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: LCCCs, Chapter 746. Standards: §§746.501, 746.503, 746.611, 746.901, 746.1305, 746.1309, 746.1311, 746.3111, 746.3113, 746.3123, 746.3317, 746.3119, 746.3401, 746.3433, 746.3501, 746.3505, 746.3601, 746.3611. Brief description of the applicable standards: Employees and children must wash hands throughout the day at specific times, including after diapering and toileting. Multiple standards require sanitation of the class environment to prevent and control infectious disease. For home providers, orientation and annual training hours must include such training, and the primary caregiver must complete such training as part of the requirements of a primary caregiver. Pre-service and annual training hours for LCCCs must include instruction on immunizations and preventing and controlling the spread of communicable diseases. ii. All CCDF-eligible licensed family child care homes. Provide the standard: RCCHs and LCCHs, Chapter 747. Standards: §§747.501, 747.503, 747.603, 747.605, 747.611, 747.901, 747.903, 747.905, 747.909, 747.3117, 747.3201, 747.3203, 747.3211, 747.3213, 747.3229, 747.3301, 747.3307, 747.3401, 747.3403, 747.3411. 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: School-Age and Before- or After-School Programs, Chapter 744. Standards: §§744.501, 744.503, 744.611, 744.901, 744.2501, 744.2531, 744.2571, 744.2573, 744.2575, 744.2576, 744.2579, 744.2581. 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: LCCCs, Chapter 746. Standards: §§746.501, 746.503, 746.603, 746.613, 746.615, 746.623, 746.625, 746.1305, 746.1309, 746.1311. Brief description of the applicable standards: All providers eligible to receive CCDF must obtain immunization records or an exemption from immunizations and a health statement for each child in care. Providers must have policies for immunizations, vaccine-preventable diseases, and health checks. Vaccine- preventable diseases for employees must also be addressed in policy, unless the operation is in the home of the permit holder, the director, or a caregiver. ii. All CCDF-eligible licensed family child care homes. Provide the standard: RCCHs and LCCHs, Chapter 747. Standards: §§747.501, 747.503, 747.603, 747.613, 747.615, 747.623, 747.627, 747.1007, 747.1107, 747.1301, 747.1305, 747.1309. 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: School-Age and Before- or After-School Programs, Chapter 744. Standards: §§744.501, 744.503, 744.603, 744.613, 744.615, 744.623, 744.1305, 744.1309, 744.1311, 744.2579, 744.2581. 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: LCCCs, Chapter 746. Standards: §§746.501, 746.1305, 746.1309, 746.1311, 746.2401, 746.2403, 746.2405, 746.2409, 746.2411, 746.2413, 746.2415, 746.2423, 746.2425, 746.2426, 746.2427, 746.2428, 746.2429, 746.3407. Brief description of the applicable standards: Any provider caring for infants and eligible to receive CCDF must follow the minimum standards which include standards for cribs and safety, require that infants be placed on their backs to sleep, and prohibit swaddling, sleeping in restrictive devices, and certain types of equipment. Minimum standards also require providers to have a safe-sleep policy and parents to sign an enrollment agreement that includes a copy of that policy. If a caregiver provides care for children younger than 24 months of age, pre-service and annual training hours must include one hour of training that covers the following topics: Recognizing and preventing shaken baby syndrome and abusive head trauma; Understanding and using safe-sleep practices and preventing SIDS; and Early childhood brain development. ii. All CCDF-eligible licensed family child care homes. Provide the standard: RCCHs and LCCHs, Chapter 747. Standards: §§747.501, 747.801, 747.1007, 747.1107, 747.1301, 747.1305, 747.1309, 747.2301, 747.2303, 747.2305, 747.2307, 747.2309, 747.2311, 747.2313, 747.2315, 747.2323, 747.2325, 747.2326, 747.2327, 747.2328, 747.2329. 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: School-age, before-, and after-school programs are not permitted to care for infants. 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: LCCCs, Chapter 746. Standards: §§746.501, 746.603, 746.605, 746.801, 746.1303, 746.1309, 746.1311, 746.3001, 746.3801, 746.3803, 746.3805, 746.3807, 746.3809, 746.3811, 746.3817, 746.3819. Brief description of the applicable standards: Minimum standards require all providers eligible to receive CCDF to have a policy regarding procedures for dispensing medication. Minimum standards also require providers to inform parents before enrollment if the provider chooses not to administer medication. Parents are required to sign an enrollment agreement that includes a copy of the provider’s medication policy. Minimum standards require authorization from a parent for the provider to administer medications (except in the event of a medical emergency). This authorization must include instructions on how to administer and store medication and guidance on how to document the administration of medication. Medication records must be kept for at least three months. If a caregiver provides care for a child with a diagnosed food allergy, the caregiver must have a food allergy emergency plan signed by the child’s heath care professional and a parent. ii. All CCDF-eligible licensed family child care homes. Provide the standard: RCCHs and LCCHs, Chapter 747. Standards: §§747.501, 747.603, 747.605, 747.801, 747.1007, 747.1107, 747.1301, 747.1305, 747.1309, 747.2901, 747.3601, 747.3603, 747.3605, 747.3607, 747.3609, 747.3611, 747.3617, 747.3619. 