereto, each susceptible child shall be required to receive the following vaccinations before enrolling in any school: (1) Diphtheria; (2) hepatitis A; (3) hepatitis B; (4) measles (rubeola); (5) meningitis; (6) mumps; (7) pertussis (whooping cough); (8) poliomyelitis; (9) rubella (German measles); (10) tetanus; and (11) varicella (chickenpox). (c) Immunization record for school entry. The immunization record of each individual who attends school shall document that the individual has received the vaccinations specified in subsection (b) from a physician or local health department or is not a susceptible child, on forms provided by the department of health and environment. (d) Immunizations required for a child in a child care facility or preschool or child care program operated by a school. Each susceptible child, including a child under 16 years of age of a child care provider who is enrolled, is placed, or resides in a child care facility or a preschool or child care program operated by a school, shall be required to receive the following immunizations as medically appropriate: (1) Diphtheria; (2) Haemophilus influenzae type B; (3) hepatitis A; (4) hepatitis B; (5) measles (rubeola); (6) mumps; (7) pertussis (whooping cough); (8) pneumococcal disease; (9) poliomyelitis; (10) rubella; (11) tetanus; and (12) varicella (chickenpox). (e) Immunization records for a child care facility. Each child's immunization record shall be maintained on the forms provided by the department of health and environment. KAR 28-4-117(c) (c) Immunizations for each child, including each child of the provider under 16 years of age, shall be current as medically appropriate and shall be maintained current for protection from the diseases specified in K.A.R. 28-1-20(d). A record of each child's immunizations shall be maintained on the child's medical record. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Kansas does not have license exempt CCDF center-based child care programs. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Kansas does not have any licensed exempt CCDF family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Kansas does not have any licensed exempt CCDF non-relative in-home care. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: KSA 65-508(g) Each child cared for in a child care facility, including children of the person maintaining the facility, shall be required to have current such immunizations as the secretary of 8 health and environment considers necessary. The person maintaining a child care facility shall maintain a record of each child's immunizations and shall provide to the secretary of health and environment such information relating thereto, in accordance with rules and regulations of the secretary, but the person maintaining a child care facility shall not have such person's license revoked solely for the failure to have or to maintain the immunization records required by this subsection. KAR 28-1-20. Immunizations; schools, child care facilities, and preschool or child care programs operated by a school. (a) Definition. For the purposes of this regulation, "susceptible child" shall mean either of the following if, for that individual, there is no history of the disease that has been documented by a physician, no laboratory documentation of immunity, or no documentation acceptable to the secretary that demonstrates current vaccination against the disease: (1) Any individual who attends school as defined in K.S.A. 72-6261, and amendments thereto; or (2) any individual who is enrolled, is placed, or resides in a child care facility as defined in K.S.A. 65-503, and amendments thereto, or a preschool or child care program operated by a school. (b) Required vaccinations. Except as provided in K.S.A. 72-6262 and amendments thereto, each susceptible child shall be required to receive the following vaccinations before enrolling in any school: (1) Diphtheria; (2) hepatitis A; (3) hepatitis B; (4) measles (rubeola); (5) meningitis; (6) mumps; (7) pertussis (whooping cough); (8) poliomyelitis; (9) rubella (German measles); (10) tetanus; and (11) varicella (chickenpox). (c) Immunization record for school entry. The immunization record of each individual who attends school shall document that the individual has received the vaccinations specified in subsection (b) from a physician or local health department or is not a susceptible child, on forms provided by the department of health and environment. (d) Immunizations required for a child in a child care facility or preschool or child care program operated by a school. Each susceptible child, including a child under 16 years of age of a child care provider who is enrolled, is placed, or resides in a child care facility or a preschool or child care program operated by a school, shall be required to receive the following immunizations as medically appropriate: (1) Diphtheria; (2) Haemophilus influenzae type B; (3) hepatitis A; (4) hepatitis B; (5) measles (rubeola); (6) mumps; (7) pertussis (whooping cough); (8) pneumococcal disease; (9) poliomyelitis; (10) rubella; (11) tetanus; and (12) varicella (chickenpox). (e) Immunization records for a child care facility. Each child's immunization record shall be maintained on the forms provided by the department of health and environment. KAR 28-4-590(d)(2) Each operator shall require that each child or youth attending the program has current immunizations as specified in K.A.R. 28- 1-20 or has an exemption for religious or medical reasons. 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: KAR 28-4-423(a)(17) Each room occupied by children shall be sufficiently lighted in all parts of the room for any activity in which each child is engaged. When children are napping and during rest periods, each room shall be lighted to allow freedom of movement and to ensure staff members are able to observe the breathing of each child. KAR 28-4-428(a)(3) No child shall be left unsupervised. KAR 28-4-436(b) (1) Each applicant with a temporary permit and each licensee shall develop a written plan for safe sleep practices and implement safe sleep practices for children in care who are napping or sleeping. (2) Each applicant with a temporary permit and each licensee shall ensure that the safe sleep practices are shared with the parent or legal guardian of each child before the first day of care. (3) Each staff member shall follow the safe sleep policies and practices of the child care center. (4) Each child who is 12 months of age or older shall nap or sleep on a cot or pad. Pads shall be used only over carpet. (5) Each applicant with a temporary permit and each licensee shall ensure that all of the following requirements are met for each infant in care: (A) The child shall nap or sleep in a crib or a playpen. Stacking cribs or bassinets shall not be used. Cribs with water- bed mattresses shall not be used. (B) A crib or playpen shall be provided and used for each child in attendance. The child shall not nap or sleep in the same crib or playpen occupied by another child at the same time. (C) If the child falls asleep on a surface other than a crib or playpen, the child shall be moved to a crib or playpen. (D) The child shall be placed on the child’s back to nap or sleep. (E) When the child is able to turn over independently from front to back and back to front, the child shall be placed on the child’s back but then shall be allowed to remain in a position preferred by the child. Wedges or infant positioners shall not be used. (F) The child shall sleep in a crib or a playpen that is free of any soft items, including pillows, quilts, blankets, bumpers, comforters, sheepskins, flat sheets, cloth diapers, bibs, stuffed animals, and toys. (G) The child may nap or sleep in sleep clothing, including sleepers and sleep sacks. Swaddling shall not be permitted. KAR 28-4-440 (d) Cribs and playpens shall be located within the self-contained unit and be separated from the play area. If a barrier is used, it shall not impede supervision. (e) Safe sleep procedures shall be followed as specified in K.A.R. 28-4- 436. ii. All CCDF-eligible licensed family child care homes. Provide the standard: KAR 28-4- 115a(a)(1) Each applicant, each applicant with a temporary permit, and each licensee shall develop a supervision plan for children in care that includes all age ranges of children for whom care will be provided. A copy of the plan shall be available for review by the parents or legal guardians of children in care and by the department. The plan shall include the following: (A) A description of the rooms, levels, or areas of the facility including indoor and outdoor areas in which the child will participate in activities, have snacks or meals, nap, or sleep. KAR 28-4-115a(c)(3) Each applicant with a temporary permit and each licensee shall ensure that supervision is provided for each child who is napping or sleeping. (A) Each child who is napping or sleeping shall be within sight or hearing distance of the provider and shall be visually checked on by the provider at least once every 15 minutes. (B) The provider shall meet all of the requirements of K.A.R. 28- 4-116a for any child who is under 12 months of age and is napping or sleeping. (C) When any child is napping or sleeping in a room separate from the provider, the door to that room shall remain open. (D) When a child awakens and is ready to get up, the provider shall attend to the child’s needs and assist the child in moving to another activity. KAR 28-4-116a(a) Rest period. Each child shall have a daily, supervised rest period as needed. Each child who does not nap or sleep shall be given the opportunity for quiet play. (b) Safe sleep practices for children in care. (1) Each applicant with a temporary permit and each licensee shall develop a written plan for safe sleep practices and implement safe sleep practices for children in care who are napping or sleeping. (2) Each applicant with a temporary permit and each licensee shall ensure that the safe sleep practices are shared with the parent or legal guardian of each child before the first day of care. (3) Each provider shall follow the safe sleep practices of the facility. (4) Each child who is 12 months of age or older shall nap or sleep on a bed, a cot, the lower bunk of a bunk bed, or a pad over a carpet or area rug on the floor. (5) Children under 12 months of age. Each applicant with a temporary permit and each licensee shall ensure that all of the following requirements are met for each child in care who is under 12 months of age: (A) The child shall nap or sleep in a crib or a playpen. Stacking cribs or bassinets shall not be used. Cribs with water-bed mattresses shall not be used. (B) If the child falls asleep on a surface other than a crib or playpen, the child shall be moved to a crib or playpen. (C) A crib or playpen shall be provided and used for each child in attendance at any one time. The child shall not nap or sleep in the same crib or playpen occupied by another child at the same time. (D) The child shall be placed on the child’s back to nap or sleep. (E) When the child is able to turn over independently from front to back and back to front, the child shall be placed on the child’s back but then shall be allowed to remain in a position preferred by the child. Wedges or infant positioners shall not be used. (F) The child shall sleep in a crib or a playpen that is free of any soft items, including pillows, quilts, blankets, bumpers, comforters, sheepskins, flat sheets, cloth diapers, bibs, stuffed animals, and toys. (G) The child may nap or sleep in sleep clothing, including sleepers and sleep sacks. Swaddling shall not be permitted. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The Lead Agency does not have license exempt CCDF child care centers v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The Lead Agency does not have license exempt CCDF family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Lead Agency does not have license exempt CCDF non-relative in-home care. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: School age Program- defined as a child care facility that serves exclusively school-age children and youth, do not care for infants. 