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Lead Agencies must have ongoing training requirements for all caregivers, teachers, and directors of eligible CCDF providers for health and safety standards but have discretion on frequency and training content (e.g., pediatric CPR refresher every year and recertification every 2 years). Lead Agencies have discretion on which health and safety standards are subject to ongoing training. Lead Agencies may exempt relative providers from these requirements. 5.6.1 Required ongoing training of health and safety standards Describe any required ongoing training of health and safety standards for caregivers, teachers, and directors of the following CCDF eligible provider types. a. Licensed child care centers: Maintaining certification in Pediatric Cardiopulmonary Resuscitation (CPR) and First Aid is required for all child care center provider directors, operators, and staff (78CSR1.8.6.f.1.). Staff who are in positions not qualified (not counted in child:staff ratio), must renew child abuse and neglect recognition training every three years (78CSR1.8.7.e.). Licensed out of school time centers: All staff shall renew child abuse and neglect recognition every three years and keep first aid and CPR certification current. (78CSR21.7.8.b.). Preliminary notice 12/13/21. b. License-exempt child care centers: West Virginia has no license exempt providers. c. Licensed family child care homes: Caregivers must maintain certification in pediatric CPR/First Aid (78CSR21.6.3.a.1.) Licensed family child care facilities: Have successfully completed an approved pediatric Cardiopulmonary Resuscitation (CPR) training (78CSR19. 15.1.i.). Certification must be maintained. Licensed family child care homes: Caregivers must maintain certification in pediatric CPR/First Aid (78CSR21.6.3.a.1.) Licensed Family Child Care Facilities: Have successfully completed an approved pediatric Cardiopulmonary Resuscitation (CPR) training (78CSR19. 15.1.i.). Certification must be maintained. Family Child Care Informal/Relative homes: A letter of agreement will be implemented to require providers to maintain approved pediatric Cardiopulmonary Resuscitation (CPR) and pediatric first aid training. Regulation 78CSR21 6.3.c. will be revised at the 2028 sunset for legislative approval: 6.3.c. Informal and relative caregivers shall obtain approved training in pediatric cardiopulmonary resuscitation (CPR) and first aid within three months of initial registration;. Certification must be maintained. d. License-exempt family child care homes: West Virginia has no license exempt providers. e. Regulated or registered in-home child care: Not applicable. f. Non-regulated or registered in-home child care: NA