Strong Start Early Care and Education

Toys and other objects: Toys used for infants shall be kept separate, washed and sanitized at least daily. Toys for toddlers, including floor and riding toys, shall be washed and sanitized at least weekly and as needed. Toys and other objects with a diameter of less than one and one-quarter inches, objects with removable parts that have a diameter of less than one and one-quarter inches, balloons and Styrofoam objects shall not be accessible to children under three years of age unless such objects are part of a designated and directly supervised activity. Plastic bags, not in use, shall be stored out of reach and inaccessible to children under three years of age. Plastic bags, while in use, may be stored within reach of children under three years of age provided access to such bags is only under direct and immediate supervision.

Rule 19a-79-10(h)(1)-(2).

Local Health Inspection: At least every two (2) years, the local health director shall make unannounced visits, inspections or investigations of the licensed child care center or group child care home.

Rule 19a-79-2a(c)(8).

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).

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).

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).

Individual care plan- signed by parents/staff: An individual plan of care for any child with special health care needs or disabilities when it is necessary that special care be taken or provided while a child is in attendance shall be developed and implemented with the child’s parent(s) and health care provider and updated, as necessary. The plan shall include appropriate care of the child to prevent and respond to a medical or other emergency and shall be signed by the parent and program staff responsible for the care of the child.

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

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).

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).

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).

Postings: The operator shall post the following items in a conspicuous place, accessible to the public: the license, the OEC complaint procedure, menus, No Smoking signs, the plan for administrative oversight, the radon test, the OEC Inspection report (posted or available), the safe sleep policy and the OEC Developmental Milestones document.

Rule 19a-79-3a(d)6)(C), (e)(1-6), 7a(e)(17), 10(g)(8).

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).

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).

Individual care plan- signed by parents/staff: An individual plan of care for any child with special health care needs or disabilities when it is necessary that special care be taken or provided while a child is in attendance shall be developed and implemented with the child’s parent(s) and health care provider and updated, as necessary. The plan shall include appropriate care of the child to prevent and respond to a medical or other emergency and shall be signed by the parent and program staff responsible for the care of the child.

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

Menus- 1 wk in advance- keep 3 mths: When a child care center or group child care home provides either meals or snacks, menus shall be prepared at least one week in advance, dated and copies posted in a conspicuous place. Changes shall be documented by the end of the program day. A copy of what was served shall be kept on file for three months.

Rule 19a-79-6a(a)(4).

Water supply- water testing: Water supply, food service and sewage disposal facilities shall be adequate, safe and in compliance with all applicable sections of the Regulations of Connecticut State Agencies. Water from at least one drinking fountain or drinking, beverage and food preparation sink, and from two such sources if the facility has more than one, shall be tested every two years for lead content. The water sample shall have been standing in plumbing pipes at least six hours and the results shall be submitted to the local director of health and kept on file at the facility. New child care facilities shall submit lead test results from each drinking, beverage and food preparation sink to the Office with the facility�s initial application. Whenever water is obtained from other than a public water system that is regulated by the Connecticut Department of Public Health, it shall be of a safe and sanitary quality and tested every two years for bacterial and chemical quality and the results submitted to the local director of health. The water analysis shall include tests for bacteria, physical parameters (color, odor, turbidity, pH), and sanitary chemicals (nitrogen series, chloride, hardness, iron, manganese and sodium). Additional tests may be required as deemed necessary by the Office. Drinking water shall be available and accessible to children at all times including at all meals and snacks.

Rule 19a-79-7a(c)(5)(A-C).

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).

Indoor climbing play equipment- shock absorbing materials under and around: Indoor play equipment for climbing shall have a shock absorbing surface, under and around, that shall effectively cushion the fall of a child. Carpet is not considered a shock absorbing surface.

Rule 19a-79-7a(g)(6).

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).

Water Hazards: Public swimming pools, wading and public swimming areas, if provided, shall comply with the provisions of sections 19-13-B33b and 19a-36-B61 of the Regulations of Connecticut State Agencies. No wading pools shall be used. Hot tubs, spas and saunas shall be locked and inaccessible to children. Locks shall be openable with a key, combination, fingerprint, magnet or other unlocking mechanism that prevents an unauthorized person from obtaining access.

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

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).

Under Three Endorsement: Ratio: 1 Staff to 4 Children: For children under three years of age, there shall be at least one (1) program staff for every four (4) children or fraction thereof in attendance. During nap time, when all of the children in the group are sleeping, the overall staff child ratios shall be maintained on the licensed premises. At no time shall a group of children be left unsupervised.

Rule 19a-79-10(c)(2) and/or 19a-79-4a(c)(6).

Documentation of Behavioral Management Techniques Discussed with Parents: The operator shall document that the techniques used to manage child behaviors in the facility have been discussed with the child’s parent(s) prior to enrollment and reviewed as needed during the period of the child’s enrollment.

Rule 19a-79-3a(b)(8)(B).

Current Fire Marshal Certificate: The operator shall post the current fire marshal certificate in a conspicuous place, accessible to the public.

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

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).

Professional Development: 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 documentation of professional development for each program staff person who cares for the children, including new employee orientation and annual training for current staff on programs policies, plans and procedures. Professional development for program staff shall be required for one (1) per cent of the total annual hours worked. The operator of the child care center or group child care home shall develop, implement and maintain a written plan for professional development in child care. The operator shall have documentation of a professional development plan for each program staff member which shall be maintained on site at the facility and made available for review.

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

Logs/Visits Documented: A written plan for consultation services shall be developed, signed annually by the consultant and implemented. Consultative services shall include documenting the activities and observations in a consultation log that is kept on file at the facility for two years.

Rule 19a-79-4a(h)(2)(G).

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).

Injury/Illness/Accident Reports: The facility shall produce and maintain on the premises, for a period of not less than two years, a written record of all injuries or accidents that result in an injury to a child or illness of a child enrolled at the facility that occur on or off site as part of the child care program. The written report for an individual child shall be available to the Office of Early Childhood and a copy shall be provided to the child’s parent(s) no later than the next business day.

Rule 19a-79-5a(a)(3).

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.

Ventilation in Toilet Room: Each toilet room shall be 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)(11)(F) &/or19a-79-7a(d)(11)(G).

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).

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).

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).

Oral/Topical/Inhalant/Injectable Medications: Unused/Expired Meds Returned/Disposed: All unused or expired medication shall be returned to the parent(s) or disposed of if it is not picked up within one (1) 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 which shall be signed by both parties. The facility shall require the parent(s) of a child who has a prescription for an automatic prefilled cartridge injector, or similar automatic injectable equipment used to treat an allergic reaction or injectable equipment used to administer glucagon or inhalant medication to treat asthma, to provide the injector or equipment labeled with the information from the prescriber upon enrollment and attendance of such child at the facility, and replace such medication and equipment prior to its expiration date.

Rule 19a-79-9a(b)(5)(D) and/or 19a-79-9a(b)(5)(E).

Administration-Ensuring the safety, health & development of children: The operator of the child care center or group child care home shall be responsible for compliance with the requirements of the Regulations of Connecticut State Agencies and applicable endorsements in such a manner as to ensure the safety, health and development of the children while in the operator’s care.

Rule 19a-79-3a.

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).