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(b) A health assessment from a health care provider assessing the ability of the operator, staff, and emergency staff person to work with children. The health assessment shall be completed within three months prior to employment or within the first month of employment and shall include health history, physical exam, vision and hearing screening, tuberculosis screening, and a review of immunization status. A new health assessment shall be obtained by the operator and teacher/caregivers at least every four years after the initial assessment or as necessary. (2) No person who is known to be afflicted with any disease in a communicable form, or who is a known carrier of such a disease, or who is afflicted with boils, infected wounds, or sores or acute respiratory infection, shall work in any capacity in a group child care home in which there is likelihood of such person transmitting disease or infection to other individuals. (3) Any staff member, including the operator, emergency person(s) and volunteer(s) who, upon examination or as a result of tests, shows a condition that could be detrimental to the children or staff, or which would prevent satisfactory performance of duties, shall not continue work at the group child care home until the healthcare provider indicates that the condition no longer presents a threat to children or staff. (4) Staff persons shall wash their hands with soap and warm running water upon arrival at the group child care home, before preparing or serving food, before assisting a child with eating, after assisting a child with toileting or diapering, before and after toileting, after administering medi- cation, after cleaning, after assisting with wiping noses, after contact with body fluids, after contact with animals, and after using cleaning materials. Hands shall be washed even if gloves are worn to perform these tasks. (5) Staff shall be excluded when they exhibit the conditions listed in the DHEC Exclusion Policy. H. Fire safety and emergency preparedness (1) Group child care homes shall comply with the regulations and codes of the State Fire Marshal. (2) The group child care home shall have an up to date written plan for evacuating in case of fire, a natural disaster or threatening situation that may pose a health or safety hazard. The group child care home shall also include procedures for staff training in this emergency plan. (3) Portable heat sources will be used according to the manufacturers’ instructions and kept in good working order and out of the reach of children. I. Transportation (1) If the operator provides or arranges for transportation, the following transportation require- ments apply: (a) The staffing ratios specified in 114-514A(2) apply. The driver of the vehicle shall not be counted in the ratios; (b) Transportation and placement of children shall be in accordance with state and federal laws; (c) A child shall not be left unattended in a vehicle; (d) The driver shall have a valid regular or commercial driver’s license and shall be in compliance with Section 20-7-2725A(4) of the Code of Laws of 1976; (e) Use of tobacco products is prohibited in the vehicle; and (f) Written consent from the parent is required prior to transportation. (2) The following requirements apply for safe pick-up and drop-off: (a) The group child care home shall have safe crossways and designated pick-up and drop-off locations and communicate these locations to the parents; and (b) Children shall be supervised during boarding and exiting vehicles. HISTORY: Added by State Register Volume 19, Issue No. 5, eff May 26, 1995. Amended by State Register Volume 29, Issue No. 6, eff June 24, 2005. 114–516. Program. A. Program of activities (1) There shall be planned, daily program of activities for all children. (2) Activities shall be developmentally appropriate.