5.3.3 Administration of medication, consistent with standards for parental consent health and safety standard a. Provide the standards, appropriate to the provider setting and age of children, that address the administration of medication for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The Lead Agency received notification of this non-compliance in Cycle 1 monitoring with notification received on December 13, 2021. Additional time is needed to come into compliance. Regulations were implemented for child care centers/preschools on 8/2/2024, however a compliance evidence review is pending with the Office of Child Care, where compliance must be verified. The current regulations in place are as follows: KAR 28-4-132(i) Medication administration (2) If nonprescription medication is to be administered to a child, each individual caring for children shall meet the following requirements: (A) Obtain written permission from each child’s parent or legal guardian before administering medication to that child; (B) require that each medication supplied by a parent or legal guardian for the child be in the original container; (C) ensure that the container is labeled with the first and last name of the child for whom the medication is intended; and (D) administer each medication according to the instructions on the label. (3) If prescription medication is administered to a child, each individual caring for children shall meet the following requirements: (A) Obtain written permission from each child’s parent or legal guardian before administering medication to that child; (B) keep each medication in the original container labeled by a pharmacist, with the following information: (i) The child’s first and last name; (ii) the name of the licensed physician, physician assistant (PA), or advanced practice registered nurse (APRN) who ordered the medication; (iii) the date the prescription was filled; (iv) the expiration date of the medication; and (v) specific, legible instructions for administration and storage of the medication; (C) consider the instructions on each label to be the order from the licensed physician, PA, or APRN; (D) administer the medication only to the child designated on the prescription label; and (E) administer the medication in accordance with the instructions on the label. (4) Documentation of each medication administered shall be kept on a form provided by the department and maintained in each child’s file. (5) A copy of the documentation of each medication administered shall be made available to the parent or legal guardian of the child. KAR 28-4-132(d)(1) Each individual caring for children shall wash that individual’s hands as needed when hands are soiled and when each of the following occurs: (E) (E) before and after administrating any medication. KAR 28-4-132(c)(2) Each individual who cares for children shall be prohibited from giving any child any medications, herbal or folk remedies, or drugs to control or manage behavior, unless prescribed by a licensed physician, physician assistant, or advanced practice registered nurse. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The Lead Agency received notification of this non-compliance in Cycle 1 monitoring with notification received on December 13, 2021. Additional time is needed to come into compliance. Regulations were implemented for family child care homes on 8/2/2024, however a compliance evidence review is pending with the Office of Child Care, where compliance must be verified. The current regulations in place are as follows: KAR 28-4-132(i) Medication administration (2) If nonprescription medication is to be administered to a child, each individual caring for children shall meet the following requirements: (A) Obtain written permission from each child’s parent or legal guardian before administering medication to that child; (B) require that each medication supplied by a parent or legal guardian for the child be in the original container; (C) ensure that the container is labeled with the first and last name of the child for whom the medication is intended; and (D) administer each medication according to the instructions on the label. (3) If prescription medication is administered to a child, each individual caring for children shall meet the following requirements: (A) Obtain written permission from each child’s parent or legal guardian before administering medication to that child; (B) keep each medication in the original container labeled by a pharmacist, with the following information: (i) The child’s first and last name; (ii) the name of the licensed physician, physician assistant (PA), or advanced practice registered nurse (APRN) who ordered the medication; (iii) the date the prescription was filled; (iv) the expiration date of the medication; and (v) specific, legible instructions for administration and storage of the medication; (C) consider the instructions on each label to be the order from the licensed physician, PA, or APRN; (D) administer the medication only to the child designated on the prescription label; and (E) administer the medication in accordance with the instructions on the label. (4) Documentation of each medication administered shall be kept on a form provided by the department and maintained in each child’s file. (5) A copy of the documentation of each medication administered shall be made available to the parent or legal guardian of the child. KAR 28-4-132(d)(1) Each individual caring for children shall wash that individual’s hands as needed when hands are soiled and when each of the following occurs: (E) (E) before and after administrating any medication. KAR 28-4-132(c)(2) Each individual who cares for children shall be prohibited from giving any child any medications, herbal or folk remedies, or drugs to control or manage behavior, unless prescribed by a licensed physician, physician assistant, or advanced practice registered nurse. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The Lead Agency does not have license exempt CCDF child care centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The Lead Agency does not have license exempt CCDF family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Lead Agency does not have license exempt CCDF in-home care. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: This non-compliance was identified in Cycle 1 monitoring with notification sent to the lead agency on Dec. 13, 2021. Preliminary findings shared with the lead agency on July 22, 2024 also showed this to be an area of non-compliance. Kansas will need additional time to ensure school age regulations are adopted to ensure correct application requirements as the agency responsible for the health and safety oversight is promulgating regulations to ensure compliance. Due to the complexity of the state process, the additional time is warranted. KAR 28-4- 590 (e) Administration of medication. (1) Nonprescription medication. If nonprescription medication is to be administered during the time children or youth are attending the program, each operator shall ensure compliance with the following procedures: (A) Obtain written permission from the child's or youth's parent or other adult responsible for the child or youth before administering nonprescription medication to that child or youth; (B) administer each medication from the original container and according to instructions on the label; and (C) require that each nonprescription medication supplied by a parent or other adult responsible for the child or youth be in the original container that is labeled with the first and last name of the child or youth for whom the medication is intended. (2) Prescription medication. If prescription medication is administered during the time children or youth are attending the program, each operator shall ensure compliance with the following procedures: (A) Obtain written permission from the child's or youth's parent or other adult responsible for the child or youth before administering prescription medication to that child or youth; (B) administer medication ordered by a licensed physician or licensed nurse practitioner only to the designated child or youth and in the dosage recommended; (C) keep each prescription medication in the original container labeled by a pharmacist with the following information: (i) The first and last name of the child or youth; (ii) the date the prescription was filled; (iii) the name of the licensed physician or licensed nurse practitioner who wrote the prescription; (iv) the expiration date of the medication; and (v) specific, legible instructions for administration and storage of the medication; (D) consider the instructions on each label to be the order from the licensed physician or licensed nurse practitioner; and (E) administer the medication in accordance with the instructions on the label. (3) Requirements for administering medication. (A) If nonprescription or prescription medication is administered, each operator shall designate staff members to administer the medication. Before administering medication, each designated staff member shall receive training in medication administration approved by the secretary. (B) Each operator shall record in the file of each child or youth who is scheduled to receive medication the following identifying information, on forms supplied by the department: (i) The name of each staff member who administered each medication; (ii) the date and time the medication was given; (iii) any change in the child's or youth's behavior, response to the medication, or adverse reaction; and (iv) any change in the administration of the medication from the instructions on the label or a notation about each missed dose. (C) Each record shall be signed by the individual who was responsible for administering the medication, and a copy of the record shall be made available to the parent or other adult responsible for the child or youth. b. Provide the standards, appropriate to the provider setting and age of children, that address obtaining permission from parents to administer medications to children for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The Lead Agency received notification of this non-compliance in Cycle 1 monitoring with notification received on December 13, 2021. Additional time is needed to come into compliance. Regulations were implemented for child care centers/preschools on 8/2/2024, however a compliance evidence review is pending with the Office of Child Care, where compliance must be verified. The current regulations in place are as follows: KAR 28-4-132(i) Medication administration (2) If nonprescription medication is to be administered to a child, each individual caring for children shall meet the following requirements: (A) Obtain written permission from each child’s parent or legal guardian before administering medication to that child; (B) require that each medication supplied by a parent or legal guardian for the child be in the original container; (C) ensure that the container is labeled with the first and last name of the child for whom the medication is intended; and (D) administer each medication according to the instructions on the label. (3) If prescription medication is administered to a child, each individual caring for children shall meet the following requirements: (A) Obtain written permission from each child’s parent or legal guardian before administering medication to that child; (B) keep each medication in the original container labeled by a pharmacist, with the following information: (i) The child’s first and last name; (ii) the name of the licensed physician, physician assistant (PA), or advanced practice registered nurse (APRN) who ordered the medication; (iii) the date the prescription was filled; (iv) the expiration date of the medication; and (v) specific, legible instructions for administration and storage of the medication; (C) consider the instructions on each label to be the order from the licensed physician, PA, or APRN; (D) administer the medication only to the child designated on the prescription label; and (E) administer the medication in accordance with the instructions on the label. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The Lead Agency received notification of this non-compliance in Cycle 1 monitoring with notification received on December 13, 2021. Additional time is needed to come into compliance. Regulations were implemented for family child care homes on 8/2/2024, however a compliance evidence review is pending with the Office of Child Care, where compliance must be verified. The current regulations in place are as follows: KAR 28-4-132 (i) Medication administration (2) If nonprescription medication is to be administered to a child, each individual caring for children shall meet the following requirements: (A) Obtain written permission from each child’s parent or legal guardian before administering medication to that child; (B) require that each medication supplied by a parent or legal guardian for the child be in the original container; (C) ensure that the container is labeled with the first and last name of the child for whom the medication is intended; and (D) administer each medication according to the instructions on the label. (3) If prescription medication is administered to a child, each individual caring for children shall meet the following requirements: (A) Obtain written permission from each child’s parent or legal guardian before administering medication to that child; (B) keep each medication in the original container labeled by a pharmacist, with the following information: (i) The child’s first and last name; (ii) the name of the licensed physician, physician assistant (PA), or advanced practice registered nurse (APRN) who ordered the medication; (iii) the date the prescription was filled; (iv) the expiration date of the medication; and (v) specific, legible instructions for administration and storage of the medication; (C) consider the instructions on each label to be the order from the licensed physician, PA, or APRN; (D) administer the medication only to the child designated on the prescription label; and (E) administer the medication in accordance with the instructions on the label. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x]Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The Lead Agency does not have license exempt CCDF center care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The Lead Agency does not have license exempt CCDF family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Lead Agency does have license exempt CCDF non-relative in-home care. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: This non-compliance was identified in Cycle 1 monitoring with notification sent to the lead agency on Dec. 13, 2021. Preliminary findings shared with the lead agency on July 22, 2024 also showed this to be an area of non-compliance. The lead agency will need more time to come into compliance. In a school age program, children are permitted to self-administer medication. KAR 28-4- 590(e)(5) (5) Self-administration of medication. (A) Any operator may permit each child or youth with a chronic illness, a condition requiring prescription medication on a regular basis, or a condition requiring the use of an inhaler to administer the medication under staff supervision. The operator shall obtain written permission for the child or youth to self-administer medication from the child's or youth's parent or other adult responsible for the child or youth, and from the licensed physician or nurse practitioner treating the condition of the child or youth. (B) Written permission for self-administration of medication shall be kept in the child's or youth's file. (C) Self-administration of each medication shall follow the procedures specified in paragraphs (e)(2)(B), (C), (D), and (E) of this regulation. (D) Each child or youth who is authorized to self-administer medication shall have immediate access to that child's or youth's medication for administration purposes. Each operator shall safely store each medication to prevent unauthorized access by others. (E) Each operator shall record the date and time each medication was self-administered. 5.3.4 Prevention of and response to emergencies due to food and allergic reactions health and safety standard a. Provide the standards, appropriate to the provider setting and age of children, that address the prevention of emergencies due to food and allergic reactions for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: The Lead Agency received notification of this non-compliance in Cycle 1 monitoring with notification received on December 13, 2021. Additional time is needed to come into compliance. Regulations were implemented for child care centers/preschools on 8/2/2024, however a compliance evidence review is pending with the Office of Child Care, where compliance must be verified. The current regulations in place are as follows: KAR 28-4-128 (a) Emergency plans; drills. (1) Each applicant, each applicant with a temporary permit, and each licensee shall develop and implement a written emergency plan to provide for the safety of children and staff members in emergencies. The emergency plan shall include the following information: (D) procedures for responding to and preventing allergic reactions of individual children. (H) procedures designating the tasks to be followed by each staff member in an emergency, including the following: (i) As appropriate, contacting 911 or other emergency response entities; (ii) assisting the children, including children with special needs, to move to a designated shelter-in-place area and to a designated offpremises relocation site; and (iii) ensuring that emergency supplies are readily available. KAR 28-4-128(a)(3) Each staff member shall be informed of and shall follow the emergency plan. (4) Each licensee shall review the emergency plan at least annually and update it as needed. KAR 28-4-439(j) Food allergies or special dietary needs of specific children shall be known to all staff members. If any child with a food allergy or a special dietary need is enrolled, the following shall be met: 82 (1) Utensils, cookware, and food preparation surfaces shall be washed and sanitized between use for foods that risk cross contamination. (2) Foods that risk cross contamination shall be stored separately from other foods with no potential for leakage onto other foods stored in the vicinity. (3) Hands shall be washed in between preparing an allergen containing dish and the dish for the child with an allergy. If gloves are used, a fresh pair of gloves will be used before changing from the allergen containing dish to the non-allergen dish. (4) A list of allergies and special dietary needs will be written and clearly displayed in the food preparation area for each child enrolled at the facility that has a known allergy or a special dietary need. (k) If any child has a food allergy or special dietary need, staff members and the parent or legal guardian of the child shall make arrangements for the provision of alternative foods or beverages. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The Lead Agency received notification of this non-compliance in Cycle 1 monitoring with notification received on December 13, 2021. Additional time is needed to come into compliance. Regulations were implemented for family child care homes on 8/2/2024, however a compliance evidence review is pending with the Office of Child Care, where compliance must be verified. The current regulations in place are as follows: KAR 28-4-128 (a) Emergency plans; drills. (1) Each applicant, each applicant with a temporary permit, and each licensee shall develop and implement a written emergency plan to provide for the safety of children and staff members in emergencies. The emergency plan shall include the following information: (D) procedures for responding to and preventing allergic reactions of individual children. (H) procedures designating the tasks to be followed by each staff member in an emergency, including the following: (i) As appropriate, contacting 911 or other emergency response entities; (ii) assisting the children, including children with special needs, to move to a designated shelter-in-place area and to a designated offpremises relocation site; and (iii) ensuring that emergency supplies are readily available. KAR 28-4-128(a)(3) Each staff member shall be informed of and shall follow the emergency plan. (4) Each licensee shall review the emergency plan at least annually and update it as needed. KAR 28-4-116(d)(8) If any child has a food allergy or special dietary need, the provider and the parent or legal guardian of the child shall make arrangements for the provision of alternative foods or beverages. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The Lead Agency does not have license exempt CCDF center care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The Lead Agency does not have license exempt CCDF family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Lead Agency does not have license exempt CCDF non-relative in-home child care. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: This non-compliance was identified in Cycle 1 monitoring with notification sent to the lead agency on Dec. 13, 2021. Preliminary findings shared with the lead agency on July 22, 2024 also showed this to be an area of non-compliance. Kansas will need additional time to ensure school age regulations are adopted to ensure correct application requirements as the agency responsible for the health and safety oversight is promulgating regulations to ensure compliance. Due to the complexity of the state process, the additional time is warranted. 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 Lead Agency received notification of this non-compliance in Cycle 1 monitoring with notification received on December 13, 2021. Additional time is needed to come into compliance. Regulations were implemented for child care centers/preschools on 8/2/2024, however a compliance evidence review is pending with the Office of Child Care, where compliance must be verified. The current regulations in place are as follows: KAR 28-4-430(a)(2) Each facility must have a medical record including the medical history of the child using the form provided by the licensing agency, signed by a parent or legal guardian. The child's medical history must include a list of the child's allergies and known medical conditions. The record must include the telephone number of physician, hospital and name and phone number of the person that can be notified in case of an emergency. KAR 28-4-128(a)(1) Each applicant, each applicant with a temporary permit, and each licensee shall develop and implement a written emergency plan to provide for the safety of children and staff members in emergencies. The emergency plan shall include the following information: (D) procedures for responding to and preventing allergic reactions of individual children. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The Lead Agency received notification of this non-compliance in Cycle 1 monitoring with notification received on December 13, 2021. Additional time is needed to come into compliance. Regulations were implemented for family child care homes on 8/2/2024, however a compliance evidence review is pending with the Office of Child Care, where compliance must be verified. The current regulations in place are as follows: KAR 28-4-117(a)(2) Each family child care home must have a medical record including the medical history of the child using the form provided by the licensing agency, signed by a parent or legal guardian. The child's medical history must include a list of the child's allergies and known medical conditions. The record must include the telephone number of physician, hospital and name and phone number of the person that can be notified in case of an emergency. KAR 28-4-128(a)(1) Each applicant, each applicant with a temporary permit, and each licensee shall develop and implement a written emergency plan to provide for the safety of children and staff members in emergencies. The emergency plan shall include the following information: (D) procedures for responding to and preventing allergic reactions of individual children. iii. All CCDF-eligible licensed in-home care. Provide the standard:: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The Lead Agency does not have license exempt CCDF center care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The Lead Agency does not have license exempt CCDF family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Lead Agency does not have license exempt CCDF non-relative in-home child care. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: This was an area of non-compliance shared in the preliminary findings with the lead agency on July 22, 2024. Kansas will need additional time to ensure school age regulations are adopted to ensure correct application requirements as the agency responsible for the health and safety oversight is promulgating regulations to ensure compliance. Due to the complexity of the state process, the additional time is warranted. KAR 28-4-582 requires a health history, including known allergies. 5.3.5 Building and physical premises safety, including the identification of and protection from hazards, bodies of water, and vehicular traffic health and safety standard a. Provide the standards, appropriate to the provider setting and age of children, that address the identification of and protection from building and physical premises hazards for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: KSA 65-508 Each facility must be approved for fire safety by a fire inspector. A basement or a second floor used for child care in a facility must be approved for fire safety by a fire inspector before use. A third floor must not be used for child care. Each child care facility must be properly heated, plumbed, lighted and ventilated. Plumbing, water, and sewerage systems must conform to all applicable state and local laws. KAR 28-4-423 Each stairway with more than two stairs must be railed. If any children under 2 1/2 years of age are in care, each stairway must be equipped with balusters not more than four inches apart or guarded to prevent a child’s head or body from falling through. Each stairway will be guarded by a secured door or gate to prevent unsupervised access by the child. Window coverings with strings or cords must not be accessible to children in care. Refrigerated medications must be in a locked box. All household cleaning supplies and bodily care products bearing warning labels, dangerous chemicals and other household or personal use items deemed hazardous, including weapons, must be in locked storage or stored out of reach of children. Chemicals and cleaning supplies shall be used and disposed of in accordance with the product safety label. KAR 28-4- 437 Outdoor play equipment that is safely constructed in good repair, and anchored if required, and must be placed in an area free of health, safety, and environmental hazards. If a trampoline is on the premises, the trampoline must be made inaccessible to children during the facility’s hours of operation. Impact- absorbent surfacing material must be installed in each use zone under and around anchored and climbing equipment. KAR 28-4-129 Steps must be removed from the pool when the pool is not in use. Each hot tub or spa must be covered with an insulated cover secured by straps or locks. ii. All CCDF-eligible licensed family child care homes. Provide the standard: KSA 65- 508 Each facility must be approved for fire safety by a fire inspector. A basement or a second floor used for child care in a facility must be approved for fire safety by a fire inspector before use. A third floor must not be used for child care. Each child care facility must be properly heated, plumbed, lighted and ventilated. Plumbing, water, and sewerage systems must conform to all applicable state and local laws. KAR 28-4-115(c) Each stairway with more than two stairs must be railed. If any children under 2 1/2 years of age are in care, each stairway must be equipped with balusters not more than four inches apart or guarded to prevent a child’s head or body from falling through. Each stairway will be guarded by a secured door or gate to prevent unsupervised access by the child. Window coverings with strings or cords must not be accessible to children in care. Refrigerated medications must be in a locked box. KAR 28-4-115(g) All household cleaning supplies and bodily care products bearing warning labels, dangerous chemicals and other household or personal use items deemed hazardous, including weapons, must be in locked storage or stored out of reach of children. including weapons, must be in locked storage or stored out of reach of children. KAR 28-4-115(i) Outdoor play equipment that is safely constructed in good repair, and anchored if required, and must be placed in an area free of health, safety, and environmental hazards. If a trampoline is on the premises, the trampoline must be made inaccessible to children during the facility’s hours of operation. Impact- absorbent surfacing material must be installed in each use zone under and around anchored and climbing equipment. Steps must be removed from the pool when the pool is not in use. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The Lead Agency does not have license exempt CCDF center child care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The Lead Agency does not have license exempt CCDF home care. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Lead Agency does not have license exempt CCDF non-relative in-home child care vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Some regulations are not applicable to School Age Programs; however, all programs have requirements to ensure building and physical premises safety in statute and regulation. KAR 28-4-585 (a) Safety and maintenance of each building. (1) Each operator shall ensure that the program is located in a building that meets the requirements specified in K.S.A. 65-508 and amendments thereto, the applicable building code, and any applicable local ordinances. Each operator shall ensure that no child or youth is knowingly exposed to environmental hazards, including asbestos, lead paint, and pesticides. KAR 28-4-585(e)(1)(A) (i) The area shall be located and arranged to reduce the risk of injury and to enable staff to provide close visual supervision at all times. (ii) Each area shall be well drained and free of known health and environmental hazards. (iii) There shall be no tall weeds or grass, untrimmed shrubbery, or trash in the activity area. (iv) Each outdoor trash and garbage container shall be covered, and the contents shall be removed weekly. KAR 28-4-585(e)(3)Protection from environmental hazards. Each operator shall ensure that each child or youth is protected from environmental hazards as follows: (A) If a small fish pond or decorative pool with water 24 inches deep or less is on the premises, no child shall have unsupervised access to it. (B) Each outdoor activity area shall have a fence, partial fence, or other barrier to reduce the safety risk to children and youth, and to prevent chance access to any adjacent hazard, including the following: (i) A busy street; (ii) railroad tracks; or (iii) a water hazard, including a ditch, irrigation ditch, pond, lake, and any standing water over 24 inches deep. Each public recreation center shall be exempt from paragraph (e)(3) of this regulation. 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: KAR 28-4-437 (b) The boundaries of outdoor play space shall be enclosed with a fence not less than four feet high. (d) The outdoor play space shall be well drained and free of hazards. ii. All CCDF-eligible licensed family child care homes. Provide the standard: KAR 28-4- 115(i) Outdoor play area. The designated area for outdoor play and large motor activities on the premises shall meet all of the following requirements: (1) The outdoor play area shall be fenced if the play area adjoins that of another child care facility, as defined in K.S.A. 65-503, and amendments thereto, or if the area surrounding, or the conditions existing outside, the play area present hazards that could be dangerous to the safety of the children, which may include any of the following: (A) A fish pond or a decorative pool containing water; (B) railroad tracks; or (C) a water hazard, including a ditch, a pond, a lake, and any standing water. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The Lead Agency does not have license exempt CCDF center child care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The Lead Agency does not have license exempt CCDF home care vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Lead Agency does not have license exempt CCDF non-relative in-home child care. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: KAR 28-4-58-(e)(3) (3) Protection from environmental hazards. Each operator shall ensure that each child or youth is protected from environmental hazards as follows: (A) If a small fish pond or decorative pool with water 24 inches deep or less is on the premises, no child shall have unsupervised access to it. (B) Each outdoor activity area shall have a fence, partial fence, or other barrier to reduce the safety risk to children and youth, and to prevent chance access to any adjacent hazard, including the following: (i) A busy street; (ii) railroad tracks; or (iii) a water hazard, including a ditch, irrigation ditch, pond, lake, and any standing water over 24 inches deep. Each public recreation center shall be exempt from paragraph (e)(3) of this regulation. KAR 28-4-586(1)(B) If a lake, pond, river, or other large body of water is located within 100 yards of the premises, each operator shall ensure that the water hazard is physically separated from the activity area to prevent access by each child or youth, or shall submit to the secretary a plan for protecting each child and youth from unsupervised access. The plan, which shall be approved by the secretary before the premises are used for an outdoor summer camp, shall include the following: (i) A description of any natural barriers separating the activity area from the water; (ii) the approximate distance from the activity area to the water; and (iii) a plan for increased supervision. 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: KAR 28-4-437(b) The boundaries of outdoor play space shall be enclosed with a fence not less than four feet high and (d) The outdoor play space shall be well drained and free of hazards. ii. All CCDF-eligible licensed family child care homes. Provide the standard: KAR 28-4- 115(i)(1) The outdoor play area shall be fenced if the play area adjoins that of another child care facility, as defined in K.S.A. 65-503, and amendments thereto, or if the area surrounding, or the conditions existing outside, the play area present hazards that could be dangerous to the safety of the children, which may include any of the following: (A) A fish pond or a decorative pool containing water; (B) railroad tracks; or (C) a water hazard, including a ditch, a pond, a lake, and any standing water. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The Lead Agency does not have license exempt CCDF center child care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The Lead Agency does not have license exempt CCDF home care. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Lead Agency does not have license exempt CCDF non-relative in-home child care. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: KAR 28-4-585(e)(3)(B) B) Each outdoor activity area shall have a fence, partial fence, or other barrier to reduce the safety risk to children and youth, and to prevent chance access to any adjacent hazard, including the following: (i) A busy street; (ii) railroad tracks; or (iii) a water hazard, including a ditch, irrigation ditch, pond, lake, and any standing water over 24 inches deep. Each public recreation center shall be exempt from paragraph (e)(3) of this regulation. 