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: If, while in care, a child becomes ill or is suspected of having a communicable disease reportable to the health department while in care, the parent shall be notified by the provider. The parent is responsible for arranging to have the child taken home. ARM 37.95.139. Good health habits, such as washing hands, must be taught during everyday activities. ARM 37.95.184 . Immunization records: A child in care must have a current immunization schedule, a medical exemption, or a religious exemption on file with the child care center to attend. Practices required: Facilities are required to have illness policies that exclude children with specific symptoms of illness or that are otherwise suspected of having a communicable disease, conduct daily health checks when a child arrives at the facility. All staff must practice proper handwashing, proper diaper changing practices, proper laundry and bedding storage, safe food handling and other environment sanitization. Annual inspections by the county health department sanitarian are required for this care type. Director and all teaching staff must complete "New Staff Health & Safety" course within 90 days of hire, which covers content regarding these standards. ii. All CCDF-eligible licensed family child care homes. Provide the standard: If, while in care, a child becomes ill or is suspected of having a communicable disease reportable to the health department while in care, the parent shall be notified by the provider. The parent is responsible for arranging to have the child taken home. Good health habits, such as washing hands, must be taught during everyday activities. Immunization records: A child in care must have a current immunization schedule, a medical exemption, or a religious exemption on file with the child care center to attend. Practices required: Facilities are required to have illness policies that exclude children with specific symptoms of illness or that are otherwise suspected of having a communicable disease, conduct daily health checks when a child arrives at the facility. All staff must practice proper handwashing, proper diaper changing practices, proper laundry and bedding storage, safe food handling and other environment sanitization. Annual inspections by the county health department sanitarian are required for this care type. Director and all teaching staff must complete "New Staff Health & Safety" course within 90 days of hire, which covers content regarding these standards. iii. All CCDF-eligible licensed in-home care. Provide the standard: Montana does not have licensed in-home care. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Montana does not have license-exempt center care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: These apply to the Family, Friend, and Neighbor providers: If, while in care, a child becomes ill or is suspected of having a communicable disease reportable to the health department while in care, the parent shall be notified by the provider. The parent is responsible for arranging to have the child taken home. Good health habits, such as washing hands, must be taught during everyday activities. Immunization records: A child in care must have a current immunization schedule, with the exceptions being 1) a child being in care by an approved relative; 2) care is being provided in the child's home, or 3) a medical exemption is claimed. Practices required: A RCE provider to have illness policies that exclude children with specific symptoms of illness or that are otherwise suspected of having a communicable disease, conduct daily health checks when a child arrives at the facility. Staff must practice proper handwashing, proper diaper changing practices, proper laundry and bedding storage, safe food handling and other environment sanitization. Staff must complete Health and Safety Overview as part of the required orientation training, which covers content regarding these standards. These apply to the Relative Care Exempt providers: If, while in care, a child becomes ill or is suspected of having a communicable disease reportable to the health department while in care, the parent shall be notified by the provider. The parent is responsible for arranging to have the child taken home. Good health habits, such as washing hands, must be taught during everyday activities. Immunization records: A child in care must have a current immunization schedule, with the exceptions being 1) a child being in care by an approved relative; 2) care is being provided in the child's home, or 3) a medical exemption is claimed. Practices required: A RCE provider must practice proper handwashing, proper diaper changing practices, proper laundry and bedding storage, safe food handling and other environment sanitization. A RCE provider must complete Health and Safety Overview as part of the required orientation training, which covers content regarding these standards. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: These apply to the Family, Friend, and Neighbor providers: If, while in care, a child becomes ill or is suspected of having a communicable disease reportable to the health department while in care, the parent shall be notified by the provider. The parent is responsible for arranging to have the child taken home. Good health habits, such as washing hands, must be taught during everyday activities. Immunization records: No immunization records are required because an exemption is given when care is being provided in the child's home. Practices required: Facilities are required to have illness policies that exclude children with specific symptoms of illness or that are otherwise suspected of having a communicable disease, conduct daily health checks when a child arrives at the facility. Staff must practice proper handwashing, proper diaper changing practices, proper laundry and bedding storage, safe food handling and other environment sanitization. Staff must complete Health and Safety Overview as part of the required orientation training, which covers content regarding these standards. These apply to the Relative Care Exempt providers: If, while in care, a child becomes ill or is suspected of having a communicable disease reportable to the health department while in care, the parent shall be notified by the provider. The parent is responsible for taking over care for the child. Good health habits, such as washing hands, must be taught during everyday activities. Immunization records: No immunization records are required because an exemption is given when care is being provided in the child's home. Practices required: A RCE provider must practice proper handwashing, proper diaper changing practices, proper laundry and bedding storage, safe food handling and other environment sanitization. A RCE provider must complete Health and Safety Overview as part of the required orientation training, which covers content regarding these standards. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Montana does not have license-exempt out-of-school programs. b. Provide the standards, appropriate to the provider setting and age of children, that address that children attending child care programs under CCDF are age-appropriately immunized, according to the latest recommendation for childhood immunizations of the respective State public health agency, for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: All staff members must meet immunization requirements pursuant to (ARM 37.95.184). Before a child may attend a Montana day care facility, that facility must be provided with the documentation that the child has been immunized as required for the child's age group against measles, rubella, mumps, poliomyelitis, diphtheria, pertussis (whooping cough), tetanus, varicella, hepatitis B, pneumococcal, and Hemophilus influenza type B, unless the child qualifies for conditional attendance (ARM 37.95.140). A conditional enrollment form allows a family to have a plan from a medical professional to come current with immunizations. A child experiencing homelessness can conditionally attend a child care facility if the conditional enrollment form documenting the child's conditional immunization status is on file at the child care facility. A child in foster care can conditionally attend a child care facility if the conditional enrollment form documenting the child's conditional immunization status is on file at the child care facility. However, there is a current Notice of Non-Enforcement regarding immunizations which was put into place in October of 2022. The Notice of Non-Enforcement allows providers to choose whether they allow children without immunizations into their facilities. If the provider chooses to take children without immunizations, they must complete a form to acknowledge this policy and notify all families that the facility does allow children without immunizations. ii. All CCDF-eligible licensed family child care homes. Provide the standard: All staff members must meet immunization requirements pursuant to (ARM 37.95.184). Before a child may attend a Montana day care facility, that facility must be provided with the documentation that the child has been immunized as required for the child's age group against measles, rubella, mumps, poliomyelitis, diphtheria, pertussis (whooping cough), tetanus, varicella, hepatitis B, pneumococcal, and Hemophilus influenza type B, unless the child qualifies for conditional attendance (ARM 37.95.140). A conditional enrollment form allows a family to have a plan from a medical professional to come current with immunizations. A child experiencing homelessness can conditionally attend a child care facility if the conditional enrollment form documenting the child's conditional immunization status is on file at the child care facility. A child in foster care can conditionally attend a child care facility if the conditional enrollment form documenting the child's conditional immunization status is on file at the child care facility. However, there is a current Notice of Non-Enforcement regarding immunizations which was put into place in October of 2022. The Notice of Non- Enforcement allows providers to choose whether they allow children without immunizations into their childcare. If the provider chooses to take children without immunizations, they must complete a form to acknowledge this policy and notify all families that the facility does allow children without immunizations. iii. All CCDF-eligible licensed in-home care. Provide the standard: Montana does not have a licensed in-home care. