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: R 400.8263 Child accidents and incidents; child and staff illness. Rule 263. (1) A center shall develop and implement a written plan for how and when a parent is notified if program staff or volunteers observe any of the following:(a) Changes in a child’s health. (b) A child experiences an accident, injury, or incident. (c) A child is too ill to remain in the group. (2) A center shall ensure that a child who is too ill to remain in the group is placed in a separate area and is cared for and supervised by program staff or an unsupervised volunteer until the parent arrives. The separate area may be an unlicensed space such as the office area, reception area, or hallway but supervision must occur during this time. Food preparation areas may not be used. (3) Items and facilities used by an ill child or adult must not be used by another individual until cleaned and disinfected. (4) If a center becomes aware that a staff member, volunteer, or child in care has contracted a communicable disease, the center shall notify parents and provide all of the following information: (a) The name of the communicable disease the children were exposed to. (b) The symptoms of the disease. (c) Prevention measures as recommended by the United States Centers for Disease Control and Prevention at the following website: https://www.cdc.gov. (5) A center shall have a written policy detailing when children, staff, and volunteers will be excluded from the center due to illness. R 400.8134 Sleeping Equipment. (16) All sleeping equipment and bedding must be cleaned and sanitized when soiled, between uses by different children, and at least once a week regardless of use by different children. R 400.8143a Outdoor nature-based child care center toilets; hand washing sinks. R 400.8325 Dishwashing. R 400.8335 Food services and nutrition; provided by center. R 400.8340 Food services and nutrition; provided by parents R 400.8320 Food preparation. R 400.8254 Diapering; toileting. Rule 254. (1) Except as provided in subrule (2) of this rule, diapering must occur in a designated diapering area that complies with all of the following: (a) Is physically separated from food preparation and food service. (b) Is within close proximity to a sink that is used exclusively for hand washing. (c) Has non-absorbent, smooth, easily cleanable surfaces in good repair. (d) Is of sturdy construction with railings or barriers to prevent falls. (e) Is an elevated diapering table or similar structure. (f) Is cleaned and disinfected after each use. (2) Children 1 year of age and older may be changed in a bathroom standing up or on a nonabsorbent, easily disinfected surface, with a changing pad between the child and the surface. (3) Diapering supplies must be within easy reach of the designated diapering area (4) A plastic-lined, tightly covered container must be used exclusively for disposable diapers, training pants, and diapering supplies. The container must be emptied, cleaned, and disinfected at the end of each day. (5) Only single-use disposable wipes or other single-use cleaning cloths must be used to clean a child during the diapering or toileting process. (6) Diapers and training pants must be checked frequently and changed when wet or soiled. (7) Guidelines for diapering must be posted in diapering areas. (8) Disposable gloves, if used for diapering, must only be used once for a specific child and be removed and disposed of in a safe and sanitary manner immediately after each diaper change. (9) The following apply when cloth diapers or training pants are used: (a) Each cloth diaper must be covered with an outer waterproof covering. Outer coverings must be removed as a singular unit with wet or soiled diapers and with wet or soiled training pants, if used. (b) Diapers, training pants, and outer coverings must not be reused until washed and sanitized. (c) Rinsing the contents must not occur at the center. (d) Soiled diapers must be placed in a plastic-lined, covered container, wet bag, or other waterproof container, and used only for that child’s soiled diapers. (e) Soiled diapers or training pants must be stored and handled in a manner that will not contaminate other items and must not be accessible to children. (f) Soiled diapers or training pants must be removed from the center every day by the child’s parent. (g) A child’s supply of clean diapers or training pants may only be used for that child. (10) Toilet learning or training must be planned cooperatively between the child’s regular teachers and the child’s parent so the toilet routine established is consistent between the center and the child’s home. (11) Equipment used for toilet learning or training must be provided. All of the following equipment is acceptable for toilet learning or training: (a) Adult-sized toilets with safe and easily cleanable modified toilet seats and step aids. (b) Child-sized toilets. (c) Non- flushing toilets or potty chairs, if they are all of the following: (i) Made of a material that is easily cleanable. (ii) Used only in a bathroom area. (iii) Used over a surface that is impervious to moisture. (iv) Cleaned and disinfected after each use. ii. All CCDF-eligible licensed family child care homes. Provide the standard: R400.1919 Communicable disease; immunization; mental and physical health; physician attestation; tuberculosis. Rule 19. (1) An applicant shall obtain a written statement, signed by a licensed physician or his or her designee within 1 year before issuance of the initial license, that attests to the applicant’s mental and physical health. The attestation must be renewed at the time of subsequent license renewals. (2) A licensee shall obtain from a child care staff member and a child care assistant a written statement, signed by a licensed physician or his or her designee within 1 year prior to caring for children, that attests to the child care staff member’s or child care assistant’s mental and physical health. The attestation must be renewed at the time of subsequent renewals of the child care home’s license. (3) An applicant, licensee, child care staff member, child care assistant, and a member of the household who is age 14 or older shall provide written evidence of freedom from communicable tuberculosis (TB) prior to caring for children or living in the child care home. (4) An individual who lives in a child care home or who cares for children in a child care home, who has a suspected or confirmed case of a communicable disease, shall not come into contact with children in the home’s care. Communicable disease includes, but is not limited to, any of the following: (a) Tuberculosis. (b) Influenza. (c) Measles.(d) Whooping cough.(e) Strep throat. (f) Scarlet fever (g) Chicken pox. (2) If immunizations, as recommended by the state department of health and human services, have not been given or completed for all minors who live in the child care home, then the licensee shall inform the parent of each child in care at the home and all personnel. (3) The documents required in this rule must be retained by the licensee for a minimum of 4 years from the date the individual no longer resides in or cares for children in the child care home. R 400.1961 Parent notification required; incidents; accidents; illness; disease; isolation. Rule 61. (1) A licensee shall promptly report to a child’s parent any of the following: (a) Any incidents, accidents, suspected illness, or other changes observed in the health of a child. R 400.1924 Hand washing. Rule 24. (1) All personnel shall wash their hands appropriately and in the following manner: (a) Before and after all of the following: Preparing and serving food, eating, and feeding. Giving medication. (b) After all of the following: Diapering. Using the toilet or helping a child use the toilet. Handling bodily fluids, such as mucus, blood, vomit, from sneezing, wiping, and blowing noses, from mouths, or from sores. Handling animals and pets. Cleaning or handling garbage. (2) Personnel shall ensure that children wash their hands at all of the following times: (a) Before and after meals, snacks, or food preparation experiences. (b) After toileting or diapering. (c) After contact with any bodily fluids. (d) After playing in sand or water. (e) After handling animals and pets. (f) When soiled. (3) Hand sanitizers and wipes may be used as a temporary measure during outings, such as field trips and outdoor activities, until soap and running water are available. (4) When an infant is too heavy to hold for handwashing, cannot stand safely to wash hands at a sink, is not developmentally ready to hold head, and for children with special needs who are not capable of washing their own hands, staff may wash the child’s hands with non-toxic disposable wipes. R 400.1923 Diapering and toilet learning. Rule 23. (1) Diapering of infants and toddlers shall only occur in a designated changing area. (2) The designated changing area must comply with all of the following:(a) Be used exclusively for changing wet or soiled diapers or underwear. (b) Be located away from food preparation and meal service areas. (c) Have access to a hand washing sink that is not used for food preparation. (d) Have a nonabsorbent, easily sanitized surface with a changing pad between the child and the surface. (e) Be cleaned and sanitized after each use. (f) Have diapering and changing supplies within easy reach. (g) Have a plastic-lined, tightly covered container that is used exclusively for disposable diapers and diapering supplies that must be emptied and sanitized at the end of each day. (3) Diapers or training pants must be changed when wet or soiled. (4) Only single use disposable wipes or other single use cleaning cloths must be used to clean a child during the diapering or toileting process. (5) All of the following requirements apply when cloth diapers or training pants are used: (a) Each cloth diaper must be covered with an outer waterproof covering. Outer coverings must be removed as a singular unit with wet or soiled diapers or training pants. (b) Diapers, training pants, and outer coverings must not be reused until machine washed and sanitized. (c) No rinsing of the contents may occur at the child care home. (d) Soiled diapers must be placed in a plastic-lined, covered container used only for that child’s soiled diapers. (e)Soiled diapers or training pants must be stored and handled in a manner that will not contaminate any other items and must not be accessible to children. (f) A child’s parent shall remove soiled diapers or training pants from the child care home every day. (g) A child’s supply of clean diapers or training pants must be used only for that child. (6) Toilet learning must be planned cooperatively between the parent and the licensee so the toilet routine established is consistent. (7) If toilet learning equipment such as potty chairs and modified toilet seats, are used, then both of the following apply: (a) They must be able to be easily cleaned and sanitized. (b) Potty chairs must be emptied, rinsed, and sanitized after each use. (8) If disposable gloves are used, then they must only be used once for a specific child and must be removed and disposed of in a safe and sanitary manner immediately after each diaper change R 400.1932 Home maintenance and safety. Rule 32. (1) The structure, premises, and furnishings of a child care home must be in good repair and maintained in a clean, safe, and comfortable condition. 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: Military and Tribal centers are licensed exempt and standards are set by military and tribal regulations. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Military and Tribal family child care homes are licensed exempt and set by military and tribal regulations. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Using Caring for Our Children Michigan has developed both the License Exempt Provider Preservice Training and Annual Ongoing Training for creating and communicating to license exempt provider the standards around care that is provided in the child’s home. Standards include: (1) Children and Provider practice hand hygiene. Use 5 step method for washing hands covered in Preservice training. Wash hands when handling food, before and after eating, after going outside, after using toilet or/and changing diapers. (2) Cleaning, sanitizing, and disinfecting is done daily, weekly and monthly using non-toxic solution following recommended schedule. More frequently if household member has been ill. (Handout provided to providers on cleaning frequency recommended by Caring for Our Children.) Standards are monitored during the license exempt healthy and safety visit. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Out-of-school programs in Michigan operate under licensed center rules and standards. 