DAR File No.: 31057
Filed: 03/12/2008, 03:17
Received by: NLRULE ANALYSIS
Purpose of the rule or reason for the change:
The changes reorganize the rule subsections and add some requirements in order to increase consistency in the health and safety requirements among all categories of child care rules.
Summary of the rule or change:
This rulemaking action clarifies existing language and increases consistency in the health and safety requirements among all categories of regulated child care providers. It also modifies personnel requirements. Provisions of the old version of the rule that will not appear in the new version include: requirements for food service and sanitation items that local health departments now inspect for; and requirements for all caregivers to have a high school diploma. Provisions of the new version of the rule that do not appear in the old version include: allowing assistant caregivers to be 16 years of age; requiring those providers who do not already have a fence surrounding their outdoor play area to get one; new playground safety requirements; and requirements for trampoline usage. In addition, new definitions were added to clarify many rules.
State statutory or constitutional authorization for this rule:
Title 26, Chapter 39
Anticipated cost or savings to:
the state budget:
The changes do not materially change the state's work load in regulating child care providers and, as such, do not impose additional cost or create savings.
local governments:
The changes do not materially change the work load for local governments in regulating in-home child care providers and, as such, do not impose additional costs or create savings.
small businesses and persons other than businesses:
All licensed family child care providers are small businesses. In-home child care licensees who care for more than 8 children may see savings related to allowing assistant caregivers age 16 and older instead of 18 and older. The department cannot estimate the number of licensees who will hire younger assistant caregivers. Licensees who do not have a four-foot fence surrounding their outdoor play area or a six-foot fence surrounding a swimming pool will be required to install one. However, the rule gives them three years to comply with this new requirement. Licensees who do not have a three-foot use zone around outdoor play equipment will be required to have one. However, the rule gives them five years to meet this new requirement. The department does not know the number of home child care providers who will need to install fencing or rearrange their outdoor playground equipment. The costs for providers will be extremely variable. A majority of the providers already meet the fencing requirement. A provider whose outdoor play equipment does not meet the fall zone requirement may choose to alter the equipment configuration or not allow children to play on the equipment. For these reasons, the department cannot reasonably estimate the aggregate costs or savings.
Compliance costs for affected persons:
A licensee who does not have a four-foot fence surrounding the licensee's outdoor play area or a six-foot fence surrounding a swimming pool will be required to install one. However, the rule gives three years to comply with this new requirement. A licensee who does not have a three-foot use zone around outdoor play equipment will be required to have one. However, the rule gives five years to meet this new requirement. Costs to an individual licensee may range from $0 to $5,000.
Comments by the department head on the fiscal impact the rule may have on businesses:
The fiscal impacts for the fencing, fall zone, and training requirements that this rulemaking requires are necessary for the safety of children in child care. The delayed implementation will give providers time to absorb the costs over three years. The costs may be partially offset by the savings that may be realized in hiring assistant caregivers who may now be 16 years old instead of 18. A. Richard Melton, Acting Executive Director
The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:
Health
Health Systems Improvement, Child Care Licensing
CANNON HEALTH BLDG
288 N 1460 W
SALT LAKE CITY UT 84116-3231Direct questions regarding this rule to:
Teresa Whiting at the above address, by phone at 801-538-6320, by FAX at 801-538-6325, or by Internet E-mail at TWHITING@utah.gov
Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:
05/01/2008
This rule may become effective on:
07/01/2008
Authorized by:
Richard Melton, Deputy Director
RULE TEXT
R430. Health, Health Systems Improvement, Child Care Licensing.
R430-90. Licensed Family Child Care.
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R430-90-1. Legal Authority.This rule is promulgated pursuant to Title 26, Chapter 39.R430-90-2. Purpose.The purpose of this rule is to establish standards for the operation and maintenance of licensed family child care providers who care for one to 16 children in their home. It establishes minimum requirements for the health and safety of children in licensed programs.R430-90-3. Definitions.(1) "Conditional enrollment" means that a child is admitted to a child care program and has received at least one dose of each required vaccine prior to enrollment and maintains a schedule for subsequent required vaccinations.(2) "Supervision" means the function of observing, overseeing, and guiding a child or group of children.(3) "Related children" means children whose child care is provided by their parents, legal guardians, grandparents, brothers, sisters, uncles or aunts.(4) "Infant" means a child younger than 13 months of age.(5) "Toddler" means a child 13 months and older, but less than 25 months of age.R430-90-4. License Required.(1) A person who provides child care in a home for nine to 16 children unrelated to the licensee for less than 24 hours a day, with a regularly scheduled, on-going enrollment, for direct or in-direct compensation must be licensed as a family group child care program.(2) A person who provides child care in a home for less than nine unrelated children for less than 24 hours per day, having a regularly scheduled, ongoing enrollment, for direct or indirect compensation may be licensed as a family child care program.R430-90-5. Licensee Qualifications and Duties.(1) The licensee of the child care program must:(a) be at least 18 years of age; or(b) have a high school diploma or G.E.D.; and(c) have knowledge of and comply with applicable laws and rules.(2) The licensee shall establish and implement policies and procedures for the health and safety of children in the home.(3) The care giver shall be physically present on-site and provide care and supervision of children at all times, both indoors and outdoors. This includes:(a) awareness of and responsibility for the ongoing activity of each child and being near enough to intervene if needed; and(b) frequent in person observation of children sleeping in cribs and play pens.(4) The licensee may permit a child to participate in supervised out of the home activities without the care giver if:(a) the care giver has prior written permission from the child's parent for the child's participation; and(b) the licensee has clearly assigned the responsibility for the child's whereabouts and supervision throughout the period of care.(5) The licensee may make arrangements for a substitute who is at least 18 years old and who is capable of providing care and supervision of children and handling emergencies in the absence of the care giver.R430-90-6. Care Giver Qualifications.(1) The licensee shall ensure that each care giver or volunteer who has direct contact with or access to children is oriented to the licensed program and successfully completes the required orientation training before starting assigned duties. The licensee shall document in a care giver's personnel record the date of completion of orientation training. The orientation training must include:(a) procedures for maintaining health and safety and handling emergencies and accidents;(b) specific job responsibilities;(c) child discipline procedures of R430-90-7;(d) reporting requirements if the care giver witnesses or suspects child abuse, neglect or exploitation; and(e) procedures for releasing children to authorized individuals.(2) All care givers who provide services shall be at least 18 years of age or have completed high school or a G.E.D.(3) There shall be at least one care giver at the home during business hours who has a current course completion in basic child and infant first-aid and Cardiac Pulmonary Resuscitation (CPR), and training in the Heimlich Maneuver for treatment of an obstructed airway.(a) First-aid and CPR refers to courses given by the American Red Cross, the Utah Emergency Medical Training Council, or other courses that the licensee of the program can demonstrate to the Department to be equivalent.(b) Documentation of the completed First-Aid and CPR training must be in the care giver's personnel record.(4) The licensee must ensure that an annual documented in-service training plan is developed and carried out. The plan shall be pertinent to the ages of the children in the program and must address the following areas:(a) proper hand washing and sanitation techniques;(b) principles of good nutrition;(c) proper procedures in administration and storage of medications;(d) recognizing early signs of illness, communicable diseases and determining if there is a need to exclude a child from the program;(e) accident prevention and safety principles;(f) positive guidance for the management of children;(g) child development; and(h) age appropriate activities.(5) If child care is provided to children under age two, the following in-service topics are also required:(a) Preventing Shaken Baby Syndrome;(b) Coping with crying babies; and(c) Preventing Sudden Infant Death Syndrome.(6) The licensee shall ensure that they and all care givers complete a minimum of 20 hours of annual in-service training. At least ten hours of in-service training shall be person-to-person instruction.(7) The licensee shall document successful completion of in-service training and maintain a record for themselves and each care giver which includes:(a) the date training was completed;(b) the topics covered; and(c) the trainer's name and organizational affiliation.(8) Each care giver upon employment and each licensee shall have an initial health evaluation within the past six months and complete tuberculosis testing using the Mantoux tuberculin skin test method within two weeks of assuming care giver responsibilities. Tuberculin skin testing does not need to be repeated during the employment period unless the employee develops signs and symptoms of the disease, as determined by a health care professional.(a) All care givers with skin tests that indicate potential exposure to tuberculosis shall receive a medical evaluation for tuberculosis disease.(b) All care givers who have documentation of previous positive reaction to the Mantoux tuberculin skin test shall present documentation of completion of therapy for tuberculosis infection or evidence of a negative chest radiograph within the past 12 months.(c) Repeated chest radiographs are not required unless the care giver develops signs and symptoms of tuberculosis disease, as determined by a health care professional.R430-90-7. Child Discipline.(1) The licensee shall inform all care givers, parents or guardians and children of expected conduct by setting clear and understandable rules.