Building Blocks Child Care & Preschool

Staff Health Records: A file shall be kept on the licensed premises for each employee of the child care center or group child care home which shall include an acceptable medical statement, completed within 12 months before the date of employment for new program staff, and every 36 months for current program staff. Such statement shall document the presence of any known medical or emotional illness or disorder that would currently pose a risk to children.

Rule 19a-79-4a(a)(1).

Professional development: Documentation of professional development for each program staff who cares for the children, including new employee orientation and annual training for current program staff on the child care center or group child care home policies, plans and procedures. Program staff, including the director, shall complete health and safety training no later than three months after the date of hire. Written verification of ongoing training that is at least one percent of the total annual hours worked. As of April 1, 2025, such annual training shall include content as defined in 45 CFR � 98.41(a)(1)(i) to (a)(1)(xi). Such education may include, but is not limited to, early education and child development, licensing and regulations, emergency preparedness, prevention and control of infectious diseases, prevention of sudden infant death syndrome and use of safe sleep practices, administration of medication, prevention and response to emergencies due to food and allergic reactions, building and physical premises safety, protection from hazards, bodies of water, and vehicular traffic; handling and storage of hazardous materials and the appropriate disposal of bio contaminants; child maltreatment, prevention of shaken baby syndrome and abusive head trauma, precautions in transporting children, pediatric first aid and cardiopulmonary resuscitation, nutrition and programming for children with disabilities or special health care needs.

Rule 19a-79-4a(a)(2), (h)(1-2).

Comprehensive background checks: The operator shall ensure that all program staff have completed a comprehensive background check before they have unsupervised access to children. The operator shall provide to the Office of Early Childhood any information obtained concerning substantiated child abuse or neglect records or criminal convictions upon request. The operator shall obtain from each prospective employee, who is eighteen years of age or older, for a position that requires the provision of care to a child or involves unsupervised access to a child, a listing of all employment held in the United States for an organization that provides care or services to children in the preceding five years. The operator shall take reasonable steps to contact each previous employer provided by the prospective employee to verify at a minimum the prospective employee�s job title, description of his/her regular duties, confirmation of employment dates, and whether such previous employer would recommend the prospective employee for rehire. This information shall be made accessible to the Office upon request. The operator shall not employ program staff, including volunteers, who have a record that the commissioner reasonably believes renders such program staff unsuitable to be employed in a child care center or group child care home.

Rule 19a-79-4a(b).

CPR Certified program staff: At all times the child care center is in operation there shall be present at least one program staff member who has current certification in CPR appropriate for all of the children served at the child care center or group child care home. The certification shall be based on a hands-on demonstration of the individual�s ability to provide cardiopulmonary resuscitation. Such program staff shall respond to all medical emergencies. Written verification of such training shall be kept on file.

Rule 19a-79-4a(f)(1).

First Aid Certified program staff: At all times the child care center or group child care home is in operation, there shall be present at least one program staff member who holds current certification in first aid based on a first aid course appropriate for all of the children served at the child care center or group child care home. Such certification shall be based on a hands-on demonstration of the individual�s ability to provide first aid. Such program staff member shall respond to all situations requiring first aid. Written verification of such training shall be kept on file.

Rule 19a-79-4a(f)(2).

Immunization records: The operator of a child care center or group child care home is responsible for maintaining on the licensed premises a current record for each child enrolled. A copy of the record shall be available and provided upon request to the Office of Early Childhood, the child’s parent(s) and the local health director. It shall include a health record that shall include date of birth, a physical examination form, an immunization record, and information regarding disabilities or special health care needs.

Rule 19a-79-5a(2)(C).

Lighting: All spaces occupied by people, equipment within buildings, approaches to buildings and parking lots shall have a minimum of one foot candle or equivalent of lighting per square foot. Child care centers and group child care homes shall have at least fifty foot candles or equivalent of light per square foot in rooms used by children for reading, painting and other close work. There shall be at least thirty foot candles of light or equivalent in other work or play areas. Programs that serve exclusively school age children may utilize program space with less lighting provided the lighting is bright enough to accommodate the activities with comfort. During napping and resting, lighting shall be maintained at a level that will enable children to be visible. All areas accessible to children shall have light fixtures that are shielded or shatter proof.

Rule 19a-79-7a(e)(7-9).