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 Lead Agency received notification of this non-compliance in Cycle 1 monitoring with notification received on December 13, 2021. Additional time is needed to come into compliance. Regulations were implemented for child care centers/preschools on 8/2/2024, however a compliance evidence review is pending with the Office of Child Care, where compliance must be verified. The current regulations in place are as follows: KAR 28-4-126(a)(1) Each individual caring for children shall be free from any physical, mental, or emotional conditions that prevent the individual’s ability to protect the health, safety, and welfare of the children, shall be qualified by temperament and emotional maturity, demonstrate an understanding of children, and shall act with sound judgment. KAR 28-4-126(a)(2) No individual in contact with children shall be in a state of impaired ability due to the use of alcohol, prescription or nonprescription drugs, or other substances. KAR 28-4-132 (b)(1) Behavior management practices shall be consistent with the goals and purposes of the program and appropriate to the age and developmental level of the child. (2) Each individual caring for children shall practice methods of behavior management that are designed to help each child develop inner controls and manage the child's own behavior in a socially acceptable manner. No individual caring for children shall use prohibited methods of punishment.KAR 28-4- 132(c)(1)(A) Corporal punishment, including hitting with the hand or any implement, slapping, swatting, shaking, pulling hair, yanking the arm, excessive exercise, exposure to extreme temperatures, and any other measure that produces physical pain or threatens the child’s health or safety; (B) mental and emotional cruelty, including verbal abuse, threats, derogatory remarks about the child or the child's family, or statements which tend to shame, humiliate, or frighten the child; (C) binding or tying the child to restrict movement; (D) confining the child in a high chair, a play yard, a crib, a closet, a locked room or area, a box, or a similar enclosure; (E) withholding or forcing foods, toilet use, or rest; and (F) placing soap or any other substances that stings, burns, or has a bitter taste in the child's mouth, on the tongue or on or in any other part of the child’s body. (2) Each individual who cares for children shall be prohibited from giving any child any medications, herbal or folk remedies, or drugs to control or manage behavior, unless prescribed by a licensed physician, physician assistant, or advanced practice registered nurse. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The Lead Agency received notification of this non-compliance in Cycle 1 monitoring with notification received on December 13, 2021. Additional time is needed to come into compliance. Regulations were implemented for family child care homes on 8/2/2024, however a compliance evidence review is pending with the Office of Child Care, where compliance must be verified. The current regulations in place are as follows: KAR 28-4-126(a)(2) No individual in contact with children shall be in a state of impaired ability due to the use of alcohol, prescription or nonprescription drugs, or other substances. KAR 28-4-132 (b)(1) Behavior management practices shall be consistent with the goals and purposes of the program and appropriate to the age and developmental level of the child. (2) Each individual caring for children shall practice methods of behavior management that are designed to help each child develop inner controls and manage the child's own behavior in a socially acceptable manner. No individual caring for children shall use prohibited methods of punishment. KAR 28-4-132(c)(1)(A) Corporal punishment, including hitting with the hand or any implement, slapping, swatting, shaking, pulling hair, yanking the arm, excessive exercise, exposure to extreme temperatures, and any other measure that produces physical pain or threatens the child’s health or safety; (B) mental and emotional cruelty, including verbal abuse, threats, derogatory remarks about the child or the child's family, or statements which tend to shame, humiliate, or frighten the child; (C) binding or tying the child to restrict movement; (D) confining the child in a high chair, a play yard, a crib, a closet, a locked room or area, a box, or a similar enclosure; (E) withholding or forcing foods, toilet use, or rest; and (F) placing soap or any other substances that stings, burns, or has a bitter taste in the child's mouth, on the tongue or on or in any other part of the child’s body. (2) Each individual who cares for children shall be prohibited from giving any child any medications, herbal or folk remedies, or drugs to control or manage behavior, unless prescribed by a licensed physician, physician assistant, or advanced practice registered nurse. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The Lead Agency does not have license exempt CCDF center child care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The Lead Agency does not have CCDF license exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Lead Agency does not have license exempt CCDF in-home non-relative child care. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: School age programs serving school age children do not require standards related to shaken baby syndrome. 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 Lead Agency received notification of this non-compliance in Cycle 1 monitoring with notification received on December 13, 2021. Additional time is needed to come into compliance. Regulations were implemented for child care centers/preschools on 8/2/2024, however a compliance evidence review is pending with the Office of Child Care, where compliance must be verified. The current regulations in place are as follows: KAR 28-4-132(b) Behavior management practices. (1) Behavior management practices shall be consistent with the goals and purposes of the program and appropriate to the age and developmental level of the child. (2) Each individual caring for children shall practice methods of behavior management that are designed to help each child develop inner controls and manage the child's own behavior in a socially acceptable manner. No individual caring for children shall use prohibited methods of punishment. (3) Each applicant, each applicant with a temporary permit, and each licensee shall develop and implement a written discipline policy indicating the methods of guidance appropriate for the ages of the children in care. Parents and legal guardians shall be informed of the policy. (c) Prohibited punishment. Punishment that is humiliating, frightening, or physically harmful to any child shall be prohibited. (1) Prohibited methods of punishment. Prohibited methods of punishment shall include the following: (A) Corporal punishment, including hitting with the hand or any implement, slapping, swatting, shaking, pulling hair, yanking the arm, excessive exercise, exposure to extreme temperatures, and any other measure that produces physical pain or threatens the child’s health or safety; (B) mental and emotional cruelty, including verbal abuse, threats, derogatory remarks about the child or the child's family, or statements which tend to shame, humiliate, or frighten the child; (C) binding or tying the child to restrict movement; (D) confining the child in a high chair, a play yard, a crib, a closet, a locked room or area, a box, or a similar enclosure; (E) withholding or forcing foods, toilet use, or rest; and (F) placing soap or any other substances that stings, burns, or has a bitter taste in the child's mouth, on the tongue or on or in any other part of the child’s body..KAR 28-4-428(a) (3) No child shall be left unsupervised. KAR 28-4-430(c)(3) Each staff member shall report within 24 hours to the Kansas department for children and families any suspected child abuse or neglect. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The Lead Agency received notification of this non-compliance in Cycle 1 monitoring with notification received on December 13, 2021. Additional time is needed to come into compliance. Regulations were implemented for family child care homes on 8/2/2024, however a compliance evidence review is pending with the Office of Child Care, where compliance must be verified. The current regulations in place are as follows: KAR 28-4-132(b) Behavior management practices. (1) Behavior management practices shall be consistent with the goals and purposes of the program and appropriate to the age and developmental level of the child. (2) Each individual caring for children shall practice methods of behavior management that are designed to help each child develop inner controls and manage the child's own behavior in a socially acceptable manner. No individual caring for children shall use prohibited methods of punishment. (3) Each applicant, each applicant with a temporary permit, and each licensee shall develop and implement a written discipline policy indicating the methods of guidance appropriate for the ages of the children in care. Parents and legal guardians shall be informed of the policy. (c) Prohibited punishment. Punishment that is humiliating, frightening, or physically harmful to any child shall be prohibited. (1) Prohibited methods of punishment. Prohibited methods of punishment shall include the following: (A) Corporal punishment, including hitting with the hand or any implement, slapping, swatting, shaking, pulling hair, yanking the arm, excessive exercise, exposure to extreme temperatures, and any other measure that produces physical pain or threatens the child’s health or safety; (B) mental and emotional cruelty, including verbal abuse, threats, derogatory remarks about the child or the child's family, or statements which tend to shame, humiliate, or frighten the child; (C) binding or tying the child to restrict movement; (D) confining the child in a high chair, a play yard, a crib, a closet, a locked room or area, a box, or a similar enclosure; (E) withholding or forcing foods, toilet use, or rest; and (F) placing soap or any other substances that stings, burns, or has a bitter taste in the child's mouth, on the tongue or on or in any other part of the child’s body. KAR 28-4-115a(b)(1) (1) Each child in care shall be under the supervision of a provider who is responsible for the child’s health, safety, and well-being. KAR 28-4-118 Each provider shall report to the Kansas department for children and families or to law enforcement any suspected child abuse or neglect within 24 hours. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The Lead Agency does not have license exempt CCDF center child care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The Lead Agency does not have CCDF license exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Lead Agency does not have license exempt CCDF non-relative in-home child care. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: This non-compliance was identified in Cycle 1 monitoring with notification sent to the lead agency on Dec. 13, 2021. Preliminary findings shared with the lead agency on July 22, 2024 also showed this to be an area of non-compliance. Kansas will need additional time to ensure school age regulations are adopted to ensure correct application requirements as the agency responsible for the health and safety oversight is promulgating regulations to ensure compliance. Due to the complexity of the state process, the additional time is warranted. 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 [ ] Training [ ] Practice drills vi. Volunteer emergency preparedness [ ] Training [ ] Practice drills vii. [x] Communication with families viii. [x] Reunification with families ix. [ ] Continuity of operations x. Accommodation of [ ] Infants [ ] Toddlers [ ] Children with disabilities [ ] Children with chronic medical conditions xi. If any of the above are not checked, describe: The Lead Agency received notification of this non-compliance in Cycle 1 monitoring with notification received on December 13, 2021. The areas identified as out of compliance were staff and volunteer training, accommodating children with chronical medical conditions, children with disabilities, accommodating infants and toddlers, and continuity of operations. Additional time is needed to come into compliance. Regulations were implemented for child care centers, preschools and family child care homes on 8/2/2024, however a compliance evidence review is pending with the Office of Child Care, where compliance must be verified. Kansas will need additional time to ensure school age regulations are adopted to ensure correct application requirements as the agency responsible for the health and safety oversight is promulgating regulations to ensure compliance. Due to the complexity of the state process, the additional time is warranted. The current regulations in place are as follows: Evacuation, Relocation, Shelter-in-place: Centers, Preschools, and Licensed Family Child Care Homes: KAR 28-4-128(a)(1) Each applicant, each applicant with a temporary permit, and each licensee shall develop and implement a written emergency plan to provide for the safety of children and staff members in emergencies. The emergency plan shall include the following information: Centers, Preschools, and Licensed Family Child Care Homes: KAR 28-4-128(a)(1)( B) a designated shelter-in-place area, a designated off-premises relocation site, and