(2) Disciplinary measures shall be implemented so as to encourage the child's self-control to reduce risk of injury and any adverse health effects to self or others. Positive discipline measures include but are not limited to:(a) rewards for positive behavior;(b) other forms of positive guidance;(c) redirection; or(d) time out.(3) Discipline measures shall not include any of the following:(a) corporal punishment, including hitting, shaking, biting, pinching, or spanking;(b) restraint of a child's movement by binding or tying;(c) use of abusive, demeaning or profane language;(d) force or withdrawing food, rest or bathroom opportunities; or(e) confining a child in a locked closet, room, or similar area.R430-90-8. Records.(1) The licensee shall obtain from the parent or legal guardian an admission agreement, which identifies the following:(a) child's full name and nickname;(b) parent or guardian's name, address and phone number;(c) name, address and phone number of additional persons to be notified in the event of an emergency when the parent or guardian cannot be located;(d) name, address and phone number of the child's primary source of emergency health and dental care.(2) The licensee shall ensure that children's records are organized and maintained to include the following:(a) immunization record (Utah School Immunization Record -USIR) according to R396-100;(b) child's health history required in R430-90-10(4) and any updates;(c) injury, accident and incident reports; and(d) medication administration records required in R430-90-10(6)(d).(3) The licensee of the program shall maintain care giver records to include:(a) background screening records;(b) initial health evaluations and TB testing;(c) food handler's permits;(d) first-aid and CPR course completion; and(e) in-service training records.(4) The licensee shall ensure a record or log is maintained to document each enrolled child's attendance.R430-90-9. Care Giver to Child Ratios.The minimum ratio of care givers to children permitted in licensed small family and family group child care are set forth in tables 1 and 2.TABLE 1
Family Minimum Care Giver to Child Ratios
Care giver Children Limits for Mixed Ages(a)
1 8 No more than two children under age 2
1 6 No more than three children under age 2(a) The mixed ages include the care giver's children under age 4.TABLE 2
Family Group Minimum Care giver to Child Ratios
Care Giver Children Limits for Ages Group Size(b)(c)
1 12 All Children 16
School-age
2 9-16 Mixed ages, 20
only four under
age 2(b) There shall be at least two care givers in the licensed family group program at all times when there are nine or more children present, counting the care givers' own children, grand children, nieces, nephews, wards, step-children, under age 12, or when more than two infants are present.(c) The care giver's own children, grand children, nieces, nephews, wards, step-children are included in the maximum group size if they are under the age of 12.R430-90-10. Child Health and Medications.(1) The licensee may not care for a child without proof of immunization, or evidence of conditional enrollment, or evidence of personal, medical or religious exemption. Each child shall have immunizations as required by the Utah School Immunization Law, R396-100.(2) The licensee shall observe each child daily for signs of illness.(a) The licensee shall notify the parent or legal guardian immediately when illness is observed or suspected.(b) The licensee must keep ill children separate from other children.(3) If a communicable illness or parasite is discovered, the owner shall notify the parent or legal guardian of all enrolled children on the day of discovery. Notification shall protect the confidentiality of care givers and children.(4) The parent or legal guardian shall provide a child health history upon admission which identifies:(a) known food sensitivities and allergies;(b) chronic illnesses, disabilities or medical conditions;(c) instructions for routine care; and(d) instructions for emergency care.(5) The parent or legal guardian shall annually review and update the child's health history with the licensee.(6) If the licensee chooses to administer prescribed or oral over-the-counter medications then:(a) Medications may be administered to children only by a designated care giver who does the following:(i) check the label and confirm the name of the child,(ii) read the directions regarding measured doses, frequency, expiration date, and other administration guidelines, and(iii) properly document administration of medication records according to subsection (d).(b) Oral over-the-counter and all prescription medications must be in the original or pharmacy container, have the original label, include the child's name, have child proof caps, and have written instructions for administration.(c) The parent or legal guardian must complete a medication release form for each child receiving medications that contains:(i) the name of the medication,(ii) the dosage,(iii) the route of administration,(iv) the times and dates to be administered,(v) the illness or condition being treated, and(vi) the parent's or legal guardian's signature.(d) The care giver who administers a child's medication shall maintain a medication record that includes:(i) the time, date, and dosage of the medication given;(ii) the signature or initials of the care giver who administered the medication; and(iii) documentation of any errors in administration or adverse reactions.(e) The licensee shall report any adverse reaction to a medication or error in administration to the parent or legal guardian immediately upon recognizing the error or reaction.(f) Medications shall be secured from access to children.(g) Medications stored in refrigerators shall be in spill-proof packaging and shall be kept in a covered, leakproof storage container.(h) The licensee shall return all unused or out-of-date prescription and oral over-the-counter medications to the parent or legal guardian.R430-90-11. Parent Notification and Child Security.(1) The licensee shall establish a procedure for care givers to check who has written authorization to pick up children. Only the parents, legal guardian, or persons with written authorization from a parent or legal guardian shall be allowed to take any child from the home, except that verbal authorization may be used in emergency situations.(2) The home of the licensee shall be accessible and open to parents or legal guardians during the hours of operation.(3) The licensee shall establish a procedure for ensuring that all children's attendance is accounted for, which shall include requiring a sign-in and out procedure.(4) The licensee shall establish written policies and monitor care givers, visitors, and residents of the home to ensure that the use and accessibility of tobacco, alcohol, illegal substances or sexually explicit materials are prohibited by any person anywhere on the premises during the hours of operation when children are under care.(5) In the case of a serious injury to a child which requires immediate hospital treatment, the licensee shall contact the parents or legal guardians after emergency personnel have been contacted.(6) For any emergency that requires a response by emergency medical treatment providers, fatality, or hospitalization of a child in care, the licensee shall:(a) notify the Department within 24 hours of occurrence, either by phone or facsimile; and(b) submit to the Department within five business days of occurrence a written injury and accident report.R430-90-12. Activities.(1) The licensee shall develop a daily activity plan that is designed for the age and development of the children accepted for care and ensure that there are sufficient supplies on hand.(2) There shall be a minimum of 35 square feet of indoor play area per child for each child in care under age 14. Toilet rooms, closets, hallways, and alcoves may not be included in calculating indoor play space. Play space does not include areas in the care giver home which are not included in the child care area.(3) Outdoor play areas shall have at least 40 square feet per child for each child in care under age 14. The total outdoor play area shall accommodate at least 40 percent of the licensed capacity at one time.(a) Outdoor play areas shall be fenced or have a natural barrier that provides protection from unsafe areas. Fences shall be at least four feet high. If local ordinances conflict with this requirement, the licensee may request a variance from the Department. Any gaps within the fence shall not be greater than three and one-half inches. The bottom edges of the fence shall not be more than three and one-half inches above the ground.(b) Outdoor play areas shall have a shaded area to protect children from excessive sun and heat. Drinking water shall be continuously accessible to children in the outdoor play area.(4) If off-site activities are provided, parent or legal guardian permission is required for children to participate. Care givers shall take with them emergency phone numbers for each child attending the activity.(5) If swimming activities are planned, care givers shall accompany children at pool side and lifeguards and pool personnel are not counted in care giver ratios.(6) If care is provided to infants, a care giver shall provide physical and verbal stimulation every 30 minutes to each infant during waking hours, including the opportunity for physical activity. Physical activity may not confine an awake child to a single device, such as infant equipment which restricts active movements for more than 30 minutes.R430-90-13. Transportation.(1) The licensee shall maintain documentation that any vehicle used for transporting children has a current vehicle registration, insurance for child care transportation, safety inspection and shall maintain the vehicle in a clean and safe manner.(2) Each vehicle shall:(a) have a first-aid kit and body fluid clean-up kit;(b) be equipped with individual, size-appropriate safety restraints such as car seats or seat belts which are described in the federal motor vehicle safety standards contained in the Code of Federal Regulations, title 49, section 571.213, for each child that are appropriate to the vehicle type and are installed and used in the manner prescribed by the manufacturer;(c) be enclosed; and(d) be locked during transport.(3) Smoking in vehicles is prohibited at all times that children are in the vehicle.(4) Any vehicle used for transporting children shall be driven by an adult who holds a current state driver's license that authorizes the driver to operate the type of vehicle driven.(5) The driver shall ensure that no child is unattended in the vehicle. The driver shall remove the keys whenever the driver is not in the driver's seat.R430-90-14. Infection Control.(1) All care givers shall comply with the universal blood and bodily fluid precautions according to the OSHA Bodily Fluid Blood-Borne Pathogen Standard.(a) The licensee shall keep and maintain a portable blood and bodily fluid clean-up kit.(b) All care givers shall know the location of the kit and how to use it.(c) All care givers shall wear new disposable latex gloves or an approved equivalent listed in OSHA part 1910.1030 for first-aid procedures involving blood or clean-up of blood containing bodily fluids.(2) If children are admitted for care who require diapers, the following applies:(a) Care givers shall change a child's diaper on a clean, smooth, washable, non-absorbent diapering surface and sanitize the surface after each use.(b) The diapering area shall not be located in a food preparation area.(c) Care givers shall place soiled diapers in a container that is lined and has a tight fitting lid or take the diapers directly to an outside covered receptacle. Care givers shall clean and disinfect the inside diaper containers daily.