Bristol Child Development Center- West Street

Policies- complete, implemented: The operator shall implement and annually review specific written policies, plans and procedures that include, but not necessarily be limited to discipline, when a child is not picked up as planned, multi-hazard and medical emergencies, supervision of children, general operating policies, administrative oversight and personnel policies. The operator shall notify the parent(s), staff and the Office of Early Childhood within five (5) days of changes in these policies, plans and procedures.

Rule 19a-79-3a(d)(2)-(7).

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).

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).

Toxic plants/materials inaccessible: Toxic plants and materials are prohibited in areas accessible to children.

Rule 19a-79-7a(e)(13).

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. Rugs, if used, shall not present a tripping or slipping hazard.

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

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).

Authorized prescriber/parent permission: Except for nonprescription topical medications, no medication shall be administered to a child without the written order of an authorized prescriber and the written permission of the child’s parent(s) which shall be on file at the facility. Individual written medication administration records for each child shall be written in ink, reviewed prior to administering each dose of medication and kept on file at the facility for at least three years after the child is no longer attending the program.

Rule 19a-79-9a(b)(3)(A-B).

Supervision: Children shall be supervised at all times while at the facility, indoors or outdoors, or on field trips. At no time shall a child be left unsupervised.

Rule 19a-79-4a(d)(4)(D).

Child behavior management: The operator and program staff shall manage child behavior using techniques based on developmentally appropriate practice, including positive guidance, redirection and setting clear limits that encourage children to develop self-control, self-discipline and positive self-esteem and communicate acceptable techniques to all staff.

Rule 19a-79-3a(b)(7)(A).

Kitchen Separated: The kitchen in child care centers or group child care homes shall not be used as a playroom, but may be used for a specific program activity room under supervision. Except for programs that serve exclusively school age children, the kitchen shall be separated by a door or a gate from the rooms used by the children in the child care center or group child care home to prevent them from entering the kitchen except under supervision.

Rule 19a-79-6a(a)(9). From a complaint.

Diapering: The diapering area shall be an elevated sturdy table or counter equipped with a safety rail. Infants and toddlers shall be diapered at a diapering area used only for this purpose and located in the program area. Each diapering area shall have a non-porous surface and be kept in good repair. Diapering areas shall be washed and disinfected after each use. Disposable paper sheets shall be used and discarded immediately after each diapering. A covered washable lined waste receptacle shall be available and located in a convenient place for soiled waste material. These materials shall be removed to an exterior waste storage area at least daily. Disposable diapers shall be discarded in a covered receptacle immediately after diapering. The hands of the program staff and the children shall be washed after each diaper change. Diapering and hand washing policies and procedures shall be posted in each diapering area and followed. When cloth diapers or training pants are used, a written plan for their use and care shall be developed and implemented. This plan shall include, but not be limited to, these procedures: placing soiled clothing and diapers in a sealed air tight container; removing soiled clothing and diapers from the child care center or group child care home daily; and cleaning and sanitizing the container daily.

Rule 19a-79-10(e)(1-10).

Consultants: An education consultant shall be available to the operator and program staff for advice and support regarding the educational content and practice of the program. A person needs to apply for approval to be an education consultant. Program staff shall not serve as education consultants for programs in which they provide direct care or direct program supervision in a non-consultative role; or in a program with the same operator as a program in which they provide direct care or direct program supervision in a non-consultative role. Specific duties of the education consultant shall include, but not be limited to making, at a minimum, annual site visits to the facility, reviewing daily plans, curriculum documents, and educational policies for the developmental and age appropriate practices, observing program staff interactions, use of materials and equipment, implementation of plans and approaches to classroom management; and providing feedback on documentation review and classroom observations to the director and head teacher. A health consultant shall be available to the operator and program staff for advice regarding the health of the children and the health program. Specific duties of the health consultant shall include, but not be limited to making, at a minimum, quarterly site visits to facilities that serve children three years of age and older; or for group child care homes, facilities that operate no more than three hours per day, or facilities that enroll only school age children, semi-annual site visits. Facilities that are closed during the summer months may omit the summer quarterly visit. Site visits shall be made by the health consultant during customary business hours when the children are present at the facility. Specific duties include, but are not limited to reviewing health and immunization records of children and program staff, reviewing the contents, storage and plan for maintenance of first aid kits, observing the indoor and outdoor environments for health and safety, observing children�s general health and development, observing diaper changing and toileting areas and diaper changing, toileting and hand washing procedures, reviewing the policies, procedures and required documentation for the administration of medications, including petitions for special medication authorizations needed for programs that administer medication, assisting in the review of individual care plans for children with special health care needs or children with disabilities, as needed; and quarterly review of all injury, illness, incident and accident reports. A social service consultant shall be available to the operator and program staff for advice regarding the emotional needs, program staff support and the social service program. A registered dietitian consultant shall be available to the operator and program staff for advice regarding nutrition and food service for those programs that prepare or plan meals. A written plan for consultation services shall be developed, signed annually by the consultant and implemented. Consultative service shall include, but not be limited to an annual review of written policies, plans and procedures that relate to the services provided by the consultant, availability by telecommunication for advice regarding problems, availability, in person, of the consultant to the program, consulting with administration and program staff about specific problems, acting as a resource person to program staff and the parent(s) to include coordinating services and assisting families and program staff in identifying necessary resources, and seeking and supporting the collaboration of multiple consultants serving the program. The activities and observations required by each consultant shall be documented in a consultation log that is kept on file at the facility for two years.

