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: 218-RICR-70-00-1.9.A & B - A. Medical Requirements 1. Child care programs adopt policies and procedures consistent with the Rhode Island Department of Health’s Immunization and Communicable Disease in Preschool, School, Colleges or Universities, 216-RICR-30-05-3. a. Programs are not required to maintain immunization for children who attend public, private, or parochial schools approved by the Rhode Island Department of Education. b. If a child is a foster child or is experiencing homelessness, a grace period of ninety (90) days can be granted to obtain the immunization documentation. 2.The parent/guardian submits evidence of an annual health examination, signed by the child’s primary care provider, which includes information regarding any condition or limitation that may affect the child's general health or participation in the program. a. Programs are not required to maintain documentation of an annual health examination for children who attend public, private, or parochial schools approved by the Rhode Island Department of Education. b. If a child is a foster child or is experiencing homelessness, a grace period of ninety (90) days can be granted to obtain the annual health examination documentation. B. Communicable Disease 1.In the event a child or staff member suffers from a communicable disease of public health significance, or in the event of an outbreak of any type, the facility must: a. Report the disease to Rhode Island Department of Health, Center for Acute Infectious Disease Epidemiology; b. Provide written notice to inform all parents/guardians to which communicable disease the child(ren) may have been exposed, without providing any identifying information regarding the source of the communicable disease. 2.In all matters of exclusion and readmission of children for reasons of illness, the decision of the Child Care or School Age Administrator applies. If applicable, due to communicable disease, this decision is made in consultation with a licensed physician, physician’s assistant, or nurse practitioner, and Rhode Island Department of Health, Center for Acute Infectious Disease Epidemiology. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 218-RICR- 70-00-2 2.3.2.A & B/218-RICR-70-00-7 7.3.2.A & B: A. Medical Requirements 1.FCCH providers must adopt policies and procedures consistent with the Rhode Island Department of Health’s Rules and Regulations Pertaining to Immunization and Communicable Disease Testing in Preschool, School, Colleges or Universities, 216-RICR-30-05-3; a. Providers are required to maintain documentation of current immunizations for children in their care unless these children attend public, private, or parochial schools approved by the Rhode Island Department of Education. b. If a child is a foster child or is experiencing homelessness, a grace period of ninety (90) days can be granted to obtain the immunization documentation, provided there is a plan upon enrollment to get immunizations documented and up to date as soon as possible. 2.The parent/guardian submits evidence of an annual health examination, signed by the child’s primary care provider, which includes information regarding any condition or limitation that may affect the child's general health or participation in the program. a. Providers are required to maintain documentation of an annual health examination for children in their care unless these children attend public, private, or parochial schools approved by the Rhode Island Department of Education. b. If a child is a foster child or is experiencing homelessness, a grace period of ninety (90) days can be granted to obtain the annual health examination documentation. B. Communicable Disease 1. In the event a child, provider, or assistant suffers from a communicable disease of public health significance, or in the event of an outbreak of any type, the provider must: a. Report the disease to Rhode Island Department of Health, Center for Acute Infectious Disease Epidemiology; as well as the Department of Human Services Licensing Unit. b. Provide written notice to inform all parents/guardians to which communicable disease the child(ren) may have been exposed, without providing any identifying information regarding the source of the communicable disease. 2.The provider decides on all matters of exclusion and readmission of children for reasons of illness; however, if the child absence is due to communicable disease, this decision must be made in consultation with a licensed physician, physician’s assistant, or nurse practitioner, and Rhode Island Department of Health, Center for Acute Infectious Disease Epidemiology. a. Any child who has been placed on an antibiotic medication may not be admitted to the program for a period of at least twenty-four (24) hours. b. Any child exhibiting signs of a parasite infection, such as scabies or head lice, may not be admitted to the program until the child has been successfully treated. 3.If a parasite infection, such as scabies or head lice, is found within the residence, the provider must: a. Wash all linens, clothes, and other cloth materials with hot water and detergent, or dry clean; and b. Vacuum all rugs/carpeting and upholstery. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 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: 218-RICR-70-00-1.9.A & B - A. Medical Requirements 1. Child care programs adopt policies and procedures consistent with the Rhode Island Department of Health’s Immunization and Communicable Disease in Preschool, School, Colleges or Universities, 216-RICR-30-05-3. a. Programs are not required to maintain immunization for children who attend public, private, or parochial schools approved by the Rhode Island Department of Education. b. If a child is a foster child or is experiencing homelessness, a grace period of ninety (90) days can be granted to obtain the immunization documentation. 2.The parent/guardian submits evidence of an annual health examination, signed by the child’s primary care provider, which includes information regarding any condition or limitation that may affect the child's general health or participation in the program. a. Programs are not required to maintain documentation of an annual health examination for children who attend public, private, or parochial schools approved by the Rhode Island Department of Education. b. If a child is a foster child or is experiencing homelessness, a grace period of ninety (90) days can be granted to obtain the annual health examination documentation. B. Communicable Disease 1.In the event a child or staff member suffers from a communicable disease of public health significance, or in the event of an outbreak of any type, the facility must: a. Report the disease to Rhode Island Department of Health, Center for Acute Infectious Disease Epidemiology; b. Provide written notice to inform all parents/guardians to which communicable disease the child(ren) may have been exposed, without providing any identifying information regarding the source of the communicable disease. 2.In all matters of exclusion and readmission of children for reasons of illness, the decision of the Child Care or School Age Administrator applies. If applicable, due to communicable disease, this decision is made in consultation with a licensed physician, physician’s assistant, or nurse practitioner, and Rhode Island Department of Health, Center for Acute Infectious Disease Epidemiology. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 218-RICR- 70-00-2 2.3.2.A & B/218-RICR-70-00-7 7.3.2.A & B: A. Medical Requirements 1.FCCH providers must adopt policies and procedures consistent with the Rhode Island Department of Health’s Rules and Regulations Pertaining to Immunization and Communicable Disease Testing in Preschool, School, Colleges or Universities, 216-RICR-30-05-3; a. Providers are required to maintain documentation of current immunizations for children in their care unless these children attend public, private, or parochial schools approved by the Rhode Island Department of Education. b. If a child is a foster child or is experiencing homelessness, a grace period of ninety (90) days can be granted to obtain the immunization documentation, provided there is a plan upon enrollment to get immunizations documented and up to date as soon as possible. 2.The parent/guardian submits evidence of an annual health examination, signed by the child’s primary care provider, which includes information regarding any condition or limitation that may affect the child's general health or participation in the program. a. Providers are required to maintain documentation of an annual health examination for children in their care unless these children attend public, private, or parochial schools approved by the Rhode Island Department of Education. b. If a child is a foster child or is experiencing homelessness, a grace period of ninety (90) days can be granted to obtain the annual health examination documentation. B. Communicable Disease 1. In the event a child, provider, or assistant suffers from a communicable disease of public health significance, or in the event of an outbreak of any type, the provider must: a. Report the disease to Rhode Island Department of Health, Center for Acute Infectious Disease Epidemiology; as well as the Department of Human Services Licensing Unit. b. Provide written notice to inform all parents/guardians to which communicable disease the child(ren) may have been exposed, without providing any identifying information regarding the source of the communicable disease. 2.The provider decides on all matters of exclusion and readmission of children for reasons of illness; however, if the child absence is due to communicable disease, this decision must be made in consultation with a licensed physician, physician’s assistant, or nurse practitioner, and Rhode Island Department of Health, Center for Acute Infectious Disease Epidemiology. a. Any child who has been placed on an antibiotic medication may not be admitted to the program for a period of at least twenty-four (24) hours. b. Any child exhibiting signs of a parasite infection, such as scabies or head lice, may not be admitted to the program until the child has been successfully treated. 3.If a parasite infection, such as scabies or head lice, is found within the residence, the provider must: a. Wash all linens, clothes, and other cloth materials with hot water and detergent, or dry clean; and b. Vacuum all rugs/carpeting and upholstery. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 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: 218-RICR-70-00- 1.10.C Sleeping 1. Sleeping routines meet the individual needs of children in the program. 2. Staff do not force children to sleep or stay awake. 3. There is a sleep plan appropriate to the needs of each child. 4. Staff may encourage children to rest, but children are not forced to stay in cribs or on cots. 5. Lighting must allow for staff to view the color of the child’s skin and to check for breathing. 