Cadence Academy Preschool of Farmington

Authorized prescriber written order: The operator shall keep the following records at the facility as part of the child’s medical record, and shall update them annually or when there is any change in the information. A current, written order signed and dated by the child’s physician, physician assistant or advanced practice registered nurse indicating the child’s name; the diagnosis of diabetes mellitus; the type of blood glucose monitoring test required; the test schedule; the target ranges for test results; specific actions to be taken and carbohydrates to be given when test results fall outside specified ranges; diet requirements and restrictions; (H) Any requirements for monitoring the child’s recreational activities; and conditions requiring immediate notification of the child’s parent(s), emergency contact, the child’s physician, physician assistant or advanced practice registered nurse.

Rule 19a-79-13(e)(1).

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).

Physical barriers- indoors/outdoors: There shall be a physical barrier separating each group of children under the age of three, indoors and outdoors.

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

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).

Safe Sleep: Infants under twelve months of age shall be placed in a supine (back) position for sleeping in a well-constructed, free standing crib or other piece of equipment designed for infant sleeping and appropriate for the particular child. A well-constructed, free standing crib or other piece of equipment shall be used designed for infant sleeping and appropriate for the particular child, with a snug fitting mattress covered by a tightly-fitted sheet. Infants under twelve months of age shall be placed in a supine (back) position for sleeping in a well-constructed, free standing crib or other piece of equipment designed for infant sleeping and appropriate for the particular child, with a snug fitting mattress covered by a tightly-fitted sheet unless the child has written documentation from a physician, physician assistant or advanced practice registered nurse specifying a medical reason for an alternative sleep position or alternate piece of equipment. When infants can easily turn over from the supine to the prone position, they shall be put down to sleep on their back, but allowed to adopt whatever position they prefer for sleep. No items including, but not limited to, pillows, soft bumpers, toys and blankets, including weighted blankets, weighted sleepers, and weighted swaddles, shall be placed with an infant in a crib or hung over the side of a crib or other piece of equipment designed for sleeping except for a pacifier without attachments unless the child has written documentation from a physician, physician assistant or advanced practice registered nurse specifying a medical reason for its use. Bibs and garments with ties or hoods shall be removed from infants that are placed to sleep. No toys or objects shall be attached to sleeping or rest equipment. No infant shall be put to sleep on a sofa, bed, couch, soft mattress, waterbed or other soft surface. No infant shall be put to sleep or allowed to remain asleep in a child restraint system intended for use in a vehicle, an infant carrier, a swing or any place that is not specifically designed to be an infant bed unless the child has written documentation from a physician, physician assistant or advanced practice registered nurse specifying a medical reason for their use. No infant shall be swaddled unless the child has written documentation from a physician, physician assistant or advanced practice registered nurse specifying instructions and a timeframe for swaddling the infant. Infants under twelve months of age shall be physically observed at least every fifteen minutes to assess the infants breathing, color, temperature and comfort. No child under three years of age shall have access to teething necklaces, teething bracelets or other jewelry that could present a choking or strangulation hazard. Written policies and procedures for sleep arrangements shall include the requirements of this subsection and shall be posted in a conspicuous place in the areas where infants under twelve months of age sleep. The operator shall document that the child’s parent(s) has been informed of the child care center or group child care home’s policies and procedures for sleep arrangements prior to enrollment and reviewed as needed during the period of the child’s enrollment.

Rule 19a-79-10(g)(1-8).

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).

Signed agreement with parent regarding equipment, supplies, materials to be discarded: The operator shall obtain a signed agreement from the child’s parent(s) that the parent(s) agrees to check and maintain the child’s equipment in accordance with manufacturer’s instructions, restocks supplies and removes material to be discarded from the facility on a daily basis. All materials to be discarded shall be kept locked until it is given to the child’s parent(s) for disposal.

Rule 19a-79-13(d)(3).

Authorized prescriber written order: The operator shall keep the following records at the facility as part of the child’s medical record, and shall update them annually or when there is any change in the information. A current, written order signed and dated by the child’s physician, physician assistant or advanced practice registered nurse indicating the child’s name; the diagnosis of diabetes mellitus; the type of blood glucose monitoring test required; the test schedule; the target ranges for test results; specific actions to be taken and carbohydrates to be given when test results fall outside specified ranges; diet requirements and restrictions; (H) Any requirements for monitoring the child’s recreational activities; and conditions requiring immediate notification of the child’s parent(s), emergency contact, the child’s physician, physician assistant or advanced practice registered nurse.

Rule 19a-79-13(e)(1).

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).

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).

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).

Staff personal articles inaccessible: Backpacks, handbags, purses or other bags belonging to adults, staff or program staff for carrying personal articles shall not be accessible to children.

