STATE OF MONTANA REQUIREMENTS FOR REGISTRATION OF FAMILY and GROUP DAY CARE HOMES (9/1/2006)
(1) "Aide" means a facility staff person who carries out assigned care-giving tasks under the direct supervision of a primary care-giver or director.
(2) "Care-giver" means a licensee, registrant, employee, aide, or volunteer who is responsible for the direct care and supervision of children in a day care facility.
(3) "CPR" means cardio-pulmonary resuscitation.
(4) "Day care" or "child care" means care for children provided by an adult, other than a parent of the children or other person living with the children as a parent, on a regular basis for daily periods of less than 24 hours, whether that care is for daytime or nighttime hours. In addition to the definitional language found at 52-2-703, MCA, the term also means care to a child up to the age of 13 years except as indicated otherwise in these rules. The term does not include care by a relative, unless registration or licensure as a day care facility is required to receive payments as provided in 52-2-713, MCA.
(5) "Day care center" means an out-of-home place in which day care is provided to 13 or more children on a regular basis.
(6) "Day care facility" means a person, association or place, incorporated or unincorporated, that provides day care on a regular basis or a place licensed or registered to provide day care on an irregular basis for children suffering from illness. It includes a family day care home, a day care center, a group day care home, or a facility providing care in a child's home for the purpose of meeting registration requirements for the receipt of payments as provided in 52-2-713, MCA. The term does not include:
(a) A person who limits care to children who are related to the person by blood or marriage or under the person's legal guardianship, unless registration or licensure as a day care facility is required to receive payments as provided in 52-2-713, MCA; or
(b) Any group facility established chiefly for educational purposes that limits its services to children who are 3 years of age or older. In addition to the previous definitional language found at 52-2-703, MCA, the term also does not include a person caring for the children of a single family, or a person, not receiving any type of state payment for day care, who is caring for children in the children's own home. In addition to the children being cared for in their own home, there may be no more than 2 children from another home being cared for by the same provider.
(7) "Delayed renewal application" means a renewal application which is submitted to the department prior to the certificate expiration date, but is submitted in an incomplete manner, resulting in a delay in the issuance of the certificate.
(8) "Department" means the department of public health and human services provided for in 2-15-2201, MCA.
(9) "Director" means the person designated on the center application or otherwise by written notice to the department as the person responsible for the daily operation of a day care center. A director is also responsible for implementing appropriate child development principles and knowledge of family relationships in providing daily care to the children cared for in the facility.
(10) "DT vaccine" means a vaccine containing a combination of diphtheria and tetanus toxoids for pediatric use.
(11) "DTP vaccine" means a vaccine containing diphtheria and tetanus toxoids and pertussis (whooping cough) vaccine combined, including a vaccine referred to as DTaP, diphtheria, tetanus toxoid and acellular pertussis vaccine combined.
(12) "Family day care home" means a private residence in which day care is provided to 3 to 6 children on a regular basis. In addition to the previous definitional language found at 52-2-703, MCA, the term also means, a day care facility providing care to no more than 3 children under 2 years of age unless care is provided for infants only. For facilities providing care only for infants, family day care home means a place in which supplemental parental care is provided for up to 4 infants. No other children shall be in attendance.
(13) "Group day care home" means a private residence or other structure in which day care is provided to 7 to 12 children on a regular basis. In addition to the previous definitional language found at 52-2-703, MCA, the term also means a day care facility providing care to 7 to 12 children with no more than 6 children under 2 years of age, unless care is provided for infants only. For facilities providing care only for infants, group day care home means a place in which supplemental parental care is provided for up to 8 infants. No other children shall be in attendance.
(a) Facilities caring for infants shall maintain a staff/infant ratio of 1 caregiver for each 4 infants in attendance.
(14) "Harm to children" means harm to a child's health or welfare as defined in 41-3-102, MCA.
(15) "Health care provider" means a licensed physician, a physician assistant-certified, a nurse practitioner, a registered nurse, or a naturopathic physician practicing within the scope of the license.
(16) "Hib vaccine" means a vaccine immunizing against infection by Haemophilus influenza type B disease.
(17) "Infant" means a child under the age of 24 months of age.
(18) "Lapsed registration/license" means
an application for registration/licensing renewal which is received by the department after the registration/licensing expiration date.;
an application which is incomplete and results in a break-in-license span; or
any break in the license/registration span resulting from a lapse of required insurance or resulting from a failure to comply with another licensure requirement.
(19) "License" means a written document issued by the department that the license holder has complied with the applicable standards and rules for day care centers.
(20) "Local health authority" means a local health officer, local department of health, or local board of health.
(21) "MMR vaccine" means a live virus vaccine containing a combination of measles, mumps, and rubella vaccine.