6. Infants sleep in a safe sleep environment consistent with the American Academy of Pediatrics Safe Sleep Guidelines (incorporated at § 1.5 (D) of this Part). a. An Infant is placed on his/her back while sleeping. b. Monitors or positioning devices are not used. c. There are no restraining devices of any type, including swaddles. d. Modifications to an Infant’s safe sleep environment, regarding positioning, are not permitted unless the Infant’s physician, physician’s assistant or nurse practitioner has completed a signed waiver indicating that the child requires an alternate sleeping arrangement. e. Infants must sleep in a crib approved by the United States Consumer Product Safety Commission Standards, equipped with a firm crib mattress and a tight-fitting sheet. (1)Older Infants may sleep on a cot, at the discretion of the program. f. Children cannot sleep in a car safety seat, bean bag chair, bouncy seat, Infant seat, swing, jumping chair, highchair, or in comparable equipment/furniture. g. If an Infant arrives at the facility asleep in a car safety seat, or falls asleep in comparable equipment, the Infant is immediately removed from the car seat or comparable equipment and placed in a safe sleep environment. h. Clothing designed for safe sleep, including sleep sacks, are permitted. i. No items are placed in the crib with an Infant except for a pacifier. j. A pacifier clip is not permitted for use in a crib. k. No additional items are placed on or above the crib or cot. l. Cribs are only used for rest or sleep. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 218-RICR- 70-00-2 2.3.3.C/218-RICR-70-00-7 7.3.3.C: C. Sleeping 1. Sleeping routines meet the individual needs of children in the program interior or exterior. 2. Provider/substitute(s)/assistant(s) may encourage children to rest, but children cannot be forced to sleep or stay awake. 3. Infants sleep in a safe sleep environment consistent with the American Academy of Pediatrics Safe Sleep Guidelines (incorporated at § 2.1.3(D) of this Part). a. An Infant must be placed on his/her back while sleeping. b. Monitors or positioning devices cannot be used. c. There are no restraining devices of any type, including swaddles. d. Modifications to an Infant’s safe sleep environment regarding positioning, are not permitted unless the Infant’s physician, physician’s assistant or nurse practitioner has completed a signed waiver indicating that the child requires an alternate sleeping arrangement. e. Infants must sleep in a crib or portable crib approved by the United States Consumer Product Safety Commission Standards (incorporated at § 2.1.3(C) of this Part), equipped with a firm crib mattress and a tight-fitting sheet. (1)The mattress must not be supplemented with additional foam materials or pads. f. Lighting must allow for provider/substitute(s)/assistant(s) to view the color of the child’s skin and to check for breathing. g. Children cannot sleep in a car safety seat, bean bag chair, bouncy seat, infant seat, swing, jumping chair, highchair, infant inclined sleepers or in comparable equipment/furniture. h. If an Infant arrives at the home or residence asleep in a car safety seat, or falls asleep in comparable equipment, the Infant is immediately removed from the car seat or comparable equipment and placed in a safe sleep environment. i. Clothing designed for safe sleep, including sleep sacks, are permitted. k. No items can be placed in the crib/portable crib with an Infant except for a pacifier. l. A pacifier clip is not permitted for use in a crib/portable crib. m. No additional items are placed on or above the crib/portable crib. n. Cribs/portable cribs are only used for rest or sleep. o. Children must rest/sleep in a location in the residence where they can be in both sight and sound supervision by the provider/substitute(s)/assistant(s) at all times. (1)During hours of operation, no child may rest/sleep behind a closed door. 4.Baby monitors, of any kind, are not permitted as a substitute for supervision. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 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: 218-RICR-70-00-1.9.C. C. Medication Administration 1.Prescribed and non-prescribed (over the counter) medication is not administered to a child without: a. Written permission from the parent/guardian; and b. A written order from a licensed physician, physician’s assistant, or nurse practitioner (which may include the label on the medication) indicating that the medicine is for a specified child. The medication must be in the original container. (1)The written order includes the name of the child, the name of the medication, circumstances under which it may be administered, route, dosage, and frequency of administration. (2)For School Age children (enrolled in Kindergarten or older) who self-carry rescue medication (prescription inhalers and/or auto-injectable epinephrine), there must also be medical documentation that the rescue medication has been prescribed and that the child needs to carry it on his or her person due to a medical condition. (3)Non-prescription sunscreen, insect repellent and diaper cream always require parental consent but do not require instructions from each child’s prescribing health professional. 2.The Child Care or School Age Administrator or designee dispenses all medications if a nurse or health care consultant is not on site (excluding school age children who self- carry). 3.A daily log is maintained of every medication administered except for those noted in § 1.9(C)(1)(b)(2) of this Part. This record includes the: a. Child's name; b. Name and dosage of medication administered; c. Date and time administered; d. Name and signature of the person who administered the medication; and e. Name of the licensed physician, physician’s assistant, or nurse practitioner prescribing the medication. 4.The medication log is transported with the child to the emergency treatment facility in the event of an emergency. 5.The first (1st) dose of a medication must be administered by the parent/guardian. 6.Medications are stored: a. In clearly labeled original containers; b. In spaces secured with child safety locks that are separate from any items that attract children; (1)Rescue medications for infants, toddlers and preschoolers may be kept unlocked but out of reach of children at all times. c. In a way that does not contaminate play surfaces or food preparation areas; and d. School-age children (enrolled in Kindergarten or older) may carry their own rescue medication (prescription inhalers and/or auto-injectable epinephrine). ii. All CCDF-eligible licensed family child care homes. Provide the standard: 218-RICR- 70-00-2 2.3.2.D/218-RICR-70-00-7 7.3.2.D: D. Administration of Medication 1.Prescribed and non-prescribed (over the counter) medication must not be administered to a child without: a. Written permission from the parent/guardian; and b. A written order from a licensed physician, physician’s assistant, or nurse practitioner (which may include the label on the medication) indicating that the medicine is for a specified child. The medication must be in the original container. (1)The written order includes the name of the child, the name of the medication, circumstances under which it may be administered, route, dosage, and frequency of administration. (2)For rescue medication (such as albuterol or epinephrin) the written order must include a care plan that outlines the protocol for administering the medication. 2.The provider, assistant or substitute must dispense all medications. 3. A daily log must be maintained of every medication administered. This record must include the following: a. Child's name; b. Name and dosage of medication administered; c .Date and time administered; d. Name and signature of the person who administered the medication; and e. Name of the licensed physician, physician’s assistant, or nurse practitioner prescribing the medication. 4.The medication log is transported with the child to the emergency treatment facility in the event of an emergency. 5.The first (1st) dose of a medication must be administered by the parent/guardian. 6.Medications must be stored: a. In clearly labeled original containers; b. In spaces secured with child safety locks that are separate from any items that attract children (such as with food, candy, or toys); and c. In a way that does not contaminate play surfaces or food preparation areas. 7.Refrigerated medications must be stores separate from food in a container or compartment in the refrigerator. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 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: 218-RICR-70-00-1.9.C. C. Medication Administration 1.Prescribed and non-prescribed (over the counter) medication is not administered to a child without: a. Written permission from the parent/guardian; and b. A written order from a licensed physician, physician’s assistant, or nurse practitioner (which may include the label on the medication) indicating that the medicine is for a specified child. The medication must be in the original container. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 218-RICR- 70-00-2 2.3.2.D/218-RICR-70-00-7 7.3.2.D: D. Administration of Medication 1.Prescribed and non-prescribed (over the counter) medication must not be administered to a child without: a. Written permission from the parent/guardian; and b. A written order from a licensed physician, physician’s assistant, or nurse practitioner (which may include the label on the medication) indicating that the medicine is for a specified child. The medication must be in the original container. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x]Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 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: 218-RICR-70-00-1.9.N - N. Food Allergies 1.For each child with food allergies or special nutritional needs, the program requests that the parent/guardian obtains a care plan from the child’s health care provider. 2.The program makes provisions for protecting children with food allergies from contact with the allergen(s). 3.The program asks the parent/guardian of a child with food allergies to give consent for posting information within the program about that child’s food allergy. a. If consent for posting is provided, that information is posted in the food preparation area and in the areas of the program the child uses. b. If consent for posting is not provided, then this information is shared verbally with all relevant staff, including substitutes, and is documented in the child’s file. 1.9.A.2 The parent/guardian submits evidence of an annual health examination, signed by the child’s primary care provider, which includes information regarding any condition or limitation that may affect the child's general health or participation in the program. 1.9.N.1 For each child with food allergies or special nutritional needs, the program requests that the parent/guardian obtains a care plan from the child’s health care provider 1.9.N.2 The program makes provisions for protecting children with food allergies from contact with the allergen(s). 1.9.N.3 The program asks the parent/guardian of a child with food allergies to give consent for posting information within the program about that child’s food allergy. a. If consent for posting is provided, that information is posted in the food preparation area and in the areas of the program the child uses. b. If consent for posting is not provided, then this information is shared verbally with all relevant staff, including substitutes, and is documented in the child’s file. 1.11.G.15 The program must have the consultant services of a licensed physician, physician’s assistant, nurse practitioner, or other approved health consultant who is a licensed health professional with education and experience in child and community health, readily available. a. The program has a written plan for accessing (via phone, virtual or in person) such consultation services at all times when children are in care; b. Maintains a letter of understanding regarding consultation services between the program and the consultant; 1.12.E.3 Within ninety (90) days of hire, all new staff must complete Department approved health and safety preservice training modules. 