Rule 19a-79-7a(d)(11).

Electrical safety- outlets inaccessible/covered: The use and maintenance of electrical cords, appliances and adaptors shall be in full compliance with state codes. For programs serving children less than school age, electrical outlets shall be made inaccessible by use of a safety device or covering that prevents access to the receptacle opening.

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

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).

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).

Equipment-clean and safe, good repair, non-toxic-sturdy, free from protruding nails, rust: All equipment shall be of such design and material as to be readily cleaned and safe for children. Equipment shall not be colored or covered by any poisonous material. Equipment shall be sturdy, safely constructed and free from protruding nails, rust, toxic material and other hazards.

Rule 19a-79-7a(g)(1).

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).

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).

Labeling and storage: Medication shall be stored in the original child-resistant safety container and appropriately labeled. Medication shall be stored in a locked area or a locked container in a refrigerator in keeping with the label directions away from food and inaccessible to children. Only personnel authorized to administer medication may be provided with the means to access such medication. Controlled drugs shall be stored in accordance with state law.

Rule 19a-79-9a(b)(5)(A-B).

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).

Child Health 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 signed physical examination form including the child’s date of birth, a statement about the child’s general health and the presence of any known medical or emotional illness or disorder that would currently pose a risk to other children or which would currently affect this child�s functional ability to participate safely in a child care setting.

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

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).

Fire marshal codes/certificate: The operator shall comply with all local codes and ordinances, including the State of Connecticut Fire Safey Code. These codes include but are not limited to: inspections by the fire marshal, ensuring fire marshal inspection certificates are on file, smoke detectors, fire extinguishers and documentation of fire drills.

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

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).

Equipment-clean and safe, good repair, non-toxic-sturdy, free from protruding nails, rust: All equipment shall be of such design and material as to be readily cleaned and safe for children. Equipment shall not be colored or covered by any poisonous material. Equipment shall be sturdy, safely constructed and free from protruding nails, rust, toxic material and other hazards.

Rule 19a-79-7a(g)(1).

Medication Trainings: 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 pharmacist, 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 as required herein. In addition to being trained in the methods of medication administration, such trained staff may administer injectable medications by a premeasured, commercially prepared auto-injector used to treat allergic reactions or other type of injectable medication and rectal medications, only after he or she has successfully completed a training program on the administration of such type of medication. After completing such training, the director, head teacher, program staff or group child care home provider shall annually have his or her skills and competency in the administration of such medication reviewed and/or validated in accordance with the regulations. The facility shall have program staff trained in the use such medications on site during all hours when a child who has orders to receive such medication is on-site. Upon completion of the required training program or the review and validation of the required training, the written training approval for staff shall be on file at the facility. Approval for the administration of oral, topical, inhalant medications, rectal medications and injectable medications other than by a premeasured commercially prepared auto-injector shall remain valid for three years. Approval for the administration of injectable medications by a premeasured commercially prepared auto-injector shall be valid for one year. A copy of the approval shall be on file at the facility for a period of three years and shall be available to Office staff upon request. The operator shall ensure that the trainer provides the trainee with an outline of the curriculum content which verifies that all mandated requirements have been included in the training program. A copy of said outline shall be on file at the facility for a period of three years for Office review. The Office may require at any time that the operator obtain the full curriculum from the trainer for review by the Office.

Rule 19a-79-9a(b)(1)(A-F)-(2)(A-C).

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).

Ratios- 1:4 (6wks-24mths), 1:5 (24-36mths): There shall be at least one program staff qualified under section 19a79-4a(e) of the Regulations of Connecticut State Agencies for every four children or fraction thereof who are under the age of two years in attendance and for every five children or fraction thereof who are two years old in attendance, indoors and outdoors.

Rule 19a-79-10(c)(2).

Group size- max 8 (6wks-24mths), max 10 (24-36mths): The group size shall not exceed eight for children that are under the age of two years and shall not exceed ten for children that are two years old, indoors and outdoors.

Rule 19a-79-10(c)(3).

2.8 yr olds enrolled in preschool-authorization: A child care center or group child care home with a preschool endorsement may deem a child who is thirty-two to thirty-six months of age, inclusive, to be three years of age for purposes of enrolling such child in a preschool program provided such child care center or group child care home receives written authorization from such child�s parent and the director to so enroll such child in the preschool program. The written authorization shall be kept on file at the child care center or group child care home and available to the Office upon request.

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

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).

Ratios: Proper staff child ratios shall be maintained at all times, indoors and outdoors. There shall be at least one program staff for every ten children, or fraction thereof in attendance. When there is a mixed age group, the lower required ratio for the age of the youngest child shall prevail. 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-79-4a(d)(4)(A-B) and (d)(6).