(22) "Night care" means care provided for a child between the hours of 7 p.m. and 7 a.m. during which the parent(s) desires a child to sleep.
(23) "Overlap care" means care provided at a day care facility for children age 3 and older for the times before and after school and approved by the department for a designated period of time not to exceed 3 hours when the number of children in care may exceed the number of children registered for care on the registration certificate.
(24) "Nonprovider staff" means a staff person of a day care facility who does not participate in a care-giving role.
(25) "Nonprescription medication" means any over the counter medication that is not specifically prescribed by a physician, but is recommended by a health care provider or a parent or guardian for a specific child.
(26) "Physician" means a person licensed to practice medicine under Title 37, chapter 3, MCA.
(27) "Preschooler" means a child between 36 months of age and the age the child will be when he or she initially enters a public or private school system.
(28) "Portable wading pool" means a structure, which contains water, is used for aquatic activities, and is less than 24 inches high.
(29) "Prescription medication" means medication prescribed by a licensed health care provider for a specific person which may only be obtained through a pharmacy by prescription.
(30) "Primary Caregiver" means a facility staff person who meets the requirements as outlined in 37.95.622 and who regularly provides direct care to the children who attend the day care facility.
(31) "Probationary license" means a day care facility license or registration certificate whose status has been reduced for a specified period of time for a licensing violation and which will be reinstated to regular status upon successful completion of and compliance with remedial measures identified by the department to address specific deficiencies.
(32) "Provider" means the applicant for license or registration, the licensee or registrant.
(33) "Provisional certificate" means a registration or license status that is given to a day care provider, if the provider does not meet all the registration or license requirements but is attempting to comply. This status can be granted for a period of up to 3 months. A second 3 month certificate may be issued at the discretion of the day care licensing program manager.
(34) "Public sewage system" means a system of collection, transportation, treatment, or disposal of sewage that is designed to serve or serves 15 or more families or 25 or more persons for a period of at least 60 days out of the calendar year.
(35) "Public water supply system" means a system for the provision of water for human consumption from any community well, water hauler for cisterns, water bottling plant, water dispenser, or other water supply that is designed to serve or serves 15 or more families or 25 or more persons daily or has at least 15 service connections at least 60 days out of the calendar year.
(36) "Registrant" means the holder of a registration certificate issued by the department in accordance with the provisions of Title 52, chapter 2, part 7, MCA.
(37) "Registration" means the process whereby the department maintains a record of all family day care homes and group day care homes, prescribes standards, promulgates rules, and requires the operator of a family day care home or a group day care home to certify compliance with the prescribed standards and promulgated rules.
(38) "Registration certificate" means a written instrument issued by the department to publicly document that the certificate holder has, in writing, certified to the department compliance with this rule and the applicable standards for family day care home and group day care homes.
(39) "Regular certificate" means a license status that is given upon determination that the day care provider is meeting all requirements set forth for family day care homes, or group day care homes, or day care centers.
(40) "Regular basis" means providing day care to children of separate families for any daily periods of less than 24 hours and within three or more consecutive weeks. In addition to the previous definitional language found at 52-2-703, MCA, the term also means the child must be in attendance four or more days a week for six hours a day or more.
(41) "Related by blood or marriage" means the status of a child who is the son, daughter, brother, sister, first cousin, nephew, niece, or grandchild of a person providing child care.
(a) The term includes the status of a child described above in a step or adoptive relationship.
(42) "Remote means of egress" means escape routes in the day care which consist of two exits whose distance apart is equal to or greater than one half the diagonal distance of the space occupied to minimize the possibility that both exits will be blocked off by a fire or other emergency condition.
(43) "Renewal registration/license" means a registration or license certificate that has reached its expiration date and the holder of that registration/license desires to renew or continue operations allowed by the registration/license.
(44) "Restricted certificate" means a restricted license or registration status assigned when it has been determined that the provider is unable to meet certain specific requirement criteria, but the provider is complying with an agreed upon plan of correction.
(45) "School-age child" means a person who is at least 5 years of age and who is younger than 13 years of age or a person with special needs, as defined by the department, who is under 18 years of age or is 18 years of age and a full time student expected to complete an educational program by 19 years of age.
(47) "Substitute" means any person not regularly employed by a child care facility who temporarily takes the place of an approved staff person, other than the director.
(48) "Supervision" means the provider and all care-givers shall be able to see or hear the children at all times.
(49) "Supplemental parental care" means the provision of day care by an adult other than a parent, guardian, or person in loco parent's on a regular basis for daily periods of less than 24 hours.
(50) "Toddler" means a child who is 24 months of age to 36 months of age.