1.12.F.2.a.4 The required Professional Development Training must be approved through a process as determined by the Department or on the approved list provided by the PDTA Hub. Four (4) of the required hours of training must be in one (1) of the following topics related to health and safety requirements: Prevention and response to emergencies due to food and allergic reactions 1.13.F. Records and Files 1. The program maintains program files, and individual files for children and staff that are available on-site at all times. a. If these files are stored electronically, there must be someone on site at all times who can access these records in a timely fashion. 2. Provisions are made for the protection of files and reports, to ensure confidentiality. 3. Parents/guardians may access their child's file at any time during the program hours of operation. 4. All program, staff, or children’s records are subject to review and/or reproduction by the Department or designee, or the Office of the Child Advocate upon request during the program hours of operation. 5. Information contained in a child's file is only released to an outside entity with written authorization from the child's parent/guardian. 6. When a child transfers to another program or school, the child's immunization record is released upon request of the parent/guardian. 7. Each child’s file must include: a. An application form completed by the parent/guardian containing the child's name, birth date, parent’s/guardian's name, current address and phone number and work or school address and phone number; b. Date of enrollment; c. Evidence of annual health exam; (1) Programs are not required to maintain documentation of an annual health examination for children who attend public, private, or parochial schools approved by the Rhode Island Department of Education. (2) If a child is a foster child or is experiencing homelessness, a grace period of ninety (90) days can be granted to obtain the annual health examination documentation. d. Immunization record; (1) Programs are not required to maintain immunization for children who attend public, private, or parochial schools approved by the Rhode Island Department of Education. (2) If a child is a foster child or is experiencing homelessness, a grace period of ninety (90) days can be granted to obtain the immunization documentation. e. Written authorization from the parent/guardian for emergency medical treatment; f. Written reports of injuries, accidents or illness occurring while the child is in the program and any treatment administered; g. Information pertaining to the child’s progress, growth and development, including IEP/IFSP information, if applicable; h. Transition plans; i. Written authorization from the parent/guardian for the child to participate in and be transported for field trips, special activities or events, and other activities that are not part of the program's daily routine; j. Names of individuals to whom the child may be released; k. A statement signed by the parent/guardian authorizing the program to act in an emergency; l. A parental consent form which authorizes or prohibits the program to photograph or videotape a child and to use images in publications, websites and social networking sites; and m. All other records or reports pertaining to the child. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 218-RICR- 70-00-2 2.3.2.K/218-RICR-70-00-7 7.3.2.K K. Food Allergies 1.For each child with food allergies or special nutritional needs, the provider requests that the parent/guardian obtains a care plan from the child’s health care professional. 2.The provider must make provisions for protecting children with food allergies from contact with the allergen(s). 3.The provider must have the consent from the parent/guardian of a child with food allergies before posting information in the program about that child’s food allergy. a. If consent for posting is provided, that information is posted in all areas of the program the child uses, including but not limited to the food preparation area. b. If consent for posting is not provided, then this information is shared verbally with all relevant staff, including substitutes and assistants, and is documented in the child’s file. 2.3.2.A.2/7.3.2.A.2 The parent/guardian submits evidence of an annual health examination, signed by the child’s primary care provider, which includes information regarding any condition or limitation that may affect the child's general health or participation in the program. a. Providers are required to maintain documentation of an annual health examination for children in their care unless these children attend public, private, or parochial schools approved by the Rhode Island Department of Education. b. If a child is a foster child or is experiencing homelessness, a grace period of ninety (90) days can be granted to obtain the annual health examination documentation. 2.3.2.K.1/7.3.2.K.1 For each child with food allergies or special nutritional needs, the provider requests that the parent/guardian obtains a care plan from the child’s health care professional. 2.3.2.K.2/7.3.2.K.2 The provider must make provisions for protecting children with food allergies from contact with the allergen(s). 2.3.2.K.3/7.3.2.K.3 The provider must have the consent from the parent/guardian of a child with food allergies before posting information in the program about that child’s food allergy. a. If consent for posting is provided, that information is posted in all areas of the program the child uses, including but not limited to the food preparation area. b. If consent for posting is not provided, then this information is shared verbally with all relevant staff, including substitutes and assistants, and is documented in the child’s file. 2.3.5.C.3/7.3.5.C.3 Within ninety (90) days of initial licensure and/or hire, all providers/substitutes/assistants must complete Department approved mandatory health and safety training modules 2.3.5.D.3.a.4/ 7.3.5.D.3.a.4 The required Professional Development Training must be approved through a process as determined by the Department or on the approved list provided by the PDTA Hub. a. Four (4) of the required hours of training must be in one (1) of the following topics related to health and safety requirements: (4) Prevention and response to emergencies due to food and allergic reactions iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 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: 1.9.L.4 All required emergency phone numbers are posted in a conspicuous place adjacent to the telephone. 1.11.C.1 For all field trips, programs must: a. Provide written notice to parents/guardians of any field trip at least three (3) days in advance; b. Have a signed permission slip, prior to departing, for each child that states the date, time, location, means of transportation, and potential risks, specific to each individual trip; c. Bring emergency information for each child on each individual trip; and d. Adhere to the relevant precautionary staff/child ratios. 1.11.D.3 Every classroom has a copy of the emergency information for each child. 1.11.G.14 Every staff member must be trained under the most recent guidelines of the American Heart Association in: a. Pediatric cardiopulmonary resuscitation (CPR) (online training is not accepted); and b. Pediatric first aid (online training is accepted). c. Renewal certification must occur within ninety (90) days of expiration for both Pediatric CPR and Pediatric First Aid. (1) Renewal certification for both Pediatric CPR and Pediatric First Aid may be done either in person or online. d. All new hires must be trained under the most recent guidelines of the American Heart Association in Pediatric cardiopulmonary resuscitation (CPR) and Pediatric first aid within ninety (90) days of employment. 1.13.A.3 The program is responsible for immediately notifying the Department in the event of an emergency situation, which includes: a. Any death and/or serious injury while in care of the program; including on-site, during transport and/or on a field trip. (1) After notifying emergency personnel, events of this nature should then be reported to the Rhode Island Department of Children, Youth and Families’ Child Protective Services hotline (1-800-RI-CHILD/1-800-742-4453). b. Activation of emergency personnel; c. Occurrence of emergency or disaster that impacts the program’s ability to operate; or d. Failure of mechanical systems. 1.13.D.8 Attendance and emergency information on each child being transported must be available in the vehicle when transportation is being provided. 1.13.F.7.k Records and Files -A statement signed by the parent/guardian authorizing the program to act in an emergency; ii. All CCDF-eligible licensed family child care homes. Provide the standard: 2.3.2.C.1/ 7.3.2.C.1 Provider shall have an Emergency Treatment Form for each child in care that is signed by the parent/guardian. This form shall be kept on file for use in the event of an emergency. It shall be taken on field trips and outings away from the home 2.3.2.M.4/7.3.2.M.4 All required emergency phone numbers are posted in a conspicuous place adjacent to the telephone or phone base. 2.3.2.M.5/7.3.2.M.5 The names and phone numbers of parents/guardians and emergency contact persons for each child in care must be readily available for all caregivers. 2.3.4.F.1/ 7.3.4.F.1 For all field trips, programs must: a. Provide written notice to parents/guardians of any field trip at least three (3) days in advance; b. Have a signed permission slip, prior to departing, for each child that states the date, time, location, means of transportation, and potential risks, specific to each individual trip; c. Bring emergency information for each child on each individual trip; and d. Adhere to the more stringent staffing pattern as stated in § 2.3.4 (B) of this Part. 2.3.5.A.2.d/ 7.3.5.A.2.d Current certification under the most recent guidelines of the American Heart Association in: (1) Pediatric Cardiopulmonary Resuscitation (CPR) (AA) Initial CPR certification must be done in person. (BB) CPR recertification may be done either in person or online. (2) Pediatric First Aid Pediatric first aid training may be done in person or online. 2.3.6.A.2/7.3.6.A.2 The provider is responsible for immediately notifying the Department in the event of an emergency situation, which includes: a. Any death and/or serious injury (defined as needing medical attention) occurring during the hours of child care, or in the residence outside of child caring hours; (1) If occurring during child care, after notifying emergency personnel, events of this nature should then be reported to the Rhode Island Department of Children, Youth and Families’ Child Protective Services hotline (1-800-RI-CHILD/1- 800-742-4453). b. Activation of emergency personnel; c. Occurrence of emergency or disaster; or d. Failure of mechanical systems 2.3.6.D.6/7.3.6.D.2 Attendance and emergency information foreach child being transported must be available in the vehicle when transportation is being provided. iii. All CCDF-eligible licensed in-home care. Provide the standard:: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 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: 218-RICR-70-00-1.8.C, G & H. C. Structural Requirements and Mechanical Systems 1.Each room, used by children, must be ventilated via a ventilation system or opened door or window. a. Any door or window that is used for ventilation must not inhibit the security of the program. b. All exterior windows that can open are securely screened. 2. Each Infant, Toddler, or Preschool classroom in an existing program, has natural light through a window, windowed door, or skylight (either directly into the classroom or from a shared space), enough to provide supervision of the entire classroom without the use of artificial lighting. 