(3) If a child's clothing is soiled by fecal material or urine, a care giver shall change the clothing promptly and place the clothing in a leakproof container to be sent home with the parent or legal guardian.(4) If personal hygiene items for children are maintained at the home such as combs or toothbrushes, they shall not be shared between children and shall be labeled and stored separately.(5) The licensee shall clean and sanitize indoor activity equipment and toys weekly or more often as necessary.(a) Stuffed animals shall be machine washable.(b) If four or more infants are present for care, the licensee shall clean and sanitize the indoor equipment and toys used by the infants during the day.(6) Care givers shall assure protection from contamination and the spread of microorganisms by implementing good hand washing practices. Care givers shall teach children proper hand washing techniques and oversee hand washing whenever possible. Care givers and children shall wash their hands after using the toilet, before and after eating, and before and after food preparation.(7) Single-use paper towels or individually labeled cloth towels shall be used for drying hands. If cloth towels are used, the care giver shall wash the towels daily.R430-90-15. Safety.(1) Indoor and outdoor play spaces, toys and equipment shall be maintained in a safe manner to prevent injury to children.(2) Infants and toddlers shall not have access to toys smaller than 1-1/4 inches in total diameter or length. Toys and equipment used by children must comply with the guidelines of the Consumer Product Safety Commission.(3) High chairs shall have safety straps or devices to prevent children from falling out.(4) There shall be no firearms or other weapons accessible to children. Firearms and other weapons shall be stored separately from ammunition and all shall be in a locked cabinet or area during times when children are on the premises, unless the use is in accordance with UCA 53-5-701 Concealed Weapons Act, UCA 76-10-523 Persons Exempt from Weapons Laws or as otherwise authorized by law.(5) Electrical outlets accessible to children four years of age and younger shall be protected or capped with safety devices.(6) Toxic or hazardous chemicals such as cleaners, insecticides, lawn products, and flammable materials shall be stored away from children in a locked or protected area. All toxic or hazardous chemicals shall be in the original container, or labeled in the container.(7) Fireplaces, open-face heaters, and wood burning stoves shall be inaccessible to children when in use. Portable space heaters are not permitted when children are on the premises.(8) Outdoor play equipment shall be located over soft material or grass.(9) All water hazards such as a swimming pool, stationary wading pool, ditches, and fish ponds shall be fenced to prevent access by children.(10) Sharp objects, medicines, plastic bags, poisonous plants, lighters and matches must be stored out of reach and inaccessible to children.(11) Hot water accessible to children shall not exceed the scalding standard of 120 degrees Fahrenheit.(12) Strings and cords long enough to encircle a child's neck, such as those found on pull toys, window blinds, or drapery cords, shall be inaccessible to children under five years of age.(13) Any structure built prior to 1978 which has peeling, flaking, chalking, or failing paint on the interior or exterior shall be tested for lead-based paint. If paint lead levels are equal to or exceed 0.06% by weight, the structure must be remodeled by encapsulation or enclosure when possible or by complete removal of lead-based paint by trained individuals.(14) Infant walkers with wheels are not permitted.(15) The licensee shall provide separate sleep equipment for each infant designed for infant use, such as a crib, bassinet, porta-crib, or play pen. Infants shall be placed on their backs for sleeping.R430-90-16. Fire, Emergency, and Disaster.(1) The licensee shall have a written emergency and disaster plan in case of fire, flood, earthquake, blizzard, power failure, or other disasters that could create structural damage to the home or pose a health hazard. The plan shall include the procedure to transport and evacuate children to another location and the procedures to turn off gas, electricity and water.(2) The licensee shall have an emergency plan in the case of a missing child or death or serious injury to a child, which includes the name of a substitute care giver in the event the owner must leave the residence for any reason.(3) The licensee shall hold simulated fire drills quarterly and an annual disaster drill. The licensee shall document the date of drills, participants, and the problems encountered.(4) Each home shall have fire extinguishers and smoke detectors in good operating condition on each floor occupied by children. Two exits leading to an open space at ground level, shall be present to permit the orderly evacuation of children. If the basement is used to provide child care, at least one exit at ground level shall be present leading to an open space.(5) The licensee shall ensure that the telephone service is in working order, unless there is a utility failure, and inform the Department of the current phone number. The names and telephone numbers of the emergency medical personnel, fire department, police, and poison control shall be posted by the telephone.(6) The licensee shall maintain a first-aid kit at the residence.R430-90-17. Housekeeping and Maintenance.(1) The licensee shall take effective and safe measures to prevent, control, and eliminate the presence of insects, rodents, and other vermin on the premises.(2) There shall be adequate housekeeping services to maintain a clean, odor free, and sanitary environment.(3) Entrances, exits, steps, and outside walkways shall be maintained in a safe condition, free of ice, snow, and other hazards.(4) The licensee shall maintain the home at air temperatures between 72 degrees Fahrenheit and 85 degrees Fahrenheit as measured 30 inches above the floor. Infant care areas shall maintain temperatures of at least 70 degrees Fahrenheit at floor level.(5) If sleeping equipment or mats for sleeping are provided, all mats and sleeping equipment shall be cleaned and sanitized weekly, and prior to use by another child.(6) The home shall be maintained to ensure that the equipment, fixtures, and furnishings are safe and in good repair.(7) Sand boxes and outdoor play areas shall be kept free of animal excrement and harmful objects.R430-90-18. Animals.(1) If the licensee permits animals at the home:(a) the animals shall be clean and in good health;(b) the animals shall have current vaccination records available at the program for all diseases transmissible to humans; and(c) the animals shall have no history of dangerous or aggressive behavior.(2) Children shall not assist with the cleaning of animals, animal cages, pens or animal equipment. Animal cages and equipment shall not be cleaned in food preparation or food storage areas.(3) The licensee of the program shall inform the parent or legal guardian of the types of animals kept at the home.(4) Children shall not handle reptiles, including turtles and lizards.R430-90-19. Food Service.(1) If the local health department completes an inspection, the inspection report shall be maintained at the home for review by the Department.(2) Food prepared by the care givers for the children in care shall be from an approved source as provided in R392-100.(a) Food brought in by parents or legal guardians to serve to other children must be from an approved source or commercially prepared;(b) Food brought in by parents or legal guardians for individual child use must be labeled.(c) Baby food must be refrigerated after opening, marked with the date and time of opening and discarded if not consumed within 24 hours of opening;(d) Infant formula and breast milk shall be discarded after feeding or within two hours of initiating a feeding.(3) All care givers who prepare or serve food and snacks must have a current food handler's permit.(4) Children's food shall be served on plates, napkins or other sanitary holders, which include a high chair tray. Multiple-use sanitary holders shall be washed, rinsed, and sanitized with a sanitizer approved in R392-100 for food contact surfaces prior to each use. Food shall not be placed on a bare table or other eating surface.(5) Meals and snacks shall be served at least once every three hours, or according to the menu.(a) The current week's menu shall be posted for review by parents or guardians and all substitutions shall be noted on the menu and retained for one week. If substitutions are made, the menu must meet the requirement of the United States Department of Agriculture (USDA) Child Care Food Program guidelines;(b) Menus can be obtained from the Department or shall be Department-approved, independently approved and signed by a registered dietitian, or approved through the United States Department of Agriculture Child and Adult Care Food Program; and(c) A different menu shall be planned for each day of the week and menus may be cycled.(6) Children and infants shall be served special diets, formula, breast milk, or food supplements in accordance with the written instructions from a parent or legal guardian.(7) If an infant is unable to sit upright and hold his own bottle, a care giver shall hold the infant during bottle feeding.R430-90-20. Penalty.The Department may impose civil monetary penalties in accordance with Title 63, Chapter 46b, Administrative Procedures Act and Section 26-39-108, if there has been a failure to comply with the provisions of this chapter, or rules promulgated pursuant to this chapter, as follows:(1) if significant problems exist that are likely to lead to the harm of a child, the department may impose a civil money penalty of $50 to $1,000 per day; and(2) if significant problems exist that result in actual harm to a child, the department may impose a civil money penalty of $1,050 to $5,000 per day.]R430-90-1. Legal Authority and Purpose.
This rule is promulgated pursuant to Title 26, Chapter 39. This rule establishes standards for the operation and maintenance of licensed family child care providers who care for one to 16 children in their home. It establishes minimum requirements for the health and safety of children in the care of licensed family providers.
R430-90-2. Definitions.
(1) "Body fluids" means blood, urine, feces, vomit, mucus, saliva, and breast milk.
(2) "Caregiver" means a person in addition to the licensee or substitute who provides direct care to a child in care.
(3) "Department" means the Utah Department of Health.
(4) "Emotional abuse" means behavior that could impair a child's emotional development, such as threatening, intimidating, humiliating, or demeaning a child, constant criticism, rejection, profane language, and inappropriate physical restraint.
(5) "Health care provider" means a licensed professional with prescriptive authority, such as a physician, nurse practitioner, or physician's assistant.
(6) "Inaccessible to children" means:
(a) locked, such as in a locked room, cupboard or drawer;
(b) secured with a child safety device, such as a child safety cupboard lock or doorknob device;
(c) behind a child safety gate;
(d) located in a cupboard or on a shelf more than 36 inches above the floor; or
(e) not in any location in a bathroom where a child could reach, including by climbing on a toilet, bathtub, or counter.
(7) "Infant" means a child aged birth through 11 months of age.