(51) "Vaccine" means one of the following:
(a) If administered in the United States, an immunizing agent approved by the bureau of biologics, food and drug administration, United States public health services; or
(b) If administered outside the United States, an immunizing agent administered by a person licensed to practice medicine in the country where it is administered or by an agent of the principal public health agency of that country and properly documented as required by ARM 16.28.704.
(52) "Varicella" means an attenuated, live virus vaccine to prevent chicken pox disease.
(53) "Volunteer" means any person who enters into service voluntarily, but who when in service is subject to discipline and regulations like any other employee.
(1) The department shall, upon request or as its own action, make an initial count of children to determine whether an applicant or a provider is required to obtain a license or registration from the department.
(2) Children of the provider's own household or children who are present in the home or facility only when their own parent is also present shall not be counted in determining whether supplemental parental care is being provided to other children.
(3) If the initial count determines that supplemental parental care is being provided to three or more children, not counting those listed in (2), the provider shall be licensed or registered as a day care facility
(1) The department shall make a separate count of children, apart from the initial licensure or registration determination count, to determine the type of license or registration required. The licensure or registration type count shall not include the provider's own children age six or over who attend school full time. The licensure or registration type count shall include all children, including the provider's own children under age six, who are present during hours when supplemental parental care is provided.
(2) The licensure or registration count shall determine:
(a) Whether the provider must be registered as a family day care home or group day care home, or licensed as a day care center;
(b) Whether the day care facility is in compliance with applicable staff to child ratios;
(c) Whether sufficient space is provided; and
(d) Whether any other safety, health or program requirements or registration or licensure restriction requiring counting of children is affected or violated
(1) Any individual, agency, or group may apply for a license to operate a day care center or may apply for a registration certificate to operate a family day care home or group day care home. Applications may be obtained from the Department of Public Health and Human Services, Quality Assurance Division, Licensure Bureau, P.O. Box 202953, 2401 Colonial Drive, Helena, MT 59620-2953.
(2) Applications for a license or registration certificate by Indians residing on Indian reservations must follow the requirements of 52-2-722, MCA.
(3) Before a regular one year license without provisions or restrictions may be granted, the following shall be submitted by the applicant at the time of application and annually thereafter:
(a) An annual approved inspection report from the state fire marshal or the fire marshal's official designee indicating the fire safety rules have been met;
(b) An annual approved inspection report from public health authorities certifying the satisfactory completion of training or a certificate of approval following inspection by local health authorities in accordance with ARM 37.95.128, 37.95.139, 37.95.140 and 37.95.205 through 37.95.227;
(c) Proof of current fire and liability insurance coverage for the day care center;
(d) A schedule of daily activities;
(f) A DPHHS personal statement of health for licensure form for each care-giver, aide, or volunteer who has direct contact with the children in care;
(g) A criminal background and child and adult protective services check on the provider or staff, including care-givers, aides, volunteers, kitchen and custodial staff, and persons over age 18 residing in the day care facility prior to any services being provided by an individual covered by this requirement;
(h) A list of each staff person's legal name, position, age, residential and mailing addresses, and telephone numbers;
(I) A written fire and emergency evacuation plan for all buildings used for child care services. For license renewal there must also be documentation of 8 annual emergency evacuation practices, including when each drill took place and how long it took to evacuate everyone from the facility; and
(j) Such other information, which may be requested by the department to determine compliance with the licensing requirements.
(4) Before a regular one year registration certificate may be granted, the following shall be submitted by the applicant at the time of application and annually thereafter:
(a) A DPHHS personal statement of health form for each care-giver, aide, or volunteer who has direct contact with the children in care;
(b) Proof of current fire and liability insurance coverage for the provision of day care in the home;
(c) A criminal background and child and adult protective services check on the provider or staff, including care-givers, aides, volunteers, kitchen and custodial staff, and persons over age 18 residing in the day care facility prior to any services being provided by an individual covered by this requirement;
(d) A written fire and emergency evacuation plan. For registration certificate renewal there must also be documentation of 8 annual emergency evacuation practices, including when each drill took place and how long it took to evacuate everyone from the facility; and
(e) Any such other information, which may be requested by the department.
(5) Applications for renewal shall be made by the provider at least 30 days prior to expiration of the license or registration certificate.
(6) A day care facility may not provide care for more than the number of children permitted at any one time by its day care license or registration certificate.
(7) Any individual, group or other agency may request that the department determine whether a facility should be licensed or registered according to law. Referral may be either in writing or by telephone.
(1) The department may investigate and inspect the conditions and qualifications of any day care facility or any person seeking or holding a license or registration.
(2) A family day care home or group day care home must be registered. A day care center must be licensed.
(3) Licensing, registration and inspection of family day care homes, group day care homes and centers are the responsibility of the department with the exception of the required local health authority and state fire marshal inspections. Licensing and issuing certificates of registration are delegated to the supervisor of the day care licensing program.