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: School-Age and Before- or After-School Programs, Chapter 744. Standards: §§744.501, 744.603, 744.605, 744.801, 744.1303, 744.1309, 744.1311, 744.2301, 744.2651, 744.2653, 744.2655, 744.2657, 744.2651, 744.2659, 744.2661, 744.2667, 744.2669. 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: LCCCs, Chapter 746. Standards: §§746.1303, 746.1309, 746.1311, 746.3803. ii. All CCDF-eligible licensed family child care homes. Provide the standard: RCCHs or LCCHs, Chapter 747. Standards: §§747.801, 747.1007, 747.1107, 747.1301, 747.1305, 747.1309, 747.3603. 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: School-Age and Before- or After-School Programs, Chapter 744. Standards: §§744.1303, 744.1309, 744.1311, 744.2653. 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: LCCCs, Chapter 746. Standards: §§746.401, 746.403, 746.605, 746.1303, 746.1309, 746.1311, 746.3001, 746.3301, 746.3817, 746.3819. Brief description of the applicable standards: Providers take the following steps when caring for children with food allergies: Obtain information about a child's allergies before admitting the child to the child care facility; Post a list of each child's food allergies that require an emergency plan; Take a copy of a child's food-allergy emergency plan and allergy medications on field trips; and Ensure that the child is not served food that is identified on the child's food- allergy emergency plan. ii. All CCDF-eligible licensed family child care homes. Provide the standard: RCCHs and LCCHs, Chapter 747. Standards: §§747.401, 747.605, 747.1007, 747.1107, 747.1301, 747.1305, 747.1309, 747.3101, 747.3109, 747.3617, 747.3619. 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: School-Age and Before- or After-School Programs, Chapter 744. Standards: §§744.401, 744.403, 744.605, 744.1303, 744.1309, 744.1311, 744.2301, 744.2401, 744.2409, 744.2667, 744.2669. 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: LCCCs, Chapter 746. Standards: §§746.1303, 746.1309, 746.1311, 746.3001, 747.3617, 747.3619. Brief description of the applicable standards: For all providers eligible to receive CCDF, minimum standards define a food-allergy emergency plan and contain guidance about when a food-allergy emergency plan is required. A food-allergy emergency plan is defined as an individualized plan prepared by the child's health care professional that includes: A list of each food the child is allergic to; Symptoms the child may exhibit if exposed to a food on the list; and The steps to take if the child has an allergic reaction. ii. All CCDF-eligible licensed family child care homes. Provide the standard: RCCHs and LCCHs, Chapter 747. Standards: §§747.1007, 747.1107, 747.1301, 747.1305, 747.1309, 747.2901, 747,3109. 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: School-Age and Before- or After-School Programs, Chapter 744. Standards: §§744.605, 744.1303, 744.1309, 744.1311, 744.2301, 744.2667, 744.2669. 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: LCCCs, Chapter 746. Standards: §§746.1303, 746.3407, 746.3701, 746.3703, 746.3707, 746.3709, 746.4311, 746.4135, 746.4751, 746.5501. Brief description of the applicable standards: For all providers eligible to receive CCDF, minimum standards require providers to take safety precautions to ensure that areas accessible to children are free from hazards, including: Electrical outlets and connections; Air conditioners, heaters, and fans; Sliding-glass doors; Play materials and equipment; Poisonous or potentially harmful plants; Storage chests, boxes, or trunks; Televisions; Dangerous individuals; and Unsafe children's products. Minimum standards prohibit the presence of firearms and other weapons on the premises of a child care center (except for firearms and other weapons carried by certified peace officers and security officers). Minimum standards for child care homes require that weapons be locked and stored out of reach of children. Ammunition must be kept in a separate locked cabinet and be inaccessible to children during all hours of operation. ii. All CCDF-eligible licensed family child care homes. Provide the standard: RCCHs and LCCHs, Chapter 747. Standards: §§747.1007, 747.1107, 747.3203, 747.3501, 747.3503, 747.3505, 747.3935, 747.4113, 747.4407, 747.5011, 747.5301. 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: School-Age and Before- or After-School Programs, Chapter 744. Standards: §§744.1303, 744.2601, 744.2603, 744.2607, 744.2609. 