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: R 400.8112 Children’s records. Rule 112. (1) At the time of a child’s initial attendance, a center shall obtain a child information card, using a form provided by the department or a comparable substitute, that is completed, signed, and dated by the child’s parent and updated as changes occur. The center shall keep current hard copies of the child information cards at the center. (2) For children under school-age, at the time of a child’s initial attendance, a center shall document 1 of the following, accessed through the Michigan care improvement registry or in a paper format if the parent or guardian chooses to provide to the center in that manner: (a) A certificate of immunization showing a minimum of 1 dose of each immunizing agent specified by the department of health and human services. (b) A medical contraindication form signed by a medical doctor or Doctor of Osteopathic Medicine stating why the child cannot receive immunizations. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Rule 7. (1) Prior to a child’s initial attendance, a licensee shall obtain the following documents: Documentation that immunizations and boosters, as recommended by the state department of health and human services, are any of the following: Have been completed. Are in progress. Are not being administered due to religious, medical, or other reasons based on a waiver signed by the parent. If a parent objects to emergency medical treatment on religious grounds, the parent shall provide a signed statement that he or she assumes responsibility for all emergency care. Records in subrule (1) of this rule must be reviewed and updated annually or when information changes. 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: Military and Tribal centers are licensed exempt and standards are set by military and tribal regulations. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Military and Tribal family child care homes are licensed exempt and set by military and tribal regulations. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Using Caring for Our Children Michigan has developed both the License Exempt Provider Preservice Training and Annual Ongoing Training for creating and communicating to license exempt provider the standards around care that is provided in the child’s home. Standards include: (1) Provider is aware of immunization schedule and shares updates with parent. (Handout given to provider: Early and Periodic Screening, Diagnostic and Treatment (EPSDT).) Standard is monitored during the license exempt healthy and safety visit. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Out-of-school programs in Michigan operate under licensed center rules and standards. 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: R 400.8216 Orientation. Rule 216. (1) Program staff and unsupervised volunteers shall participate in the center’s orientation training about the center’s policies and practices and these rules. (2) Within 30 calendar days after being present at the center and before caring for children, program staff and unsupervised volunteers shall have training on all of the following, as applicable: (a) The prevention of shaken baby syndrome, if the center serves infants and toddlers. (b) The prevention of sudden infant death syndrome and use of safe sleep practices, if the center serves infants and toddlers. R 400.8219 Sleeping, resting. Rule 219. (1) Children under 3 years of age shall be provided opportunities to rest regardless of the number of hours in care. (2) A center shall allow children under 18 months of age to sleep on demand. (3) Infants shall rest or sleep alone in cribs or portable cribs. (4) Infants shall be placed on their backs for resting and sleeping. (5) Infants unable to roll from their stomachs to their backs and from their backs to their stomachs shall be placed on their backs when found face down. (6) When infants can easily turn over from their stomachs to their backs and from their backs to their stomachs, they shall be initially placed on their backs but are allowed to adopt whatever position they prefer for sleep. (7) For an infant who cannot rest or sleep on her or his back due to disability or illness, written instructions, signed by the infant’s licensed health care provider, detailing an alternative safe sleep position or other special sleeping arrangements for the infant must be followed and maintained on file at the center. The instructions must include an end date. R 400.8134 Sleeping Equipment. Rule 134. (1) All bedding and sleeping equipment must be appropriate for the child, clean, comfortable, safe, and in good repair. (2) Heavy objects that could fall on a child, such as shelving and televisions, must not be above sleeping equipment. (3) A crib or portable crib must be provided for all infants in care. (4) A crib, portable crib, cot, or mat, and a sheet or blanket of appropriate size must be provided for all toddlers and preschoolers less than 3 years of age in care. (5) Along with a cot or a mat, a sheet or blanket of appropriate size must be provided as follows: (a) For all preschoolers 3 years of age and older in care for 5 or more continuous hours. (b) For any child in care who regularly naps. (c) On a parent’s request for any child in care. (6) Car seats, infant seats, swings, bassinets, and play yards are not approved sleeping equipment. (7) Documentation from the child’s licensed health care provider is required if a child has a health issue or special need that requires the child to sleep in something other than a crib or portable crib for infants or toddlers, or cot or mat for toddlers. The documentation must include specific sleeping instructions and time frames for how long the child needs to sleep in this manner, including an end date. (8) Swaddling with a sleep sack swaddle attachment or swaddle wrap is allowed only for infants up to 2 months of age. If a child has a health issue or special need that requires the child use a swaddle attachment or swaddle wrap after the child is 2 months of age, documentation from the child’s licensed health care provider is required. The documentation must include specific sleeping instructions and time frames for how long the child needs to sleep in this manner, including an end date. (9) A center shall not use stacking cribs. (10) Cribs and portable cribs must comply with the federal product safety standards issued by the United States Consumer Product Safety Commission. (11) A crib or portable crib must have a firm, tight-fitting waterproof mattress. (12) A tightly fitted bottom sheet must cover the crib or portable crib mattress with no additional padding placed between the sheet and mattress. ii. All CCDF-eligible licensed family child care homes. Provide the standard: R 400.8131 Professional development requirements. Rule 131. (1) The center shall provide an orientation about the center’s policies and practices and these administrative rules for all personnel hired after the effective date of these rules and before unsupervised contact with children. (4) Child care staff members shall have training that includes information about prevention of sudden infant death syndrome and use of safe sleep practices before caring for infants and toddlers. R 400.1905 Training (3) A licensee shall ensure that child care staff members and child care assistants, prior to caring for children, have training that includes information on all of the following: (a) Safe sleep practices to prevent sudden infant death syndrome. 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: Military and Tribal centers are licensed exempt and standards are set by military and tribal regulations. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Military and Tribal family child care homes are licensed exempt and set by military and tribal regulations. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Using Caring for Our Children Michigan has developed both the License Exempt Provider Preservice Training and Annual Ongoing Training for creating and communicating to license exempt provider the standards around care that is provided in the child’s home. Standards include: (1) Infants & toddlers are sleeping and napping in cribs, bassinets, or pack-n-plays only, with firm mattresses and tight-fitting sheets. (2) Infants are positioned on their backs to sleep. (3) No items (toys, pillows, blankets, positioners, etc.) are in the crib with the infant. Standards are monitored during the license exempt healthy and safety visit. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Out of school programs in Michigan operate under center licensing regulations and standards. 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: R 400.8260 Medication; administrative. Rule 260. (1) Medication, prescription or nonprescription, must be given to a child by program staff only. (2) Program staff shall give or apply medication, prescription or nonprescription, only with prior written permission from a parent. (3) All medication must be in its original container, stored according to instructions, and clearly labeled for a named child, including all nonprescription topical medications described in subrule (8) of this rule. (4) Prescription medication must have the pharmacy label indicating the physician’s name, child’s first and last name, instructions, name and strength of the medication, and must be given according to those instructions. (5) Program staff shall keep all medication out of the reach of children and return it to the child’s parent or destroy it if the parent determines it is no longer needed, or it has expired. (6) Program staff shall give or apply any prescription or nonprescription medication according to the directions on the original container, unless otherwise authorized by a written order from the child’s licensed health care provider. (7) Program staff shall not add medication to a child’s bottle, beverage, or food unless indicated on the prescription label. (8) Topical nonprescription medication, including, but not limited to, diapering cream, triple antibiotic, sunscreen, and insect repellant, requires written parental authorization annually. (9) A center shall maintain a record as to the time and the amount of medication given or applied, with the exception of medications described in subrule (8) of this rule, on a form provided by the department or a comparable substitute approved by the department. One form per medication is required. The signature of the program staff administering the medication must be included. ii. All CCDF-eligible licensed family child care homes. Provide the standard: R 400.1918 Medication; administration; procedures. Rule 18 (1) Medication, prescription or nonprescription, must be given to a child in care by a licensee or a child care staff member only. A child care assistant shall not give medication to a child in care. (2) All medication must be in the original container, stored according to instructions, and clearly labeled for a named child. (3) Prescription medication must have the pharmacy label indicating the physician's name, child's first and last name, instructions, and name and strength of the medication, and must be given in accordance with those instructions. (4) All medication must be kept out of the reach of children and returned to the child's parent when he or she determines it is no longer needed or when it has expired. (5) A licensee or child care staff member shall give or apply prescription or nonprescription medication according to the directions on the original container unless otherwise authorized by a written order of the child's physician. (6) A record of the date, time, and the amount of all medication given or applied must be maintained on a form provided by the department or a comparable substitute approved by the department. (7) Topical nonprescription medication, including but not limited to sunscreen, insect repellant, and diaper rash ointment, is exempt from subrules (1) and (7) of this rule. (8) TR 400.1918 Medication; administration; procedures. Rule 18 (1) Medication, prescription or nonprescription, must be given to a child in care by a licensee or a child care staff member only. A child care assistant shall not give medication to a child in care. (2) All medication must be in the original container, stored according to instructions, and clearly labeled for a named child. (3) Prescription medication must have the pharmacy label indicating the physician's name, child's first and last name, instructions, and name and strength of the medication, and must be given in accordance with those instructions. (4) All medication must be kept out of the reach of children and returned to the child's parent when he or she determines it is no longer needed or when it has expired. (5) A licensee or child care staff member shall give or apply prescription or nonprescription medication according to the directions on the original container unless otherwise authorized by a written order of the child's physician. (6) A record of the date, time, and the amount of all medication given or applied must be maintained on a form provided by the department or a comparable substitute approved by the department. (7) Topical nonprescription medication, including but not limited to sunscreen, insect repellant, and diaper rash ointment, is exempt from subrules (1) and (7) of this rule. (8) The records required in this rule must be retained for a minimum of 4 years. R 400.1918 Medication; administration; procedures. (9) Medication, prescription or nonprescription, must be given or applied only with prior written permission from a parent.] the records required in this rule must be retained for a minimum of 4 years. R 400.1918 Medication; administration; procedures. (9) Medication, prescription or nonprescription, must be given or applied only with prior written permission from a parent.] 