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: Rule 5.1.2: General Health Examinations: Within forty-five (45) days of enrollment, the licensee shall obtain documentation of the child’s age appropriate well care exam from the parent. Documentation shall include information regarding any health conditions and medications that may impact the care of the child. 5.2 - Routine Health Practices: 5.2.1 Hand washing 5.2.1.1 CBCCPP staff shall ensure that adults and children wash their hands: • Upon arrival at the CBCCPP; • Before they eat, prepare or handle food; • Before and after handling raw meat; • Before feeding children; • After toileting or diapering; • After cleaning; • After taking out the garbage; • After handling animals; and • After outdoor play. 5.2.1.2 The program director shall ensure that adults also wash their hands: • Before and after giving medications; • Before and after caring for a child who is injured or may be sick; • Before diapering; and • After coming into contact with blood, fecal matter, urine, vomit, nasal secretions or other body fluids. 5.2.1.3 The licensee shall ensure the hand washing procedures include the following steps in order: • Use of warm running water and liquid soap; • Moistening hands with water, applying soap, and washing hands for a minimum of twenty (20) seconds; • Rinsing hands under running water; • Drying hands with a single use towel or paper towel; and then • Disposing of the towel. 5.2.1.4 When hand washing is not practical due to outside activities or being off- site, and hands are not visibly soiled, hand sanitizer may be used by staff, other adults, and children in lieu of washing with soap and warm water. Staff shall ensure that children using a hand sanitizer rub their hands until the sanitizer has dried. Only non-alcohol hand sanitizer shall be used for children under twenty- four (24) months of age. 5.2.1.5 Sinks used for hand washing shall have hot and cold running water that comes from a single spigot. The hot water shall not exceed 120°F. 5.2.1.6 Soap and paper towels or individual single use cloth towels shall be available and accessible to the children at each hand washing sink. 5.2.1.7 If hand washing sinks are not child height, a step stool shall be available. 5.2.1.8 Staff shall wash the hands of children who are unable to wash their own hands and provide developmentally appropriate guidance and supervision to help children learn and practice healthy hand washing. 5.2.2 Children’s clothing 5.2.2.1 The licensee shall ensure that extra clothing is available for children either by providing a sufficient quantity directly or requiring parents to provide and maintain a clean spare set of clothing for each child. 5.2.2.2 Staff shall ensure that children’s clothing is changed when wet or soiled. 5.2.2.3 Wet or soiled clothing shall be placed in a sealed plastic container or bag, labeled with the child’s name, and returned to the child’s parent at the end of the day. 5.2.2.4 Children’s personal articles, including combs and brushes, shall not be shared among children and shall be stored separately with individual children’s personal belongings. 5.2.3 Diapering 5.2.3.1 Staff shall ensure that children’s diapers are changed when wet or soiled. 5.2.3.2 Staff shall have an established procedure for checking diapers regularly including visually inspecting children’s diapers at least every two (2) hours. 5.2.3.3 Staff shall monitor the supply of diapers for each child and make sure they are replenished regularly. 5.2.3.4 The licensee shall ensure that there is a sturdy diaper changing area with a clean, washable, and non-absorbent surface. The diaper changing area shall not be located in the kitchen, or any area where food is stored, prepared or served. 5.2.3.5 The hand washing sink used for toileting and diapering shall be conveniently located near the toileting and diapering areas. This sink shall not be used for food preparation and shall meet requirements in the rule 5.2.1.5 of these regulations. 5.2.3.6 The licensee shall ensure that used disposable diapers are placed in a container that is washable and has a cover that prevents children from accessing the diapers. 5.2.3.7 The container for diapers shall be within arm’s reach of the diaper changing area. 5.2.3.8 The container for diapers shall be emptied, cleaned, and disinfected daily. 5.2.3.9 If cloth diapers are used, staff shall place the wet or soiled diaper in a plastic bag or individual container that can be sealed and kept out of the reach of children. 5.2.3.10 Cloth diapers shall be sent home with the child on a daily basis. 5.2.3.11 Each diaper changing procedure shall include: • Preparation: assemble supplies, staff member washes hands, prepares changing surface with either a disposable covering or ensure that the surface was recently cleaned and disinfected and bring the child to the diaper changing area. • Dirty Phase: remove soiled diaper, dispose of diaper, and cleanse diaper area of the child. • Clean Phase: put on clean diaper, dress child, and wash the child’s hands. • Clean up: clean and disinfect the diaper changing surface, and staff member washes their own hands. • Record diaper change. 5.2.3.12 The licensee shall post the diaper changing procedure at each diaper changing area. 5.2.3.13 In addition to hand washing, disposable non-porous gloves shall be worn during diapering when: • A staff member has an open cut, sore or cracked skin; • A child has an open cut or sore on his/her skin; or • A child has a known infection that is spread through feces. 5.2.4 Toileting and Toilet Learning/Training 5.2.4.1 Children shall be accommodated in a timely manner when they need to use the toilet. 5.2.4.2 Staff shall provide positive guidance on safe and sanitary toileting. Children shall be supported in developing toileting skills appropriate to their age and ability. 5.2.4.3 Staff shall ensure that all toilet learning/training is carried out with the parent’s knowledge and consent. Toilet training methods performed by staff shall be consistent with the parent’s toilet training methods when these are developmentally appropriate and do not constitute a violation of these regulations. The child’s progress and success in toileting shall be communicated regularly to the child’s parent(s). 4 5.2.4.4 Safe and cleanable equipment for toilet learning/training such as child- sized toilets, step aids, modified child-sized toilet seats or inserts that fit directly over the toilet shall be provided for children who are learning to use the toilet. 5.2.5 Standard Practices for Exposure to Bodily Fluids Staff shall use standard precautions when exposed to blood or blood-containing bodily fluids. The standard precautions include: • Use of nonporous disposable gloves to clean up the blood or blood-containing fluid unless the material used to clean it up can easily contain the fluid; • Clean and disinfect the soiled surface; • Dispose of contaminated materials and store washable items in securely sealed plastic bags; and • Wash hands thoroughly as required in the rule 5.2.1.3 of these regulations. 5.2.6 Cleaning, Sanitizing, and Disinfecting (see section 2.2 of these regulations for definitions of these terms) 5.2.6.1 Cleaning shall occur prior to sanitizing and disinfecting unless otherwise instructed by the manufacturer’s recommendations. 5.2.6.2 All sanitizing and disinfecting solutions shall be EPA registered and used according to the manufacturers’ instructions. 5.2.6.3 Household bleach may be used for both sanitizing and disinfecting. When bleach is used for these purposes, fresh bleach solutions shall be mixed daily. 5.2.6.4 Cleaning of the following items shall be done on the following schedule: After each use: • Countertops; • Food preparation appliances; • Plastic mouthed toys; • Changing tables; and • Cribs, cots, mats, and bedding, if used by different children. When it touches another surface: • Pacifiers Every Day: • Uncarpeted floors Every week: • Cribs, cots, mats, and bedding if used by the same child every day. Every month: • Machine washable toys; • Dress-up clothes including hats; • Play activity centers; and • Refrigerator. 5.2.6.5 Sanitizing of the following items shall be done on the following schedule: Before and after each use: • Food preparation surfaces; • Dining tables and highchair trays; and • Non flushing potty chairs. After each use: • Eating utensils and dishes; At the end of each day: • Food preparation appliances; • Plastic mouthed toys; and • Pacifiers. 5.2.6.6 Disinfecting of the following items shall be done at the end of each day: • Door and cabinet handles; • Hand washing sinks and faucets; • Countertops; • Toilets and toilet learning equipment; • Diaper pails; and • Drinking fountains. Section 5.3 Managing Infectious Diseases: 5.3.1 The licensee shall develop and implement a plan for the management of communicable disease in the CBCCPP including the following: • Naming and identifying symptoms of illnesses for which a child will be excluded or sent home from the CBCCPP; • Identifying communicable diseases for which a child will not be admitted to the CBCCPP without a statement from a health care provider; and • Written notification to parents when children may have been exposed to a reportable communicable disease. 5.3.2 Daily Health Check Upon arrival into the CBCCPP staff shall observe each child for symptoms of communicable disease and signs of injuries. Any obvious injuries shall be documented along with any comments from the parent pertaining to the child’s condition. This documentation shall be maintained in the child’s file for a minimum of 365 days. 5.3.3 Exclusion of Children from Care 5.3.3.1 Staff shall follow the exclusion policies as set forth in Signs and Symptoms of Illness Chart, (see Appendix A). 5.3.3.2 Signs and Symptoms of Illness Chart document shall be posted where it is clearly visible to staff and parents. 5.3.3.3 A child shall be excluded from care if, in the opinion of the program director, he/she is too ill to participate in usual daily activities. 5.3.4 Responding to Children Who Become Ill 5.3.4.1 The program director shall ensure that a comfortable space, separate from other children, can be created for children who are exhibiting symptoms of illness until their parent arrives to pick them up. The separate area shall be appropriately furnished to allow the child to sleep or rest, which shall not be located in the kitchen or toilet area. 5.3.4.2 All items used by an ill child shall be cleaned and disinfected prior to being used by another child. 5.3.4.3 Staff shall ensure that an ill child is supervised. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The FCCP shall ensure that the FCCH environment and practices support children’s health and safety. 5.1.2 General Health Examinations: Within forty-five (45) days of enrollment the FCCP shall obtain documentation of the child’s age appropriate well care exam from the parent. Documentation shall include information regarding any health conditions and medications that may impact the care of the child. . 5.2 Routine Health Practices 5.2.1 Hand washing 5.2.1.1 The FCCP shall ensure that adults and children wash their hands: • Upon arrival at the FCCH; • Before they eat, prepare or handle food; • Before and after handling raw meat; • Before feeding children; • After toileting or diapering; • After cleaning; • After taking out the garbage; • After handling animals; and • After outdoor play. 5.2.1.2 The FCCP shall ensure that adults also wash their hands: • Before and after giving medications; • Before and after caring for a child who is injured or may be sick; • Before diapering; and • After coming into contact with blood, fecal matter, urine, vomit, nasal secretions or other body fluids. 5.2.1.3 The FCCP shall ensure the hand washing procedure include the following steps in order: • Use of warm running water and liquid soap; • Moistening hands with water, applying soap, and washing hands for a minimum of twenty (20) seconds; • Rinsing hands under running water; • Drying hands with a single use towel or paper towel; and then • Disposing of the towel. 5.2.1.4 When hand washing is not practical due to outside activities or being off-site, and hands are not visibly soiled, hand sanitizer may be used by the FCCP, staff, other adults, and children in lieu of washing with soap and warm water. Staff shall ensure that children using a hand sanitizer rub their hands until the sanitizer has dried. Only non-alcohol hand sanitizer shall be used for children under twenty-four (24) months of age. 5.2.1.5 Sinks used for hand washing shall have hot and cold running water that comes from a single spigot. The hot water shall not exceed 120°F. 5.2.1.6 Soap and paper towels or individual single use cloth towels shall be available and accessible to the children at each hand washing sink. 5.2.1.7 If hand washing sinks are not child height, a step stool shall be available. 5.2.1.8 The FCCP and/or staff shall wash the hands of children who are unable to wash their own and provide developmentally appropriate guidance and supervision to help children learn and practice healthy hand washing. 5.2.2 Children’s clothing 5.2.2.1 The FCCP shall ensure that extra clothing is available for children either by providing a sufficient quantity directly or requiring parents to provide and maintain a clean spare set of clothing for each child. 5.2.2.2 The FCCP shall ensure that children’s clothing is changed when wet or soiled. 5.2.2.3 Wet or soiled clothing shall be placed in a sealed plastic container or bag labeled with the child’s name and returned to the child’s parent at the end of the day. A FCCP may choose to launder wet or soiled clothing on site. 5.2.2.4 Children’s personal articles, including combs and brushes, shall not be shared among children and shall be stored separately with individual children’s personal belongings. 5.2.3 Diapering 5.2.3.1 The FCCP shall ensure that children’s diapers are changed when wet or soiled. 5.2.3.2 The FCCP shall have an established procedure for checking diapers regularly including visually inspecting children’s diapers at least every two (2) hours. 5.2.3.3 The FCCP shall monitor the supply of diapers for each child and make sure they are replenished regularly. 5.2.3.4 The FCCP shall ensure that there is a sturdy diaper changing area with a clean, washable and non-absorbent surface. The diapering changing area shall not be located in the kitchen or any area where food is stored, prepared or served. 5.2.3.5 If the hand washing sink used for toileting and diapering is also used for food preparation, the faucet and sink shall be sanitized prior to being used for food preparation. 5.2.3.6 The FCCP shall ensure that used disposable diapers are placed in a leak proof bag or container that is washable and has a firmly fitting cover. 5.2.3.7 A container used for diapers s hall be out of reach of children. 5.2.3.8 A container for diapers shall be emptied, cleaned and disinfected daily. 5.2.3.9 If cloth diapers are used, the FCCP shall ensure that wet or soiled diapers are placed in a plastic bag or individual container that can be sealed and kept out of reach of children. 5.2.3.10 Cloth diapers shall be sent home with the child on a daily basis. The FCCP may choose to wash cloth diapers daily. 5.2.3.11 Each diaper changing procedure shall include: • Preparation: assemble supplies, staff member washes hands, prepares changing surface with either a disposable covering or ensure that the surface was recently cleaned and disinfected and bring the child to the diaper changing area. • Dirty Phase: remove soiled diaper and cleanse diaper area of the child. • Clean Phase: put on clean diaper, dress child, and wash the child’s hands. • Clean up: clean and disinfect the diaper changing surface, dispose of diaper, and staff member washes their own hands. • Record diaper change. 5.2.3.12 The FCCP shall have a written diaper changing procedure that is accessible to staff. 5.2.3.13 A licensed FCCP shall post the diaper changing procedure at each diaper changing area. 5.2.3.14 In addition to hand washing, disposable non-porous gloves shall be worn during diapering when: • A staff person has an open cut, sore or cracked skin; • A child has an open cut or sore on his/her skin; or • A child has a known infection that is spread through the feces. 5.2.4 Toileting and Toilet Learning/Training 5.2.4.1 Children shall be accommodated in a timely manner when they need to use the toilet. 5.2.4.2 The FCCP and staff shall provide positive guidance on safe and sanitary toileting. Children shall be supported in developing toileting skills appropriate to their age and ability. 5.2.4.3 The FCCP shall ensure that all toilet learning/training is carried out with the parent’s knowledge and consent. Toilet training methods shall be consistent with the parent’s toilet training methods when these are developmentally appropriate and do not constitute a violation of these regulations. The child’s progress and success in toileting shall be communicated regularly to the child’s parent(s). 5.2.4.4 Safe and cleanable equipment for toilet learning/training such as child- sized toilets, step aids, modified child-sized toilet seats or inserts that fit directly over the toilet shall be provided for children who are learning to use the toilet. 5.2.5 Standard Practices for Exposure to Body Fluids Staff shall use standard precautions when exposed to blood or blood-containing body fluids. The standard precautions include: • Use of nonporous disposable gloves to clean up the blood or blood-containing fluid unless the material used to clean it up can easily contain the fluid; • Clean and disinfect the soiled surface; • Dispose of contaminated materials and store washable items in securely sealed plastic bags; and • Wash hands thoroughly as required in the rule 5.2.1.3 of these regulations. 5.2.6 Cleaning, Sanitizing and Disinfecting (see section 2.2 of these regulations for definitions of these terms) 5.2.6.1 Cleaning shall occur prior to sanitizing and disinfecting unless otherwise instructed by the manufacturer’s recommendations. 5.2.6.2 All sanitizing and disinfecting solutions shall be EPA registered and used according to the manufacturers’ instructions. 5.2.6.3 Household bleach may be used for both sanitizing and disinfecting. When bleach is used for these purposes, fresh bleach solutions shall be mixed daily. 5.2.6.4 Cleaning of the following items shall be done on the following schedule: After each use: • Plastic mouthed toys; • Changing tables; and • Cribs, cots, mats, and bedding, if used by different children. When it touches another surface: • Pacifiers Every week: • Cribs, cots and mats, and bedding if used by the same child every day. Every month: • Machine washable toys; • Dress-up clothes including hats; • Play activity centers; and • Refrigerator. 5.2.6.5 Sanitizing of the following items shall be done on the following schedule: Before and after each use: • Food preparation surfaces; and • Dining tables and highchair trays. After each use: • Eating utensils and dishes At the end of each day: • Food preparation appliances; • Plastic mouthed toys; and • Pacifiers. 5.2.6.6 The following items shall be Disinfected at the end of each day: • Door handles; • Hand washing sinks and faucets; • Countertops; • Toilets and toilet learning equipment; • Diaper pails; and • Drinking fountains. 5.3 Managing Infectious Diseases 5.3.1 The FCCP shall develop and implement a plan for the management of communicable disease in the FCCH including the following: • Naming and identifying symptoms of illnesses for which a child will be excluded or sent home from the FCCH; • Identifying communicable diseases for which a child will not be admitted to the FCCH without a statement from a health care provider; and • Written notification to parents when children may have been exposed to a reportable communicable disease. 5.3.2 Daily Health Check Upon arrival into the FCCH staff shall observe each child for symptoms of communicable disease and signs of injuries. Any obvious injuries shall be documented along with any comments from the parent pertaining to the child’s condition. This documentation shall be maintained in the child’s file for a minimum of 365 days. 5.3.3 Exclusion of Children from Care 5.3.3.1 The FCCP shall follow the exclusion policies as set forth in Signs and Symptoms of Illness Chart (see Appendix A). 5.3.3.2 The Signs and Symptoms of Illness Chart document shall be available for staff and parents to read. 5.3.3.3 A child may be excluded from care if, in the opinion of the FCCP, he/she is too ill to participate in usual daily activities. 5.3.4 Responding to Children Who Become Ill 5.3.4.1 The FCCP shall ensure that a comfortable space, separate from other children, can be created for children who are exhibiting symptoms of illness until their parent arrives to pick them up. The separate area shall be appropriately furnished to allow the child to sleep or rest, which shall not be located in the kitchen or toilet area. 5.3.4.2 All items used by an ill child shall be cleaned and disinfected prior to being used by another child. 5.3.4.3 Staff shall ensure that an ill child is supervised. 