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: LCCCs, Chapter 746. Standards: §§746.605, 746.1303, 746.1309, 746.1311, 746.1325, 746.2105, 746.3701, 746.5001, 746.5003, 746.5005, 746.5007, 746.5009, 746.5011, 746.5013, 746.5017. Brief description of the applicable standards: For all providers eligible to receive CCDF, minimum standards require providers to take safety precautions to ensure that areas accessible to children are free from hazards related to bodies of water, such as pools, hot tubs, ponds, creeks, birdbaths, fountains, buckets, and barrels. ii. All CCDF-eligible licensed family child care homes. Provide the standard: RCCHs and LCCHs, Chapter 744. Standards: §§747.301, 747.605, 747.1007, 747.1107, 747.1301, 747.1305, 747.1309, 747.1323, 747.2005, 747.3501, 747.4801, 747.4803, 747.4805, 747.4807, 747.4811, 747.4812, 747.4813, 747.4817. 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: School-Age and Before- or After-School Programs, Chapter 744. Standards: §§744.301, 744.605, 744.1303, 744.1309, 744.1311, 744.1318, 744.1905, 744.2601, 744.3401, 744.3403, 744.3405, 744.3407, 744.3409, 744.3410, 744.3411, 744.3415. 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: LCCCs, Chapter 746. Standards: §§746.1303, 746.1309, 746.1311, 746.5605. Brief description of the applicable standards: For all providers eligible to receive CCDF, minimum standards require training in understanding building and physical premises safety, including identification and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic. ii. All CCDF-eligible licensed family child care homes. Provide the standard: RCCHs and LCCHs, Chapter 747. Standards: §§747.1007, 747.1107, 747.1301, 747.1305, 747.1309, 747.5405. 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: School-Age and Before- or After-School Programs, Chapter 744. Standards: §§744.1303, 744.1309, 744.1311, 744.3805. 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: LCCCs, Chapter 746. Standards: §§746.501, 746.1305, 746.1309, 746.1311. Brief description of the applicable standards: CCR minimum standards require employees to ensure that no child is abused or neglected while in the care of the facility and report suspected abuse or neglect. An overview of the policy on the prevention, recognition, and reporting of child maltreatment must be covered in orientation and as part of annual training for all caregivers and must be covered in written operational policies. The standards also list acceptable and prohibited forms of discipline and guidance. SIDS and shaken baby syndrome must be covered in pre-service and annual training. ii. All CCDF-eligible licensed family child care homes. Provide the standard: RCCHs and LCCHs, Chapter 747. Standards: §§747.1007, 747.1107, 747.1301, 747.1305, 747.1309. 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: School-age and before- or after-school programs are not permitted to care for infants. 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: LCCCs, Chapter 746. Standards: §§746.501, 746.901, 746.1303, 746.1309, 746.1311, 746.2803, 746.2805. ii. All CCDF-eligible licensed family child care homes. Provide the standard: RCCHs and LCCHs, Chapter 747. Standards: §§747.501, 747.901, 747.1007, 747.1107, 747.1301, 747.1403, 747.2703, 747.2705. 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: School-Age and Before- or After-School Programs, Chapter 744. Standards: §§744.501, 744.901, 744.1303, 744.1309, 744.1311, 744.2103, 744.2105. 5.3.7 Emergency preparedness and response planning standard Identify by checking below that the emergency preparedness and response planning due to natural disasters and human-caused events standard includes procedures in the following areas: i. [x] Evacuation ii. [x] Relocation iii. [x] Shelter-in-place iv. [x] Lock down v. Staff emergency preparedness [x] Training [x] Practice drills vi. Volunteer emergency preparedness [x] Training [x] Practice drills vii. [x] Communication with families viii. [x] Reunification with families ix. [x] Continuity of operations x. Accommodation of [x] Infants [x] Toddlers [x] Children with disabilities [x] Children with chronic medical conditions xi. If any of the above are not checked, describe: 5.3.8 Handling and storage of hazardous materials and the appropriate disposal of biocontaminants health and safety standard a. Provide the standards, appropriate to the provider setting and age of children, that address the handling and storage of hazardous materials for the following CCDF-eligible providers: i. All CCDF-eligible licensed center care. Provide the standard: LCCCs, Chapter 746. Standards: §§746.1303, 746.1309, 746.1311, 746.3317, 746.3407, 746.3415, 746.3425, 746.3701. Brief description of the applicable standards: For all providers eligible to receive CCDF, minimum standards require providers to: Clearly mark cleaning supplies and other toxic materials; Keep cleaning supplies and other toxic materials away from food and inaccessible to children; Use, store, and dispose of hazardous materials as recommended by the manufacturer; Wash hands after handling cleaners, toxic materials, or bodily fluids; and Wear gloves when handling blood. ii. All CCDF-eligible licensed family child care homes. Provide the standard: RCCHs and LCCHs, Chapter 747. Standards: §§747.1007, 747.1107, 747.1301, 747.1305, 747.1309, 747.3203, 747.3117, 747.3211, 747.3221, 747.3225, 747.3501. 