The Learning Experience - Stamford

Preparation/transportation of food-follow DPH Model Food Code: Preparation and transportation of food(s) not prepared on the licensed premises shall satisfy all applicable requirements of the Department of Public Health’s Model Food Code.

Rule 19a-79-6a(a)(1). From a complaint.

Nutritious meals and snacks: A nutritionally adequate meal shall be provided by the child care center or group child care home, or the parent(s) whenever a child remains on the premises for five (5) hours or more. Children who stay on the premises less than five (5) hours shall have a nutritious snack. Children who stay on the premises longer than five (5) but less than eight (8) hours shall have one (1) meal and one (1) nutritious snack. Children who stay on the premises eight (8) hours or more shall have one (1) meal plus two (2) nutritious snacks, or two (2) meals plus one (1) nutritious snack.

Rule 19a-79-6a(a)(2). From a complaint.

Proper Refrigeration -41 degrees: There shall be proper refrigeration of no more than forty-one (41) degrees Fahrenheit for perishable foods in all child care centers and group child care homes and on field trips.

Rule 19a-79-6a(a)(3). From a complaint.

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). From a complaint.

Kitchen- clean, safe storage of food/supplies: 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 clean, well-lighted and ventilated, protected by window screening and provided with hot and cold running water, adequate and safe storage for food and supplies and refrigeration.

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

Separate hand washing facilities: Separate hand washing facilities shall be located convenient to the room where food is prepared in child care centers and group child care homes.

Rule 19a-79-6a(a)(7). From a complaint.

Manufacture guidelines followed-furniture, equipment and toys- CPSC unsafe/recalls: All manufacturer guidelines shall be followed for furniture, equipment and any toy that is used by, or around, children. Any furniture, equipment and toy that has been identified by the United States Consumer Product Safety Commission as unsafe or subject to recall shall be removed or repaired as indicated.

Rule 19a-79-7a(g)(5). From a complaint.

Notification of Change: The operator shall notify the Office of Early Childhood, the parent(s) and staff of any changes in programs or services. Notification of personnel changes shall be made within five (5) business days after the change. If the change is for a head teacher, a plan for interim head teacher coverage shall be submitted to the Office of Early Childhood. A qualified head teacher or a plan approved by the commissioner shall be in place within thirty (30) days of change of a qualified head teacher. Notification of changes related to the licensed capacity, fees, services or voluntary closing shall be made at least thirty (30) days prior to the effective date of the proposed change. A change of location, change of operator or a change of ownership requires a new initial application.

Rule 19a-79-3a(c)(1-4).

Designated head teacher - 60%: A designated head teacher shall be on site for sixty percent (60%) of the time the child care center or group child care home is in operation on a weekly basis. The head teacher shall be approved by the Office.

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

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). From a complaint.

Nutritious meals and snacks: A nutritionally adequate meal shall be provided by the child care center or group child care home, or the parent(s) whenever a child remains on the premises for five (5) hours or more. Children who stay on the premises less than five (5) hours shall have a nutritious snack. Children who stay on the premises longer than five (5) but less than eight (8) hours shall have one (1) meal and one (1) nutritious snack. Children who stay on the premises eight (8) hours or more shall have one (1) meal plus two (2) nutritious snacks, or two (2) meals plus one (1) nutritious snack.

Rule 19a-79-6a(a)(2).

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).

Ensuring the safety & health 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(a).

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).

Nutritious meals and snacks: A nutritionally adequate meal shall be provided by the child care center or group child care home, or the parent(s) whenever a child remains on the premises for five (5) hours or more. Children who stay on the premises less than five (5) hours shall have a nutritious snack. Children who stay on the premises longer than five (5) but less than eight (8) hours shall have one (1) meal and one (1) nutritious snack. Children who stay on the premises eight (8) hours or more shall have one (1) meal plus two (2) nutritious snacks, or two (2) meals plus one (1) nutritious snack.

Rule 19a-79-6a(a)(2).

Proper Refrigeration -41 degrees: There shall be proper refrigeration of no more than forty-one (41) degrees Fahrenheit for perishable foods in all child care centers and group child care homes and on field trips.

Rule 19a-79-6a(a)(3).

Food Service Inspection: All areas used for the preparation and serving of meals in child care centers shall meet the requirements as set forth in the Department of Public Health’s Model Food Code, of the Regulations of Connecticut State Agencies. Child care centers that prepare food shall maintain at the child care center and make available to the Office upon request a copy of a current and full food service inspection report issued by the local director of health.

