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: Standards of Practice: If a child shows signs of a contagious illness that could be communicable, he or she shall be removed from care and placed in an isolated area until the family is able to pick up the child from the facility. The child shall remain outside of the facility until he or she is symptom-free for 24-hours. 922 KAR 2:120 Child-care health and safety standards Section 3 General Requirements Subsection 6: (6) A staff person suspected of being infected with a communicable disease shall: (a) Not perform duties that could allow for the transmission of the disease until the infectious condition can no longer be transmitted; and (b) Provide a statement of fitness to return to work from a health professional, if requested. Section 3 General Requirements Subsection 4 a-c; Subsection 5 a-d; (4) A child shall: (a) Be helped with personal care and cleanliness based upon his or her developmental skills; (b) Except as established in paragraph (c) of this subsection, wash his or her hands with liquid soap and warm running water: 1. a. Upon arrival at the center; or b. Within thirty (30) minutes of arrival for school-age children; 2. Before and after eating or handling food; 3. After toileting or diaper change; 4. After handling animals; 5. After touching an item or an area of the body soiled with body fluids or wastes; and 6. After outdoor or indoor play time; and (c) Use hand sanitizer or hand-sanitizing wipes if liquid soap and warm running water are not available in accordance with paragraph (b) of this subsection. The child shall wash the child's hands as soon as practicable once liquid soap and warm running water are available. (5) Staff shall: (a) Maintain personal cleanliness; (b) Conform to hygienic practices while on duty; (c) Except as established in paragraph (d) of this subsection, wash their hands with liquid soap and running water: 1. Upon arrival at the center; 2. After toileting or assisting a child in toileting; 3. Before and after diapering each child; 4. After wiping or blowing a child's or own nose; 5. After handling animals; 6. After caring for a sick child; 7. Before and after feeding a child or eating; 8. Before dispensing medication; 9. After smoking or vaping; and 10. If possible, before administering first aid; and (d) Use hand sanitizer or hand-sanitizing wipes if liquid soap and warm running water are not available in accordance with paragraph (c) of this subsection. The staff shall wash the staff's hands as soon as practicable once liquid soap and warm running water are available. Section 12 Toilet, Diapering and Toiletry Requirements. Subsections 1-13: (1) A child-care center shall have a minimum of one (1) toilet and one (1) lavatory for each twenty (20) children. Urinals may be substituted for up to one-half (1/2) of the number of toilets required for a male toilet room. (2) A toilet room shall: (a) 1. Be provided for each gender; or 2. A plan shall be implemented to use the same toilet room at separate times; (b) Have a supply of toilet paper; and (c) Be cleaned and disinfected daily. (3) A sink shall be: (a) Located in or immediately adjacent to toilet rooms; (b) Equipped with hot and cold running water that allows for hand washing; (c) Equipped with hot water at a minimum temperature of ninety (90) degrees Fahrenheit and a maximum of 120 degrees Fahrenheit; (d) Equipped with liquid soap; (e) Equipped with hand-drying blower or single use disposable hand drying material; (f) Equipped with an easily cleanable waste receptacle; and (g) Immediately adjacent to a changing area used for infants and toddlers. (4) Each toilet shall: (a) Be kept in clean condition; (b) Be kept in good repair; (c) Be in a lighted room; and (d) Have ventilation to outside air. (5) Toilet training shall be coordinated with the child's parent. (6) An adequate quantity of freshly laundered or disposable diapers and clean clothing shall be available. (7) If a toilet training chair is used, the chair shall be: (a) Used over a surface that is impervious to moisture; (b) Out of reach of other toilets or toilet training chairs; (c) Emptied promptly; and (d) Disinfected after each use. (8) Diapers or clothing shall be: (a) Changed when soiled or wet; (b) Stored in a covered container temporarily; and (c) Washed or disposed of at least once a day. (9) The proper methods of diapering and hand-washing shall be posted at each diaper changing area. (10) When a child is diapered, the child shall: (a) Not be left unattended; and (b) Be placed on a surface that is: 1. Clean; 2. Padded; 3. Free of holes, rips, tears, or other damage; 4. Nonabsorbent; 5. Easily cleaned; and 6. Free of any items not used for diaper changing. (11) Unless the child is allergic, individual disposable washcloths shall be used to thoroughly clean the affected area of the child. (12) Staff shall disinfect the diapering surface after each child is diapered. (13) If staff wears disposable gloves, the gloves shall be changed and disposed after each child is diapered. Section 7 First Aid and Medicine. Subsection 8: (8) Each center shall ensure that every staff member has received training on first aid and cardiopulmonary resuscitation (CPR). To meet this requirement, DCC has implemented a free course on ECE-TRIS for all child care providers. This course covers communicable diseases and prevention strategies in Module 5. In addition to regulation requirements, providers will find more resources in the Tips and Tools section of the Child Care Aware of Kentucky website. www.childcareawareky.org/tipsand-tools/ Resources include but not limited to: Diapering Steps Posters, Handwashing Posters, Sanitizing and Disinfecting Directions, etc. All new staff are required to take Orientation, which includes a section on Health and Safety standards with resources, activities and knowledge checks. Orientation also meets the first aid and CPR training requirement, but does not result in a certification. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 922 KAR 2:120 Child-care health and safety standards Section 3 General Requirements Subsection 6: (6) A staff person suspected of being infected with a communicable disease shall: (a) Not perform duties that could allow for the transmission of the disease until the infectious condition can no longer be transmitted; and (b) Provide a statement of fitness to return to work from a health professional, if requested. 922 KAR 2:100 Section 13 Care Requirements for a Provider Subsection 1-5 (1) A provider shall ensure the health, safety, and comfort of each child. (2) (a) Care for a child with a special need shall be consistent with the nature of the need as documented by the child's health professional. (b) A child may include a person eighteen (18) years of age if the person has a special need for which child care is required. (3) Television or video viewing by a child shall be limited to: (a) Two (2) hours daily; (b) The planned program activities; and (c) Developmentally appropriate child-related content, as designated by standardized content guidelines. (4) A child shall: (a) Wash hands with liquid soap and warm running water: 1. Before and after eating or handling food; 2. After toileting or diaper change; 3. After handling animals; 4. After touching an item or an area of the body soiled with body fluids or waste; and 5. After outdoor and indoor play time; or (b) Use hand sanitizer or hand-sanitizing wipes if liquid soap and warm running water are not available in accordance with paragraph (a) of this subsection. The child shall wash the child's hands as soon as practicable once liquid soap and warm running water are available. (5) A provider and an assistant shall: (a) Wash hands with liquid soap and warm running water: 1. Before and after diapering a child; 2. Before and after feeding a child; 3. After toileting or assisting a child with toileting; 4. After handling animals; 5. Before dispensing medication; 6. After caring for a sick child; 7. After wiping or blowing a child's or own nose; and 8. After smoking or vaping; or (b) Use hand sanitizer or hand-sanitizing wipes if liquid soap and warm running water are not available in accordance with paragraph (a) of this subsection. The provider or assistant shall wash his or her hands as soon as practicable once liquid soap and warm running water are available. 922 KAR 2:100 Section 13 Care Requirements for a Provider Subsection 6 (6) A provider shall ensure that a child does not share: (a) Cups; (b) Eating utensils; (c) Wash cloths; (d) Towels; and (e) Toiletry items. 922 KAR 2:100 Section 13 Care Requirements for a Provider Subsection 18 (18) Waste and biological contaminants, such as bodily fluids, blood, or excretions, shall be: (a) Disposed of in a manner that prevents exposure to children; (b) Inaccessible to children; and (c) In a covered plastic-lined receptacle with a close-fitting lid. 922 KAR 2:100 Section 14. Toilet and Diapering Requirements. Subsection 1-12 (1) A toilet room shall: (a) Have an adequate supply of toilet paper; and (b) Be cleaned and disinfected daily. (2) A sink shall be: (a) Located near or in close proximity to toilets; (b) Equipped with hot and cold running water that allows for hand washing; (c) Equipped with hot water at a minimum temperature of ninety (90) degrees Fahrenheit and a maximum of 120 degrees Fahrenheit; (d) Equipped with liquid soap and single use, disposable hand drying material; (e) Equipped with an easily cleanable, covered waste receptacle; and (f) Near or in close proximity to a changing area used for infants and toddlers. (3) Each toilet shall: (a) Be kept in clean condition; (b) Be kept in good repair; (c) Be in a lighted room; and (d) Have ventilation. (4) Toilet training shall be coordinated with the child's parent. (5) An adequate quantity of freshly laundered or disposable diapers and clean clothing shall be available. (6) If a toilet training chair is used, the chair shall be: (a) Emptied promptly; and (b) Disinfected after each use. (7) Diapers or clothing shall be: (a) Changed when soiled or wet; (b) Stored in a covered leak proof container temporarily; and (c) Washed or disposed of at least once a day. (8) The proper methods of diapering and hand-washing shall be available at each diaper changing area. (9) If a child is being diapered, the child shall: (a) Not be left unattended; and (b) Be placed on a surface that is: 1. Clean; 2. Padded; 3. Free of holes, rips, tears, or other damage; 4. Nonabsorbent; 5. Easily cleaned; and 6. Free of items not used for diaper changing. (10) Unless another cleaning method is authorized by the child's parent or prescribed by a physician, individual disposable washcloths shall be used to thoroughly clean the affected area of a child. (11) A provider or an assistant shall disinfect the diapering surface after each child is diapered. (12) If a provider or an assistant wear disposable gloves, the gloves shall be changed and disposed of after each child is diapered. 922 KAR 2:100 Section 16 Medication and First Aid Subsection 7-8 (7) A quiet, separate area that is easily supervised shall be provided for a child too sick to remain with other children. (8) A provider and an assistant shall: (a) Be able to recognize symptoms of childhood illnesses; (b) Be able to provide basic first aid; and (c) Maintain a child care program that assures affirmative steps are taken to protect children from abuse or neglect pursuant to KRS 600.020(1). iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A - There are no CCDF-eligible license-exempt center based programs. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Registered Relative child care Providers do not have regulatory requirements for addressing the prevention and control of infectious disease. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Registered Relative child care Providers do not have regulatory requirements for addressing the prevention and control of infectious disease. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Standards of Practice: If a child shows signs of a contagious illness that could be communicable, he or she shall be removed from care and placed in an isolated area until the family is able to pick up the child from the facility. The child shall remain outside of the facility until he or she is symptom-free for 24-hours. 922 KAR 2:120 Child-care health and safety standards Section 3 General Requirements Subsection 6: (6) A staff person suspected of being infected with a communicable disease shall: (a) Not perform duties that could allow for the transmission of the disease until the infectious condition can no longer be transmitted; and (b) Provide a statement of fitness to return to work from a health professional, if requested. Section 3 General Requirements Subsection 4 a-c; Subsection 5 a-d; (4) A child shall: (a) Be helped with personal care and cleanliness based upon his or her developmental skills; (b) Except as established in paragraph (c) of this subsection, wash his or her hands with liquid soap and warm running water: 1. a. Upon arrival at the center; or b. Within thirty (30) minutes of arrival for school-age children; 2. Before and after eating or handling food; 3. After toileting or diaper change; 4. After handling animals; 5. After touching an item or an area of the body soiled with body fluids or wastes; and 6. After outdoor or indoor play time; and (c) Use hand sanitizer or hand-sanitizing wipes if liquid soap and warm running water are not available in accordance with paragraph (b) of this subsection. The child shall wash the child's hands as soon as practicable once liquid soap and warm running water are available. (5) Staff shall: (a) Maintain personal cleanliness; (b) Conform to hygienic practices while on duty; (c) Except as established in paragraph (d) of this subsection, wash their hands with liquid soap and running water: 1. Upon arrival at the center; 2. After toileting or assisting a child in toileting; 3. Before and after diapering each child; 4. After wiping or blowing a child's or own nose; 5. After handling animals; 6. After caring for a sick child; 7. Before and after feeding a child or eating; 8. Before dispensing medication; 9. After smoking or vaping; and 10. If possible, before administering first aid; and (d) Use hand sanitizer or hand-sanitizing wipes if liquid soap and warm running water are not available in accordance with paragraph (c) of this subsection. The staff shall wash the staff's hands as soon as practicable once liquid soap and warm running water are available. Section 12 Toilet, Diapering and Toiletry Requirements. Subsections 1-13: (1) A child-care center shall have a minimum of one (1) toilet and one (1) lavatory for each twenty (20) children. Urinals may be substituted for up to one-half (1/2) of the number of toilets required for a male toilet room. (2) A toilet room shall: (a) 1. Be provided for each gender; or 2. A plan shall be implemented to use the same toilet room at separate times; (b) Have a supply of toilet paper; and (c) Be cleaned and disinfected daily. (3) A sink shall be: (a) Located in or immediately adjacent to toilet rooms; (b) Equipped with hot and cold running water that allows for hand washing; (c) Equipped with hot water at a minimum temperature of ninety (90) degrees Fahrenheit and a maximum of 120 degrees Fahrenheit; (d) Equipped with liquid soap; (e) Equipped with hand-drying blower or single use disposable hand drying material; (f) Equipped with an easily cleanable waste receptacle; and (g) Immediately adjacent to a changing area used for infants and toddlers. (4) Each toilet shall: (a) Be kept in clean condition; (b) Be kept in good repair; (c) Be in a lighted room; and (d) Have ventilation to outside air. (5) Toilet training shall be coordinated with the child's parent. (6) An adequate quantity of freshly laundered or disposable diapers and clean clothing shall be available. (7) If a toilet training chair is used, the chair shall be: (a) Used over a surface that is impervious to moisture; (b) Out of reach of other toilets or toilet training chairs; (c) Emptied promptly; and (d) Disinfected after each use. (8) Diapers or clothing shall be: (a) Changed when soiled or wet; (b) Stored in a covered container temporarily; and (c) Washed or disposed of at least once a day. (9) The proper methods of diapering and hand-washing shall be posted at each diaper changing area. (10) When a child is diapered, the child shall: (a) Not be left unattended; and (b) Be placed on a surface that is: 1. Clean; 2. Padded; 3. Free of holes, rips, tears, or other damage; 4. Nonabsorbent; 5. Easily cleaned; and 6. Free of any items not used for diaper changing. (11) Unless the child is allergic, individual disposable washcloths shall be used to thoroughly clean the affected area of the child. (12) Staff shall disinfect the diapering surface after each child is diapered. (13) If staff wears disposable gloves, the gloves shall be changed and disposed after each child is diapered. Section 7 First Aid and Medicine. Subsection 8: (8) Each center shall ensure that every staff member has received training on first aid and cardiopulmonary resuscitation (CPR). To meet this requirement, DCC has implemented a free course on ECE-TRIS for all child care providers. This course covers communicable diseases and prevention strategies in Module 5. In addition to regulation requirements, providers will find more resources in the Tips and Tools section of the Child Care Aware of Kentucky website. www.childcareawareky.org/tipsand-tools/ Resources include but not limited to: Diapering Steps Posters, Handwashing Posters, Sanitizing and Disinfecting Directions, etc. All new staff are required to take Orientation, which includes a section on Health and Safety standards with resources, activities and knowledge checks. Orientation also meets the first aid and CPR training requirement, but does not result in a certification. 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: 922 KAR 2:090 Section 9. Records Subsection 1 A child-care center is required to maintain a current immunization certificate for each child in care within thirty (30) days of the child's enrollment, unless an attending physician or the child's parent objects to the immunization of the child. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 922 KAR 2:100 Section 19. Records Subsection 1 A provider is required to maintain a current immunization certificate for each child in care within thirty (30) days of the child's enrollment, unless an attending physician or the child's parent objects to the immunization of the child. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A - There are no CCDF-eligible license-exempt center based programs. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Registered Relative child care Providers do not have regulatory requirements 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. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Registered Relative child care Providers do not have regulatory requirements 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. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: 922 KAR 2:090 Section 9. Records Subsection 1 A child-care center is required to maintain a current immunization certificate for each child in care within thirty (30) days of the child's enrollment, unless an attending physician or the child's parent objects to the immunization of the child. 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: 922 KAR 2:120. Child- care center health and safety standards. Section 6 Sleeping and Napping Requirements. (1) An infant shall sleep or nap on the infant's back unless the infant's health professional signs a waiver that states the infant requires an alternate sleeping position. (2) Rest time shall be provided for each child who is not school-age and who is in care for more than four (4) hours. (3) Rest time shall occur in an adequate space according to the child's age as follows: (a) For an infant: 1. An individual non-tiered crib that meets Consumer Product Safety Commission standards established in 16 C.F.R. 1219-1220; 2. A firm crib mattress in good repair with a clean tight-fitted sheet that shall be changed: a. Weekly; or b. Immediately if it is soiled or wet; 3. No bedding other than a clean tight-fitted sheet; and 4. No toys or other items except the infant's pacifier; or (b) For a toddler or preschool-age child: 1. An individual bed, a two (2) inch thick waterproof mat, or cot in good repair; and 2. Bedding that is in good repair and is changed: a. Weekly; or b. Immediately if it is soiled or wet. (4) Rest time shall not exceed two (2) hours for a preschool-age child unless the child is attending the child-care center during nontraditional hours. (5) A child who does not sleep shall be permitted to play quietly and shall be visually supervised. (6) Cots, equipment, and furnishings used for sleeping and napping shall be spaced twelve (12) inches apart to allow free and safe movement by a person. (7) If cots or mats are used, floors shall be free from: (a) Drafts; (b) Liquid substances; (c) Dirt; and (d) Dampness. (8) (a) Cots or mats not labeled for individual use by a child shall be cleaned after each use. (b) Cots or mats labeled for individual use by a child shall be: 1. Cleaned at least weekly; and 2. Disinfected immediately if it is soiled or wet. (9) Individual bedding shall be stored in a sanitary manner. Our mandated Pediatric Abusive Head Trauma training includes a section on safe sleep for infants and preventing SIDS, SUIDS and more. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 922 KAR 2:100. Certification of family child-care homes. Section 13. Care Requirements for Provider Subsections 7-12: (7) An infant shall sleep and nap on the infant's back unless the infant's health professional signs a waiver that states the infant requires an alternate sleeping position. (8) Rest time shall be provided for each child who is not school-age and who is in care for more than four (4) hours. (9) Rest time shall include adequate space specified by the child's age as follows: (a) For an infant: 1. An individual non-tiered crib that meets Consumer Product Safety Commission standards established in 16 C.F.R. 1219-1220; 2. A firm crib mattress in good repair with a clean tight-fitted sheet that is changed: a. Weekly; or b. Immediately if it is soiled or wet; 3. No loose bedding, such as a bumper or a blanket; and 4. No toys or other items except for the infant's pacifier; or (b) For a toddler or preschool-age child: 1. An individual bed, a two (2) inch thick waterproof mat, or cot in good repair; and 2. Bedding that is in good repair and is changed: a. Weekly; or b. Immediately if it is soiled or wet. (10) Rest time shall not exceed two (2) hours for a preschool-age child unless the child is attending nontraditional hours or is sick. (11) A child who does not sleep shall be permitted to play quietly and be visually supervised. (12) If overnight care is provided, a provider or an assistant shall: (a) Remain awake until every child in care is asleep; and (b) Sleep on the same floor level of the home as an infant or toddler. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A - There are no CCDF-eligible license-exempt center providers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Registered relative child care providers do not have regulations that address the prevention of sudden infant death syndrome and use of safe sleeping practices. Registered relative child care providers are required to take the pediatric abusive head trauma training, upon application and every subsequent 5 years, which addresses safe infant sleep and the prevention of SIDS. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Registered relative child care providers do not have regulations that address the prevention of sudden infant death syndrome and use of safe sleeping practices. Registered relative child care providers are required to take the pediatric abusive head trauma training, upon application and every subsequent 5 years, which addresses safe infant sleep and the prevention of SIDS. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: 922 KAR 2:120. Child-care center health and safety standards. Section 6 Sleeping and Napping Requirements. (1) An infant shall sleep or nap on the infant's back unless the infant's health professional signs a waiver that states the infant requires an alternate sleeping position. (2) Rest time shall be provided for each child who is not school-age and who is in care for more than four (4) hours. (3) Rest time shall occur in an adequate space according to the child's age as follows: (a) For an infant: 1. An individual non-tiered crib that meets Consumer Product Safety Commission standards established in 16 C.F.R. 1219-1220; 2. A firm crib mattress in good repair with a clean tight-fitted sheet that shall be changed: a. Weekly; or b. Immediately if it is soiled or wet; 3. No bedding other than a clean tight-fitted sheet; and 4. No toys or other items except the infant's pacifier; or (b) For a toddler or preschool-age child: 1. An individual bed, a two (2) inch thick waterproof mat, or cot in good repair; and 2. Bedding that is in good repair and is changed: a. Weekly; or b. Immediately if it is soiled or wet. (4) Rest time shall not exceed two (2) hours for a preschool-age child unless the child is attending the child-care center during nontraditional hours. (5) A child who does not sleep shall be permitted to play quietly and shall be visually supervised. (6) Cots, equipment, and furnishings used for sleeping and napping shall be spaced twelve (12) inches apart to allow free and safe movement by a person. (7) If cots or mats are used, floors shall be free from: (a) Drafts; (b) Liquid substances; (c) Dirt; and (d) Dampness. (8) (a) Cots or mats not labeled for individual use by a child shall be cleaned after each use. (b) Cots or mats labeled for individual use by a child shall be: 1. Cleaned at least weekly; and 2. Disinfected immediately if it is soiled or wet. (9) Individual bedding shall be stored in a sanitary manner. Our mandated Pediatric Abusive Head Trauma training includes a section on safe sleep for infants and preventing SIDS, SUIDS and more. 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: 922 KAR 2:120 Section 7. First Aid and Medicine, Subsection 4-7 (4) Prescription and nonprescription medication shall be administered to a child in care: (a) 1. With a written request of the child's parent or the child's prescribing health professional; and 2. According to the directions or instructions on the medication's label; or (b) For epinephrine, in accordance with KRS 199.8951 and 311.646. (5) The child-care center shall keep a written record of the administration of medication, including: (a) Time of each dosage; (b) Date; (c) Amount; (d) Name of staff person giving the medication; (e) Name of the child; and (f) Name of the medication. (6) Medication, including refrigerated medication, shall be: (a) Stored in a separate and locked place, out of the reach of a child unless the medication is: 1. A first aid supply and is maintained in accordance with subsection (1) of this section; 2. Diaper cream, sunscreen, or toothpaste. Diaper cream, sunscreen, or toothpaste shall be inaccessible to a child; 3. An epinephrine auto-injector. A licensed child-care center shall comply with KRS 199.8951 and 311.646, including: a. An epinephrine auto-injector shall be inaccessible to a child; b. A child-care center shall have at least one (1) person onsite who has received training on the administration of an epinephrine auto-injector if the child-care center maintains an epinephrine auto-injector; c. A child-care center shall seek emergency medical care for a child if an auto- injector is administered to the child; and d. A child-care center shall report to the child's parent and the cabinet in accordance with 922 KAR 2:090, Section 13(1)(b), if an epinephrine auto-injector is administered to a child; or 4. An emergency or rescue medication for a child in care, such as medication to respond to diabetic or asthmatic condition, as prescribed by the child's physician. Emergency or rescue medication shall be inaccessible to a child in care; (b) Kept in the original bottle; and (c) Properly labeled. (7) Medication shall not be given to a child if the medication's expiration date has passed. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 922 KAR 2:100 Section 16 Medication and First Aid Subsections 1-6 (1) Medication, including medicine that requires refrigeration, shall be stored in a locked container or area with a lock unless the medication is: (a) A first aid supply. A first aid supply shall be maintained in accordance with subsection (4) of this section; (b) Diaper cream, sunscreen, or toothpaste. Diaper cream, sunscreen, or toothpaste shall be inaccessible to a child in care; (c) An epinephrine auto-injector. A family child-care home shall comply with KRS 199.8951, including: 1. An epinephrine auto-injector shall be inaccessible to a child in care; 2. A certified family child-care home provider shall have training on the administration of an epinephrine auto-injector if the provider maintains an epinephrine auto-injector for a child; 3. A certified family child-care home shall seek emergency medical care for a child if an auto-injector is administered to a child; and 4. A certified family child-care home shall report to the child's parent and the cabinet in accordance with subsection (6) of this section and Section 20(10) of this administrative regulation if an epinephrine auto-injector is administered to a child; or (d) An emergency or rescue medication for a child in care, such as medication to respond to diabetic or asthmatic condition, as prescribed by the child's physician. Emergency or rescue medication shall be inaccessible to a child in care. (2) Prescription and nonprescription medication shall be administered to a child in care: (a) With a written request of the child's parent or the child's prescribing health professional; or (b) In accordance with KRS 311.646. (3) Prescription and nonprescription medications shall be: (a) Labeled; and (b) Administered according to directions or instructions on the label. (4) A provider shall: (a) Maintain first aid supplies that are easily accessible for use in an emergency, and these supplies shall be inaccessible to the children in care; (b) Wash superficial wounds with soap and water before bandaging; (c) Use disposable gloves for the clean-up of biological contaminants, such as blood, bodily fluids, or excretions; (d) Place contaminated clothing or other absorbent materials in a sealed plastic container or bag labeled with the child's name, and returned to the parent; and (e) Clean and disinfect the soiled surfaces. (5) First aid supplies shall include a fully-equipped first aid kit containing the following non-expired items: (a) Adhesive bandages; (b) Sterile gauze; (c) Medical tape; (d) Scissors; (e) Thermometer; (f) Disposable gloves; and (g) CPR mouthpiece. (6) A provider shall provide immediate notification of a medical emergency to a child's: (a) Parent; or (b) Emergency contact, if the parent is unavailable. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A - There are no CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Registered relative child care providers do not have regulations that address the administration of medication. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Registered relative child care providers do not have regulations that address the administration of medication. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: 922 KAR 2:120 Section 7. First Aid and Medicine, Subsection 4-7 (4) Prescription and nonprescription medication shall be administered to a child in care: (a) 1. With a written request of the child's parent or the child's prescribing health professional; and 2. According to the directions or instructions on the medication's label; or (b) For epinephrine, in accordance with KRS 199.8951 and 311.646. (5) The child-care center shall keep a written record of the administration of medication, including: (a) Time of each dosage; (b) Date; (c) Amount; (d) Name of staff person giving the medication; (e) Name of the child; and (f) Name of the medication. (6) Medication, including refrigerated medication, shall be: (a) Stored in a separate and locked place, out of the reach of a child unless the medication is: 1. A first aid supply and is maintained in accordance with subsection (1) of this section; 2. Diaper cream, sunscreen, or toothpaste. Diaper cream, sunscreen, or toothpaste shall be inaccessible to a child; 3. An epinephrine auto-injector. A licensed child-care center shall comply with KRS 199.8951 and 311.646, including: a. An epinephrine auto-injector shall be inaccessible to a child; b. A child-care center shall have at least one (1) person onsite who has received training on the administration of an epinephrine auto-injector if the child-care center maintains an epinephrine auto-injector; c. A child-care center shall seek emergency medical care for a child if an auto- injector is administered to the child; and d. A child-care center shall report to the child's parent and the cabinet in accordance with 922 KAR 2:090, Section 13(1)(b), if an epinephrine auto-injector is administered to a child; or 4. An emergency or rescue medication for a child in care, such as medication to respond to diabetic or asthmatic condition, as prescribed by the child's physician. Emergency or rescue medication shall be inaccessible to a child in care; (b) Kept in the original bottle; and (c) Properly labeled. (7) Medication shall not be given to a child if the medication's expiration date has passed. 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: 922 KAR 2:120 Section 7. First Aid and Medicine, Subsection 4-7 (4) Prescription and nonprescription medication shall be administered to a child in care: (a) 1. With a written request of the child's parent or the child's prescribing health professional; and 2. According to the directions or instructions on the medication's label; or (b) For epinephrine, in accordance with KRS 199.8951 and 311.646. (5) The child-care center shall keep a written record of the administration of medication, including: (a) Time of each dosage; (b) Date; (c) Amount; (d) Name of staff person giving the medication; (e) Name of the child; and (f) Name of the medication. (6) Medication, including refrigerated medication, shall be: (a) Stored in a separate and locked place, out of the reach of a child unless the medication is: 1. A first aid supply and is maintained in accordance with subsection (1) of this section; 2. Diaper cream, sunscreen, or toothpaste. Diaper cream, sunscreen, or toothpaste shall be inaccessible to a child; 3. An epinephrine auto-injector. A licensed child-care center shall comply with KRS 199.8951 and 311.646, including: a. An epinephrine auto-injector shall be inaccessible to a child; b. A child-care center shall have at least one (1) person onsite who has received training on the administration of an epinephrine auto-injector if the child-care center maintains an epinephrine auto-injector; c. A child-care center shall seek emergency medical care for a child if an auto- injector is administered to the child; and d. A child-care center shall report to the child's parent and the cabinet in accordance with 922 KAR 2:090, Section 13(1)(b), if an epinephrine auto-injector is administered to a child; or 4. An emergency or rescue medication for a child in care, such as medication to respond to diabetic or asthmatic condition, as prescribed by the child's physician. Emergency or rescue medication shall be inaccessible to a child in care; (b) Kept in the original bottle; and (c) Properly labeled. (7) Medication shall not be given to a child if the medication's expiration date has passed. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 922 KAR 2:100 Section 16 Medication and First Aid Subsections 1-6 (1) Medication, including medicine that requires refrigeration, shall be stored in a locked container or area with a lock unless the medication is: (a) A first aid supply. A first aid supply shall be maintained in accordance with subsection (4) of this section; (b) Diaper cream, sunscreen, or toothpaste. Diaper cream, sunscreen, or toothpaste shall be inaccessible to a child in care; (c) An epinephrine auto-injector. A family child-care home shall comply with KRS 199.8951, including: 1. An epinephrine auto-injector shall be inaccessible to a child in care; 2. A certified family child-care home provider shall have training on the administration of an epinephrine auto-injector if the provider maintains an epinephrine auto-injector for a child; 3. A certified family child-care home shall seek emergency medical care for a child if an auto-injector is administered to a child; and 4. A certified family child-care home shall report to the child's parent and the cabinet in accordance with subsection (6) of this section and Section 20(10) of this administrative regulation if an epinephrine auto-injector is administered to a child; or (d) An emergency or rescue medication for a child in care, such as medication to respond to diabetic or asthmatic condition, as prescribed by the child's physician. Emergency or rescue medication shall be inaccessible to a child in care. (2) Prescription and nonprescription medication shall be administered to a child in care: (a) With a written request of the child's parent or the child's prescribing health professional; or (b) In accordance with KRS 311.646. (3) Prescription and nonprescription medications shall be: (a) Labeled; and (b) Administered according to directions or instructions on the label. (4) A provider shall: (a) Maintain first aid supplies that are easily accessible for use in an emergency, and these supplies shall be inaccessible to the children in care; (b) Wash superficial wounds with soap and water before bandaging; (c) Use disposable gloves for the clean-up of biological contaminants, such as blood, bodily fluids, or excretions; (d) Place contaminated clothing or other absorbent materials in a sealed plastic container or bag labeled with the child's name, and returned to the parent; and (e) Clean and disinfect the soiled surfaces. (5) First aid supplies shall include a fully-equipped first aid kit containing the following non-expired items: (a) Adhesive bandages; (b) Sterile gauze; (c) Medical tape; (d) Scissors; (e) Thermometer; (f) Disposable gloves; and (g) CPR mouthpiece. (6) A provider shall provide immediate notification of a medical emergency to a child's: (a) Parent; or (b) Emergency contact, if the parent is unavailable. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x]Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A - There are no CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Registered relative child care providers do not have regulations that address the administration of medication. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Registered relative child care providers do not have regulations that address the administration of medication. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: 922 KAR 2:120 Section 7. First Aid and Medicine, Subsection 4-7 (4) Prescription and nonprescription medication shall be administered to a child in care: (a) 1. With a written request of the child's parent or the child's prescribing health professional; and 2. According to the directions or instructions on the medication's label; or (b) For epinephrine, in accordance with KRS 199.8951 and 311.646. (5) The child-care center shall keep a written record of the administration of medication, including: (a) Time of each dosage; (b) Date; (c) Amount; (d) Name of staff person giving the medication; (e) Name of the child; and (f) Name of the medication. (6) Medication, including refrigerated medication, shall be: (a) Stored in a separate and locked place, out of the reach of a child unless the medication is: 1. A first aid supply and is maintained in accordance with subsection (1) of this section; 2. Diaper cream, sunscreen, or toothpaste. Diaper cream, sunscreen, or toothpaste shall be inaccessible to a child; 3. An epinephrine auto-injector. A licensed child-care center shall comply with KRS 199.8951 and 311.646, including: a. An epinephrine auto-injector shall be inaccessible to a child; b. A child-care center shall have at least one (1) person onsite who has received training on the administration of an epinephrine auto-injector if the child-care center maintains an epinephrine auto-injector; c. A child-care center shall seek emergency medical care for a child if an auto-injector is administered to the child; and d. A child-care center shall report to the child's parent and the cabinet in accordance with 922 KAR 2:090, Section 13(1)(b), if an epinephrine auto-injector is administered to a child; or 4. An emergency or rescue medication for a child in care, such as medication to respond to diabetic or asthmatic condition, as prescribed by the child's physician. Emergency or rescue medication shall be inaccessible to a child in care; (b) Kept in the original bottle; and (c) Properly labeled. (7) Medication shall not be given to a child if the medication's expiration date has passed. 