Outdoor space: There shall be access to a minimum of seventy-five (75) square feet per child of outdoor space for the number of children using the space at any one time. The outdoor area shall be fenced or protected for safety. Outdoor play equipment shall have a shock absorbing surface, under and around, that shall effectively cushion the fall of a child, except where the child is sitting or standing at ground level. The shock absorbing surface shall be maintained at a depth of at least eight inches, be free of water and not allowed to become compacted. Acceptable shock absorbing surfaces may include mulch, sand, and wood chips. Synthetic material that is less than eight inches in depth, including but not limited to, rubber mats or tiles may be acceptable surfaces provided the operator maintains documentation on the licensed premises that the synthetic material is manufactured for this purpose, installed in accordance with the manufacturer�s specifications and sufficient to cushion the fall of a child. Concrete, asphalt, grass and dirt shall not be considered a shock absorbing surface. The playground shall be free of glass, debris, holes and other hazards. Nuts, bolts and screws shall be tight; and those that protrude shall be covered or protected. Outside equipment shall be anchored for stability when recommended by the manufacturer. Anchors shall be buried below ground level. The operator shall provide documentation to the Office, upon request, by a certified playground safety inspector that newly constructed playgrounds and all newly installed playground equipment that are set in position and anchored in such a way to last indefinitely are designed and installed in accordance with U.S. Consumer Product Safety Commission and the American Society for Testing and Materials Standards. Drinking water shall be available and accessible to children. Outdoor equipment shall be arranged in such a way as to avoid accidents. All play equipment, fences, and structures shall not pose a hazard.

Rule 19a-79-7a(h)(1-9).

Non-Prescription Topical Medications: The written permission of the parent(s) shall be required prior to the administration of the nonprescription topical medication shall be kept on file at the facility for each child administered a nonprescription topical medication. The parent(s) shall be immediately notified of any medication error, and notified of such error in writing not more than seventy two hours after the medication error occurred, and such medication error shall be documented in the child�s record. The medication shall be stored in the original container and shall contain the following information on the container or packaging indicating the individual child�s name; the name of the medication; and directions for the medication�s administration. The medication shall be stored away from food and inaccessible to children. Any unused portion of the medication shall be returned to the parent(s). Any expired medication shall be destroyed in a safe manner or returned to the parent.

Rule 19a-79-9a(a)(2-3).

Licensed premises-clean, good repair, hazard free-maintenance program: For programs serving children younger than school age, the building, equipment and furnishings shall be maintained in a good state of repair. A maintenance program shall be established that ensures that the interior, exterior and grounds of the building are maintained, kept clean and orderly, free from accumulations of refuse, dampness, stagnant water, dilapidated structures and other health and safety hazards.

Rule 19a-79-7a(c)(2).

Toileting: Where toilets and sinks are shared by children and adults, a written policy shall be developed and implemented that requires supervision of children when using the shared toilet room. Programs shall provide changing and sanitary facilities appropriate to meet the individual needs of children who are enrolled at the facility who need assistance with toileting or who are not independent with toileting. Facilities using potty chairs in addition to the required toilets shall ensure that they are of a nonporous, synthetic product, and emptied into the toilet, cleaned and disinfected after each individual use. For programs serving children under five years of age there shall be at least one toilet and one sink with hot and cold running water for every sixteen children, or fraction thereof. For programs serving only school age children, there shall be at least one toilet and one sink with running water for every twenty-five children, or fraction thereof. Toilet facilities shall be designed in such a manner to allow individual privacy. Sinks with running water shall be readily accessible to the toilet rooms if not located within them. Toilet tissue, soap, a mechanism for individual hand drying and a waste receptacle shall be accessible to the toilets and sinks. Staff, program staff, and children shall wash their hands with soap and water after toileting. Each toilet and sink shall be located at the facility or licensed premises, as applicable, of the child care center or group child care home. Each toilet room shall be well lighted and ventilated to the outside atmosphere. In child care centers constructed or renovated after January 1, 1994, all toilet facilities shall be mechanically ventilated to the outside atmosphere.

Rule 19a-79-7a(d)(10)(A-H).

Lighting: All spaces occupied by people, equipment within buildings, approaches to buildings and parking lots shall have a minimum of one foot candle or equivalent of lighting per square foot. Child care centers and group child care homes shall have at least fifty foot candles or equivalent of light per square foot in rooms used by children for reading, painting and other close work. There shall be at least thirty foot candles of light or equivalent in other work or play areas. Programs that serve exclusively school age children may utilize program space with less lighting provided the lighting is bright enough to accommodate the activities with comfort. During napping and resting, lighting shall be maintained at a level that will enable children to be visible. All areas accessible to children shall have light fixtures that are shielded or shatter proof.

Rule 19a-79-7a(e)(7-9).