Rule 19a-79-4a(i)(1-2)(H), (F).

Kitchen Separated: The kitchen in child care centers or group child care homes shall not be used as a playroom, but may be used for a specific program activity room under supervision. Except for programs that serve exclusively school age children, the kitchen shall be separated by a door or a gate from the rooms used by the children in the child care center or group child care home to prevent them from entering the kitchen except under supervision.

Rule 19a-79-6a(a)(9).

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).

Potentially hazardous substances, materials � labeled, inaccessible to children: Potentially hazardous substances and materials in the child care centers and group child care homes shall be stored in a labeled container identifying the exact contents and dilutions, used according to the manufacturer�s instructions and for the intended purpose, handled in a safe manner and inaccessible to children.

Rule 19a-79-7a(e)(10).

Authorized prescriber/parent permission: Except for nonprescription topical medications, no medication shall be administered to a child without the written order of an authorized prescriber and the written permission of the child’s parent(s) which shall be on file at the facility. Individual written medication administration records for each child shall be written in ink, reviewed prior to administering each dose of medication and kept on file at the facility for at least three years after the child is no longer attending the program.

Rule 19a-79-9a(b)(3)(A-B).

Unused/Expired meds-destroyed/returned: All unused or expired medication, except for controlled substances, shall be returned to the parent(s) or disposed of if it is not picked up within one week following the termination of the order, in the presence of at least one witness. The facility shall keep a written record of the medications destroyed for three years which shall be signed by both parties.

Rule 19a-79-9a(b)(5)(D).

Supervision: Children shall be supervised at all times while at the facility, indoors or outdoors, or on field trips. At no time shall a child be left unsupervised.

Rule 19a-79-4a(d)(4)(D).

Supervision: Children shall be supervised at all times while at the facility, indoors or outdoors, or on field trips. At no time shall a child be left unsupervised.

Rule 19a-79-4a(d)(4)(D).

Supervision: The operator shall be responsible for assuring the supervision of the children at all times while the children are at the facility, indoors or outdoors, or on field trips. At no time shall a child be left unsupervised.

Rule 19a-79-4a(c)(4)(D).

First Aid Kit(s):Indoor/Outdoor/Field Trip: The facility shall maintain at least one (1) portable, readily available first aid kit wherever children are in care, including field trips, outdoor play areas and one to remain at the facility if all the children do not attend the field trip. Each kit shall be a closed container for storing first aid supplies, accessible to staff at all times but out of the reach of children. The first aid kit shall contain specified items and be restocked after use, and an inventory shall be conducted at least monthly.

Rule 19a-6a(c) and/or 19a-6a(d).

Adequate Sinks in Program Space: In child care centers that serve children under three years of age, there shall be a sink with hot and cold running water designated for diaper changing and hand washing of staff and children in the program space. Visual contact with all other children shall be maintained while changing diapers or using the sink. Child care centers which staff three (3) adults to a group size of eight (8) infants or toddlers may use an accessible diaper changing facility if it is immediately adjoining the program area. Separate sinks shall be available for purposes other than hand washing after diaper changing within child care centers. Group child care homes shall have a sink accessible for hand washing other than the sink used for food preparation.

Rule 19a-79-10(d)(1).

Individual Care Plan (Signed by Parent/Staff): 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 an individual plan of care for any child with special health care needs or disabilities, developed with the child’s parent(s) and health care provider and updated, as necessary.

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

Potentially Hazardous Substances Locked: Potentially hazardous substances in the child care centers and group child care homes shall be stored in a separate locked area.

Rule 19a-79-7a(e)(10).

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).

Nonprescription Topical Medications: Administration/Parent Permission/MAR: The written permission of the parent(s) shall be required prior to the administration of the nonprescription topical medication and a medication administration record shall be written in ink and kept on file at the facility for each child administered a nonprescription topical medication.

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

Oral/Topical/Inhalant/Injectable Medications: Authorized Prescriber/Parent Permission/MAR: Except for nonprescription topical medications, no medication shall be administered to a child without the written order of an authorized prescriber and the written permission of the child’s parent(s) which shall be on file at the facility. Individual written medication administration records for each child shall be written in ink, reviewed prior to administering each dose of medication and kept on file at the facility for at least two (2) years after the child is no longer attending the program.

Rule 19a-79-9a(b)(3) and/or 19a-79-9a(b)(4).