(8) "Infectious disease" means an illness that is capable of being spread from one person to another.
(9) "Licensee" means the person holding a Department of Health child care license.
(10) "Over-the-counter medication" means medication that can be purchased without a written prescription. This includes herbal remedies.
(11) "Parent" means the parent or legal guardian of a child in care.
(12) "Physical abuse" means causing nonaccidental physical harm to a child.
(13) "Preschooler" means a child aged 2 through 4, and 5 year olds who have not yet started kindergarten.
(14) "Protective cushioning" means stationary play equipment cushioning material that is approved by the American Society for Testing and Materials or the Consumer Products Safety Commission. For example, sand, pea gravel, or engineered wood fibers.
(15) "Protrusion hazard" means a component or piece of hardware that could impale or cut a child if the child falls against it.
(16) "Provider" means the licensee, a substitute, or a caregiver.
(17) "Related children" means children for whom a provider is the parent, legal guardian, step-parent, grandparent, step-grandparent, great-grandparent, sibling, step-sibling, aunt, step-aunt, great-aunt, uncle, step-uncle, or great-uncle.
(18) "Sanitize" means to reduce the number of germs on a surface to such a level that disease transmission by that surface is unlikely.
(19) "School age" means kindergarten and older age children.
(20) "Sexual abuse" means abuse as provided in Utah Code, Section 76-5-404.1.
(21) "Sexually explicit material" means any depiction of sexually explicit conduct, as defined in Utah Code, Section 76-5a-2(8).
(22) "Stationary play equipment" means equipment such as a climber, a slide, a swing, a merry-go-round, or a spring rocker that is meant to stay in one location when a child uses it. Stationary play equipment does not include:
(a) a sandbox;
(b) a stationary circular tricycle;
(c) a sensory table; or
(d) a playhouse, if the playhouse has no play equipment, such as a slide, swing, ladder, or climber attached to it.
(23) "Strangulation hazard" means something on which a child's clothes or something around a child's neck could become caught on a component of playground equipment. For example, bolt ends that extend more than two threads beyond the face of the nut, hardware configurations that form a hook or leave a gap or space between components, and open "S" type hooks.
(24) "Substitute" means a person who assumes the licensee's duties under this rule when the licensee is not present. This includes emergency substitutes.
(25) "Supervision" means the function of observing, overseeing, and guiding a child or group of children.
(26) "Toddler" means a child aged 12 months but less than 24 months.
(27) "Unrelated children" means children who are not related children.
(28) "Use zone" means the area beneath and surrounding a play structure or piece of equipment that is designated for unrestricted movement around the equipment, and onto which a child falling from or exiting the equipment could be expected to land.
(29) "Volunteer" means a person who provides direct care to a child but does not receive direct or indirect compensation for doing so. A volunteer is not included in the provider to child ratio.
R430-90-3. License Required.
(1) A person must either be licensed under this rule or certified under R430-50, if he or she:
(a) provides care in lieu of care ordinarily provided by a parent;
(b) provides care for five or more unrelated children;
(c) provides care for four or more hours per day;
(d) has a regularly scheduled, ongoing enrollment; and
(e) provides care for direct or indirect compensation.
(2) The Department does not license, nor is a license required for:
(a) a person who cares for related children only; or
(b) a person who provides care on a sporadic basis only.
R430-90-4. Indoor Environment.
(1) The licensee shall ensure that any building or playground structure on the premises constructed prior to 1978 which has peeling, flaking, chalking, or failing paint is tested for lead based paint. If lead based paint is found, the licensee shall contact the local health department and follow all required procedures for the remediation of the lead based paint hazard.
(2) There shall be a working toilet and a working handwashing sink accessible to each child in care.
(3) Each school age child shall have privacy when using the bathroom.
(4) The home shall be ventilated by mechanical ventilation or by windows that open and have screens.
(5) The licensee shall maintain the indoor temperature between 65 and 82 degrees Fahrenheit.
(6) The licensee shall maintain adequate light intensity for the safety of children and the type of activity being conducted and shall keep the lighting equipment in good working condition.
(7) There shall be at least 35 square feet of indoor play space for each child, including providers' related children who are not counted in the provider to child ratios.
(8) Indoor space per child may include floor space used for furniture, fixtures, or equipment if the furniture, fixture, or equipment is used:
(a) by children;
(b) for the care of children; or
(c) to store children's materials.
(9) Bathrooms, closets, hallways, and entryways are not included when calculating indoor space for children's use.
R430-90-5. Cleaning and Maintenance.
(1) The licensee shall ensure that a clean and sanitary environment is maintained.
(2) The licensee shall take safe and effective measures to prevent and eliminate the presence of insects, rodents, and other vermin.
(3) The licensee shall maintain ceilings, walls, floor coverings, draperies, blinds, furniture, fixtures, and equipment in good repair to prevent injury to children.
(4) The licensee shall ensure that entrances, exits, steps and outside walkways are maintained in a safe condition, and free of ice, snow, and other hazards.
R430-90-6. Outdoor Environment.
(1) There shall be an outdoor play area for children that is safely accessible to children.
(2) The outdoor play area shall have at least 40 square feet of space for each child using the space at one time.
(3) The outdoor play area shall be enclosed within a 4 foot high fence or wall or within a solid natural barrier that is at least 4 feet high. Licensees licensed prior to 1 July 2008 who do not have a fence that meets this requirement shall have until 1 July 2011 to meet this requirement.
(4) There shall be no gaps in fences greater than 5 inches at any point, nor shall gaps between the bottom of the fence and the ground be more than 5 inches.
(5) The outdoor play area shall be free of trash, animal excrement, harmful plants or objects, toxic or hazardous substances, and standing water.
(6) If a wading pool is used:
(a) a provider must be at the pool supervising each child whenever there is water in the pool;
(b) each diapered child must wear a swim diaper or rubber pants while in the pool; and
(c) the pool shall be emptied and sanitized after each use.
(7) If there is a swimming pool on the premises that is not emptied after each use:
(a) the licensee shall ensure that the pool is enclosed within a fence or other solid barrier at least six feet high that is kept locked whenever the pool is not in use by any child in care, except that if the licensee currently has a fence at least four feet high surrounding the pool, he or she shall have until 1 July 2011 to meet the six foot fence requirement;
(b) the licensee shall maintain the pool in a safe manner;
(c) the licensee shall meet all applicable state and local laws and ordinances related to the operation of a swimming pool; and
(d) if the pool is over six feet deep, there shall be a Red Cross certified life guard on duty, or a lifeguard certified by another agency that the licensee can demonstrate to the Department to be equivalent to Red Cross certification, any time any child in care has access to the pool.
(8) The outdoor play area shall have a shaded area to protect each child from excessive sun and heat.
(9) An outdoor source of drinking water, such as individually labeled water bottles or a pitcher of water and individual cups that are taken outside, shall be available to each child whenever the outside temperature is 75 degrees or higher.
(10) If there is a trampoline on the premises that is accessible to any child in care, the licensee shall ensure compliance with the following requirements:
(a) A provider must be at the trampoline supervising its use whenever any child in care is on the trampoline.
(b) Only one person at a time may use a trampoline.
(c) No child in care shall be allowed to do somersaults or flips on the trampoline.
(d) The trampoline must have shock absorbing pads that completely cover its springs, hooks, and frame.
(e) The trampoline must be placed at least 6 feet away from any structure, including playground equipment, trees, and fences.
(f) There shall be no ladders near the trampoline.
(g) No child in care shall be allowed to play under an above ground trampoline when it is in use.
(h) A parent of each child in care who uses the trampoline shall sign a Department-approved permission form before his or her child uses the trampoline.
(11) Outdoor stationary play equipment used by any child in care shall be located over grass or 6" of protective cushioning, in a 3' use zone. The licensee shall have until 1 July 2013 to meet the 3' requirement.
(12) There shall be no openings of a size greater than 3-1/2 by 6-1/4 inches and less than 9 inches in diameter on any piece of stationary play equipment where the feet of any child in care whose head is entrapped in the opening cannot touch the ground.
(13) There shall be no protrusion hazard or strangulation hazard in or adjacent to the use zone of any piece of stationary play equipment.
(14) There shall be no crush, shearing, or sharp edge hazards in or adjacent to the use zone of any piece of stationary play equipment.
(15) There shall be no tripping hazards, such as concrete footings, tree stumps, tree roots, or rocks within the use zone of any piece of stationary play equipment.
(16) The licensee shall ensure that outdoor play areas and outdoor play equipment are maintained to protect each child's safety.
R430-90-7. Personnel.
(1) The licensee and all substitutes and caregivers must:
(a) be at least 18 years of age; and
(b) have knowledge of and comply with all applicable laws and rules.
(2) All assistant caregivers shall:
(a) be at least 16 years of age;
(b) work under the immediate supervision of a provider who is at least 18 years of age; and
(c) have knowledge of and comply with all applicable laws and rules.
(3) Assistant caregivers may be included in provider to child ratios, but only if there is also another provider present in the home who is 18 years of age or older.
(4) Assistant caregivers shall meet the training and TB screening requirements of this rule.