Outdoor space: There shall be access to a minimum of seventy-five (75) square feet per child of outdoor space for the number of children using the space at any one time. The outdoor area shall be fenced or protected for safety. Outdoor play equipment shall have a shock absorbing surface, under and around, that shall effectively cushion the fall of a child, except where the child is sitting or standing at ground level. The shock absorbing surface shall be maintained at a depth of at least eight inches, be free of water and not allowed to become compacted. Acceptable shock absorbing surfaces may include mulch, sand, and wood chips. Synthetic material that is less than eight inches in depth, including but not limited to, rubber mats or tiles may be acceptable surfaces provided the operator maintains documentation on the licensed premises that the synthetic material is manufactured for this purpose, installed in accordance with the manufacturer�s specifications and sufficient to cushion the fall of a child. Concrete, asphalt, grass and dirt shall not be considered a shock absorbing surface. The playground shall be free of glass, debris, holes and other hazards. Nuts, bolts and screws shall be tight; and those that protrude shall be covered or protected. Outside equipment shall be anchored for stability when recommended by the manufacturer. Anchors shall be buried below ground level. The operator shall provide documentation to the Office, upon request, by a certified playground safety inspector that newly constructed playgrounds and all newly installed playground equipment that are set in position and anchored in such a way to last indefinitely are designed and installed in accordance with U.S. Consumer Product Safety Commission and the American Society for Testing and Materials Standards. Drinking water shall be available and accessible to children. Outdoor equipment shall be arranged in such a way as to avoid accidents. All play equipment, fences, and structures shall not pose a hazard.

Rule 19a-79-7a(h)(1-9).

Non-Prescription Topical Medications: The written permission of the parent(s) shall be required prior to the administration of the nonprescription topical medication shall be kept on file at the facility for each child administered a nonprescription topical medication. The parent(s) shall be immediately notified of any medication error, and notified of such error in writing not more than seventy two hours after the medication error occurred, and such medication error shall be documented in the child�s record. The medication shall be stored in the original container and shall contain the following information on the container or packaging indicating the individual child�s name; the name of the medication; and directions for the medication�s administration. The medication shall be stored away from food and inaccessible to children. Any unused portion of the medication shall be returned to the parent(s). Any expired medication shall be destroyed in a safe manner or returned to the parent.

Rule 19a-79-9a(a)(2-3).

Washed/Disinfected: Diapering areas shall be washed and disinfected after each use.

Rule 19a-79-10(e)(4).

Staff Health Records: A file shall be kept on the licensed premises for each employee of the child care center or group child care home which shall include an acceptable medical statement and a written report of a negative tuberculin test.

Rule 19a-79-4a(a)(1) and/or 19a-79-4a(a)(2).

Child Health Records/Immunizations/TB: The operator of a child care center or group child care home is responsible for maintaining on the licensed premises a current record for each child enrolled. A copy of the record shall be available and provided upon request to the Office of Early Childhood, the child’s parent(s) and the local health director. It shall include a health record that shall include date of birth, a physical examination form, an immunization record, and information regarding disabilities or special health care needs.

Rule 19a-79-5a(a)(2)(A) through (E)and/or19a-79-6a(e).

License Premise Clean/Good Repair/Safe: The building, equipment and services shall be maintained in a good state of repair. A maintenance program shall be established that ensures that the interior, exterior and grounds of the building are maintained, kept clean and orderly, free from accumulations of refuse, dampness, stagnant water, dilapidated structures and other health and safety hazards.

Rule 19a-79-6a and/or 19a-79-7a.

Individual Storage of Clothing/Bedding: There shall be an area available for the individual storage of each child’s clothing and bedding.

Rule 19a-79-7a(d)(8).

Walls/Ceilings/Floors/Rugs: Clean/Good Repair: Walls, ceilings, floors and rugs shall be maintained in a state of good repair and be washable or easily cleanable.

Rule 19a-79-7a(e)(5).

Rugs Secured: Rugs, if used, shall be secured to the floor.

Rule 19a-79-7a(e)(5).

Playground Free From Hazards: Hardware such as air conditioners, water heaters or fuse boxes shall be inaccessible to children. The playground shall be free of glass, debris, holes and other hazards.

Rule 19a-79-7a(g)(4) and/or 19a-79-7a(h).

Impact Absorbing Material under Equipment: Where swings, seesaws or climbing apparatus are used, the surface in the space shall be protected with a minimum of eight (8) inches of impact absorbing materials.

Rule 19a-79-7a(h)(2).

Outdoor Play Area Protected/Fenced: The outdoor play area shall be protected from traffic, bodies of water, gullies and other hazards by barriers in a manner safe for children.

Rule 19a-79-7a(h)(7).

Administration of Medications: Training Outline/Med Training: Upon completion of the required medication administration training program, the training approval and an outline of the curriculum content shall be on file at the facility.

Rule 19a-79-9a(b).

Med Trained Staff/Certificates: Prior to the administration of any medication, the director(s), head teacher(s), program staff or group child care home provider(s) who are responsible for administering the medications shall first be trained by a physician, physician assistant, advanced practice registered nurse or registered nurse in the methods of administration of medications and shall receive written approval from the trainer which indicates that the trainee has successfully completed a training program. A director(s), head teacher(s), program staff or group child care home provider(s) trained and approved to administer medication shall be present whenever a child who has orders to receive medication is present at the facility. The training in the administration of medications shall be documented. A copy of the approval shall be on file at the facility where the director, head teacher, program staff or group child care home provider is employed and shall be available to Office of Early Childhood staff upon request.

Rule 19a-79-9a(b)(1) &/or 19a-79-9a(b)(2).