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: Military and Tribal centers are licensed exempt and standards are set by military and tribal regulations. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Military and Tribal family child care homes are licensed exempt and set by military and tribal regulations. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Using Caring for Our Children Michigan has developed both the License Exempt Provider Preservice Training and Annual Ongoing Training for communicating the license exempt provider standards around care that is provided in the child’s home. Standards include: Provider ensures that before they administer medication, both prescription and over the counter has either: (1) Written permission from the parent/ guardian (2) Written permission child’s physician in the form of a note from the doctor or the prescription bottle. Standards are monitored during the license exempt healthy and safety visit. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Out-of-school programs in Michigan operate under licensed center regulations and standards. 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: R 400.8260 Medication; administrative. Rule 260. (1) Medication, prescription or nonprescription, must be given to a child by program staff only. (2) Program staff shall give or apply medication, prescription or nonprescription, only with prior written permission from a parent ii. All CCDF-eligible licensed family child care homes. Provide the standard: A licensee or child care staff member shall give or apply medication, prescription or nonprescription, only with prior written permission from a parent. R 400.1918 Medication; administration; procedures. Rule 18. (1) Medication, prescription or nonprescription, must be given to a child in care by a licensee or a child care staff member only. A child care assistant shall not give medication to a child in care. (2) Medication, prescription or nonprescription, must be given or applied only with prior written permission from a parent. 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: Military and Tribal centers are licensed exempt and standards are set by military and tribal regulations. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Military and Tribal family child care homes are licensed exempt and set by military and tribal regulations. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Lead Agency uses Caring for Our Children, License Exempt Provider Preservice Training and Annual Ongoing Training for creating and communicating to license exempt provider the standards around care that is provided in the child’s home. Standards include: All medications, whether prescription or Over the Counter are: Kept in their original containers. Stored out of reach of children. Properly disposed of when order expires. Dosage must not exceed the recommended dosage unless written permission is given from a physician. Child Care Providers can list the ￿Five Rights’ to follow before, during, and after administering medication. (The right Child, Medication, Dose, Time & Route) vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Out-of-school programs in Michigan operate under licensed center regulations and standards. 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: R 400.8216 Orientation. Rule 216. (1) Program staff and unsupervised volunteers shall participate in the center’s orientation training about the center’s policies and practices and these rules. (6) Within 90 days after being present at the center and before caring for children unsupervised, program staff and unsupervised volunteers shall complete the following trainings, which are allowed to be counted toward annual professional development hours and are available at MiRegistry: (b) Prevention of and response to emergencies due to food and allergic reactions as provided in R 400.8269a. R 400.8269a Food. Rule 269a. (1) A written plan for the prevention of and response to emergencies due to food and allergic reactions must be developed and implemented to include a child care plan, prevention measures, and emergency procedures. (2) The child’s care plan must include all of the following, at a minimum: (a) The child’s name with a list of their food allergies. (b) The names, doses, and methods of medication administration the child should receive if there is a reaction. (c) Training on the recognition of the child’s allergic reaction. (3) The child’s care plan must be carried on field trips. (4) The prevention measures must include all of the following, at a minimum: (a) Notify parents and guardians of all known food allergens to avoid bringing in foods to the classroom or center. (b) Post the child’s name and known food allergy prominently in the classroom or other area, on parent approval. (c) Train program staff and unsupervised volunteers on the symptoms of anaphylaxis. (d) Prevent food sharing between children. (5) The emergency procedures must include all of the following, at a minimum: (a) Promptly and properly administer medications in an event of an allergic reaction according to the instructions in the child’s care plan. (b) Contact emergency medical services immediately if any child has a serious allergic reaction, a new suspected serious allergic reaction occurs with any child, or whenever epinephrine is administered, even if the child appears to have recovered from the allergic reaction. (c) Notify parents or guardians immediately of any suspected allergic reactions, the ingestion of the problem food, or contact with the problem food, even if a reaction did not occur. ii. All CCDF-eligible licensed family child care homes. Provide the standard: On September 29, 2023, the agency received preliminary notice of a non-compliance related to this subsection. The agency needs additional time to meet this requirement. The current policy states that a licensee shall complete not less than 10 clock hours of training each calendar year related to child development, program planning, and administrative management for a child care business, not including CPR, first aid, and infectious disease, including immunizations, training. Within 90 days after receiving a child care license or of being hired at a child care home, a licensee, a child care staff member, and a child care assistant shall complete training on all of the following topics: Prevention of and response to emergencies due to food and allergic reactions. With the revisions planned, it is expected that this policy will meet all requirements and be in compliance by January 2026. 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: Military and Tribal centers are licensed exempt and standards are set by military and tribal regulations. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Military and Tribal family child care homes are licensed exempt and set by military and tribal regulations. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Using Caring for Our Children Michigan has developed both the License Exempt Provider Preservice Training and Annual Ongoing Training for creating and communicating to license exempt provider the standards around care that is provided in the child’s home. Standards include: (1) Food is prepared in a clean sanitized area and stored properly. (2) Any remaining formula or breast milk is discarded after 2 hours. (3) Measures are in place to minimize potential food allergy reactions. Reading labels for items in processed foods. Avoiding cross contamination. Following care plan for children with food allergies. Standards are monitored during the license exempt healthy and safety visit. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Out-of-school programs in Michigan operate under center regulations and standards. 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: R 400.8216 Orientation. Rule 216. (1) Program staff and unsupervised volunteers shall participate in the center’s orientation training about the center’s policies and practices and these rules. (6) Within 90 days after being present at the center and before caring for children unsupervised, program staff and unsupervised volunteers shall complete the following trainings, which are allowed to be counted toward annual professional development hours and are available at MiRegistry: (b) Prevention of and response to emergencies due to food and allergic reactions as provided in R 400.8269a. ii. All CCDF-eligible licensed family child care homes. Provide the standard: On September 29, 2023, the agency received preliminary notice of a non-compliance related to this subsection. The agency needs additional time to meet this requirement. The current policy states that a licensee shall complete not less than 10 clock hours of training each calendar year related to child development, program planning, and administrative management for a child care business, not including CPR, first aid, and infectious disease, including immunizations, training. Within 90 days after receiving a child care license or of being hired at a child care home, a licensee, a child care staff member, and a child care assistant shall complete training on all of the following topics: Prevention of and response to emergencies due to food and allergic reactions. The lack of policies relating to the response to food and allergic reaction is the reason for the agencies noncompliance. With the revisions planned, it is expected that this policy will meet all requirements and be in compliance by January 2026. 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: Military and Tribal centers are licensed exempt and standards are set by military and tribal regulations. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Military and Tribal family child care homes are licensed exempt and set by military and tribal regulations. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Using Caring for Our Children Michigan has developed both the License Exempt Provider Preservice Training and Annual Ongoing Training for creating and communicating to license exempt provider the standards around care that is provided in the child’s home. Standards include: (1) Provider displays ability to identify and act upon mild and severe food allergy symptoms, including administering Epinephrine (EpiPen) if warranted. Standards are monitored during the license exempt healthy and safety visit. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Out-of-school programs in Michigan operate under licensed center regulations and standards. 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: R 400.8125 Outdoor play area. (4) If outdoor space is not available adjacent to the center, a center may use a park or other outdoor facility. The outdoor space must meet all of the following requirements: (a) The area must be easily accessible by a safe walking route. (b) The play area must be inspected before each use to ensure that no hazards are present. (6) The outdoor play area must be in a safe location. (7) The outdoor play area must be protected from hazards, when necessary, by a fence or natural barrier that is not less than 48 inches in height. (8) Children shall only use age-appropriate equipment. (9) An outdoor play area and any equipment located on the center’s premises must be maintained in a safe condition and inspected daily before use to ensure that no hazards are present. (21) Small capacity centers shall abide by all of the following: (a) Provide a clean, safe, and hazard-free outdoor play area on the premises or within a reasonable walking distance of the center. (b) Inspect the outdoor play areas daily before use to ensure that no hazards are present. R 400.8216 Orientation. Rule 216. (6) Within 90 days after being present at the center and before caring for children unsupervised, program staff and unsupervised volunteers shall complete the following (c) Building and physical premises safety, including identification of and protection from hazards, bodies of water, and vehicular traffic. ii. All CCDF-eligible licensed family child care homes. Provide the standard: R 400.1932 Home maintenance and safety. Rule 32. (1) The structure, premises, and furnishings of a child care home must be in good repair and maintained in a clean, safe, and comfortable condition. (2) All dangerous and hazardous materials or items must be stored securely and out of the reach of children. 