(5) The licensee may make arrangements for a substitute who is at least 18 years old and who is capable of providing care, supervising children, and handling emergencies in the absence of the licensee.
(6) Substitutes who care for children an average of 10 hours per week or more shall meet the training, first aid and CPR, and TB screening requirements of this rule.
(7) In an unforeseeable emergency, such as a medical emergency requiring immediate care at a hospital or at an urgent care center or a lost child, the licensee may assign an emergency substitute who has not had a criminal background screening to care for the children. A licensee may use an emergency substitute for up to 24 hours for each emergency event.
(a) The emergency substitute shall be at least 18 years of age.
(b) The emergency substitute is not required to meet the training, first aid and CPR, and TB screening requirements of this rule.
(c) The emergency substitute cannot be a person who has been convicted of a felony or misdemeanor or has been investigated for abuse or neglect by any federal, state, or local government agency. The emergency substitute must provide a shall make a signed, written declaration to the licensee that he or she is not disqualified under this subsection.
(d) During the term of the emergency, the emergency substitute may be counted as a provider for the purpose of maintaining the required provider to child ratios.
(e) The licensee shall make reasonable efforts to minimize the time that the emergency substitute has unsupervised contact with the children in care.
(8) Any new caregiver, volunteer, or non-emergency substitute shall receive orientation training prior to assuming caregiving duties. Orientation training shall be documented in the individual's file and shall include the following topics:
(a) specific job responsibilities;
(b) the licensee's written policies and procedures;
(c) the licensee's emergency and disaster plan;
(d) child care licensing rules for:
(i) Supervision and Ratios. R430-90-11;
(ii) Injury Prevention. R430-90-12;
(iii) Parent Notification and Child Security. R430-90-13;
(iv) Child Health. 430-90-14;
(v) Child Nutrition. R430-90-15;
(vi) Infection Control. R430-90-16;
(vii) Medications. R430-90-17;
(viii) Napping. R430-90-18;
(ix) Child Discipline. R430-90-19;
(x) Activities. R430-90-20;
(xi) Transportation, R430-90-21, if any child in care is transported while in care;
(xii) Animals, R430-90-22, if there are animals on the premises that are accessible to any child in care;
(xiii) Diapering, R430-90-23, if the licensee accepts diapered children; and
(xiv) Infant and Toddler Care, R430-90-24, if the licensee accepts infants or toddlers for care.
(e) introduction and orientation to the children in care;
(f) a review of the information in the health assessment for each child in care;
(g) procedure for releasing children to authorized individuals only;
(h) proper clean up of body fluids;
(i) signs and symptoms of child abuse and neglect, and legal reporting requirements for witnessing or suspicion of abuse, neglect, and exploitation;
(j) obtaining assistance in emergencies; and
(k) if the licensee accepts infants or toddlers for care, orientation training topics shall also include:
(i) preventing shaken baby syndrome and coping with crying babies; and
(ii) preventing sudden infant death syndrome.
(9) Substitutes who care for children an average of 10 hours per week or more, the licensee, and all caregivers shall complete a minimum of 20 hours of training each year, based on the license date. A minimum of 10 hours of the required annual training shall be face-to-face instruction.
(a) Documentation of annual training shall be kept in each individual's file, and shall include the name of the training organization, the date, the training topic, and the total hours or minutes of training.
(b) All caregivers and non-emergency substitutes who begin employment partway through the license year shall complete a proportionate number of training hours based on the number of months worked prior to the relicense date.
(c) Annual training hours shall include the following topics at least once every two years:
(i) a review of all of the current child care licensing rules for:
(A) Supervision and Ratios. R430-90-11;
(B) Injury Prevention. R430-90-12;
(C) Parent Notification and Child Security. R430-90-13;
(D) Child Health. 430-90-14;
(E) Child Nutrition. R430-90-15;
(F) Infection Control. R430-90-16;
(G) Medications. R430-90-17;
(H) Napping. R430-90-18;
(I) Child Discipline. R430-90-19;
(J) Activities. R430-90-20;
(K) Transportation, R430-90-21, if any child in care is transported while in care;
(L) Animals, R430-90-22, if there are animals on the premises that are accessible to any child in care;
(M) Diapering, R430-90-23, if the licensee accepts diapered children; and
(N) Infant and Toddler Care, R430-90-24, if the licensee accepts infants or toddlers for care; and
(ii) a review of the licensee's written policies and procedures and emergency and disaster plan, including any updates;
(iii) signs and symptoms of child abuse and neglect, and legal reporting requirements for witnessing or suspicion of abuse, neglect, and exploitation;
(iv) principles of child growth and development, including development of the brain; and
(v) positive guidance; and
(d) if the licensee accepts infants or toddlers for care, required training topics shall also include:
(i) preventing shaken baby syndrome and coping with crying babies; and
(ii) preventing sudden infant death syndrome.
R430-90-8. Administration.
(1) The licensee is responsible for all aspects of the operation and management of the child care program.
(2) The licensee shall comply with all federal, state, and local laws and rules pertaining to the operation of a child care program.
(3) The licensee shall not engage in or allow conduct that is adverse to the public health, morals, welfare, and safety of the children in care.
(4) The licensee shall take all reasonable measures to protect the safety of each child in care. The licensee shall not engage in activity or allow conduct that unreasonably endangers any child in care.
(5) Either the licensee or a substitute with authority to act on behalf of the licensee shall be present whenever there is a child in care.
(6) Each week, the licensee shall be present at the home at least 50% of the time that one or more children are in care.
(7) There shall be a working telephone in the home. The licensee shall inform the parents of each child in care and the Department of any changes to the licensee's telephone number within 48 hours of the change.
(8) The licensee shall call the Department within 24 hours to report any fatality, hospitalization, emergency medical response, or injury that requires attention from a health care provider, unless an emergency medical transport was part of a child's individualized medical treatment plan identified by the parent. The licensee shall also mail or fax a written report to the Department within five days of the incident.
(9) The licensee shall establish, and all non-emergency substitutes, caregivers, and volunteers shall follow, written policies and procedures for the health and safety of each child in care. The written policies and procedures shall address at least the following areas:
(a) direct supervision and protection of each child at all times, including when he or she is sleeping, outdoors, and during off-site activities;
(b) procedures to account for each child's attendance and whereabouts;
(c) the use of television, movies, and video or computer games, including what industry ratings and television programs the licensee allows;
(d) recognizing early signs of illness and determining when there is a need for exclusion from care;
(e) discipline of children, including behavioral expectations of children and discipline methods used;
(f) transportation to and from off-site activities, or to and from home, if the licensee offers these services; and
(g) if the program offers transportation to or from school, policies addressing:
(i) how long a child will be unattended by a provider before school starts and after school lets out;
(ii) what steps will be taken if a child fails to meet the vehicle; and
(iii) how and when parents will be notified of delays or problems with transportation to and from school.
(10) The licensee shall ensure that the written policies and procedures are available for review by parents and the Department during business hours.
R430-90-9. Records.
(1) The licensee shall maintain the following records on-site for review by the Department during any inspection:
(a) documentation of the previous 12 months of quarterly fire drills and annual disaster drills as specified in R430-90-10(9) and R430-90-10(11);
(b) current animal vaccination records as required in R430-90-22(3);
(c) a six week record of child attendance, including sign-in and sign-out records, as required in R430-90-13(3) and (4);
(d) all current variances granted by the Department;
(e) a current local health department kitchen inspection;
(f) an initial local fire department clearance for all areas of the home being used for care;
(g) the most recent "Request for Annual Renewal of CBS/MIS Criminal History Information for Child Care";
(h) records for each currently enrolled child, including the following:
(i) an admission form containing the following information for each child:
(A) name;
(B) date of birth;
(C) date of enrollment;
(D) the parent's name, address, and phone number, including a daytime phone number;
(E) the names of people authorized by the parent to pick up the child;
(F) the name, address and phone number of a person to be contacted in the event of an emergency if a provider is unable to contact the parent;
(G) the name, address, and phone number of an out of area/state emergency contact person for the child, if available, or a statement from the parent that one is not available; and
(H) child health information, as required in R430-90-14(5);
(I) current emergency medical treatment and emergency medical transportation releases with the parent's signature;
(ii) current immunization records or documentation of a legally valid exemption, as specified in R430-90-14(4);
(iii) a completed transportation permission form, if transportation services are offered to any child in care;
(iv) a six week record of medication permission forms, and a six week record of medications actually administered as specified in R430-90-17(4) and R430-90-17(6)(e), if medications are administered to any child in care; and
(v) a six week record of incident, accident, and injury reports; and
(i) records for the licensee and each non-emergency substitute and caregiver, including the following:
(i) results of an initial TB screening, as required in R430-90-16(11) and (12);
(ii) approved initial "CBS/MIS Consent and Release of Liability for Child Care" form;
(iii) if the licensee has been licensed for more than a year, the most recent criminal background "Disclosure Statement" for the licensee and each individual who has worked for or resided in the home of the licensee since the last license renewal date;
(iv) orientation training documentation for all non-emergency substitutes and caregivers as required in R430-90-7(8);
(v) annual training documentation for the past two years, for the licensee and all non-emergency substitutes and caregivers, as required in R430-90-7(9)(a); and
(vi) current first aid and CPR certification, as required in R430-90-10(2), R430-90-20(3)(d), and R430-90-21(2); and
(j) records for the each volunteer, including the following:
(i) approved initial "CBS/MIS Consent and Release of Liability for Child Care" form;
(ii) if the licensee has been licensed for more than a year, the most recent criminal background "Disclosure Statement" for each individual who has volunteered since the last license renewal date; and
(iii) orientation training documentation as required in R430-90-7(8).