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: School-Age and Before- or After-School Programs, Chapter 744. Standards §§744.1303, 744.1309, 744.1311, 744.2419, 744.2507, 744.2515, 744.2523, 744.2601. 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: LCCCs, Chapter 746. Standards: §§746.1303, 746.1309, 746.1311, 746.3407, 746.3425. Brief description of the applicable standards: All providers must clearly mark cleaning supplies and other toxic materials and keep them separate from food and inaccessible to children. Additionally, providers must follow the manufacturer’s recommendations for the use, storage, and disposal of hazardous materials. ii. All CCDF-eligible licensed family child care homes. Provide the standard: RCCHs and LCCHs, Chapter 747. Standards: §§747.1007, 747.1107, 747.1301, 747.1305, 747.1309, 747.3203, 747.3221. 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: School-Age and Before- or After-School Programs, Chapter 744. Standards: §§744.1303, 744.1309, 744.1311, 744.2507, 744.2523. 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: LCCCs, Chapter 746. Standards: §§746.301, 746.501, 746.605, 746.901, 746.1301, 746.1303, 746.1311, 746.1316, 746.1805, 746.3001, 746.3703, 746.5605, 746.5607, 746.5609, 746.5613, 746.5615, 746.5617, 746.5619, 746.5621, 746.5623, 746.5625. Brief description of the applicable standards: Minimum standards for LCCCs, school-age, before-, and after-school programs, LCCHs, and RCCHs require providers to: Obtain a parent or guardian's permission to transport the children in their care; Have a transportation policy; Prohibit alcohol, controlled substances, and smoking while transporting; Maintain vehicles in safe operating condition; Take safety precautions when loading and unloading children; Use passenger safety seat systems; Require the use of safety belts for caregivers and drivers; Carry a driver’s license and documentation of the names of the children being transported; Carry emergency medical transport and treatment authorization forms for each child being transported; Carry parent’s names and telephone numbers and emergency telephone numbers for each child being transported; Carry safety equipment, including a fire extinguisher and first-aid kit; Cave a plan to handle transportation emergencies; Have communication requirements regarding the transport of children; and Under certain circumstances, have an electronic child-safety alarm installed. For LCCCs with a vehicle purchased or leased on or after December 31, 2013, the vehicle must be equipped with an electronic child-safety alarm if it is designed to seat eight or more individuals and the operation that uses the vehicle to transport is responsible for ensuring that the alarm is installed and maintained according to the manufacturer’s instructions. The alarm must always be used whenever a vehicle is used to transport a child in care. Child care homes are not required to have an electronic child-safety alarm installed. If the home transports children whose chronological or developmental age is younger than nine years old, two clock hours of annual transportation safety training is required for the primary caregiver and each employee before transporting a child. ii. All CCDF-eligible licensed family child care homes. Provide the standard: RCCHs and LCCHs, Chapter 747. Standards: §§747.301, 747.605, 747.901, 747.1007, 747.1107, 747.1301, 747.1303, 747.1305, 747.1309, 747.1314, 747.1903, 747.2901, 747.3503, 747.5401, 747.5403, 747.5405, 747.5407, 747.5409, 747.5411, 747.5413, 747.5415, 747.5417, 747.5419, 747.5421. 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: School-Age and Before- or After-School Programs, Chapter 744. Standards: §§744.301, 744.501, 744.605, 744.901, 744.1301, 744.1303, 744.1309, 744.1311, 744. 1317, 744.1403, 744.2301, 744.2603, 747.2901, 744.3801, 744.3803, 744.3805, 744.3807, 744.3809, 744.3811, 744.3813, 744.3815, 744.3817, 744.3819, 744.3821. 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: LCCCs, Chapter 746. Standards: §§746.1301, 746.1315, 746.1329, 746.1403, 746.3001, 746.3117, 746.3119. Brief description of the applicable standards: For all providers eligible to receive CCDF, CCR minimum standards for LCCCs, school-age, before-, and after-school programs, LCCHs, and RCCHs require Pediatric First Aid and CPR training and recertification to adhere to the guidelines for cardiopulmonary resuscitation for laypersons established by the American Heart Association. Each caregiver and the child care center director must have a current certificate of training with an expiration or renewal date. ii. All CCDF-eligible licensed family child care homes. Provide the standard: RCCHs and LCCHs, Chapter 747. Standards: §§747.1007, 747.1107, 747.1209, 747.1301, 747.1303, 747.1305, 747.1309, 747.1313, 747.1327, 747.2901. 