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: Section 13 - Health Standards: 13.1 Staff shall use universal precautions when in contact with all blood and other body fluids that are potentially infectious (saliva, nose and eye discharges, vomit, urine, feces) by following the procedures listed below: • wear non-porous latex or vinyl gloves unless the fluid can be easily contained by the material used to clean it up (tissue for noses, etc.) being careful not to get any of the fluid being handled into eyes, nose, mouth or open sores/cuts • clean and then disinfect any surfaces coming into contact with body fluids using a bleach dilution according to manufacturer’s instructions for disinfecting • dispose of contaminated materials and store launderable items in securely sealed containers or bags • wash hands with soap and water. 13.2 Children shall have free access to toilet facilities. 13.3 Devices that diffuse or emit airborne chemicals, such as anti-pest strips, ozone generators, plug-in air fresheners, nail polish, nail polish remover, and aerosol sprays shall not be used in the Afterschool Child Care Program. 13.4 Children shall have access to clean, sanitary drinking water which is readily available in indoor and outdoor areas throughout the day. Conditions for Exclusion 13.5 Children and Staff may be excluded if in the opinion of the Program Administrator or Site Director, designee or medical professional the individual is too ill to participate. 13.6 Staff shall follow the exclusion policies as set forth in the document Signs and Symptoms of Illness Chart (Adapted) which shall be made available to parents and Staff, and posted where parents and Staff can read it. (See Appendix A). Hand Washing 13.7 Staff and children shall all wash their hands with soap under warm, running water: • before they eat or prepare food • after they use the toilet • after handling animals • after playing outside. 13.8 Staff shall also wash their hands with soap under running water: • before and after giving medication • after eating • after cleaning up after a sick child or injured child • after handling items soiled with blood or body fluids. 13.9 Hand sanitizers shall only be used when running water is not available such as during outdoor play or on field trips. Cleaning Practices 13.10 All toys and indoor equipment shall be cleaned at least monthly. 13.11 Toilets and sinks shall be cleaned and disinfected daily. 13.12 Bathrooms shall be cleaned daily. 13.13 Shelves and doorknobs shall be washed and disinfected weekly so as to minimize the spread of illness. 13.14 The tops of tables used for eating snacks or meals or other surfaces coming into contact with food shall be washed and sanitized prior to eating. 13.15 Hard floors and carpets shall be cleaned at least daily. Carpets shall be vacuumed daily. Carpets shall be hot water extracted at least twice per year. 13.16 Sanitizers and disinfectants including bleach shall be registered with US Environmental Protection Agency. If environmentally preferable cleaning products are used, these products shall comply with 18 V.S.A. Chapter 39. 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: Rule 3.4.4.1: The program director shall maintain a complete and up-to-date enrollment file on-site for each child enrolled in the CBCCPP. A complete file shall contain, at minimum, the following information: • Child’s immunization record or Vermont Department of Health approved exemption document as required in the rules in section 5.1.3 of these regulations. Rule 5.1.3: Immunizations: The licensee shall maintain documentation in the child’s file of each child’s current immunization status. • Immunization records shall include the immunization administered and the date of each immunization. The immunization record should be updated after each additional immunization has been received. • If an enrolled child is in the process of complying with immunization requirements in accordance with the Vermont recommended immunization schedule, documentation in the child’s file shall include the required Vermont Department of Health form. • If a child has not had a required immunization due to a Vermont allowed exemption, documentation in the child’s file shall include the required Vermont Department of Health form. Rule 5.1.4: The licensee shall submit a Vermont Child Care Immunization Report at least once every 365 days to the Vermont Department of Health, Immunization Office as required by 18 V.S.A. §§ 1120 - 1129. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 3.3.4.1 The FCCP shall maintain a complete and up-to-date enrollment file on-site for each child enrolled in the FCCH. A complete file shall contain, at minimum, the following information: • Child’s immunization record or Vermont Department of Health approved exemption document as required in the rules in section 5.1.3 of these regulations 5.1.3 Immunizations: The FCCP shall maintain documentation in the child’s file of each child’s current immunization status. • Immunization records shall include the immunization administered and the date of each immunization. The immunization record should be updated after each additional immunization has been received. • If an enrolled child is in the process of complying with immunization requirements in accordance with the Vermont recommended immunization schedule, documentation in the child’s file shall include the required Vermont Department of Health form. • If a child has not had a required immunization due to a Vermont allowed exemption, documentation in the child’s file shall include the required Vermont Department of Health form. 5.1.4 The FCCP shall submit a Vermont Child Care Immunization Report at least once every 365 days to the Vermont Department of Health, Immunization Office as required by 18 V.S.A. §§ 1120 - 1129. iii. All CCDF-eligible licensed in-home care. Provide the standard: N/A [x] Not applicable. iv. All CCDF-eligible license-exempt center care. Provide the standard: 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: 4.3 A child shall be admitted in an Afterschool Child Care Program when there is on file on the premises, either in hard copy or accessible and printable electronic format documentation in the child’s file of each child’s current immunization status. • Immunization records shall include the immunization administered and the date of each immunization. • If an enrolled child is in the process of complying with immunization requirements in accordance with the Vermont recommended immunization schedule, documentation in the child’s file shall include the required Vermont Department of Health form. • If a child has not had a required immunization due to a Vermont allowed exemption, documentation in the child’s file shall include the required Vermont Department of Health form. This is documented in the Administrative Memo, issued by CDD, effective October 1, 2024. 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: 5.4.2 Safe Sleep Practices for Infants Under Twelve (12) Months of Age 5.4.2.1 Infants shall be allowed to nap when tired. 5.4.2.2 Infants shall always be placed on their backs to sleep. 5.4.2.3 Staff shall ensure that infants sleep in cribs or port-a-cribs. Infants shall not be placed to sleep on soft surfaces, such as a couch or sofa, pillow, quilts, sheepskins, or blankets. Infants shall not be placed in car seats, swings, high chairs, jumping chairs or similar equipment for sleep. A child that falls asleep in this type of equipment shall be gently transferred to a crib or port-a-crib as soon as feasible. 5.4.2.4 Each crib and port-a-crib shall have a firm, tight-fitting mattress covered by a tight-fitting crib sheet. 5.4.2.5 Soft objects, toys or loose bedding shall not be used in infants’ sleep areas. Soft or loose bedding includes bumper pads, pillows, quilts, comforters, sheepskins, blankets, flat sheets, cloth diapers, and bibs. Infants shall not be swaddled for sleep. 5.4.2.6 Clothing sacks or similar clothing designed for safe sleep may be used. Bibs, necklaces, and garments with ties or hoods shall be removed from the child prior to placing the child in the crib or port-a-crib. 5.4.2.7 No positioning devices shall be used unless required by the child’s health care provider. Instructions for the use of any such device shall be kept in the child’s file in writing from the child’s health care provider. 5.4.2.8 Infants shall not be placed in cribs or port-a-cribs with bottles. Pacifiers are permitted in cribs and port-a-cribs with parental permission. Pacifiers may not have cords or clips that may pose a strangulation risk. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 5.4.2 Safe Sleep Practices for Infants Under Twelve (12) Months of Age 5.4.2.1 Infants shall be allowed to nap when tired. 5.4.2.2 Infants shall always be placed on their backs to sleep. 5.4.2.3 The FCCP and staff shall ensure that infants sleep in cribs or port-a-cribs. Infants shall not be placed to sleep on soft surfaces, such as a couch or sofa, pillow, quilts, sheepskins or blankets. Infants shall not be placed in car seats, swings, high chairs, jumping chairs or similar equipment for sleep. A child that falls asleep in this type of equipment shall be gently transferred to a crib or porta-crib as soon as feasible. 5.4.2.4 Each crib and port-a-crib shall have a firm, tight-fitting mattress covered by a tight-fitting crib sheet. 5.4.2.5 Soft objects, toys or loose bedding shall not be used in infant sleep areas. Soft or loose bedding includes: bumper pads, pillows, quilts, comforters, sheepskins, blankets, flat sheets, cloth diapers, and bibs. Infants shall not be swaddled for sleep. 5.4.2.6 Clothing sacks or similar clothing designed for safe sleep may be used. Bibs, necklaces, and garments with ties or hoods shall be removed from the child prior to placing the child in the crib or port-a-crib. 5.4.2.7 No positioning devices shall be used unless required by the child’s health care provider. Instructions for the use of any such device shall be kept in the child’s file in writing from the child’s health care provider. 5.4.2.8 Infants shall not be placed in cribs or portacribs with bottles. Pacifiers are permitted in cribs and port-a-cribs with parental permission. Pacifiers may not have cords or clips that may pose a strangulation risk 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: This is not applicable for ASP because they do not serve 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: CBCCPP providers are required to maintain records pertaining to all medications administered to children either in the child’s file or a in a separate medication administration log book and kept for 365 days from the date the medication was given. Additionally, Vermont has rules that guide CBCCPPs on the safe administration of medication which include: the program director shall develop and consistently implement a written policy and plan regarding the administration of medication to children; the program director shall ensure that only staff, who have completed a training course approved by the Division, administer medication in the CBCCPP; all prescription medication administered by staff shall be in its original container, properly labeled for the child, and administered prior to the expiration date on the container; all non-prescription medication administered by staff shall be labeled with the child’s name and be in its original container with directions for its administration. It must be administered prior to the expiration date on the container. Any deviations from the label’s instructions shall be in writing from the child’s health care provider; a record of the administration of all medications shall be made including medication dosage, time of administration, name of staff administering, and any adverse effects observed. These records shall be maintained for 365 days from the start date of medication administration and may be kept in the child’s file or in a medication administration log; unused medication shall be returned to the parent when no longer needed by the child; insect repellent, sunscreen and non-prescription diaper ointment are not considered medications; all medication and non-medications shall be securely stored and inaccessible to children; prescription rescue medication, such as rescue inhalers, epinephrine pen ("epi pen"), and seizure medication must be kept immediately accessible for use in cases of emergency. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Vermont has rules that guide FCCPs on the administration of medication which include: the FCCP shall develop and consistently implement a written policy and plan regarding the administration of medication to children; the FCCP are required tol ensure that only staff, who have completed a training course approved by the Division, administer medication in the FCCH; the FCCP shall ensure that parents are notified if a substitute is not approved to administer medication; all prescription medication administered by staff shall be in its original container, properly labeled for the child, and administered prior to the expiration date on the container; all non-prescription medication administered by staff is required to be labeled with the child’s name and be in its original container with directions for its administration. It must be administered prior to the expiration date on the container. Any deviations from the label’s instructions shall be in writing from the child’s health care provider; a record of the administration of all medications is required to be made including medication dosage, time of administration, name of staff administering, and any adverse effects observed. These records are required to be maintained for 365 days from the start date of medication administration and may be kept in the child’s file or in a medication administration log; unused medication shall be returned to the parent when no longer needed by the child; insect repellent, sunscreen and non-prescription diaper ointment are not considered medications; all medication and non- medications shall be securely stored and inaccessible to children; prescription rescue medication, such as rescue inhalers, epi pen, and seizure medication must be kept immediately accessible for use in cases of emergency. 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: Vermont has rules that support the safe administration of medication in ASPs that include: all medications shall be inaccessible to children but immediately accessible to designated staff; all prescription medications shall be kept in the original containers and be clearly labeled with children’s name, dosage, medication name, and schedule of administration; the program shall maintain onsite a record of all prescribed medications given which include the name of the medication(s), date, dosage, and time given. 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: 3.4.6.3 The licensee shall maintain records pertaining to all medications administered to children as required in the rule 5.6.7 of these regulations. These may be kept in children’s files or in a separate medication administration log book. Medication records must be kept for a minimum of 365 days from the date the medication was given. 5.6 Administration of Medication 5.6.1 The program director shall develop and consistently implement a written policy and plan regarding the administration of medication to children. 5.6.2 The program director shall ensure that only staff, who have completed a training course approved by the Division, administer medication in the CBCCPP. With written parental permission, a school age child may self-medicate under the direct supervision of staff who meets the training requirement within this rule. 5.6.3 Medication or herbal/folk remedies shall not be administered to a child unless the CBCCPP has received written permission from the child’s parents for each medication given. 5.6.4 Written permission from parents to administer medication must include all of the following information for each prescription and non-prescription medication administered to children: • Name of the child; • Child’s date of birth; • Any medication allergies; • Name of medication; • Dosage to be given; • Time when medication is to be given; • Route of administration (mouth, ear, nose, topical, inhalation); • Reason for the medication; • Start and end dates for administration of the medication; and • Any special instructions. 5.6.5 All prescription medication administered by staff shall be in its original container, properly labeled for the child, and administered prior to the expiration date on the container. 5.6.6 All non-prescription medication administered by staff shall be labeled with the child’s name and be in its original container with directions for its administration. It must be administered prior to the expiration date on the container. Any deviations from the label’s instructions shall be in writing from the child’s health care provider. 5.6.7 A record of the administration of all medications shall be made including medication dosage, time of administration, name of staff administering, and any adverse effects observed. These records shall be maintained for 365 days from the start date of medication administration and may be kept in the child’s file or in a medication administration log. 5.6.8 Un-used medication shall be returned to the parent when no longer needed by the child. 51 5.6.9 Insect repellent, sunscreen and non-prescription diaper ointment are not considered medications. Written parental permission shall be obtained prior to the application of insect repellent, sunscreen and non- prescription diaper ointment. This parental permission shall specify the product but may permit application as needed over a span of time. Such permission shall be updated at least once every 365 days and shall be maintained in each child's file. Children younger than school age shall not apply any of these items independently. School age children may apply these items independently with supervision. 5.6.10 All medication and non-medications described in the rule 5.6.9 of these regulations shall be securely stored and inaccessible to children. 5.6.11 Prescription rescue medication, such as rescue inhalers, epinephrine (epi) pen, and seizure medication must be kept immediately accessible for use in cases of emergency. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 3.3.6.3 The FCCP shall maintain records pertaining to all medications administered to children as required in the rule 5.6.8 of these regulations. These may be kept in children’s files or in a separate medication administration log book. Medication records must be kept for a minimum of 365 days from the date the medication was given. 5.6 Administration of Medication 5.6.1 The FCCP shall develop and consistently implement a written policy and plan regarding the administration of medication to children. 5.6.2 The FCCP shall ensure that only staff, who have completed a training course, approved by the Division, administer medication in the FCCH. 5.6.3 The FCCP shall ensure that medication or herbal/folk remedies is not administered to a child unless the FCCH has received written permission from the child’s parents for each medication given. 5.6.4 The FCCP shall ensure that parents are notified if a substitute is not approved to administer medication. 5.6.5 The FCCP shall ensure that written permission from parents to administer medication must include all of the following information for each prescription and non-prescription medication administered to children: • Name of the child; • Child’s date of birth; • Any medication allergies; • Name of medication; • Dosage to be given; • Time when medication is to be given; • Route of administration (mouth, ear, nose, topical, inhalation); • Reason for the medication; • Start and end dates for administration of the medication; and • Any special instructions. 5.6.6 The FCCP shall ensure that all prescription medication is in its original container, properly labeled for the child, and administered prior to the expiration date on the container. 5.6.7 The FCCP shall ensure that all non-prescription medication shall be labeled with the child’s name and be in its original container with directions for its administration. It must be administered prior to the expiration date on the container. Any deviations from the label’s instructions shall be in writing from the child’s health care provider. 5.6.8 The FCCP shall ensure that there is a record of the administration of all medications including medication dosage, time of administration, name of staff administering, and any adverse effects observed. These records shall be maintained for 365 days from the start date of medication administration, and may be kept in the child’s file or in a medication administration log. 5.6.9 The FCCP shall ensure that un-used medication is returned to the parent when no longer needed by the child. 5.6.10 Insect repellent, sunscreen and non-prescription diaper ointment are not considered medications. The FCCP shall ensure that written parental permission is obtained prior to the application of insect repellent, sunscreen and non- prescription diaper ointment. This parental permission shall specify the product but may permit application as needed over a span of time. Such permission shall be updated at least once every 365 days and shall be maintained in each child's file. Children younger than school age shall not apply any of these items independently. School age children may apply these items independently with supervision. 