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: Kentucky Standards of Practice (SOP) Guide: All staff should be notified of food allergies and allergic reactions that are reported by parents. Allergies and intolerances should be documented by a physician. An allergy is an immune response and an intolerance is a metabolic response (e.g., a lactate deficiency for lactose intolerant children). If a parent/guardian has given written permission, a child's allergy may be posted in sight for all staff. Be alert to unexpected encounters with allergic substances. Be sure to get written instructions and training from the child's doctor for how to respond to a child's allergic reactions, including and medication needed or emergency treatment (including training in the use of epinephrine, e.g., an EpiPen®, for a child with a history of allergic reactions.) Citation for statute utilized in 922 KAR 2:120 and the Standards of Practice regarding epinephrine: https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=45348 922 KAR 2:120 Section 9. Food and Drink Requirements for All Child-Care Centers Subsection 19 (19) For food provided by the center, all children in the center shall be offered the same food items unless: (a) A parent provides written authorization to substitute the food with an alternative that meets the same component requirement; or (b) A physician provides written authorization to substitute the food or the food component and includes the food that the child shall not have and the food substitution that the child shall have. 922 KAR 2:090 Section 9 (1)(b) mandates that a written record for each child: (3) To contain: (d) The child's general health status and medical history including, if applicable: (i) Allergies DRCC's survey method states : "Review children’s files to determine compliance. Siblings’ forms may be placed in the same file; however, each child is required to have their own individual information." ii. All CCDF-eligible licensed family child care homes. Provide the standard: 922 KAR 2:100 Section 19 Records Subsection 1 (b)(3)(d) and (h) (1) A provider shall maintain: (b) A written record for each child: d. Food or other allergies in a documented care plan that includes: (i) Instructions regarding the allergy, including any identifying symptoms; (ii) Steps taken to avoid and prevent the allergen; and (iii) A plan of treatment in the event of an allergic reaction, including medication, doses, and the administration of an epinephrine auto-injector in accordance with Section 16(1)(c) of this administrative regulation. h. A permission form and allergy care plan if applicable for each trip away from the family child-care home signed by the child's parent in accordance with Section 18(1) of this administrative regulation iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A - There are no CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Registered relative child care providers do not have regulations that address the prevention of emergencies due to food and allergic reactions. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Registered relative child care providers do not have regulations that address the prevention of emergencies due to food and allergic reactions. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Kentucky Standards of Practice (SOP) Guide: All staff should be notified of food allergies and allergic reactions that are reported by parents. Allergies and intolerances should be documented by a physician. An allergy is an immune response and an intolerance is a metabolic response (e.g., a lactate deficiency for lactose intolerant children). If a parent/guardian has given written permission, a child's allergy may be posted in sight for all staff. Be alert to unexpected encounters with allergic substances. Be sure to get written instructions and training from the child's doctor for how to respond to a child's allergic reactions, including and medication needed or emergency treatment (including training in the use of epinephrine, e.g., an EpiPen®, for a child with a history of allergic reactions.) Citation for statute utilized in 922 KAR 2:120 and the Standards of Practice regarding epinephrine: https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=45348 922 KAR 2:120 Section 9. Food and Drink Requirements for All Child-Care Centers Subsection 19 (19) For food provided by the center, all children in the center shall be offered the same food items unless: (a) A parent provides written authorization to substitute the food with an alternative that meets the same component requirement; or (b) A physician provides written authorization to substitute the food or the food component and includes the food that the child shall not have and the food substitution that the child shall have. 922 KAR 2:090 Section 9 (1)(b) mandates that a written record for each child: (3) To contain: (d) The child's general health status and medical history including, if applicable: (i) Allergies DRCC's survey method states : "Review children’s files to determine compliance. Siblings’ forms may be placed in the same file; however, each child is required to have their own individual information." 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: Kentucky Standards of Practice (SOP) Guide: If a parent/guardian has given written permission, a child's allergy may be posted in sight for all staff. Be alert to unexpected encounters with allergic substances. Be sure to get written instructions and training from the child's doctor for how to respond to a child's allergic reactions, including and medication needed or emergency treatment (including training in the use of epinephrine, e.g., an EpiPen®, for a child with a history of allergic reactions.) Citation for statute utilized in 922 KAR 2:120 and the Standards of Practice regarding epinephrine: https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=45348 922 KAR 2:120 Section 7 First Aid and Medicine Subsection 6 (a)(3) An epinephrine auto-injector. A licensed child-care center shall comply with KRS 199.8951 and 311.646, including: a. An epinephrine auto-injector shall be inaccessible to a child; b. A child-care center shall have at least one (1) person onsite who has received training on the administration of an epinephrine auto-injector if the child-care center maintains an epinephrine auto-injector; c. A child-care center shall seek emergency medical care for a child if an auto- injector is administered to the child; and d. A child-care center shall report to the child's parent and the cabinet in accordance with 922 KAR 2:090, Section 13(1)(b), if an epinephrine auto-injector is administered to a child; ii. All CCDF-eligible licensed family child care homes. Provide the standard: 9922 KAR 2:100 Section 16 Medication and First Aid Subsection 1(c) (c) An epinephrine auto-injector. A family child-care home shall comply with KRS 199.8951, including: 1. An epinephrine auto-injector shall be inaccessible to a child in care; 2. A certified family child-care home provider shall have training on the administration of an epinephrine auto-injector if the provider maintains an epinephrine auto-injector for a child; 3. A certified family child-care home shall seek emergency medical care for a child if an auto-injector is administered to a child; and 4. A certified family child-care home shall report to the child's parent and the cabinet in accordance with subsection (6) of this section and Section 20(10) of this administrative regulation if an epinephrine auto-injector is administered to a child; 922 KAR 2:100 Section 19 Records Subsection 1 (b)(3)(d) (1) A provider shall maintain: (b) A written record for each child: 3. To contain: d. Food or other allergies in a documented care plan that includes: (i) Instructions regarding the allergy, including any identifying symptoms; (ii) Steps taken to avoid and prevent the allergen; and (iii) A plan of treatment in the event of an allergic reaction, including medication, doses, and the administration of an epinephrine auto-injector in accordance with Section 16(1)(c) of this administrative regulation. iii. All CCDF-eligible licensed in-home care. Provide the standard:: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A - There are no CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Registered relative child care providers do not have regulations that address the response to emergencies due to food and allergic reactions. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Registered relative child care providers do not have regulations that address the response to emergencies due to food and allergic reactions. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Kentucky Standards of Practice (SOP) Guide: If a parent/guardian has given written permission, a child's allergy may be posted in sight for all staff. Be alert to unexpected encounters with allergic substances. Be sure to get written instructions and training from the child's doctor for how to respond to a child's allergic reactions, including and medication needed or emergency treatment (including training in the use of epinephrine, e.g., an EpiPen®, for a child with a history of allergic reactions.) Citation for statute utilized in 922 KAR 2:120 and the Standards of Practice regarding epinephrine: https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=45348 922 KAR 2:120 Section 7 First Aid and Medicine Subsection 6 (a)(3) An epinephrine auto-injector. A licensed child-care center shall comply with KRS 199.8951 and 311.646, including: a. An epinephrine auto-injector shall be inaccessible to a child; b. A child-care center shall have at least one (1) person onsite who has received training on the administration of an epinephrine auto-injector if the child-care center maintains an epinephrine auto-injector; c. A child-care center shall seek emergency medical care for a child if an auto- injector is administered to the child; and d. A child-care center shall report to the child's parent and the cabinet in accordance with 922 KAR 2:090, Section 13(1)(b), if an epinephrine auto-injector is administered to a child; 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: 922 KAR 2:120 Child- care center health and safety standards Section 4 Premises Requirements (1) The premises shall be: (a) Suitable for the purpose intended; (b) Kept clean and in good repair; and (c) Equipped with: 1. A working telephone accessible to a room used by a child; and 2. A list of emergency numbers posted by the telephone or maintained in the telephone's contact, including numbers for the: a. Police department; b. Fire department; c. Emergency medical care and rescue squad; and d. Poison control center. (2) A child-care center shall be in compliance with the codes administered by the Kentucky Fire Marshal and the local zoning laws. (3) Fire and emergency exits shall be kept clear of debris. (4) A working carbon monoxide detector shall be required in a licensed child-care center that is in a home if the home: (a) Uses fuel burning appliances; or (b) Has an attached garage. (5) The building shall be constructed to ensure the: (a) Building is: 1. Dry; 2. Ventilated; and 3. Well lit, including clean light fixtures that are: a. In good repair in all areas; and b. Shielded or have shatter-proof bulbs installed; and (b) Following are protected: 1. Windows; 2. Doors; 3. Stoves; 4. Heaters; 5. Furnaces; 6. Pipes; and 7. Stairs. (6) Exclusive of the kitchen, bathroom, hallway, and storage area, there shall be a minimum of thirty-five (35) square feet of space per child. (7) Measures shall be utilized to control the presence of: (a) Rodents; (b) Flies; (c) Roaches; and (d) Other vermin. (8) An opening to the outside shall be effectively protected against the entrance of vermin by: (a) Self-closing doors; (b) Closed windows; (c) Screening; (d) Controlled air current; or (e) Other effective means. (9) Floors, walls, and ceilings shall be smooth, in good repair, and constructed to be easily cleaned. (10) The water supply shall be: (a) Potable; (b) Protected from contamination; (c) Adequate in quality and volume; (d) Under sufficient pressure to permit unrestricted use; and (e) Obtained from an approved public water supply or a source approved by the local health department. (11) Groundwater supplies for a child-care center caring for: (a) More than twenty-five (25) children shall comply with requirements of the Energy and Environment Cabinet, Division of Water, established in KRS Chapter 151 and 401 KAR Chapter 8, as applicable; or (b) Twenty-five (25) children or less shall secure approval from the: 1. Energy and Environment Cabinet; or 2. Local health department. (12) Sewage shall be properly disposed by a method approved by the: (a) Energy and Environment Cabinet; or (b) Cabinet. (13) All plumbing shall comply with the State Plumbing Code established in KRS Chapter 318. (14) Solid waste shall be kept in a suitable receptacle in accordance with local, county, and state law, as governed by KRS 211.350 to 211.380. (15) If a portion of the building is used for a purpose other than child care: (a) Necessary provisions shall be made to avoid interference with the child-care program; and (b) A separate restroom shall be provided for use only by those using the building for its child care purpose. (16) The temperature of the indoor area of the premises shall be sixty-five (65) to eighty-two (82) degrees Fahrenheit. (17) Outdoor activity shall be restricted based upon: (a) Temperature; (b) Weather conditions; (c) Weather alerts, advisories, and warnings issued by the National Weather Service; or (d) Age or temperament of the child. (18) A kitchen shall not be required if: (a) The only food served is an afternoon snack to school-age children; and (b) Adequate refrigeration is maintained. (19) The Department of Housing, Buildings and Construction, the Kentucky Fire Marshal's Office, and cabinet shall be contacted concerning a planned new building, addition, or major renovation prior to construction. (20) An outdoor play area shall be: (a) Except for an after-school child-care program, located on the premises of a public or state-accredited nonpublic school, fenced for the safety of the children; (b) A minimum of sixty (60) square feet per child, separate from and in addition to the thirty-five (35) square feet minimum pursuant to subsection (6) of this section; (c) Free from: 1. Litter; 2. Glass; 3. Rubbish; and 4. Flammable materials; (d) Safe from foreseeable hazard; (e) Well drained; (f) Well maintained; (g) In good repair; and (h) Visible to staff at all times. (21) A protective surface shall: (a) Be provided for outdoor play equipment used to: 1. Climb; 2. Swing; and 3. Slide; and (b) Have a fall zone equal to the height of the equipment. (22) If a child-care center does not have access to an outdoor play area, an indoor space shall: (a) Be used as a play area; (b) Have a minimum of sixty (60) square feet per child, separate from and in addition to the thirty-five (35) square feet minimum pursuant to subsection (6) of this section; (c) Include equipment for gross motor skills; and (d) Have a protective surface of at least two (2) inches thick around equipment intended for climbing. (23) While attending, a child shall: (a) Have moderate to vigorous activity each day, including active play that: 1. Includes outdoor play unless unavailable pursuant to subsections (17) or (22) of this section; 2. Shall occur for a minimum of; a. Thirty (30) minutes per day in a half-day program; or b. Sixty (60) minutes per day in a full-day program; and 3. May be broken into smaller increments of time throughout a day; and (b) Not be punished or rewarded in regards to play time. (24) Fences shall be: (a) Constructed of safe material; (b) Stable; and (c) In good condition. (25) Supports for climbing apparatus and large equipment shall be securely fastened to the ground. (26) Crawl spaces, such as tunnels, shall be short and wide enough to permit access by adults. (27) A sandbox shall be: (a) Constructed to allow for drainage; (b) Covered while not in use; (c) Kept clean; and (d) Checked for vermin prior to use. (28) Bodies of water that shall not be utilized include: (a) Portable wading pools; (b) Natural bodies of water; and (c) Unfiltered, nondisinfected containers. (29) A child-care center shall have enough toys, play apparatus, and developmentally appropriate materials to provide each child with a variety of activities during the day, as specified in Section 2 of this administrative regulation. (30) Storage space shall be provided: (a) In the form of: 1. Shelves; or 2. Other storage device accessible to the children; and (b) In sufficient quantity for each child's personal belongings. (31) Supplies shall be stored so that the adult can reach them without leaving a child unattended. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 922 KAR 2:100 Certification of Family Child-Care Homes Section 12 The General Requirements of the Family Child-Care Home Environment (1) A provider's home and each play area used for child care shall: (a) Be free from risk of harm in accordance with the requirements of this administrative regulation; and (b) Have adequate: 1. Heating and cooling; 2. Light; and 3. Ventilation. (2) Each floor level used for child care shall have at least one (1): (a) Unblocked exit to the outside; (b) Smoke detector, including in the kitchen area and in the children's sleeping areas; (c) Properly maintained fire extinguisher, including in the kitchen area; and (d) Carbon monoxide detector if the home: 1. Uses fuel burning appliances; or 2. Has an attached garage. (3) The areas of the home that are accessible to children in care shall be free from items harmful to children including: (a) Cleaning supplies, poisons, paints, and insecticides; (b) Knives, scissors, and sharp objects; (c) Power tools, lawn mowers, hand tools, nails, and other equipment; (d) Matches, cigarettes, lighters, combustibles, flammable liquids, and all fire hazards; (e) Plastic bags; and (f) Litter and rubbish. (4) Alcohol shall: (a) Not be consumed by any person on the certified family child-care home's premises during hours of operation; and (b) Be kept out of reach and sight of a child in care. (5) In accordance with KRS 527.070(1), firearms and ammunition shall be stored away from the presence of children, in separate locked containers, which, in order to be opened, require a: (a) Key; or (b) Combination. (6) Electrical outlets not in use shall be covered. (7) An electric fan, floor furnace, freestanding heater or fireplace, or other source of heat shall: (a) Be out of the reach of a child; or (b) Have a safety guard to protect a child from injury. (8) A certified family child-care home shall have: (a) At least one (1) accessible and working telephone on each level used for child care while a child in care is present on that level; and (b) A list of emergency numbers posted on each level used for child care or maintained in the contacts of each telephone, including numbers for the: 1. Police; 2. Fire station; 3. Emergency medical care and rescue squad; and 4. Poison control center. (9) Equipment and toys shall be: (a) Designated by the manufacturer as developmentally appropriate to the age of children in care; (b) In sufficient quantity for the number of children in care; and (c) Safe, sound, clean, and in good repair. (10) Stairs and steps used for children in care shall be: (a) Solid; (b) Safe; and (c) Railed. (11) If an infant or toddler is in the care of a provider, indoor stairs with more than two (2) steps shall be blocked. (12) Exclusive of the bathroom and storage area, an indoor area, including furnishings, used for child care shall contain at least thirty-five (35) square feet per child for: (a) Play; and (b) Activities that meet the developmental needs of the children in care. (13) An outdoor play area shall be free of unavoidable danger or risk. (14) Each child in an outdoor play area shall be under the direct supervision of the provider or assistant. (15) Outdoor stationary play equipment shall be: (a) Securely anchored; (b) Developmentally appropriate; and (c) Safe. (16) A trampoline shall not be accessible to a child in the care of a provider. (17) Children in an outside play area shall have constant and active supervision and shall be protected by physical or natural barriers that prohibit access to: (a) Traffic; (b) Gullies; and (c) Other hazards. (18) Constant and active supervision shall be maintained around any body of water and shall be inaccessible to children by secured physical or natural barriers of adequate height and appropriately secured except in accordance with subsections (19) and (20) of this section. (19) A swimming pool on the premises shall: (a) Be maintained and free of debris and body waste; (b) Have a water filtering system or be emptied daily; (c) Be supervised when in use, with a ratio of one (1) adult to one (1) infant or toddler; and (d) Be inaccessible to a child when not in use. (20) An above-ground pool shall: (a) Have a stationary wall no less than four (4) feet tall; (b) Have hand holds or foot holds that are inaccessible when the pool is not in use; and (c) Be supervised when in use, with a ratio of one (1) adult to one (1) infant or toddler. (21) A fire drill shall be: (a) Conducted during hours of operation at least monthly; and (b) Documented. (22) An earthquake drill, tornado drill, shelter-in-place drill, and lockdown drill shall be: (a) Conducted during hours of operation at least quarterly; and (b) Documented. (23) In the event of a natural disaster, fire, shelter-in-place, lockdown, or other emergency, a written plan shall be in place to communicate reunification with families and accommodations for: (a) Infants and toddlers; (b) Children with disabilities; and (c) Children with chronic medical conditions. (24) A family child-care home shall: (a) Be clean; (b) Be uncluttered; (c) Be free of insects and rodents; (d) Have a water supply that is: 1. Potable; 2. Adequate; and 3. From an approved public water supply; and (e) Have bathrooms, including toilets, sinks, and potty chairs that are: 1. Sanitary; and 2. In good working condition. (25) Windows, doors, and outer openings shall be screened to prevent the entrance of vermin. (26) Indoor and outdoor garbage shall be stored in a waterproof container with a tight-fitting cover. (27) Playpens and play yards shall: (a) Meet the federal standards as issued by the Consumer Product Safety Commission, including 16 C.F.R. 1221; (b) Be manufactured for commercial use; and (c) Not be used for sleeping or napping. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A - There are no CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Registered relative child care providers do not have regulations that address the identification of and protection from building and physical premises hazards. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Registered relative child care providers do not have regulations that address the identification of and protection from building and physical premises hazards. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: 922 KAR 2:120 Child-care center health and safety standards Section 4 Premises Requirements (1) The premises shall be: (a) Suitable for the purpose intended; (b) Kept clean and in good repair; and (c) Equipped with: 1. A working telephone accessible to a room used by a child; and 2. A list of emergency numbers posted by the telephone or maintained in the telephone's contact, including numbers for the: a. Police department; b. Fire department; c. Emergency medical care and rescue squad; and d. Poison control center. (2) A child-care center shall be in compliance with the codes administered by the Kentucky Fire Marshal and the local zoning laws. (3) Fire and emergency exits shall be kept clear of debris. (4) A working carbon monoxide detector shall be required in a licensed child-care center that is in a home if the home: (a) Uses fuel burning appliances; or (b) Has an attached garage. (5) The building shall be constructed to ensure the: (a) Building is: 1. Dry; 2. Ventilated; and 3. Well lit, including clean light fixtures that are: a. In good repair in all areas; and b. Shielded or have shatter-proof bulbs installed; and (b) Following are protected: 1. Windows; 2. Doors; 3. Stoves; 4. Heaters; 5. Furnaces; 6. Pipes; and 7. Stairs. (6) Exclusive of the kitchen, bathroom, hallway, and storage area, there shall be a minimum of thirty-five (35) square feet of space per child. (7) Measures shall be utilized to control the presence of: (a) Rodents; (b) Flies; (c) Roaches; and (d) Other vermin. (8) An opening to the outside shall be effectively protected against the entrance of vermin by: (a) Self-closing doors; (b) Closed windows; (c) Screening; (d) Controlled air current; or (e) Other effective means. (9) Floors, walls, and ceilings shall be smooth, in good repair, and constructed to be easily cleaned. (10) The water supply shall be: (a) Potable; (b) Protected from contamination; (c) Adequate in quality and volume; (d) Under sufficient pressure to permit unrestricted use; and (e) Obtained from an approved public water supply or a source approved by the local health department. (11) Groundwater supplies for a child-care center caring for: (a) More than twenty-five (25) children shall comply with requirements of the Energy and Environment Cabinet, Division of Water, established in KRS Chapter 151 and 401 KAR Chapter 8, as applicable; or (b) Twenty-five (25) children or less shall secure approval from the: 1. Energy and Environment Cabinet; or 2. Local health department. (12) Sewage shall be properly disposed by a method approved by the: (a) Energy and Environment Cabinet; or (b) Cabinet. (13) All plumbing shall comply with the State Plumbing Code established in KRS Chapter 318. (14) Solid waste shall be kept in a suitable receptacle in accordance with local, county, and state law, as governed by KRS 211.350 to 211.380. (15) If a portion of the building is used for a purpose other than child care: (a) Necessary provisions shall be made to avoid interference with the child-care program; and (b) A separate restroom shall be provided for use only by those using the building for its child care purpose. (16) The temperature of the indoor area of the premises shall be sixty-five (65) to eighty-two (82) degrees Fahrenheit. (17) Outdoor activity shall be restricted based upon: (a) Temperature; (b) Weather conditions; (c) Weather alerts, advisories, and warnings issued by the National Weather Service; or (d) Age or temperament of the child. (18) A kitchen shall not be required if: (a) The only food served is an afternoon snack to school-age children; and (b) Adequate refrigeration is maintained. (19) The Department of Housing, Buildings and Construction, the Kentucky Fire Marshal's Office, and cabinet shall be contacted concerning a planned new building, addition, or major renovation prior to construction. (20) An outdoor play area shall be: (a) Except for an after-school child-care program, located on the premises of a public or state-accredited nonpublic school, fenced for the safety of the children; (b) A minimum of sixty (60) square feet per child, separate from and in addition to the thirty-five (35) square feet minimum pursuant to subsection (6) of this section; (c) Free from: 1. Litter; 2. Glass; 3. Rubbish; and 4. Flammable materials; (d) Safe from foreseeable hazard; (e) Well drained; (f) Well maintained; (g) In good repair; and (h) Visible to staff at all times. (21) A protective surface shall: (a) Be provided for outdoor play equipment used to: 1. Climb; 2. Swing; and 3. Slide; and (b) Have a fall zone equal to the height of the equipment. (22) If a child-care center does not have access to an outdoor play area, an indoor space shall: (a) Be used as a play area; (b) Have a minimum of sixty (60) square feet per child, separate from and in addition to the thirty-five (35) square feet minimum pursuant to subsection (6) of this section; (c) Include equipment for gross motor skills; and (d) Have a protective surface of at least two (2) inches thick around equipment intended for climbing. (23) While attending, a child shall: (a) Have moderate to vigorous activity each day, including active play that: 1. Includes outdoor play unless unavailable pursuant to subsections (17) or (22) of this section; 2. Shall occur for a minimum of; a. Thirty (30) minutes per day in a half-day program; or b. Sixty (60) minutes per day in a full-day program; and 3. May be broken into smaller increments of time throughout a day; and (b) Not be punished or rewarded in regards to play time. (24) Fences shall be: (a) Constructed of safe material; (b) Stable; and (c) In good condition. (25) Supports for climbing apparatus and large equipment shall be securely fastened to the ground. (26) Crawl spaces, such as tunnels, shall be short and wide enough to permit access by adults. (27) A sandbox shall be: (a) Constructed to allow for drainage; (b) Covered while not in use; (c) Kept clean; and (d) Checked for vermin prior to use. (28) Bodies of water that shall not be utilized include: (a) Portable wading pools; (b) Natural bodies of water; and (c) Unfiltered, nondisinfected containers. (29) A child-care center shall have enough toys, play apparatus, and developmentally appropriate materials to provide each child with a variety of activities during the day, as specified in Section 2 of this administrative regulation. (30) Storage space shall be provided: (a) In the form of: 1. Shelves; or 2. Other storage device accessible to the children; and (b) In sufficient quantity for each child's personal belongings. (31) Supplies shall be stored so that the adult can reach them without leaving a child unattended. 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: 922 KAR 2:120 Child- care center health and safety standards Section 4 Premises Requirements: Subsections 20, 24 & 28 (20) An outdoor play area shall be: (a) Except for an after-school child-care program, located on the premises of a public or state-accredited nonpublic school, fenced for the safety of the children; (24) Fences shall be: (a) Constructed of safe material; (b) Stable; and (c) In good condition. (28) Bodies of water that shall not be utilized include: (a) Portable wading pools; (b) Natural bodies of water; and (c) Unfiltered, nondisinfected containers. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Section 12. The General Requirements of the Family Child-Care Home Environment Subsections 17 - 20 (17) Children in an outside play area shall have constant and active supervision and shall be protected by physical or natural barriers that prohibit access to: (a) Traffic; (b) Gullies; and (c) Other hazards. (18) Constant and active supervision shall be maintained around any body of water and shall be inaccessible to children by secured physical or natural barriers of adequate height and appropriately secured except in accordance with subsections (19) and (20) of this section. (19) A swimming pool on the premises shall: (a) Be maintained and free of debris and body waste; (b) Have a water filtering system or be emptied daily; (c) Be supervised when in use, with a ratio of one (1) adult to one (1) infant or toddler; and (d) Be inaccessible to a child when not in use. (20) An above-ground pool shall: (a) Have a stationary wall no less than four (4) feet tall; (b) Have hand holds or foot holds that are inaccessible when the pool is not in use; and (c) Be supervised when in use, with a ratio of one (1) adult to one (1) infant or toddler. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A - There are no CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Registered relative child care providers do not have regulations that address the identification of and protection from bodies of water. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Registered relative child care providers do not have regulations that address the identification of and protection from bodies of water. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: 922 KAR 2:120 Child-care center health and safety standards Section 4 Premises Requirements: Subsections 20, 24 & 28 (20) An outdoor play area shall be: (a) Except for an after-school child-care program, located on the premises of a public or state-accredited nonpublic school, fenced for the safety of the children; (24) Fences shall be: (a) Constructed of safe material; (b) Stable; and (c) In good condition. (28) Bodies of water that shall not be utilized include: (a) Portable wading pools; (b) Natural bodies of water; and (c) Unfiltered, nondisinfected containers. 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: 922 KAR 2:120 Child- care center health and safety standards Section 4 Premises Requirements Subsections 20 & 24 (20) An outdoor play area shall be: (a) Except for an after-school child-care program, located on the premises of a public or state-accredited nonpublic school, fenced for the safety of the children; and (d) Safe from foreseeable hazard; (24) Fences shall be: (a) Constructed of safe material; (b) Stable; and (c) In good condition. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 922 KAR 2:100 Certification of Family Child-Care Homes Section 12 The General Requirements of the Family Child-Care Home Environment Subsections 1 & 17 (1) A provider's home and each play area used for child care shall: (a) Be free from risk of harm in accordance with the requirements of this administrative regulation; (17) Children in an outside play area shall have constant and active supervision and shall be protected by physical or natural barriers that prohibit access to: (a) Traffic; (b) Gullies; and (c) Other hazards iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A - There are no CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Registered relative child care providers do not have regulations that address the identification of and protection from vehicular traffic hazards. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Registered relative child care providers do not have regulations that address the identification of and protection from vehicular traffic hazards. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: 922 KAR 2:120 Child-care center health and safety standards Section 4 Premises Requirements Subsections 20 & 24 (20) An outdoor play area shall be: (a) Except for an after-school child-care program, located on the premises of a public or state-accredited nonpublic school, fenced for the safety of the children; and (d) Safe from foreseeable hazard; (24) Fences shall be: (a) Constructed of safe material; (b) Stable; and (c) In good condition. 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: 922 KAR 2:120 Child- care health and safety standards, Section 2 Child Care Services: Section (11) A child shall not be subjected to: (a) Corporal physical discipline pursuant to KRS 199.896(18); (b) Loud, profane, threatening, frightening, humiliating, or abusive language; or (c) Discipline that is associated with: 1. Rest; 2. Toileting; 3. Play time; or 4. Food. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 922 KAR 2:100 Certification of family child care homes Section 13 Care Requirements for a Provider (15) Use of corporal physical discipline shall be prohibited pursuant to KRS 199.896(18). (16) A Provider shall ensure precautions are taken to prevent shaken baby syndrome, abusive head trauma, and child maltreatment. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A - There are no CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: There are not specific standards that dictate the prevention of pediatric abusive head trauma or shaken baby syndrome for Registered Relative Providers, outside of the required training at the initial application and renewal. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: There are not specific standards that dictate the prevention of pediatric abusive head trauma or shaken baby syndrome for Registered Relative Providers, outside of the required training at the initial application and renewal. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: 922 KAR 2:120 Child-care health and safety standards, Section 2 Child Care Services: Section (11) A child shall not be subjected to: (a) Corporal physical discipline pursuant to KRS 199.896(18); (b) Loud, profane, threatening, frightening, humiliating, or abusive language; or (c) Discipline that is associated with: 1. Rest; 2. Toileting; 3. Play time; or 4. Food. 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: 922 KAR 2:120 Child- care health and safety standards, Section 2 Child Care Services: Section (11) A child shall not be subjected to: (a) Corporal physical discipline pursuant to KRS 199.896(18); (b) Loud, profane, threatening, frightening, humiliating, or abusive language; or (c) Discipline that is associated with: 1. Rest; 2. Toileting; 3. Play time; or 4. Food. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 922 KAR 2:100 Certification of family child care homes Section 13 Care Requirements for a Provider (1) A provider shall ensure the health, safety, and comfort of each child. (15) Use of corporal physical discipline shall be prohibited pursuant to KRS 199.896(18). (16) A Provider shall ensure precautions are taken to prevent shaken baby syndrome, abusive head trauma, and child maltreatment. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A - There are no CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: There are not specific standards that dictate the prevention of pediatric abusive head trauma or shaken baby syndrome for Registered Relative Providers, outside of the required training at the initial application and renewal. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: There are not specific standards that dictate the prevention of pediatric abusive head trauma or shaken baby syndrome for Registered Relative Providers, outside of the required training at the initial application and renewal. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: 922 KAR 2:120 Child-care health and safety standards, Section 2 Child Care Services: Section (11) A child shall not be subjected to: (a) Corporal physical discipline pursuant to KRS 199.896(18); (b) Loud, profane, threatening, frightening, humiliating, or abusive language; or (c) Discipline that is associated with: 1. Rest; 2. Toileting; 3. Play time; or 4. Food. 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. [ ] Relocation iii. [x] Shelter-in-place iv. [x] Lock down v. Staff emergency preparedness [x] Training [x] Practice drills vi. Volunteer emergency preparedness [ ] Training [ ] Practice drills vii. [x] Communication with families viii. [ ] Reunification with families ix. [ ] Continuity of operations x. Accommodation of [x] Infants [x] Toddlers [ ] Children with disabilities [ ] Children with chronic medical conditions xi. If any of the above are not checked, describe: The Division of Child Care received a non-compliance notice on December 13, 2021 and June 15, 2023 because the monitoring team did not find evidence that DCC has requirements in place for Licensed Type I, Type II, and Certified Family Child Care Providers that include the volunteer practice drill components of emergency preparedness and response planning. Additionally, the monitoring visit did not find evidence of emergency preparedness and response planning and accommodations for infant and toddlers, children with disabilities, and children with chronic medical conditions. At this time DCC is requesting additional time to continue work on the TA received for the emergency preparedness and response planning with the expected completion of the changes being completed by early 2025. Currently the professional development team is working with the Child Care Aware Health and Safety regional manager to update the ￿Licensed Provider Evacuation Planning Form￿ and the ￿Certified Provider Evacuation Planning Form￿ to include planning resources specific to the special populations requested in the TA. DCC Professional Development team is also updating the Emergency Preparedness Training to include specific resources for the special populations requested in the TA, and to award 1 training credit hour to incentivize providers to have their staff take this training for free. Additionally, DCC has updated the regulations to include a more clear definition for the role of ￿volunteers￿ and will be amended the proposed regulation 922 KAR 2:090 to include: Section 9 ￿J) A written plan and diagram outlining the course of action in the event of a natural or manmade disaster, including drills posted in a prominent place; and provided to all staff, volunteers and visitors" And section 10) F) Assure the development, implementation, and monitoring of child-care centers plans, policies, and procedures for staff, volunteers and visitors.￿ And ￿G) Supervise staff, volunteer and visitor conduct to ensure implementation of program policies and procedures.￿ The public comment period will be ending August 31, 2024 and after that is completed we will amend with our internal process for approval of the amendment. The expected time of completion for these regulatory changes are November 2024. Current Emergency Preparedness and Disaster Plan information can be found here: https://www.childcareawareky.org/wp-content/uploads/2023/03/Emergency-Disaster- Plan-Form-rev-03-23.pdf 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: 922 KAR 2:120 Child- care center health and safety standards Section 3. General Requirements (7) The following shall be inaccessible to a child in care: (a) Toxic cleaning supplies, poisons, and insecticides; (b) Matches, cigarettes, lighters, and flammable liquids; and (c) Personal belongings and medications of staff. (8) The following shall be inaccessible to a child in care unless under direct supervision and part of planned program of instruction: (a) Knives and sharp objects; (b) Litter and rubbish; (c) Bar soap; and (d) Plastic bags not used for personal belongings. (9) In accordance with KRS 527.070(1), firearms and ammunition shall be stored separately from each other in a locked area outside of the designated child care area. (10) Smoking or vaping shall: (a) Be permitted in accordance with local ordinances; (b) Be allowed only in outside designated areas; and (c) Not be permitted in the presence of a child. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 922 KAR 2:100 Section 12(3) from https://apps.legislature.ky.gov/law/kar/titles/922/002/100/ (3) The areas of the home that are accessible to children in care shall be free from items harmful to children including: (a) Cleaning supplies, poisons, paints, and insecticides; (b) Knives, scissors, and sharp objects; (c) Power tools, lawn mowers, hand tools, nails, and other equipment; (d) Matches, cigarettes, lighters, combustibles, flammable liquids, and all fire hazards; (e) Plastic bags; and (f) Litter and rubbish. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A - There are no CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Registered relative child care providers do not have specific regulations that address the handling and storage of hazardous materials. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Registered relative child care providers do not have specific regulations that address the handling and storage of hazardous materials. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: 922 KAR 2:120 Child-care center health and safety standards Section 3. General Requirements (7) The following shall be inaccessible to a child in care: (a) Toxic cleaning supplies, poisons, and insecticides; (b) Matches, cigarettes, lighters, and flammable liquids; and (c) Personal belongings and medications of staff. (8) The following shall be inaccessible to a child in care unless under direct supervision and part of planned program of instruction: (a) Knives and sharp objects; (b) Litter and rubbish; (c) Bar soap; and (d) Plastic bags not used for personal belongings. (9) In accordance with KRS 527.070(1), firearms and ammunition shall be stored separately from each other in a locked area outside of the designated child care area. (10) Smoking or vaping shall: (a) Be permitted in accordance with local ordinances; (b) Be allowed only in outside designated areas; and (c) Not be permitted in the presence of a child. 