evacuation routes for each area and for each site; Lock Down: Centers, Preschools, and Licensed Family Child Care Homes: KAR 28-4-128(a)(1)(A) Procedures for emergencies likely to occur on or near the premises, including a fire, a weather-related event, a missing or runaway child, a chemical release, a utility failure, an intruder, an act of terrorism, a lockdown, and an unscheduled closing; Training Licensed Family Child Care Homes: KAR 28-4-114a(b)(3)(G) emergency preparedness and response planning for emergencies resulting from a natural disaster or a human-caused event, including violence at a facility; Centers and Preschools: KAR 28-4-428a(b)(2)(G) emergency preparedness and response planning for emergencies resulting from a natural disaster or a human-caused event, including violence at a facility; Practice drills Staff & Volunteers: Centers, Preschools, and Licensed Family Child Care Homes: KAR 28-4-122(b)(16) ￿Staff member￿ means an employee, a substitute, or a volunteer in a facility, a residential center, or a group boarding home. Centers, Preschools, and Licensed Family Child Care Homes: KAR 28-4-128(a)(6) Each licensee shall ensure that each staff member and child participate in the following drills: (A) A fire drill shall be conducted monthly. A record of the date and time of each fire drill and a record of each evacuation time shall be kept on file on the premises for one year. (B) A tornado drill shall be conducted monthly. A record of the date and time of each tornado drill and a record of each evacuation time shall be kept on file on the premises for one year. Training: Centers, Preschools, and Licensed Family Child Care Homes: KAR 28-4-128(a)(3) Each staff member shall be informed of and shall follow the emergency plan. Centers and Preschools: KAR 28-4-428a(a)(4)(B) the policies and practices of the preschool or child care center, including emergency procedures, behavior management, and discipline; (orientation) Licensed Family Child Care Homes: KAR 28-4-114a(a)(2)(B) (B) the policies and practices of the facility, including emergency procedures, behavior management, and discipline; Communication with families: Centers, Preschools, and Licensed Family Child Care Homes: KAR 28-4-128(a)(1)(E) procedures for notifying each parent or adult responsible for a child of any off-premises relocation; Reunification with families: Centers, Preschools, and Licensed Family Child Care Homes: KAR 28-4-128(a)(1)(F) procedures for reuniting each child with each parent or adult responsible for the child Continuity of operations: Centers, Preschools, and Licensed Family Child Care Homes: KAR 28-4-128(a)(1)(G) procedures for continuity of operations, including backing up or retrieving health and other required records; Accommodations of infants, toddlers, children with disabilities, children with chronic medical conditions: Centers, Preschools, and Licensed Family Child Care Homes: KAR 28-4-128(a)(1)(C) procedures to meet the needs of individual children, including each child with special needs and chronic medical conditions 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: KAR 28-4-423 (e) Storage, handling, and disposal of hazardous items. The following hazardous items shall be safely stored, handled, and disposed: (1) All household supplies, cleaning supplies, dangerous chemicals and all bodily care products bearing warning labels to keep out of reach of children shall be in locked storage, except that hand sanitizers, disinfectant solutions used daily to disinfect surfaces, and diapering supplies may be kept unlocked at least five feet above the floor and out of reach of children. Soap used for hand washing may be kept unlocked and placed on the back of the counter by a bathroom or sink. 61 (2) All medications and products containing alcohol shall be in locked storage. (3) Tobacco products, ashtrays, lighters, and matches shall be kept in locked storage. (4) Chemicals and cleaning supplies shall be used and disposed of in accordance with the product safety label. ii. All CCDF-eligible licensed family child care homes. Provide the standard: KAR 28-4- 115(g) Storage, handling, and disposal of hazardous items. The following hazardous items shall be safely stored, handled, and disposed: (1) All household supplies, cleaning supplies, dangerous chemicals, and all bodily care products containing alcohol or bearing warning labels to keep out of reach of children shall be in locked storage or stored out of reach of children under six years of age. Soap used for hand washing may be kept unlocked and placed on the back of the counter by a sink. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The Lead Agency does not have license exempt CCDF center child care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The Lead Agency does not have CCDF license exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Lead Agency does not have license exempt CCDF non-relative in-home child care. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: KAR 28-4-590(e)(4) Each operator shall keep all medication at the recommended temperature and, except as specified, in locked storage. Each medication container shall have a child- protective cap. KAR 28-4-591(a)(3)(B) Food shall not be stored with poisonous or toxic materials. If cleaning agents cannot be stored in a room separate from food storage areas, the cleaning agents shall be clearly labeled and kept in locked cabinets not used for the storage of food. KAR 28-4-585(a)(6)Each operator shall safely store toxic substances and materials, including cleaning supplies, pesticides, and poisons, in a locked janitor's closet, locked room, or other locked area. No child or youth shall have unsupervised access to toxic substances and materials. 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 Lead Agency received notification of this non-compliance in Cycle 1 monitoring with notification received on December 13, 2021. Additional time is needed to come into compliance. Regulations were implemented for child care centers/preschools on 8/2/2024, however a compliance evidence review is pending with the Office of Child Care, where compliance must be verified. The current regulations in place are as follows: KAR 28-4-128(b) Each applicant, applicant with a temporary permit, and each licensee shall ensure that each staff member complies with the following standard precautions when handling blood and other bodily fluids or waste: Each staff member shall avoid coming into direct contact with blood and other bodily fluids or waste. Each staff member shall wear single-use gloves in the following situations: When cleaning contaminated surfaces or areas; before dressing a cut or sore that is leaking body fluids; and when cleaning up each spill, including urine, feces, blood, saliva, vomit, and tissue discharge. Each contaminated surface or area on which a spill occurs shall be cleaned by removing any visible spill from the surface or area with a water-saturated disposable paper towel or wipe. After the surface or area has been cleaned, the surface or area shall be sanitized by wetting the entire surface or area with a disinfectant solution of chlorine bleach mixed according to the directions on the label, or an appropriate commercial disinfectant used according to the directions on the label. Each mop used to clean up a contaminated area shall be cleaned and rinsed in a disinfecting solution, wrung as dry as possible, and hung to dry. Each paper towel, sponge, or other material used for cleaning up a contaminated area shall be placed in a plastic bag with a secure tie and thrown away in a covered container. KAR 28-4-132(g) Diapering practices must be adhered to which includes a table that has moisture-proof, nonabsorbent, smooth surface that is undamaged, does not trap soil, and is easily cleaned. Each diaper-changing surface shall be cleaned and disinfected after each use. The surface shall be cleaned by removing any visible soil from the surface with a water saturated disposable paper towel or wipe. After the surface has been cleaned, the surface shall be disinfected. Each facility shall have a covered, hands-free trash container located within reach of the changing surface. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The Lead Agency received notification of this non-compliance in Cycle 1 monitoring with notification received on December 13, 2021. Additional time is needed to come into compliance. Regulations were implemented for family child care homes on 8/2/2024, however a compliance evidence review is pending with the Office of Child Care, where compliance must be verified. The current regulations in place are as follows: KAR 28-4-128(b) Each applicant, applicant with a temporary permit, and each licensee shall ensure that each staff member complies with the following standard precautions when handling blood and other bodily fluids or waste: Each staff member shall avoid coming into direct contact with blood and other bodily fluids or waste. Each staff member shall wear single-use gloves in the following situations: When cleaning contaminated surfaces or areas; before dressing a cut or sore that is leaking body fluids; and when cleaning up each spill, including urine, feces, blood, saliva, vomit, and tissue discharge. Each contaminated surface or area on which a spill occurs shall be cleaned by removing any visible spill from the surface or area with a water-saturated disposable paper towel or wipe. After the surface or area has been cleaned, the surface or area shall be sanitized by wetting the entire surface or area with a disinfectant solution of chlorine bleach mixed according to the directions on the label, or an appropriate commercial disinfectant used according to the directions on the label. Each mop used to clean up a contaminated area shall be cleaned and rinsed in a disinfecting solution, wrung as dry as possible, and hung to dry. Each paper towel, sponge, or other material used for cleaning up a contaminated area shall be placed in a plastic bag with a secure tie and thrown away in a covered container. KAR 28-4-132(g) Diapering practices must be adhered to which includes a table that has moisture-proof, nonabsorbent, smooth surface that is undamaged, does not trap soil, and is easily cleaned. Each diaper-changing surface shall be cleaned and disinfected after each use. The surface shall be cleaned by removing any visible soil from the surface with a water saturated disposable paper towel or wipe. After the surface has been cleaned, the surface shall be disinfected. Each facility shall have a covered, hands-free trash container located within reach of the changing surface. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The Lead Agency does not have license exempt CCDF center child care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The Lead Agency does not have CCDF license exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Lead Agency does not have license exempt CCDF non-relative in-home child care. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: This non-compliance was identified in Cycle 1 monitoring with notification sent to the lead agency on Dec. 13, 2021. Preliminary findings shared with the lead agency on July 22, 2024 also showed this to be an area of non-compliance. Kansas will need additional time to ensure school age regulations are adopted to ensure correct application requirements as the agency responsible for the health and safety oversight is promulgating regulations to ensure compliance. Due to the complexity of the state process, the additional time is warranted. KAR 28-4-592(d) Each operator shall ensure that each staff member complies with the following standard precautions when handling blood and other bodily fluids or waste: Each staff member shall avoid coming into direct contact with blood and other bodily fluids or waste. Each staff member shall wear single-use gloves in the following situations: When cleaning contaminated surfaces or areas; before dressing a cut or sore that is leaking body fluids; and when cleaning up each spill, including urine, feces, blood, saliva, vomit, and tissue discharge. Each contaminated surface or area on which a spill occurs shall be cleaned by removing any visible spill from the surface or area with a water-saturated disposable paper towel or wipe. After the surface or area has been cleaned, the surface or area shall be sanitized by wetting the entire surface or area with a disinfectant solution of chlorine bleach mixed according to the directions on the label, or an appropriate commercial disinfectant used according to the directions on the label. Each mop used to clean up a contaminated area shall be cleaned and rinsed in a disinfecting solution, wrung as dry as possible, and hung to dry. Each paper towel, sponge, or other material used for cleaning up a contaminated area shall be placed in a plastic bag with a secure tie and thrown away in a covered container. 