5.6.11 The FCCP shall ensure that all medication and non-medications described in the rule 5.6.10 of these regulations shall be securely stored and inaccessible to children. 5.6.12 Prescription rescue medication, such as rescue inhalers, epinephrine (epi) pen, and seizure medication, must be kept immediately accessible for use in cases of emergency. 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: Medications and Topical Applications 13.17 All medications shall be inaccessible to children but immediately accessible to designated Staff. A child with parent permission to self-medicate may do so under direct Staff supervision. 13.18 Written parental permission shall be obtained before administering any medication. The permission statement shall include the name of the child, name of the medication, dosage, the date and time to be given and how the medication is to be given (mouth, ear, etc.). 13.19 No Staff, employee, or volunteer shall administer medicines, drugs or herbal or folk remedies that affect behavior except as prescribed by a health care provider with specific written instructions and parental permission. 13.20 All prescription medications shall be kept in the original containers and be clearly labeled with children’s name, dosage, medication name, and schedule of administration. 13.21 The program shall maintain onsite a record of all prescribed medications given which include the name of the medication(s), date, dosage, and time given. 13.22 Written general permission for over-the-counter medications shall be obtained from parents for giving oral medication to a child. Parents shall be verbally notified before oral medications are given. 13.23 Prior to supervised application, written general permission shall be obtained from parents prior to the application of non-prescription medications and products, such as ointments, creams, sunscreens, tick and insect repellants, and other topically applied ointments and lotions. Such general permission shall be updated annually. 13.24 Direct supervision is required for all topical applications applied by children. 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: CBCCPP directors shall maintain complete and up-to-date enrollment files on-site for each child enrolled in the CBCCPP. A complete file shall contain, at minimum, the following information: A description of any special medical, developmental, emotional, or educational needs of the child including allergies, existing illnesses or injuries, previous serious illnesses or injuries, and any prescribed medication including those for emergency situations. Additionally, the program director shall develop and implement a written policy concerning meals and snacks. This policy shall be provided to all parents at the time of enrollment and include: a description of all food services provided; usual time of snacks and meals; policies and procedures related to food allergies, religious dietary requirements, and other special needs; and policies and procedures for safe eating habits. ii. All CCDF-eligible licensed family child care homes. Provide the standard: The FCCP shall maintain a complete and up-to-date enrollment file on-site for each child enrolled in the FCCH. A complete file shall contain, at minimum, the following information: A description of any special medical, developmental, emotional or educational needs of the child including allergies, existing illnesses or injuries, previous serious illnesses or injuries and any prescribed medication including those for emergency situations. Additionally, the FCCP shall develop and implement a written policy concerning meals and snacks. This policy shall be provided to all parents at the time of enrollment and include: a description of all food services provided; usual time of snacks and meals; policies and procedures related to food allergies, religious dietary requirements and other special needs; and policies and procedures for safe eating habits. 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: In ASPs when a child has a medically diagnosed food allergy, a special care plan from the child’s health care provider shall be readily available and describe steps to take in the event of exposure. Children with food sensitivities or allergies shall be offered an alternative snack. All Staff are required to be aware of a child’s food allergy and of the emergency steps to be taken should an allergic child be exposed to the problem food. 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: 3.4.4.1 The program director shall maintain a complete and up-to-date enrollment file on-site for each child enrolled in the CBCCPP. A complete file shall contain, at minimum, the following information: • A description of any special medical, developmental, emotional, or educational needs of the child including allergies, existing illnesses or injuries, previous serious illnesses or injuries and any prescribed medication including those for emergency situations; 5.11.1.1 The program director shall develop and implement a written policy concerning meals and snacks. This policy shall be provided to all parents at the time of enrollment as required in the rule 4.7 of these regulations. It shall include: • Policies and procedures related to food allergies, religious dietary requirements, and other special needs; 5.11.8.2 The program director shall ensure that if the parent requests modification of basic meal patterns due to a child’s medical need such as food allergies or food intolerance that the parent provides the CBCCPP with written documentation from the child’s health care provider authorizing the modification 6.2.6.3 When children are eating, staff shall be positioned to allow for visual supervision of all children and shall be able to physically respond immediately to any child that may be choking. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 3.3.4.1 The FCCP shall maintain a complete and up-to-date enrollment file on-site for each child enrolled in the FCCH. A complete file shall contain, at minimum, the following information: • A description of any special medical, developmental, emotional or educational needs of the child including allergies, existing illnesses or injuries, previous serious illnesses or injuries and any prescribed medication including those for emergency situations; 5.11.1.1 The FCCP shall develop and implement a written policy concerning meals and snacks. This policy shall be provided to all parents at the time of enrollment as required in the rule 4.7 of these regulations. It shall include: • A description of all food services provided; • Usual time of snacks and meals; • Policies and procedures related to food allergies, religious dietary requirements and other special needs; and • Policies and procedures for safe eating habits 5.11.8.2 The FCCP shall ensure that if the parent requests modification of basic meal patterns due to a child’s medical need such as food allergies or food intolerance that the parent provides the FCCP with written documentation from the child’s health care provider authorizing the modification. 6.2.4.5 When children are eating, the FCCP and/or staff shall be positioned to allow for visual supervision of all children and shall be able to physically respond immediately to any child that may be choking. 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: 15.6 When a child has a medically diagnosed food allergy, a special care plan from the child’s health care provider shall be readily available and describe steps to take in the event of exposure. 15.7 Children with food sensitivities or allergies shall be offered an alternative snack. All Staff and Volunteers shall be aware of a child’s food allergy and of the emergency steps to be taken should an allergic child be exposed to the problem food. 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: 5.10 Physical Environment and Safety 5.10.1 General Safety of Building and Grounds 5.10.1.1 General Safety: The licensee shall ensure the physical facilities of the CBCCPP, grounds, equipment, and toys present no hazard to the health, safety, and well-being of the children. 5.10.1.1.1 The licensee shall ensure that children are protected from electrical outlets, such as by using protective covers, tamper- proof outlets, or other devices manufactured for this purpose. 5.10.1.1.2 Children shall be protected from choking hazards presented by cords on window coverings, electric or electronic appliances or equipment and telephones. 5.10.1.1.3 Furniture and equipment shall be sturdy. Furniture and equipment that present a tipping or falling hazard shall be secured. 5.10.1.1.4 Closet and bathroom doors that can be locked shall have an unlocking device readily accessible to staff. No locking or fastening device shall be used on the outside of the door that would prevent free escape. 5.10.1.1.5 Children younger than three (3) years of age shall not have unsupervised access to small toys and objects that pose a choking hazard, deemed by the Consumer Product Safety Commission (CPSC) as objects being smaller than their Choke Test Cylinder (1.25 inches in diameter and 2.25 inches in length). 5.10.1.1.6 Sharp objects shall be kept out of children’s reach unless used for a planned activity and closely supervised by an adult. 5.10.1.2 Fire Safety 5.10.1.2.1 The licensee shall ensure that the CBCCPP is in compliance with Vermont Division of Fire Safety rules at all times. This includes but is not limited to: • Complying with Vermont Division of Fire Safety inspection reports; 54 • Having regular fire systems inspected with violations identified during the inspection noted as corrected; and • Having fire extinguishers tagged with valid inspection tags. 5.10.1.2.2 Staff shall be physically able to assist in exiting all of the children present at one (1) time in the case of a fire. 5.10.1.2.3 Staff shall be familiar with the use and handling of a fire extinguisher. 5.10.1.3 Plumbing, Water and Sewage 5.10.1.3.1 The licensee shall ensure that the CBCCPP plumbing is kept in good working condition. 5.10.1.3.2 The licensee shall ensure that the CBCCPP meets all applicable plumbing codes as established by the Vermont Division of Fire Safety. 5.10.1.3.3 The licensee shall ensure that the CBCCPP is in compliance with applicable rules from the Department of Environmental Conservation at all times. 5.10.1.3.4 The licensee shall ensure that any outlets used for drinking, cooking purposes, and brushing teeth is potable by meeting Vermont's legally enforceable drinking water standards at all times. Bottled water for drinking, cooking purposes, and brushing teeth shall be provided until such time as at least one (1) outlet meets Vermont's legally enforceable drinking water standards and is in compliance with CBCCPP rule 5.10.2.1.2. 5.10.1.4 Trash, Recycling and Composting 5.10.1.4.1 Garbage and compost shall be in containers that are securely covered. 5.10.1.4.2 Children shall only access compost containers when under direct supervision of staff. 5.10.1.4.3 Recycling materials shall be rinsed and stored in a manner that does not attract insects, rodents, or other pests that pose a safety or health hazard for children. 5.10.1.4.4 Recycling items that pose a safety hazard for children such as metal cans shall be inaccessible to children. 5.10.1.4.5 Garbage, recycling and compost shall be removed daily from rooms used by children. 5.10.1.4.6 Garbage and recycling shall be removed from the premises on a regular basis but not less than once every fourteen (14) days. 5.10.1.4.7 Compost shall be removed from the premises on a regular basis but not less than once every (7) days; unless a contained composter is constructed outside, away from where children play, and shall be maintained in a manner that does not pose any safety or health risks to children. 5.10.1.5 Ventilation, Heating and Cooling 5.10.1.5.1 Any room in the CBCCPP used by the children shall be maintained at a minimum temperature of 65°F and a maximum of 85°F at one (1) foot above floor level. Areas used by infants shall be kept at least 68°F at floor level. 5.10.1.5.2 Adequate ventilation shall be provided indoors during hot weather. All rooms occupied by children shall have at least one (1) window that opens and is properly screened, unless artificial ventilation is used. 5.10.1.5.3 A window that opens and is properly screened or an operating electric exhaust fan shall ventilate each bathroom to the outside air. 5.10.1.5.4 The use of unvented kerosene heaters is prohibited. 5.10.1.5.5 The licensee shall ensure that all heating and cooling equipment is safely shielded to prevent injury to children and approved for use by the Vermont Division of Fire Safety. 5.10.1.5.6 The licensee shall ensure that screens used on all windows, doors or other openings to the outside are in good repair. Doors that remain open to the outside, excluding fire doors, shall have screens. 5.10.1.5.7 The licensee shall ensure that air conditioners, electric fans and 56 heaters, including all floor or window fans are inaccessible to children when they pose a health or safety hazard. If they are mounted indoors or outdoors, they shall be securely attached. 5.10.1.6 Lighting 5.10.1.6.1 The licensee shall ensure that the CBCCPP has sufficient natural and artificial lighting in all areas where care and education is provided to allow children to see clearly to reduce the risk of injury and allow staff to supervise the children visually. 5.10.1.6.2 The licensee shall ensure that parking areas, pedestrian walkways, and other exterior portions of the premises used by children, parents and staff members after dark are illuminated. 5.10.1.7 Hazardous Finishes and Surfaces The licensee shall ensure that all surfaces and finishes in the CBCCPP and premises are safe and non-hazardous. 5.10.1.8 Childhood Lead Poisoning Prevention The licensee shall comply with the requirements of 18 V.S.A. Chapter 38 Vermont Lead Law and shall ensure that Essential Maintenance Practices (EMP) is performed. This includes but is not limited to protecting children from peeling or chipping paint, and dust build up from the friction of moving doors or windows. 5.10.1.9 Use of Pesticides 5.10.1.9.1 The licensee shall ensure that pesticide applications shall be used only when other pest prevention and control measures fail. Pesticides shall not be used to control pests for aesthetic reasons alone. Whenever possible the CBCCPP shall use pesticides of least risk. Only pesticides registered with the Vermont Department of Agriculture, Food and Markets shall be used, and be documented in administrative records as required in the rule 3.4.6.4 of these regulations. 5.10.1.9.2 The licensee shall ensure that all contracted pesticide applications shall be applied only by commercial applicators certified by the Vermont Agency of Agriculture, Food and Markets. 5.10.1.9.3 The licensee shall ensure that parents of children and staff are notified in writing five (5) days prior to any planned application of pesticides. Notice shall include the site of the planned application, pests to be treated for, and proposed pesticide to be used. 5.10.1.9.4 The licensee shall ensure that application of pesticides shall only be made when children are not present, that there is ample time to ventilate indoor areas after application, and that surfaces that can be touched or mouthed by children are not treated or are thoroughly cleaned and sanitized after an application. If outdoor applications of pesticides are made while children are present, children shall not be permitted in those areas until recommended by the manufacturer’s instructions and/or the applicator’s instructions, if applied by a pest control professional. 5.10.1.9.5 The licensee shall ensure that pest baits are not to be used unless in childproof bait boxes. Bait boxes shall be inaccessible to children. 5.10.1.11 Use of Tobacco, Alcohol and Illegal Drugs 5.10.1.11.1 The licensee and the program director shall ensure that the use of tobacco and tobacco substitutes (including e-cigarettes), alcohol and illegal drugs is prohibited at the CBCCPP (both indoor and outdoor environments used by children) and also in any vehicle used to transport children. 5.10.1.11.2 No person in the CBCCPP shall use or be under the influence of alcohol or drugs while present at the CBCCPP. Medication prescribed by a physician or over the counter medication that does not impair the ability of staff to adequately supervise and care for the children may be taken. 5.10.1.12 Firearms and Other Weapons The licensee shall ensure no firearms and other weapons; including hunting knives, archery equipment, and weapon accessories such as ammunition are present at the CBCCPP. 5.10.1.13 Telephones 5.10.1.13.1 The licensee shall ensure that the CBCCPP has an operating telephone that is present and in service at all times children are present. The telephone number shall be provided to the Division and the parents of children that are enrolled. If an answering machine is used, staff shall check it every fifteen (15) minutes to ensure parents are able to communicate with staff during the day. 5.10.1.13.2 The program director shall ensure that a list of the following phone numbers is posted or located near the phone along with 911 and the directions to the CBCCPP: • Police; • Fire; • Ambulance/Rescue Squad; • Poison Center (1-800- 222-1222); • Child Development Division; • Interpreter Service (when needed for enrolled children); and • Child Abuse Hotline 800 number. Child specific information: • Parental contacts; • Emergency contacts; and • Doctor contact information. 5.10.1.14 Pets 5.10.1.14.1 The program director shall ensure that animals present at the CBCCPP do not present a danger or health hazard to the children and staff. 5.10.1.14.2 The program director shall ensure that any animals or pets present at or brought into the CBCCPP are vaccinated as prescribed by law with documentation maintained at the CBCCPP. 5.10.1.14.3 Animals present in the CBCCPP shall be maintained and cared for in a safe and sanitary manner that does not pose a health hazard for children or staff. 5.10.1.14.4 Animals shall not be allowed on surfaces where food or drink is prepared or served. 5.10.1.15 Disruptive or Dangerous Behavior The licensee shall prohibit any person, including but not limited to parents, staff, partner staff or volunteers, from the CBCCPP and property, when his/her presence or behavior disrupts the program, distracts the staff from their responsibilities, intimidates or promotes fear among the children and/or staff, or when there is reason to believe that his/her actions or behavior presents a risk of harm to children present. 5.10.2 Kitchen 5.10.2.1 General Kitchen Provisions 5.10.2.1.1 The licensee shall ensure that all on-site meal preparation shall have approval by the Division. The on-site preparation of snacks only does not require approval by the Division. 5.10.2.1.2 The food preparation surfaces shall not be used for other activities when food or drink is being prepared or served. A bathroom sink shall not be used for food preparation. 5.10.2.1.3 The kitchen and all food preparation, storage and serving areas, and utensils shall be kept clean, sanitary, and free of insects, rodents, dust, and other contaminants. 5.10.2.1.4 The kitchen shall have at least one (1) sink with a single spigot with hot and cold running water. 5.10.2.1.5 Children shall be permitted in the meal preparation areas only when under the direct supervision of staff. 5.10.2.2 Kitchen Equipment, Dishwashing and Surfaces 5.10.2.2.1 All dishes, cups and glasses used by the children shall be free from chips, cracks, or other defects. 5.10.2.2.2 The kitchen shall contain the necessary operable equipment to prepare, store, serve and clean-up all meals and snacks for children and adults. All kitchen machinery and equipment shall be constructed and arranged to be easily cleanable and shall be in good repair. 5.10.2.2.3 If the CBCCPP uses a dishwasher, the dishwasher shall be installed and operated according to the manufacturer’s recommendations. 5.10.2.2.4 When a dishwasher is not available, and single service items are not used for food service, the licensee shall ensure there shall be three (3) compartments with a drain board set-up for cleaning dishes. A four (4) step process shall include dishwashing, rinsing, sanitizing, and air drying of all dishes and utensils. • Dishes shall be washed with soap in hot clean water. • Dishes shall be rinsed in hot clean water. • Dishes shall then be immersed for at least ten (10) seconds in a sanitizing rinse. The sanitizing rinse shall be EPA registered or a diluted bleach and water mixture. If using bleach, staff shall follow the manufacturer’s instructions when mixing for this purpose. • Dishes shall be air dried. 5.10.2.2.5 All surfaces used for food preparation shall be easily cleanable and non- porous. 5.10.2.2.6 All single service items including cups, plates, spoons, forks, and other single service containers and utensils shall only be used once. 5.10.2.3 Storage 5.10.2.3.1 The CBCCPP shall have a refrigerator to keep perishable foods at 40°F or colder and a freezer to maintain frozen food at 0°F or colder. Food stored in the refrigerator shall be stored in a manner that allows the free circulation of cool air. All refrigerated foods shall be covered. 