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: All CCDF licensed center care providers are required to make immediate notification to the Louisiana Department of Health (LDH) for reportable infectious diseases listed in LAC 51.II.105. Providers are required to complete annual training in this topic in addition to their 12 clock hours. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Not applicable 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: CCDF license- exempt center care providers are required to make immediate notification to the Louisiana Department of Health (LDH) for reportable infectious diseases listed in LAC 51.II.105. Providers are required to complete annual training in this topic. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: CCDF license-exempt family child care home providers are required to make immediate notification to the Louisiana Department of Health (LDH) for reportable infectious diseases listed in LAC 51.II.105. Providers are required to complete annual training in this topic. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: CCDF license-exempt in-home care providers are required to make immediate notification to the Louisiana Department of Health (LDH) for reportable infectious diseases listed in LAC 51.II.105. Providers are required to complete annual training in this topic. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Not applicable 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: All children receiving services under CCDF are age-appropriately immunized or provide verification that such immunizations are in progress, unless the parent or guardian submits a written statement from the physician or a written dissent for religious or personal reasons. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Not applicable 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: All children receiving services under CCDF license-exempt center care are age-appropriately immunized or provide verification that such immunizations are in progress, unless the parent or guardian submits a written statement from the physician or a written dissent for religious or personal reasons. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: All children receiving services under CCDF license-exempt family child care are age- appropriately immunized or provide verification that such immunizations are in progress, unless the parent or guardian submits a written statement from the physician or a written dissent for religious or personal reasons. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: All children receiving services under CCDF license-exempt in-home care are age-appropriately immunized or provide verification that such immunizations are in progress, unless the parent or guardian submits a written statement from the physician or a written dissent for religious or personal reasons. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Not applicable 5.3.2 Prevention of sudden infant death syndrome and the use of safe-sleep practices health and safety standard Provide the standards, appropriate to the provider setting and age of children, that address the prevention of sudden infant death syndrome and use of safe sleeping practices for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: All CCDF center-based providers are required to ensure staff receive orientation on prevention of sudden infant death syndrome and the use of safe sleep practices within 7 calendar days of the first day of becoming present at the center and prior to assuming sole responsibility for any children. All CCDF and non-CCDF providers are required to ensure the following: only one infant shall be placed in a crib and infants shall be placed on their backs for sleeping; written authorization from a physician is required for any other sleeping position, and written notice of the specifically authorized sleeping position shall be posted on or near the crib; infants shall not be placed in positioning devices, unless the center has written authorization from a physician to use a positioning device; written authorization from a physician is required for a child to sleep in a car seat or other similar device and shall include the amount of time that the child is allowed to remain in said device; ￿Back To Sleep￿ signs shall be posted in the room where infants sleep; infants who use pacifiers shall be offered their pacifier when they are placed to sleep, but it shall not be placed back in the mouth once the child is asleep; bibs shall not be worn by any child while asleep; nothing shall be placed over the head or face of an infant; a safety-approved crib shall be available for each infant. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Not applicable 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: Prior to certification, all CCDF-eligible license-exempt center care providers are required to ensure completion of orientation on prevention of sudden infant death syndrome and the use of safe-sleep practices. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Prior to certification, all CCDF-eligible license-exempt family child care home providers are required to ensure staff receive orientation on prevention of sudden infant death syndrome and the use of safe sleep practices. All CCDF providers are required to ensure the following: only one infant shall be placed in a crib, and infants shall be placed on their backs for sleeping; written authorization from a physician is required for any other sleeping position, and written notice of the specifically authorized sleeping position shall be posted on or near the crib; infants shall not be placed in positioning devices, unless there is written authorization from a physician to use a positioning device; written authorization from a physician is required for a child to sleep in a car seat or other similar device and shall include the amount of time that the child is allowed to remain in said device; ￿Back To Sleep￿ signs shall be posted in the room where infants sleep; infants who use pacifiers shall be offered their pacifier when they are placed to sleep, but it shall not be placed back in the mouth once the child is asleep; bibs shall not be worn by any child while asleep; nothing shall be placed over the head or face of an infant; a safety-approved crib shall be available for each infant. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Prior to certification, all CCDF-eligible license-exempt in-home care providers are required to ensure completion of orientation on prevention of sudden infant death syndrome and the use of safe-sleep practices. All CCDF providers are required to ensure the following: only one infant shall be placed in a crib, and infants shall be placed on their backs for sleeping; written authorization from a physician is required for any other sleeping position, and written notice of the specifically authorized sleeping position shall be posted on or near the crib; infants shall not be placed in positioning devices, unless there is written authorization from a physician to use a positioning device; written authorization from a physician is required for a child to sleep in a car seat or other similar device and shall include the amount of time that the child is allowed to remain in said device; ￿Back To Sleep￿ signs shall be posted in the room where infants sleep; infants who use pacifiers shall be offered their pacifier when they are placed to sleep, but it shall not be placed back in the mouth once the child is asleep; bibs shall not be worn by any child while asleep; nothing shall be placed over the head or face of an infant; a safety-approved crib shall be available for each infant. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Not applicable 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: All licensed CCDF providers who have staff members administering medication are required to have medication administration training that includes information about the use of auto-injectable epinephrine. Whether administering medication or not, at least two staff members in child care centers are required to have training in medication administration. This training must be completed every two years via Lead Agency-approved training. No medication or special medical procedure can be administered to a child unless authorized in writing by the parent, and that authorization should include name of child; drug name and strength; date(s) to be administered; directions for use, including the route (e.g., oral, topical), dosage, frequency, time and schedule, and special instructions, if any; and signature of parent and date of signature. It is not acceptable to note "as indicated on the bottle." All medication shall be sent to the site, must be in its original container, shall not have an expired date, and must be clearly labeled with the name of the child. For prescription medication to be administered at the site, the site shall maintain the original pharmacy container with the complete pharmacy label. For non-prescription medication to be administered, the site shall maintain the original bottle packing for the medicine or a printed document from the manufacturer's website, which shall include the drug name and strength and clear directions for use. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Not applicable 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: Prior to certification, all CCDF-eligible license-exempt center care providers must provide documentation of current medication administration training approved by the Department. Providers must ensure no medication or special medical procedure shall be administered to a child unless authorized in writing by the parent. Such authorization shall include the name of the child; drug name and strength; date(s) to be administered; directions for use, including route, dosage, frequency, time, and special instructions if applicable; and signature of parent and date of signature. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Prior to certification, all CCDF-eligible license-exempt family child care home providers must provide documentation of current medication administration training approved by the Department. The provider must ensure that no medication or special medical procedure shall be administered to a child unless authorized in writing by the parent. Such authorization shall include the name of the child; drug name and strength, date(s) to be administered; directions for use, including route, dosage, frequency, time, and special instructions if applicable; and signature of parent and date of signature. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Prior to certification, all CCDF-eligible license-exempt in-home care providers must provide documentation of current medication administration training approved by the Department. Providers must ensure no medication or special medical procedure shall be administered to a child unless authorized in writing by the parent. Such authorization shall include the name of the child; drug name and strength; date(s) to be administered; directions for use, including route, dosage, frequency, time, and special instructions if applicable; and signature of parent and date of signature. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Not applicable 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: No medication can be administered to a child unless authorized in writing by the parent, and that authorization should include name of child; drug name and strength; date(s) to be administered; directions for use, including the route (e.g., oral, topical), dosage, frequency, time and schedule, and special instructions, if any; and signature of parent and date of signature. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Not applicable 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: Prior to certification, license-exempt center care providers are required to provide documentation of current medication administration training and ensure no medication or special medical procedure shall be administered to a child unless authorized in writing by the parent. Such authorization shall include the name of the child; drug name and strength; date(s) to be administered; directions for use, including route, dosage, frequency, time and special instructions if applicable; and signature of parent and date of signature. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Prior to certification, license-exempt family child care home providers are required to provide documentation of current medication administration training and ensure no medication or special medical procedure shall be administered to a child unless authorized in writing by the parent. Such authorization shall include the name of the child; drug name and strength; date(s) to be administered; directions for use, including route, dosage, frequency, time and special instructions if applicable; and signature of parent and date of signature. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Prior to certification, license-exempt in-home care providers are required to provide documentation of current medication administration training and ensure no medication or special medical procedure shall be administered to a child unless authorized in writing by the parent. Such authorization shall include the name of the child; drug name and strength; date(s) to be administered; directions for use, including route, dosage, frequency, time and special instructions if applicable; and signature of parent and date of signature. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Not applicable 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: All licensed CCDF providers are required to ensure staff receive center-specific orientation on prevention of and response to emergencies due to food and allergic reactions within 7 calendar days of the first day being present at the center and prior to assuming sole responsibility for any children. Information regarding food allergies and special diets of children shall be posted in the food preparation area with special care taken to ensure that individual names of children are not in public view. If a parent chooses to allow the center to post the child’s name and allergy information in public view, the center shall obtain a signed and dated authorization from the parent. Children with allergies or special diets shall not be served foods identified as restricted by the parent. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Not applicable 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: Prior to certification, license-exempt center care providers must complete pre-service orientation regarding prevention and response to emergencies due to food and allergic reactions. Information regarding food allergies and special diets of children shall be posted in the food preparation area with special care taken to ensure that individual names of children are not in public view. If a parent chooses to allow the provider to post the child’s name and allergy information in public view, a signed and dated authorization from the parent shall be obtained. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Prior to certification, license-exempt family child care home providers must complete pre-service orientation regarding prevention and response to emergencies due to food and allergic reactions. Information regarding food allergies and special diets of children shall be posted in the food preparation area with special care taken to ensure that individual names of children are not in public view. If a parent chooses to allow the provider to post the child’s name and allergy information in public view, a signed and dated authorization from the parent shall be obtained. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Prior to certification, license-exempt in-home care providers must complete pre-service orientation regarding prevention and response to emergencies due to food and allergic reactions. Information regarding food allergies and special diets of children shall be posted in the food preparation area with special care taken to ensure that individual names of children are not in public view. If a parent chooses to allow the provider to post the child’s name and allergy information in public view, a signed and dated authorization from the parent shall be obtained. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Not applicable 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: All licensed CCDF providers are required to ensure staff receive center-specific orientation on prevention of and response to emergencies due to food and allergic reactions within 7 calendar days of the first day being present at the center and prior to assuming sole responsibility for any children. All licensed CCDF providers are required to make immediate notification, of any emergencies due to food or allergic reactions, to the parent and within 24 hours to the Lead Agency and to Child Welfare. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Not applicable 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: Prior to certification, license-exempt center care providers must complete pre-service orientation regarding prevention and response to emergencies due to food and allergic reactions. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Prior to certification, license-exempt family child care home providers must complete pre-service orientation regarding prevention and response to emergencies due to food and allergic reactions. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Prior to certification, license-exempt in-home care providers must complete pre-service orientation regarding prevention and 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: Not applicable 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: All CCDF providers are required to ensure all equipment used by children shall be maintained in a clean and safe condition and in good repair. Indoor and outdoor space shall be used exclusively by children in care and center staff during hours of operation. Indoor and outdoor areas shall be free of hazards. Items that can be harmful to children, such as medications, poisons, cleaning supplies and chemicals, and equipment, tools, knives and other potentially dangerous utensils, shall be kept in a locked cabinet or other secure place that ensures they are inaccessible to children. Outdoor play space shall be enclosed with a permanent fence or other permanent barrier in a manner that protects children from traffic hazards, prevents children from leaving the premises without proper supervision, and prevents contact with animals or unauthorized persons. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Not applicable 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: Prior to certification, all license-exempt center care providers must receive orientation in building and physical premises safety. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Prior to certification, all license-exempt family child care home providers must receive orientation in building and physical premises safety. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Prior to certification, all license-exempt in-home care providers must receive orientation in building and physical premises safety. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Not applicable 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: All CCDF providers must ensure within 7 calendar days of the first day present at the center and prior to assuming sole responsibility for any children orientation is completed in protection from bodies of water. Swimming, wading, and boating is prohibited in lakes, ponds, and other similar bodies of water. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Not applicable 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: Prior to certification, all license-exempt center care providers must receive orientation in identification of and protection from bodies of water. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Prior to certification, all license-exempt family child care home providers must receive orientation in identification of and protection from bodies of water. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Prior to certification, all license-exempt in-home care providers must receive orientation in 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: Not applicable 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: All CCDF providers must have an outdoor play space enclosed with a permanent fence or other permanent barrier in a manner that protects children from traffic hazards. Within 7 calendar days of the first day present at a licensed center, and prior to assuming sole responsibility for any children, each staff member shall complete orientation training that addresses the identification of and protection from vehicular traffic hazards. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Not applicable 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: Prior to certification, all license-exempt center care providers must receive orientation in identification of and protection from vehicular traffic hazards. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Prior to certification, all license-exempt family child care home providers must receive orientation in identification of and protection from vehicular traffic hazards. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Prior to certification, all license-exempt in-home care providers must receive orientation in 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: Not applicable 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: All CCDF providers caring for infants are required to ensure staff receive orientation on prevention of shaken baby syndrome and abusive head trauma within 7 calendar days of being present at the center and prior to assuming sole responsibility for any children. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Not applicable 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: Prior to certification, license-exempt center care providers must maintain policy and procedures to identify, prevent, and respond to shaken baby syndrome and abusive head trauma. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Prior to certification, license-exempt family child care home providers caring for infants must maintain policy and procedures to identify, prevent, and respond to shaken baby syndrome and abusive head trauma. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Prior to certification, license-exempt in-home care providers caring for infants must maintain policy and procedures to identify, prevent, and respond to shaken baby syndrome and abusive head trauma. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Not applicable 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: All CCDF providers caring for a child of any age are required to ensure staff receive orientation on prevention of child maltreatment within 7 calendar days of being present at the center and prior to assuming sole responsibility for any children. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Not applicable 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: Prior to certification, license-exempt center care providers caring for a child of any age must maintain policy and procedures to identify, prevent, and respond to child maltreatment. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Prior to certification, license-exempt family child care home providers caring for a child of any age must maintain policy and procedures to identify, prevent, and respond to child maltreatment. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Prior to certification, license-exempt in-home care providers caring for a child of any age must maintain policy and procedures to identify, prevent, and respond to child maltreatment. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Not applicable 5.3.7 Emergency preparedness and response planning standard Identify by checking below that the emergency preparedness and response planning due to natural disasters and human-caused events standard includes procedures in the following areas: i. [x] Evacuation ii. [x] Relocation iii. [x] Shelter-in-place iv. [x] Lock down v. Staff emergency preparedness [x] Training [x] Practice drills vi. Volunteer emergency preparedness [x] Training [x] Practice drills vii. [x] Communication with families viii. [x] Reunification with families ix. [x] Continuity of operations x. Accommodation of [x] Infants [x] Toddlers [x] Children with disabilities [x] Children with chronic medical conditions xi. If any of the above are not checked, describe: 5.3.8 Handling and storage of hazardous materials and the appropriate disposal of biocontaminants health and safety standard a. Provide the standards, appropriate to the provider setting and age of children, that address the handling and storage of hazardous materials for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: All CCDF providers must ensure items that can be harmful to children, such as medications, poisons, cleaning supplies and chemicals, and equipment, tools, knives and other potentially dangerous utensils, shall be kept in a locked cabinet or other secure place that ensures they are inaccessible to children. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Not applicable 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: Prior to certification, all license-exempt center care providers must ensure items such as medications, poisons, cleaning supplies and chemicals, equipment, tools, knives and other potentially dangerous utensils that can be harmful to children shall be kept in a locked cabinet or other secure place that ensures items are inaccessible to children. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Prior to certification, all license-exempt family child care home providers must ensure items such as medications, poisons, cleaning supplies and chemicals, equipment, tools, knives and other potentially dangerous utensils that can be harmful to children shall be kept in a locked cabinet or other secure place that ensures items are inaccessible to children. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Prior to certification, all license-exempt in-home care providers must ensure items such as medications, poisons, cleaning supplies and chemicals, equipment, tools, knives and other potentially dangerous utensils that can be harmful to children shall be kept in a locked cabinet or other secure place that ensures items are inaccessible to children. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Not applicable 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: All CCDF providers must ensure staff shall properly dispose of all bio contaminants to safeguard against the spread of infectious disease by taking the following steps: 1. Discard disposable rubber gloves that come into contact with a bio contaminant after each use; 2. Discard tissues, paper towels, disposable wipes, and similar products that come into contact with a bio contaminant after each use; 3. Place soiled disposable diapers in a closed container that is lined with a leak-proof or impervious lining, remove the soiled disposable diapers from the facility, and place them in a closed garbage receptacle outside the building on a daily basis; 4. Place soiled non-disposable diapers in a sealed plastic container that has been labeled with the child's name and return the diapers to the child's parent at the end of the day; 5. Place soiled clothes in a sealed plastic container that has been labeled with the child's name and return the clothes to the child's parent at the end of each day or launder the clothes at the facility. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Not applicable 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: Prior to certification, all license-exempt center care providers must ensure proper disposal of all bio contaminants to safeguard against the spread of infectious disease. This includes the following steps: a. Discard disposable rubber gloves that come into contact with a bio contaminant after each use. b. Discard tissues, paper towels, disposable wipes, and similar products that come into contact with a bio contaminant after each use. c. Place soiled disposable diapers in a closed container that is lined with a leak-proof or impervious lining, remove the soiled disposable diapers from the facility, and place them in a closed garbage receptacle outside the building on a daily basis. d. Place soiled non-disposable diapers in a sealed plastic container that has been labeled with the child's name and return the diapers to the child's parent at the end of the day. e. Place soiled clothes in a sealed plastic container that has been labeled with the child's name and return the clothes to the child's parent at the end of the day or launder the clothes at the facility. f. Sheets and coverings shall be changed immediately when soiled or wet. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Prior to certification, all license-exempt family child care providers must ensure proper disposal of all bio contaminants to safeguard against the spread of infectious disease. This includes the following steps: a. Discard disposable rubber gloves that come into contact with a bio contaminant after each use. b. Discard tissues, paper towels, disposable wipes, and similar products that come into contact with a bio contaminant after each use. c. Place soiled disposable diapers in a closed container that is lined with a leak-proof or impervious lining, remove the soiled disposable diapers from the facility, and place them in a closed garbage receptacle outside the building on a daily basis. d. Place soiled non-disposable diapers in a sealed plastic container that has been labeled with the child's name and return the diapers to the child's parent at the end of the day. e. Place soiled clothes in a sealed plastic container that has been labeled with the child's name and return the clothes to the child's parent at the end of the day or launder the clothes at the facility. f. Sheets and coverings shall be changed immediately when soiled or wet. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Prior to certification, all license-exempt in-home care providers must ensure proper disposal of all bio contaminants to safeguard against the spread of infectious disease. This includes the following steps: a. Discard disposable rubber gloves that come into contact with a bio contaminant after each use. b. Discard tissues, paper towels, disposable wipes, and similar products that come into contact with a bio contaminant after each use. c. Place soiled disposable diapers in a closed container that is lined with a leak-proof or impervious lining, remove the soiled disposable diapers from the facility, and place them in a closed garbage receptacle outside the building on a daily basis. d. Place soiled non-disposable diapers in a sealed plastic container that has been labeled with the child's name and return the diapers to the child's parent at the end of the day. e. Place soiled clothes in a sealed plastic container that has been labeled with the child's name and return the clothes to the child's parent at the end of the day or launder the clothes at the facility. f. Sheets and coverings shall be changed immediately when soiled or wet. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Not applicable 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: All CCDF provider must ensure staff members responsible for transporting children shall receive additional orientation training in the following areas prior to assuming their transportation duties: transportation regulations, including the modeling of how to properly conduct a vehicle passenger check and demonstration by staff to director on how to conduct a vehicle passenger check; proper use of child safety restraints required by state law; proper loading, unloading, and tracking of children as required by state law; and location of first aid supplies and emergency procedures for the vehicle, including actions to be taken in the event of accidents or breakdowns. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Not applicable 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: Prior to certification, all license-exempt center care providers transporting children must ensure use of child safety restraints, such as car seat belts, child restraint seats, infant carrier seats, etc., as required by law in the transportation of children; b. take precautions necessary to ensure the safety of children being transported; c. develop written emergency procedures and actions to be taken in the event of an accident or breakdown; d. maintain a current driver’s license and current automobile insurance as required by law; e. obtain written permission from a parent to transport the child; and f. maintain a transportation log for each trip to be used to track children during transportation, which shall include the child’s name; the date, time, and place of pick up and drop off; and the name of the person to whom a child is released. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Prior to certification, all license-exempt family child care home providers transporting children must ensure use of child safety restraints, such as car seat belts, child restraint seats, infant carrier seats, etc., as required by law in the transportation of children; b. take precautions necessary to ensure the safety of children being transported; c. develop written emergency procedures and actions to be taken in the event of an accident or breakdown; d. maintain a current driver’s license and current automobile insurance as required by law; e. obtain written permission from a parent to transport the child; and f. maintain a transportation log for each trip to be used to track children during transportation, which shall include the child’s name; the date, time, and place of pick up and drop off; and the name of the person to whom a child is released. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Prior to certification, all license-exempt in-home care providers transporting children must ensure use of child safety restraints, such as car seat belts, child restraint seats, infant carrier seats, etc., as required by law in the transportation of children; b. take precautions necessary to ensure the safety of children being transported; c. develop written emergency procedures and actions to be taken in the event of an accident or breakdown; d. maintain a current driver’s license and current automobile insurance as required by law; e. obtain written permission from a parent to transport the child; and f. maintain a transportation log for each trip to be used to track children during transportation, which shall include the child’s name; the date, time, and place of pick up and drop off; and the name of the person to whom a child is released. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Not applicable 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: Within 90 calendar days from the date of hire and prior to assuming sole responsibility for any children, all licensed CCDF providers must ensure each staff member has current certification in pediatric first aid. Prior to receiving certification, caregivers and teachers who provide direct care for children must be supervised until training is completed. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Not applicable 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: Prior to certification, all license-exempt center care providers must have documentation of current pediatric first aid. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Prior to certification, all license-exempt family child care home providers must have documentation of current pediatric first aid. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Prior to certification, all license-exempt in-home care providers must have documentation of current pediatric first aid. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Not applicable 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: Within 90 calendar days from the date of hire and prior to assuming sole responsibility for any children, all licensed CCDF providers must ensure each staff member has current certification in pediatric CPR. Prior to certification, caregivers and teachers who provide direct care for children must be supervised until training is completed. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Not applicable 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: Prior to certification, all license-exempt center care providers must have documentation of current pediatric CPR. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Prior to certification, all license-exempt family child care home providers must have documentation of current pediatric CPR. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Prior to certification, all license-exempt in-home care providers must have documentation of current pediatric CPR. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Not applicable 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: Within seven calendar days of date of hire and prior to assuming sole responsibility for any children, all licensed CCDF providers must ensure each staff member shall receive orientation regarding child abuse identification and reporting. Licensed centers shall establish in writing and implement a child abuse and neglect policy. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Not applicable 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: Prior to certification, all license-exempt center care providers must have orientation in recognition of child abuse and neglect. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Prior to certification, all license-exempt family child care home providers must have orientation in recognition of child abuse and neglect. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Prior to certification, all license-exempt in-home care providers must have orientation in recognition of child abuse and neglect. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Not applicable 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: Within seven calendar days of date of hire and prior to assuming sole responsibility for any children, all licensed CCDF providers must ensure each staff member shall receive orientation regarding child abuse identification and reporting. Licensed centers shall establish in writing and implement a child abuse and neglect policy. All staff and owners shall report any allegation or suspected abuse or neglect of a child to the Louisiana Child Protection Statewide Hotline at (855) 4LA-KIDS [(855) 452-5437]. There shall not be a delay in the reporting of suspected abuse or neglect to the Child Protection Statewide Hotline in order to conduct an internal investigation to verify the abuse or neglect allegations, and staff shall not be required to report suspected abuse or neglect to the center or management prior to reporting it to the Child Protection Statewide Hotline. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Not applicable 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: Prior to certification, all license-exempt center care providers must have orientation in reporting of child abuse and neglect. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Prior to certification, all license-exempt family child care home providers must have orientation in reporting of child abuse and neglect. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Prior to certification, all license-exempt in-home care providers must have orientation in reporting of child abuse and neglect. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Not applicable 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: All meals and snacks provided by licensed centers, and their preparation, service, and storage, shall meet the requirements for meals of the U.S. Department of Agriculture (USDA) Child and Adult Care Food Program (CACFP), 7 CFR 226.20, and LAC 51:XXIII. A minimum of breakfast or a morning snack, lunch, and afternoon snack shall be served to children, and meals and snacks shall be served not more than three hours apart. Centers that do not serve breakfast shall have nutritious food available for children who arrive in the morning without having eaten breakfast. Children under age four shall not have foods that are implicated in choking incidents. Examples of these foods include, but are not limited to, whole hot dogs, hot dogs sliced in rounds, raw carrot rounds, whole grapes, hard candy, nuts, seeds, raw peas, hard pretzels, hard chips with the exception of puffs, peanuts, popcorn, whole marshmallows other than when melted in other foods or found in boxed cereals, spoons of peanut butter, and chunks of meat larger than what can be swallowed whole. ii. Access to physical activity. Describe: An early learning center shall establish in writing and implement procedures for physical activity: children under age two shall be provided time and space for age-appropriate physical activity, both indoors and outdoors, weather permitting, for a minimum of 60 minutes per day; children age two and older shall be provided physical activity that includes a combination of both teacher-led and free play, both indoors and outdoors, weather permitting, for a minimum of 60 minutes per day. iii. Caring for children with special needs. Describe: When the nature of a child with special health care needs or the number of children with special health care needs warrants added care, the center shall add sufficient staff as necessary. iv. Any other areas determined necessary to promote child development or to protect children’s health and safety. Describe: Within 30 calendar days of hire, each staff member shall receive orientation to the additional policies and practices of the center that at a minimum shall include child development, child guidance, and learning activities.