3.Each Infant, Toddler, Preschool, or School Age classroom, in a program licensed subsequent to the date of these Regulations, has natural light through a wall-level window, directly within each classroom space, enough to provide supervision of the entire classroom without the use of artificial lighting. a. Exceptions may be made for public, private, or parochial schools approved by the Rhode Island Department of Education. 4. Each classroom and activity space has artificial lighting that is intact and in good working order. 5.The temperature in all classrooms and other spaces used by children is maintained within a range of sixty-five degrees Fahrenheit and seventy- four degrees Fahrenheit (65° F ￿ 74° F), at the children’s height. a. In an infant classroom, the temperature should be minimum, sixty-eight degrees Fahrenheit (68° F) at the height of the crib. 6.Portable space heaters are prohibited. 7.All classroom and program exits/egresses are: a. Clearly identified; and b. Free of clutter around the area of the door. 8.Any unfamiliar individual requesting entry into the program must provide photo identification prior to admittance. 9. All entrances to the program are kept locked with mechanisms in place for monitoring entry. a. If at any time an entrance to the program is unlocked (e.g., drop off/pick up, service deliveries), a designated staff person is required to directly monitor all entries/exits from the program and is then responsible for re- securing the entrance. 10.All hand-washing sinks have running tempered water. 11.There is a telephone (landline or cellular), solely designated for program and business use, located within the program at all times and readily available for use in case of an emergency. 12.Facilities used by children are above grade, as defined by the Rhode Island Building Code. G. Outdoor Requirements 1.Each program has an outdoor play area: a. With at least seventy-five (75) square feet of usable outdoor space per child for at least fifty percent (50%) of the licensed capacity of the program; or b. With at least seventy-five (75) square feet of usable outdoor space per child, as designated by a schedule of use, subject to approval by the Department. 2.If the licensed facility does not have access to usable outdoor space the program must submit a plan for outdoor play, subject to approval by the Department. a. The Department will consider the following criteria when reviewing the plan: (1)Traffic patterns of vehicles and people in the area; (2)Ages of children enrolled; (3)Availability of age- appropriate equipment; (4)Usage of the location by other groups when the children would be most likely to use it; (5)Neighborhood circumstances, hazards, and risks, including the crime rate for the area; (6)Accessibility to children and caregivers by foot or the availability of push carts or other means of transporting infants and toddlers; (7)Reasonable accessibility of restroom facilities; and (8)Ability to obtain assistance, if needed, when injury or illness occurs. b. If approved, parents/guardians of children in care must be notified of the plan to use alternate outdoor space and have a way to contact the provider when the provider is off site. 3.The outdoor play area is required to be surrounded by a permanent structure. If a fence is used, it must be: a. At least four feet (4’) in height when measured from the ground; b. Not prevent the observation of children by staff; and c. Adhere to State building codes 4.In a program licensed subsequent to the date of these Regulations, fencing must: a. Include at least two (2) exits b. Be equipped with self-closing and self-latching closure mechanisms. 5.If equipment that requires children’s feet to leave the ground is used, it must: a. Be anchored into the ground; b. Be maintained and in good repair; and c. Have safety surfacing that is maintained and in good repair. 6.Outdoor trampolines are prohibited. 7.If sandboxes are used, they must be covered when not in use and should be regularly cleaned of foreign matter. 8.School Age programs operating in a public, private, or parochial school approved by the Rhode Island Department of Education are subject to the Rhode Island Department of Education requirements for outdoor space. 9.Programs with a pool must comply with the Rhode Island Department of Health Rules and Regulations for Licensing of Aquatic Venues, 216- RICR-50-05-4. a. The pool license must be posted in a visible area. b. If a program’s pool has been deemed by the Rhode Island Department of Health as a status of ￿voluntary close￿ it is not permitted for children’s use, until such time that the Rhode Island Department of Health changes the status. c. The use of diving boards is not permitted. H. Overall Facility Safety 1.Equipment, materials, furnishings and play areas should be sturdy, safe and in good repair and must be free of the following safety hazards; a. Openings that could entrap a child’s head or limbs; b. Elevated surfaces that are inadequately guarded; c. Lack of specified surfacing and fall zones under and around climbable equipment; d. Insufficient spacing between equipment; e. Tripping hazards; f. Equipment that is known to be of a hazardous type; g. Sharp points or corners; h. Splinters; i. Protruding nails, bolts, or other components that could entangle clothing or snag skin; j. Loose, rusty parts; k. Strangulation hazards (e.g., straps, strings, etc.); l. Flaking paint; m. Tip-over hazards, such as chests, bookshelves, and televisions 2.In any event where weather or disaster compromises safety of the facility, the program ensures: a. Safe passage in and out of the program; and b. That all structural and mechanical systems are fully functional. 3.All storage chests, boxes, trunks, or comparable items with hinged lids must be equipped with a lid support designed to hold the lid open in any position, be equipped with ventilation holes, and must not have a latch that might close and trap a child inside. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 218-RICR- 70-00-2 2.3.1.G 7 H /218-RICR-70-00-7 7.3.1.G & H - G.Outdoor Requirements 1.Each program has an outdoor play area that is safe, protected and free from hazards that include, but are not limited to: a.Access to the street; b.Debris, trash, broken glass; c.Animal waste; d.Peeling paint; e.Tools and construction materials; f.Holes that present a tripping hazard or contain still water; and g.Open drainage ditches, wells, or other bodies of water. 2.Outdoor activity space must: a.Be surrounded by a fence or clear physical obstacle that prevents movement or access to another area. b.Effective January 1, 2023, outdoor activity space must be surrounded by a permanent structure such as a fence, which is at least four feet (4’) in height. 3.If a FCCH does not have access to an outdoor activity space onsite, they must submit a plan to the Department for approval that identifies a nearby park, schoolyard, or other alternative outdoor space. a. The Department will consider the following criteria when reviewing the plan: (1)Traffic patterns of vehicles and people in the area; (2)Ages of children enrolled; (3)Availability of age- appropriate equipment; (4)Usage of the location by other groups when the children would be most likely to use it; (5)Neighborhood circumstances, hazards, and risks, including the crime rate for the area; (6)Accessibility to children and caregivers by foot or the availability of push carts or other means of transporting infants and toddlers; (7)Reasonable accessibility of restroom facilities; and (8)Ability to obtain assistance, if needed, when injury or illness occurs. b. If approved, parents/guardians of children in care must be notified of the plan to use alternate outdoor space and have a way to contact the provider when the provider is off site. 4.Outdoor porches above the first (1st) floor cannot be used as play areas unless they are fully enclosed by a wooden framing covered with screen, glass or comparable material and structurally sound. 5.Outdoor porches and decks at the first (1st) floor level, used as play areas, must: a. Be enclosed with a minimum of a four foot (4’) railing; b. Slats that are no more than three and one half inches (3 1/2￿) apart; c. Have a gate that is kept securely fastened at the entry to any steps or stairways. 6.If there is any playground equipment that requires children’s feet to leave the ground, it must: a. Be anchored into the ground, in accordance with manufacturer’s directions; b. Be maintained and in good repair in accordance with the United States Consumer Product Safety Commission Standards (incorporated at § 2.1.3(A) of this Part); and c. Have safety surfacing that is maintained and in good repair, in accordance with United States Consumer Product Safety Commission Standards (incorporated at § 2.1.3(A) of this Part). 7.Outdoor trampolines are prohibited. 8.If sandboxes are used, they must be covered when not in use. 9.If the residence has an in-ground pool, the provider must prevent children’s access: a. The pool must be separated by a fence that is at least six feet (6’)in height, with no openings or protrusions that a child could use to get over, under or through, and b. It must be equipped with a gate that opens out from the pool, and self-close and self-latch at a height where a child can't reach. 10.If the residence has an above ground pool, it must have a four foot (4’) fence extension along the outer rim of the pool, provided that the ladder leading to the pool folds up and locks into place and the height from the ground is at least six feet (6’). 11.Each swimming pool more than six feet (6’) in width, length, or diameter must be equipped with at least two (2) life saving devices such as a ring buoy and rope, a rescue tube, or a throwing line and a shepherd’s hook that will not conduct electricity. This equipment must be long enough to reach the center of the pool from the edge of the pool, kept in good repair, and stored safely and conveniently for immediate access. 12.Pools without a filtration system must be: a. Emptied and disinfected after each use; and b. Stored upside down or indoors when not in use. 13.Pools equipped with a filtration system must: a. Be maintained in accordance with any applicable city/town and State Rules regarding residential swimming pools, and b. Shall be cleaned and maintained in accordance with the manufacturer’s or installer’s printed instructions regarding cleaning, filtration, and chemical treatment. c. Has drain covers that are used in compliance with the Virginia Graeme Baker Pool and Spa Safety Act, 15 U.S.C.§§ 8001 through 8008. 14. All pool chemicals must be stored out of the reach of children. 15.Provider must obtain written permission from the parent/guardian prior to taking a child into a pool. 16.The use of diving boards is not permitted. H. Overall Safety of Residence 1.Providers are wholly responsible for ensuring that all parts of the residence and grounds are maintained in a way that ensures health and safety at all times. Areas accessed by children during operating hours should be free of the following safety hazards: a. Openings that could entrap a child’s head or limbs; b. Elevated surfaces that are inadequately guarded; c. Lack of specified surfacing and fall zones under and around climbable equipment; d. Insufficient spacing between equipment; e. Tripping hazards; f. Equipment that is known to be of a hazardous type; g. Sharp points or corners; h. Splinters; i. Loose, rusty parts; j. Strangulation hazards (e.g., straps, strings, etc.); k. Flaking paint; and l. Tip-over hazards, such as chests, bookshelves, and televisions. 2.In any event where weather or disaster compromises safety of the residence, the provider ensures: a. Safe passage in and out of the residence; and b. That all structural and mechanical systems are fully functional. 3.A monthly outdoor inspection report must be completed by provider and kept available for review by the department. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 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: 218-RICR-70-00- 1.11.B.13- Programs must adhere to a precautionary staff/child ratio for field trips, (other activities that may impose additional safety considerations), and swim activities (which include swimming, wading, or sitting in water) as described in the table. 1.8.A.1h- Prior to receiving an initial license, the program must show compliance with current inspections or certifications regarding Public pools (as applicable for programs with a pool on program grounds);to be completed in accordance with Licensing Aquatic Venues, 216-RICR-50-05-4 issued by the Rhode Island Department of Health 1.8.A.3.f - To maintain licensure, upon renewal, the program must show compliance with current inspections or certifications regarding public pools (as applicable for programs with a pool on program grounds) 1.8.G.9 - 9.Programs with a pool must comply with the Rhode Island Department of Health Rules and Regulations for Licensing of Aquatic Venues, 216-RICR-50-05-4 a. The pool license must be posted in a visible area. b. If a program’s pool has been deemed by the Rhode Island Department of Health as a status of ￿voluntary close￿ it is not permitted for children’s use, until such time that the Rhode Island Department of Health changes the status. c. The use of diving boards is not permitted. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 218-RICR- 70-00-2 2.3.1.G.9-16/218-RICR-70-00-7 7.3.1.G.9-16 9.If the residence has an in- ground pool, the provider must prevent children’s access: a. The pool must be separated by a fence that is at least six feet (6’)in height, with no openings or protrusions that a child could use to get over, under or through, and b. It must be equipped with a gate that opens out from the pool, and self-close and self-latch at a height where a child can't reach. 10.If the residence has an above ground pool, it must have a four foot (4’) fence extension along the outer rim of the pool, provided that the ladder leading to the pool folds up and locks into place and the height from the ground is at least six feet (6’). 11. Each swimming pool more than six feet (6’) in width, length, or diameter must be equipped with at least two (2) life saving devices such as a ring buoy and rope, a rescue tube, or a throwing line and a shepherd’s hook that will not conduct electricity. This equipment must be long enough to reach the center of the pool from the edge of the pool, kept in good repair, and stored safely and conveniently for immediate access. 12.Pools without a filtration system must be: a. Emptied and disinfected after each use; and b. stored upside down or indoors when not in use. 13.Pools equipped with a filtration system must: a. Be maintained in accordance with any applicable city/town and State Rules regarding residential swimming pools, and b. Shall be cleaned and maintained in accordance with the manufacturer’s or installer’s printed instructions regarding cleaning, filtration, and chemical treatment. c. Has drain covers that are used in compliance with the Virginia Graeme Baker Pool and Spa Safety Act, 15 U.S.C.§§ 8001 through 8008. 14. All pool chemicals must be stored out of the reach of children. 15. Provider must obtain written permission from the parent/guardian prior to taking a child into a pool. 16. The use of diving boards is not permitted. 2.3.4.B.7/ 7.3.4.B.7 - Programs must adhere to a more stringent staffing pattern of one (1) provider/substitute/assistant for every two (2) children for events such as field trips, (other activities that may impose additional safety considerations), and swimming activities. a. All provider/ substitute(s)/ assistant(s) supervising swim activities must be in or directly adjacent to the water. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 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: 218-RICR-70-00- 1.8.G.2 a.1 - If the licensed facility does not have access to usable outdoor space the program must submit a plan for outdoor play, subject to approval by the Department. A. The Department will consider the following criteria when reviewing the plan: (1)Traffic patterns of vehicles and people in the area/ 1.8.G.3 3.The outdoor play area is required to be surrounded by a permanent structure. If a fence is used, it must be: a. At least four feet (4’) in height when measured from the ground; b. Not prevent the observation of children by staff; and c. Adhere to State building codes ii. All CCDF-eligible licensed family child care homes. Provide the standard: 218-RICR- 70-00-2 2.3.1.G.2/ 2.3.1.G.3 /218-RICR-70-00-7 7.3.1.G.2/ 7.3.1.G.3- 2.Outdoor activity space must: a.Be surrounded by a fence or clear physical obstacle that prevents movement or access to another area. b.Effective January 1, 2023, outdoor activity space must be surrounded by a permanent structure such as a fence, which is at least four feet (4’) in height. 3.If a FCCH does not have access to an outdoor activity space onsite, they must submit a plan to the Department for approval that identifies a nearby park, schoolyard, or other alternative outdoor space. a.The Department will consider the following criteria when reviewing the plan: (1)Traffic patterns of vehicles and people in the area; (2)Ages of children enrolled; (3)Availability of age-appropriate equipment; (4)Usage of the location by other groups when the children would be most likely to use it; (5)Neighborhood circumstances, hazards, and risks, including the crime rate for the area; (6)Accessibility to children and caregivers by foot or the availability of push carts or other means of transporting infants and toddlers; (7)Reasonable accessibility of restroom facilities; and (8)Ability to obtain assistance, if needed, when injury or illness occurs. b. If approved, parents/guardians of children in care must be notified of the plan to use alternate outdoor space and have a way to contact the provider when the provider is off site. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 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: 1.9.E.1 Any suspected case of child abuse and/or neglect is reported to the Rhode Island Department of Children, Youth and Families’ Child Protective Services (CPS) hotline (1-800-RI-CHILD/1-800-742-4453) within twenty-four (24) hours in accordance with State law and Department policy. 1.9.E.2 If the suspected case occurred at the program, the program must report to the Department’s licensing unit immediately after reporting to the CPS hotline. 1.9.F.2 Corporal punishment is strictly prohibited. Corporal punishment includes, but is not limited to: a. Hitting, spanking, shaking, slapping, twisting, pulling, squeezing, or biting a child; 1.9.J.1 A daily health check is conducted on each child as soon as possible after the child arrives at the program. 1.12.F.2.a.6 The required Professional Development Training must be approved through a process as determined by the Department or on the approved list provided by the PDTA Hub. a. Four (4) of the required hours of training must be in one (1) of the following topics related to health and safety requirements: Prevention of Shaken Baby Syndrome, abusive head trauma, and child maltreatment 1.14.C.1 Classroom staff are required to: a. Implement the classroom level curriculum; b. Actively engage with children; c. Develop individual relationships with children by providing care that is responsive, attentive, consistent, comforting, supportive and culturally sensitive; d. Serve as a positive role model for children; e. Use positive methods in guiding and redirecting children; f. Encourage appropriate behavior and set clear limits; g. Match expectations with the children's developing abilities and capabilities; h. Praise the children's accomplishments as well as their attempts at tasks; i. Create a positive environment through their own behaviors such as frequent social conversations with children, joint laughter and affection, eye contact, pleasant tone of voice and smiles; and j. Assist children who present challenging behaviors by: (1) Identifying and documenting factors that may predict or contribute to the challenging behavior; (2) Making adaptations to the child’s environment as necessary; (3) Supporting families by sharing documentation and information; and (4) Providing connection to relevant services and outside resources, when necessary. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 218-RICR- 70-00-2 2.3.2.F.1/ 7.3.2.F.1 Any suspected case of child abuse and/or neglect is reported to the Rhode Island Department of Children, Youth and Families’ Child Protective Services (CPS) hotline (1-800-RI-CHILD/1-800-742-4453) within twenty-four (24) hours in accordance with State law and Department policy. 2.3.2.F.2/7.3.2.F.2 If the suspected case occurred at the program, the program must report to the Department’s licensing unit after reporting to the CPS hotline. 2.3.2.G.2/ 7.3.2.G.2 Corporal punishment is strictly prohibited. Corporal punishment includes, but is not limited to: a. Hitting, spanking, shaking, slapping, twisting, pulling, squeezing, or biting a child; b. Demanding excessive physical exercise, excessive rest, or strenuous or bizarre postures of a child; c. Compelling a child to eat or have in his/her mouth soap, food, spices, or foreign substances; d. Exposing a child to extremes of temperature; e. Isolating a child in an adjacent room, hallway, closet, darkened area, play area, or any other area where a child cannot be seen or supervised; and f. Binding, tying, or taping to restrict movement. 2.3.5.D.3.a.6/2.3.5.D.3.a.6 The required Professional Development Training must be approved through a process as determined by the Department or on the approved list provided by the PDTA Hub. a. Four (4) of the required hours of training must be in one (1) of the following topics related to health and safety requirements: Prevention of Shaken Baby Syndrome, abusive head trauma, and child maltreatment; 2.3.7.C.1/7.3.7.C.1 Providers, substitutes and assistants are required to: a. Implement developmentally appropriate, planned activities; b. Actively engage with all children; c. Develop individual, meaningful relationships with children by providing care that is responsive, attentive, consistent, comforting, supportive and culturally sensitive; d. Serve as a positive role model for children; e. Use positive methods in guiding and redirecting children; f. Encourage age appropriate behavior and set clear limits; g. Match expectations with the children's developing abilities and capabilities; h. Praise the children's accomplishments as well as their attempts at tasks; i. Create a positive environment through their own behaviors such as frequent social conversations with children, joint laughter and affection, eye contact, pleasant tone of voice and smiles; j. Recognize and respect children for their uniqueness as individuals; k. Ensure that children are treated with courtesy, respect, acceptance, and patience; and l. Assist children who present challenging behaviors by: (1) Identifying and documenting factors that may predict or contribute to the challenging behavior; (2) Making adaptations to the child’s environment as necessary; (3) Supporting families by sharing documentation and information; and (4) Providing connection to relevant services and outside resources, when necessary. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 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: 218-RICR-70-00-1 1.9.E.1 Any suspected case of child abuse and/or neglect is reported to the Rhode Island Department of Children, Youth and Families’ Child Protective Services (CPS) hotline (1-800-RI-CHILD/1-800-742-4453) within twenty-four (24) hours in accordance with State law and Department policy. 