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Montana does not have license-exempt center care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: All staff members must meet immunization requirements pursuant to (ARM 37.95.184). Before a child may attend a Montana day care facility, that facility must be provided with the documentation that the child has been immunized as required for the child's age group against measles, rubella, mumps, poliomyelitis, diphtheria, pertussis (whooping cough), tetanus, varicella, hepatitis B, pneumococcal, and Hemophilus influenza type B, unless the child qualifies for conditional attendance (ARM 37.95.140). A conditional enrollment form allows a family to have a plan from a medical professional to come current with immunizations. A child experiencing homelessness can conditionally attend a child care facility if the conditional enrollment form documenting the child's conditional immunization status is on file at the child care facility. A child in foster care can conditionally attend a child care facility if the conditional enrollment form documenting the child's conditional immunization status is on file at the child care facility. However, there is a current Notice of Non-Enforcement regarding immunizations which was put into place in October of 2022. The Notice of Non- Enforcement allows providers to choose whether they allow children without immunizations into their childcare. If the provider chooses to take children without immunizations, they must complete a form to acknowledge this policy and notify all families that the facility does allow children without immunizations. A child in care must have a current immunization schedule, with the exceptions being 1) a child being in care by an approved relative; 2) care is being provided in the child's home, or 3) a medical exemption is claimed. A provider have immunization records or the exemption on file. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: All staff members must meet immunization requirements pursuant to (ARM 37.95.184). Before a child may attend a Montana day care facility, that facility must be provided with the documentation that the child has been immunized as required for the child's age group against measles, rubella, mumps, poliomyelitis, diphtheria, pertussis (whooping cough), tetanus, varicella, hepatitis B, pneumococcal, and Hemophilus influenza type B, unless the child qualifies for conditional attendance (ARM 37.95.140). A conditional enrollment form allows a family to have a plan from a medical professional to come current with immunizations. A child experiencing homelessness can conditionally attend a child care facility if the conditional enrollment form documenting the child's conditional immunization status is on file at the child care facility. A child in foster care can conditionally attend a child care facility if the conditional enrollment form documenting the child's conditional immunization status is on file at the child care facility. However, there is a current Notice of Non-Enforcement regarding immunizations which was put into place in October of 2022. The Notice of Non- Enforcement allows providers to choose whether they allow children without immunizations into their childcare. If the provider chooses to take children without immunizations, they must complete a form to acknowledge this policy and notify all families that the facility does allow children without immunizations. A child in care must have a current immunization schedule, with the exceptions being 1) a child being in care by an approved relative; 2) care is being provided in the child's home, or 3) a medical exemption is claimed. A provider have immunization records or the exemption on file. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Montana does not have license-exempt out-of-school programs. 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: Child care facilities must employ practices known to promote a safe sleep environment (ARM 37.95.1005). Practices required: Infants laid down for sleep must be placed on their backs on a firm surface with no incline and with no blankets or loose items other than a pacifier in the crib. Sleep sacks may be used if arms are not confined. Infant's heads and faces must not be covered. Infants must not be allowed to sleep in car seats, swings, or other apparatus. Any variations to sleep position must be supported with medical documentation. All cries must be investigated. All facilities that provide care to children under age 2 must develop a written policy for safe sleep. Infant teachers must sign an acknowledgement of the facility's safe sleep policy. Director and all teachers must complete Infant Safety Essentials within 30 days of hire, which covers content specific to this standard. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Child care facilities must employ practices known to promote a safe sleep environment. (ARM 37.95.1005). Practices required: Infants laid down for sleep must be placed on their backs on a firm surface with no incline and with no blankets or loose items other than a pacifier in the crib. Sleep sacks may be used if arms are not confined. Infant's heads and faces must not be covered. Infants must not be allowed to sleep in car seats, swings, or other apparatus. Any variations to sleep position must be supported with medical documentation. All cries must be investigated. All facilities that provide care to children under age 2 must develop a written policy for safe sleep. Infant teachers must sign an acknowledgement of the facility's safe sleep policy. Director and all teachers must complete Infant Safety Essentials within 30 days of hire, which covers content specific to this standard. iii. All CCDF-eligible licensed in-home care. Provide the standard: N/A [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Montana does not have license-exempt center care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: A FFN or RCE provider must employ practices known to promote a safe sleep environment. ARM 37.95.1005 Practices required: Infants laid down for sleep must be placed on their backs on a firm surface with no incline and with no blankets or loose items other than a pacifier in the crib. Sleep sacks may be used if arms are not confined. Infant's heads and faces must not be covered. Infants must not be allowed to sleep in car seats, swings, or other apparatus. Any variations to sleep position must be supported with medical documentation. All cries must be investigated. Staff must complete Health and Safety Overview, which covers content specific to this standard. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: A FFN or RCE provider must employ practices known to promote a safe sleep environment. ARM 37.95.1005 Practices required: Infants laid down for sleep must be placed on their backs on a firm surface with no incline and with no blankets or loose items other than a pacifier in the crib. Sleep sacks may be used if arms are not confined. Infant's heads and faces must not be covered. Infants must not be allowed to sleep in car seats, swings, or other apparatus. Any variations to sleep position must be supported with medical documentation. All cries must be investigated. Staff must complete Health and Safety Overview, which covers content specific to this standard. Director and all teachers must complete Infant Safety Essentials within 30 days of hire, which covers content specific to this standard. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Montana does not have license-exempt out-of-school programs. 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: To administer medication to a child in care in a licensed center, Montana’s administrative rules (ARM 37.95.181, ARM 37.95.182, ARM 37.95.141) require the following practices: providers must have a written medication administration policy that includes parental consent and a medication storage policy. Any medication brought into the facility by the parent or legal guardian of a child shall be dated and kept in the original container labeled with the child's information, dosage information, and stored at proper temperatures in a location inaccessible to the children in care or in a locked box. Written authorization must include dosage instructions. If medications are administered at the facility, the provider must also maintain a medication administration log. A program’s Director and all teaching staff must complete "New Staff Health & Safety" course within 90 days of hire, which covers content regarding these standards. ii. All CCDF-eligible licensed family child care homes. Provide the standard: To administer medication to a child in care in a licensed family child care home, Montana’s administrative rules (ARM 37.95.181, ARM 37.95.182, ARM 37.95.141) require the following practices: providers must have a written medication administration policy that includes parental consent and a medication storage policy. Any medication brought into the facility by the parent or legal guardian of a child shall be dated and kept in the original container labeled with the child's information, dosage information, and stored at proper temperatures in a location inaccessible to the children in care or in a locked box. Written authorization must include dosage instructions. If medications are administered at the facility, the provider must also maintain a medication administration log. A program’s Director and all teaching staff must complete "New Staff Health & Safety" course within 90 days of hire, which covers content regarding these standards. iii. All CCDF-eligible licensed in-home care. Provide the standard: Montana does not have licensed in-home care. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Montana does not have license-exempt center care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: To administer medication to a child in care for a license-exempt in-home, Montana’s administrative rules (ARM 37.95.181, ARM 37.95.182, ARM 37.95.141) require the following practices: providers must have a written medication administration policy that includes parental consent and a medication storage policy. Any medication brought into the facility by the parent or legal guardian of a child shall be dated and kept in the original container labeled with the child's information, dosage information, and stored at proper temperatures in a location inaccessible to the children in care or in a locked box. Written authorization must include dosage instructions. If medications are administered at the facility, the provider must also maintain a medication administration log. Staff must complete Health and Safety Overview, which covers content regarding these standards. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: To administer medication to a child in care for a license-exempt in-home, Montana’s administrative rules (ARM 37.95.181, ARM 37.95.182, ARM 37.95.141) require the following practices: providers must have a written medication administration policy that includes parental consent and a medication storage policy. Any medication brought into the facility by the parent or legal guardian of a child shall be dated and kept in the original container labeled with the child's information, dosage information, and stored at proper temperatures in a location inaccessible to the children in care or in a locked box. Written authorization must include dosage instructions. If medications are administered at the facility, the provider must also maintain a medication administration log. Staff must complete Health and Safety Overview, which covers content regarding these standards. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Montana does not have license-exempt out-of-school programs. b. Provide the standards, appropriate to the provider setting and age of children, that address obtaining permission from parents to administer medications to children for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: No child care employee, owner, or operator at a licensed center may administer any medication to a child without the written authorization of the parents including the signature of the child's parent or guardian per Montana’s Administrative Rules (ARM 37.95.181, ARM 37.95.141). Practices required: Regulations are in place that require providers to have a written medication administration policy that includes parental consent and a medication storage policy. Director and all teaching staff of all program types must complete "New Staff Health & Safety" course within 90 days of hire, which covers content regarding these standards. ii. All CCDF-eligible licensed family child care homes. Provide the standard: No child care employee, owner, or operator at a licensed family child care home may administer any medication to a child without the written authorization of the parents including the signature of the child's parent or guardian per Montana’s Administrative Rules (ARM 37.95.181, ARM 37.95.141). Practices required: Regulations are in place that require providers to have a written medication administration policy that includes parental consent and a medication storage policy. Director and all teaching staff of all program types must complete "New Staff Health & Safety" course within 90 days of hire, which covers content regarding these standards. iii. All CCDF-eligible licensed in-home care. Provide the standard: Montana does not have licensed in-home care. [x]Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Montana does not have license-exempt center care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: No child care employee, owner, or operator at licensed exempt in-home care may administer any medication to a child without the written authorization of the parents including the signature of the child's parent or guardian per Montana’s Administrative Rules (ARM 37.95.181, ARM 37.95.141). Practices required: Regulations are in place that require providers to have a written medication administration policy that includes parental consent and a medication storage policy. Staff must complete Health and Safety Overview, which covers content regarding these standards. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: No child care employee, owner, or operator at licensed exempt in-home care may administer any medication to a child without the written authorization of the parents including the signature of the child's parent or guardian per Montana’s Administrative Rules (ARM 37.95.181, ARM 37.95.141). Practices required: Regulations are in place that require providers to have a written medication administration policy that includes parental consent and a medication storage policy. Staff must complete Health and Safety Overview, which covers content regarding these standards. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Montana does not have license-exempt out-of-school programs. 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: Providers will take steps to prevent food and allergic reactions. Providers will know how to respond to food and other allergic reactions (ARM 39.95.139). Practices required: Regulations are in place that require providers to have a plan in place for emergencies as well as a first aid policy that includes the prevention and response to food and allergic reactions. All teaching staff must have current certification in CPR and pediatric first aid so that they can be prepared to respond to choking. Prior to a child being enrolled or entered a child care facility, written information on each child explaining any special needs of the child, including allergies must be on file. For children under 19 months old, an individualized diet and feeding schedule must be provided according to a written plan submitted by the parents or by the infant's physician with the knowledge and consent of the parents or guardian. A change of diet and schedule shall be noted on each infant's daily diet and feeding schedule. Director and all teaching staff must complete "New Staff Health & Safety" course within 90 days of hire, which covers content regarding this standard including information about choking hazards. ARM 37.95.711 requires that meal and snack service to children and the preparation of food by children shall be carefully supervised. Proper methods of handling, preparing, and serving food in a safe and sanitary manner shall be consistently implemented by the provider. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Providers will take steps to prevent food and allergic reactions. Providers will know how to respond to food and other allergic reactions (ARM 39.95.139). Practices required: Regulations are in place that require providers to have a plan in place for emergencies as well as a first aid policy that includes the prevention and response to food and allergic reactions. All teaching staff must have current certification in CPR and pediatric first aid so that they can be prepared to respond to choking. Prior to a child being enrolled or entered a child care facility, written information on each child explaining any special needs of the child, including allergies must be on file. For children under 19 months old, an individualized diet and feeding schedule must be provided according to a written plan submitted by the parents or by the infant's physician with the knowledge and consent of the parents or guardian. A change of diet and schedule shall be noted on each infant's daily diet and feeding schedule. Director and all teaching staff must complete "New Staff Health & Safety" course within 90 days of hire, which covers content regarding this standard including information about choking hazards. ARM 37.95.711 requires that meal and snack service to children and the preparation of food by children shall be carefully supervised. Proper methods of handling, preparing, and serving food in a safe and sanitary manner shall be consistently implemented by the provider. iii. All CCDF-eligible licensed in-home care. Provide the standard: Montana does not have licensed in-home care. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Montana does not have license-exempt center care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: On January 30, 2024, the Lead Agency received a Preliminary Notice of Non- Compliance from the Office of Child Care. This letter indicates the results of Montana’s Monitoring conducted on July 11 ￿ 13, 2023. OCC identified Inspections for license- exempt in-home care as lacking sufficient monitoring provisions to ensure the prevention emergencies due to food and allergic reactions for license-exempt in home providers. The Lead Agency is anticipating coming into compliance with this provision following Sine Die of the 2025 Montana Legislative Session when an updated Child Care Licensing rules package goes into effect. In the interim, the Lead Agency is taking steps so providers are trained to prevent food and allergic reactions. Providers will know how to respond to food and other allergic reactions (ARM 37.95.139). Practices required: Regulations are in place for all other provider types that require providers to have a plan in place for emergencies as well as a first aid policy that includes the prevention and response to food and allergic reactions. The Child Care Licensing Program asks license exempt providers to follow these provisions, however, it is not enforceable until the updated Child Care Licensing rule package is in effect. All teaching staff must have current certification in CPR and pediatric first aid so that they can be prepared to respond to choking. Prior to a child being enrolled or entered a child care facility, written information on each child explaining any special needs of the child, including allergies must be on file. For children under 19 months old, an individualized diet and feeding schedule must be provided according to a written plan submitted by the parents or by the infant's physician with the knowledge and consent of the parents or guardian. A change of diet and schedule shall be noted on each infant's daily diet and feeding schedule. Staff must complete the Health and Safety Overview, which covers content regarding this standard including information about choking hazards. ARM 37.95.711 requires that meal and snack service to children and the preparation of food by children shall be carefully supervised. Proper methods of handling, preparing, and serving food in a safe and sanitary manner shall be consistently implemented by the provider. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: On January 30, 2024, the Lead Agency received a Preliminary Notice of Non-Compliance from the Office of Child Care. This letter indicates the results of Montana’s Monitoring conducted on July 11 ￿ 13, 2023. OCC identified Inspections for license- exempt in-home care as lacking sufficient monitoring provisions to ensure the prevention emergencies due to food and allergic reactions for license-exempt in home providers. The Lead Agency is anticipating coming into compliance with this provision following Sine Die of the 2025 Montana Legislative Session when an updated Child Care Licensing rules package goes into effect. In the interim, the Lead Agency is taking steps so providers are trained to prevent food and allergic reactions. Providers will know how to respond to food and other allergic reactions (ARM 37.95.139). Practices required: Regulations are in place for all other provider types that require providers to have a plan in place for emergencies as well as a first aid policy that includes the prevention and response to food and allergic reactions. The Child Care Licensing Program asks license exempt providers to follow these provisions, however, it is not enforceable until the updated Child Care Licensing rule package is in effect. All teaching staff must have current certification in CPR and pediatric first aid so that they can be prepared to respond to choking. Prior to a child being enrolled or entered a child care facility, written information on each child explaining any special needs of the child, including allergies must be on file. For children under 19 months old, an individualized diet and feeding schedule must be provided according to a written plan submitted by the parents or by the infant's physician with the knowledge and consent of the parents or guardian. A change of diet and schedule shall be noted on each infant's daily diet and feeding schedule. Staff must complete the Health and Safety Overview, which covers content regarding this standard including information about choking hazards. ARM 37.95.711 requires that meal and snack service to children and the preparation of food by children shall be carefully supervised. Proper methods of handling, preparing, and serving food in a safe and sanitary manner shall be consistently implemented by the provider. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Montana does not have license-exempt out-of-school programs. 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: Providers will take steps to prevent food and allergic reactions. Providers will know how to respond to food and other allergic reactions (ARM 39.95.139). Practices required: Regulations are in place that require providers to have a plan in place for emergencies as well as a first aid policy that includes the prevention and response to food and allergic reactions. All teaching staff must have current certification in CPR and pediatric first aid so that they can be prepared to respond to choking. Prior to a child being enrolled or entered a child care facility, written information on each child explaining any special needs of the child, including allergies must be on file. For children under 19 months old, an individualized diet and feeding schedule must be provided according to a written plan submitted by the parents or by the infant's physician with the knowledge and consent of the parents or guardian. A change of diet and schedule shall be noted on each infant's daily diet and feeding schedule. Director and all teaching staff must complete "New Staff Health & Safety" course within 90 days of hire, which covers content regarding this standard including information about choking hazards. ARM 37.95.711 requires that meal and snack service to children and the preparation of food by children shall be carefully supervised. Proper methods of handling, preparing, and serving food in a safe and sanitary manner shall be consistently implemented by the provider. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Providers will take steps to prevent food and allergic reactions. Providers will know how to respond to food and other allergic reactions (ARM 39.95.139). Practices required: Regulations are in place that require providers to have a plan in place for emergencies as well as a first aid policy that includes the prevention and response to food and allergic reactions. All teaching staff must have current certification in CPR and pediatric first aid so that they can be prepared to respond to choking. Prior to a child being enrolled or entered a child care facility, written information on each child explaining any special needs of the child, including allergies must be on file. For children under 19 months old, an individualized diet and feeding schedule must be provided according to a written plan submitted by the parents or by the infant's physician with the knowledge and consent of the parents or guardian. A change of diet and schedule shall be noted on each infant's daily diet and feeding schedule. Director and all teaching staff must complete "New Staff Health & Safety" course within 90 days of hire, which covers content regarding this standard including information about choking hazards. ARM 37.95.711 requires that meal and snack service to children and the preparation of food by children shall be carefully supervised. Proper methods of handling, preparing, and serving food in a safe and sanitary manner shall be consistently implemented by the provider. iii. All CCDF-eligible licensed in-home care. Provide the standard:: Montana does not have licensed in-home care. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Montana does not have license-exempt center care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: On January 30, 2024, the Lead Agency received a Preliminary Notice of Non- Compliance from the Office of Child Care. This letter indicates the results of Montana’s Monitoring conducted on July 11 ￿ 13, 2023. OCC identified Inspections for license- exempt in-home care as lacking sufficient monitoring provisions to ensure that these providers can respond to emergencies due to food and allergic reactions. The Lead Agency is anticipating coming into compliance with this provision following Sine Die of the 2025 Montana Legislative Session when an updated Child Care Licensing rules package goes into effect. In the interim, the Lead Agency is taking steps so providers are trained to respond to food and allergic reactions. Providers will know how to respond to food and other allergic reactions (ARM 37.95.139). Practices required: Regulations are in place for all other provider types that require providers to have a plan in place for emergencies as well as a first aid policy that includes the prevention and response to food and allergic reactions. The Child Care Licensing Program asks license exempt providers to follow these provisions, however, it is not enforceable until the updated Child Care Licensing rule package is in effect. All teaching staff must have current certification in CPR and pediatric first aid so that they can be prepared to respond to choking. Prior to a child being enrolled or entered a child care facility, written information on each child explaining any special needs of the child, including allergies must be on file. For children under 19 months old, an individualized diet and feeding schedule must be provided according to a written plan submitted by the parents or by the infant's physician with the knowledge and consent of the parents or guardian. A change of diet and schedule shall be noted on each infant's daily diet and feeding schedule. Staff must complete the Health and Safety Overview, which covers content regarding this standard including information about choking hazards. ARM 37.95.711 requires that meal and snack service to children and the preparation of food by children shall be carefully supervised. Proper methods of handling, preparing, and serving food in a safe and sanitary manner shall be consistently implemented by the provider. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: On January 30, 2024, the Lead Agency received a Preliminary Notice of Non-Compliance from the Office of Child Care. This letter indicates the results of Montana’s Monitoring conducted on July 11 ￿ 13, 2023. OCC identified Inspections for license- exempt in-home care as lacking sufficient monitoring provisions to ensure that these providers can respond to emergencies due to food and allergic reactions. The Lead Agency is anticipating coming into compliance with this provision following Sine Die of the 2025 Montana Legislative Session when an updated Child Care Licensing rules package goes into effect. In the interim, the Lead Agency is taking steps so providers are trained to respond to food and allergic reactions. Providers will know how to respond to food and other allergic reactions (ARM 37.95.139). Practices required: Regulations are in place for all other provider types that require providers to have a plan in place for emergencies as well as a first aid policy that includes the prevention and response to food and allergic reactions. The Child Care Licensing Program asks license exempt providers to follow these provisions, however, it is not enforceable until the updated Child Care Licensing rule package is in effect. All teaching staff must have current certification in CPR and pediatric first aid so that they can be prepared to respond to choking. Prior to a child being enrolled or entered a child care facility, written information on each child explaining any special needs of the child, including allergies must be on file. For children under 19 months old, an individualized diet and feeding schedule must be provided according to a written plan submitted by the parents or by the infant's physician with the knowledge and consent of the parents or guardian. A change of diet and schedule shall be noted on each infant's daily diet and feeding schedule. Staff must complete the Health and Safety Overview, which covers content regarding this standard including information about choking hazards. ARM 37.95.711 requires that meal and snack service to children and the preparation of food by children shall be carefully supervised. Proper methods of handling, preparing, and serving food in a safe and sanitary manner shall be consistently implemented by the provider. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Montana does not have license-exempt out-of-school programs. 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: Providers must know how to mitigate the hazards and risks in the environment and implement policies and practices that protect children from harm (ARM 37.95.121, ARM 37.95.127). Practices required: Regulations are in place that require providers to maintain safe indoor and outdoor environments free from hazards. Providers are required to store cleaning and other hazardous materials out of reach. Guns must be safely and securely stored. Pets must be friendly and vaccinated. Extension cords must not be used for permanent wiring. Indoor and outdoor play areas must be reasonably clean and free from hazards. Toys and equipment must be safe and well maintained. The building must have approved and unobstructed exits. Children must have a smoke-free environment. Outdoor play areas must have a 4- foot fence with no gaps greater than 4 inches. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Providers must know how to mitigate the hazards and risks in the environment and implement policies and practices that protect children from harm (ARM 37.95.121, ARM 37.95.127). Practices required: Regulations are in place that require providers to maintain safe indoor and outdoor environments free from hazards. Providers are required to store cleaning and other hazardous materials out of reach. Guns must be safely and securely stored. Pets must be friendly and vaccinated. Extension cords must not be used for permanent wiring. Indoor and outdoor play areas must be reasonably clean and free from hazards. Toys and equipment must be safe and well maintained. The building must have approved and unobstructed exits. Children must have a smoke-free environment. Outdoor play areas must have a 4-foot fence with no gaps greater than 4 inches. iii. All CCDF-eligible licensed in-home care. Provide the standard: Montana does not have licensed in-home care. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Montana does not have license-exempt center care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Providers must know how to mitigate the hazards and risks in the environment and implement policies and practices that protect children from harm (ARM 37.95.121, ARM 37.95.127). Practices required: Regulations are in place that require providers to maintain safe indoor and outdoor environments free from hazards. Providers are required to store cleaning and other hazardous materials out of reach. Guns must be safely and securely stored. Pets must be friendly and vaccinated. Extension cords must not be used for permanent wiring. Indoor and outdoor play areas must be reasonably clean and free from hazards. Toys and equipment must be safe and well maintained. The building must have approved and unobstructed exits. Children must have a smoke-free environment. Outdoor play areas must have a 4-foot fence with no gaps greater than 4 inches. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Providers must know how to mitigate the hazards and risks in the environment and implement policies and practices that protect children from harm (ARM 37.95.121, ARM 37.95.127). Practices required: Regulations are in place that require providers to maintain safe indoor and outdoor environments free from hazards. Providers are required to store cleaning and other hazardous materials out of reach. Guns must be safely and securely stored. Pets must be friendly and vaccinated. Extension cords must not be used for permanent wiring. Indoor and outdoor play areas must be reasonably clean and free from hazards. Toys and equipment must be safe and well maintained. The building must have approved and unobstructed exits. Children must have a smoke-free environment. Outdoor play areas must have a 4-foot fence with no gaps greater than 4 inches. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Montana does not have license-exempt out-of-school programs. 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: Providers must know how to mitigate the hazards and risks in the environment and implement policies and practices that protect children from harm (ARM 37.95.121, ARM 37.95.127, ARM 37.95.1004) Practices required: Proper fencing must be in place in areas that are next to bodies of water such as ditches, creeks, etc that are a minimum of 4 feet high and no gap larger than 4 inches, all water receptacles must be emptied after use, swimming pools and hot tubs must be inaccessible to children while not in use, supervision and ratio must be maintained in portable swimming pools or have lifeguard training in larger pools, supervision must be maintained if a child requires a bath. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Providers must know how to mitigate the hazards and risks in the environment and implement policies and practices that protect children from harm (ARM 37.95.121, ARM 37.95.127, ARM 37.95.1004) Practices required: Proper fencing must be in place in areas that are next to bodies of water such as ditches, creeks, etc that are a minimum of 4 feet high and no gap larger than 4 inches, all water receptacles must be emptied after use, swimming pools and hot tubs must be inaccessible to children while not in use, supervision and ratio must be maintained in portable swimming pools or have lifeguard training in larger pools, supervision must be maintained if a child requires a bath. iii. All CCDF-eligible licensed in-home care. Provide the standard: Montana does not have licensed in-home care. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Montana does not have license-exempt center care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Providers must know how to mitigate the hazards and risks in the environment and implement policies and practices that protect children from harm (ARM 37.95.121, ARM 37.95.127, ARM 37.95.1004) Practices required: Proper fencing must be in place in areas that are next to bodies of water such as ditches, creeks, etc that are a minimum of 4 feet high and no gap larger than 4 inches, all water receptacles must be emptied after use, swimming pools and hot tubs must be inaccessible to children while not in use, supervision and ratio must be maintained in portable swimming pools or have lifeguard training in larger pools, supervision must be maintained if a child requires a bath. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Providers must know how to mitigate the hazards and risks in the environment and implement policies and practices that protect children from harm (ARM 37.95.121, ARM 37.95.127, ARM 37.95.1004) Practices required: Proper fencing must be in place in areas that are next to bodies of water such as ditches, creeks, etc that are a minimum of 4 feet high and no gap larger than 4 inches, all water receptacles must be emptied after use, swimming pools and hot tubs must be inaccessible to children while not in use, supervision and ratio must be maintained in portable swimming pools or have lifeguard training in larger pools, supervision must be maintained if a child requires a bath. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Montana does not have license-exempt out-of-school programs. 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: Regulations are in place that require providers to maintain safe outdoor areas by installing a fence that meets minimum requirements of 4 feet high and no gaps larger than 4 inches if the outdoor play area is adjacent to traffic areas. Providers must have a transportation policy, have vehicles insured with proper vehicle restraints, and use equipment that meets National Highway Transportation Safety Administration recommendation. Providers are prohibited from leaving children alone in the vehicle and must have doors locked while vehicle is in motion. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Regulations are in place that require providers to maintain safe outdoor areas by installing a fence that meets minimum requirements of 4 feet high and no gaps larger than 4 inches if the outdoor play area is adjacent to traffic areas. Providers must have a transportation policy, have vehicles insured with proper vehicle restraints, and use equipment that meets National Highway Transportation Safety Administration recommendation. Providers are prohibited from leaving children alone in the vehicle and must have doors locked while vehicle is in motion. iii. All CCDF-eligible licensed in-home care. Provide the standard: Montana does not have licensed in-home care. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Montana does not have license-exempt center care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Regulations are in place that require providers to maintain safe outdoor areas by installing a fence that meets minimum requirements of 4 feet high and no gaps larger than 4 inches if the outdoor play area is adjacent to traffic areas. Providers must have a transportation policy, have vehicles insured with proper vehicle restraints, and use equipment that meets National Highway Transportation Safety Administration recommendation. Providers are prohibited from leaving children alone in the vehicle and must have doors locked while vehicle is in motion. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Regulations are in place that require providers to maintain safe outdoor areas by installing a fence that meets minimum requirements of 4 feet high and no gaps larger than 4 inches if the outdoor play area is adjacent to traffic areas. Providers must have a transportation policy, have vehicles insured with proper vehicle restraints, and use equipment that meets National Highway Transportation Safety Administration recommendation. Providers are prohibited from leaving children alone in the vehicle and must have doors locked while vehicle is in motion. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Montana does not have license-exempt out-of-school programs. 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: Providers must use appropriate forms of discipline and child guidance. (ARM 37.95.163, ARM 37.95.171). Practices required: Regulations are in place that require providers maintain staff who have been trained in the prevention of shaken baby syndrome, abusive head trauma, and mandatory reporting of child abuse and neglect. Regulations prohibit inappropriate discipline and encourage positive guidance and redirection. Director and all teaching staff must complete Infant Safety Essentials" within 30 days of hire, which covers content specific to these standards. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Providers must use appropriate forms of discipline and child guidance. (ARM 37.95.163, ARM 37.95.171). Practices required: Regulations are in place that require providers maintain staff who have been trained in the prevention of shaken baby syndrome, abusive head trauma, and mandatory reporting of child abuse and neglect. Regulations prohibit inappropriate discipline and encourage positive guidance and redirection. Director and all teaching staff must complete Infant Safety Essentials" within 30 days of hire, which covers content specific to these standards. iii. All CCDF-eligible licensed in-home care. Provide the standard: Montana does not have licensed in-home care. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Montana does not have license-exempt center care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: n January 30, 2024, the Lead Agency received a Preliminary Notice of Non- Compliance from the Office of Child Care. This letter indicates the results of Montana’s Monitoring conducted on July 11￿ 13, 2023. OCC identified Inspections for license- exempt in-home care as lacking sufficient monitoring provisions to ensure that these providers have adequate training to prevent shaken baby syndrome and abusive head trauma. The Lead Agency is anticipating coming into compliance with this provision following Sine Die of the 2025 Montana Legislative Session when an updated Child Care Licensing rules package goes into effect. Until it is in effect, the Child Care Licensing program requests license-exempt in-home providers. Providers must use appropriate forms of discipline and child guidance (ARM 37.95.163, ARM 37.95.171), including following regulations that are in place that require providers maintain staff who have been trained in the prevention of shaken baby syndrome, abusive head trauma, and mandatory reporting of child abuse and neglect. Regulations prohibit inappropriate discipline and encourage positive guidance and redirection. Staff must complete the Health and Safety Overview, which covers content specific to these standards. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: On January 30, 2024, the Lead Agency received a Preliminary Notice of Non-Compliance from the Office of Child Care. This letter indicates the results of Montana’s Monitoring conducted on July 11￿ 13, 2023. OCC identified Inspections for license- exempt in- home care as lacking sufficient monitoring provisions to ensure that these providers have adequate training to prevent shaken baby syndrome and abusive head trauma. The Lead Agency is anticipating coming into compliance with this provision following Sine Die of the 2025 Montana Legislative Session when an updated Child Care Licensing rules package goes into effect. Until it is in effect, the Child Care Licensing program requests license-exempt in-home providers. Providers must use appropriate forms of discipline and child guidance (ARM 37.95.163, ARM 37.95.171), including following regulations that are in place that require providers maintain staff who have been trained in the prevention of shaken baby syndrome, abusive head trauma, and mandatory reporting of child abuse and neglect. Regulations prohibit inappropriate discipline and encourage positive guidance and redirection. Staff must complete the Health and Safety Overview, which covers content specific to these standards. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Montana does not have license-exempt out-of-school programs. 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: Providers must use appropriate forms of discipline and child guidance. (ARM 37.95.163, ARM 37.95.171). Practices required: Regulations are in place that require providers maintain staff who have been trained in the prevention of shaken baby syndrome, abusive head trauma, and mandatory reporting of child abuse and neglect. Regulations prohibit inappropriate discipline and encourage positive guidance and redirection. Director and all teaching staff must complete Infant Safety Essentials" within 30 days of hire, which covers content specific to these standards. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Providers must use appropriate forms of discipline and child guidance. (ARM 37.95.163, ARM 37.95.171). Practices required: Regulations are in place that require providers maintain staff who have been trained in the prevention of shaken baby syndrome, abusive head trauma, and mandatory reporting of child abuse and neglect. Regulations prohibit inappropriate discipline and encourage positive guidance and redirection. Director and all teaching staff must complete Infant Safety Essentials" within 30 days of hire, which covers content specific to these standards. iii. All CCDF-eligible licensed in-home care. Provide the standard: Montana does not have licensed in-home care. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Montana does not have license-exempt center care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: On January 30, 2024, the Lead Agency received a Preliminary Notice of Non- Compliance from the Office of Child Care. This letter indicates the results of Montana’s Monitoring conducted on July 11￿ 13, 2023. OCC identified Inspections for license- exempt in-home care as lacking sufficient monitoring provisions to ensure that these providers have adequate training to prevent child maltreatment. The Lead Agency is anticipating coming into compliance with this provision following Sine Die of the 2025 Montana Legislative Session when an updated Child Care Licensing rules package goes into effect. Until it is in effect, the Child Care Licensing program requests license-exempt in-home providers use appropriate forms of discipline and child guidance. (ARM 37.95.163, ARM 37.95.171). Practices required: Regulations are in place that require providers maintain staff who have been trained in the prevention of shaken baby syndrome, abusive head trauma, and mandatory reporting of child abuse and neglect. Regulations prohibit inappropriate discipline and encourage positive guidance and redirection. Staff must complete the Health and Safety Overview, which covers content specific to these standards. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: On January 30, 2024, the Lead Agency received a Preliminary Notice of Non-Compliance from the Office of Child Care. This letter indicates the results of Montana’s Monitoring conducted on July 11￿ 13, 2023. OCC identified Inspections for license- exempt in- home care as lacking sufficient monitoring provisions to ensure that these providers have adequate training to prevent child maltreatment. The Lead Agency is anticipating coming into compliance with this provision following Sine Die of the 2025 Montana Legislative Session when an updated Child Care Licensing rules package goes into effect. Until it is in effect, the Child Care Licensing program requests license-exempt in-home providers use appropriate forms of discipline and child guidance. (ARM 37.95.163, ARM 37.95.171). Practices required: Regulations are in place that require providers maintain staff who have been trained in the prevention of shaken baby syndrome, abusive head trauma, and mandatory reporting of child abuse and neglect. Regulations prohibit inappropriate discipline and encourage positive guidance and redirection. Staff must complete the Health and Safety Overview, which covers content specific to these standards. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Montana does not have license-exempt out-of-school programs. 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: Cleaning materials, flammable liquids, detergents, aerosol cans, and other poisonous and toxic materials must be kept in their original containers and in a place inaccessible to children. They must be used in such a way that will not contaminate play surfaces, food, food preparation areas, or constitute a hazard to the children. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Cleaning materials, flammable liquids, detergents, aerosol cans, and other poisonous and toxic materials must be kept in their original containers and in a place inaccessible to children. They must be used in such a way that will not contaminate play surfaces, food, food preparation areas, or constitute a hazard to the children. iii. All CCDF-eligible licensed in-home care. Provide the standard: Montana does not have licensed in-home care. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Montana does not have license-exempt center care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Cleaning materials, flammable liquids, detergents, aerosol cans, and other poisonous and toxic materials must be kept in their original containers and in a place inaccessible to children. They must be used in such a way that will not contaminate play surfaces, food, food preparation areas, or constitute a hazard to the children. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Cleaning materials, flammable liquids, detergents, aerosol cans, and other poisonous and toxic materials must be kept in their original containers and in a place inaccessible to children. They must be used in such a way that will not contaminate play surfaces, food, food preparation areas, or constitute a hazard to the children. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Montana does not have license-exempt out-of-school programs. 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: Child care facilities must be free from environmental hazards. Providers must properly use, store, and dispose of hazardous materials (ARM 37.95.121). Practices required: Regulations are in place for providers to practice safe handling for bio-contaminants including blood, bodily fluids, and other infectious materials must be properly disposed of. Director and all teaching staff must complete "New Staff Health & Safety" course within 90 days of hire, which covers content specific to this standard. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Child care facilities must be free from environmental hazards. Providers must properly use, store, and dispose of hazardous materials (ARM 37.95.121). Practices required: Regulations are in place for providers to practice safe handling for bio- contaminants including blood, bodily fluids, and other infectious materials must be properly disposed of. Director and all teaching staff must complete "New Staff Health & Safety" course within 90 days of hire, which covers content specific to this standard. iii. All CCDF-eligible licensed in-home care. Provide the standard: Montana does not have licensed in-home care. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Montana does not have license-exempt center care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Child care facilities must be free from environmental hazards. Providers must properly use, store, and dispose of hazardous materials (ARM 37.95.121). Practices required: Regulations are in place for providers to practice safe handling for bio-contaminants including blood, bodily fluids, and other infectious materials must be properly disposed of. Staff must complete Health and Safety Overview, which covers content specific to this standard. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Child care facilities must be free from environmental hazards. Providers must properly use, store, and dispose of hazardous materials (ARM 37.95.121). Practices required: Regulations are in place for providers to practice safe handling for bio- contaminants including blood, bodily fluids, and other infectious materials must be properly disposed of. Staff must complete Health and Safety Overview, which covers content specific to this standard. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Montana does not have license-exempt out-of-school programs. 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: Providers who choose to transport children must implement policies and practices that protect children from harm during transport (ARM 37.95.132). Practices required: Providers must have written consent from parents to transport children. Providers must develop a written transportation policy outlining safe transport practices and how all children will be supervised and accounted for during the transitions to and from the vehicle. This policy must be made available to parents. Transportation plans must be available to the parents. Drivers must be at least 18 years of age and possess a valid driver's license. Vehicles must be locked while in motion. Children must have safety restraints required by law according to age and weight and may not be double buckled. Children must never be left unattended in a vehicle. There must be at least one adult in addition to the driver for each four children under age two being transported. An adult must accompany each child to and from the vehicle to the child's home or authorized drop-off. Director and all teaching staff must complete "New Staff Health & Safety" course within 90 days of hire, which covers content specific to this standard. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Providers who choose to transport children must implement policies and practices that protect children from harm during transport (ARM 37.95.132). Practices required: Providers must have written consent from parents to transport children. Providers must develop a written transportation policy outlining safe transport practices and how all children will be supervised and accounted for during the transitions to and from the vehicle. This policy must be made available to parents. Transportation plans must be available to the parents. Drivers must be at least 18 years of age and possess a valid driver's license. Vehicles must be locked while in motion. Children must have safety restraints required by law according to age and weight and may not be double buckled. Children must never be left unattended in a vehicle. There must be at least one adult in addition to the driver for each four children under age two being transported. An adult must accompany each child to and from the vehicle to the child's home or authorized drop-off. Director and all teaching staff must complete "New Staff Health & Safety" course within 90 days of hire, which covers content specific to this standard. iii. All CCDF-eligible licensed in-home care. Provide the standard: Montana does not have licensed in-home care. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Montana does not have license-exempt center care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Providers who choose to transport children must implement policies and practices that protect children from harm during transport (ARM 37.95.132). Practices required: Providers must have written consent from parents to transport children. Providers must develop a written transportation policy outlining safe transport practices and how all children will be supervised and accounted for during the transitions to and from the vehicle. This policy must be made available to parents. Transportation plans must be available to the parents. Drivers must be at least 18 years of age and possess a valid driver's license. Vehicles must be locked while in motion. Children must have safety restraints required by law according to age and weight and may not be double buckled. Children must never be left unattended in a vehicle. There must be at least one adult in addition to the driver for each four children under age two being transported. An adult must accompany each child to and from the vehicle to the child's home or authorized drop-off. Staff must complete Health and Safety Overview, which covers content specific to this standard. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Providers who choose to transport children must implement policies and practices that protect children from harm during transport (ARM 37.95.132). Practices required: Providers must have written consent from parents to transport children. Providers must develop a written transportation policy outlining safe transport practices and how all children will be supervised and accounted for during the transitions to and from the vehicle. This policy must be made available to parents. Transportation plans must be available to the parents. Drivers must be at least 18 years of age and possess a valid driver's license. Vehicles must be locked while in motion. Children must have safety restraints required by law according to age and weight and may not be double buckled. Children must never be left unattended in a vehicle. There must be at least one adult in addition to the driver for each four children under age two being transported. An adult must accompany each child to and from the vehicle to the child's home or authorized drop-off. Staff must complete Health and Safety Overview, which covers content specific to this standard. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Montana does not have license-exempt out-of-school programs. 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: All early childhood teachers, directors, substitutes, and assistant teachers must have a current pediatric first aid certification. Ped First Aid rules are found in ARM sections 37.95.622.2(d), 37.95.160(a), and 37.95.163.2(a). Practices required: Regulations are in place that require all teachers in a child care setting to be current in pediatric first aid. This training must be successfully completed within 30 days of hire and before providing unsupervised care to children. ii. All CCDF-eligible licensed family child care homes. Provide the standard: All early childhood teachers, directors, substitutes, and assistant teachers must have a current pediatric first aid certification. Ped First Aid rules are found in ARM sections 37.95.622.2(d), 37.95.160(a), and 37.95.163.2(a). Practices required: Regulations are in place that require all teachers in a child care setting to be current in pediatric first aid. This training must be successfully completed within 30 days of hire and before providing unsupervised care to children. iii. All CCDF-eligible licensed in-home care. Provide the standard: Montana does not licensed in-home care. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Montana does not have license-exempt center care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Staff must have a current pediatric first aid certification. Pediatric First Aid rules are found in ARM sections 37.95.622.2(d), 37.95.160(a), and 37.95.163.2(a). Practices required: Regulations are in place that require the RCE must current in pediatric first aid to provide care for child(ren). vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Staff must have a current pediatric first aid certification. Pediatric First Aid rules are found in ARM sections 37.95.622.2(d), 37.95.160(a), and 37.95.163.2(a). Practices required: Regulations are in place that require the RCE must current in pediatric first aid to provide care for child(ren). vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Montana does not have license-exempt out-of-school programs. 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: All early childhood teachers, directors, substitutes, and assistant teachers must have a current pediatric CPR. Ped CPR rules are found in ARM sections 37.95.622.2(d), 37.95.160(a), and 37.95.163.2(a). Practices required: Regulations are in place that require all teachers in a child care setting to be current in pediatric CPR. This training must be successfully completed within 30 days of hire and before providing unsupervised care to children. ii. All CCDF-eligible licensed family child care homes. Provide the standard: All early childhood teachers, directors, substitutes, and assistant teachers must have a current pediatric CPR. Ped CPR rules are found in ARM sections 37.95.622.2(d), 37.95.160(a), and 37.95.163.2(a). Practices required: Regulations are in place that require all teachers in a child care setting to be current in pediatric CPR. This training must be successfully completed within 30 days of hire and before providing unsupervised care to children. iii. All CCDF-eligible licensed in-home care. Provide the standard: Montana does not have licensed in-home care. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Montana does not have license-exempt center care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: All early childhood teachers, directors, substitutes, and assistant teachers must have a current pediatric CPR. Ped CPR rules are found in ARM sections 37.95.622.2(d), 37.95.160(a), and 37.95.163.2(a). Practices required: Regulations are in place that require the RCE must current in pediatric first aid to provide care for child(ren). vi. All CCDF-eligible license-exempt in-home care. Provide the standard: All early childhood teachers, directors, substitutes, and assistant teachers must have a current pediatric CPR. Ped CPR rules are found in ARM sections 37.95.622.2(d), 37.95.160(a), and 37.95.163.2(a). Practices required: Regulations are in place that require the RCE must current in pediatric first aid to provide care for child(ren). vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Montana does not have license-exempt out-of-school programs. 