(2) The licensee shall ensure that information in any child's file is not released without written parental permission.
R430-90-10. Emergency Preparedness.
(1) The licensee shall post the home's street address and emergency numbers, including ambulance, fire, police, and poison control, near the telephone.
(2) The licensee and all substitutes who care for children an average of 10 hours per week or more shall maintain a current Red Cross, American Heart Association, or equivalent first aid and infant and child CPR certification.
(3) The licensee shall maintain first-aid supplies in the home.
(4) The licensee shall have a written emergency and disaster plan which shall include at least the following:
(a) procedures for responding to medical emergencies and serious injuries that require treatment by a health care provider;
(b) procedures for responding to fire, earthquake, flood, power failure, and water failure;
(c) the location of and procedure for emergency shut off of gas, electricity, and water;
(d) procedures to be followed if a child is missing;
(e) the name and phone number of a substitute to be called in the event the licensee must leave the home for any reason;
(f) an emergency relocation site where children will be housed if the licensee's home is uninhabitable;
(g) provisions for emergency supplies, including at least food, water, a first aid kit, and diapers if the licensee accepts diapered children for care; and
(h) procedures for ensuring adequate supervision of children during emergency situations, including while at the emergency relocation site.
(5) The licensee shall ensure that the emergency and disaster plan is followed in the event of an emergency.
(6) The licensee shall review the emergency and disaster plan annually, and update it as needed. The licensee shall note the date of reviews and updates to the plan on the plan.
(7) The emergency and disaster plan shall be available for immediate review by parents and the Department during business hours.
(8) The licensee shall conduct fire evacuation drills quarterly. Drills shall include complete exit of all children and staff from the home.
(9) The licensee shall document all fire drills, including:
(a) the date and time of the drill;
(b) the number of children participating;
(c) the total time to complete the evacuation; and
(d) any problems encountered.
(10) The licensee shall conduct drills for disasters other than fires at least once every 12 months.
(11) The licensee shall document all disaster drills, including:
(a) the type of disaster, such as earthquake, flood, prolonged power outage, or tornado;
(b) the date and time of the drill;
(c) the number of children participating;
(d) any problems encountered.
(12) The licensee shall vary the days and times on which fire and other disaster drills are held.
R430-90-11. Supervision and Ratios.
(1) The licensee or a substitute shall be physically present on-site and provide care and direct supervision of each child at all times, both indoors and outdoors Direct care and supervision of each child includes:
(a) awareness of and responsibility for the ongoing activity of each child, including being near enough to intervene if needed; and
(b) monitoring of each sleeping infant in one of the following ways:
(i) by placing each infant for sleep in a location where the infant is within sight and hearing of a provider;
(ii) by in person observation of each sleeping infant at least once every 15 minutes; or
(iii) by using a Department-approved infant sleep monitoring device.
(2) A provider shall actively supervise each child during outdoor play to minimize the risk of injury to a child. A provider may allow only school age children to play outdoors while the provider is indoors, if:
(a) a provider can hear the children playing outdoors; and
(b) the children playing outdoors are in an area completely enclosed within a 4 foot high fence or wall, or a solid natural barrier that is at least 4 feet high.
(3) The licensee may permit a child to participate in supervised out of the home activities without the licensee if:
(a) the licensee has prior written permission from the child's parent for the child's participation; and
(b) the licensee has clearly assigned the responsibility for the child's whereabouts and supervision to a responsible adult who accepts responsibility for the care and supervision of the child throughout the period of the out of home activity.
(4) The maximum allowed capacity for a licensed family child care facility is 16 children, including providers' own children under age 4.
(5) The licensee shall maintain the minimum provider to child ratios and group sizes in Table 1 and Table 2.
TABLE 1
CHILD CARE RATIO AND GROUP SIZE WITH 1 PROVIDER
# of Providers' Maximum Allowed Total # of All
Related Children Licensed Capacity, Children Through
Ages 4-12 Present Including the Age 12 in the
in the Home During Providers' Children Home During
Child Care Hours Under Age 4 Child Care Hours
0 - 2 8 children, including 10
no more than 2
children under age 2
0 - 2 6 children, including 8
no more than 3
children under age 2
3 7 children, including 10
no more than 2
children under age 2
4 6 children, including 10
no more than 2
children under age 2
5 5 children, including 10
no more than 2
children under age 2
6 4 children, including 10
no more than 2
children under age 2
7 3 children, including 10
no more than 2
children under age 2
8 2 children 10
9 1 child 10TABLE 2
CHILD CARE RATIO AND GROUP SIZE WITH 2 PROVIDERS
# of Providers' Maximum Allowed Total # of All
Related Children Licensed Capacity, Children Through
Ages 4-12 Present Including the Age 12 in the
in the Home During Providers' Children Home During
Child Care Hours Under Age 4 Child Care Hours
0 - 4 16 children, including 20
no more than 4
children under age 2
5 15 children, including 20
no more than 4
children under age 2
6 14 children, including 20
no more than 4
children under age 2
7 13 children, including 20
no more than 4
children under age 2
8 12 children, including 20
no more than 4
children under age 2
9 11 children, including 20
no more than 4
children under age 2
10 10 children, including 20
no more than 4
children under age 2
11 9 children, including 20
no more than 4
children under age 2
12 8 children, including 20
no more than 4
children under age 2
13 7 children, including 20
no more than 4
children under age 2
14 6 children, including 20
no more than 4
children under age 2
15 5 children, including 20
no more than 4
children under age 2
16 4 children 20
17 3 children 20
18 2 children 20
19 1 child 20R430-90-12. Injury Prevention.
(1) The licensee shall ensure that the home, outdoor play area, toys, and equipment are maintained and used in a safe manner to prevent injury to children.
(2) The licensee shall ensure that the indoor environment is free of tripping hazards such as unsecured flooring or cords.
(3) Areas accessible to children shall be free of unstable heavy equipment, furniture, or other items that a child could pull down on himself or herself.
(4) The following items shall be inaccessible to each child in care:
(a) firearms, ammunition, and other weapons on the premises. Firearms shall be stored separately from ammunition, in a locked cabinet or area, unless the use is in accordance with the Utah Concealed Weapons Act, or as otherwise allowed by law;
(b) tobacco, alcohol, illegal substances, and sexually explicit material;
(c) when in use: portable space heaters, fireplaces, and wood burning stoves;
(d) toxic or hazardous chemicals such as cleaners, insecticides, lawn products, and flammable materials;
(e) poisonous plants;
(f) matches or cigarette lighters;
(g) open flames;
(h) sharp objects, edges, corners, or points which could cut or puncture skin;
(i) for children age 4 and under, strings and cords long enough to encircle a child's neck, such as those found on window blinds or drapery cords;
(j) for children age 4 and under, empty plastic bags large enough for a child's head to fit inside, latex gloves, and balloons; and
(k) for children age 2 and under, toys or other items with a diameter of less than 1-1/4 inch and a length of less than 2-1/4 inches, or objects with removable parts that have a diameter of less than 1-1/4 inch and a length of less than 2-1/4 inches.
(5) The licensee shall ensure that all toxic or hazardous chemicals are stored in a container labeled with its contents.
(6) Electrical outlets and surge protectors accessible to children age four and younger shall have protective caps or safety devices when not in use.
(7) Hot water accessible to children shall not exceed 120 degrees Fahrenheit.
(8) High chairs shall have T-shaped safety straps or devices that are used whenever a child is in the chair.
R430-90-13. Parent Notification and Child Security.
(1) The licensee shall either post or, upon enrollment, give each parent a copy of the Department's child care guide.
(2) Parents shall have access to the licensee's home and outdoor play area at all times their child is in care.
(3) The licensee shall ensure that a daily attendance record is maintained to document each enrolled child's attendance.
(4) A provider or parent shall sign each child in and out daily, including the date and the time the child arrives and leaves and when the child goes to and returns from school.
(5) Only parents or persons with written authorization from the parent may pick up any child. In an emergency, a provider may accept verbal authorization if the provider can confirm the identity of the person giving the verbal authorization and the identity of the person picking up the child.
(6) The licensee shall ensure that parents are given a written report of every serious incident, accident, or injury involving their child on the day of occurrence. A provider and the person picking up the child shall sign the report to acknowledge that he or she has received it.
(7) The licensee shall ensure that parents are notified verbally of minor accidents and injuries on the day of occurrence.
(8) In the case of a life threatening incident or injury to a child, or an incident or injury that poses a threat of the loss of vision, hearing, or a limb, a provider shall contact emergency personnel immediately, before contacting the parent. If the parent cannot be reached after emergency personnel have been contacted, a provider shall attempt to contact the child's emergency contact person.