Child Health 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 signed physical examination form including the child’s date of birth, a statement about the child’s general health and the presence of any known medical or emotional illness or disorder that would currently pose a risk to other children or which would currently affect this child�s functional ability to participate safely in a child care setting.

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

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).

Fire marshal codes/certificate: The operator shall comply with all local codes and ordinances, including the State of Connecticut Fire Safey Code. These codes include but are not limited to: inspections by the fire marshal, ensuring fire marshal inspection certificates are on file, smoke detectors, fire extinguishers and documentation of fire drills.

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

Electrical safety- outlets inaccessible/covered: The use and maintenance of electrical cords, appliances and adaptors shall be in full compliance with state codes. For programs serving children less than school age, electrical outlets shall be made inaccessible by use of a safety device or covering that prevents access to the receptacle opening.

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

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).

Hot water/steam pipes protected: Hot water or steam pipes located in areas accessible to children shall have adequate protective covering which is maintained safely and in good repair.

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

Equipment-clean and safe, good repair, non-toxic-sturdy, free from protruding nails, rust: All equipment shall be of such design and material as to be readily cleaned and safe for children. Equipment shall not be colored or covered by any poisonous material. Equipment shall be sturdy, safely constructed and free from protruding nails, rust, toxic material and other hazards.

Rule 19a-79-7a(g)(1).

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).

Medication Trainings: 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 pharmacist, 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 as required herein. In addition to being trained in the methods of medication administration, such trained staff may administer injectable medications by a premeasured, commercially prepared auto-injector used to treat allergic reactions or other type of injectable medication and rectal medications, only after he or she has successfully completed a training program on the administration of such type of medication. After completing such training, the director, head teacher, program staff or group child care home provider shall annually have his or her skills and competency in the administration of such medication reviewed and/or validated in accordance with the regulations. The facility shall have program staff trained in the use such medications on site during all hours when a child who has orders to receive such medication is on-site. Upon completion of the required training program or the review and validation of the required training, the written training approval for staff shall be on file at the facility. Approval for the administration of oral, topical, inhalant medications, rectal medications and injectable medications other than by a premeasured commercially prepared auto-injector shall remain valid for three years. Approval for the administration of injectable medications by a premeasured commercially prepared auto-injector shall be valid for one year. A copy of the approval shall be on file at the facility for a period of three years and shall be available to Office staff upon request. The operator shall ensure that the trainer provides the trainee with an outline of the curriculum content which verifies that all mandated requirements have been included in the training program. A copy of said outline shall be on file at the facility for a period of three years for Office review. The Office may require at any time that the operator obtain the full curriculum from the trainer for review by the Office.

Rule 19a-79-9a(b)(1)(A-F)-(2)(A-C).

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).

Policies: 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, emergencies, supervision of children, general operating policies, 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. 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.

Rule 19a-79-3a(d)(2) thru (8) &/or19a-79-7a(d)(11)(A). From a complaint.

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). From a complaint.

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). From a complaint.

Designated Director: The child care center or group child care home shall maintain documentation on site that there is a qualified designated director.

Rule 19a-79-4a(d)(1). From a complaint.

All Openings for Ventilation Screened: The kitchen in child care centers or group child care homes that is used for the preparation and serving of food to children shall be ventilated and protected by window screening. All windows that open to the outside and are used for ventilation shall be equipped with 16 mesh screening...and to prevent the entrance of vectors. There shall be effective measures taken to prevent vermin from entering or breeding in the facility.

Rule 19-79-6a(a)(6);19a-79-7a(d)(4)];19a-79-7a(e)(16).

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).

Under Three Endorsement: Physical Barriers/Groups of 8 (Indoors/Outdoors): For children under three years of age, there shall be a physical barrier separating each group of eight (8) children, indoors and outdoors.

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

Plastic Bags/Balloons/Styrofoam Objects Inaccessible: Plastic bags, balloons and Styrofoam objects shall not be accessible to children under three (3) years of age.

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

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).

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).

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.

Approved Safety Outlets/Covers: Electrical outlets shall be provided with safety covers or approved safety outlets. The use and maintenance of electrical cords, appliances and adaptors shall be in full compliance with state codes.

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

Hand Washing After Toileting: Staff/Children: Staff and children shall wash their hands with soap and water after toileting.

Rule 19a-79-7a(d)(11)(E).

Walkways Maintained: Established walkways shall be provided and properly maintained for each entrance and exit leading to a driveway or street.

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

Windows Protected to Prevent Falls: All windows that open to the outside and are used for ventilation shall be protected to prevent falls.

Rule 19a-79-7a(d)(4).

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).

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

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

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).