5.10.2.3.2 The CBCCPP shall ensure that perishable food provided by home is stored in insulated lunch boxes with at least two (2) ice packs. The CBCCPP shall ensure that perishable food provided by home is stored in a refrigerator as specified in the rule 5.10.2.3.1 of these regulations when the perishable food is not stored in an insulated lunch box, and/or not stored with at least two (2) ice packs. 5.10.2.3.3 All food shall be stored in containers that are dated. Food items used by or intended for specific children shall be plainly labeled. 5.10.2.3.4 All utensils, equipment and food shall be stored in a clean, dry place free from insects, rodents, dust and other contamination and shall be handled in such a manner as to prevent contamination. • If stored openly, all containers and utensils shall be stored eighteen (18) inches off of the floor; • Dishes shall be stored in a closed space; • Utensils shall be covered or inverted when not in use; and • Single service items shall be purchased and stored in sanitary cartons. 5.10.2.3.5 Food items shall be stored separately from cleaning materials. 5.10.2.4 Food Safety 5.10.2.4.1 The program director shall ensure that individuals who are ill do not prepare food for children and are not present in the food preparation area and that individuals with open sores that cannot be covered do not handle or prepare food. 5.10.2.4.2 Foods shall be cooked to proper temperatures and shall be served promptly after preparation. All reheated food shall be cooked to at least 165°F. Hot foods shall be maintained at temperatures not less than 135°F and cold foods shall be maintained at temperatures not more than 41°F. 5.10.2.4.3 All readily perishable food shall not be kept at room temperature for more than one (1) hour while being prepared or served. Readily perishable food shall be stored in the refrigerator in a covered shallow pan. 5.10.2.4.4 Frozen foods shall be thawed in the refrigerator, under cold running water or defrosted in the microwave oven. 5.10.2.4.5 All unsafe, contaminated food shall be disposed of promptly. Swelled, rusty, dented or punctured canned food or drink shall not be consumed. 5.10.2.4.6 Fresh fruits and vegetables shall be thoroughly washed before being served. 5.10.2.4.7 Food that has been served to a child or adult shall be disposed of if not eaten. Once food has been served, it shall not be re-used, served to a different child, or stored, except as compost. 5.10.3 Outdoor Play Area 5.10.3.1 General Outdoor Play Area Provisions 5.10.3.1.1 There shall be a safe outdoor play area with a minimum of seventy-five (75) square feet per child to provide opportunities for vigorous play and large muscle activity on the premises or within a safe walking distance of the CBCCPP approved by the Division. 5.10.3.1.2 The outdoor play area shall include a provision for shade. 5.10.3.1.3 The play area shall be fenced or otherwise protected from traffic and other hazards. Fencing or natural barriers, such as hedges or other clear land boundaries, shall prevent children from exiting and allow for safe supervision of outdoor play. 5.10.3.1.4 If fencing is used, it shall be sturdy, safe, and reinforced to give support, constructed to discourage climbing, and shall not prevent visual supervision of children by staff. 5.10.3.1.5 Fencing installed after the effective date of these regulations shall: • Be a minimum of four (4) feet in height with openings no larger than 3.5 inches; • Equipped with gates with self-closing and self-latching mechanisms; and • Include at least two (2) exits with one (1) that does not lead into the CBCCPP. 5.10.3.1.6 The outdoor play area shall be free of dumpsters, uncovered trash cans, highly flammable materials, standing pools of water and other hazards. Staff shall inspect the outdoor play area before children begin to play to make sure there are no hazards present such as, but not limited to, animal feces, litter, adult tools, or other items that might injure a child. 5.10.3.2 Play Equipment and Riding Toys 5.10.3.2.1 All outdoor play equipment shall be sturdy, safe, clean and free from rough edges, sharp corners, pinch and crush points, splinters, and exposed bolts. • To prevent entrapment, no openings in equipment shall be between 3.5 and nine (9) inches. • Chains on swings shall have protective coverings and swing seats shall be made of soft materials with no sharp edges. 5.10.3.2.2 Equipment shall be arranged so that children playing on one (1) piece of equipment will not interfere with children playing on another piece of equipment. 5.10.3.2.3 The licensee shall ensure that large outdoor play equipment is anchored firmly in accordance with manufacturers’ specifications, is not located on concrete or asphalt surfaces and is placed so as to accommodate manufacturers’ specifications for use zones. 5.10.3.2.4 Sandboxes shall be maintained in a safe and sanitary manner. 5.10.3.2.5 Bicycles, tricycles, scooters, and other riding toys shall be the correct size for the child using the riding toy, and riding toys shall be maintained in good condition. • Tricycles shall not have spokes, and tricycles and bicycles with chains shall have chain guards. • Staff shall ensure that all children wear properly fitting safety helmets while riding outside on bicycles and using scooters. 5.10.3.3 Safe Use Zones For all play equipment that is thirty (30) inches or higher from the ground, including climbing equipment, slides, swings and other similar equipment, the licensee shall ensure that the surface under and around the equipment, including recommended use zones, is of approved resilient material that protects children if they fall. • Materials in the use zone shall consist of wood chips, pea stone, mulch, engineered wood fibers, sand, safety-tested shredded or rubber like material or rubber mats designed for protective cushioning; • Materials used in the use zone shall follow the recommendations listed in the most recent publication of U.S. Consumer Product Safety Commission’s Public Playground Safety Handbook regarding critical depth of tested materials determined by the height of the highest climbing surface of the equipment; • Materials used in the use zone shall be installed and maintained according to the manufacturer’s instructions; • If the loose material such as sand, mulch, or shredded rubber is used in use zones, the licensee shall ensure that the material is raked regularly and replenished to maintain depth and resilience; and • If the resilient material in use zones freezes, staff shall ensure that children will not play on the equipment until the resilient material has thawed and is once again resilient. 5.10.4 Indoor Area 5.10.4.1 Access to Useable Space by Children The licensee shall ensure that interior space licensed for use by children shall provide a minimum of thirty-five (35) square feet of safe useable space per child for the maximum number of children using the space at one (1) time. Each child shall have adequate space for free movement and active play. Measurements shall be from wall to wall on the inside of the building. Furniture that restricts children’s free movement and active play shall be considered a deductible factor when determining square footage. Bathroom, storage spaces, hallways, furnace rooms and other areas not used by children for sleep or play on a routine basis shall not be counted in computing square footage of useable space. 5.10.4.2 Exits: Stairways, hallways, windows, and doors from rooms used by children shall be clear and unobstructed from stored items, non-movable barriers, toys, and other items at all times. 5.10.4.3 Steps and Stairs 5.10.4.3.1 The licensee shall ensure that stairways over three (3) steps, inside and outside, have railings and are well lit. 5.10.4.3.2 The licensee shall ensure that safe and sturdy gates are used on stairways accessible to children, at all times when children under thirty-six (36) months of age are present. 5.10.4.4 Bathrooms 5.10.4.4.1 The CBCCPP shall include at least one (1) conveniently located toilet and sink for every fifteen (15) children present at any one (1) time. 5.10.4.4.2 Bathrooms identified in the rule 5.10.4.4.1 of these regulations shall only be used by children, parents, CBCCPP staff, partner staff, auxiliary staff, the business manager, and volunteers of the program while the program is operating. 5.10.4.4.3 The licensee shall ensure the bathroom is equipped with properly functioning toilet(s) and hand sink(s) that meet criteria in the rule 5.2.1.5 of these regulations. 5.10.4.4.4 Bathrooms used by enrolled children shall have toilet paper readily available and dispensed properly. Toilets shall be flushed after every use. 5.10.4.5 Cleanliness, Maintenance and Safety 5.10.4.5.1 The program director shall ensure that the CBCCPP, its furnishings, and toys are kept in a clean and orderly condition. 5.10.4.5.2 All interior and exterior walls, roofs, chimneys, floors, doors, ceilings, windows, skylights, stairways, ramps, and porches shall be maintained in good repair. 5.10.4.5.3 The licensee shall ensure that the CBCCPP is kept free from rodent and insect infestation. 5.10.4.5.4 Carpeted floors in areas where care and education is provided shall be vacuumed daily and cleaned by hot water extraction at least twice per year. 5.10.4.5.5 Hard surfaces accessible to children shall be smooth, non-porous, and easy to clean. See the rules in section 5.2.6 of these regulations for a schedule for cleaning, disinfecting, and sanitizing of specific surfaces and items. 5.10.4.5.6 Exterior stairs, walks, ramps, and porches shall be cleared of ice and snow or other environmental hazards that may block exits. 5.10.4.5.7 The program director shall ensure that toys and other equipment used by children are sturdy and free from hazards such as but not limited to rough edges, pinch and crush points, splinters, exposed bolts, small loose pieces, areas that cause entrapment, and free from recall from the U.S. Consumer Product Safety Commission. 5.10.4.5.8 Mobile baby walkers shall not be used unless deemed medically necessary by a qualified health practitioner. 5.10.4.5.9 Trampolines may be used if they measure thirty-six (36) inches or smaller in size. 5.10.4.5.10 The program director shall ensure that all art and play materials are nontoxic. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 5.10 Physical Environment and Safety 5.10.1 General Safety of Building and Grounds 5.10.1.1 General Safety: The FCCP shall ensure the physical facilities of the FCCH, grounds, equipment, and toys present no hazard to the health, safety and well- being of the children. 5.10.1.1.1 The FCCP shall ensure that children are protected from electrical outlets, such as by using protective covers, tamper-proof outlets, or other devices manufactured for this purpose. 5.10.1.1.2 The FCCP shall ensure that children are protected from choking hazards presented by cords on window coverings, electric or electronic appliances or equipment and telephone cords. 5.10.1.1.3 The FCCP shall ensure that furniture and equipment are sturdy. Furniture and equipment that present a tipping or falling hazard shall be secured. 5.10.1.1.4 The FCCP shall ensure that closet and bathroom doors that can be locked have an unlocking device readily accessible. No locking or fastening device shall be used on the outside of the door that would prevent free escape. 5.10.1.1.5 The FCCP shall ensure that children younger than three (3) years of age do not have unsupervised access to small toys and objects that pose a choking hazard, deemed by the Consumer Product Safety Commission (CPSC) as objects being smaller than their Choke Test Cylinder (1.25 inches in diameter and 2.25 inches in length). 5.10.1.1.6 The FCCP shall ensure that sharp objects are kept out of children’s reach unless used for a planned activity and closely supervised by an adult. 5.10.1.2 Fire Safety 5.10.1.2.1 The licensed FCCP shall ensure that the licensed FCCH is in compliance with Vermont Division of Fire Safety rules at all times. This includes but is not limited to • Complying with Vermont Division of Fire Safety inspection reports; • Having regular fire systems inspected with violations identified during the inspection noted as corrected; and • Having fire extinguishers tagged with valid inspection tags. 5.10.1.2.2 The FCCP shall limit the care of children to the ground floor of the home unless another level used has two (2) separate means of exit to the outside of the home. If the second floor is used there shall be a safe evacuation plan for children from the second floor. 5.10.1.2.3 On the basement level, at least one (1) exit shall be directly to the outside of the home. Bulkhead type doors are prohibited as exits. If the basement is used, one (1) of the exits may be a window provided the window is no more than forty-four (44) inches from the sill of the window to the floor and has a minimum opening of at least twenty (20) inches wide by twenty- four (24) inches high. The window shall be accessible to children and staff and easy to open. 5.10.1.2.4 The FCCP shall ensure that each floor of the home, and in the corridor to access the home in an apartment building, has an operating smoke detector as well as a smoke detectors in the immediate vicinity where children sleep. The FCCP shall ensure carbon monoxide monitors are located outside of rooms were children sleep. 5.10.1.2.4.1 The licensed FCCP shall ensure that each floor of the home, and in the corridor to access the home in an apartment building, has an operating smoke detector as well as smoke detectors in all rooms where children sleep. The licensed FCCP shall ensure carbon monoxide monitors are located outside of rooms were children sleep. 5.10.1.2.5 There shall be at least one (1) easily accessible dry chemical fire extinguisher which has at least a 2-A: 10BC classification. This fire extinguisher shall be maintained in operating condition. It shall bear an official tag, properly signed, attesting to current operating condition. 49 5.10.1.2.6 The extinguisher shall be visibly mounted to the wall near an exit door. 5.10.1.2.7 The FCCP and all staff (as applicable) shall be familiar with the use and handling of the fire extinguisher. 5.10.1.2.8 The FCCP and staff (as applicable) shall be physically able to assist in exiting all of the children present at one (1) time in the case of a fire. 5.10.1.3 Plumbing, Water and Sewage 5.10.1.3.1 The FCCP shall ensure that the FCCH plumbing is kept in good working condition. 5.10.1.3.2 The licensed FCCP shall ensure that the licensed FCCH meets all applicable plumbing codes as established by the Vermont Division of Fire Safety. 5.10.1.3.3 The licensed FCCP shall ensure that the licensed FCCH is in compliance with applicable rules from the Department of Environmental Conservation at all times. 5.10.1.3.4 The FCCP shall ensure that drinking water is potable by meeting Vermont standards at all times or shall provide bottled water for drinking. 5.10.1.4 Trash, Recycling and Composting 5.10.1.4.1 The FCCP shall ensure that garbage and compost are kept in containers that are securely covered. 5.10.1.4.2 The FCCP shall ensure children only access compost containers when under direct supervision of staff. 5.10.1.4.3 The FCCP shall ensure recycling materials are rinsed and stored in a manner that does not attract insects, rodents, or other pests that pose a safety or health hazard for children. 5.10.1.4.4 The FCCP shall ensure recycling items for children such as metal cans are inaccessible to children. 5.10.1.4.5 The FCCP shall ensure garbage, recycling and compost is not allowed to exceed the limits of its container and is removed from rooms used by children at least once the container is full, if it develops an odor, or presents some other health or safety risk. 5.10.1.4.6 The FCCP shall ensure garbage and recycling is removed from the premises on a regular basis but not less than once every fourteen (14) days. 5.10.1.4.7 The FCCP shall ensure compost is removed from the premises on a regular basis but not less than once every (7) days; unless a contained composter is constructed outside, away from where children play, and shall be maintained in a manner that does not pose any safety or health risks to children. 5.10.1.5 Ventilation, Heating and Cooling 5.10.1.5.1 The FCCP shall ensure that any room in the FCCH used by children is maintained at a minimum temperature of 65°F and a maximum of 85°F at one (1) foot above floor level and that areas used by infants shall be kept at least 68°F at floor level. 5.10.1.5.2 Adequate ventilation shall be provided indoors during hot weather. All rooms occupied by children shall have at least one (1) window that opens and is properly screened, unless artificial ventilation is used. 5.10.1.5.3 A window that opens and is properly screened or an operating electric exhaust fan shall ventilate each bathroom to the outside air. 5.10.1.5.4 The use of unvented kerosene heaters is prohibited. 5.10.1.5.5 The FCCP shall ensure that all heating and cooling equipment is safely shielded to prevent injury to children and approved for use by the Vermont Division of Fire Safety. 5.10.1.5.6 The FCCP shall ensure that screens used on all windows, doors or other openings to the outside are in good repair. Doors that remain open to the outside, excluding fire doors, shall have screens. 5.10.1.5.7 The FCCP shall ensure that air conditioners, electric fans and heaters, including all floor or window fans are inaccessible to children when they pose a health or safety hazard. If they are mounted indoors or outdoors they shall be securely attached. 5.10.1.6 Lighting 5.10.1.6.1 The FCCP shall ensure that the FCCH has sufficient natural and artificial lighting in all areas where care and education are provided to allow children to see clearly to reduce the risk of injury and allow the FCCP and staff to supervise the children visually. 5.10.1.6.2 The FCCP shall ensure that parking areas of driveways, pedestrian walkways, and other exterior portions of the premises used by children, parents and staff members after dark are illuminated. 5.10.1.7 Hazardous Finishes and Surfaces The FCCP shall ensure that all surfaces and finishes in the FCCH and premises are safe and non-hazardous. 5.10.1.8 Childhood Lead Poisoning Prevention The FCCP shall comply with the requirements of 18 V.S.A. Chapter 38 Vermont Lead Law and shall ensure that Essential Maintenance Practices (EMP) is performed. This includes but is not limited to protecting children from peeling or chipping paint, and dust build up from the friction of moving doors or windows. 5.10.1.9 Use of Pesticides 5.10.1.9.1 The FCCP shall ensure that pesticide applications shall be used only when other pest prevention and control measures fail. Pesticides shall not be used to control pests for aesthetic reasons alone. Whenever possible the FCCH shall use pesticides of least risk. Only pesticides registered with the Vermont Department of Agriculture, Food and Markets shall be used, and be documented in administrative records as required in the rule 3.3.6.4 of these regulations. 5.10.1.9.2 The FCCP shall ensure that all contracted pesticide applications shall be applied only by commercial applicators certified by the Vermont Department of Agriculture, Food and Markets. 5.10.1.9.3 The FCCP shall ensure that parents of children and staff are notified in writing five (5) days prior to any planned application of pesticides. Notice shall include the site of the planned application, pests to be treated for, and proposed pesticide to be used. 5.10.1.9.4 The FCCP shall ensure that application of pesticides shall only be made when children are not present, that there is ample time to ventilate indoor areas after application, and that surfaces that can be touched or mouthed by children in care are not treated or are thoroughly cleaned and sanitized after an application. If outdoor applications of pesticides are made while children are present, children shall not be permitted in those areas until recommended by the manufacturer’s instructions and/or the applicator’s instructions, if applied by a pest control professional. 5.10.1.9.5 The FCCP shall ensure that pest baits are not be used unless in childproof bait boxes. Bait boxes shall be inaccessible to children. 5.10.1.11 Use of Tobacco, Alcohol and Illegal Drugs 5.10.1.11.1 The FCCP shall ensure that the use of tobacco and tobacco substitutes (including e-cigarettes), alcohol and illegal drugs is prohibited at the FCCH (both indoor and outdoor environments used by children) when children are present and also in any vehicle used to transport children for program purposes. 5.10.1.11.2 If smoking occurs in the FCCH when children are not present, the FCCP shall inform parents that their child will be exposed to an environment in which tobacco products or tobacco substitutes, or both, are used prior to the parent enrolling the child in the FCCH. 5.10.1.11.3 No person working or volunteering in the FCCH shall use or be under the influence of alcohol or drugs while children are present at the FCCH. Medication prescribed by a physician or over the counter medication that does not impair the ability of the FCCP and staff to adequately supervise and care for the children may be taken. 