19 (3) All steps, stairs, porches, and elevated structures to which children in care have access must be protected to prevent falls, and must be free of ice and snow accumulation. (4) A handrail is required for 3 or more steps, or a total rise of 24 inches or more. (5) Parents shall be notified before pesticide or fertilizer treatments. (6) There must be no flaking or deteriorating paint on interior and exterior surfaces, equipment, and toys accessible to children. (7) If the child care home was built prior to 1978, then the licensee shall inform parents of each child in care and all personnel, in writing, prior to any remodeling, renovating or re-painting that could potentially disturb lead based paint or produce lead dust. Providers are encouraged to use EPA Renovation, Repair and Painting (RRP) trained and certified individuals when remodeling child care areas to ensure lead safety for their children in care. (8) Open-flame devices and candles must not be used, except for birthdays or religious celebrations, and they must be inaccessible to children and extinguished when done. R 400.1942 Electrical service; maintenance. Rule 42. (1) The electrical service of a child care home must be maintained in a safe condition. When warranted, an electrical inspection by an electrical inspecting authority may be required. (2) All electrical outlets, including outlets on multiple outlet devices, accessible to children must have safety covers or be tamper resistant outlets. (3) Electrical cords must be arranged so they are not hazardous to children. R 400.1920 Outdoor play area and equipment. Rule 20. (1) A child care home shall provide a clean, safe, and hazard free outdoor play area, on the premises or within a reasonable walking distance of the home. (2) The play area size must be 1 of the following: (a) Not less than 400 square feet for a family child care home. (b) Not less than 600 square feet for a group child care home. (3) A licensee shall provide an adequate and varied supply of outdoor play equipment, materials, and furniture, that is all of the following: (a) Appropriate to the developmental needs and interests of children. (b) Appropriate to the number of children. (c) Safe and in good repair. (4) The outdoor play area and equipment must be organized to meet all of the following requirements: (a) To separate active and quiet activities. (b) For a clear and unobstructed view of the whole play area. 14 (c) To ensure that there are safe distances between equipment. (5) When swings, climbers, slides, and other similar play equipment with a designated play surface above 30 inches are used, they must: (a) Not be placed over concrete, asphalt, or a similar surface, such as hard-packed dirt or grass. (b) Be safe, in good repair, and age-appropriate. (c) Be placed at least 6 feet from the perimeter of other play structures or obstacles. (6) Trampolines must not be used outdoors by children in care. (7) Bounce houses are permissible outdoors with direct supervision by a licensee or child care staff member, and pursuant to the manufacturer’s recommendations. (8) Children in care shall not be permitted to ride all-terrain vehicles, motor bikes, go-carts, recreational, or other motorized vehicles. 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: Military and Tribal centers are licensed exempt and standards are set by military and tribal regulations. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Military and Tribal family child care homes are licensed exempt and set by military and tribal regulations. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Using Caring for Our Children Michigan has developed both the License Exempt Provider Preservice Training and Annual Ongoing Training for creating and communicating to license exempt provider the standards around care that is provided in the child’s home. Standards include: (1) Children are properly supervised by Child Care Provider. Children under age 6 are under constant supervision by sound and sight. Visual checks are done frequently while napping. Children over the age of 6 are supervised based on individual needs identified by the parent. (2)Children are directly supervised when outdoor hazards like traffic, bodies of water, and unsafe playgrounds are identified. (3) Provider protects children from insect bites, animal bites, and sun exposure. Following recommendations from orientation assessing and monitoring surroundings/environment. (4) Provider identifies any areas that may be at risk of lead and prevent children from being exposed to lead poisoning. (5) Inside and outside are free of hazards. (i.e. Not Chemicals, power equipment, tools). Children kept off areas where any lawn pesticides/fertilizers were spread. (6)All weapons and ammunition are stored in a lock box out of reach and out of sight of children. (7) Safety items such as smoke alarms, gates, outlet covers, cupboard door locks are used when applicable. Standards are monitored during the license exempt healthy and safety visit. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Out-of-school programs in Michigan operate under licensed child care center standards. 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: R 400.8216 Orientation. Rule 216. (6) Within 90 days after being present at the center and before caring for children unsupervised, program staff and unsupervised volunteers shall complete the following (c) Building and physical premises safety, including identification of and protection from hazards, bodies of water, and vehicular traffic. ii. All CCDF-eligible licensed family child care homes. Provide the standard: R 400.1921 Water hazards; water activities. Rule 21. (1) A licensee shall ensure that barriers exist to prevent children from gaining access to any swimming pool, drainage ditch, well, natural or constructed pond, or other body of open water located on or adjacent to the property where the child care home is located. These barriers must be a minimum of 4 feet in height and appropriately secured to prevent children from gaining access to such areas. (2) A hot tub or spa pool must not be used when children are in care. (3) A hot tub or spa pool, whether indoors or outdoors, must be made inaccessible to children in care by the use of a locked hard cover. (4) A wading pool may be used when all of the following requirements are met: (a) It is clean and free of debris. (b) It is emptied and cleaned after each play period or immediately when it becomes dirty or contaminated. (c) It remains empty at all times when not in use. (5) Before use of a residential pool or any other body of water by children in care, a licensee shall ensure that the water is clean, safe, and sanitary, and that the children will be appropriately and adequately supervised. (6) Public swimming areas may be used only if a lifeguard is present. (7) If there are 2 groups of children, 1 group in the water and 1 group out of the water, then the personnel to child ratios, as required in R 400.1910, must be maintained for each group, with the exception that the personnel to child ratio for children under 3 years of age who are in the water must be 1-to-1 at all times. (8) Rescue equipment must be readily accessible at all times. (9) A working telephone must be immediately accessible in the water activity area. (10) A licensee shall obtain and keep on file written permission from a child's parent for the child's participation in either of the following: (a) Before each outdoor water activity at a swimming pool, lake, or other body of water off the child care home premises. (b)Once per season for water activities occurring on the child care home premises. (11) The emergency plan in R 400.1945 must include procedures for water emergencies. 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: Military and Tribal centers are licensed exempt and standards are set by military and tribal regulations. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Military and Tribal family child care homes are licensed exempt and set by military and tribal regulations. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Lead Agency uses Caring for Our Children, License Exempt Provider Preservice Training and Annual Ongoing Training for creating and communicating to license exempt provider the standards around care that is provided in the child’s home. Standards include: (1) Children are properly supervised by Child Care Provider. Children under age 6 are under constant supervision by sound and sight. Visual checks are done frequently while napping. Children over the age of 6 are supervised based on individual needs identified by the parent. (2) Children are directly supervised when outdoor hazards like traffic, bodies of water, and unsafe playgrounds. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Out-of-school programs in Michigan operate under licensed child care centers. 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: R 400.8125 Outdoor play area. (4) If outdoor space is not available adjacent to the center, a center may use a park or other outdoor facility. The outdoor space must meet all of the following requirements: (a) The area must be easily accessible by a safe walking route. (b) The play area must be inspected before each use to ensure that no hazards are present. (c) The location of the alternative outdoor play area must be specified in writing to the department. (6) The outdoor play area must be in a safe location. (7) The outdoor play area must be protected from hazards, when necessary, by a fence or natural barrier that is not less than 48 inches in height. ii. All CCDF-eligible licensed family child care homes. Provide the standard: On September 29, 2023 the agency received preliminary notice of a non-compliance related to this subsection. The agency needs additional time to meet this requirement. The current policy states that a child care home shall provide a clean, safe, and hazard free outdoor play area, on the premises or within a reasonable walking distance of the home. The agency lacks policies related to ensuring the identification of and protection from vehicular traffic hazards causing the non-compliance. With the revisions planned, it is expected that this policy will meet all requirements and be in compliance by January 2026. 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: Military and Tribal centers are licensed exempt and standards are set by military and tribal regulations. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Military and Tribal family child care homes are licensed exempt and set by military and tribal regulations. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Using Caring for Our Children Michigan has developed both the License Exempt Provider Preservice Training and Annual Ongoing Training for creating and communicating to license exempt provider the standards around care that is provided in the child’s home. Standards include: (1) Children are properly supervised by Provider. Children under age 6 are under constant supervision by sound and sight. Visual checks are done frequently while napping. Children over the age of 6 are supervised based on individual needs identified by the parent. (2) Children are directly supervised when outdoor hazards like traffic, bodies of water, and unsafe playgrounds are identified. (3) Driveway safety is observed: Children do not play near parked vehicles. Children are never left in vehicles. Driver checks that no children are nearby before driving. Standards are monitored during the license exempt healthy and safety visit. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Out-of-state programs in Michigan operate under licensed center regulations and standards. 