(9) If a child is injured and the injury appears serious but not life threatening, a provider shall contact the parent immediately, in addition to giving the parent a written report of the injury.
R430-90-14. Child Health.
(1) The licensee shall ensure that no child is subjected to physical, emotional, or sexual abuse while in care.
(2) All providers shall follow the reporting requirements for witnessing or suspicion of abuse, neglect, and exploitation found in Utah Code, Section 62A-4a-403 and 62A-4a-411.
(3) The use of tobacco, alcohol, illegal substances, or sexually explicit material on the premises or in vehicles used to transport children is prohibited any time that a child is in care.
(4) The licensee shall not admit any child for care without documentation of:
(a) proof of current immunizations as required by Utah law;
(b) proof of receiving at least one dose of each required vaccine prior to enrollment, and a written schedule to receive all subsequent required vaccinations; or
(c) written documentation of an immunization exemption due to personal, medical or religious reasons.
(5) The licensee shall not admit any child for care without the following written health information from the parent:
(a) allergies;
(b) food sensitivities;
(c) acute and chronic medical conditions;
(d) instructions for special or non-routine daily health care;
(e) current medications; and
(f) any other special health instructions for the licensee.
(6) The licensee shall ensure that each child's parent reviews, updates, and signs or initials the child's health information at least annually.
R430-90-15. Child Nutrition.
(1) If food service is provided:
(a) The licensee shall ensure that his or her meal service complies with local health department food service regulations.
(b) Foods served by license holders not currently participating and in good standing with the USDA Child and Adult Care Food Program (CACFP) shall comply with the nutritional requirements of the CACFP. The licensee shall either use standard Department-approved menus, menus provided by the CACFP, or menus approved by a registered dietician. Dietitian approval shall be noted and dated on the menus, and shall be current within the past 5 years.
(c) License holders not currently participating and in good standing with the CACFP shall keep a six week record of foods served at each meal or snack.
(d) The current week's menu shall be available for parent review.
(2) The licensee shall ensure that each child in care is offered a meal or a snack at least once every three hours.
(3) Providers shall serve each child's food on dishes, napkins, or sanitary high chair trays, except for individual serving size items, such as crackers, if they are placed directly in the child's hands. Providers shall not place food on a bare table.
(4) The licensee shall ensure that food and drink brought in by parents for an individual child's use is labeled with the child's name, and refrigerated if needed.
R430-90-16. Infection Control.
(1) All providers and volunteers shall wash their hands with soap and running water at the following times:
(a) before handling or preparing food or bottles;
(b) before and after eating meals and snacks or feeding a child;
(c) after diapering each child;
(d) after using the toilet or helping a child use the toilet;
(e) after coming into contact with body fluids, including breast milk;
(f) after playing with or handling animals;
(g) when coming in from outdoors; and
(h) before administering medication.
(2) The licensee shall ensure that each child washes his or her hands with soap and running water at the following times:
(a) before and after eating meals and snacks;
(b) after using the toilet;
(c) after coming into contact with body fluids;
(d) after playing with animals; and
(e) when coming in from outdoors.
(3) During outdoor play time, the requirements of subsections (1) and (2) may be met by having each provider, volunteer, and child clean his or her hands with individual disposable wet wipes and hand sanitizer.
(4) Only single-use paper towels or individually labeled cloth towels shall be used to dry a child's hands. If cloth towels are used, they shall not be shared by children, providers, or volunteers, and a provider shall wash the towels daily.
(5) The licensee shall ensure that toilet paper is accessible to each child, and that it is kept in a dispenser.
(6) The licensee shall ensure that children are taught proper hand washing techniques, and shall oversee hand washing whenever possible.
(7) Personal hygiene items such as toothbrushes, or combs and hair accessories that are not sanitized between each use, shall not be shared by children or used by a provider on more than one child. Each child's items shall be stored so that they do not touch another child's items.
(8) The licensee shall ensure that all washable toys and materials are cleaned and sanitized after each 5 days of use, or more often if needed.
(9) Stuffed animals, cloth dolls, and dress-up clothes must be machine washable. Pillows must be machine washable, or have removable covers that are machine washable. The licensee shall ensure that all stuffed animals, cloth dolls, dress-up clothes, and pillows or covers are washed after each 5 days of use, or more often if needed.
(10) If a water play table or tub is used, the licensee shall ensure that the table or tub is washed daily, and that each child washes his or her hands prior to engaging in the activity.
(11) The licensee, all substitutes who work an average of 10 hours each week or more, and all caregivers shall be tested for tuberculosis (TB) prior to licensure or within two weeks of hire by a skin testing method and follow-up acceptable to the Department.
(12) If the TB test is positive, the person shall provide documentation from a health care provider detailing:
(a) the reason for the positive reaction;
(b) whether the person is contagious; and
(c) if needed, how the person is being treated.
(13) Persons with contagious TB shall not work, assist with, or be present with any child in care.
(14) An individual having a medical condition which contra-indicates a TB test must provide documentation from a health care provider indicating the individual is exempt from testing, with an associated time frame if applicable. The licensee shall maintain this documentation in the individual's file.
(15) A provider shall promptly change a child's clothing if the child has a toileting accident.
(16) If a child's clothing is wet or soiled from body fluids, the licensee shall ensure that:
(a) the clothing is not rinsed or washed at the licensee's home; and
(b) the clothing is placed in a leakproof container, labeled with the child's name, and returned to the parent.
(17) If a child uses a potty chair, the licensee shall ensure that it is cleaned and sanitized after each use.
(18) The home shall have a portable body fluid clean up kit.
(a) The licensee, all non-emergency substitutes, and all caregivers shall know the location of the kit and how to use it.
(b) The licensee shall ensure that the kit us used to clean up spills of body fluids.
(c) The licensee shall restock the kit as needed.
(19) The licensee shall ensure that any child who is ill with an infectious disease is separated from any other children in care in a safe, supervised location.
(20) The licensee shall ensure that the parents of any child who is ill are contacted as soon as the illness is observed or suspected.
(21) The licensee shall ensure that the parents of every child in care are informed when any person in the home or child in care has an infectious disease or parasite. Parents shall be notified the day the infectious disease or parasite is discovered.
R430-90-17. Medications.
(1) Only a provider trained in the administration of medications may administer medication to a child in care.
(2) All over-the-counter and prescription medications shall:
(a) be labeled with the child's name;
(b) be kept in the original or pharmacy container;
(c) have the original label; and,
(d) have child-safety caps.
(3) The licensee shall ensure that all non-refrigerated over-the-counter and prescription medication is inaccessible to children. The licensee shall ensure that all refrigerated over-the-counter and prescription medication is placed in a waterproof container to avoid contamination between food and medication.
(4) The licensee shall have a written medication permission form completed and signed by the parent prior to the administering of any over-the-counter or prescription medication brought in by a parent for his or her child. The permission form must include:
(a) the name of the medication;
(b) written instructions for administration; including:
(i) the dosage;
(ii) the method of administration;
(iii) the times and dates to be administered; and
(iv) the disease or condition being treated; and
(c) the parent's dated signature.
(5) If the licensee keeps over-the-counter medication that is not brought in by a parent for his or her child's use, the medication shall not be administered to any child without prior parental consent for each instance it is given. The consent must be either:
(a) prior written consent; or
(b) oral consent for which a provider documents in writing the date and time of the consent, and which the parent signs upon picking up the child.
(6) When administering medication, the person administering the medication shall:
(a) wash his or her hands;
(b) if the parent supplies the medication, check the medication label to confirm the child's name;
(c) if the parent supplies the medication, compare the instructions on the parent release form with the directions on the prescription label or product package to ensure that a child is not given a dosage larger than that recommended by the health care provider or the manufacturer;
(d) if the licensee supplies the medication, check the product package to ensure that a child is not given a dosage larger than that recommended by the manufacturer;
(e) administer the medication; and
(f) immediately record the following information:
(i) the date, time, and dosage of the medication given;
(ii) the signature or initials of the provider who administered the medication; and,
(iii) any errors in administration or adverse reactions.
(7) The licensee shall ensure that any adverse reaction to a medication or any error in administration is reported to the parent immediately upon recognizing the error or reaction, or after notifying emergency personnel if the reaction is life threatening.
(8) The licensee shall not keep medications in the home for any child who is no longer enrolled.
R430-90-18. Napping.
(1) The licensee shall ensure that children in care are offered a daily opportunity for rest or sleep in an environment that provides a low noise level and freedom from distractions.
(2) If the licensee has a scheduled nap time for children, it shall not exceed two hours daily.
(3) If mats, cots, or other sleeping equipment is provided, the licensee shall meet the following requirements:
(a) The licensee shall maintain sleeping equipment in good repair.
(b) If sleeping equipment is clearly assigned to and used by an individual child, a provider must clean and sanitize it as needed, but at least weekly.
(c) If sleeping equipment is not clearly assigned to and used by an individual child, a provider must clean and sanitize it prior to each use.
(4) Sleeping equipment may not block exits at any time.
R430-90-19. Child Discipline.
(1) The licensee shall inform non-emergency substitutes, caregivers, parents, and children of the licensee's behavioral expectations for children.