5.10.1.12 Firearms and Other Weapons The FCCP shall ensure all firearms and other weapons, including but not limited to hunting knives, archery equipment and weapon accessories such as ammunition, are locked at the FCCH. Ammunition shall be locked and stored in a location separate from weapons. 5.10.1.13 Telephones 5.10.1.13.1 The FCCP shall ensure that the FCCH has an operating telephone that is present and in service at all times children are present. The telephone number shall be provided to the Division and the parents of children that are enrolled. If an answering machine is used, the FCCP shall check it every fifteen (15) minutes to ensure parents are able to communicate with the FCCP during the day. 5.10.1.13.2 The FCCP shall ensure that a list of the following phone numbers is posted or located near the phone along with 911 and the directions to the FCCH: • Police; • Fire; • Ambulance/Rescue Squad; • Poison Center (1-800-222-1222); • Child Development Division; and • Child Abuse Hotline 800 number Child specific information: • Parental contacts; • Emergency contacts; and • Doctor contact information. 5.10.1.14 Pets 5.10.1.14.1 The FCCP shall ensure that animals present at the FCCH do not present a danger or health hazard to the children and staff. 5.10.1.14.2 The FCCP shall ensure that any animals or pets present at or brought into the FCCH are vaccinated as prescribed by law, with documentation maintained at the FCCH. 5.10.1.14.3 Animals present at the FCCH shall be maintained and cared for in a safe and sanitary manner that does not pose a health hazard for children or staff. 5.10.1.14.4 Animals shall not be allowed on surfaces where food or drink is prepared or served. Animals who roam freely shall not be allowed near children who are eating. 5.10.1.15 Disruptive or Dangerous Behavior The FCCP shall prohibit any person, including but not limited to household members, parents, staff, partner staff or volunteers, from the FCCH and property when his/her presence or behavior disrupts the program, distracts the staff from their responsibilities, intimidates or promotes fear among the children and/or staff, or when there is reason to believe that his/her actions or behavior presents a risk of harm to children present. 5.10.2 Kitchen 5.10.2.1 General Kitchen Provisions 5.10.2.1.1 The licensed FCCP shall ensure that all on-site meal preparation shall have approval by the Division. The on-site preparation of snacks only does not require approval by the Division. 5.10.2.1.2 The food preparation surfaces shall not be used for other activities when food or drink is being prepared or served. 5.10.2.1.3 The kitchen and all food preparation, storage and serving areas, and utensils shall be kept clean, sanitary, and free of insects, rodents, dust and other contaminants. 5.10.2.1.4 The kitchen shall have at least one (1) sink with a single spigot with hot and cold running water. 5.10.2.2 Equipment, Dishwashing and Surfaces 5.10.2.2.1 The FCCP shall ensure all dishes, cups and glasses used by the children are free from chips, cracks or other defects. 5.10.2.2.2 The kitchen shall contain the necessary operable equipment to prepare, store, serve and clean-up all meals and snacks for children and adults. All kitchen machinery and equipment shall be constructed and arranged to be easily cleanable and shall be in good repair. 5.10.2.2.3 If the FCCP uses a dishwasher, the dishwasher shall be installed and operated according to the manufacturer’s recommendations. 5.10.2.2.4 When a dishwasher is not available, and single-service items are not used for food service, the FCCP shall ensure there shall be three (3) compartments with a drain board set-up for cleaning dishes. A four (4) step process shall include dishwashing, rinsing, sanitizing, and air drying all dishes and utensils. • Dishes shall be washed with soap in hot clean water. • Dishes shall be rinsed in hot clean water. • Dishes shall then be immersed for at least ten (10) seconds in a sanitizing rinse. The sanitizing rinse shall be EPA registered or a diluted bleach and water mixture. If using bleach, the FCCP shall follow the manufacturer’s instructions when mixing for this purpose. • Dishes shall be air dried. 5.10.2.2.5 All surfaces used for food preparation shall be easily cleanable and non- porous. 5.10.2.2.6 All single service items including cups, plates, spoons, forks, and other single service containers and utensils shall only be used once. 5.10.2.3 Storage 5.10.2.3.1 The FCCP shall have a refrigerator to keep perishable foods at 40°F or colder and a freezer to maintain frozen food at 0°F or colder. Food stored in the refrigerator, including lunch boxes, shall be stored in a manner that allows the free circulation of cool air. All refrigerated foods shall be covered. 5.10.2.3.2 All food shall be stored in containers that are dated. Food items used by or intended for specific children shall be plainly labeled. 5.10.2.3.3 All utensils, equipment and food shall be stored in a clean, dry place free from insects, rodents, dust and other contamination and shall be handled in such a manner as to prevent contamination. • If stored openly, all containers and utensils shall be stored eighteen (18) inches off of the floor; • Dishes shall be stored in a closed space; • Utensils shall be covered or inverted when not in use; and • Single service items shall be purchased and stored in sanitary cartons. 5.10.2.3.4 Food items shall be stored separately from cleaning materials. 5.10.2.4 Food Safety 5.10.2.4.1 The FCCP shall ensure that individuals with open sores that cannot be covered do not handle or prepare food. 5.10.2.4.2 Foods shall be cooked to proper temperatures and shall be served promptly after preparation. All reheated food shall be cooked to at least 165°F. Hot foods shall be maintained at temperatures not less than 135°F and cold foods shall be maintained at temperatures not more than 41°F. 5.10.2.4.3 All readily perishable food shall not be kept at room temperature for more than one (1) hour while being prepared or served. Readily perishable food shall be stored in the refrigerator in a covered shallow pan. 5.10.2.4.4 Frozen foods shall be thawed in the refrigerator, under cold running water, or defrosted in the microwave oven. 5.10.2.4.5 All unsafe, contaminated food shall be disposed of promptly. Swelled, rusty, dented or punctured canned food or drink shall not be consumed. 5.10.2.4.6 Fresh fruits and vegetables shall be thoroughly washed before being served. 5.10.2.4.7 Food that has been served to a child or adult shall be disposed of if not eaten. Once food has been served, it shall not be re-used, served to a different child or stored, except as compost. 5.10.3 Outdoor Play Area 5.10.3.1 General Outdoor Play Area Provisions 5.10.3.1.1 There shall be a safe outdoor play area large enough to provide opportunities for vigorous play and large muscle activity on the premises or within a safe walking distance of the FCCH approved by the Division. 5.10.3.1.1.1 A licensed FCCP shall maintain or have access to a safe outdoor play area with at least seventy-five (75) square feet per child to provide opportunities for vigorous play and large muscle activity on the premises or within a safe walking distance of the licensed FCCH approved by the Division. 5.10.3.1.2 The outdoor play area shall include a provision for shade. 5.10.3.1.3 The outdoor play area shall be fenced or otherwise protected from traffic and other hazards. Fencing or natural barriers, such as hedges or other clear land boundaries, shall prevent children from exiting and allow for safe supervision of outdoor play. 5.10.3.1.4 If fencing is used, it shall be sturdy, safe and reinforced to give support, constructed to discourage climbing, and shall not prevent visual supervision of children by the FCCP and/or staff. 5.10.3.1.5 Fencing installed after the effective date of these regulations shall: • Be a minimum of four (4) feet in height with openings no larger than 3.5 inches; • Equipped with gates with self-closing and self-latching mechanisms; and • Include at least two (2) exits with one (1) that does not lead into the FCCH. 5.10.3.1.6 The outdoor play area shall be free of dumpsters, uncovered trash cans, highly flammable materials, standing pools of water and other hazards. The FCCP shall inspect the outdoor play area before children begin to play to make sure there are no hazards present such as, but not limited to, animal feces, litter, adult tools, or other items that might injure a child. 5.10.3.2 Play Equipment and Riding Toys 5.10.3.2.1 All outdoor play equipment is sturdy, safe, clean and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts. • To prevent entrapment, no openings in equipment shall be between 3.5 and nine (9) inches. • Chains on swings shall have protective coverings and swing seats shall be made of soft materials with no sharp edges. 5.10.3.2.2 Equipment shall be arranged so that children playing on one (1) piece of equipment will not interfere with children playing on another 58 piece of equipment, excluding a multifunction, prefabricated residential play structure. 5.10.3.2.3 The FCCP shall ensure that large outdoor play equipment is anchored firmly in accordance with manufacturers’ specifications, is not located on concrete or asphalt surfaces and is placed so as to accommodate manufacturers’ specifications for use zones. 5.10.3.2.4 Sandboxes shall be maintained in a safe and sanitary manner. 5.10.3.2.5 Bicycles, tricycles, scooters, and other riding toys shall be the correct size for the child using the riding toy and the riding toys shall be maintained in good condition. • Tricycles shall not have spokes, and tricycles and bicycles with chains shall have chain guards. • The FCCP shall ensure that all children wear properly fitting safety helmets while riding outside on bicycles and using scooters. 5.10.3.3 Safe Use Zones For all play equipment that is thirty (30) inches or higher from the ground, including climbing equipment, slides, swings and other similar equipment, the FCCP shall ensure that the surface under and around the equipment, included recommended use zones, is of approved resilient material that protects children if they fall. • Materials in the use zone shall consist of wood chips, pea stone, mulch, engineered wood fibers, sand, safety-tested shredded or rubber like material or rubber mats designed for protective cushioning; • Materials used in the use zone shall follow the recommendations listed in the most recent publication of U.S. Consumer Product Safety Commission’s Public Playground Safety Handbook regarding critical depth of tested materials determined by the height of the highest climbing surface of the equipment; • Materials used in the use zone shall be installed and maintained according to the manufacturer’s instructions; • If the loose material such as sand, mulch, or shredded rubber is used in use zones, the FCCP shall ensure that the material is raked regularly and replenished to maintain depth and resilience; and • If the resilient material in use zones freezes, the FCCP shall ensure that the children will not play on the equipment until the resilient material has thawed and is once again resilient. 5.10.4 Indoor Area 5.10.4.1 Access to Useable Space by Children The FCCP shall ensure that interior space designated for use by children is available to children when the FCCH is in operation, is sufficient, and arranged to allow each child adequate space for free movement and active play. 5.10.4.1.1 In a licensed FCCH, a minimum of thirty-five (35) square feet of safe useable space per child is available. Each child shall have adequate space for free movement and active play. Measurements shall be from wall to wall on the inside of the home. Furniture that restricts children’s free movement and active play shall be considered a deductible factor when determining square footage. Bathroom, storage spaces, hallways, furnace rooms and other areas not used by children for sleep or play on a routine basis shall not be counted in computing required square footage of useable space. 5.10.4.2 Exits: Stairways, hallways, windows, and doors from the rooms used by children shall be clear and unobstructed from stored items, non-movable barriers, toys, and other items at all times. 5.10.4.3 Steps and Stairs 5.10.4.3.1 The FCCP shall ensure that stairways over three (3) steps, inside and outside, have railings and are well lit. 5.10.4.3.2 The FCCP shall ensure that safe and sturdy gates are used on stairways, accessible to children, at all times when children younger than thirty-six (36) months of age are present. 5.10.4.4 Bathrooms 5.10.4.4.1 The FCCP shall ensure that the FCCH has at least one (1) bathroom equipped with one (1) properly functioning toilet and hand sink. 5.10.4.4.2 The FCCP shall ensure the bathroom is equipped with properly functioning hand sink(s) that meet criteria in the rule 5.2.1.5 of these regulations. 5.10.4.4.3 Bathrooms used by children shall have toilet paper shall be readily available and dispensed properly. Toilets shall be flushed after every use. 5.10.4.5 Cleanliness, Maintenance and Safety 5.10.4.5.1 The FCCP shall ensure that the FCCH, its furnishings, and toys are kept in a clean and orderly condition. 5.10.4.5.2 All interior and exterior walls, roofs, chimneys, floors, doors, ceilings, windows, skylights, stairways, ramps and porches shall be maintained in good repair. 5.10.4.5.3 The FCCP shall ensure that the FCCH is kept free from rodent and insect infestation. 5.10.4.5.4 In areas where care and education is provided floors shall be kept clean. • Uncarpeted floors shall be swept daily, and • Carpeted floors shall be vacuumed weekly. 5.10.4.5.5 Hard surfaces accessible to children shall be smooth, non-porous, and easy to clean. See the rules in section 5.2.6 of these regulations for a schedule for cleaning, disinfecting and sanitizing specific surfaces and items. 5.10.4.5.6 Exterior stairs, walks, ramps and porches shall be cleared of ice and snow or other environmental hazards that may block exits. 5.10.4.5.7 The FCCP shall ensure that toys and other equipment used by children are sturdy and free from hazards such as but not limited to rough edges, pinch and crush points, splinters, exposed bolts, small loose pieces, areas that cause entrapment, and free from recall from the U.S. Consumer Product Safety Commission. 5.10.4.5.8 Mobile baby walkers shall not be used unless deemed medically necessary by a qualified health practitioner. 5.10.4.5.9 Trampolines may be used if they measure thirty six (36) inches or smaller in size. 5.10.4.5.10 The FCCP shall ensure that all art and play materials are nontoxic. 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: General Standards 11.1 The licensed space shall provide at least thirty-five (35) square feet of safe, usable space per child inside the facility, excluding areas where children’s personal belongings are stored and areas primarily used for hallways, bathrooms, offices and the food preparation area in the kitchen. 11.2 There shall be a safe outdoor play area which provides a minimum of seventy-five (75) square feet of space per child. The play area shall include provision for shade and be fenced or otherwise separated from traffic and other hazards. 11.3 The facility shall provide a pleasant, safe, and clean, environment suitable for children. 11.4 Areas licensed as indoor useable space for children shall have sufficient lighting. 11.5 The temperature, ventilation, and noise level in the indoor space shall be adequate and appropriate for the ages and activities of the children. 11.6 All indoor areas used by children shall be at least 68 degrees Fahrenheit one foot above the floor. Indoor gross motor areas not counted in the indoor square footage 33 measurement are exempt from this provision. 11.7 All areas used to determine the indoor licensed capacity shall not be subject to drafts. 11.8 The following shall be maintained in good condition: • roofs • chimneys • interior and exterior walls • doors • skylights • windows • floors • ceilings • stairways • ramps • porches • gates 11.9 The facility’s grounds, fencing and equipment shall be well-maintained and kept in good repair. 11.10 Bathroom and kitchen floors and molding surfaces shall be constructed and maintained to permit easy cleaning. 11.11 Surfaces accessible to children shall be smooth and easily cleanable and free of toxic materials 11.12 Air conditioners, electric fans and heaters shall be mounted out of children’s reach or have safeguards that prevent children from being injured. 11.13 Stairs, ramps, walks, platforms and porches shall be equipped with handrails and be kept clear and safe. 11.14 The Licensee shall ensure garbage, recycling and compost is not allowed to exceed the limits of its container and is removed from rooms used by children at least once the container is full, if it develops an odor, or presents some other health or safety risk. 11.15 Reasonable efforts shall be made to keep the center free of insects and rodents. 11.16 Outdoor play areas shall be free of dumpsters, uncovered garbage cans, highly flammable materials and other hazards. 11.17 All electrical receptacles shall be in compliance with applicable current Vermont Division of Fire Safety code. 11.18 Pools and swimming facilities shall be maintained in accordance with sound health and safety practices. 11.19 Piers, floats and platforms used by children in swimming areas shall be maintained in good repair. Bathrooms 11.20 There shall be a conveniently located toilet and hand washing sink for every fifteen children or portion thereof. Toilets are to be used only by children, parents, Staff and volunteers of the center during program hours. 11.21 A screened window that opens or an operating electric exhaust fan shall ventilate each bathroom to the outside air. 11.22 Sinks used for hand washing shall have running water not to exceed 120 degrees Fahrenheit. Sinks shall have hot and cold running water. 11.23 Toilet paper shall be available and dispensed within children’s arm reach. 11.24 Liquid soap and disposable paper towels, or properly functioning electric air hand dryer, shall be available and accessible to the children at each hand washing area. 11.25 Step stools for children shall be required if hand sinks are installed at other than child height. 11.26 Bathrooms are to be kept in good repair with adequate lighting. Lead and Asbestos Safe Facilities The following subsection is pursuant to 18 V.S.A. Chapter 38, Childhood Lead Poisoning Prevention Law (ACT 165 of 1995) and pertains only to buildings constructed before 1978. Regulated programs housed in public schools are exempt. 11.27 Essential Maintenance Practices (EMPs) shall be performed prior to initial licensure and annually thereafter in the space defined as licensed space. Essential Maintenance Practices shall be performed by a person who (a) has been certified by the Vermont Department of Health to perform Essential Maintenance Practices, or (b) is supervised on-site by a person certified by the Vermont Department of Health to perform Essential Maintenance Practices. 11.28 The Licensee shall protect children from lead exposure by following Essential Maintenance Practices related to: • a visual on-site inspection of interior and exterior surfaces to identify deteriorated paint in areas frequented by children in warm weather • the stabilization of paint if more than one square foot of deteriorated paint is found on any interior or exterior surface • the stabilization of paint or restricting access by children if more than one square foot of deteriorated paint is found on any exterior surface accessible to children • assurance that window well inserts are properly installed in all windows wells in areas defined as licensed space • cleaning of window wells and windowsills with a HEPA (High Efficiency Particulate Air) filter vacuum and general all-purpose cleaner • assuring that notice is posted in a prominent location emphasizing to building occupants the importance of reporting deteriorated paint to the facility owner. 11.29 Responsible precautions shall be taken when disturbing painted surfaces including approved work practices and safety precautions to prevent the spread of lead dust. 11.30 At the conclusion of work on painted surfaces, the work area shall be cleaned using a HEPA filtered vacuum and general all-purpose cleaner. 11.31 Burning, water blasting, dry scraping power sanding or sand blasting of painted surfaces is prohibited. 11.32 An Essential Maintenance Practices Compliance Statement shall be filed annually with the Childhood Lead Poisoning Prevention Program of the Vermont Department of Health and the Licensee’s liability insurance carrier. 