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: R 400.8131 Professional development requirements. Rule 131. The center shall provide an orientation about the center’s policies and practices and these administrative rules for all personnel hired after the effective date of these rules and before unsupervised contact with children. Before caring for children, all child care staff members and unsupervised volunteers who work directly with children shall be trained on prevention of shaken baby syndrome, abusive head trauma and child maltreatment, and recognition and reporting of child abuse and neglect. R 400.8140 Discipline. Rule 140. (1) Positive methods of discipline that encourage self-control, self direction, self-esteem, and cooperation must be used. (2) All of the following means of punishment are prohibited: (a) Hitting, spanking, shaking, biting, pinching, or inflicting other forms of corporal punishment. (b) Placing any substances in a child’s mouth, including but not limited to, soap, hot sauce, or vinegar. (c) Restricting a child’s movement by binding or tying him or her. (d) Inflicting mental or emotional punishment, such as humiliating, shaming, or threatening a child. (e) Depriving a child of meals, snacks, rest, or necessary toilet use. (f) Excluding a child from outdoor play or other gross motor activities. (g) Excluding a child from daily learning experiences. (h) Confining a child in an enclosed area, such as a closet, locked room, box, or similar enclosure. (i) Time out must not be used for children under 3 years of age. (3) Non-severe and developmentally appropriate discipline or restraint may be used when reasonably necessary, based on a child’s development, to prevent a child from harming himself or herself or to prevent a child from harming other persons or property, excluding those forms of punishment prohibited by subrule (2) of this rule. (4) A written policy must be developed and implemented regarding the age appropriate, non-severe discipline of children. The policy must be provided to staff and parents. ii. All CCDF-eligible licensed family child care homes. Provide the standard: R 400.1905 Training. Rule 5. (3) A licensee shall ensure that child care staff members and child care assistants, prior to caring for children, have training that includes information on all of the following: Recognition of and the reporting of child abuse and neglect. Prevention of shaken baby syndrome, abusive head trauma and child maltreatment. R 400.1913 Discipline; child handling. Rule 13. (1) A licensee shall develop and have on file a written policy regarding the discipline of children. (2) Developmentally appropriate positive methods of discipline that encourage self control, self-direction, self esteem, and cooperation must be used. (3) Personnel shall not do any of the following: (a) Hit, spank, shake, bite, pinch, or inflict other forms of corporal punishment. (b) Use any substance in a child’s mouth such as, but not limited to, soap, hot sauce, or vinegar. (c) Restrict a child's movement by binding or tying him or her. (d) Inflict mental or emotional stress, such as humiliating, shaming, threatening a child, or using derogatory remarks. (e) Deprive a child of meals, snacks, rest, or necessary toilet use. (f) Confine a child in an enclosed area such as a closet, locked room, box, or similar enclosure. (g) Use time out for children under 3 years old. 10 (4) Reasonably appropriate discipline or restraint may be used to prevent a child from harming himself or herself, or to prevent a child from harming other persons or property, or to allow a child to gain control of himself or herself excluding those forms of punishment prohibited by subrule (3) of this rule. (5) This rule is not subject to the variance specified in R 400.1963. 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: Military and Tribal centers are licensed exempt and standards are set by military and tribal regulations. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Military and Tribal family child care homes are licensed exempt and set by military and tribal regulations. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Using Caring for Our Children Michigan has developed both the License Exempt Provider Preservice Training and Annual Ongoing Training for creating and communicating to license exempt provider the standards around care that is provided in the child’s home. Standards include: (1) Provider identifies the actions that can result in Abusive Head Trauma that were presented in orientation training. (2) Provider identifies the following actions that can result in Abusive Head Trauma and Shaken Baby Syndrome that were presented in orientation and ongoing training. Vigorously shaking a baby or striking a baby head can cause damage to the brain, eyes, ribs and can cause death. (3) Injury happens because: Babies heads are heavy and large in proportion to their body size. Babies have weak neck muscles. Babies have fragile undeveloped brains. Large size and strength difference between the victim and perpetrator (4) Provider uses appropriate safe actions to reduce their stress when frustrated by infants crying. Standards are monitored during the license exempt healthy and safety visit. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Out-of-school programs in Michigan operate under licensed child care center standards. 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: R 400.8216 Orientation. Rule 216. (1) Program staff and unsupervised volunteers shall participate in the center’s orientation training about the center’s policies and practices and these rules. (2) Within 30 calendar days after being present at the center and before caring for children, program staff and unsupervised volunteers shall have training on all of the following, as applicable: (d) The prevention of child maltreatment. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 400.1905 Training. (3) A licensee shall ensure that child care staff members and child care assistants, prior to caring for children, have training that includes information on all of the following: Recognition of and the reporting of child abuse and neglect. Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment. R 400.1913 Discipline; child handling. Rule 13. (1) A licensee shall develop and have on file a written policy regarding the discipline of children. (2) Developmentally appropriate positive methods of discipline that encourage self- control, self-direction, self-esteem, and cooperation must be used. (3) Personnel shall not do any of the following: (a) Hit, spank, shake, bite, pinch, or inflict other forms of corporal punishment. (b) Use any substance in a child’s mouth such as, but not limited to, soap, hot sauce, or vinegar. (c) Restrict a child's movement by binding or tying him or her. (d) Inflict mental or emotional stress, such as humiliating, shaming, threatening a child, or using derogatory remarks. (e) Deprive a child of meals, snacks, rest, or necessary toilet use. (f) Confine a child in an enclosed area such as a closet, locked room, box, or similar enclosure. (g) Use time out for children under 3 years old. 10 (4) Reasonably appropriate discipline or restraint may be used to prevent a child from harming himself or herself, or to prevent a child from harming other persons or property, or to allow a child to gain control of himself or herself excluding those forms of punishment prohibited by subrule (3) of this rule. (5) This rule is not subject to the variance specified in R 400.1963. 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: Military and Tribal centers are licensed exempt and standards are set by military and tribal regulations. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Military and Tribal family child care homes are licensed exempt and set by military and tribal regulations. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Using Caring for Our Children Michigan has developed both the License Exempt Provider Preservice Training and Annual Ongoing Training for creating and communicating to license exempt provider the standards around care that is provided in the child’s home. Standards include: (1) Provider uses appropriate guidance to discipline and direct children and avoids corporal punishment. The State of Michigan manual for licensed childcare providers prohibits the following means of punishment: hitting, spanking, shaking, biting, pinching, restricting movement, and inflicting emotional or mental harm. (2) Provider uses appropriate safe actions to reduce their stress when frustrated by infants crying. Standards are monitored during the license exempt healthy and safety visit. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Out-of-school programs in Michigan operate under licensed child care center standards. 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: R 400.8216 Orientation. Rule 216. (1) Program staff and unsupervised volunteers shall participate in the center’s orientation training about the center’s policies and practices and these rules. (6) Within 90 days after being present at the center and before caring for children unsupervised, program staff and unsupervised volunteers shall complete the following trainings, which are allowed to be counted toward annual professional development hours and are available at MiRegistry:(d) Handling and storage of hazardous materials and appropriate disposal of Bio contaminants. ii. All CCDF-eligible licensed family child care homes. Provide the standard: R 400.1905 Training. (4) Within 90 days after receiving a child care license or of being hired at a child care home, a licensee, a child care staff member, and a child care assistant shall complete training on all of the following topics: Handling and storage of hazardous materials and the appropriate disposal of bio-contaminants. R400.1932 Home maintenance and safety All dangerous and hazardous materials or items must be stored securely and out of the reach of children R400.1942 Electrical service: maintenance Electrical cords must be arranged so they are not hazardous to children. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Tribal or military centers are license exempt and set their own rules/regulations. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Tribal and military family child care homes are licensed exempt and set by tribal regulations. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Using Caring for Our Children Michigan has developed both the License Exempt Provider Preservice Training and Annual Ongoing Training for creating and communicating to license exempt provider the standards around care that is provided in the child’s home. Standards are: (1) Hazardous materials in and near home are: (a) Properly labeled. (b) In their original containers (c) Safely stored out of reach of children. (2) Medications belonging to the provider and/or residents of home are safely stored out of reach of children. (3) The telephone number for the Poison Control Center is either programmed into the Child Care Provider’s phone or posted in an easily visible location in the home. (4) All potentially hazardous materials, which include, but are not limited to, drugs, alcohol, cleaning and other poisonous or toxic materials, must not be used as they are a hazard to children. (5) All potentially hazardous materials, which include, but are not limited to, matches, lighters, medicines, cleaning materials, detergents, aerosol cans, and other poisonous or toxic materials, must be used in a way that they will not contaminate play surfaces, food, food preparation areas or constitute a hazard to children. Standards are monitored during the license exempt healthy and safety visit. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Out-of-school programs in Michigan operate under center regulations and standards. 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: R 400.8164 Poisonous or toxic materials. Rule 164. Containers of poisonous or toxic materials must be clearly labeled for easy identification of contents and stored out of reach of children. This includes chemical sanitizers and disinfectants. R 400.8257 Bio contaminants. Rule 257. A center shall use standard precautions regarding prevention, exposure, and disposal of bio contaminants. R 400.8315 Food and equipment storage. (6) Poisonous or toxic materials must not be stored with food, food service equipment, utensils, or single-service articles. R 400.8216 Orientation. Rule 216. (1) Program staff and unsupervised volunteers shall participate in the center’s orientation training about the center’s policies and practices and these rules. (6) Within 90 days after being present at the center and before caring for children unsupervised, program staff and unsupervised volunteers shall complete the following trainings, which are allowed to be counted toward annual professional development hours and are available at MiRegistry (d) Handling and storage of hazardous materials and appropriate disposal of Bio contaminants. ii. All CCDF-eligible licensed family child care homes. Provide the standard: R 400.1905 Training. (4) Within 90 days after receiving a child care license or of being hired at a child care home, a licensee, a child care staff member, and a child care assistant shall complete training on all of the following topics: Handling and storage of hazardous materials and the appropriate disposal of bio-contaminants. R400.1932 Home maintenance and safety All dangerous and hazardous materials or items must be stored securely and out of the reach of children Containers of poisonous or toxic materials shall be clearly labeled for easy identification of contents and stored out of reach of children. Health and safety training on this topic includes toxic substances, mistaken identity items and proper disposal of hazardous materials. A plastic-lined, tightly covered container must be used exclusively for soiled disposable diapers and training pants and diapering supplies. The container must be emptied and sanitized at the end of each day. Soiled cloth diapers must be placed in a plastic lined covered container, wet bag, or other waterproof container, and used only for that child's soiled diapers. All dangerous and hazardous materials or items shall be stored securely and out of the reach of children. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Tribal or military program centers are license exempt and set their own rules/regulations. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Tribal or military child care homes are license exempt and set their own rules/regulations. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Using Caring for Our Children Michigan has developed both the License Exempt Provider Preservice Training and Annual Ongoing Training for creating and communicating to license exempt provider the standards around care that is provided in the child’s home. Standards include: (1) A diaper changing procedure, and all cleaning of bodily fluids is followed that minimizes the spread of germs. (a) Location is removed from food prep and play areas. (b) Provider disposes of any bodily fluids or diaper properly. Cleans & disinfects contaminated area, and washes hands immediately. Standards are monitored during the license exempt healthy and safety visit. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Out-of-school programs in Michigan operate under license center regulations and standards. 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: R 400.8750 Motor vehicle operator. Rule 750. (1) The driver of any motor vehicle transporting children shall comply with all of the following: (a) Be at least 18 years of age. (b) Possess a valid operator or chauffeur’s license with the appropriate endorsement as required by chapter III of the Michigan vehicle code, 1949 PA 300, MCL 257.301 to 257.329. (c) Have a personal driving record with not more than 6 active points as determined by the secretary of state. (d) Have proof of valid automobile insurance and registration. (e) Be familiar with the contents of the first aid kit. (f) Be familiar with the operation of the fire extinguisher, if a fire extinguisher is required. (2) All of the following documents must be kept on file at the center: (a) A copy of each driver’s driving record, except for drivers of volunteer motor vehicles, obtained from the secretary of state at least once a year. (b) A self- certifying statement that all volunteer drivers comply with subrule (1) of this rule. (c) A copy of a valid driver’s license for each driver. (3) Drivers shall be provided with a copy of the child information card or comparable substitute for each child being transported in their motor vehicles. R 400.8720 All motor vehicles. Rule 720. (1) All motor vehicles must be in safe operating condition. (2) All motor vehicles, except multifunction school activity buses and school buses inspected by the department of state police as indicated in subrule (3) of this rule, must be inspected annually by a licensed mechanic. A copy of the inspection must be kept on file at the center. Volunteer vehicles are not required to be inspected. (3) Centers that use multifunction school activity buses and school buses must do all of the following: (a) Contact the department of state police to determine if an annual inspection by the department of state police is required under section 39 of the pupil transportation act, 1990 PA 187, MCL 257.1839. (b) If directed by the department of state police, obtain an annual inspection by the department of state police. A copy of the inspection must be kept on file at the center. (4) A statement verifying that all motor vehicles, including volunteer vehicles, are in compliance with Michigan vehicle code safety equipment requirements, as defined in sections 683 to 711 of the Michigan vehicle code, 1949 PA 300, MCL 257.683 to 257.711, must be kept on file at the center.(5) The use of passenger vans with a rated seating capacity of 11 or more, including volunteer vehicles, is prohibited. (6) Multifunction school activity buses used for transporting children between the child care center and school must comply with all minimum safety specifications, except color, identification, and alternating flashing lights, as defined in the pupil transportation act, 1990 PA 187, MCL 257.1801 to 257.1877. (7) Motor vehicle seats used by children, staff, and volunteers must not face sideways. (8) A truck must not be used to transport children, except in the cab. (9) There must be no loose or heavy objects in the passenger compartment of any motor vehicle. R 400.8730 Safety equipment in motor vehicles. Rule 730. (1) All motor vehicles used to transport children must carry all the following safety equipment: (a) Three bidirectional emergency reflective triangles properly cased and securely stored in the motor vehicle. (b) A first aid kit securely stored in an accessible location in the driver compartment. (2) Any motor vehicle with a manufacturer’s rated seating capacity of more than 10 occupants used to transport children must carry both of the following additional: (a) Not less than 3 15-minute flares or an approved battery-operated substitute properly cased and securely stored in the driver’s compartment. (b) Fire extinguisher of dry chemical type rated not less than 2A- 10BC mounted in an accessible place in the driver’s compartment. The fire extinguisher must be inspected and maintained in accordance with NFPA-10. The fire extinguisher must bear a tag indicating the last date of inspection or service and the initials of the person who performed the inspection or service. (3) Volunteer motor vehicles are exempt from subrule (1)(a) of this rule. R 400.8740 Manufacturer’s rated seating capacity; restraint devices; safety belts. Rule 740. (1) Each child transported shall be seated according to the manufacturer’s rated seating capacity and properly restrained by a passenger restraint device pursuant to sections 710d and 710e of the Michigan vehicle code, 1949 PA 300, MCL 257.710d and 257.710e. (2) Passenger restraint devices, as required by subrule (1) of this rule, are not required for children transported on a school bus or a multifunction school activity bus. (3) Each restraint device must be properly anchored to the vehicle seat and used according to the manufacturer’s specifications. (4) Allowing 2 or more children to share a seat belt or restraint device is prohibited. (5) The driver of a motor vehicle and all adult passengers shall be seated according to the manufacturer’s rated seating capacity and properly restrained by safety belts when the motor vehicle is in motion. (6) All safety belts and restraint devices used while transporting children and adults must be in good working condition. ii. All CCDF-eligible licensed family child care homes. Provide the standard: R 400.1951 Transportation. Rule 51. (1) A vehicle used to transport children in care must be maintained in a good, safe working condition. (2) A licensee shall ensure that the driver of a vehicle transporting children is an adult, who has a valid driver's license, valid vehicle registration, and proof of current automobile insurance. (3) A licensee shall notify the parents in advance when drivers other than child care staff members are used to transport children. (4) If the driver will have unsupervised access to children, the driver shall complete a comprehensive background check and be determined eligible by the department in compliance with section 5n of the act, MCL 722.115n. (5) Each child passenger restraint device and each safety belt must be installed, anchored, and used according to the manufacturer's specifications and must be maintained in a safe working condition. (6) The transportation of all children must be conducted pursuant to state law. (7) Each child transported shall remain seated and properly restrained by a child passenger restraint device appropriate for his or her age. The manufacturer's rated seating capacity for the vehicle must not be exceeded. (8) A licensee shall provide a driver with a copy of the child information card, or comparable facsimile, for each child being transported in a vehicle. (9) The driver of each vehicle transporting children shall carry in the vehicle, and be familiar with, the contents of a first aid kit. The first aid kit, must contain, at a minimum, all of the following: (a) Adhesive tape. (b) Bandages (assorted sizes) (c) Cold pack. (d) Disposable gloves. (e) Gauze pads and roller gauze (assorted sizes). (f) Hand sanitizer. (g) Plastic bags. (h) Scissors and tweezers. (i) Triangular bandage. R 400.1952 Child transportation; parent permission; child information card; required when off premises. Rule 52 (1) A licensee shall obtain and keep on file written permission from a child's parent before a child is transported in a vehicle. Written permission must be obtained for both of the following: (a) Routine transportation, at least annually. (b) Nonroutine transportation, before each trip. (2) At the time of initial enrollment, a licensee shall obtain written permission from a child’s parent for the child to go on field trips that do not involve a vehicle including, but not limited to, walking to a park or in the neighborhood. (3) A licensee shall have a copy of each child's information card and a first aid kit, containing the items listed in R 400.1951(9), accessible at all times when children leave the premises. R 400.1905 Training Within 90 days after receiving a child care license or of being hired at a child care home, a licensee, a child care staff member, and a child care assistant shall complete training on all of the following topics: (e) Precautions in transporting children. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Tribal or military centers are licensed exempt and set their own rules/regulations. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Tribal and miliary family child care homes are licensed exempt and set their own rules/regulations. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Using Caring for Our Children Michigan has developed both the License Exempt Provider Preservice Training and Annual Ongoing Training for creating and communicating to license exempt provider the standards around care that is provided in the child’s home. Standards include: (1) Children are using the appropriate transportation safety device for their size, be it a rear-facing car seat, a forward- facing car seat, a booster seat, or a seat belt. (2) Provider self certifies that car seats are: Installed according to manufactures recommendations. Have not expired. Have not been in an accident or recalled. (3) Provide displays proper use of car seat harnesses: (a)The harness clip is positioned at armpit level. (b) The harness is snug and not able to be pinched. (c) Children are not wearing bulky coats while in safety seats. (4) Permission is obtained from parent prior to transporting child(ren). Standards are monitored during the license exempt healthy and safety visit. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Out-of-school programs in Michigan operate under license child care center standards. 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: R 400.8216 Orientation. Rule 216. (1) Program staff and unsupervised volunteers shall participate in the center’s orientation training about the center’s policies and practices and these rules. (6) Within 90 days after being present at the center and before caring for children unsupervised, program staff and unsupervised volunteers shall complete the following trainings, which are allowed to be counted toward annual professional development hours and are available at MiRegistry: (g) Pediatric first aid and pediatric, infant, child, and adult cardiopulmonary resuscitation training. (7) Before issuing a license to operate a child care center, and before the renewal of a license, the department shall verify that not less than 50% of the program staff are currently certified in pediatric first aid and pediatric, child, and adult cardiopulmonary resuscitation. Each of these program staff’s first aid and cardiopulmonary resuscitation certificates must be valid and retained on file in the center or at the central office until 2 years after the effective date of this rule, after which they must be made available online at MiRegistry ii. All CCDF-eligible licensed family child care homes. Provide the standard: On September 29, 2023 the agency received preliminary notice of a non-compliance related to this subsection. The agency needs additional time to meet this requirement. The current policy states, before caring for children at a child care home, an individual shall provide the licensee with a valid certification of first aid. The reason for the non-compliance is the language relating to first aid is not specific to pediatric first aid. With the revisions planned, it is expected that this policy will meet all requirement and be in compliance by January 2026. 