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: School-Age and Before- or After-School Programs, Chapter 744. Standards: §§744.1301, 744.1303, 744.1309, 744.1311, 744.1315, 744.1331, 744.1403, 744.2301. 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: LCCCs, Chapter 746. Standards: §§746.1301, 746.1309, 746.1311, 746.1315, 746.1329, 746.1403, 746.3001, 746.3117, 746.3119. Brief description of the applicable standards: For all providers eligible to receive CCDF, CCR minimum standards for LCCCs, school-age, before-, and after-school programs, LCCHs, and RCCHs require CPR training and recertification to adhere to the guidelines for cardiopulmonary resuscitation for laypersons established by the American Heart Association. Each caregiver and the child care center director must have a current certificate of training with an expiration or renewal date. ii. All CCDF-eligible licensed family child care homes. Provide the standard: RCCHs and LCCHs, Chapter 747. Standards: §§747.1007, 747.1107, 747.1209, 747.1303, 747.1309, 747.1313, 747.1327, 747.2901. 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: School-Age and Before- or After-School Programs, Chapter 744. Standards: §§744.1301, 744.1315, 744.1331, 744.1403, 744.2301. 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: LCCCs, Chapter 746. Standards: §§746.501, 746.901, 746.1201, 746.1303, 746.1309, 746.1311. Brief description of the applicable standards: CCR Minimum standards require employees to ensure that no child is abused or neglected while in the care of the center. All caregivers must report suspected abuse, neglect, or exploitation. An overview of the policy on prevention, recognition, and reporting of child maltreatment must be covered in orientation and as part of annual training for all caregivers. Providers must also develop written policies and procedures on preventing and responding to abuse and neglect of children that include the following: Requirements for annual training for employees; Methods for increasing employee and parent awareness of child abuse and neglect, including information on warning signs that a child may be a victim of abuse or neglect and factors that may indicate that a child is at risk; Strategies for coordination between the center and appropriate community organizations; and Actions that the parent of a child who is a victim of abuse or neglect should take to obtain assistance and intervention, including procedures for reporting child abuse or neglect. CCR minimum standards require directors to ensure that: No child is abused or neglected; Employees report abuse and neglect; and Policies are provided to parents and include instructions on how to report abuse and neglect. Directors must also ensure that employees are trained on the provider's policies about the prevention, recognition, and reporting of abuse or neglect, including: Factors indicating that a child is at risk of abuse or neglect; Warning signs that a child might be a victim of abuse or neglect; procedures for reporting abuse or neglect; and Information about community organizations that have additional training on the topic. ii. All CCDF-eligible licensed family child care homes. Provide the standard: RCCHs and LCCHs, Chapter 747. Standards: §§747.1007, 747.1107, 747.1301, 747.1403. 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: School-Age and Before- or After-School Programs, Chapter 744. Standards: §§744.901, 744.1201, 744.1303, 744.1309, 744.1311, 744.2109. 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: LCCCs, Chapter 746. Standards: §§746.201, 746.307, 746.405, 746.901, 746.1201, 746.1303, 746.1309, 746.1311. Brief description of the applicable standards: The number for the Texas Abuse Hotline (1-800-252-5400) is required to be posted in a prominent area within the facility. Additional requirements include notification of all parents and guardians of children in care regarding any incident of abuse, neglect, or exploitation of a child. ii. All CCDF-eligible licensed family child care homes. Provide the standard: RCCHs and LCCHs, Chapter 747. Standards: §§747.207, 747.305, 747.403, 747.501, 747.1007, 747.1107, 747.1301, 747.1403, 747.1501. 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: School-Age and Before- or After-School Programs, Chapter 744. Standards: §§744.201, 744.307, 744.405, 744.501, 744.901, 744.1201, 744.1303, 744.1309, 744.1311. 