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: 922 KAR 2:120 Child- care center health and safety standards Section 4. Premises Requirements (12) Sewage shall be properly disposed by a method approved by the: (a) Energy and Environment Cabinet; or (b) Cabinet. (13) All plumbing shall comply with the State Plumbing Code established in KRS Chapter 318. (14) Solid waste shall be kept in a suitable receptacle in accordance with local, county, and state law, as governed by KRS 211.350 to 211.380. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 922 KAR 2:100 Certification of family child-care homes. Section 13. Care Requirements for a Provider. (18) Waste and biological contaminants, such as bodily fluids, blood, or excretions, shall be: (a) Disposed of in a manner that prevents exposure to children; (b) Inaccessible to children; and (c) In a covered plastic-lined receptacle with a close-fitting lid. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A - There are no CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Registered relative child care providers do not have specific regulations that address the disposal of bio contaminants. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Registered relative child care providers do not have specific regulations that address the disposal of bio contaminants. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: 922 KAR 2:120 Child-care center health and safety standards Section 4. Premises Requirements (12) Sewage shall be properly disposed by a method approved by the: (a) Energy and Environment Cabinet; or (b) Cabinet. (13) All plumbing shall comply with the State Plumbing Code established in KRS Chapter 318. (14) Solid waste shall be kept in a suitable receptacle in accordance with local, county, and state law, as governed by KRS 211.350 to 211.380. 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: 922 KAR 2:120 Child- care center health and safety standards Section 14. Transportation (1) A center shall document compliance with KRS Chapter 186 and 603 KAR 5:072 pertaining to: (a) Vehicles; (b) Drivers; and (c) Insurance. (2) A center providing or arranging transportation service shall: (a) Be licensed and approved by the cabinet or its designee prior to transporting a child; (b) Have a written plan that details the type of transportation, staff schedule, transportation schedule, and transportation route; and (c) Have written policies and procedures, including emergency procedures practiced monthly by staff who transports children. (3) Prior to transporting a child, a center providing transportation services of a child shall notify the cabinet or its designee in writing of the: (a) Type of transportation offered; (b) Type of vehicle used for transportation; (c) Plan for ensuring staff perform duties relating to transportation properly; (d) Full insurance coverage for each vehicle; (e) Agency policy and procedures relating to an emergency plan for evacuating the vehicle; (f) Contracts, agreements, or documents detailing arrangements with any third party for services; and (g) Safety procedures for: 1. Transporting a child; 2. Loading and unloading a child; and 3. Providing adequate supervision of a child. (4) A vehicle used to transport children shall be equipped with: (a) A fire extinguisher; (b) First aid supplies as established in Section 7 of this administrative regulation; (c) Emergency reflective triangles; and (d) A device to cut the restraint system, if necessary. (5) Transportation provided by licensed public transportation or a school bus shall comply with subsections (1) and (2) of this section. (6) A vehicle used to transport children shall comply with the requirements established in paragraphs (a) through (d) of this subsection. (a) For a twelve (12) or more passenger vehicle, the child-care center shall maintain a current certification of inspection from the Transportation Cabinet. (b) A vehicle that requires traffic to stop while loading and unloading a child shall be equipped with a system of: 1. Signal lamps; 2. Identifying colors; and 3. Cautionary words. (c) A vehicle shall be equipped with seat belts for each occupant to be individually secured. (d) A vehicle shall not transport children and hazardous materials at the same time. (7) The appropriate car safety seat meeting federal and state motor vehicle safety standards in 49 C.F.R. 571.213 and KRS 189.125 shall be used for each child. (8) A daily inspection of the vehicle shall be performed prior to the vehicle's use and documented for: (a) Tire inflation consistent with tire manufacturer's recommended air pressure; (b) Working lights, signals, mirrors, gauges, and wiper blades; (c) Working safety restraints; (d) Adequate fuel level; and (e) Cleanliness and good repair. (9) (a) The staff-to-child ratios set forth in Section 2 (2) of this administrative regulation shall apply to vehicle transport, if not inconsistent with special requirements or exceptions in this section. (b) An individual who is driving with a child in the vehicle shall supervise no more than four (4) children under the age of five (5). (10) Each child shall: (a) Have a seat; (b) Be individually belted or harnessed in the seat; and (c) Remain seated while the vehicle is in motion. (11) A child shall not be left unattended: (a) At the site of aftercare delivery; or (b) In a vehicle. (12) If the parent or designee is unavailable, a prearranged written plan shall be completed to designate where the child can be picked up. (13) A child shall not be picked up or delivered to a location that requires crossing the street or highway unless accompanied by an adult. (14) A vehicle transporting a child shall have the headlamps on. (15) If a vehicle needs to be refueled, it shall be refueled only while not being used to transport a child. If emergency refueling or repair is necessary during transporting, all children shall be removed and supervised by an adequate number of adults while refueling or repair is occurring. (16) If the driver is not in the driver's seat, the: (a) Engine shall be turned off; (b) Keys shall be removed; and (c) Emergency brake shall be set. (17) Transportation services provided shall: (a) Be recorded in writing and include: 1. The first and last name of the child transported; and 2. The time each child gets on and the time each child gets off; (b) Be completed by a staff member other than the driver; and (c) Be kept for five (5) years. (18) A driver of a vehicle transporting a child for a center shall: (a) Be at least twenty-one (21) years old; (b) Complete: 1. The background checks as described in 922 KAR 2:280; and 2. An annual check of the: a. Kentucky driver history records in accordance with KRS 186.018; or b. Driver history records through the state transportation agency that issued the driver's license; (c) Hold a current driver's license that has not been suspended or revoked during the last five (5) years; and (d) Not caused an accident that resulted in the death of a person. (19) Firearms, ammunition, alcohol, or illegal substances shall not be transported in a vehicle transporting children. (20) (a) Based on the harm, threat, or danger to a child's health, safety, and welfare, the cabinet shall revoke a center's privilege to transport a child or pursue an adverse action in accordance with Section 15, 16, 17, or 18 of 922 KAR 2:090: 1. For a violation of this section; or 2. If the center: a. Fails to report an accident in accordance with 922 KAR 2:090, Section 13; or b. Transports more passengers than the vehicle's seating capacity and safety restraints can accommodate. (b) Revocation of a center's privilege to provide transportation services in accordance with paragraph (a) of this subsection shall: 1. Apply to each site listed under the licensee; and 2. Remain effective for no less than a twelve (12) month period. (21) A parent may use the parent's vehicle to transport the parent's child during a field trip. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 922 KAR 2:100 Certification of family child-care homes. Section 18. Transportation (1) If transportation is provided or arranged by the certified family child-care home provider, the provider shall: (a) Have written permission from a parent to transport his or her child; (b) Have a car or van equipped with seat belts; (c) Require that a child: 1. Be restrained in an appropriate safety seat meeting state and federal motor vehicle safety standards in accordance with KRS 189.125 and 49 C.F.R. 571.213; 2. Remain seated while the vehicle is in motion; and 3. If under thirteen (13) years of age, be transported in the back seat; (d) Have emergency and identification information about each child in the vehicle if children are being transported; and (e) Conform to state laws pertaining to vehicles, driver's license, and insurance pursuant to KRS 186.020. (2) A child shall not be left unattended: (a) At the site of aftercare delivery; or (b) In a vehicle. (3) A child shall not be left in a vehicle while it is being repaired. (4) The back of a pickup truck shall not be used to transport a child. (5) Firearms, ammunition, alcohol, or illegal substances shall not be transported in a vehicle transporting children. (6) A vehicle shall not transport children and hazardous materials at the same time. (7) A vehicle transporting a child shall have the headlamps on. (8) If the driver is not in the driver's seat, the: (a) Engine shall be turned off; (b) Keys shall be removed; and (c) Emergency brake shall be set. (9) A driver of a vehicle transporting a child for a certified provider shall: (a) Be at least twenty-one (21) years old; (b) Complete: 1. The background checks described in Section 2(2)(c)5 or 2(5) of this administrative regulation; and 2. An annual check of the: a. Kentucky driver history records in accordance with KRS 186.018; or b. Driver history records through the state transportation agency that issued the driver's license; (c) Hold a current driver's license that has not been suspended or revoked during the last five (5) years; and (d) Not have caused an accident which resulted in the death of a person. (10) Based on the harm, threat, or danger to a child's health, safety, and welfare, the cabinet shall pursue an adverse action in accordance with Section 5, 6, 7, or 8 of this administrative regulation: (a) For a violation of this section; or (b) If the provider: 1. Fails to report an accident in accordance with Section 20(10)(a) of this administrative regulation; or 2. Transports more passengers than the vehicle's seating capacity and safety restraints can accommodate. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A - There are no CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Registered relative child care providers do not have regulations that address precautions in transporting children. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Registered relative child care providers do not have regulations that address precautions in transporting children. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: 922 KAR 2:120 Child-care center health and safety standards Section 14. Transportation (1) A center shall document compliance with KRS Chapter 186 and 603 KAR 5:072 pertaining to: (a) Vehicles; (b) Drivers; and (c) Insurance. (2) A center providing or arranging transportation service shall: (a) Be licensed and approved by the cabinet or its designee prior to transporting a child; (b) Have a written plan that details the type of transportation, staff schedule, transportation schedule, and transportation route; and (c) Have written policies and procedures, including emergency procedures practiced monthly by staff who transports children. (3) Prior to transporting a child, a center providing transportation services of a child shall notify the cabinet or its designee in writing of the: (a) Type of transportation offered; (b) Type of vehicle used for transportation; (c) Plan for ensuring staff perform duties relating to transportation properly; (d) Full insurance coverage for each vehicle; (e) Agency policy and procedures relating to an emergency plan for evacuating the vehicle; (f) Contracts, agreements, or documents detailing arrangements with any third party for services; and (g) Safety procedures for: 1. Transporting a child; 2. Loading and unloading a child; and 3. Providing adequate supervision of a child. (4) A vehicle used to transport children shall be equipped with: (a) A fire extinguisher; (b) First aid supplies as established in Section 7 of this administrative regulation; (c) Emergency reflective triangles; and (d) A device to cut the restraint system, if necessary. (5) Transportation provided by licensed public transportation or a school bus shall comply with subsections (1) and (2) of this section. (6) A vehicle used to transport children shall comply with the requirements established in paragraphs (a) through (d) of this subsection. (a) For a twelve (12) or more passenger vehicle, the child-care center shall maintain a current certification of inspection from the Transportation Cabinet. (b) A vehicle that requires traffic to stop while loading and unloading a child shall be equipped with a system of: 1. Signal lamps; 2. Identifying colors; and 3. Cautionary words. (c) A vehicle shall be equipped with seat belts for each occupant to be individually secured. (d) A vehicle shall not transport children and hazardous materials at the same time. (7) The appropriate car safety seat meeting federal and state motor vehicle safety standards in 49 C.F.R. 571.213 and KRS 189.125 shall be used for each child. (8) A daily inspection of the vehicle shall be performed prior to the vehicle's use and documented for: (a) Tire inflation consistent with tire manufacturer's recommended air pressure; (b) Working lights, signals, mirrors, gauges, and wiper blades; (c) Working safety restraints; (d) Adequate fuel level; and (e) Cleanliness and good repair. (9) (a) The staff-to-child ratios set forth in Section 2 (2) of this administrative regulation shall apply to vehicle transport, if not inconsistent with special requirements or exceptions in this section. (b) An individual who is driving with a child in the vehicle shall supervise no more than four (4) children under the age of five (5). (10) Each child shall: (a) Have a seat; (b) Be individually belted or harnessed in the seat; and (c) Remain seated while the vehicle is in motion. (11) A child shall not be left unattended: (a) At the site of aftercare delivery; or (b) In a vehicle. (12) If the parent or designee is unavailable, a prearranged written plan shall be completed to designate where the child can be picked up. (13) A child shall not be picked up or delivered to a location that requires crossing the street or highway unless accompanied by an adult. (14) A vehicle transporting a child shall have the headlamps on. (15) If a vehicle needs to be refueled, it shall be refueled only while not being used to transport a child. If emergency refueling or repair is necessary during transporting, all children shall be removed and supervised by an adequate number of adults while refueling or repair is occurring. (16) If the driver is not in the driver's seat, the: (a) Engine shall be turned off; (b) Keys shall be removed; and (c) Emergency brake shall be set. (17) Transportation services provided shall: (a) Be recorded in writing and include: 1. The first and last name of the child transported; and 2. The time each child gets on and the time each child gets off; (b) Be completed by a staff member other than the driver; and (c) Be kept for five (5) years. (18) A driver of a vehicle transporting a child for a center shall: (a) Be at least twenty-one (21) years old; (b) Complete: 1. The background checks as described in 922 KAR 2:280; and 2. An annual check of the: a. Kentucky driver history records in accordance with KRS 186.018; or b. Driver history records through the state transportation agency that issued the driver's license; (c) Hold a current driver's license that has not been suspended or revoked during the last five (5) years; and (d) Not caused an accident that resulted in the death of a person. (19) Firearms, ammunition, alcohol, or illegal substances shall not be transported in a vehicle transporting children. (20) (a) Based on the harm, threat, or danger to a child's health, safety, and welfare, the cabinet shall revoke a center's privilege to transport a child or pursue an adverse action in accordance with Section 15, 16, 17, or 18 of 922 KAR 2:090: 1. For a violation of this section; or 2. If the center: a. Fails to report an accident in accordance with 922 KAR 2:090, Section 13; or b. Transports more passengers than the vehicle's seating capacity and safety restraints can accommodate. (b) Revocation of a center's privilege to provide transportation services in accordance with paragraph (a) of this subsection shall: 1. Apply to each site listed under the licensee; and 2. Remain effective for no less than a twelve (12) month period. (21) A parent may use the parent's vehicle to transport the parent's child during a field trip. 5.3.10 Pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) health and safety standard a. Provide the standards, appropriate to the provider setting and age of children, that address pediatric first aid for all staff for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: 922 KAR 2:090 Child Care Licensure Section 11 Staff Requirements Subsection 3-5 These subsections detail the requirements for centers to have at least one person on-site that is certified in CPR/First Aid based on age group (Infant and child; adult). CPR and First Aid training is not included in ongoing professional development training hours. 922 KAR 2:120 Section 7 Subsection 8 Each center shall ensure that every staff member has received training on first aid and cardiopulmonary resuscitation (CPR). The Division of Child Care offers several ways this requirement can be met. It is included in pre-service Orientation, so that new employees meet this requirement. If a child care staff has ever been certified in CPR and First Aid (even if it is now expired), this can count for the training requirement. The Division of Child Care also created a standalone, on-demand training that is hosted free of charge on ECE-TRIS that meets this training requirement. The Division of Child Care received a non-compliance notice on December 13, 2021, because the monitoring team did not find evidence that DCC has requirements in place for all CCDF-funded providers (appropriate to provider setting and age of children served) requirements to include pediatric first aid and CPR. DCC has completed updates to all license types to include the requirement of pediatric first aid training appropriate to provider setting and age served. Registered Relative care provider regulations were updated in October 2023 to include providing verification for the required cabinet-approved trainings: "Age- appropriate cardiopulmonary resuscitation (CPR) and first aid certified by a training agency that has been approved by the cabinet as providing research- based and scientific best practices;". Citation: https://apps.legislature.ky.gov/law/kar/titles/922/002/180/ Certified Provider regulations were updated April 2024 to include applicants seeking certification shall ￿be currently certified by an agency approved in accordance with 922 KAR 2:240 in infant, child and adult: (1) Cardiopulmonary resuscitation (CPR); and (2) First aid.￿ Certified regulations for assistants were also updated to ￿prior to being left alone with a child, an assistant shall be certified by a cabinet-approved agency in infant, child and adult: (a) Cardiopulmonary Resuscitation (CPR); and (b) First aid.