1.9.E.2 Any suspected case of child abuse and/or neglect is reported to the Rhode Island Department of Children, Youth and Families’ Child Protective Services (CPS) hotline (1-800-RI-CHILD/1-800-742-4453) within twenty-four (24) hours in accordance with State law and Department policy. 1.9.F.2 Corporal punishment is strictly prohibited. Corporal punishment includes, but is not limited to: a. Hitting, spanking, shaking, slapping, twisting, pulling, squeezing, or biting a child; b. Demanding excessive physical exercise, excessive rest, or strenuous or bizarre postures of a child; c. Compelling a child to eat or have in his/her mouth soap, food, spices, or foreign substances; d. Exposing a child to extremes of temperature; e. Isolating a child in an adjacent room, hallway, closet, darkened area, play area, or any other area where a child cannot be seen or supervised; and f. Binding, tying, or taping to restrict movement. 1.9.F.3 Other practices that are strictly prohibited include, but may not be limited to: a. Using or withholding food as a punishment or reward; b. Toilet training methods that punish, demean, or humiliate a child; c. Rejecting, terrorizing, ignoring, isolating, or corrupting a child; d. Using abusive, profane, sarcastic language, verbal abuse, threats, or derogatory remarks about the child or child’s family; e. Engaging in any form of public or private humiliation, including threats of physical punishment; f. Taking away physical activity/outdoor time as punishment; g. Smoking and the use of tobacco products in the program or on program grounds; h. Smoking in any vehicle used by the program for transporting children; i. Possessing, using, or being under the influence of illegal drugs and/or alcohol while in the program or on program grounds; and j. Possessing or using firearms or weapons of any kind in the program or on program grounds. 1.1.2.E.2 The orientation includes information regarding: a. The DHS Child Care Center and School Age Program Regulations for Licensure; b. State law governing child abuse and neglect, and reporting procedures; and c. Program policies, procedures, and operations, as documented in the Staff Handbook. d. Proof of this orientation must be kept in an employee’s file, signed and dated by the employee and a member of the leadership team. 1.12.F.2.a.11 The required Professional Development Training must be approved through a process as determined by the Department or on the approved list provided by the PDTA Hub. a. Four (4) of the required hours of training must be in one (1) of the following topics related to health and safety requirements: (11) Recognition and reporting of child abuse and neglect. 1.13.C.4 If an individual attempting to pick up a child from the program appears to be under the influence of drugs or alcohol, the program: a. Does not release the child; b. Contacts the local police; and c. Contacts the Rhode Island Department of Children, Youth and Families’ Child Protective Services (CPS) hotline (1-800-RI-CHILD/1-800-742-4453) ii. All CCDF-eligible licensed family child care homes. Provide the standard: 218-RICR- 70-00-2 2.3.2.F.1/7.3.2.F.1 Any suspected case of child abuse and/or neglect is reported to the Rhode Island Department of Children, Youth and Families’ Child Protective Services (CPS) hotline (1-800-RI-CHILD/1-800-742-4453) within twenty-four (24) hours in accordance with State law and Department policy. 2.3.2.F.2/7.3.2.F.2 If the suspected case occurred at the program, the program must report to the Department’s licensing unit after reporting to the CPS hotline. 2.3.2.G.2/ 7.3.2.G.2 Corporal punishment is strictly prohibited. Corporal punishment includes, but is not limited to: a. Hitting, spanking, shaking, slapping, twisting, pulling, squeezing, or biting a child; b. Demanding excessive physical exercise, excessive rest, or strenuous or bizarre postures of a child; c. Compelling a child to eat or have in his/her mouth soap, food, spices, or foreign substances; d. Exposing a child to extremes of temperature; e. Isolating a child in an adjacent room, hallway, closet, darkened area, play area, or any other area where a child cannot be seen or supervised; and f. Binding, tying, or taping to restrict movement. 2.3.2.G.3/7.3.2.G.3 Other practices that are strictly prohibited include, but may not be limited to: a. Using or withholding food as a punishment or reward; b. Toilet training methods that punish, demean, or humiliate a child; c. Rejecting, terrorizing, ignoring, isolating, or corrupting a child; d. Using abusive, profane, sarcastic language, verbal abuse, threats, or derogatory remarks about the child or child’s family; e. Engaging in any form of public or private humiliation, including threats of physical punishment; f. Withholding physical activity/outdoor time as punishment; g. Smoking and the use of tobacco products in the residence or on grounds during child care operating hours; h. Smoking in any vehicle used by the program for transporting children. 2.3.2.F.3/7.3.2.F.3 The provider is responsible for alerting the Department immediately of any DCYF investigation associated with themselves, a household member, assistant or substitute. 2.3.5.C.1 & 2/ 7.3.5.C.1 & 2 All new assistants must be oriented by the provider during their first (1st) week in the program. 2. The orientation includes information regarding: a. The Department's Family Child Care Home Regulations for Licensure; b. State law governing child abuse and neglect, and reporting procedures; and 2.3.5.D.3.a.11/7.3.5.D.3.a.11 The required Professional Development Training must be approved through a process as determined by the Department or on the approved list provided by the PDTA Hub. a. Four (4) of the required hours of training must be in one (1) of the following topics related to health and safety requirements: Recognition and reporting of child abuse and neglect. 2.3.6.C.4/7.3.6.C.4 If an individual attempting to pick up a child from the program appears to be under the influence of drugs or alcohol, the provider/substitute/assistant in charge of the program at the time: a. Must not release the child; b. Must contact the local police; and c. Must contact the Rhode Island Department of Children, Youth and Families’ Child Protective Services (CPS) hotline (1-800-RI-CHILD/1-800-742-4453). iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 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: N/A 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: 218-RICR-70-00-1 1.9.G1 The facility, equipment, and materials are clean, free of hazards, and kept in good repair. 1.9.G.2 Any product used for cleaning, sanitizing and/or disinfecting is approved by the United States Environmental Protection Agency (incorporated at § 1.5(A) of this Part) and is used in accordance with the manufacturer’s instructions. 1.9.G.3 Toxic substances and any other items of potential danger to children are clearly labeled and are in an area that is secured by a child safety lock or out of reach of all children in the facility. 1.9.G.4 All preventive maintenance performed within the program must be performed at times when children are not in the area of the equipment or systems being serviced. a. Tools, supplies, materials, parts, or debris must not be left at the job site, unless they are secured and stored in an area that is not accessible to children. 1.9.G.5 Garbage receptacles are covered in all areas that are accessible to children, lined and garbage is removed from the program daily. 1.9.G.6 Any rodent and insect infestation is promptly treated. Insecticides and rodenticides are used in accordance with the Rules and Regulations Relating to Pesticides, 250-RICR-40-15-2, issued by the Rhode Island Department of Environmental Management and used in accordance with manufacturer’s instructions. 1.9.H.2 Staff wash their hands with liquid soap and warm running water as needed and: a. After each diaper change; b. After personal toileting; c. After assisting a child with toileting; d. After wiping a runny nose; e. After touching any bodily fluid; f. Before and after using water, sand, or other sensory tables; g. After messy play; and/or h. Before any food preparation or service. 1.9.H.3 Staff ensure that children wash their hands with liquid soap and warm running water as needed and: a. After each toileting; b. Before each meal or snack; c. After wiping or blowing their nose; d. After touching any bodily fluid; e. Before and after using water, sand, or other sensory tables; f. After messy play; and/or g. Upon entry from the outdoors. 1.12.F.2.a.8 The required Professional Development Training must be approved through a process as determined by the Department or on the approved list provided by the PDTA Hub. a. Four (4) of the required hours of training must be in one (1) of the following topics related to health and safety requirements: (8) Handling and storage of hazardous materials and the appropriate disposal of bio contaminants ii. All CCDF-eligible licensed family child care homes. Provide the standard: 218-RICR- 70-00-2/7 2.3.2.I.1/7.3.2.I.1 The residence, equipment, and materials are clean, free of hazards, and kept in good repair. 2.3.2.I.2/7.3.2.I.2 Any product used for cleaning, sanitizing and/or disinfecting is approved by the United States Environmental Protection Agency as indicated on the product label and is used in accordance with the manufacturer’s instructions. 2.3.2.I.3/7.3.2.I.3 Toxic substances and any other items of potential danger to children are clearly labeled and are in an area that is secured by a child safety lock or safely out of the reach of any child. 2.3.2.I.4/7.3.2.I.4 All preventive maintenance within the residence must occur at times when children are not in the area of the equipment or systems being serviced. a. Tools, supplies, materials, parts, or debris must not be left at the job site, unless they are secured and stored away from children. 2.3.2.I.6/7.3.2.I.6 Any rodent and insect infestation is promptly treated. Insecticides and rodenticides must be approved by the Rhode Island Department of Health and used in accordance with manufacturer’s instructions. Guidelines and requirements are found in R.I. Gen. Laws § 23-25-38 and must be adhered to. 2.3.1.D.6/7.3.1.D.6 There must be a diaper changing area immediately near the bathroom sink and in a different room of the house from any space used for cooking, preparing, or eating 2.3.2.J.2/7.3.2.J.2 Provider/substitute(s)/assistant(s) wash their hands with liquid soap and warm running water as needed and: a. After each diaper change; b. After personal toileting; c. After assisting a child with toileting; d. After wiping a runny nose; e. After touching any bodily fluid; f. Before and after using water, sand, or other sensory tables; g. After messy play; h. After handling and/or feeding animals or pets; and i. Before any food preparation or service. 2.3.2.J.3/7.3.2.J.3 Provider/substitute(s)/assistant(s) ensure that children wash their hands with liquid soap and warm running water as needed and: a. After each toileting; b. Before each meal or snack; c. After wiping or blowing their nose; d. After touching any bodily fluid; e. Before and after using water, sand, or other sensory tables; f. After messy play; g. After handling and/or feeding pets; and h. Upon entry from the outdoors. 