11.33 Protection of Children from Asbestos: Prior to any renovation or remodeling of the Afterschool Child Care Program or if demolition, repair, maintenance, or other conditions in the Afterschool Child Care Program are observed that indicate building material that may contain asbestos has been disturbed or exposed, the licensee shall ensure that an assessment is performed by a person certified by the Vermont Department of Health in compliance with statutory and regulatory requirements of 18 V.S.A. Chapter 26 and the Vermont 36 Department of Health’s Regulations for Asbestos Control. The licensee shall ensure that any and all abatement recommendations made as a result of that assessment are followed. A copy of the assessment, which includes the recommendations and statement of compliance achieved, shall be submitted to the Division. Regulatory action may be taken on the basis of children potentially exposed to asbestos as a health hazard. Plumbing and Water 11.34 All plumbing shall comply with the applicable federal and state plumbing codes. Work notices shall be filed by a Master Plumber with the Fire Safety Division of the Vermont Department of Public Safety prior to beginning new construction or renovation of plumbing. 11.35 An approved drinking water system serving at least twenty-five persons daily shall provide a supply of water that meets applicable standards as defined by Department of Environmental Conservation. 11.36 Water supply employing water haulage (tank truck haulage, containers, etc.) to the distribution system shall be used only in emergency situations and after approval is granted by the Division. 11.37 Water from a public water system shall be in compliance with the applicable Department of Environmental Conservation regulations. 11.38 Private water systems shall be capable of furnishing an adequate supply of potable water at pressure necessary to sustain equipment during all hours of operation. A minimum residual pressure of twenty pounds per square inch is required during maximum draft at faucets. General Standards 12.1 Children in care shall be protected from any and all conditions which threaten a child's health, safety and well-being. 12.2 Furniture shall be appropriate for the size, abilities and activities of the children. Furniture and equipment shall be clean, sturdy, without sharp edges, and present minimal hazards. 12.3 Indoor climbing structures that allow children to achieve a height of more than 30 inches shall have appropriate shock absorbing cushioned surfaces beneath them to protect children from injury in the event of a fall. 12.4 Bookcases and other shelving units above 3 feet in height shall be secured. Other shelving units shall not present a tipping or falling hazard. 12.5 Hazardous substances shall be in their original container, stored separately and inaccessible to children. 12.6 Closet and bathroom doors which can be locked shall have an unlocking device readily accessible to Staff. A locking or fastening device shall not be used on the outside of the door which would prevent free escape from inside. 12.7 There shall be no animal present at the facility which presents a danger or health hazard to the children. Children shall not have contact with wild animals unless animals are under the supervision of a professional wild animal handler. Outdoor Safety 12.8 Children shall be provided with a variety of outdoor play experiences daily when weather and air quality conditions do not pose a significant health risk. The Program Administrator or Site Director shall be aware of extreme weather conditions such as excessive heat and humidity, cold temperatures including wind chill factors, or poor air quality that could affect the well-being or health of children. Children shall not be allowed to play outside during extreme weather conditions. 12.9 Children shall be properly attired for the weather and be outfitted with coats, hats, boots, gloves, etc. when appropriate. 12.10 Each day the program is operating and prior to use by children a designated person shall: • inspect the playground equipment and fencing to ensure it is in good repair. Equipment found in disrepair shall be either repaired or not used by children until appropriate repairs are made; and • inspect the playground for hazardous materials (for example, broken glass, syringes, condoms, etc.). Hazardous materials shall be removed prior to the playground being used by children. 12.11 Outdoor play equipment shall be available and appropriate for the children. 12.12 Equipment made with pressure-treated lumber that was constructed prior to the effective date of these regulations shall be sealed every year with a sealant such as an oil-based stain. 12.13 All outside equipment, materials, furnishings and play areas shall be sturdy, safe, and in good repair and shall meet the recommendations of the U.S. Consumer Product Safety Commission (CPSC). (See Appendix B). 12.14 Cushioning material which is absorbent shall be in place under climbers, slides, swings, or other structures which allow children to achieve a height of more than thirty inches. The depth of surfacing materials shall be appropriate to the height and use of the equipment as outlined by the Consumer Product Safety Commission’s National Playground Safety Standards (see Appendix B). Surfacing material shall be maintained in good condition. Grass, bare ground, asphalt and concrete are prohibited under these structures. If weather conditions make the use of equipment unsafe, Staff shall keep children off of the equipment. 12.15 Children on bicycles, roller blades, skateboards, or scooters shall wear helmets. 12.16 Play equipment and play surfaces shall be provided for children with disabilities in accordance with recommendations from the Americans with Disabilities Act (ADA). 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: 5.10.5 Swimming and Access to Water and Pools 5.10.5.1 Written permission from each child’s parent shall be obtained prior to the child engaging in swimming or wading activities. This written permission shall be retained in each child’s file. 5.10.5.2 Pool/Water Fencing 5.10.5.2.1 A fence is not required for water filled wading pools. 5.10.5.2.2 For in ground or above ground pools or natural or manmade bodies of water accessible from the outdoor play area, the licensee shall ensure that a fence is installed so that no child may gain access without staff approval, observation, and supervision. Fences around pools shall be at least four (4) feet high with a maximum vertical clearance of 3.5 inches at the bottom. Gates shall swing outward with self-closing and self-latching devices installed at least three (3) inches below the top of the gate on the side facing the pool/water. Gates shall be locked when not in use. 5.10.5.3 Pool/Water Sanitation Practices 5.10.5.3.1 The program director shall ensure that wading pools are cleaned and disinfected daily when used and filled with fresh water at least daily. Wading pools shall be empty and stored dry when not in use. 5.10.5.3.2 For in ground or above ground pools the licensee shall ensure that the water is filtered and maintained in accordance with the pool/filter manufacturer’s recommendations. Pools shall be maintained in accordance with sound health and safety practices. 5.10.5.3.3 For natural or manmade bodies of water accessible from the outdoor play area, the program director shall visually inspect the area prior to use to ensure it is free of hazards such as glass, animal feces or other health and safety risks. 5.10.5.4 Pool/Water Supervision/Prohibitions 5.10.5.4.1 The program director shall ensure that when children are using wading pools, staff with valid certification in infant/child CPR is/are present, and physically and visually supervising all children at all times. 5.10.5.4.2 The program director shall ensure that when children are swimming or playing in in-ground or above ground pools or natural or manmade bodies of water, staff who are confident swimmers and hold a valid certification in infant/child CPR is/are present and physically and visually supervising all children at all times. 5.10.5.4.3 When twelve (12) or fewer enrolled children swim or play in an in ground or above ground pools or natural or manmade bodies of water at one (1) time, the licensee shall maintain the following staff/child ratios if no lifeguard is present: • One (1) adult: two (2) children for infants/toddlers and pre- kindergarten age children; • One (1) adult: six (6) children for school age children. 5.10.5.4.4 When thirteen (13) or more enrolled children swim or play in in-ground or above ground pools or natural or manmade bodies of water at one (1) time, the licensee shall ensure that there is one (1) certified lifeguard assigned to each group of twenty-five (25) or fewer children in the water. 5.10.5.4.5 Lifeguards shall possess first aid, CPR, and lifeguard certification from the YMCA, American Red Cross (ARC), Boy Scouts of America (BSA), Ellis & Associates or another nationally recognized organization that provides equivalent certification. 5.10.5.4.6 When lifeguards are on duty supervising the swimming area, they shall not be counted in the following staff/child ratios. The minimum staff/child ratios for children participating in a swimming activity supervised by a certified lifeguard shall be: • One (1): ten (10) for children age eight (8) and older; • One (1): eight (8) for children ages six (6) and seven (7); • One (1): six (6) for children ages three (3) ￿ five (5); and • One (1): three (3) for children younger than three (3) years. 5.10.5.4.7 The program director shall develop a written aquatic plan that addresses supervision and safety of swimming activities. This plan shall have a table of contents and plot plan for any swimming facility in use by the program indicating where first aid is to be practiced and where emergency equipment is to be placed. The plan shall be: • Reviewed once every 365 days; • Updated as needed; • Known by all staff present at the swimming facility; • Kept on file at the facility with a copy available while swimming occurs; • In the case of off-site swimming locations, the plan is formulated in conjunction with off-site aquatics personnel; and • Available for review. 5.10.5.4.8 The written aquatic plan shall include the designation of an aquatic director who is responsible for the implementation of the plan when children are present and shall include the following systems: • Assessing each child’s swimming ability performed by a person who holds a valid American Red Cross (ARC) Water Safety Instructor (WSI) certificate or current certificate issued by an approved certifying agency providing for equivalent levels of training. When bathers are in water less than waist deep, a system for assessing swimming ability is not required. • Identification of each bather by name, predetermined status of swimmer or non-swimmer, his/her swimming ability, and the area to which the bather is assigned. • Identify a system for visual identification of each child. • Restricting non-swimmers to areas where the water is less then waist deep, except for ￿learn to swim￿ programs or when shallow water is in a non-swimming area. • Recording the entry to and exit from the swim area for each bather. • Assigning each bather to a buddy who must have the same swimming ability. One threesome is allowed per swimming area. When children are unable to comprehend or implement a buddy system, another method that provides an equivalent level of bather safety, supervision and accountability shall be substituted and described in the written aquatic plan. • Instructing buddies to notify the lifeguard when their partner is distressed or missing. • Checking all bathers every fifteen (15) minutes. • Addressing a ￿lost swimmer￿ plan which becomes activated when a check fails to account for all bathers and shall include clearing the water and searching for and supervising children during the search for the lost swimmer. 5.10.5.4.9 Swimming/use of pools/bodies of water is prohibited during hours of darkness. 5.10.5.4.10 Diving is prohibited for enrolled children. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 5.10.5 Swimming and Access to Water and Pools 5.10.5.1 Written permission from each child’s parent shall be obtained prior to the child engaging in swimming or wading activities. This written permission shall be retained in each child’s file. 5.10.5.2 Pool/Water Fencing 5.10.5.2.1 A fence is not required for water filled wading pools 5.10.5.2.2 For in ground or above ground pools or natural or manmade bodies of water accessible from the outdoor play area, the FCCP shall ensure that a fence is installed so that no child may gain access without FCCP and/or staff approval, observation and supervision. Fences around pools shall be at least four (4) feet high with a maximum vertical clearance of 3.5 inches at the bottom. Gates shall swing outward with self-closing and self- latching devices installed at least three (3) inches below the top of the gate on the side facing the pool/water. Gates shall be locked when not in use. 5.10.5.3 Pool/Water Sanitation Practices 5.10.5.3.1 The FCCP shall ensure that wading pools are cleaned and disinfected daily when used, and filled with fresh water at least daily. Wading pools shall be empty and stored dry when not in use. 5.10.5.3.2 For in ground or above ground pools the FCCP shall ensure that the water is filtered and maintained in accordance with the pool/filter manufacturer’s recommendations. Pools shall be maintained in accordance with sound health and safety practices. 5.10.5.3.3 For natural or manmade bodies of water accessible from the outdoor play area, the FCCP shall visually inspect the area prior to use to ensure it is free of hazards such as glass, animal feces or other health and safety risks. 5.10.5.4 Pool/Water Supervision/Prohibitions 5.10.5.4.1 The FCCP shall ensure that when children are using wading pools, the FCCP and/or staff with valid certification in infant/child CPR is/are present and physically and visually supervising all children at all times. 5.10.5.4.2 The FCCP shall ensure that when children are swimming or playing in in ground or above ground pools or natural or manmade bodies of water, the FCCP shall ensure that the FCCP and/or staff who are confident swimmers and hold a valid certification in infant/child CPR is/are present and physically and visually supervising all children at all times. 5.10.5.4.3 The FCCP shall ensure that when children in care are swimming or playing in an in ground or above ground pool or natural or manmade bodies of water, the FCCP shall ensure that a lifeguard is present or shall maintain the following staff/child ratios: • One (1) adult: two (2) children for infants/toddlers and pre-kindergarten age children; • One (1) adult: six (6) children for school age children. 5.10.5.4.4 Lifeguards shall possess first aid, CPR and lifeguard certification from the YMCA, American Red Cross (ARC), Boy Scouts of America (BSA), Ellis & Associates or another nationally recognized organization that provides equivalent certification. 5.10.5.4.5 When lifeguards are on duty supervising the swimming area, they shall not be counted in the following staff/child ratios. The minimum staff/child ratios for children participating in a swimming activity supervised by a certified lifeguard shall be: • One (1): ten (10) for children age eight (8) and older; • One (1): eight (8) for children ages six (6) and seven (7); • One (1): six (6) for children ages three (3) ￿ five (5); and • One (1): three (3) for children younger than three (3) years. 5.10.5.4.6 Swimming/use of pools/bodies of water is prohibited during hours of darkness. 5.10.5.4.7 Diving is prohibited for enrolled children. 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: 16.1 Each child shall have written permission from her/his parent prior to participating in a wading or swimming activity. 16.2 Swimming facilities shall be protected and pools fenced so that no child may gain access without Staff approval, observation and supervision. 16.3 For each group of 26 children, the Licensee shall ensure that a lifeguard with current certification from a nationally recognized organization is supervising the swimming area. 16.4 The minimum ratio of Staff to children participating in a swimming activity shall be: Ratio Age of Youngest Child in Group 1:10 8 years and older 1:8 6 and 7 years old 1:6 5 years old 16.5 When lifeguards are on duty supervising the swimming area, they shall not be counted in the staff/child ratios for swimming as designated in rule 16.4 of these regulations. 16.6 When swimming lessons are being provided, the lessons shall be provided by a certified instructor. 16.7 The Staff of the licensed program is responsible for supervising the children in their care when the children are engaged in swimming activities regardless of who employs the lifeguard(s) on duty. Staff/child ratios shall also apply when a lifeguard is on duty. 16.8 The Licensee or the Licensee’s designee shall develop a written aquatic safety plan addressing supervision and safety of all swimming activities. This plan shall: • be reviewed annually • be updated as needed • be known by program Staff persons present at the swimming facility • include the location of the first aid and emergency supplies, and • be kept on file at the licensed program facility with a copy available where swimming occurs. 16.9 The written aquatic safety plan shall include: • an assessment of each child’s swimming ability, performed by a person who holds a valid American Red Cross Water Safety Instructor certificate or current certificate issued by an approved certifying agency providing for equivalent levels of training. • a system whereby each child’s designation of swimmer or non-swimmer shall be predetermined, documented and on file. When all bathers are in water less than waist deep on them, swimming ability assessment is not required. • a system whereby non- swimmers are restricted to areas where the water is less then waist deep on them (except for learn to swim programs or when shallow water is in a non-swimming area). • the emergency plan should a child be missing or in distress in the water. The plan shall include supervising children during times of emergency. 16.10 Swimmers shall be assigned to specific Staff members who will monitor their activities. 16.11 Swimmers shall be accounted for at least every ten minutes. 16.12 Swimming is prohibited during the hours of darkness unless adequate lighting is provided and swimming is restricted to shallow water. 16.13 If diving is permitted, the minimum water depth shall be clearly marked. The minimum water depth for a one-meter board shall be at least ten feet and free from stumps, rocks, or other debris. 16.14 When children in care share swimming areas with other bathers, a visible system of identification shall be in place to distinguish children in care. Personal flotation devices of any kind shall not be used as identifiers. 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: All CBCCPP play areas must be fenced or otherwise protected from traffic and other hazards. ii. All CCDF-eligible licensed family child care homes. Provide the standard: All FCCH play areas must be fenced or otherwise protected from traffic and other hazards. 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: All ASP outdoor play areas must be fenced or otherwise protected from traffic and other hazards. 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: CBCCPP program directors shall develop and implement a policy in plain language regarding positive guidance and behavior management of children. Staff’s expectations of children’s behavior and responses to children’s behavior shall be appropriate to each child’s level of development and understanding. Guidance shall be designed to meet the individual needs of each child. No form of inappropriate discipline or corporal punishment shall be used with children such as but not limited to hitting, shaking, biting, pinching, restricting a child’s movements or actions through use of physical force, binding, tying, use of any other mechanical restraint. These regulations help protect children from shaken baby syndrome and abusive head trauma. ii. All CCDF-eligible licensed family child care homes. Provide the standard: FCCPs shall develop and implement a policy in plain language regarding positive guidance and behavior management of children. Staff’s expectations of children’s behavior and responses to children’s behavior shall be appropriate to each child’s level of development and understanding. Guidance shall be designed to meet the individual needs of each child. No form of inappropriate discipline or corporal punishment shall be used with children such as but not limited to hitting, shaking, biting, pinching, restricting a child’s movements or actions through use of physical force, binding, tying, use of any other mechanical restraint. These regulations help protect children from shaken baby syndrome and abusive head trauma. 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: There are no standards for ASPs that speak to shaken baby syndrome given the children served must be five (5) years of age or older to receive services. ASP staff orientation includes training on positive behavior management and child guidance and no staff, employee, volunteer or parent shall use corporal punishment or other forms of inappropriate discipline, such as, but not limited to hitting, shaking, biting, pinching, or restricting a child's movement through binding, tying or use of any other restraint which could help protect children from experiencing abusive head trauma. 