￿ Citation: https://apps.legislature.ky.gov/law/kar/titles/922/002/100/ Licensed Provider regulations were updated in May 2024 and are currently in ￿Proposed￿ status, with the expectation the regulation will be passed after the open comment period. The proposed regulations include the following changes for CCDF compliance: ￿For a child-care center licensed for infant, toddler, or preschool-age children, at least one (1) person on duty and present with the children shall be currently certified by a cabinet-approved training agency in the following skills: (a) Infant and child cardiopulmonary resuscitation; and (b) Infant and child first aid. (4) For a child-care center licensed for school-age children, at least one (1) person on duty and present with the children shall be currently certified by a cabinet-approved training agency in the following skills: (a) Adult cardiopulmonary resuscitation; and (b) First aid. Citation: https://apps.legislature.ky.gov/law/kar/titles/922/002/090/REG/ ii. All CCDF-eligible licensed family child care homes. Provide the standard: 922 KAR 2:100 Section 2 Certification Process Subsection 4 Applicants for a licensed family child care homes are required to be certified by an approved agency in infant, child and adult CPR and First Aid. Section 10 Standards for the Providers Subsection 6 Assistants in a family child care home must be certified by an approved agency in infant, child and adult CPR and First Aid. Section 3 Renewal of Certification Subsection 2(d) In order to renew their certification, providers must maintain their certification in an approved agency in infant, child and adult CPR and First Aid. The Division of Child Care recieved a non-compliance notice on December 13, 2021 because the monitoring team did not find evidence that DCC has requirements in place for all CCDF-funded providers (appropriate to provider setting and age of children served) requirements to include pediatric first aid and CPR. DCC has completed updates to all license types to include the requirement of pediatric first aid training appropriate to provider setting and age served. Registered Relative care provider regulations were updated in October 2023 to include providing verification for the required cabinet-approved trainings: "Age- appropriate cardiopulmonary resuscitation (CPR) and first aid certified by a training agency that has been approved by the cabinet as providing research- based and scientific best practices;". Citation: https://apps.legislature.ky.gov/law/kar/titles/922/002/180/ Certified Provider regulations were updated April 2024 to include applicants seeking certification shall ￿be currently certified by an agency approved in accordance with 922 KAR 2:240 in infant, child and adult: (1) Cardiopulmonary resuscitation (CPR); and (2) First aid.￿ Certified regulations for assistants were also updated to ￿prior to being left alone with a child, an assistant shall be certified by a cabinet-approved agency in infant, child and adult: (a) Cardiopulmonary Resuscitation (CPR); and (b) First aid.￿ Citation: https://apps.legislature.ky.gov/law/kar/titles/922/002/100/ Licensed Provider regulations were updated in May 2024 and are currently in ￿Proposed￿ status, with the expectation the regulation will be passed after the open comment period. The proposed regulations include the following changes for CCDF compliance: ￿For a child-care center licensed for infant, toddler, or preschool-age children, at least one (1) person on duty and present with the children shall be currently certified by a cabinet-approved training agency in the following skills: (a) Infant and child cardiopulmonary resuscitation; and (b) Infant and child first aid. (4) For a child-care center licensed for school-age children, at least one (1) person on duty and present with the children shall be currently certified by a cabinet-approved training agency in the following skills: (a) Adult cardiopulmonary resuscitation; and (b) First aid. Citation: https://apps.legislature.ky.gov/law/kar/titles/922/002/090/REG/ iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A - There are no CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: 922 KAR 2:180 Section 2 Application Rights and Requirements for Relative Child Care Provider Registration Subsection 2 (b)(2) Within 90 days of submitting and application, a potential provider must obtain age-appropriate cardiopulmonary resuscitation (CPR) and first aid certified by a training agency that has been approved by the cabinet. Section 7 Renewal of Registration Subsection 2(c) In order to renew, providers must obtain certification in cabinet-approved age- appropriate cardiopulmonary resuscitation (CPR) and first aid. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: 922 KAR 2:180 Section 2 Application Rights and Requirements for Relative Child Care Provider Registration Subsection 2 (b)(2) Within 90 days of submitting and application, a potential provider must obtain age-appropriate cardiopulmonary resuscitation (CPR) and first aid certified by a training agency that has been approved by the cabinet. Section 7 Renewal of Registration Subsection 2(c) In order to renew, providers must obtain certification in cabinet-approved age- appropriate cardiopulmonary resuscitation (CPR) and first aid. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: 922 KAR 2:090 Child Care Licensure Section 11 Staff Requirements Subsection 3-5 These subsections detail the requirements for centers to have at least one person on-site that is certified in CPR/First Aid based on age group (Infant and child; adult). CPR and First Aid training is not included in ongoing professional development training hours. 922 KAR 2:120 Section 7 Subsection 8 Each center shall ensure that every staff member has received training on first aid and cardiopulmonary resuscitation (CPR). The Division of Child Care offers several ways this requirement can be met. It is included in pre-service Orientation, so that new employees meet this requirement. If a child care staff has ever been certified in CPR and First Aid (even if it is now expired), this can count for the training requirement. The Division of Child Care also created a standalone, on-demand training that is hosted free of charge on ECE-TRIS that meets this training requirement. 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: 922 KAR 2:090 Child Care Licensure Section 11 Staff Requirements Subsection 3-5 These subsections detail the requirements for centers to have at least one person on-site that is certified in CPR/First Aid based on age group (Infant and child; adult). CPR and First Aid training is not included in ongoing professional development training hours. 922 KAR 2:120 Section 7 Subsection 8 Each center shall ensure that every staff member has received training on first aid and cardiopulmonary resuscitation (CPR). The Division of Child Care offers several ways this requirement can be met. It is included in pre-service Orientation, so that new employees meet this requirement. If a child care staff has ever been certified in CPR and First Aid (even if it is now expired), this can count for the training requirement. The Division of Child Care also created a standalone, on-demand training that is hosted free of charge on ECE-TRIS that meets this training requirement. The Division of Child Care recieved a non-compliance notice on December 13, 2021 because the monitoring team did not find evidence that DCC has requirements in place for all CCDF-funded providers (appropriate to provider setting and age of children served) requirements to include pediatric first aid and CPR. DCC has completed updates to all license types to include the requirement of pediatric first aid training appropriate to provider setting and age served. Registered Relative care provider regulations were updated in October 2023 to include providing verification for the required cabinet-approved trainings: "Age- appropriate cardiopulmonary resuscitation (CPR) and first aid certified by a training agency that has been approved by the cabinet as providing research- based and scientific best practices;". Citation: https://apps.legislature.ky.gov/law/kar/titles/922/002/180/ Certified Provider regulations were updated April 2024 to include applicants seeking certification shall ￿be currently certified by an agency approved in accordance with 922 KAR 2:240 in infant, child and adult: (1) Cardiopulmonary resuscitation (CPR); and (2) First aid.￿ Certified regulations for assistants were also updated to ￿prior to being left alone with a child, an assistant shall be certified by a cabinet-approved agency in infant, child and adult: (a) Cardiopulmonary Resuscitation (CPR); and (b) First aid.￿ Citation: https://apps.legislature.ky.gov/law/kar/titles/922/002/100/ Licensed Provider regulations were updated in May 2024 and are currently in ￿Proposed￿ status, with the expectation the regulation will be passed after the open comment period. The proposed regulations include the following changes for CCDF compliance: ￿For a child-care center licensed for infant, toddler, or preschool-age children, at least one (1) person on duty and present with the children shall be currently certified by a cabinet-approved training agency in the following skills: (a) Infant and child cardiopulmonary resuscitation; and (b) Infant and child first aid. (4) For a child-care center licensed for school-age children, at least one (1) person on duty and present with the children shall be currently certified by a cabinet-approved training agency in the following skills: (a) Adult cardiopulmonary resuscitation; and (b) First aid. Citation: https://apps.legislature.ky.gov/law/kar/titles/922/002/090/REG/ ii. All CCDF-eligible licensed family child care homes. Provide the standard: 922 KAR 2:100 Section 2 Certification Process Subsection 4 Applicants for a licensed family child care homes are required to be certified by an approved agency in infant, child and adult CPR and First Aid. Section 10 Standards for the Providers Subsection 6 Assistants in a family child care home must be certified by an approved agency in infant, child and adult CPR and First Aid. Section 3 Renewal of Certification Subsection 2(d) In order to renew their certification, providers must maintain their certification in an approved agency in infant, child and adult CPR and First Aid. The Division of Child Care recieved a non-compliance notice on December 13, 2021 because the monitoring team did not find evidence that DCC has requirements in place for all CCDF-funded providers (appropriate to provider setting and age of children served) requirements to include pediatric first aid and CPR. DCC has completed updates to all license types to include the requirement of pediatric first aid training appropriate to provider setting and age served. Registered Relative care provider regulations were updated in October 2023 to include providing verification for the required cabinet-approved trainings: "Age- appropriate cardiopulmonary resuscitation (CPR) and first aid certified by a training agency that has been approved by the cabinet as providing research- based and scientific best practices;". Citation: https://apps.legislature.ky.gov/law/kar/titles/922/002/180/ Certified Provider regulations were updated April 2024 to include applicants seeking certification shall ￿be currently certified by an agency approved in accordance with 922 KAR 2:240 in infant, child and adult: (1) Cardiopulmonary resuscitation (CPR); and (2) First aid.￿ Certified regulations for assistants were also updated to ￿prior to being left alone with a child, an assistant shall be certified by a cabinet-approved agency in infant, child and adult: (a) Cardiopulmonary Resuscitation (CPR); and (b) First aid.￿ Citation: https://apps.legislature.ky.gov/law/kar/titles/922/002/100/ Licensed Provider regulations were updated in May 2024 and are currently in ￿Proposed￿ status, with the expectation the regulation will be passed after the open comment period. The proposed regulations include the following changes for CCDF compliance: ￿For a child-care center licensed for infant, toddler, or preschool-age children, at least one (1) person on duty and present with the children shall be currently certified by a cabinet-approved training agency in the following skills: (a) Infant and child cardiopulmonary resuscitation; and (b) Infant and child first aid. (4) For a child-care center licensed for school-age children, at least one (1) person on duty and present with the children shall be currently certified by a cabinet-approved training agency in the following skills: (a) Adult cardiopulmonary resuscitation; and (b) First aid. Citation: https://apps.legislature.ky.gov/law/kar/titles/922/002/090/REG/ iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A - There are no CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: 922 KAR 2:180 Section 2 Application Rights and Requirements for Relative Child Care Provider Registration Subsection 2 (b)(2) Within 90 days of submitting and application, a potential provider must obtain age-appropriate cardiopulmonary resuscitation (CPR) and first aid certified by a training agency that has been approved by the cabinet. Section 7 Renewal of Registration Subsection 2(c) In order to renew, providers must obtain certification in cabinet-approved age- appropriate cardiopulmonary resuscitation (CPR) and first aid. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: 922 KAR 2:180 Section 2 Application Rights and Requirements for Relative Child Care Provider Registration Subsection 2 (b)(2) Within 90 days of submitting and application, a potential provider must obtain age-appropriate cardiopulmonary resuscitation (CPR) and first aid certified by a training agency that has been approved by the cabinet. Section 7 Renewal of Registration Subsection 2(c) In order to renew, providers must obtain certification in cabinet-approved age- appropriate cardiopulmonary resuscitation (CPR) and first aid. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: 922 KAR 2:090 Child Care Licensure Section 11 Staff Requirements Subsection 3-5 These subsections detail the requirements for centers to have at least one person on-site that is certified in CPR/First Aid based on age group (Infant and child; adult). CPR and First Aid training is not included in ongoing professional development training hours. 922 KAR 2:120 Section 7 Subsection 8 Each center shall ensure that every staff member has received training on first aid and cardiopulmonary resuscitation (CPR). The Division of Child Care offers several ways this requirement can be met. It is included in pre-service Orientation, so that new employees meet this requirement. If a child care staff has ever been certified in CPR and First Aid (even if it is now expired), this can count for the training requirement. The Division of Child Care also created a standalone, on-demand training that is hosted free of charge on ECE-TRIS that meets this training requirement. 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: Per KY Statute: https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=53977, child care providers are mandated reporters. 922 KAR 2:120 Child-care center health and safety standards. Section 2 (3) (a) Each center shall maintain a child-care program that assures each child shall be: 1. Provided with adequate supervision at all times by a qualified staff person who ensures the child is: a. Within scope of vision and range of voice; or b. For a school-age child, within scope of vision or range of voice; and 2. Protected from abuse and neglect. (b) The program shall include: 1. A procedure to ensure compliance with and inform child care staff of the laws of the Commonwealth pertaining to child abuse or neglect set forth in KRS 620.030 KRS 620.030 Duty to report dependency, neglect, abuse, human trafficking, or female genital mutilation ￿ husband-wife and professional-client/patient privileges not grounds for refusal to report ￿ statewide reporting system ￿ exceptions ￿ penalties. (1) Any person who knows or has reasonable cause to believe that a child is dependent, neglected, or abused shall immediately cause an oral or written report, including but not limited to electronic submissions, to be made to a local law enforcement agency or to the Department of Kentucky State Police, the cabinet or its designated representative, the Commonwealth's attorney, or the county attorney by telephone or otherwise. If the cabinet receives a report of abuse or neglect allegedly committed by a person other than a parent, guardian, fictive kin, person in a position of authority, person in a position of special trust, or person exercising custodial control or supervision, the cabinet shall refer the matter to the Commonwealth's attorney or the responsible for the abuse or neglect; and e. Any other information that the person making the report believes may be helpful in the furtherance of the purpose of this section. (b) Upon notification, the supervisor or the designated agent, if any, shall facilitate the cooperation of the institution, school, facility, or agency with the investigation of the report. (c) Any person who knowingly causes intimidation, retaliation, or obstruction in the investigation of the report shall be guilty of a Class A misdemeanor. (d) This section shall not require more than one (1) report from any institution, school, facility, or agency. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Per KY Statute: https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=53977, child care providers are mandated reporters. 922 KAR 2:100 Certification of family child-care homes Section 2. Certification process (9) Within three (3) months of submission to the cabinet of a complete OIG-DRCC- 03, an applicant shall: (a) In accordance with KRS 199.8982(1)(a)(6), demonstrate completion of six (6) hours of cabinet-approved pre-service orientation training in the following topics: 1. Federal minimum health and safety requirements established in 45 C.F.R. 98.41 related to: a. Prevention and control of infectious diseases, including immunization; b. Prevention of sudden infant death syndrome and use of safe sleeping practices; c. Administration of medication, consistent with standards for parental consent; d. Prevention of and response to emergencies due to food and allergic reactions; e. Building and physical premises safety, including identification of and protection from hazards, bodies of water, and vehicular traffic; f. Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment; g. Emergency preparedness and response planning for emergencies resulting from a natural disaster or a human-caused event; h. Handling and storage of hazardous materials and the appropriate disposal of biological contaminants; and i. Precautions in transporting children; 2. Recognizing and reporting child abuse; and 3. Developmentally appropriate practices; and (b) Develop and implement a written plan for obtaining: 1. Three (3) hours of cabinet-approved training within the first year of operation, including one and one-half (1 1/2) hours of cabinet-approved pediatric abusive head trauma training in accordance with KRS 199.8982(2); and 2. Nine (9) hours of cabinet-approved training annually between July 1 and the following June 30 of each subsequent year of operation, including one and one- half (11/2) hours of cabinet-approved pediatric abusive head trauma training completed once every five (5) years as required in Section 10(1) of this administrative regulation. Section 16 Medication and First Aid (8) A provider and an assistant shall: (a) Be able to recognize symptoms of childhood illnesses; (b) Be able to provide basic first aid; and (c) Maintain a child care program that assures affirmative steps are taken to protect children from abuse or neglect pursuant to KRS 600.020(1). Section 19 Records (4) A certified family child-care home provider shall: (a) Report an incident of suspected child abuse or neglect pursuant to KRS 620.030; and (b) Provide the cabinet access and information in the completion of the investigation pursuant to KRS 620.030. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A - There are no CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Legislation mandates education on the identification and prevention of Pediatric Abusive Head Trauma for various groups in the state who work with or care for young children. 922 KAR 2:180 Requirements for registered relative child care providers in the Child Care Assistance Program Section 2 Application Rights and Requirements for Relative Child Care Provider Registration 922 KAR 2:180 Requirements for registered relative child care providers in the Child Care Assistance Program Section 2. Application rights and requirements for relative child care providers (2) (a) An applicant may receive conditional approval in accordance with Section 4(2) of this administrative regulation; (b) Within ninety (90) calendar days of submitting an application to be a registered relative child care provider in CCAP pursuant to subsection (1) of this section, the applicant shall provide verification that the applicant has obtained training approved by the cabinet or its designee in the areas of: 1. Recognition of child abuse and neglect, which shall include one and one-half (1.5) hours of cabinet-approved pediatric abusive head trauma training in accordance with KRS 199.896(16); and 2. Age-appropriate cardiopulmonary resuscitation (CPR) and first aid certified by a training agency that has been approved by the cabinet as providing research- based and scientific best practices; and (c) An applicant who fails to complete the training required by paragraph (b) of this subsection shall be subject to cabinet action in accordance with Section 4(4) of this administrative regulation. Section 7. Renewal of Registration (2) To renew child care provider registration prior to the expiration of the registration, a registered child care provider shall: (a) Meet the requirements specified in: 1. Sections 2, 5, and 6 of this administrative regulation; and 2. 922 KAR 2:280; (b) Complete, and provide verification of, one and one-half (1 1/2) hours of pediatric abusive head trauma training once and each subsequent five (5) years of employment or operation as a child care provider; (c) Obtain certification in cabinet-approved age-appropriate cardiopulmonary resuscitation (CPR) and first aid; and (d) Complete cabinet-approved training on billing and utilizing the DCC-94E in accordance with 922 KAR 2:160. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Legislation mandates education on the identification and prevention of Pediatric Abusive Head Trauma for various groups in the state who work with or care for young children. This training will help caregivers recognize the signs of maltreatment, which can prevent escalations to Pediatric Abusive Head Trauma. All employees and owners of a licensed, certified and registered child-care program are required to take a minimum of 1.5 hours of training on PAHT once every five years as part of their continuing education requirements and counts towards the required annual training total. The Division of Child Care partners with Prevent Child Abuse Kentucky and Dr. Melissa Currie for the PAHT curriculum development. A recent update to the PAHT curriculum was completed in November 2023. This training addresses bruising, as well as other identification and reporting factors. 922 KAR 2:180 Requirements for registered relative child care providers in the Child Care Assistance Program Section 2 Application Rights and Requirements for Relative Child Care Provider Registration 922 KAR 2:180 Requirements for registered relative child care providers in the Child Care Assistance Program Section 2. Application rights and requirements for relative child care providers (2) (a) An applicant may receive conditional approval in accordance with Section 4(2) of this administrative regulation; (b) Within ninety (90) calendar days of submitting an application to be a registered relative child care provider in CCAP pursuant to subsection (1) of this section, the applicant shall provide verification that the applicant has obtained training approved by the cabinet or its designee in the areas of: 1. Recognition of child abuse and neglect, which shall include one and one-half (1.5) hours of cabinet-approved pediatric abusive head trauma training in accordance with KRS 199.896(16); and 2. Age-appropriate cardiopulmonary resuscitation (CPR) and first aid certified by a training agency that has been approved by the cabinet as providing research- based and scientific best practices; and (c) An applicant who fails to complete the training required by paragraph (b) of this subsection shall be subject to cabinet action in accordance with Section 4(4) of this administrative regulation. Section 7. Renewal of Registration (2) To renew child care provider registration prior to the expiration of the registration, a registered child care provider shall: (a) Meet the requirements specified in: 1. Sections 2, 5, and 6 of this administrative regulation; and 2. 922 KAR 2:280; (b) Complete, and provide verification of, one and one-half (1 1/2) hours of pediatric abusive head trauma training once and each subsequent five (5) years of employment or operation as a child care provider; (c) Obtain certification in cabinet-approved age-appropriate cardiopulmonary resuscitation (CPR) and first aid; and (d) Complete cabinet-approved training on billing and utilizing the DCC-94E in accordance with 922 KAR 2:160. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Per KY Statute: https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=53977, child care providers are mandated reporters. 922 KAR 2:120 Child-care center health and safety standards. Section 2 (3) (a) Each center shall maintain a child-care program that assures each child shall be: 1. Provided with adequate supervision at all times by a qualified staff person who ensures the child is: a. Within scope of vision and range of voice; or b. For a school-age child, within scope of vision or range of voice; and 2. Protected from abuse and neglect. (b) The program shall include: 1. A procedure to ensure compliance with and inform child care staff of the laws of the Commonwealth pertaining to child abuse or neglect set forth in KRS 620.030 KRS 620.030 Duty to report dependency, neglect, abuse, human trafficking, or female genital mutilation ￿ husband-wife and professional-client/patient privileges not grounds for refusal to report ￿ statewide reporting system ￿ exceptions ￿ penalties. (1) Any person who knows or has reasonable cause to believe that a child is dependent, neglected, or abused shall immediately cause an oral or written report, including but not limited to electronic submissions, to be made to a local law enforcement agency or to the Department of Kentucky State Police, the cabinet or its designated representative, the Commonwealth's attorney, or the county attorney by telephone or otherwise. If the cabinet receives a report of abuse or neglect allegedly committed by a person other than a parent, guardian, fictive kin, person in a position of authority, person in a position of special trust, or person exercising custodial control or supervision, the cabinet shall refer the matter to the Commonwealth's attorney or the responsible for the abuse or neglect; and e. Any other information that the person making the report believes may be helpful in the furtherance of the purpose of this section. (b) Upon notification, the supervisor or the designated agent, if any, shall facilitate the cooperation of the institution, school, facility, or agency with the investigation of the report. (c) Any person who knowingly causes intimidation, retaliation, or obstruction in the investigation of the report shall be guilty of a Class A misdemeanor. (d) This section shall not require more than one (1) report from any institution, school, facility, or agency. 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: Per KY Statute: https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=53977, child care providers are mandated reporters. KRS 620.030 Duty to report dependency, neglect, abuse, human trafficking, or female genital mutilation ￿ husband-wife and professional-client/patient privileges not grounds for refusal to report ￿ statewide reporting system ￿ exceptions ￿ penalties. (1) Any person who knows or has reasonable cause to believe that a child is dependent, neglected, or abused shall immediately cause an oral or written report, including but not limited to electronic submissions, to be made to a local law enforcement agency or to the Department of Kentucky State Police, the cabinet or its designated representative, the Commonwealth's attorney, or the county attorney by telephone or otherwise. If the cabinet receives a report of abuse or neglect allegedly committed by a person other than a parent, guardian, fictive kin, person in a position of authority, person in a position of special trust, or person exercising custodial control or supervision, the cabinet shall refer the matter to the Commonwealth's attorney or the responsible for the abuse or neglect; and the local law enforcement agency or the Department of Kentucky State Police. Nothing in this section shall relieve individuals of their obligations to report. (2) (a) Any person, including but not limited to a physician, osteopathic physician, nurse, teacher, school personnel, social worker, coroner, medical examiner, child- caring personnel, resident, intern, chiropractor, dentist, optometrist, emergency medical technician, paramedic, health professional, mental health professional, peace officer, or any organization or agency for any of the above, who knows or has reasonable cause to believe that a child is dependent, neglected, or abused, regardless of whether the person believed to have caused the dependency, neglect, or abuse is a parent, guardian, fictive kin, person in a position of authority, person in a position of special trust, person exercising custodial control or supervision, or another person, or who has attended such child as a part of his or her professional duties, shall: 1. Immediately make an oral or written report, including but not limited to electronic submissions, in accordance with subsection (1) of this section; 2. Immediately notify the supervisor of the institution, school, facility, agency, or designated agent of the person in charge; and 3. If requested, in addition to the report required in subsection (1) or (3) of this section, file with the local law enforcement agency or the Department of Kentucky State Police, the cabinet or its designated representative, the Commonwealth's attorney, or county attorney within forty-eight (48) hours of the original report a written report, including but not limited to electronic submissions, containing: a. The names and addresses of the child and his or her parents or other persons exercising custodial control or supervision; b. The child's age; c. The nature and extent of the child's alleged dependency, neglect, or abuse, including any previous charges of dependency, neglect, or abuse, to this child or his or her siblings; d. The name and address of the person allegedly responsible for the abuse or neglect; and e. Any other information that the person making the report believes may be helpful in the furtherance of the purpose of this section. (b) Upon notification, the supervisor or the designated agent, if any, shall facilitate the cooperation of the institution, school, facility, or agency with the investigation of the report. (c) Any person who knowingly causes intimidation, retaliation, or obstruction in the investigation of the report shall be guilty of a Class A misdemeanor. (d) This section shall not require more than one (1) report from any institution, school, facility, or agency. In addition to the requirement for providers to complete Pediatric Abusive Head Trauma, which includes identification of child abuse and neglect like bruising, the pre-service Orientation also discusses child maltreatment and reporting requirements for providers. 922 KAR 2:120 Section 2 Child Care Services Subsection 3(b) (3) (a) Each center shall maintain a child-care program that assures each child shall be: 1. Provided with adequate supervision at all times by a qualified staff person who ensures the child is: a. Within scope of vision and range of voice; or b. For a school-age child, within scope of vision or range of voice; and 2. Protected from abuse and neglect. (b) The program shall include: 1. A procedure to ensure compliance with and inform child care staff of the laws of the Commonwealth pertaining to child abuse or neglect set forth in KRS 620.030 All staff must report suspected abuse or neglect. Reports of suspected abuse or neglect can be made to the Department of Community Based Services (DCBS) at 1 (877) 597- 2331. In case of an emergency or if a child is in immediate danger, dial 911 first. Child care staff may prefer to report suspected abuse or neglect of a child to the to a local law enforcement agency or the Department of Kentucky State Police; the Commonwealth's attorney or the county attorney. Non- emergency reports may be made online at: https://prd.webapps.chfs.ky.gov/reportabuse/home.aspx If a child care center staff makes notification to DCBS about a suspicion of abuse or neglect, this person must also notify their local Division of Regulated Child Care (DRCC) office to report the incident of abuse or neglect. Notification to DRCC can be made by phone, fax, email, or by a hand-delivered written statement. (https://www.childcareawareky.org/wp-content/uploads/2022/10/Child-Abuse- and-Neglect-example-policy-10.2022.pdf) ii. All CCDF-eligible licensed family child care homes. Provide the standard: 922 KAR 2:100 Section 19 Records Subsection 4 Section 19 Records (4) A certified family child-care home provider shall: (a) Report an incident of suspected child abuse or neglect pursuant to KRS 620.030; and (b) Provide the cabinet access and information in the completion of the investigation pursuant to KRS 620.030. All providers must report suspected abuse or neglect. Reports of suspected abuse or neglect can be made to the Department of Community Based Services (DCBS) at 1 (877) 597- 2331. In case of an emergency or if a child is in immediate danger, dial 911 first. Child care staff may prefer to report suspected abuse or neglect of a child to the to a local law enforcement agency or the Department of Kentucky State Police; the Commonwealth's attorney or the county attorney. Non- emergency reports may be made online at: https://prd.webapps.chfs.ky.gov/reportabuse/home.aspx If a child care center staff makes notification to DCBS about a suspicion of abuse or neglect, this person must also notify their local Division of Regulated Child Care (DRCC) office to report the incident of abuse or neglect. Notification to DRCC can be made by phone, fax, email, or by a hand-delivered written statement. (https://www.childcareawareky.org/wp-content/uploads/2022/10/Child-Abuse- and-Neglect-example-policy-10.2022.pdf) iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A - There are no CCDF-eligible license-exempt centers. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Legislation mandates education on the identification and prevention of Pediatric Abusive Head Trauma for various groups in the state who work with or care for young children. KRS 620.030 - Duty to report dependency, neglect, abuse, human trafficking, or female genital mutilation ￿ husband-wife and professional-client/patient privileges not grounds for refusal to report ￿ statewide reporting system ￿ exceptions ￿ penalties. (1) Any person who knows or has reasonable cause to believe that a child is dependent, neglected, or abused shall immediately cause an oral or written report, including but not limited to electronic submissions, to be made to a local law enforcement agency or to the Department of Kentucky State Police, the cabinet or its designated representative, the Commonwealth's attorney, or the county attorney by telephone or otherwise. If the cabinet receives a report of abuse or neglect allegedly committed by a person other than a parent, guardian, fictive kin, person in a position of authority, person in a position of special trust, or person exercising custodial control or supervision, the cabinet shall refer the matter to the Commonwealth's attorney or the county attorney and the local law enforcement agency or the Department of Kentucky State Police. Nothing in this section shall relieve individuals of their obligations to report. (2) (a) Any person, including but not limited to a physician, osteopathic physician, nurse, teacher, school personnel, social worker, coroner, medical examiner, child- caring personnel, resident, intern, chiropractor, dentist, optometrist, emergency medical technician, paramedic, health professional, mental health professional, peace officer, or any organization or agency for any of the above, who knows or has reasonable cause to believe that a child is dependent, neglected, or abused, regardless of whether the person believed to have caused the dependency, neglect, or abuse is a parent, guardian, fictive kin, person in a position of authority, person in a position of special trust, person exercising custodial control or supervision, or another person, or who has attended such child as a part of his or her professional duties, shall: 1. Immediately make an oral or written report, including but not limited to electronic submissions, in accordance with subsection (1) of this section; 2. Immediately notify the supervisor of the institution, school, facility, agency, or designated agent of the person in charge; and 3. If requested, in addition to the report required in subsection (1) or (3) of this section, file with the local law enforcement agency or the Department of Kentucky State Police, the cabinet or its designated representative, the Commonwealth's attorney, or county attorney within forty-eight (48) hours of the original report a written report, including but not limited to electronic submissions, containing: a. The names and addresses of the child and his or her parents or other persons exercising custodial control or supervision; b. The child's age; c. The nature and extent of the child's alleged dependency, neglect, or abuse, including any previous charges of dependency, neglect, or abuse, to this child or his or her siblings; d. The name and address of the person allegedly responsible for the abuse or neglect; and e. Any other information that the person making the report believes may be helpful in the furtherance of the purpose of this section. (b) Upon notification, the supervisor or the designated agent, if any, shall facilitate the cooperation of the institution, school, facility, or agency with the investigation of the report. (c) Any person who knowingly causes intimidation, retaliation, or obstruction in the investigation of the report shall be guilty of a Class A misdemeanor. (d) This section shall not require more than one (1) report from any institution, school, facility, or agency. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Legislation mandates education on the identification and prevention of Pediatric Abusive Head Trauma for various groups in the state who work with or care for young children. KRS 620.030 [AJK(DD1] Duty to report dependency, neglect, abuse, human trafficking, or female genital mutilation ￿ husband-wife and professional- client/patient privileges not grounds for refusal to report ￿ statewide reporting system ￿ exceptions ￿ penalties. (1) Any person who knows or has reasonable cause to believe that a child is dependent, neglected, or abused shall immediately cause an oral or written report, including but not limited to electronic submissions, to be made to a local law enforcement agency or to the Department of Kentucky State Police, the cabinet or its designated representative, the Commonwealth's attorney, or the county attorney by telephone or otherwise. If the cabinet receives a report of abuse or neglect allegedly committed by a person other than a parent, guardian, fictive kin, person in a position of authority, person in a position of special trust, or person exercising custodial control or supervision, the cabinet shall refer the matter to the Commonwealth's attorney or the county attorney and the local law enforcement agency or the Department of Kentucky State Police. Nothing in this section shall relieve individuals of their obligations to report. (2) (a) Any person, including but not limited to a physician, osteopathic physician, nurse, teacher, school personnel, social worker, coroner, medical examiner, child- caring personnel, resident, intern, chiropractor, dentist, optometrist, emergency medical technician, paramedic, health professional, mental health professional, peace officer, or any organization or agency for any of the above, who knows or has reasonable cause to believe that a child is dependent, neglected, or abused, regardless of whether the person believed to have caused the dependency, neglect, or abuse is a parent, guardian, fictive kin, person in a position of authority, person in a position of special trust, person exercising custodial control or supervision, or another person, or who has attended such child as a part of his or her professional duties, shall: 1. Immediately make an oral or written report, including but not limited to electronic submissions, in accordance with subsection (1) of this section; 2. Immediately notify the supervisor of the institution, school, facility, agency, or designated agent of the person in charge; and 3. If requested, in addition to the report required in subsection (1) or (3) of this section, file with the local law enforcement agency or the Department of Kentucky State Police, the cabinet or its designated representative, the Commonwealth's attorney, or county attorney within forty-eight (48) hours of the original report a written report, including but not limited to electronic submissions, containing: a. The names and addresses of the child and his or her parents or other persons exercising custodial control or supervision; b. The child's age; c. The nature and extent of the child's alleged dependency, neglect, or abuse, including any previous charges of dependency, neglect, or abuse, to this child or his or her siblings; d. The name and address of the person allegedly responsible for the abuse or neglect; and e. Any other information that the person making the report believes may be helpful in the furtherance of the purpose of this section. (b) Upon notification, the supervisor or the designated agent, if any, shall facilitate the cooperation of the institution, school, facility, or agency with the investigation of the report. (c) Any person who knowingly causes intimidation, retaliation, or obstruction in the investigation of the report shall be guilty of a Class A misdemeanor. (d) This section shall not require more than one (1) report from any institution, school, facility, or agency. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Per KY Statute: https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=53977, child care providers are mandated reporters. KRS 620.030 Duty to report dependency, neglect, abuse, human trafficking, or female genital mutilation ￿ husband-wife and professional-client/patient privileges not grounds for refusal to report ￿ statewide reporting system ￿ exceptions ￿ penalties. (1) Any person who knows or has reasonable cause to believe that a child is dependent, neglected, or abused shall immediately cause an oral or written report, including but not limited to electronic submissions, to be made to a local law enforcement agency or to the Department of Kentucky State Police, the cabinet or its designated representative, the Commonwealth's attorney, or the county attorney by telephone or otherwise. If the cabinet receives a report of abuse or neglect allegedly committed by a person other than a parent, guardian, fictive kin, person in a position of authority, person in a position of special trust, or person exercising custodial control or supervision, the cabinet shall refer the matter to the Commonwealth's attorney or the responsible for the abuse or neglect; and the local law enforcement agency or the Department of Kentucky State Police. Nothing in this section shall relieve individuals of their obligations to report. (2) (a) Any person, including but not limited to a physician, osteopathic physician, nurse, teacher, school personnel, social worker, coroner, medical examiner, child- caring personnel, resident, intern, chiropractor, dentist, optometrist, emergency medical technician, paramedic, health professional, mental health professional, peace officer, or any organization or agency for any of the above, who knows or has reasonable cause to believe that a child is dependent, neglected, or abused, regardless of whether the person believed to have caused the dependency, neglect, or abuse is a parent, guardian, fictive kin, person in a position of authority, person in a position of special trust, person exercising custodial control or supervision, or another person, or who has attended such child as a part of his or her professional duties, shall: 1. Immediately make an oral or written report, including but not limited to electronic submissions, in accordance with subsection (1) of this section; 2. Immediately notify the supervisor of the institution, school, facility, agency, or designated agent of the person in charge; and 3. If requested, in addition to the report required in subsection (1) or (3) of this section, file with the local law enforcement agency or the Department of Kentucky State Police, the cabinet or its designated representative, the Commonwealth's attorney, or county attorney within forty-eight (48) hours of the original report a written report, including but not limited to electronic submissions, containing: a. The names and addresses of the child and his or her parents or other persons exercising custodial control or supervision; b. The child's age; c. The nature and extent of the child's alleged dependency, neglect, or abuse, including any previous charges of dependency, neglect, or abuse, to this child or his or her siblings; d. The name and address of the person allegedly responsible for the abuse or neglect; and e. Any other information that the person making the report believes may be helpful in the furtherance of the purpose of this section. (b) Upon notification, the supervisor or the designated agent, if any, shall facilitate the cooperation of the institution, school, facility, or agency with the investigation of the report. (c) Any person who knowingly causes intimidation, retaliation, or obstruction in the investigation of the report shall be guilty of a Class A misdemeanor. (d) This section shall not require more than one (1) report from any institution, school, facility, or agency. In addition to the requirement for providers to complete Pediatric Abusive Head Trauma, which includes identification of child abuse and neglect like bruising, the pre-service Orientation also discusses child maltreatment and reporting requirements for providers. 922 KAR 2:120 Section 2 Child Care Services Subsection 3(b) (3) (a) Each center shall maintain a child-care program that assures each child shall be: 1. Provided with adequate supervision at all times by a qualified staff person who ensures the child is: a. Within scope of vision and range of voice; or b. For a school-age child, within scope of vision or range of voice; and 2. Protected from abuse and neglect. (b) The program shall include: 1. A procedure to ensure compliance with and inform child care staff of the laws of the Commonwealth pertaining to child abuse or neglect set forth in KRS 620.030 All staff must report suspected abuse or neglect. Reports of suspected abuse or neglect can be made to the Department of Community Based Services (DCBS) at 1 (877) 597- 2331. In case of an emergency or if a child is in immediate danger, dial 911 first. Child care staff may prefer to report suspected abuse or neglect of a child to the to a local law enforcement agency or the Department of Kentucky State Police; the Commonwealth's attorney or the county attorney. Non- emergency reports may be made online at: https://prd.webapps.chfs.ky.gov/reportabuse/home.aspx If a child care center staff makes notification to DCBS about a suspicion of abuse or neglect, this person must also notify their local Division of Regulated Child Care (DRCC) office to report the incident of abuse or neglect. Notification to DRCC can be made by phone, fax, email, or by a hand-delivered written statement. (https://www.childcareawareky.org/wp-content/uploads/2022/10/Child-Abuse- and-Neglect-example-policy-10.2022.pdf) 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: 922 KAR 2:120 Section 9 Food and Drink Requirements for All Child Care Centers Section 9. Food and Drink Requirements for All Child-Care Centers. (1) Food shall be: (a) Clean; (b) Free from: 1. Spoilage; 2. Adulteration; and 3. Misbranding; (c) Safe for human consumption; (d) Withheld from service or discarded if the food is hermetically sealed, nonacidic, or low-acidic food that has been processed in a place other than a commercial food processing establishment; (e) Obtained from a source that is in compliance with the Department for Public Health's food safety standards and permits, established in KRS Chapter 217; (f) Acceptable if from an established commercial food store; (g) Served in a quantity that is developmentally appropriate for the child with additional portions provided upon request of the child; and (h) Protected against contamination from: 1. Dust; 2. Flies; 3. Rodents and other vermin; 4. Unclean utensils and work surfaces; 5. Unnecessary handling; 6. Coughs and sneezes; 7. Cuts in skin; 8. Communicable disease; 9. Flooding; 10. Drainage; and 11. Overhead leakage. (2) Food shall not be: (a) Used for reward; (b) Used for discipline; (c) Withheld until all other foods are consumed; or (d) Served while viewing electronic devices. (3) A serving of milk shall consist of: (a) Breast milk or iron-fortified formula for a child: 1. Age birth to twelve (12) months; or 2. Beyond twelve (12) months of age as documented by the parent or the child's physician; (b) Pasteurized unflavored whole milk for children ages twelve (12) months to twenty four (24) months; or (c) Pasteurized unflavored low fat one (1) percent or fat-free skim milk for children ages twenty-four (24) months to school-age. (4) Formula or breast milk provided by the parent shall be prepared and labeled. (5) A child-care center may participate in the Child and Adult Care Food Program (CACFP). (6) A serving of bread shall only consist of whole or enriched grain. (7) Drinking water shall be freely available to a child throughout the day. (8) Food shall be stored on: (a) Clean racks; (b) Clean shelves; (c) Other clean surfaces; or (d) If maintained in a sanitary condition, in nonabsorbent labeled containers a minimum of six (6) inches off the floor. (9) Fruits and vegetables shall be washed before cooking or serving. (10) Children shall not be served food that has been deep-fried on-site. (11) Meat salads, poultry salads, and cream-filled pastries shall be: (a) Prepared with utensils that are clean; and (b) Refrigerated unless served immediately. (12) An individual portion of food served to a child or adult shall not be served again. (13) Wrapped food that is still wholesome and has not been unwrapped may be reserved. (14) Meals shall be: (a) Served every two (2) to three (3) hours; and (b) Served to a child: 1. Seated with sufficient room to manage food and tableware; and 2. Supplied with individual eating utensils designed for use by a child. (15) Drinks served to children shall not have added sugar. Children shall drink water, milk, or 100% juice with meals. (16) Juice shall: (a) Not include added sugar; (b) Not be served more than once per day; (c) Not be served to children under the age of twelve (12) months; and (d) Serve as a fruit or vegetable meal component replacement. (17) A meat alternative shall include: (a) Tofu; (b) Soy products; (c) Cheese, including cottage or ricotta cheese; (d) Eggs; (e) Cooked dry beans; (f) Peanut butter or soy nut butter; (g) Yogurt, plain or flavored; or (h) Peanuts, soy nuts, tree nuts, or seeds. (18) Cheese shall be natural and pasteurized processed cheese. Children shall not be served cheese product, imitation cheese, cheese food, or cheese spread as a meat alternative. (19) For food provided by the center, all children in the center shall be offered the same food items unless: (a) A parent provides written authorization to substitute the food with an alternative that meets the same component requirement; or (b) A physician provides written authorization to substitute the food or the food component and includes the food that the child shall not have and the food substitution that the child shall have. (20) Children shall be served all daily food components required by Section 10 or 11 of this administrative regulation 922 KAR 2:120 Section 10 Meal Planning Requirements for a Center that Provides Meals (1) Breakfast shall include the following three (3) components: (a) Milk; (b) Bread or grain, which may: 1. Be exchanged for a meat or meat alternative up to three (3) times per week; and 2. Include ready-to-eat cereal with six (6) grams of sugar or less per dry ounce; and (c) 1. Fruit; 2. Vegetable; or 3. 100 percent juice. (2) A snack shall include two (2) of the following components: (a) Milk; (b) Meat or meat alternative; (c) Bread or grain; or (d) 1. Fruit; 2. Vegetable; or 3. 100 percent juice. (3) Lunch, and dinner if served, shall include the following components: (a) Milk; (b) Meat or meat alternative; (c) Bread or grain; and (d) 1. Two (2) different vegetables; or 2. One (1) fruit and one (1) vegetable. (4) A grain-based dessert shall not replace the bread or grain component of a meal. (5) Yogurt served to children shall have twenty-three (23) grams of sugar or less per six (6) ounces. (6) The serving size for milk shall be: (a) Four (4) ounces for one (1) or two (2) year old children; (b) Six (6) ounces for three (3) to five (5) year old children; or (c) Eight (8) ounces for school-age children. (7) At least one (1) whole grain bread or grain shall be served daily. (8) A component shall be considered "whole grain" if: (a) The product is listed by any state agency's Special Supplemental Nutrition Program for Women, Infants, and Children as whole grain; (b) The product is labeled as "whole wheat" and has a Standard of Identity issued by the U.S. Food and Drug Administration (FDA); (c) The product includes one of the FDA-approved whole grain health claims on its packaging, exactly as written; (d) The product meets the whole grain-rich criteria under the National School Lunch Program (NSLP); (e) The product is identified on the package as "whole grain," "whole wheat," or "whole grain-rich"; or (f) Proper documentation from a manufacturer or standardized recipe demonstrates that whole grains are the primary grain ingredient by weight. (9) A weekly menu shall be: (a) Prepared; (b) Dated; (c) Posted in advance in a conspicuous place; (d) Kept on file for thirty (30) days; and (e) Amended in writing with any substitutions on the day the meal is served. 922 KAR 2:120 Section 11 Meal Planning Requirements for a Center that Does Not Provide Meals (1) A child-care center that does not provide meals shall serve: (a) 1. Breakfast; or 2. A mid-morning snack; (b) 1. Lunch; or 2. A mid-afternoon snack; and (c) Dinner, if appropriate. (2) Breakfast shall include three (3) of the following components: (a) Milk; (b) Bread or grain; (c) Meat or meat alternative; or (d) 1. Fruit; 2. Vegetable; or 3. 100 percent juice. (3) A snack shall include two (2) of the following components: (a) Milk; (b) Bread or grain; (c) Meat or meat alternative; or (d) 1. Fruit; 2. Vegetable; or 3. 100 percent juice. (4) Lunch, and dinner if served, shall include: (a) Milk; (b) Bread or grain; (c) Meat or meat alternative; and (d) 1. Two (2) different vegetables; or 2. One (1) fruit and one (1) vegetable. 922 KAR 2:100 Section 15 Food Requirements (1) A provider and an assistant shall: (a) Use sanitary procedures when preparing and serving food; (b) Refrigerate perishable food and beverages; and (c) Serve: 1. Breast milk or iron-fortified formula to a child: a. Age birth to twelve (12) months; or b. Beyond twelve (12) months of age as documented by the parent or the child's physician; 2. Pasteurized whole milk to a child age twelve (12) months to twenty-four (24) months; or 3. Pasteurized skim or low fat one (1) percent milk to a child age twenty-four (24) months to school-age. (2) Water shall be: (a) Available to a child in care; and (b) Served in addition to meal requirements if a child requests throughout the day. (3) A certified family child-care home shall offer each child the same food items unless the child's parent or health professional documents a dietary restriction that necessitates an alternative food item for the child. (4) Second servings shall be available to a child. (5) Food shall not be: (a) Used for: 1. Reward; or 2. Discipline; or (b) Withheld until all other food items are consumed. (6) Meals shall: (a) Be served in an amount appropriate to the age of the child; (b) Include appropriate types of food according to the age of the child; (c) Not be served during television or video viewing; (d) Be served every two (2) to three (3) hours; and (e) Be served to a child: 1. Seated with sufficient room to manage food and tableware; and 2. Supplied with individual eating utensils designed for use by a child. (7) Breakfast shall include: (a) Milk; (b) A whole grain or an enriched grain bread; and (c) Fruit, vegetable, or 100 percent juice. (8) A snack shall include two (2) of the following: (a) Milk; (b) Protein source; (c) Fruit, vegetable, or 100 percent juice; or (d) A whole grain or an enriched grain bread. (9) Lunch and dinner shall include: (a) Milk; (b) Protein source; (c) 1. Two (2) vegetables; 2. Two (2) fruits; or 3. One (1) fruit and one (1) vegetable; and (d) A whole grain or an enriched grain bread. (10) A weekly menu shall be: (a) Prepared; (b) Dated; (c) Available to a parent of a child in care or the cabinet upon request; and (d) Kept on file for thirty (30) calendar days. (11) Substitutions to a weekly menu shall be noted on the day the meal is served. (12) Unless provided as part of the fee for child care or the provider is a participant in the food program, an infant's formula shall be prepared, labeled, and provided by the parent. (13) Each child's bottle shall be: (a) Labeled; (b) Covered; and (c) Refrigerated. (14) The refrigerator shall: (a) Be in working order; and (b) Maintain a product temperature at or below forty-five (45) degrees Fahrenheit. (15) Except if thawed for preparation or use, frozen food shall be kept at a temperature of zero degrees Fahrenheit as verified by a thermometer in the freezer. (16) While bottle-feeding an infant, the: (a) Child shall be held; and (b) Bottle shall not be: 1. Propped; 2. Left in the mouth of a sleeping infant; or 3. Heated in a microwave. (17) A certified family child-care home shall meet requirements of subsections (1)(c) and (7) through (9) of this section if the provider participates in the Child and Adult Food Care Program and meets meal requirements specified in 7 C.F.R. 226.20. ii. Access to physical activity. Describe: 922 KAR 2:120 Section 4 Premises Requirements Subsection 22(a) (22) If a child-care center does not have access to an outdoor play area, an indoor space shall: (a) Be used as a play area; (b) Have a minimum of sixty (60) square feet per child, separate from and in addition to the thirty-five (35) square feet minimum pursuant to subsection (6) of this section; (c) Include equipment for gross motor skills; and (d) Have a protective surface of at least two (2) inches thick around equipment intended for climbing. 922 KAR 2:100 Section 13 Care Requirements for a Provider Subsection 13 (d) (13) A certified family child care home shall provide a daily planned program: (a) That is available to a parent of a child in care or the cabinet upon request; (b) Of activities that are developmentally appropriate for each child served; (c) That provides experience to promote the individual child's physical, emotional, social, and intellectual growth and well-being; and (d) That offers a variety of creative activities, such as: 1. Art or music; 2. Math or numbers; 3. Dramatic play; 4. Stories and books; 5. Science or nature; 6. Block building or stacking; 7. Tactile or sensory activity; 8. Multi-cultural exposure; 9. Indoor or outdoor play in which a child makes use of both small and large muscles; 10. A balance of active and quiet play, including group and individual activity; and 11. An opportunity for a child to: a. Have some free choice of activities; b. If desired, play apart from the group at times; and c. Practice developmentally appropriate self-help procedures in respect to: (i) Clothing; (ii) Toileting; (iii) Hand-washing; and (iv) Eating. iii. Caring for children with special needs. Describe: 922 KAR 2:120 Section 2 Subsection 13(a)(b) (13) (a) Care for a child with a special need shall be consistent with the nature of the need as documented by the child's health professional. (b) A child may include a person eighteen (18) years of age if the person has a special need for which child care is required. 922 KAR 2:100 Section 13 Subsection 2 (a-b) (2) (a) Care for a child with a special need shall be consistent with the nature of the need as documented by the child's health professional. (b) A child may include a person eighteen (18) years of age if the person has a special need for which child care is required iv. Any other areas determined necessary to promote child development or to protect children’s health and safety. Describe: 922 KAR 2:120 Section 13 Toys and Furnishings (1) All toys and furniture contacted by a child shall be: (a) Kept clean and in good repair; and (b) Free of peeling, flaking, or chalking paint. (2) Indoor and outdoor equipment shall: (a) Be clean, safe, and in good repair; (b) Meet the physical, developmental needs, and interests of children of different age groups; (c) Be free from sharp points or corners, splinters, protruding nails or bolts, loose or rusty parts, hazardous small parts, lead-based paint, poisonous material, and flaking or chalking paint; and (d) Be designed to guard against entrapment or situations that may cause strangulation. (3) Toys shall be: (a) Used according to the manufacturer's safety specifications; (b) Durable; and (c) Without sharp points or edges. (4) A toy or another item that is considered a mouth contact surface by a child not toilet trained shall be sanitized daily by: (a) 1. Scrubbing in warm, soapy water using a brush to reach into crevices; 2. Rinsing in clean water; 3. Submerging in a sanitizing solution for at least two (2) minutes; and 4. Air dried; or (b) Cleaning in a dishwasher if the toy or other item is dishwasher safe. (5) Tables and chairs shall be of suitable size for children. (6) Chairs appropriate for staff shall be provided to use while feeding, holding, or playing with a child. 922 KAR 2:120 Section 15 Animals (1) An animal shall not be allowed in the presence of a child in care: (a) Unless: 1. The animal is under the supervision and control of an adult; 2. Written parental consent has been obtained; and 3. The animal is certified as vaccinated against rabies; or (b) Except in accordance with subsection (3) of this section. (2) A parent shall be notified in writing if a child has been bitten or scratched by an animal. (3) An animal that is considered undomesticated, wild, or exotic shall not be allowed at a child-care center unless the animal is: (a) A part of a planned program activity led by an animal specialist affiliated with a zoo or nature conservatory; and (b) In accordance with 301 KAR 2:081 and 301 KAR 2:082. (4) This section shall not apply to wild animals on the outer property of the child-care center that are expected to be found outdoors, such as squirrels and birds, if they are not: (a) Disturbed; or (b) Brought indoors 922 KAR 2:100 Section 17 Animals (1) An animal shall not be allowed in the presence of a child in care: (a) Unless: 1. The animal is under the supervision and control of an adult; 2. Written parental consent has been obtained; and 3. The animal is certified as vaccinated against rabies; or (b) Except in accordance with subsection (3) of this section. (2) A parent shall be notified in writing if a child has been bitten or scratched by an animal. (3) An animal that is considered undomesticated, wild, or exotic shall not be allowed at a certified family child-care home unless the animal is: (a) A part of a planned program activity led by an animal specialist affiliated with a zoo or nature conservatory; and (b) In accordance with 301 KAR 2:081 and 301 KAR 2:082.