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: Tribal or military centers are license exempt and have their own rules/regulations. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Tribal and military family child care homes are licensed exempt and have their own rules/regulations. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Lead Agency uses Caring for Our Children, License Exempt Provider Preservice Training and Annual Ongoing Training for creating and communicating to license exempt provider the standards around care that is provided in the child’s home. Standards include: Provider has completed training or certification during orientation in Pediatric First Aid. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Out-of-school programs that operate in Michigan operate under license center regulations and standards. 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: R 400.8216 Orientation. Rule 216. (1) Program staff and unsupervised volunteers shall participate in the center’s orientation training about the center’s policies and practices and these rules. (6) Within 90 days after being present at the center and before caring for children unsupervised, program staff and unsupervised volunteers shall complete the following trainings, which are allowed to be counted toward annual professional development hours and are available at MiRegistry:(g) Pediatric first aid and pediatric, infant, child, and adult cardiopulmonary resuscitation training. (7) Before issuing a license to operate a child care center, and before the renewal of a license, the department shall verify that not less than 50% of the program staff are currently certified in pediatric first aid and pediatric, child, and adult cardiopulmonary resuscitation. Each of these program staff’s first aid and cardiopulmonary resuscitation certificates must be valid and retained on file in the center or at the central office until 2 years after the effective date of this rule, after which they must be made available online at MiRegistry. ii. All CCDF-eligible licensed family child care homes. Provide the standard: R 400.1902 Applicant; licensee; requirements. (d) Have proof of certification in both of the following: Infant, child, and adult cardiopulmonary resuscitation (CPR). First aid Rule 2. (1) An applicant and a licensee shall meet all of the following requirements. R 400.1904a Child care staff member; employment requirements. Before caring for children at a child care home, an individual shall provide the licensee with all of the following: A valid certification in infant, child, and adult CPR. (b) A valid certification in first aid. R 400.1905 Training. (7) CPR and first aid training certification must be maintained according to the expiration dates on the individual’s certification cards. 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: Tribal or military centers are license exempt and set their own rules/regulations. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Tribal and military family child care homes are licensed exempt and have their own rules/regulations. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Lead Agency uses Caring for Our Children, License Exempt Provider Preservice Training and Annual Ongoing Training for creating and communicating to license exempt provider the standards around care that is provided in the child’s home. Standards include: Provider has completed training or certification during orientation in age-appropriate CPR. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Out-of-school programs that operate in Michigan operate under license center regulations and standards. 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: R 400.8213 Staff; volunteer. Rule 213. (1) All staff and volunteers present at the center shall: (d) Sign and date a written statement at the time of hiring or before volunteering and indicate all of the following information: (i) The individual is aware that abuse and neglect of children is against the law. (ii) The individual is informed of the center’s policies on child abuse and neglect. (iii) The individual knows they are mandated reporters of child abuse and child neglect and are required by law to immediately report suspected abuse and neglect to the department of health and human services, children’s protective services, as described in subdivision (c) of this subrule. R 400.8216 Orientation. Rule 216. (1) Program staff and unsupervised volunteers shall participate in the center’s orientation training about the center’s policies and practices and these rules. (2) Within 30 calendar days after being present at the center and before caring for children, program staff and unsupervised volunteers shall have training on all of the following, as applicable: (d) The prevention of child maltreatment. (e) The recognition and reporting of child abuse and neglect. ii. All CCDF-eligible licensed family child care homes. Provide the standard: R 400.1902 Applicant; licensee; requirements. Rule 2. (1) An applicant and a licensee shall meet all of the following requirements: (e) Have documentation of completed training in both of the following: (i) Recognition and reporting of child abuse and neglect R 400.1903 Licensee responsibilities (g) Report to the department within, 3 business days, any changes in the household composition or when any new or existing member of the household or child care personnel has any of the following: (iv) Is being investigated by the state department of health and human services for an allegation of child abuse or neglect. R 400.1906 (1)(g) (1) A licensee shall maintain a file for each child care staff member and each child care assistant that includes all of the following: A written statement, signed and dated by the child care staff member or child care assistant at the time of hiring, indicating all of the following information: The individual is aware that abuse and neglect of children is unlawful. The individual knows that he or she is mandated by law to report child abuse and neglect. The individual has received a copy of the licensee’s discipline policy. 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: Tribal or military program centers are license exempt and set their own rules/regulations. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Tribal family child care homes are licensed exempt and set by tribal regulations. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: The Lead Agency uses Caring for Our Children, License Exempt Provider Preservice Training and Annual Ongoing Training for creating and communicating to license exempt provider the standards around care that is provided in the child’s home. Standards include: (1) Care Provider displays an awareness of the responsibilities & immunity of being a Mandated Reporter. (a) Understands the requirement to report if abuse is suspected. (b) Displays an awareness of the process used to file a report. (2) Provider shares a general knowledge of types of abuse and neglect and signs of each type. (3) Provider understands how to use the TEN-4-FACESp Bruising Rule to identify possible abuse in children under age 4. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Out-of-school programs in Michigan operate under license center regulations and standards. 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: R 400.8269a Food. Rule 269a. (1) A written plan for the prevention of and response to emergencies due to food and allergic reactions must be developed and implemented to include a child ii. All CCDF-eligible licensed family child care homes. Provide the standard: R 400.1906 (1)(g) (1) A licensee shall maintain a file for each child care staff member and each child care assistant that includes all of the following: (g) A written statement, signed and dated by the child care staff member or child care assistant at the time of hiring, indicating all of the following information: (i) The individual is aware that abuse and neglect of children is unlawful. (ii) The individual knows that he or she is mandated by law to report child abuse and neglect. (iii) The individual has received a copy of the licensee’s discipline policy. R 400.1905 Training. A licensee shall ensure that child care staff members and child care assistants, prior to caring for children, have training that includes information on all of the following: (c) Prevention of 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: Tribal or military centers are license exempt and set their own rules/regulations. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Tribal and military family child care homes are licensed exempt and set their own rules/regulations. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: State of Michigan requires all individuals that work with children to be identified as mandated reporters of child abuse and neglect. Michigan Child Protection Law reads: 722.623 Individual required to report child abuse or neglect; report by telephone or online reporting system; written report; contents; transmitting report to centralized intake; copies to prosecuting attorney and probate court; conditions requiring transmission of report to law enforcement agency; pregnancy or presence of sexually transmitted infection in child less than 12 years of age; exposure to or contact with methamphetamine production. Sec. 3. An individual is required to report under this act as follows: (a) A physician, dentist, physician's assistant, registered dental hygienist, medical examiner, nurse, person licensed to provide emergency medical care, audiologist, psychologist, physical therapist, physical therapist assistant, occupational therapist, athletic trainer, marriage and family therapist, licensed professional counselor, social worker, licensed master's social worker, licensed bachelor's social worker, registered social service technician, social 8 service technician, a person employed in a professional capacity in any office of the friend of the court, school administrator, school counselor or teacher, law enforcement officer, member of the clergy, or regulated child care provider who has reasonable cause to suspect child abuse or child neglect shall make an immediate report to centralized intake by telephone, or, if available, through the online reporting system, of the suspected child abuse or child neglect. Within 72 hours after making an oral report by telephone to centralized intake, the reporting person shall file a written report as required in this act. If the immediate report has been made using the online reporting system and that report includes the information required in a written report under subsection , that report is considered a written report for the purposes of this section and no additional written report is required. If the reporting person is a member of the staff of a hospital, agency, or school, the reporting person shall notify the person in charge of the hospital, agency, or school of his or her finding and that the report has been made, and shall make a copy of the written or electronic report available to the person in charge. A notification to the person in charge of a hospital, agency, or school does not relieve the member of the staff of the hospital, agency, or school of the obligation of reporting to the department as required by this section. One report from a hospital, agency, or school is adequate to meet the reporting requirement. A member of the staff of a hospital, agency, or school shall not be dismissed or otherwise penalized for making a report required by this act or for cooperating in an investigation. 722.633 Failure to report suspected child abuse or neglect; damages; violation as misdemeanor; unauthorized dissemination of information as misdemeanor; civil liability; maintaining report or record required to be expunged as misdemeanor; false report of child abuse or neglect. Sec. 13. (1) A person who is required by this act to report an instance of suspected child abuse or neglect and who fails to do so is civilly liable for the damages proximately caused by the failure. (2) A person who is required by this act to report an instance of suspected child abuse or neglect and who knowingly fails to do so is guilty of a misdemeanor punishable by imprisonment for not more than 93 days or a fine of not more than $500.00, or both. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Out-of-school programs in Michigan operate under licensed center regulations and standards. 