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: 2.1.5 Children in a regulated Center Based Child Care and Preschool Program shall not be subjected to abuse, neglect, mistreatment, or immoral surroundings. 6.2.5 Quality of Interactions 6.2.5.1 Each child shall be treated with consideration and respect with equal opportunities to take part in all developmentally appropriate activities. 6.2.5.2 Staff shall appropriately hold, touch, smile and talk to children. 6.2.5.3 Staff shall speak to children at their eye level. 6.2.5.4 Staff shall be available and responsive to children, encouraging them to share experiences, ideas, and feelings. 6.2.5.5 At least one (1) staff member shall sit with children during meals and snacks. 6.2.5.6 Staff shall listen to children with attention and respect. 6.2.5.7 Children shall be attended to when they cry. 6.2.5.8 Nurturing activities performed by staff, including diapering, toileting, feeding, dressing, and resting; shall be performed in a relaxed, reassuring and individualized manner that is developmentally appropriate and promotes the child’s learning, self-help and social skills. 6.2.5.9 Nurturing activities performed by staff shall be performed with consideration of the parents’ expressed preferences and nurturing practices when these are developmentally appropriate and do not constitute a violation of these regulations. 6.2.5.10 Staff’s voices shall not dominate the overall sound of the group. 6.2.7 Positive Guidance and Behavior Management 6.2.7.1 The program director shall develop and implement a policy in plain language regarding positive guidance and behavior management of children. The policy shall be routinely provided to staff and parents. 6.2.7.2 Staff’s expectations of children’s behavior and responses to children’s behavior shall be appropriate to each child’s level of development and understanding. Guidance shall be designed to meet the individual needs of each child. 6.2.7.3 Staff shall use positive methods of guidance and behavior management that encourage self-control, self-direction, self-esteem, and cooperation. 6.2.7.4 No form of inappropriate discipline or corporal punishment shall be used with children such as but not limited to: 6.2.7.4.1 Hitting, shaking, biting, pinching; 6.2.7.4.2 Restricting a child’s movements or actions through use of physical force, binding, tying, use of any other mechanical restraint, or using medication without written parental permission, without following the medicine's label, and/or without following medical prescription; 6.2.7.4.3 Withholding of food, water, or toilet use; 6.2.7.4.4 Confining a child in an enclosed or darkened area, such as a closet or a locked room; 6.2.7.4.5 Inflicting mental or emotional punishment such as humiliating, shaming, threatening, or frightening a child; or 6.2.7.4.6 Making disparaging remarks regarding a child or his/her family. 6.2.7.5 No punitive action shall be taken with children for not going to sleep, for toileting accidents, for failure to eat all or part of a meal or for failure to complete a prescribed activity. 6.2.7.6 Profanity and obscene language shall not be used in the CBCCPP while children are present. 6.2.7.7 The program director shall consult with parents and professionals to design an effective behavior management plan and adapt behavior management practices for a child who exhibits a pattern of challenging behaviors. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 2.1.5 Children in a regulated FCCH shall not be subjected to abuse, neglect, mistreatment, or immoral surroundings. 6.2.5 Positive Guidance and Behavior Management 6.2.5.1 The FCCP shall develop and implement a policy in plain language regarding positive guidance and behavior management of children. The policy shall be routinely provided to staff and parents. 6.2.5.2 The FCCP and/or staff’s expectations of children’s behavior and responses to children’s behavior shall be appropriate to each child’s level of development and understanding. Guidance shall be designed to meet the individual needs of each child. 6.2.5.3 The FCCP and/or staff shall use positive methods of guidance and behavior management that encourage self-control, self-direction, self-esteem and cooperation. 6.2.5.4 No form of inappropriate discipline or corporal punishment shall be used with children such as but not limited to: 6.2.5.4.1 Hitting, shaking, biting, pinching; 6.2.5.4.2 Restricting a child’s movements through binding, tying, or use of any other mechanical restraint; 6.2.5.4.3 Withholding of food, water, or toilet use; 6.2.5.4.4 Confining a child in an enclosed or darkened area, such as a closet or a locked room; 6.2.5.4.5 Inflecting mental or emotional punishment such humiliating, shaming, threatening, or frightening a child; or 6.2.5.4.6 Making disparaging remarks regarding a child or his/her family. 6.2.5.5 No punitive action shall be taken with children for not going to sleep, for toileting accidents, for failure to eat all or part of a meal or for failure to complete a prescribed activity. 6.2.5.6 Profanity and obscene language shall not be used in the FCCH while children are present. 6.2.5.7 The FCCP shall consult with parents and professionals to design an effective behavior management plan and adapt behavior management practices for a child who exhibits a pattern of challenging behaviors. 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: 3.12 Any person shall be prohibited from the facility when her/his presence or behavior disrupts the program, distracts the Staff from their responsibilities, intimidates or promotes fear among the children, or when there is reason to believe that her/his actions or behavior will present risk of harm to the children in the program. 9.1 Staff shall use positive methods of guidance that meet the individual needs of each child and encourage self-control, self-direction, self-esteem and cooperation including: • redirection • planning ahead to prevent problems • reinforcing and praising appropriate behavior • encouraging children to express their feelings and ideas instead of solving problems with force. 9.2 No Staff, employee, volunteer or parent shall use corporal punishment or other forms of inappropriate discipline, such as, but not limited to: 9.2.a. hitting, shaking, biting, pinching 9.2.b. restricting a child's movement through binding, tying or use of any other restraint 9.2.c. withholding food, water, or toilet use 3 9.2.d. confining a child in an enclosed or darkened area such as a closet or locked room 9.2.e. inflicting mental or emotional punishment such as humiliating, shaming, threatening or frightening a child 9.2.f. the intentional infliction of pain by any means for the purpose of punishment, correction, discipline, instruction or any other reason. 9.3 Staff shall positively model and set limits for children in areas of health, safety, and personal interactions. 9.4 Staff shall encourage and guide children to resolve their own conflicts. 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: The licensee and/or FCCH shall develop and maintain a written Emergency Response Plan to respond to a full range of emergencies both natural and man-made. A complete plan shall include how the licensee will address and manage the following situations and responsibilities: • Evacuations or other emergencies such as leaving the premise and lockdown situations; • Specific concerns related to the location of the program, such as proximity to a nuclear reactor, an area prone to flooding or power loss; • Notifying the local authorities of the emergency • A system for notifying the parents of the emergency; • Notifying the local emergency planning committee regarding the location of the CBCCPP and using the committee as a resource in emergency planning for the program; • A system of identifying the children and staff present at the time of the emergency and maintaining knowledge of their whereabouts; • A system for handling infants, toddlers, and children with special needs; • An established evacuation meeting location within walking distance of the CBCCPP; • A system to account for all children and staff at the evacuation meeting place; • A process for relocation if necessary, including safe transportation; • A system for shelter in place if the staff and children present need to remain in the CBCCPP for an extended period; and • Staff chain of command and individual staff roles and responsibilities, (if applicable) during emergencies • A process for reunifying children with their families in the event of an emergency 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: 5.2.5 Standard Practices for Exposure to Bodily Fluids Staff shall use standard precautions when exposed to blood or blood-containing bodily fluids. The standard precautions include: • Use of nonporous disposable gloves to clean up the blood or blood-containing fluid unless the material used to clean it up can easily contain the fluid; • Clean and disinfect the soiled surface; • Dispose of contaminated materials and store washable items in securely sealed plastic bags; and • Wash hands thoroughly as required in the rule 5.2.1.3 of these regulations. 5.10.1.10 Management of Toxic Substances 5.10.1.10.1 All containers of poisonous, toxic, or hazardous materials present in the CBCCPP shall be labeled for easy identification and used only in such a manner and under conditions that will not contaminate food or create a hazard to the children or staff. 5.10.1.10.2 The storage of flammable liquids and gases shall not be permitted in the CBCCPP except as permitted by the Vermont Division of Fire Safety. 5.10.1.10.3 All poisonous or toxic materials, except materials required for routine cleaning, shall be locked in a secure storage area. 5.10.1.10.4 Materials required for routine cleaning shall be stored and used in a safe manner out of the reach of children. 5.10.1.10.5 Devices that diffuse or emit airborne chemicals such as anti-pest strips, ozone generators, plug-in air fresheners, nail polish, nail polish remover, and aerosol sprays shall not be used in the CBCCPP. 5.10.1.10.6 Plants accessible to children (indoors and outdoors) shall be non-toxic. 5.10.1.10.7 Protection of Children from Asbestos: Prior to any renovation or remodeling of the CBCCPP or if demolition, repair, maintenance, or other conditions in the CBCCPP are observed that indicate building material that may contain asbestos has been disturbed or exposed, the licensee shall ensure that an assessment is performed by a person certified by the Vermont Department of Health in compliance with statutory and regulatory requirements of 18 V.S.A. Chapter 26 and the Vermont Department of Health’s Regulations for Asbestos Control. The licensee shall ensure that any and all abatement recommendations made as a result of that assessment are followed. A copy of the assessment, which includes the recommendations and statement of compliance achieved, shall be submitted to the Division. Regulatory action may be taken on the basis of children potentially exposed to asbestos as a health hazard. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 5.2.5 Standard Practices for Exposure to Body Fluids Staff shall use standard precautions when exposed to blood or blood-containing body fluids. The standard precautions include: • Use of nonporous disposable gloves to clean up the blood or bloodcontaining fluid unless the material used to clean it up can easily contain the fluid; • Clean and disinfect the soiled surface; Dispose of contaminated materials and store washable items in securely sealed plastic bags; and • Wash hands thoroughly as required in the rule 5.2.1.3 of these regulations. 5.10.1.10 Management of Toxic Substances 5.10.1.10 Management of Toxic Substances 5.10.1.10.1 All containers of poisonous, toxic, or hazardous materials present in the FCCH shall be labeled for easy identification and used only in such a manner and under conditions that will not contaminate food or create a hazard to the children or staff. 5.10.1.10.2 The storage of flammable liquids and gases shall not be permitted in the FCCH except as permitted by the Vermont Division of Fire Safety. 5.10.1.10.3 All poisonous or toxic materials shall be inaccessible to children. 5.10.1.10.4 Devices that diffuse or omit airborne chemicals such as anti-pest strips, ozone generators, plug-in air fresheners, nail polish, nail polish remover, and aerosol sprays shall not be used in the FCCH while children are present. 5.10.1.10.5 Plants accessible to children (indoors and outdoors) shall be non-toxic. 5.10.1.10.6 Protection of Children from Asbestos: Prior to any renovation or remodeling of the FCCH or if demolition, repair, maintenance, or other conditions in the FCCH are observed that indicate building material that may contain asbestos has been disturbed or exposed, the FCCP shall ensure that an assessment is performed by a person certified by the Vermont Department of Health in compliance with statutory and regulatory requirements of 18 V.S.A. Chapter 26 and the Vermont Department of Health’s Regulations for Asbestos Control. The FCCP shall ensure that any and all abatement recommendations made as a result of that assessment are followed. A copy of the assessment, which includes the recommendations and statement of compliance achieved, shall be submitted to the Division. Regulatory action may be taken on the basis of children potentially exposed to asbestos as a health hazard. 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: 12.5 Hazardous substances shall be in their original container, stored separately and inaccessible to children. 13.1 Staff shall use universal precautions when in contact with all blood and other body fluids that are potentially infectious (saliva, nose and eye discharges, vomit, urine, feces) by following the procedures listed below: • wear non-porous latex or vinyl gloves unless the fluid can be easily contained by the material used to clean it up (tissue for noses, etc.) being careful not to get any of the fluid being handled into eyes, nose, mouth or open sores/cuts • clean and then disinfect any surfaces coming into contact with body fluids using a bleach dilution according to manufacturer’s instructions for disinfecting • dispose of contaminated materials and store launderable items in securely sealed containers or bags • wash hands with soap and water. 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: All CBCCPP staff counted in ratio and/or allowed to work alone with children must complete an orientation training that includes the disposal of bio contaminants. CBCCPPs have standard practices for exposure to bodily fluids which includes staff using standard precautions when exposed to blood or blood-containing bodily fluids. The standard precautions include use of nonporous disposable gloves to clean up the blood or blood-containing fluid unless the material used to clean it up can easily contain the fluid; clean and disinfect the soiled surface; dispose of contaminated materials and store washable items in securely sealed plastic bags; and wash hands thoroughly. ii. All CCDF-eligible licensed family child care homes. Provide the standard: All FCCPs and staff must complete an orientation training that includes the disposal of bio contaminants. FCCPs have standard practices for exposure to bodily fluids which includes staff using standard precautions when exposed to blood or blood- containing bodily fluids. The standard precautions include use of nonporous disposable gloves to clean up the blood or blood-containing fluid unless the material used to clean it up can easily contain the fluid; clean and disinfect the soiled surface; dispose of contaminated materials and store washable items in securely sealed plastic bags; and wash hands thoroughly. 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: All ASPs staff must complete an orientation training that includes the disposal of bio contaminants. Staff shall use universal precautions when in contact with all blood and other body fluids that are potentially infectious (saliva, nose and eye discharges, vomit, urine, feces) by following the procedures listed below: wear non-porous latex or vinyl gloves unless the fluid can be easily contained by the material used to clean it up (tissue for noses, etc.) being careful not to get any of the fluid being handled into eyes, nose, mouth or open sores/cuts; clean and then disinfect any surfaces coming into contact with body fluids using a bleach dilution according to manufacturer’s instructions for disinfecting; dispose of contaminated materials and store launderable items in securely sealed containers or bags; and, wash hands with soap and water. 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: 5.10.6 Transportation 5.10.6.1 Vehicle Safety 5.10.6.1.1 The licensee shall ensure that any vehicle, owned by the CBCCPP, used for transporting children be registered, inspected, and insured according to state law. 5.10.6.1.2 The licensee shall ensure that any vehicle, owned by the CBCCPP, used to transport children is equipped with a first aid kit and additional emergency items as specified in the rule 5.7.3 of these regulations. 5.10.6.1.3 The program director shall ensure that any vehicle, not owned by the CBCCPP, meets requirements in the rules 5.10.6.1.1 ￿ 5.10.6.1.2 of these regulations. This documentation shall be kept on file at the CBCCPP for 365 days. 5.10.6.1.4 The program director shall ensure that any driver does not transport more persons, including children and adults, than the capacity of the vehicle. 5.10.6.2 Car Seats and Seat Belts 5.10.6.2.1 All children under eight (8) years of age shall be properly secured in a federally approved child restraint system appropriate to their weight and size unless a child’s medical condition requires the use of a special seat. These child restraint system requirements do not apply to bussing options that do not have seat belts. 5.10.6.2.2 All children over eight (8) years of age, the driver, and any adult passengers shall be properly restrained using a child restraint, or safety belt system in good working order at all times. 5.10.6.3 Interior Temperature of Vehicle All vehicles shall have operable heating and air conditioning. A comfortable temperature shall be maintained in vehicles while transporting children. Buses that are not equipped with an air conditioning feature may be used when the interior of the bus does not exceed 85°F degrees. 5.10.6.4 Vehicle Maintenance 5.10.6.4.1 The licensee shall ensure that any vehicle, owned by the CBCCPP, used to transport children is safe and in good repair. 5.10.6.4.2 When a vehicle is used to transport children that is not owned by the CBCCPP, the program director shall obtain a written statement from the vehicle owner stating the vehicle is safe and in good repair. This documentation shall be kept on file at the CBCCPP for 365 days. 5.10.6.5 Qualifications and Safe Practice of Driver 5.10.6.5.1 The licensee shall ensure that the driver of any motor vehicle, employed by the CBCCPP, who is transporting children, holds a valid operator’s license that is appropriate for that vehicle. If sixteen (16) or more persons, including the driver, are transported at one (1) time, the driver shall hold a valid commercial driver’s license with a passenger endorsement. 5.10.6.5.2 The licensee shall ensure that the driver, employed by the CBCCPP, obeys all traffic laws. 5.10.6.5.3 The licensee shall ensure that the driver, employed by the CBCCPP, does not use a cell phone or text while driving. Should communication be necessary, the driver shall park the vehicle before using any hand held device. 5.10.6.5.4 The program director shall ensure that the driver of any motor vehicle, not employed by the CBCCPP, who is transporting children, meets the requirements in the rules 5.10.6.5.1 ￿ 5.10.6.5.3 of these regulations. 5.10.6.6 Safety and Supervision of Transported Children 5.10.6.6.1 The program director shall ensure that written permission is obtained from parents prior to providing transportation of children. Parents shall also be notified when someone not employed by the program may transport their child. This written permission shall be retained in each child’s file. 5.10.6.6.1.1 Written permission authorizing the CBCCPP to transport children home shall specify the address where the children shall be released and whether the child may be released without an authorized person present. 5.10.6.6.1.2 Written permission authorizing the CBCCPP to release a child to a transportation service not under the authority of this CBCCPP shall be noted as such within the written permission. 5.10.6.6.2 No child shall ever be left unattended or unsupervised in a vehicle at any time. 5.10.6.6.3 Staff/child ratios established in the rules in section 6.2.1 of these regulations shall be maintained at all times while children are being transported. 5.10.6.6.4 No more than six (6) children shall be transported in a vehicle without the presence of a second adult in addition to the driver. 5.10.6.6.5 The program director shall ensure that when there are three (3) or more non-ambulatory children in the vehicle, there must be at least two (2) staff members present. When there are more than six (6) non-ambulatory children in the vehicle a one (1): four (4) staff/child ratio shall apply in addition to the driver. 