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: Under Montana Law and Child Care Licensing rules, child care providers are mandated reporters of child abuse and neglect (ARM 37.95.171). Practices required: The director, assistant director or any staff member of the child care facility who has reason to suspect that any child is or has been abused or neglected is required to personally report the matter promptly to the department child abuse hotline at 1 (866) 820- 5437. The child care provider or staff member shall make the report within 24 hours of receiving information concerning suspected child abuse or neglect. Teachers must learn the legal requirements for reporting abuse and neglect, as well as how, where and when to make a report of suspected abuse or neglect to Centralized Intake. Regulations are in place that require providers maintain staff who have been trained in mandatory reporting of child abuse and neglect. Director and all teaching staff must complete "New Staff Health & Safety" course within 90 days of hire, which covers content specific to this standard. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Under Montana Law and Child Care Licensing rules, child care providers are mandated reporters of child abuse and neglect (ARM 37.95.171). Practices required: The director, assistant director or any staff member of the child care facility who has reason to suspect that any child is or has been abused or neglected is required to personally report the matter promptly to the department child abuse hotline at 1 (866) 820-5437. The child care provider or staff member shall make the report within 24 hours of receiving information concerning suspected child abuse or neglect. Teachers must learn the legal requirements for reporting abuse and neglect, as well as how, where and when to make a report of suspected abuse or neglect to Centralized Intake. Regulations are in place that require providers maintain staff who have been trained in mandatory reporting of child abuse and neglect. Director and all teaching staff must complete "New Staff Health & Safety" course within 90 days of hire, which covers content specific to this standard. iii. All CCDF-eligible licensed in-home care. Provide the standard: Montana does not have licensed in-home care. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Montana does not have license-exempt center care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Under Montana Law and Child Care Licensing rules, child care providers are mandated reporters of child abuse and neglect (ARM 37.95.171). Practices required: The director, assistant director or any staff member of the child care facility who has reason to suspect that any child is or has been abused or neglected is required to personally report the matter promptly to the department child abuse hotline at 1 (866) 820-5437. The child care provider or staff member shall make the report within 24 hours of receiving information concerning suspected child abuse or neglect. Teachers must learn the legal requirements for reporting abuse and neglect, as well as how, where and when to make a report of suspected abuse or neglect to Centralized Intake. Regulations are in place that require providers maintain staff who have been trained in mandatory reporting of child abuse and neglect. Staff must complete Health and Safety Overview, which covers content specific to this standard. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Under Montana Law and Child Care Licensing rules, child care providers are mandated reporters of child abuse and neglect (ARM 37.95.171). Practices required: The director, assistant director or any staff member of the child care facility who has reason to suspect that any child is or has been abused or neglected is required to personally report the matter promptly to the department child abuse hotline at 1 (866) 820-5437. The child care provider or staff member shall make the report within 24 hours of receiving information concerning suspected child abuse or neglect. Teachers must learn the legal requirements for reporting abuse and neglect, as well as how, where and when to make a report of suspected abuse or neglect to Centralized Intake. Regulations are in place that require providers maintain staff who have been trained in mandatory reporting of child abuse and neglect. Staff must complete Health and Safety Overview, which covers content specific to this standard. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Montana does not have license-exempt out-of-school programs. 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: Under Montana Law and Child Care Licensing rules, child care providers are mandated reporters of child abuse and neglect (ARM 37.95.171). Practices required: The director, assistant director or any staff member of the child care facility who has reason to suspect that any child is or has been abused or neglected is required to personally report the matter promptly to the department child abuse hotline at 1 (866) 820- 5437. The child care provider or staff member shall make the report within 24 hours of receiving information concerning suspected child abuse or neglect. Teachers must learn the legal requirements for reporting abuse and neglect, as well as how, where and when to make a report of suspected abuse or neglect to Centralized Intake. Regulations are in place that require providers maintain staff who have been trained in mandatory reporting of child abuse and neglect. Director and all teaching staff must complete "New Staff Health & Safety" course within 90 days of hire, which covers content specific to this standard. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Under Montana Law and Child Care Licensing rules, child care providers are mandated reporters of child abuse and neglect (ARM 37.95.171). Practices required: The director, assistant director or any staff member of the child care facility who has reason to suspect that any child is or has been abused or neglected is required to personally report the matter promptly to the department child abuse hotline at 1 (866) 820-5437. The child care provider or staff member shall make the report within 24 hours of receiving information concerning suspected child abuse or neglect. Teachers must learn the legal requirements for reporting abuse and neglect, as well as how, where and when to make a report of suspected abuse or neglect to Centralized Intake. Regulations are in place that require providers maintain staff who have been trained in mandatory reporting of child abuse and neglect. Director and all teaching staff must complete "New Staff Health & Safety" course within 90 days of hire, which covers content specific to this standard. iii. All CCDF-eligible licensed in-home care. Provide the standard: Montana does not have licensed in-home care. [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: Montana does not have license-exempt center care. v. All CCDF-eligible license-exempt family child care homes. Provide the standard: Under Montana Law and Child Care Licensing rules, child care providers are mandated reporters of child abuse and neglect (ARM 37.95.171). Practices required: The director, assistant director or any staff member of the child care facility who has reason to suspect that any child is or has been abused or neglected is required to personally report the matter promptly to the department child abuse hotline at 1 (866) 820-5437. The child care provider or staff member shall make the report within 24 hours of receiving information concerning suspected child abuse or neglect. Teachers must learn the legal requirements for reporting abuse and neglect, as well as how, where and when to make a report of suspected abuse or neglect to Centralized Intake. Regulations are in place that require providers maintain staff who have been trained in mandatory reporting of child abuse and neglect. Staff must complete Health and Safety Overview, which covers content specific to this standard. vi. All CCDF-eligible license-exempt in-home care. Provide the standard: Under Montana Law and Child Care Licensing rules, child care providers are mandated reporters of child abuse and neglect (ARM 37.95.171). Practices required: The director, assistant director or any staff member of the child care facility who has reason to suspect that any child is or has been abused or neglected is required to personally report the matter promptly to the department child abuse hotline at 1 (866) 820-5437. The child care provider or staff member shall make the report within 24 hours of receiving information concerning suspected child abuse or neglect. Teachers must learn the legal requirements for reporting abuse and neglect, as well as how, where and when to make a report of suspected abuse or neglect to Centralized Intake. Regulations are in place that require providers maintain staff who have been trained in mandatory reporting of child abuse and neglect. Staff must complete Health and Safety Overview, which covers content specific to this standard. vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: Montana does not have license-exempt out-of-school programs. 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: Regulations are in place that require providers to provide meals that meet the USDA meal requirements. In addition, the regulations specify the number of meals required throughout the day. Centers are required to have a registered dietician approve menus (ARM 37.95.215 and ARM 37.95.711). There is no training required specific to this standard. Relative Care is exempt from this standard. ii. Access to physical activity. Describe: The regulations require developmentally appropriate activities including physical growth. Outdoor play is required each day (ARM 37.95.715 and ARM 37.95.602). There is no training required specific to this standard. Relative care is exempt from this standard. iii. Caring for children with special needs. Describe: The regulations require a Special Needs Health Care Plan for children with special needs. This plan should be utilized to meet the needs of the child. In addition, the requirements also do not allow for discrimination based on disabilities (ARM 37.95.103, 37.95.108). There is no training required specific to this standard. Relative care is exempt from this requirement. iv. Any other areas determined necessary to promote child development or to protect children’s health and safety. Describe: The regulations indicate that screen time should be limited to child-appropriate programs and should not be excessive. ARM 37.95.715, 37.95.720. Montana Law (MCA 52-2-702). ARM 37.95.602 and ARM 37.95.613 There is no training required specific to this standard. Relative care is exempt from this requirement.