Rule 19a-79-6a(a)(5).

Kitchen- clean, safe storage of food/supplies: 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 clean, well-lighted and ventilated, protected by window screening and provided with hot and cold running water, adequate and safe storage for food and supplies and refrigeration.

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

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).

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).

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).

Manufacture guidelines followed-furniture, equipment and toys- CPSC unsafe/recalls: All manufacturer guidelines shall be followed for furniture, equipment and any toy that is used by, or around, children. Any furniture, equipment and toy that has been identified by the United States Consumer Product Safety Commission as unsafe or subject to recall shall be removed or repaired as indicated.

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

Educational requirements: The written plan shall include the use of a variety of indoor and outdoor environments based on the children’s interest, individual needs and the learning to be addressed; a flexible schedule that allows time for children to make choices, continue projects over time, and transition from one activity to another; learning experiences that are relevant to the children’s lives and cultural context; a balance of child-initiated and teacher-initiated experiences; exploration and discovery; the use of a variety of materials that support active engagement and promote skills across areas of learning and development; rest, sleep or quiet activities; nutritious meals and snacks; toileting and clean up; individual and small group activities; and moderate and vigorous physical activity for children three years of age and older unless a child has a disability or is experiencing a developmental delay, which prevents such child from engaging in such physical activity. Such activity shall take place outdoors. No child care center or group child care home shall provide access to mobile cellular telephones, laptops and desktop computers or equipment that is capable of playing a video game or digital video disk to children under two years of age. Each child care center and group child care home shall restrict access to mobile cellular telephones, laptop and desktop computers or equipment that is capable of playing a video game or digital video disk by children two years of age and older except for educational or physical activity purposes. This subsection shall not apply to a child in the care of such child care center or group child care home that has a disability or is experiencing a developmental delay, and requires the use of such devices as a result of such disability or delay.

Rule 19a-79-8a-(a)(1-11)-(b).

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).

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).

CO/NCAP Compliance Violation(s): A Negotiated Corrective Action Plan or Consent Order is a voluntary agreement in which a provider/program agrees to take certain steps or make changes above and beyond the regulations in order to retain their license. The operator shall ensure compliance with the conditions.

Rule Not given.

Preparation/transportation of food-follow DPH Model Food Code: Preparation and transportation of food(s) not prepared on the licensed premises shall satisfy all applicable requirements of the Department of Public Health�s Model Food Code.

Rule 19a-79-6a(a)(1). From a complaint.

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).

Plastic bags/balloons/styrofoam inaccessible unless under direct supervision: 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)(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).

Children’s Enrollment information: 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. The record shall include enrollment information signed and dated by the parent(s) that shall include, but not be limited to: the child�s name, address, date of birth and date enrolled, the residence, business address(es) and telephone number(s) of the parent(s) and the name and telephone number of the child�s physician or other primary health care provider.

Rule 19a-79-5a(a)(1)(A)-(C).

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).

Injury, Illness, Incident, Accident reports: A written report shall be produced and maintained on the licensed premises, and for a period of not less than 2 years, documenting any injuries or accidents that result in an injury to a child, or illness of a child enrolled at the facility, an incident that is required to be reported to DCF. This report shall be available to the OEC upon request and a copy shall be provided to the parent no later than the next business day.

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

Proper Refrigeration -41 degrees: There shall be proper refrigeration of no more than forty-one (41) degrees Fahrenheit for perishable foods in all child care centers and group child care homes and on field trips.

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

Lead Paint- testing, management plans: If the child care center or group child care home is housed in any portion of a building that was constructed prior to 1978, the operator shall submit to the Office and maintain documentation on file at the child care center or group child care home of the following. Prior to use, all space used by staff, program staff, and children shall have undergone a comprehensive lead inspection by a lead consultant licensed by the Department of Public Health. Such lead inspection shall include testing of representative components of each type of painted surface throughout the facility, dust wipes sampling of a window well, window sill and floor in each room, hallway and entry/egress areas, and testing of bare soil areas in the child play areas. Identified toxic level(s) of lead on defective surface(s) as those terms are defined in section 19a-111-1 of the Regulations of Connecticut State Agencies shall be remediated by an EPA Certified Firm using lead-safe work practice standards. All intact surfaces, including areas that have undergone remediation, for paint and soil shall be documented on a lead management plan that has been approved by the local director of health and shall be monitored in accordance with the approved plan by the operator. A letter issued by the local director of health confirming that appropriate action to remediate identified lead hazards has been completed, that clearance dust wipes have passed and that an approved lead management plan is on file.