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: Children's nutritional need is met through providing meals and snacks as required by the minimal meal requirements of the child care food program, as administered. For child care centers the following regulations apply; R 400.8269a Food. Rule 269a. (1) A written plan for the prevention of and response to emergencies due to food and allergic reactions must be developed and implemented to include a child care plan, prevention measures, and emergency procedures. (2) The child’s care plan must include all of the following, at a minimum: (a) The child’s name with a list of their food allergies. (b) The names, doses, and methods of medication administration the child should receive if there is a reaction. (c) Training on the recognition of the child’s allergic reaction. (3) The child’s care plan must be carried on field trips. (4) The prevention measures must include all of the following, at a minimum: (a) Notify parents and guardians of all known food allergens to avoid bringing in foods to the classroom or center. (b) Post the child’s name and known food allergy prominently in the classroom or other area, on parent approval. (c) Train program staff and unsupervised volunteers on the symptoms of anaphylaxis. (d) Prevent food sharing between children. (5) The emergency procedures must include all of the following, at a minimum:(a) Promptly and properly administer medications in an event of an allergic reaction according to the instructions in the child’s care plan. (b) Contact emergency medical services immediately if any child has a serious allergic reaction, a new suspected serious allergic reaction occurs with any child, or whenever epinephrine is administered, even if the child appears to have recovered from the allergic reaction. (c) Notify parents or guardians immediately of any suspected allergic reactions, the ingestion of the problem food, or contact with the problem food, even if a reaction did not occur. R 400.8335 Food services and nutrition; provided by center. Rule 335. (1) Food and beverages provided by a center must be of sufficient quantity and nutritional quality to provide for the dietary needs of each child according to the minimum meal requirements of the child and adult care food program (CACFP), as administered by the department of education. (2) The following standards are incorporated by reference in these rules: ￿Child and Adult Care Food Program,￿ 7 CFR part 226. Copies of these regulations may be obtained from the Department of Lifelong Education, Advancement, and Potential, Child Care Licensing Bureau, 105 West Allegan Street, Lansing, Michigan 48933 and from the United States Department of Agriculture (USDA), Food and Nutrition Service, CACFP at 1400 Independence Avenue, S.W., Washington DC 20250. Regulations and guidance are available at the USDA’s website at https://www.fns.usda.gov/cacfp/program-operator. (3) Infants shall only be served formula to drink unless written authorization is provided by the child’s licensed health care provider. (4) Children 12 months of age until 2 years of age shall be served whole homogenized Vitamin D- fortified cow’s milk, except as provided in R 400.8330(4). (5) Formula must be commercially prepared and ready-to-feed. (6) All fluid milk and fluid milk products must be pasteurized and meet the grade ￿A￿ quality standards. (7) Milk must be served from 1 of the following: (a) A commercially filled container stored in a mechanically refrigerated bulk milk dispenser. (b) A commercially filled container not to exceed 1 gallon. (c) A sanitized container only if poured directly from the original container. (8) All of the following apply to milk: (a) Containers must be labeled with the date opened. (b) Milk must be served within 7 days after opening. (c) Milk must not be served if the contents appear unsanitary or have been unrefrigerated for a period exceeding 1 hour. (d) Milk must not be combined with the contents of other partially filled containers. (9) Contents remaining in single-service containers of milk must be discarded at the end of the snack or mealtime. (10) All containers of ready-to-feed formula, once opened, must be labeled with the date and time of opening, refrigerated, and used within 48 hours or be discarded. (11 ) Prepared bottles and beverage containers of milk and formula must be refrigerated and labeled with the child’s first and last name, date, and time of preparation. (12) Contents of unused bottles of formula must be discarded, along with any bottle liners, after 48 hours. (13) All liners, nipples, formula, milk, and other materials used in bottle preparation must be prepared, handled, and stored in a sanitary manner. (14) Reusable nipples and bottles must be cleaned and sanitized before reuse. (15) Bottle liners and disposable nipples must be for single use only, by an individual child, and discarded with any remaining formula or milk after use. (16) Commercially packaged baby food must be served from a dish, not directly from a factory-sealed container, unless the entire container is served to only 1 child and is discarded at the end of the feeding period. (17) Uneaten food that remains on a dish from which a child was fed must be discarded. (18) Food that was served and handled by the consumer of the food may not be served again, unless it is in the original, unopened wrapper. (19) Home canned products are prohibited. (20) Food containing contaminants, such as lead, recalled through the Food and Drug Administration or the department of agriculture and rural development, must be properly disposed of and not served again. R 400.8301 Definitions. Rule 301. As used in this part: (a) ￿Bulk foods￿ means larger quantities of food that are used over time, such as flour, sugar, noodles, and rice. Food that is used up in a week or less, such as crackers, are not considered bulk foods. (b) ￿Corrosion-resistant materials￿ means those materials that maintain their original surface characteristics under prolonged influence of the food to be contacted, the normal use of cleaning compounds and bacterial solutions, and other conditions-of-use environment. (c) ￿Food￿ means any raw, cooked, or processed edible substance, ice, beverage, or ingredient used or intended for use in whole or in part for human consumption. (d) ￿Food-contact surface￿ means those surfaces of equipment and utensils with which food normally comes in contact, and those surfaces from which food may drain, drip, or splash back onto surfaces normally in contact with food. (e) ￿Food grade surface￿ means a surface that is easily cleanable and made from a material that will not migrate into, contaminate, or taint the food. (f) ￿Food service equipment￿ means stoves, ovens, ranges, hoods, slicers, mixers, meat blocks, tables, counters, refrigerators, sinks, dishwashing machines, steam tables, and similar items other than utensils, used in the operation of a center. (g) ￿Packaged￿ means bottled, canned, in a carton, or securely wrapped. (h) ￿Ready to eat food￿ means food that does not require cooking and is not cooked before being served. (i) ￿Sealed￿ means free of cracks or other openings that allow the entry or passage of moisture. (j) ￿Single- service articles￿ means those food service articles intended for 1-time, 1­ person use and then discarded. (k)￿Tableware￿ means multi-use eating and drinking utensils. (l) Time/Temperature Control for Safety food￿ or ￿TCS food￿ means any food that consists in whole or in part of milk or milk products, eggs, meat, poultry, fish, shellfish, edible crustacean, or other ingredients, including synthetic ingredients, in a form capable of supporting rapid and progressive growth of infectious or toxigenic microorganisms. (m) ￿Utensil￿ means any implement used in the storage, preparation, transportation, or service of food. R 400.8330 Food services and nutrition generally. Rule 330. (1) Snacks and meals must be provided by the center, except if 1 of the following circumstances occurs: (a) A majority of the children are in attendance less than 2.5 hours. (b) Food is provided by a parent. (2) A written agreement must be maintained on file at the center if the parent has agreed to provide formula, milk, or food. The center shall provide an adequate amount of formula, milk, or food if the parent does not. (3) Beverages and food must be appropriate for the child’s individual nutritional requirements, developmental stages, and special dietary needs, including cultural preferences. (4) A center shall ensure a child who has special dietary needs is provided with snacks and meals in accordance with the child’s needs and with the instructions of the child’s parent or licensed health care provider. R 400.8340 Food services and nutrition; provided by parents. Rule 340. (1) As used in this rule: (a) ￿Same-day supply￿ means for use during a single day. (b) ￿Multi-day supply￿ means for use over a multiple day period, up to 7 days. (2) Breast milk, formula, milk, or other beverages provided in a same- day supply must be furnished daily in either of the following: (a) Clean, sanitary, ready- to-feed bottles or beverage containers. (b) A clean, sanitary, beverage container. The beverage must be poured into a clean, sanitary bottle or beverage container before each feeding. (3) Breast milk, formula, milk, other beverages, and food furnished in a same-day supply must be covered and labeled with the child’s first and last name and the date. (4) Any food or beverages furnished in a same-day supply must be returned to the parent at the end of the day or discarded. (5) Milk, other beverages, and non- perishable food items may be furnished in a multi-day supply in an unopened commercial container. (6) Breast milk may be supplied in a multi-day supply in a clean, sanitized container maintained in the refrigerator for up to 4 days or in the freezer for no more than 2 weeks. (7) Milk and other beverages furnished in a multi-day supply must be labeled with the child’s first and last name and the date of opening and be returned to the parent or discarded 7 days after opening. (8) Non-perishable food items furnished in a multi-day supply must be labeled with the date of opening and if applicable, the first and last name of the child for whom its use is intended. (9) Beverages and food must be fed only to the child for whom the item is labeled. (10) Breast milk, formula, and milk must be refrigerated until used. (11) Other perishable beverages and food items not discarded by the end of the day must be dated and refrigerated or otherwise maintained at a safe temperature until used, which must not be more than 7 calendar days after the date opened or prepared. (12) Fresh, whole fruits and vegetables may be unrefrigerated for up to 3 calendars days in a clearly labeled and dated container. ii. Access to physical activity. Describe: R 400.8271 Child development. Rule 271. (1) As used in this rule: (2) A center shall implement a child development program plan that includes daily learning experiences appropriate to the developmental level of the children. Experiences must be designed to develop all of the following, which are described in Michigan’s early childhood standards of quality: (a) Physical development. (4) Developmentally appropriate experiences must be designed so that throughout the day each child has opportunities to do all of the following: (g) Be physically active. R 400.8125 Outdoor play area. Rule 125. (1) The outdoor play area is considered an outdoor classroom and an extension of the learning environment. (2) A center operating with children in attendance for 3 or more continuous hours per day shall provide daily outdoor play, unless prevented by inclement weather or other weather conditions that could result in children becoming overheated or excessively chilled. iii. Caring for children with special needs. Describe: The daily activity program includes appropriate opportunities for children to have a variety of play opportunities indoor and outdoor using small and large muscles. For child care centers, access to physical activity is described in the following regulations: R 400.8271 Child development. Rule 271. (1) As used in this rule: (12) For children with special needs, care must be provided according to the child’s needs as identified by parents, medical personnel, or other relevant professionals. R 400.8269 Emergency preparedness and response planning procedures. (2) The written procedures must include all the following as applicable to the type of emergency: (g) A plan for how each child with special needs will be accommodated during an emergency. iv. Any other areas determined necessary to promote child development or to protect children’s health and safety. Describe: R 400.8216a Professional development requirements. Rule 216a. (1) Program staff, except for substitute teachers and unsupervised volunteers, shall complete 16 clock hours of professional development in a calendar year on topics relevant to job responsibilities that include, but are not limited to, any of the following subjects: (a) Child development and learning. (b) Health, safety, and nutrition. (c) Family and community collaboration. (d) Program management. (e) Teaching and learning. (f) Observation, documentation, and assessment. (g) Interactions and guidance. (h) Updates to topics covered in R 400.8216. (i) Child care center rules R 400.8101 to R 400.8840, as applicable to the center.