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: CCR Minimum standards include requirements for how often to provide snacks and meals. The meals and snacks served must follow the meal patterns established by the US Department of Agriculture (TDA) CACFP that is administered by the Texas TDA. LCCCs, school-age, before-, and after-school programs, LCCHs, and RCCHs must follow these patterns regardless of whether the operation participates in the program for reimbursement. CCR minimum standards have specific requirements for feeding infants and specify the daily food needs of children by the age groups outlined by CACFP. Minimum standards prohibit serving fruit or vegetable juice to children younger than 12 months and specify the permissible amount of juice to serve to children in age groups 12 months through five and six years of age and older. For an infant who is not yet ready for table food, providers must obtain and follow written feeding instructions that are signed and dated by the infant's parent or health care professional. These instructions must be updated every 30 days. Annual training hours may include nutrition education, but there are no specific requirements. ii. Access to physical activity. Describe: CCR minimum standards for physical activity were updated to align with the best practices published in the fourth edition of Caring for Our Children. Minimum standards now require children ages 18 months and older be allowed 60 to 90 total minutes of outdoor time each day. Minimum standards include specific requirements for the types of activities provided for the following age groups: infants, toddlers, prekindergarten, and school-age. Minimum standards require all children ages 18 months and older to be provided with the opportunity for outdoor play twice a day, weather permitting. Infants are required to have the opportunity for outdoor play at least once a day. The daily activity plan must contain a balance of active and quiet play that includes group and individual activities. Withholding active play or keeping a child inside as a consequence for behavior, unless the child is exhibiting behavior during active play that requires a brief supervised separation or time-out, is prohibited. Operational policies should include and address the promotion of indoor and outdoor physical activity and cover the following: The benefits of physical activity and outdoor play; The duration of both indoor and outdoor physical activity at the operation; The type of physical activity (structured and unstructured) that children may engage in at the operation; Each setting in which physical activity will take place; The recommended clothing and footwear that allow children to participate freely and safely in physical activities; and A plan to ensure physical activity occurs on days when extreme weather conditions prohibit or limit outdoor play. Providers must ensure that screen time activity, if used: Is related to planned activities that meet educational goals; is age- appropriate; Does not exceed one hour per day; Is not during mealtimes, snack times, nap times, or rest times; and Does not include advertising or violence. A school-age child may use screen time without restriction for homework. Screens must be turned off when not in use. Annual training hours may include instruction on physical activity, but there are no specific requirements. iii. Caring for children with special needs. Describe: CCR minimum standards require operations to ensure that children who need special care due to disabling or limiting conditions receive the care recommended by a health care professional or by qualified individuals affiliated with the local school district or early childhood intervention program. They must also have procedures for supporting inclusive services to children with special care needs. Information about special needs requirements must be obtained at admission. These basic care requirements must be documented and on file for review at the child care center during operating hours. Caregivers must provide care that is consistent with a child’s special needs, including any special supervision needs and provide planned activities that integrate children with special care needs by adapting equipment and procedures as necessary. All activities must integrate all children with or without special care needs. Annual training hours may include caring for children with special needs, but there are no specific requirements. iv. Any other areas determined necessary to promote child development or to protect children’s health and safety. Describe: Minimum standards include requirements for diapering, including how and when diapers must be changed, what equipment is required, and how to prevent the spread of germs when diapering children. Minimum standards prohibit the use of tobacco products in or on the grounds of an operation. Child care homes are prohibited from tobacco use only during operating hours. The only providers eligible to provide in-home care are individuals related to the child. Relative-only providers are exempt from these requirements. Minimum standards require that operations be equipped with a working carbon monoxide detection system. Minimum standards require annual fire inspections for centers. Fire inspections are not applicable to child care homes; however, local ordinances may require one. If care is provided for children above or below the ground floor of the child care home, written approval must be granted from the state or local fire marshal.