5.10.6.6.6 The program director shall establish and implement a procedure for accounting for all children transported. The procedure shall minimally include: • Recording information on all trips including date, time, driver, vehicle, and children transported; • Recording the adult, a child was released to if not CBCCPP staff; • Recording the address, a child was released to if not to an authorized person or CBCCPP Staff; and • A method for confirming that every child exits the vehicle after each trip. 5.10.6.7 The program director shall ensure that when the CBCCPP provides transportation, the maximum amount of time a child can be transported to or from the child’s home, the CBCCPP, or school shall not exceed forty-five (45) minutes one (1) way. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 5.10.6 Transportation 5.10.6.1 Vehicle Safety 5.10.6.1.1 The FCCP shall ensure that any vehicle used for transporting children shall be registered, inspected and insured according to state law. 5.10.6.1.2 The FCCP shall ensure that any vehicle used to transport children is equipped with a first aid kit and additional emergency items as specified in the rule 5.7.3 of these regulations. 5.10.6.1.3 The FCCP shall ensure that any vehicle, not owned by the FCCH, meets requirements in the rules 5.10.6.1.1 ￿ 5.10.6.1.2 of these regulations. This documentation shall be kept on file at the FCCH for 365 days. 5.10.6.1.4 The FCCP shall ensure that any driver does not transport more persons, including children and adults, than the capacity of the vehicle. 5.10.6.2 Car Seats and Seat Belts 5.10.6.2.1 All children under eight (8) years of age shall be properly secured in a federally approved child restraint system appropriate to their weight and size unless a child’s medical condition requires the use of a special seat. These child restraint system requirements do not apply to bussing options that do not have seat belts. 5.10.6.2.2 All children over eight (8) years of age, the driver, and any adult passengers shall be properly restrained using a child restraint or safety belt system in good working order at all times. 5.10.6.3 Interior Temperature of Vehicle All vehicles shall have operable heating and air conditioning. A comfortable temperature shall be maintained in vehicles while transporting children. Buses that are not equipped with an air conditioning feature may be used when the interior of the bus does not exceed 85°F degrees. 5.10.6.4 Vehicle Maintenance The FCCP shall ensure that any vehicle used to transport children is safe and in good repair. 5.10.6.5 Qualifications and Safe Practice of Driver 5.10.6.5.1 The FCCP shall ensure that the driver of any motor vehicle who is transporting children holds a valid operator’s license that is appropriate for that vehicle. If sixteen (16) or more persons, including the driver, are transported at one (1) time, the driver shall hold a valid commercial driver’s license with a passenger endorsement. 5.10.6.5.2 The FCCP shall ensure that the driver obey all traffic laws. 5.10.6.5.3 The FCCP shall ensure that the driver does not use a cell phone or text while driving. Should communication be necessary, the driver shall park the vehicle before using any hand held device. 5.10.6.6 Safety and Supervision of Transported Children 5.10.6.6.1 The FCCP shall ensure that written permission is obtained from parents prior to providing transportation of children. Parents will also be notified when someone not employed by the program may transport their child. This written permission shall be retained in each child’s file. 5.10.6.6.1.1 Written permission authorizing the FCCH to transport children home shall specify the address where the children shall be released and whether the child may be released without an authorized person present. 5.10.6.6.1.2 Written permission authorizing the FCCH to release a child to a transportation service not under the authority of the FCCH shall be noted as such within the written permission. 5.10.6.6.2 No child shall ever be left unattended or unsupervised in a vehicle at any time. 5.10.6.6.3 Staff/child ratios established in the rules in section 6.2 of these regulations shall be maintained at all times while children are being transported. 5.10.6.6.4 The FCCP shall ensure that when there are three (3) or more non- ambulatory children in the vehicle, there must be at least two (2) staff members present. When there are more than six (6) non-ambulatory children in the vehicle a one (1): Four (4) staff/child ratios shall apply in addition to the driver. 5.10.6.6.5 The FCCP shall establish and implement a procedure for accounting for all children transported. The procedure shall minimally include: • Recording information on all trips including date, time, driver, vehicle and children transported; • Recording what adult a child was released to if not the FCCP; • Recording the address a child was released to if not to an authorized person or FCCP and/or staff; and • A method for confirming that every child exits the vehicle after each trip. 5.10.6.7 The FCCP shall ensure that when the FCCH provides transportation, the maximum amount of time a child can be transported to or from the child’s home, the FCCH, or school shall not exceed forty-five (45) minutes one (1) way. 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: 17.1 The Program Administrator or Site Director shall ensure that written permission is obtained from parents prior to providing transportation of children. Parents shall also be notified when someone not employed by the program may transport their child. This written permission shall be retained in each child’s file. 17.2 Any vehicles used for transporting children shall be registered, inspected and insured according to Vermont State Law. 17.3 The operator of any motor vehicle who is transporting children shall hold a valid operator's license that is appropriate for that vehicle. The Licensee shall ensure that the driver obeys all traffic laws. 17.4 If sixteen or more persons, including the driver, are transported at one time, the driver shall hold a valid commercial driver’s license with a passenger endorsement as required by Vermont State Law. 17.5 Children in vehicles shall not be left unsupervised or unattended at any time. 17.6 Staff/child ratios are as follows for transporting ambulatory children: Number of Children Number of Staff 1 ￿ 6 children 1 Staff person (can be the driver) 7 - 13 children 2 Staff persons (can include the driver) 17.7 Two Staff persons shall be present in addition to the driver when fourteen or more children are transported. 17.8 The Program Administrator or Site Director shall ensure that when there are three or more non-ambulatory children in the vehicle, there must be at least two staff members present. When there are more than six non-ambulatory children in the vehicle a one: four staff/child ratio shall apply in addition to the driver. 17.9 When being transported in a motor vehicle, all passengers, except children who have physical conditions which prevent the use of a child safety seat or seat belt, shall be properly restrained in accordance with Vermont State Law. 17.10 The number of children within the school bus shall not be more than the number of seating spaces provided. 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: The CBCCPP licensee shall ensure that at least one (1) staff who has successfully completed and is currently certified in pediatric first aid is on the premises at all times children are present. Staff who are counted in the staff/child ratios and auxiliary staff left alone with children and/or counted in staff/child ratio shall obtain training in pediatric first aid within three (3) months of beginning work in the CBCCPP and remain currently certified. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 7.1.2.1 The FCCP shall have successfully completed pediatric first aid and CPR prior to being licensed and must remain currently certified. 7.1.2.2 The FCCP shall ensure that at least one (1) responsible adult who has successfully completed and is currently certified in pediatric first aid and infant and child CPR is on the premises at all times children are present. 7.1.2.3 The licensed FCCP shall ensure that staff who are counted in the staff/child ratios shall obtain training in pediatric first aid and infant and child CPR within three (3) months of beginning work in the licensed FCCH and remain currently certified. 7.6.7 The licensed FCCP shall ensure substitutes obtain training in pediatric first aid and infant and child CPR as required in the rule 7.1.2.3 of these regulations. 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: The ASP standard in Vermont requires the Program Administrator, the Site Director, new and returning ASP staff and aides to have infant/child first aid training and maintain certification and at least one Staff person who holds a current CPR card in rescue breathing, and airway obstruction shall be present at all times. 5.39 Within three months of hire, all paid Staff counted in the staff/child ratios shall have obtained CDD-approved training in infant/child CPR and basic first aid for children, injury prevention and emergency readiness. All Staff shall receive retraining in first aid prior to the expiration date on each Staff person’s first aid card. 5.41 Substitutes shall obtain training in pediatric first aid and child CPR within three months of beginning work and remain currently certified. 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: The CBCCPP licensee shall ensure that at least one (1) staff who has successfully completed and is currently certified in infant and child CPR is on the premises at all times children are present. Staff who are counted in the staff/child ratios and auxiliary staff left alone with children and/or counted in staff/child ratio shall obtain training in infant and child CPR within three (3) months of beginning work in the CBCCPP and remain currently certified. ii. All CCDF-eligible licensed family child care homes. Provide the standard: 7.1.2.1 The FCCP shall have successfully completed pediatric first aid and CPR prior to being licensed and must remain currently certified. 7.1.2.2 The FCCP shall ensure that at least one (1) responsible adult who has successfully completed and is currently certified in pediatric first aid and infant and child CPR is on the premises at all times children are present. 7.1.2.3 The licensed FCCP shall ensure that staff who are counted in the staff/child ratios shall obtain training in pediatric first aid and infant and child CPR within three (3) months of beginning work in the licensed FCCH and remain currently certified. 7.6.7 The licensed FCCP shall ensure substitutes obtain training in pediatric first aid and infant and child CPR as required in the rule 7.1.2.3 of these regulations. 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: The ASP standard in Vermont requires the Program Administrator, the Site Director, new and returning ASP staff and aides to have infant/child CPR and maintain certification and at least one Staff person who holds a current CPR card in rescue breathing, and airway obstruction shall be present at all times. 5.39 Within three months of hire, all paid Staff counted in the staff/child ratios shall have obtained CDD-approved training in infant/child CPR and basic first aid for children, injury prevention and emergency readiness. All Staff shall receive retraining in first aid prior to the expiration date on each Staff person’s first aid card. 5.41 Substitutes shall obtain training in pediatric first aid and child CPR within three months of beginning work and remain currently certified. 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: CBCCPP directors must develop and implement written policies requiring staff to report suspected cases of child abuse or neglect and that staff are trained in the prevention and identification of child abuse and neglect, in the prevention of child sexual abuse, in the signs and symptoms of sexual abuse, sexual violence, and grooming processes; in recognizing the dangers of child sexual abuse in and close to the home; and other predatory behaviors of sex offenders. These standards apply to staff and volunteers. ii. All CCDF-eligible licensed family child care homes. Provide the standard: Licensed FCCPs must develop and implement written policies requiring staff to report suspected cases of child abuse or neglect and that staff are trained in the prevention and identification of child abuse and neglect, in the prevention of child sexual abuse, in the signs and symptoms of sexual abuse, sexual violence, and grooming processes; in recognizing the dangers of child sexual abuse in and close to the home; and other predatory behaviors of sex offenders. These standards apply to staff and volunteers. It is the responsibility of the registered FCCP to ensure that staff and partner staff working with children in the FCCH understand that abuse and/or neglect of children is against the law and that all child care workers are legally required to report suspected child abuse or 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: The ASP licensee shall ensure all staff receive an orientation, based on materials recommended by AHS and AOE on the prevention, identification, and mandatory reporting requirements of child abuse, including child sexual abuse, signs and symptoms of sexual abuse, sexual violence, grooming processes, recognizing the dangers of child sexual abuse in and close to the home, and other predatory behaviors of sex offenders. 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: 3.3 Legal Mandates Regarding Child Abuse and Neglect 3.3.1 The licensee, staff, auxiliary staff, and partner staff shall be informed of and have ready access to the twenty-four (24) hour Child Abuse Hotline maintained by the Department. 3.3.2 The licensee, staff, auxiliary staff, and partner staff working with children are mandated reporters of child abuse and neglect pursuant to 33 V.S.A. §4913 and are required to report to the Child Abuse Hotline when they reasonably suspect abuse or neglect of a child. This report must be made within twenty-four (24) hours of the time information regarding the suspected abuse or neglect was first received or observed. 3.3.3 The licensee, staff, auxiliary staff, and partner staff shall understand that abuse and/or neglect of children is against the law and that all child care workers are 31 legally required to report suspected child abuse or neglect as specified in the rule 3.3.2 of these regulations. 3.3.4 The program director shall develop and implement a written policy requiring the licensee, staff, and auxiliary staff to report suspected child abuse or neglect to the Department as specified in the rule 3.3.2 of these regulations. 3.3.5 The licensee, staff, and auxiliary staff shall be trained in prevention, identification and mandatory reporting of child abuse and neglect. 3.3.6 The licensee, staff, and auxiliary staff shall be trained in prevention of child sexual abuse; in signs and symptoms of sexual abuse, sexual violence, and grooming processes; in recognizing the dangers of child sexual abuse in and close to the home; and other predatory behaviors of sex offenders. 3.3.7 The licensee shall not discharge, demote, transfer, reduce pay, benefits or work privileges, prepare a negative work performance evaluation, or take any other action detrimental to any person because he/she filed a good faith report with the Department regarding suspicion of abuse or neglect of a child ii. All CCDF-eligible licensed family child care homes. Provide the standard: 3.2 Legal Mandates Regarding Child Abuse and Neglect 3.2.1 The FCCP, staff, and partner staff shall be informed of and have ready access to the twenty-four (24) hour Child Abuse Hotline maintained by the Department. 3.2.2 The FCCP, staff, and partner staff working with children are mandated reporters of child abuse and neglect pursuant to 33 V.S.A. §4913 and are required to report to the Child Abuse Hotline when they reasonably suspect abuse or neglect of a child. This report must be made within twenty-four (24) hours of the time information regarding the suspected abuse or neglect was first received or observed. 3.2.3 It is the responsibility of the FCCP to ensure that staff and partner staff working with children in the FCCH understand that abuse and/or neglect of children is against the law and that all child care workers are legally required to report suspected child abuse or neglect as specified in the rule 3.2.2 of these regulations. 3.2.4 The licensed FCCH program director shall develop and implement a written policy requiring the licensed FCCP, and staff to report suspected child abuse or neglect to the Department as specified in the rule 3.2.2 of these regulations. 3.2.5 The licensed FCCP and staff shall be trained in prevention, identification and mandatory reporting of child abuse and neglect. 3.2.6 The licensed FCCP and staff shall be trained in prevention of child sexual abuse; in signs and symptoms of sexual abuse, sexual violence, grooming processes; in recognizing the dangers of child sexual abuse in and close to the home; and other predatory behaviors of sex offenders. 3.2.7 A licensed FCCP shall not discharge, demote, transfer, reduce pay, benefits or work privileges, prepare a negative work performance evaluation or take any other action detrimental to any person because he/she filed a good faith report with the Department regarding suspicion of abuse or neglect of a child. 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: 4.10 The licensee and staff shall be informed of and have ready access to the twenty-four (24) hour Child Abuse Hotline maintained by the Department. 4.11 The licensee and staff working with children are mandated reporters of child abuse and neglect pursuant to 33 V.S.A. §4913 and are required to report to the Child Abuse Hotline when they reasonably suspect abuse or neglect of a child. This report must be made within twenty-four (24) hours of the time information regarding the suspected abuse or neglect was first received or observed. 4.12 The licensee and staff shall understand that abuse and/or neglect of children is against the law and that all child care workers are legally required to report suspected child abuse or neglect as specified in the rule 4.11 of these regulations. 4.13 The Licensee shall develop and implement a policy requiring all Staff to report suspected child abuse or neglect to the Department for Children and Families within 24 hours when there is reasonable cause to believe that a child has been abused or neglected. 4.14 The Licensee shall ensure that they and all Staff receive training and demonstrate understanding of their legal responsibilities regarding preventing and reporting suspected child abuse and neglect. 4.15 The Licensee shall not discharge, demote, transfer, reduce pay, benefits or work privileges, prepare a negative work performance evaluation or take any other action detrimental to any Staff member because the Staff member filed a good faith report with the Department regarding suspicion of abuse or neglect of a child. 4.16 The Licensee shall comply with Act One (2009) which requires licensed child care facilities to ensure that all individuals working at the facility receive an orientation, based on materials recommended by the Agency of Human Services and the Agency of Education, on the prevention, identification, and mandatory reporting requirements of child abuse, including child sexual abuse, signs and symptoms of sexual abuse, sexual violence, grooming processes, recognizing the dangers of child sexual abuse in and close to the home, and other predatory behaviors of sex offenders. 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: CBCCPPs, FCCHs, and ASPs regulations have "Food and Nutrition" standards when providing meals and snacks; nutritional content of meals and snacks; handling of hot food and liquids around children; accessibility to drinking water; food vendor requirements; infant nutrition standards and storage requirements; nutritional education provided to parents who provide their own food; and, how to handle special nutritional requests and restrictions. ii. Access to physical activity. Describe: CBCCPPs and FCCHs have standards regarding providing children with outdoor play/gross motor activity/opportunities. ASPs have program curriculum standards activity options offered each day. iii. Caring for children with special needs. Describe: CBCCPPs and FCCHs have standards to support children with special health needs, disabilities, and English Language Learners. ASPs have standards to support children with special needs. All programs have policies and practices to support the inclusion of children with special needs and disabilities. iv. Any other areas determined necessary to promote child development or to protect children’s health and safety. Describe: CBCCPPs, FCCHs, and ASPs are all required to meet the Vermont Department of Health’s lead water testing. If a program is on a well, they must also test their water taps for bacteria and chemicals. Additionally, all buildings built before 1977 must comply with Vermont’s Asbestos and Lead Regulatory Program ("ALRP").