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: K.A.R. 28-4-130. Transportation. Each applicant with a temporary permit and each licensee shall ensure that the requirements of this regulation are met when the facility, residential center, or group boarding home arranges for or provides transportation for children in care. (a) Each driver shall be at least 18 years of age. (b) Each driver shall hold a valid driver’s license that meets the requirements of the Kansas motor vehicle drivers’ license act, K.S.A. 8-234a et seq. and amendments thereto. (c) Each driver shall be informed of the requirements of this regulation. (d) Each transporting vehicle shall be maintained in safe operating condition. (e) Each transporting vehicle owned or leased by the facility, residential center, or group boarding home shall have an annual mechanical safety check. The safety check shall be documented on a form provided by the department. A record of the date of the safety check and corrections made shall be kept on file at the facility, residential center, or group boarding home. (f) Trailers, camper shells, or truck beds shall not be used for transportation of children. (g) Fifteen- passenger vans shall not be used to transport children. Any 15-passenger van purchased or leased before December 31, 2023, shall be exempt from this requirement. (h) Each vehicle shall be covered by accident and liability insurance in an amount of not less than $100,000 for personal injury or death in any one accident, $300,000 for injury or death to two or more persons in any one accident; and $50,000 for loss to property of others. (i) Emergency release forms and health assessment records shall be in the vehicle when children enrolled in residential centers or group boarding homes are transported more than 60 miles from the residential center or group boarding home, or if children are in emergency medical care. (j) Each transporting vehicle owned or leased by the facility, residential center, or group boarding home shall have a first-aid kit that meets the requirements in K.A.R. 28-4-128. (k) The following requirements regarding the use of seat belts and child safety seats shall apply: (1) Each individual shall be secured by the use of a seat belt or a child safety seat when the vehicle is in motion. (2) No more than one individual shall be secured in any seat belt or child safety seat. (3) Each seat belt shall be properly anchored to the vehicle. (4) When a child safety seat, including a booster seat, is required, the seat shall meet the following requirements: (A) Has current federal approval; (B) has a label with the date of manufacture, date of expiration, and model number; (C) according to the label, is not past the expiration date; (D) has not been recalled; (E) has no missing parts or cracks in the frame; (F) has not been in a crash; (G) is installed according to the manufacturer’s instructions and vehicle owner’s manual; (H) is appropriate to the height, weight, and physical condition of the child, according to the manufacturer’s instructions and state statutes and regulations; and (I) is properly maintained. (5) The manufacturer’s instructions for use shall be kept on file at the facility, residential center, or group boarding home. (l) For each child younger than five years of age after August 31 of the current school year, each facility, residential center, or group boarding home shall utilize an age and size appropriate child safety restraining system when transporting a child in a school bus or a bus operated by a common carrier. (m) The safety of each child riding in each vehicle shall be protected as follows: (1) All doors shall be locked while the vehicle is in motion. (2) Discipline shall be maintained at all times. (3) All parts of each child’s body shall remain inside the vehicle at all times. (4) No child shall either enter or exit the vehicle into a lane of traffic. (5) No child shall be left in a vehicle unattended by an adult. (6) When the vehicle is vacated, the driver shall make certain no child is left in the vehicle. (7) Tobacco product use in the vehicle shall be prohibited while children are being transported. (8) No cell phone or other electronic device shall be used by the driver when the vehicle is in motion. If a cell phone or electronic device is used for navigation, it shall be in hands-free mode only. (9) Each facility shall maintain applicable staff-child ratios in the vehicle when children are being transported. (10) Residential centers and group boarding homes shall maintain applicable staff child ratios when children under six are being transported. (n) A copy of the requirements in subsection (m) shall be posted in each vehicle or given to each driver. (o) Each child shall be transported directly to the location designated by the applicant with a temporary permit or the licensee. No unauthorized stops shall be made along the way, except in an emergency. ii. All CCDF-eligible licensed family child care homes. Provide the standard: K.A.R. 28- 4-130. Transportation. Each applicant with a temporary permit and each licensee shall ensure that the requirements of this regulation are met when the facility, residential center, or group boarding home arranges for or provides transportation for children in care. (a) Each driver shall be at least 18 years of age. (b) Each driver shall hold a valid driver’s license that meets the requirements of the Kansas motor vehicle drivers’ license act, K.S.A. 8-234a et seq. and amendments thereto. (c) Each driver shall be informed of the requirements of this regulation. (d) Each transporting vehicle shall be maintained in safe operating condition. (e) Each transporting vehicle owned or leased by the facility, residential center, or group boarding home shall have an annual mechanical safety check. The safety check shall be documented on a form provided by the department. A record of the date of the safety check and corrections made shall be kept on file at the facility, residential center, or group boarding home. (f) Trailers, camper shells, or truck beds shall not be used for transportation of children. (g) Fifteen- passenger vans shall not be used to transport children. Any 15-passenger van purchased or leased before December 31, 2023, shall be exempt from this requirement. (h) Each vehicle shall be covered by accident and liability insurance in an amount of not less than $100,000 for personal injury or death in any one accident, $300,000 for injury or death to two or more persons in any one accident; and $50,000 for loss to property of others. (i) Emergency release forms and health assessment records shall be in the vehicle when children enrolled in residential centers or group boarding homes are transported more than 60 miles from the residential center or group boarding home, or if children are in emergency medical care. (j) Each transporting vehicle owned or leased by the facility, residential center, or group boarding home shall have a first-aid kit that meets the requirements in K.A.R. 28-4-128. (k) The following requirements regarding the use of seat belts and child safety seats shall apply: (1) Each individual shall be secured by the use of a seat belt or a child safety seat when the vehicle is in motion. (2) No more than one individual shall be secured in any seat belt or child safety seat. (3) Each seat belt shall be properly anchored to the vehicle. (4) When a child safety seat, including a booster seat, is required, the seat shall meet the following requirements: (A) Has current federal approval; (B) has a label with the date of manufacture, date of expiration, and model number; (C) according to the label, is not past the expiration date; (D) has not been recalled; (E) has no missing parts or cracks in the frame; (F) has not been in a crash; (G) is installed according to the manufacturer’s instructions and vehicle owner’s manual; (H) is appropriate to the height, weight, and physical condition of the child, according to the manufacturer’s instructions and state statutes and regulations; and (I) is properly maintained. (5) The manufacturer’s instructions for use shall be kept on file at the facility, residential center, or group boarding home. (l) For each child younger than five years of age after August 31 of the current school year, each facility, residential center, or group boarding home shall utilize an age and size appropriate child safety restraining system when transporting a child in a school bus or a bus operated by a common carrier. (m) The safety of each child riding in each vehicle shall be protected as follows: (1) All doors shall be locked while the vehicle is in motion. (2) Discipline shall be maintained at all times. (3) All parts of each child’s body shall remain inside the vehicle at all times. (4) No child shall either enter or exit the vehicle into a lane of traffic. (5) No child shall be left in a vehicle unattended by an adult. (6) When the vehicle is vacated, the driver shall make certain no child is left in the vehicle. (7) Tobacco product use in the vehicle shall be prohibited while children are being transported. (8) No cell phone or other electronic device shall be used by the driver when the vehicle is in motion. If a cell phone or electronic device is used for navigation, it shall be in hands-free mode only. (9) Each facility shall maintain applicable staff-child ratios in the vehicle when children are being transported. (10) Residential centers and group boarding homes shall maintain applicable staff child ratios when children under six are being transported. (n) A copy of the requirements in subsection (m) shall be posted in each vehicle or given to each driver. (o) Each child shall be transported directly to the location designated by the applicant with a temporary permit or the licensee. No unauthorized stops shall be made along the way, except in an emergency. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The Lead Agency does not have license exempt CCDF center child care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The Lead Agency does not have CCDF license exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Lead Agency does not have license exempt CCDF non-relative in-home child care. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: K.A.R. 28-4-593. Program-sponsored transportation. (a) If the operator provides or arranges for transportation for children and youth to and from the premises or for program-sponsored activities, the operator shall ensure that prior written permission is obtained for each child or youth to be transported as specified in K.A.R. 28-4-582. The operator shall ensure that the authorization for emergency medical care for each child or youth is in the vehicle in which the children or youth are being transported or is immediately available to emergency personnel. If the operator is unable to obtain written permission or authorization for emergency medical care, the operator shall follow the plan approved by the secretary as specified in K.A.R. 28-4-582. (b) Transportation safety. (1) Each operator shall ensure that the following transportation safety requirements are met while transporting children or youth: (A) No child or youth under 13 years of age shall be seated in the front seat of a vehicle that is equipped with a passenger air bag. (B) No child or youth shall be transported in a trailer pulled by another vehicle, a camper shell, or a truck bed. (C) Each vehicle that is owned or leased by the operator and is used to transport children or youth shall be maintained in safe operating condition and shall contain a first-aid kit. (2) Each driver shall comply with the following safety requirements: (A) Be 18 years of age or older, hold an operator's license of the type appropriate for the vehicle being used, and observe all traffic laws; (B) not allow the capacity of the transporting vehicle to be exceeded; (C) remove accumulated trash from the transporting vehicle daily; (D) lock or have under control each vehicle door while the vehicle is in motion; (E) maintain order in the vehicle and ensure that all parts of each passenger's body remain inside the vehicle at all times; (F) not permit any child or youth to enter the vehicle from or exit the vehicle into a traffic lane; (G) leave no child or youth unattended in the vehicle at any time and, when the vehicle is vacated, ensure that no child or youth is left in the vehicle; (H) prohibit smoking in the vehicle while children or youth are in the vehicle; (I) not use a cellular phone while the vehicle is in motion; and (J) transport each child or youth directly to the location designated by the operator and make no unauthorized stops along the way except in an emergency. (c) Vehicle seat belt restraints. (1) Except as specified in paragraph (d)(2), each operator shall ensure that each driver and each child or youth uses an individual seat belt restraint and that no more than one child or youth is restrained in each seat belt. (2) If buses of the type used by schools are used to transport children and youth and are not equipped with individual restraints, no operator shall be required to install individual restraints. 