2.3.5.D.3.a.8/7.3.5.D.3.a.8 The required Professional Development Training must be approved through a process as determined by the Department or on the approved list provided by the PDTA Hub. a. Four (4) of the required hours of training must be in one (1) of the following topics related to health and safety requirements: (8) Handling and storage of hazardous materials and the appropriate disposal of bio contaminants; iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 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: 218-RICR-70-00-1 1.8A-B Required Inspections and Certifications 1. Prior to receiving an initial license, the program must show compliance with current inspections or certifications regarding: a. Building; b. Fire, from a State Fire Marshal; c. Lead; to be completed in accordance with Lead Poisoning Prevention, 216-RICR-50-15-3, promulgated by the Rhode Island Department of Health pursuant to R.I. Gen. Laws § 23-24.6-14 (not applicable in buildings built after 1978 or in public school buildings); d. Asbestos; to be completed in accordance with Asbestos Control, 216-RICR-50-15-1, issued by the Rhode Island Department of Health; e. Radon; to be completed in accordance with Radon Control, 216-RICR-50-15-2, issued by the Rhode Island Department of Health; f. Water potability (as applicable for programs with well-water); to be completed in accordance with Public Drinking Water Regulations, 216-RICR-50-05-1, and Private Drinking Water Systems Regulations, 216-RICR-50-05-2, both issued by the Rhode Island Department of Health; g. Food safety (as applicable for programs that prepare and serve meals); h. Public pools (as applicable for programs with a pool on program grounds);to be completed in accordance with Licensing Aquatic Venues, 216-RICR-50-05-4 issued by the Rhode Island Department of Health; and i. Playground Inspection for any new facilities applying for licensure subsequent to the date of these Regulations or any previously licensed program making structural changes to their playground/playground equipment subsequent to the date of these Regulations. 2. If you are a school age program operating in a public-school building, the program must show compliance with the current inspections or certifications below: a. Fire, from a city, town or State Fire Marshal; and b. Radon; to be completed in accordance with Radon Control, 216-RICR-50-15-2, issued by the Rhode Island Department of Health. 3. To maintain licensure, upon renewal, the program must show compliance with current inspections or certifications regarding: a. Fire b. Lead; every two (2) years unless deemed ￿Full Lead Safe￿ by a certificate. c. Radon; every three (3) years d. Water potability (as applicable for programs with well-water); e. Food safety (as applicable for programs that prepare and serve meals); and f. Public pools (as applicable for programs with a pool on program grounds). B. Construction 1. The construction of new buildings or outdoor space for the use of children, or the renovation/modification of existing buildings or outdoor space used by children requires approval by the Department prior to the start of construction. 2. The program is responsible to obtain new inspections as necessitated by construction. a. Any construction at programs licensed prior to these Regulations will require the program to adhere to the most recent set of Regulations for the age group in which the construction is impacting. 3. Removal of lead paint must be done in accordance with the guidelines set for in the Removal of Lead Based Paint from Exterior Surfaces, 250-RICR-120-05-24, promulgated by the Rhode Island Department of Environmental Management. 218-RICR-70-00-1 1.9.G.4 4. All preventive maintenance performed within the program must be performed at times when children are not in the area of the equipment or systems being serviced. a. Tools, supplies, materials, parts, or debris must not be left at the job site, unless they are secured and stored in an area that is not accessible to children. 218-RICR-70-00-1 1.10.B.9 All soiled diapers are removed from the building daily. 1.10.B.10 If disposable diapers are used, they are placed in a covered receptacle that is: a. Lined with a plastic bag; b. Kept away from the children's activity and food service areas; c. Emptied as necessary to eliminate odors; and d. Cleaned and disinfected daily. 1.10.B.11 If cloth diapers are used, they are: a. Not rinsed or emptied at the child care program; b. Completely wrapped in a non-permeable material; c. Kept away from the children's activity and food service areas; and d. Given directly to the parent/guardian upon discharge of the child. 1.12.F.2.a.8 The required Professional Development Training must be approved through a process as determined by the Department or on the approved list provided by the PDTA Hub. a. Four (4) of the required hours of training must be in one (1) of the following topics related to health and safety requirements: (8) Handling and storage of hazardous materials and the appropriate disposal of bio contaminants. Center 1.9.H.2.a-e Staff wash their hands with liquid soap and warm running water as needed and: a. After each diaper change; b. After personal toileting; c. After assisting a child with toileting; d. After wiping a runny nose; e. After touching any bodily fluid; 1.9.H.3 a,c & d Staff ensure that children wash their hands with liquid soap and warm running water as needed and: a. After each toileting; c. After wiping or blowing their nose; d. After touching any bodily fluid; 1.9.J.4a.3 & 4 A first aid kit is available in each classroom and outdoor play areas. a. The following first aid supplies should be in all first aid kits: (3) Disposable powder-free, latex-free gloves (4) Plastic bags (for disposing of blood and other bodily fluids) 1.13.D.4.c In addition, vehicles used to transport children must have: c. c. First aid, emergency airway and bodily fluid spill kits; ii. All CCDF-eligible licensed family child care homes. Provide the standard: 218-RICR- 70-00-2/7 2.3.1.A-B/ 7.3.1.A-B A. Required Inspections and Certifications Prior to receiving an initial license and to maintain this licensure status, the provider must show compliance with the following inspections or certifications: a. Fire; to be completed annually; b. Lead; to be completed every two (2) years unless lead-free certificate is obtained; (1) Provider shall comply with Lead Poisoning Prevention, 216-RICR-50-15-3, promulgated by the Rhode Island Department of Health pursuant to R.I. Gen. Laws § 23-24.6-14 (Lead Poisoning Prevention Act). c. Radon; to be completed every three (3) years in accordance with the Rules and Regulations for Radon Control, 216-RICR-50-15-2, issued by the Rhode Island Department of Health; d. Water potability; tests to be completed in accordance with the Rules and Regulations for Private Drinking Water Systems, 216-RICR-50- 05-2 issued by the Rhode Island Department of Health. B. Construction 1. Any construction or large-scale modifications to the home (inside or outside) that changes the measurements, or quality of the space used by children, requires approval by the Department’s Licensing Administrator prior to the start of construction. 2. The provider is responsible 218-70-00-2/7 2.3.2.I.4/7.3.2.I.4 All preventive maintenance within the residence must occur at times when children are not in the area of the equipment or systems being serviced. a. Tools, supplies, materials, parts, or debris must not be left at the job site, unless they are secured and stored away from children. 218-RICR-70-00-2/7 2.3.1.D.5/7.3.1.D.5 If a toilet training chair is used it must be: a. Emptied into the flush toilet and sanitized after each use in a sink that is not used for food preparation; b. Placed on a waterproof floor, without carpeting or rugs, and c. Next to a bathroom sink and in a different room from any space used for cooking, preparing or eating food; 2.3.1.D.6/7.3.1.D.6 There must be a diaper changing area immediately near the bathroom sink and in a different room of the house from any space used for cooking, preparing, or eating food 2.3.3.B.9/7.3.3.B.9 All soiled diapers are removed from the residence daily. 2.3.3.B.10/7.3.3.B.10 If disposable diapers are used, they are placed in a covered receptacle that is: a. Lined with a plastic bag; b. Kept away from the children's activity and food preparation and service areas; c. Emptied as necessary to eliminate odors; and d. Clean and disinfected daily. 2.3.3.B.11/7.3.3.B.11 If cloth diapers are used, they are: a. Not rinsed or emptied at the child care program; b. Completely wrapped in a non-permeable material; c. Kept away from the children's activity and food preparation and service areas; and d. Given directly to the parent/guardian at pickup at the end of the day. 2.3.5.D.3.a.8/7.3.5.D.3.a.8 The required Professional Development Training must be approved through a process as determined by the Department or on the approved list provided by the PDTA Hub. a. Four (4) of the required hours of training must be in one (1) of the following topics related to health and safety requirements: (8) Handling and storage of hazardous materials and the appropriate disposal of bio contaminants; FCC 2.3.2.J.2 a-e/7.3.2.J.2.a-e Staff wash their hands with liquid soap and warm running water as needed and: a. After each diaper change; b. After personal toileting; c. After assisting a child with toileting; d. After wiping a runny nose; e. After touching any bodily fluid; 2.3.2.J.3.a,c & d/7.3.2.J.3.a,c & e Staff ensure that children wash their hands with liquid soap and warm running water as needed and: a. After each toileting; c. After wiping or blowing their nose; d. After touching any bodily fluid; 2.3.2.N.3.a.3-4/7.3.2.N.3.a.3-4. A first aid kit is available in each classroom and outdoor play areas. a. The following first aid supplies should be in all first aid kits: (3) Disposable powder-free, latex-free gloves (4) Plastic bags (for disposing of blood and other bodily fluids) iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 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: 218-RICR-70-00- 1.13.D D. Transportation of Children 1.If the program chooses to provide transportation, a transportation policy must be written. 2.The program is required to adhere to State law and the Rules and Regulations of the Rhode Island Registry of Motor Vehicles and comply with State Regulations for vehicles that transport children as part of the program regarding: a. Registration; b. Inspections; and c. Insurance. 3.All individuals who provide transportation of children must: a. Hold a valid Rhode Island Chauffeur’s License or equivalent from another State; and b .Have a completed background check on file. 4.In addition, vehicles used to transport children must have: a. Two-inch (2￿) lettering on the vehicle (unless leased and then a magnetized sign can be used), stating the program’s name; b. A fire extinguisher; c. First aid, emergency airway and bodily fluid spill kits; and d. Audible door and back-up alarms (mountable or installed). 5.At least two (2) staff are in the vehicle while transportation is provided, unless all children being transported are School Age. If all children are School Age, one (1) staff may provide transportation. 6.Children must never be left alone in the vehicle. 7.A face-to-name attendance check of all children is completed upon entrance to and departure from the vehicle. 8.Attendance and emergency information on each child being transported must be available in the vehicle when transportation is being provided. 9.When being transported, children must be properly secured in the appropriate safety restraint or car seat for their age. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 218-RICR- 70-00-2 2.3.6.D /218-RICR-70-00-7 7.3.6.D - D. Transportation of Children 1.If the provider chooses to provide transportation, a transportation policy must be written. 2.The program is required to adhere to State law and the Rules and Regulations of the Rhode Island Department of Motor Vehicles, and comply with State Regulations for vehicles that transport children as part of the program regarding: a. Registration; b. Inspections; and c. Insurance. 