Prevention and Control of Infectious Diseases, Including Immunizations

(a) Providers and children shall wash their hands with liquid soap and warm running water as needed and:

(1) After each diaper change or toileting;

(2) After handling any bodily fluid;

(3) After cleaning up or handling garbage;

(4) After playing outdoors;

(5) Before and after eating;

(6) Before and after administering medication; and

(7) Before and during any food preparation or service as often as necessary to remove soil and contamination and prevent cross-contamination when changing tasks or from raw to ready-to-eat foods.

(b) Providers shall:

(1) Teach children the importance of handwashing with liquid soap and warm running water;

(2) Instruct, encourage, remind, or assist children as needed throughout each day to wash their hands as necessary to comply with (a)(1) through (5) above; and

(3) Wash the hands of infants as necessary to comply with (a)(4) and (a)(5) above.

(c) Providers shall observe each child for symptoms of illness or injury throughout the day and contact the parent if a child has:

(1) More than one episode of vomiting in one day;

(2) More than one episode of diarrhea in one day;

(3) Uncontrolled coughing or wheezing;

(4) Skin lesions which have not been diagnosed or treated by a licensed health care practitioner; or

(5) An oral temperature of 101 degrees Fahrenheit or higher or an under arm temperature of 100 degrees Fahrenheit or higher combined with any of the following:

a. Diarrhea;

b. Rash;

c. Earache;

d. Sore throat; or

e. Vomiting.

(d) Any time there is a spill of bodily fluids, or any provider or child has symptoms of, or are known to have, a communicable disease:

(1) Any spills of bodily fluids shall be immediately cleaned and sanitized;

(2) Persons involved in cleaning surfaces contained with bodily fluids shall:

a. Wear protective disposable gloves while cleaning, disinfecting, and sanitizing the contaminated surface; and

b. Immediately wash their hands with liquid soap and warm running water after discarding the gloves;

(3) Any materials, including disposable gloves and diapers contaminated by bodily fluids, shall be disposed of in a plastic bag with a secure tie or in a covered, plastic bag-lined, hands-free receptacle; and

(4) The provider shall contact the bureau of disease control and prevention at (800) 852-3345, ext. 4496 for instructions regarding whether the ill individual is required to be excluded from child care and to determine reporting requirements in accordance with RSA 141-C:7 and He-P 301.03(d) and (e), He-P 301.03(i), and He-P 301.05(i)(3)b.

(e) All foods prepared and served to children shall be free from spoilage, filth, and other contamination.

(f) Providers shall check children in diapers and change diapers and clothing if they are soiled or wet as needed, and at minimum once every 2 hours.

(g) The plastic bag containing the soiled diapers and cleansing articles shall be removed daily, securely closed, and placed outside in covered garbage cans for collection or removal at regular intervals.

(h) Providers shall clean and disinfect bathroom facilities whenever visibly soiled but at a minimum of once per week.

(i) All bedding used by children in care shall be cleaned at least once per week and more frequently if soiled.

(j) Providers shall ensure that the presence of pets does not present a hazard to the children.

(k) When there are pets in a provider’s home, providers shall:

(1) Ensure dogs and cats have a current vaccination for rabies;

(2) Keep cages that house small animals, fish tanks, and litter boxes away from food preparation, or food service areas, as well as any other area where children play; and

(3) Ensure children do not have direct contact with animal feces or urine either indoors or outdoors.

(l) Documentation of immunizations, in accordance with RSA 141-C:20-a, RSA 141-C:20-b, and He-P 301.14, shall be on file for each child on the first day the child is in attendance with the provider.

(m) Exemptions from the immunizations required under (l) above shall be in accordance with RSA 141-C:20-c and pursuant to 45 CFR Part 98.41(a)(1)(i)(C) for children experiencing homelessness or children in foster care. Providers may enroll children and allow for 60 days for families to obtain and provide documentation of immunizations.

(n) Providers shall not be required to obtain immunization records for children whose parent objects, on the grounds that such immunization is contrary to their religious beliefs, or for children with medical conditions that contraindicate immunization.

(o) Documentation for the exemptions listed in (n) above shall be on file with the provider, and shall be in accordance with RSA 141-C:20-c.

Source. #12536, eff 5-24-18; ss by #13650, eff 5-25-23