Rule 19a-79-7a(c)(6)(A-D).

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).

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).

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).

Parent notification of illness or injury: The operator shall immediately notify the parent of a child enrolled if such child exhibits or develops an illness or is injured while in the care of the child care center or group child care home.

Rule 19a-79-5a(a)(3)(B). From a complaint.

z111-Under Three Endorsement: Group Size no Larger than 8: For children under three years of age, the group size shall not exceed eight (8) children.

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

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). From a complaint.

Infants Held for Bottles/Indiv. Attn/Tummy Time: Infants shall be removed from their cribs and held for all bottle feedings. They may be placed in chairs for all other feedings. Infants and toddlers shall be removed from their cribs or playpens at other intervals during the day for individual cuddlings and for verbal communication. They shall be allowed to crawl and toddle as age and development permit. Each infant shall be placed in a prone (front) position part of the time when awake.

Rule 19a-79-10(j). From a complaint.

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. 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.

Sturdy/Safety Rail/Nonporous/Exclusive Use: 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.

Rule 19a-79-10(e)(1)(2)(3).

No Toys/Objects Less than 1 1/4: Toys and other objects with a diameter of less than one and one-quarter (1 1/4) inches, objects with removable parts that have a diameter of less than one and one-quarter (1 1/4) inches shall not be accessible to children under three (3) years of age.

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

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.

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).

Notification of Change: The operator shall notify the Office of Early Childhood, the parent(s) and staff of any changes in programs or services. Notification of personnel changes shall be made within five (5) business days after the change. If the change is for a head teacher, a plan for interim head teacher coverage shall be submitted to the Office of Early Childhood. A qualified head teacher or a plan approved by the commissioner shall be in place within thirty (30) days of change of a qualified head teacher. Notification of changes related to the licensed capacity, fees, services or voluntary closing shall be made at least thirty (30) days prior to the effective date of the proposed change. A change of location, change of operator or a change of ownership requires a new initial application.

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

Food Service Certificate: The operator shall post a food service certificate as required by the local director of health in a conspicuous place, accessible to the public.

Rule 19a-79-3a(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).

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).

Background Checks: 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 evidence that the necessary information and documentation specified by the Office of Early Childhood in order to conduct background checks has been submitted. 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.

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

Designated Head Teacher/60%: A designated head teacher shall be on site for sixty percent (60%) of the time the child care center or group child care home is in operation on a weekly basis. A program providing care for one (1) or more hours between the hours of ten (10) P.M. and five (5) A.M. shall have a person on the licensed premises designated as the person in charge who shall meet the head teacher qualifications.

Rule 19a-79-4a(c)(1), 19a-79-11(f)&/or19a-79-12(b)(1).

Consultant Agreements/Contracts: A written plan for consultation services shall be developed, signed annually by the consultant and implemented. These services shall include an early childhood educational consultant, a health consultant, a dentist or dental hygienist consultant, a social service consultant, and a registered dietitian consultant for those programs that serve meals. Consultative services shall include annual review of written policies, plans and procedures, annual review of education programs, availability by telecommunication for advice regarding problems, availability, in person of the consultant to the program, consulting with administration and staff about specific problems, and acting as a resource person to staff and the parents.

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

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).

Enrollment Information: 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. The record shall include enrollment information and permission forms signed and dated by the parent(s).

Rule 19a-79-5a(a)(1)(A) through (C).

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).

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).

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).

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).

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: Labeling/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. Controlled drugs shall be stored in accordance with state law. Equipment and medications prescribed to treat asthma, administer glucagons, or as an emergent first line of defense medication against an allergic response shall be stored in a safe manner, inaccessible to other children, to allow for quick access in an emergency.

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

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).

Ratio: 1 Staff to 10 Children: There shall be at least one (1) program staff person for every ten (10) children, or fraction thereof in attendance at all times. 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(c)(4)(A) thru (C) &/or 19a-79-4a(c)(6).

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).

CO/NCAP Compliance Violation(s): A Negotiated Corrective Action Plan or Consent Order is a voluntary agreement in which a provider/program agrees to take certain steps or make changes above and beyond the regulations in order to retain their license.

Rule Not given.