(2) Providers and volunteers may discipline children using positive reinforcement and redirection, and by setting clear limits that promote a child's ability to become self-disciplined.
(3) A provider may use gentle, passive restraint with a child only when it is needed to stop the child from injuring himself or herself or others or from destroying property.
(4) Disciplinary measures shall not include any of the following:
(a) any form of corporal punishment such as hitting, spanking, shaking, biting, pinching, or any other measure that produces physical pain or discomfort;
(b) restraining a child's movement by binding, tying, or any other form of restraint that exceeds that specified in Subsection (3) above;
(c) shouting at any child;
(d) any form of emotional abuse;
(e) forcing or withholding of food, rest, or toileting; and,
(f) confining a child in a closet, locked room, or other enclosure such as a box, cupboard, or cage.
R430-90-20. Activities.
(1) The licensee shall develop a daily activity plan that offers activities to support each child's healthy physical, social-emotional, and cognitive-language development.
(2) The licensee shall ensure that the toys and equipment needed to carry out the activity plan are accessible to children.
(3) If off-site activities are offered:
(a) the licensee shall obtain parental consent for off-site activities in advance;
(b) the licensee shall accompany the children and shall take written emergency information and releases with them for each child in the group, which shall include:
(i) the child's name;
(ii) the parent's name and phone number;
(iii) the name and phone number of a person to notify in the event of an emergency if the parent cannot be contacted;
(iv) the names of people authorized by the parent to pick up the child; and
(v) current emergency medical treatment and emergency medical transportation releases;
(c) the licensee shall maintain required provider to child ratios and direct supervision during the activity;
(d) at least one provider present shall have a current Red Cross, American Heart Association, or equivalent first aid and infant and child CPR certification; and
(e) the licensee shall ensure that there is a way for each provider, volunteer, and child to wash his or her hands as specified in R430-90-16(1) and (2). If there is no source of running water, providers, volunteers, and children may clean their hands with individual disposable wet wipes and hand sanitizer.
(4) If swimming activities are offered, providers shall remain with the children during the activity, and lifeguards and pool personnel shall not count toward the provider to child ratio.
R430-90-21. Transportation.
(1) Any vehicle used for transporting any child in care shall:
(a) be enclosed;
(b) be equipped with individual, size appropriate safety restraints, properly installed and in working order, for each child being transported;
(c) have a current vehicle registration and safety inspection;
(d) be maintained in a safe and clean condition;
(e) maintain temperatures between 60-90 degrees Fahrenheit when in use;
(f) contain a first aid kit; and
(g) contain a body fluid clean up kit.
(2) At least one adult in each vehicle transporting any child in care shall have a current Red Cross, American Heart Association, or equivalent first aid and infant and child CPR certification.
(3) The adult transporting any child in care shall:
(a) have and carry with them a current valid Utah driver's license for the type of vehicle being driven whenever he or she is transporting any child in care;
(b) have with him or her written emergency contact information for each child in care being transported;
(c) ensure that each child in care being transported is wearing an appropriate individual safety restraint;
(d) ensure that each child is always attended by an adult while in the vehicle;
(e) ensure that all children remain seated while the vehicle is in motion;
(f) ensure that keys are never left in the ignition when the driver is not in the driver's seat; and,
(g) ensure that the vehicle is locked during transport.
R430-90-22. Animals.
(1) The licensee shall inform parents of the types of animals permitted on the premises.
(2) The licensee shall ensure that all animals on the premises and accessible to any child in care :
(a) are clean and free of obvious disease or health problems that could adversely affect any child in care; and
(b) have current vaccinations for all vaccine preventable diseases that are transmissible to humans. The licensee shall have documentation of the vaccinations.
(3) The licensee shall ensure that there is no animal on the premises that has a history of dangerous, attacking, or aggressive behavior, or a history of biting even one person.
(4) The licensee shall ensure that no child in care assists with the cleaning of animals or animal cages, pens, or equipment.
(5) The licensee shall ensure that there is no animal or animal equipment in food preparation or eating areas during food preparation or eating times.
(6) The licensee shall ensure that no child in care handles reptiles or amphibians while in care.
R430-90-23. Diapering.
If children in care are diapered on the premises, the following applies:
(1) The diapering surface shall be smooth, waterproof, and in good repair.
(2) A provider shall clean and sanitize the diapering surface after each diaper change, or use a disposable non-permeable diapering surface that is thrown away after each diaper change.
(3) The provider shall wash his or her hands after each diaper change.
(4) The provider shall place soiled disposable diapers in a container that has a disposable plastic lining and a tightly fitting lid, or place soiled diapers directly in an outdoor garbage container.
(5) A provider shall daily clean and sanitize indoor containers where soiled diapers are placed.
(6) If cloth diapers are used:
(a) they shall not be rinsed at the facility; and
(b) after a diaper change, the provider shall place the cloth diaper directly into a leakproof container that is inaccessible to any child and labeled with the child's name, or a leakproof diapering service container.
(7) The licensee shall ensure that each child's diaper is checked at least once every two hours, and that each child's diaper is changed promptly if it is wet or soiled.
R430-90-24. Infant and Toddler Care.
If the licensee accepts infants or toddlers for care, the following applies:
(1) If an infant is not able to sit upright and hold his or her own bottle, a provider shall hold the infant during bottle feeding. Bottles shall not be propped.
(2) A provider shall clean and sanitize high chair trays prior to each use.
(3) A provider shall cut solid foods for infants into pieces no larger than 1/4 inch in diameter. A provider shall cut solid foods for toddlers into pieces no larger than 1/2 inch in diameter.
(4) If there is more than one infant in care, baby food, infant formula, and breast milk for each infant that is brought from home must be labeled with the child's name or another unique identifier.
(5) Baby food, infant formula, and breast milk for infants that is brought from home for an individual child's use must be:
(a) kept refrigerated if needed; and
(b) discarded within 24 hours of preparation or opening, except that powdered formula or dry foods which are opened, but are not mixed, are not considered prepared.
(6) The licensee shall ensure that infant formula and milk, including breast milk, is discarded after each feeding, or within two hours of initiating a feeding.
(7) To prevent burns, a provider shall shake each heated bottle and test it for temperature before the bottle is fed to a child.
(8) If there is more than one infant or toddler in care, pacifiers and bottles shall be:
(a) labeled with each child's name or another unique identifier; or
(b) washed and sanitized after each individual use.
(9) The licensee shall ensure that only one infant occupies any one piece of equipment, such as a crib, playpen, stroller, or swing, at any time, unless the equipment has individual seats for more than one child.
(10) The licensee shall ensure that infants sleep in equipment designed for sleep, such as a crib, bassinet, porta-crib or play pen. The licensee shall ensure that infants are not placed to sleep on mats or cots, or in bouncers, swings, car seats, or other similar pieces of equipment, unless the licensee has written permission from the infant's parent.
(11) The licensee shall ensure that each infant crib:
(a) has a tight fitting mattress;
(b) has slats spaced no more than 2-3/8 inches apart;
(c) has at least 20 inches from the top of the mattress to the top of the crib rail; and
(d) does not have strings, cords, ropes, or other entanglement hazards strung upon the crib rails or within reach of the child.
(12) The licensee shall ensure that infants are not placed on their stomachs for sleeping, unless there is documentation from a health care provider for treatment of a medical condition.
(13) The licensee shall ensure that each infant and toddler is allowed to follow his or her own pattern of sleeping and eating.
(14) Infant walkers with wheels are prohibited.
(15) The licensee shall ensure that infants and toddlers do not have access to objects made of styrofoam.
(16) The licensee shall ensure that a provider responds as promptly as possible to infants and toddlers who are in emotional distress due to conditions such as hunger, fatigue, wet or soiled diapers, fear, teething, or illness.
(17) The licensee shall ensure that awake infants and toddlers receive positive physical stimulation and positive verbal interaction with a provider at least once every 20 minutes.
(18) The licensee shall ensure that awake infants are not confined for more than 30 minutes in one piece of equipment, such as swings, high chairs, cribs, play pens, or other similar pieces of equipment.
(19) The licensee shall ensure that mobile infants and toddlers have freedom of movement in a safe area.
(20) To stimulate their healthy development, there shall be safe toys accessible to infants and toddlers. The licensee shall ensure that there are enough toys for each child in the group to be engaged in play with toys.
(21) The licensee shall ensure that all toys used by infants and toddlers are cleaned and sanitized:
(a) weekly;
(b) after being put in a child's mouth; and
(c) after being contaminated by body fluids.
KEY: child care facilities
Date of Enactment or Last Substantive Amendment: [
February 15, 2002]2008Notice of Continuation: July 29, 2003
Authorizing, and Implemented or Interpreted Law: 26-39
Document Information
- Effective Date:
- 7/1/2008
- Publication Date:
- 04/01/2008
- Filed Date:
- 03/12/2008
- Agencies:
- Health,Health Systems Improvement, Child Care Licensing
- Rulemaking Authority:
Title 26, Chapter 39
- Authorized By:
- Richard Melton, Deputy Director
- DAR File No.:
- 31057
- Related Chapter/Rule NO.: (1)
- R430-90. Licensed Family Child Care.