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: KAR 28-4-428a(c) Pediatric first aid and cardiopulmonary resuscitation (CPR) certifications. (1) Each staff member counted in the staff-child ratio, each volunteer counted in the staff- child ratio, and each program director shall obtain certification in pediatric first aid and in pediatric CPR as specified in this subsection either before the date of employment or volunteering or not later than 30 calendar days after the date of employment or volunteering. (2) First aid and CPR training and certification shall include a practical application component and be demonstrated in front of an instructor certified by a nationally recognized certification program. (3) Each individual who is required to obtain the certifications shall maintain current certifications. (4) Each licensee shall ensure that, for each unit in a preschool or child care center, at least one staff member or volunteer counted in the staff-child ratio who has current certification in pediatric first aid and current certification in pediatric CPR is present at all times. ii. All CCDF-eligible licensed family child care homes. Provide the standard: KAR 28-4- 114a (c) Pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) certifications. Each applicant, each applicant with a temporary permit, each licensee, and each provider shall obtain certification in pediatric first aid and pediatric CPR as specified in this subsection. (1) Certifications shall include a practical application component and be demonstrated in front of an instructor certified by a nationally recognized first aid and CPR training organization. (2) Each applicant and each applicant with a temporary permit shall obtain the certifications not later than 30 calendar days after submitting an application for a license. (3) Each provider shall obtain the certifications before the date of employment or not later than 30 calendar days after the date of employment. (4) Each individual required to obtain the certifications shall maintain current certifications. (5) Each applicant with a temporary permit and each licensee shall ensure that at least one provider who has current certification in pediatric first aid and current certification in pediatric CPR is present at all times. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The Lead Agency does not have license exempt CCDF center child care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The Lead Agency does not have CCDF license exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Lead Agency does not have license exempt CCDF non-relative in-home child care. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: This non-compliance was identified in Cycle 1 monitoring with notification sent to the lead agency on Dec. 13, 2021. Preliminary findings shared with the lead agency on July 22, 2024 also showed this to be an area of non-compliance. Kansas will need additional time to ensure school age regulations are adopted to ensure correct application requirements as the agency responsible for the health and safety oversight is promulgating regulations to ensure compliance. Due to the complexity of the state process, the additional time is warranted. KAR 28-4-590 (c) First aid and cardiopulmonary resuscitation (CPR). (1) Each operator shall ensure that there is at least one staff member on the premises who is readily available to each child or youth at all times and who has a current certification in first aid and a current certification in CPR appropriate to the age of children and youth attending the program. 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: KAR 28-4-428a (c) Pediatric first aid and cardiopulmonary resuscitation (CPR) certifications. (1) Each staff member counted in the staff-child ratio, each volunteer counted in the staff- child ratio, and each program director shall obtain certification in pediatric first aid and in pediatric CPR as specified in this subsection either before the date of employment or volunteering or not later than 30 calendar days after the date of employment or volunteering. (2) First aid and CPR training and certification shall include a practical application component and be demonstrated in front of an instructor certified by a nationally recognized certification program. (3) Each individual who is required to obtain the certifications shall maintain current certifications. (4) Each licensee shall ensure that, for each unit in a preschool or child care center, at least one staff member or volunteer counted in the staff-child ratio who has current certification in pediatric first aid and current certification in pediatric CPR is present at all times. ii. All CCDF-eligible licensed family child care homes. Provide the standard: KAR 28-4- 114a(c) Pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) certifications. Each applicant, each applicant with a temporary permit, each licensee, and each provider shall obtain certification in pediatric first aid and pediatric CPR as specified in this subsection. (1) Certifications shall include a practical application component and be demonstrated in front of an instructor certified by a nationally recognized first aid and CPR training organization. (2) Each applicant and each applicant with a temporary permit shall obtain the certifications not later than 30 calendar days after submitting an application for a license. (3) Each provider shall obtain the certifications before the date of employment or not later than 30 calendar days after the date of employment. (4) Each individual required to obtain the certifications shall maintain current certifications. (5) Each applicant with a temporary permit and each licensee shall ensure that at least one provider who has current certification in pediatric first aid and current certification in pediatric CPR is present at all times. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The Lead Agency does not have license exempt CCDF center child care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The Lead Agency does not have CCDF license exempt family child care homes. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Lead Agency does not have license exempt CCDF non-relative in-home child care. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: KAR 28-4-592(c) First aid and cardiopulmonary resuscitation (CPR). (1) Each operator shall ensure that there is at least one staff member on the premises who is readily available to each child or youth at all times and who has a current certification in first aid and a current certification in CPR appropriate to the age of children and youth attending the program. This non-compliance was identified in Cycle 1 monitoring with notification sent to the lead agency on Dec. 13, 2021. Preliminary findings shared with the lead agency on July 22, 2024 also showed this to be an area of non- compliance, and more time will be needed to come into compliance. The Kansas Department of Health and Environment is engaged in a regulation promulgation process to update and bring into compliance state regulations for school age programs. A drafted set of regulations is beginning to move through the state required process. 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: KAR 28-4-430(c)(3) Each staff member shall report within 24 hours to the Kansas department for children and families any suspected child abuse or neglect. ii. All CCDF-eligible licensed family child care homes. Provide the standard: KAR 28-4- 118. Reporting suspected child abuse or neglect. Each provider shall report to the Kansas department for children and families or to law enforcement any suspected child abuse or neglect within 24 hours. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The Lead Agency does not have license exempt CCDF center child care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The Lead Agency does not have CCDF license exempt family child care homes vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Lead Agency does not have license exempt CCDF non-relative in-home child care. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: KAR 28-4-592(h) Reporting suspected child abuse or neglect. Each operator and each staff member shall report to the Kansas department for children and families or to law enforcement any suspected child abuse or child neglect within 24 hours. 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: KAR 28-4-430(c)(3) Each staff member shall report within 24 hours to the Kansas department for children and families any suspected child abuse or neglect. ii. All CCDF-eligible licensed family child care homes. Provide the standard: KAR 28-4- 118. Reporting suspected child abuse or neglect. Each provider shall report to the Kansas department for children and families or to law enforcement any suspected child abuse or neglect within 24 hours. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: The Lead Agency does not have license exempt CCDF center child care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: The Lead Agency does not have CCDF license exempt family child care homes vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Lead Agency does not have license exempt CCDF non-relative in-home child care. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: KAR 28-4-592(h) Reporting suspected child abuse or neglect. Each operator and each staff member shall report to the Kansas department for children and families or to law enforcement any suspected child abuse or child neglect within 24 hours. 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: NA ii. Access to physical activity. Describe: NA iii. Caring for children with special needs. Describe: Programs (child care centers or preschools) serving children with special health care needs and disabilities shall do the following: Each applicant with a temporary permit and each licensee shall maintain on file a copy of the most recent individual family service plan or individual education plan for each child with special health care needs and disabilities enrolled. The plan shall be reviewed by staff in the unit and in consultation with the child’s parent or legal guardian upon enrollment and at least annually. Each unit enrolling children with impaired mobility shall have 50 square feet of space for each child with impaired mobility. When children with impaired mobility are enrolled, toilets and sinks used for hand washing shall be designed to accommodate them. Each child with special health care needs or disabilities shall be allowed to utilize adaptive equipment as necessary. Each applicant with a temporary permit and each licensee enrolling children with special health care needs and disabilities shall determine, by an individual assessment of each child’s needs, whether a lower staff-child ratio is required. The staff-child ratio shall allow the needs of all children enrolled to be met. iv. Any other areas determined necessary to promote child development or to protect children’s health and safety. Describe: NA