3.All individuals who provide transportation of children for the Family Child Care Home must: a. Hold a valid Rhode Island Chauffeur’s License or equivalent from another state (see R.I. Gen. Laws Chapter 31-22 Miscellaneous Rules, R.I. Gen. Laws § 31-22-11.6 Child Care Vehicles and School Extra-Curricular Vehicles); and b. Have a completed Comprehensive Background Check on file. 4.Children can never be left alone in the vehicle. 5.A face-to-name attendance check of all children must be completed (and documented) upon entrance to and departure from the vehicle. 6.Attendance and emergency information foreach child being transported must be available in the vehicle when transportation is being provided. 7.When being transported, children must be properly secured in the appropriate safety restraint or car seat for their age. 8.At the discretion of the provider, and with adherence to the more stringent staffing patterns, public transportation may be used. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 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: 218-RICR-70-00- 1.11.G.14 - 14.Every staff member must be trained under the most recent guidelines of the American Heart Association in: a. Pediatric cardiopulmonary resuscitation (CPR) (online training is not accepted); and b. Pediatric first aid (online training is accepted). c. Renewal certification must occur within ninety (90) days of expiration for both Pediatric CPR and Pediatric First Aid. (1) Renewal certification for both Pediatric CPR and Pediatric First Aid may be done either in person or online. d. All new hires must be trained under the most recent guidelines of the American Heart Association in Pediatric cardiopulmonary resuscitation (CPR) and Pediatric first aid within ninety (90) days of employment. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 218-RICR- 70-00-2 2.3.5.A.2.d.2/ 218-RICR-70-00-7 2.3.5.A.2.d.2 ￿ A. Requirements for Family Child Care Home Providers d. Current certification under the most recent guidelines of the American Heart Association in: (1)Pediatric Cardiopulmonary Resuscitation (CPR) (AA)Initial CPR certification must be done in person. (BB)CPR recertification may be done either in person or online. (2) Pediatric First Aid (AA)Pediatric first aid training may be done in person or online. 2.3.5.B.2.a.2/7.3.5.A.2.d.2 - B. Requirements for Family Child Care Home assistants and substitutes b. Current certification under the most recent guidelines of the American Heart Association in: (1)Pediatric Cardiopulmonary Resuscitation (CPR) (AA)Initial CPR certification must be done in person. (BB)CPR recertification may be done in person or online. (2) Pediatric first aid (AA)Pediatric first aid training may be done in person or online. 2.3.5.D.3.10 // 7.3.5.D.3.10 - 3.The required Professional Development Training must be approved through a process as determined by the Department or on the approved list provided by the PDTA Hub. a. Four (4) of the required hours of training must be in one (1) of the following topics related to health and safety requirements (10) Pediatric First-Aid and CPR iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 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: 218-RICR-70-00- 1.11.G.14 - 14.Every staff member must be trained under the most recent guidelines of the American Heart Association in: a. Pediatric cardiopulmonary resuscitation (CPR) (online training is not accepted); and b. Pediatric first aid (online training is accepted). c. Renewal certification must occur within ninety (90) days of expiration for both Pediatric CPR and Pediatric First Aid. (1) Renewal certification for both Pediatric CPR and Pediatric First Aid may be done either in person or online. d. All new hires must be trained under the most recent guidelines of the American Heart Association in Pediatric cardiopulmonary resuscitation (CPR) and Pediatric first aid within ninety (90) days of employment. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 218-RICR- 70-00-2 2.3.5.A.2.d.2/ 218-RICR-70-00-7 2.3.5.A.2.d.2 ￿ A. Requirements for Family Child Care Home Providers d. Current certification under the most recent guidelines of the American Heart Association in: (1)Pediatric Cardiopulmonary Resuscitation (CPR) (AA)Initial CPR certification must be done in person. (BB)CPR recertification may be done either in person or online. (2) Pediatric First Aid (AA)Pediatric first aid training may be done in person or online. 2.3.5.B.2.a.2/7.3.5.A.2.d.2 - B. Requirements for Family Child Care Home assistants and substitutes b. Current certification under the most recent guidelines of the American Heart Association in: (1)Pediatric Cardiopulmonary Resuscitation (CPR) (AA)Initial CPR certification must be done in person. (BB)CPR recertification may be done in person or online. (2) Pediatric first aid (AA)Pediatric first aid training may be done in person or online. 2.3.5.D.3.10 // 7.3.5.D.3.10 - 3.The required Professional Development Training must be approved through a process as determined by the Department or on the approved list provided by the PDTA Hub. a.Four (4) of the required hours of training must be in one (1) of the following topics related to health and safety requirements (10) Pediatric First-Aid and CPR iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 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: 218-RICR-70-00-1 1.9.E.1 Any suspected case of child abuse and/or neglect is reported to the Rhode Island Department of Children, Youth and Families’ Child Protective Services (CPS) hotline (1-800-RI-CHILD/1-800-742-4453) within twenty-four (24) hours in accordance with State law and Department policy. 1.9.E.2 Any suspected case of child abuse and/or neglect is reported to the Rhode Island Department of Children, Youth and Families’ Child Protective Services (CPS) hotline (1-800-RI-CHILD/1-800-742-4453) within twenty-four (24) hours in accordance with State law and Department policy. 1.9.J.1 A daily health check is conducted on each child as soon as possible after the child arrives at the program. 1.12.E.2 The orientation includes information regarding: a. The DHS Child Care Center and School Age Program Regulations for Licensure; b. State law governing child abuse and neglect, and reporting procedures; and c. Program policies, procedures, and operations, as documented in the Staff Handbook. d. Proof of this orientation must be kept in an employee’s file, signed and dated by the employee and a member of the leadership team. 1.12.F.2.a.11 The required Professional Development Training must be approved through a process as determined by the Department or on the approved list provided by the PDTA Hub. a. Four (4) of the required hours of training must be in one (1) of the following topics related to health and safety requirements: (11) Recognition and reporting of child abuse and neglect. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 218-RICR- 70-00-2/7 2.3.2.F.1/7.3.2.F.1 Any suspected case of child abuse and/or neglect is reported to the Rhode Island Department of Children, Youth and Families’ Child Protective Services (CPS) hotline (1-800-RI-CHILD/1-800-742-4453) within twenty- four (24) hours in accordance with State law and Department policy. 2.3.2.F.2/7.3.2.F.2 If the suspected case occurred at the program, the program must report to the Department’s licensing unit after reporting to the CPS hotline. 2.3.5.C.1 & 2/7.3.5.C.1 & 2 All new assistants must be oriented by the provider during their first (1st) week in the program. 2. The orientation includes information regarding: a. The Department's Family Child Care Home Regulations for Licensure; b. State law governing child abuse and neglect, and reporting procedures; and 2.3.5.D.3.a.11/7.3.5.D.3.a.11 The required Professional Development Training must be approved through a process as determined by the Department or on the approved list provided by the PDTA Hub. a. Four (4) of the required hours of training must be in one (1) of the following topics related to health and safety requirements: Recognition and reporting of child abuse and neglect. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 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: 218-RICR-70-00-1.9.E -E. Child Abuse and Neglect 1.Any suspected case of child abuse and/or neglect is reported to the Rhode Island Department of Children, Youth and Families’ Child Protective Services (CPS) hotline (1-800-RI-CHILD/1-800-742-4453) within twenty- four (24) hours in accordance with State law and Department policy. 2. If the suspected case occurred at the program, the program must report to the Department’s licensing unit immediately after reporting to the CPS hotline. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 218-RICR- 70-00-2 2.3.2.F/218-RICR-70-00-7 7.3.2.F - F.Child Abuse and Neglect 1.Any suspected case of child abuse and/or neglect is reported to the Rhode Island Department of Children, Youth and Families’ Child Protective Services (CPS) hotline (1-800-RI-CHILD/1-800-742-4453) within twenty-four (24) hours in accordance with State law and Department policy. 2.If the suspected case occurred at the program, the program must report to the Department’s licensing unit after reporting to the CPS hotline. 3.The provider is responsible for alerting the Department immediately of any DCYF investigation associated with themselves, a household member, assistant or substitute. iii. All CCDF-eligible licensed in-home care. Provide the standard: [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: N/A v. All CCDF-eligible license-exempt family child care homes. Provide the standard: N/A vi. All CCDF-eligible license-exempt in-home care. Provide the standard: N/A vii. All CCDF-eligible out-of-school programs (afterschool programs, summer camps, day camps, etc.). Provide the standard: N/A 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: The standard found in Child Care Center and School Age Program Regulations 218-RICR-70-00-1.9.M and Family Child Care/Group Family Child Care 218-RICR-70-00-2 2.3.2.L/218-RICR-70-00-7 7.3.2.L outlines nutrition standards aligned to national best practice and aligned to the United States Department of Agriculture (USDA) Child and Adult Care Food Program nutritional standards. The Rhode Island Department of Health also partners with the lead agency to provide additional feedback and input into these sections during the promulgation of updated regulations. ii. Access to physical activity. Describe: The standard found in Child Care Center and School Age Program Regulations 218-RICR-70-00 1.14.B.3 and Family Child Care/Group Family Child Care 218-RICR-70-00-2 2.3.7.B.3/218-RICR-70- 00-7 7.3.7.B outlines a required amount of daily physical activity for all provider types regulated by the Lead Agency. iii. Caring for children with special needs. Describe: The standard found in Child Care Center and School Age Program Regulations 218-RICR-70-00 1.9.D & 1.14.E and Family Child Care/Group Family Child Care 218-RICR-70-00-2 2.3.2.E/218-RICR-70-00-7 7.3.2.E outlines specific documentation that providers are required to keep on site for children with special needs as well as ensuring that children with special needs are able to safely participate in the program iv. Any other areas determined necessary to promote child development or to protect children’s health and safety. Describe: The Lead Agency updated the regulations for all licensed child care provider types in the last year. These updates have all been aimed at ensuring the health and safety of children as well as promoting best practices related to child development. When updates occur, the proposed changes are sent to all other state agencies to ensure that the changes align with various other content experts in fields that also promote and support child development and health and safety.