(4) A registrant or licensee shall not discriminate in child admissions or employment of staff on the basis of race, sex, religion, creed, color, national origin, or disability. Any determination of discrimination will be made by the Montana human rights commission.
(5) Within 30 days of receipt of the signed and completed application forms, the department will evaluate the application for registration or licensure based upon the requirements found in these rules.
(a) A prospective family day care home or group day care home that meets all requirements as evidenced by the application shall be issued a registration certificate. The registration certificate may be provisional, restricted, or regular.
(b) A prospective day care center will be visited and the program and facility inspected by a licensing worker within 30 days of receipt of the completed application. If the applicant meets the requirements for licensure the department will issue a license to the applicant. The license may be either provisional or regular.
(6) A provisional registration certificate or license may be issued for a period of up to 3 months when the day care facility does not meet all of the requirements if the facility is attempting to comply. A second 3 month provisional certificate or license may be issued in special circumstances, at the discretion of the program supervisor, the total length of time of issuance not to exceed 6 months.
(a) A plan for full compliance with requirements for registration or licensure must be submitted by the day care facility to the department before issuance of a provisional certificate or license.
(b) Written notification of the granting of a provisional certificate or license by the department must be made to the licensee, or registrant specifying the reason, duration and conditions for continuing or terminating the provisional certificate or license.
(c) The department may not issue a provisional license to any day care center which has not been approved by the state fire marshal and the public health authorities.
(d) The department may not issue a provisional certificate or license to any day care facility, which does not have current public liability insurance and fire insurance.
(7) Regular registration certificates and licenses are issued from the department's quality assurance division licensure bureau for periods up to 3 years.
(a) A three year license or registration may be offered to any provider who has not received a notice of deficiency during a current on site inspection.
(b) A two year license/registration may be offered to a provider who has five or fewer deficiencies in areas of the rules that the department determines do not significantly affect or threaten the health and safety of any child attending the facility.
(c) A provider who has been in operation less than one year is not eligible for an extended license/registration.
(8) The department, after written notice to the applicant, licensee or registrant, may deny, suspend, restrict, revoke or reduce to a provisional status a registration certificate or license upon finding that the applicant has not met the requirements for licensure or registration set forth in these rules.
(1) The following written information shall be made available to all parents:
(a) A typical daily schedule of activities;
(b) Admission requirements, enrollment procedures, hours of operation;
(c) Frequency and type of meals and snacks served;
(e) Regulations concerning sick children;
(f) Transportation and trip arrangements;
(h) Department day care licensing requirements.
(2) Day care facility shall post a copy of the facility registration or license and the phone number of state and local quality assurance division offices in a conspicuous place. Parents should be encouraged to contact the division if they have questions regarding the license or the day care regulations.
(3) The licensee or registrant shall allow custodial and non-custodial parental access as well as access by legal guardians to the facility at any time during which child day care services are provided, unless there is a current court order preventing parent-child contact.
(1) Any day care facility which operates a day care program in connection with another non-day care program on the same premises must have separate staff and separate space for each program. However, staff and space may be shared for janitorial, maintenance, cooking, or other support services.
(2) Children attending the facility for day care shall not come in contact with other persons who are receiving care in the facility unless the provider can prove to the department's satisfaction that those persons will not pose any threat to the health, safety and well-being of the children in day care.
(3) If multiple programs, including multiple day care programs or facilities in the same building, increase the number of people regularly in the building to more than 12 individuals, all fire, safety and sanitation requirements which may be impacted must be complied with by the day care facility.
(a) Multiple day care group homes which are currently operating under a "double group" registration within a single structure will have 3 years or until September 30, 2003, to either upgrade to center status and meet all center requirements, or relinquish one group registration and limit the number of children accordingly.
(4) Persons, corporations or organizations may be licensed or registered for more than one day care facility if facility sites, staff, and space are completely separate from one another.
(a) If the day care facility is housed in a private single-family living structure, the structure can only obtain one registration or license.
(b) If the multiple program day care facility is in a non-residential structure, and is owned by the same entity or person it will be licensed as a center and will be required to meet all center regulations.
(c) If more than one day care program exists in one retail or commercial structure, and there are separate owners or entities of each program, the department will grant individual registrations or licenses.
(d) If the day care facility is contained in a multi-family structure, such as an apartment building, the structure will be allowed to house multiple day care facilities that meet the requirements of (1) and (2) above.
(e) If the facility is licensed or registered as a day care facility, but also serves as a foster care home, the department's child and family services (CFS) regional administrator and quality assurance division (QAD) must approve the dual license or registration.
(1) Cleaning materials, flammable liquids, detergents, aerosol cans, and and toxic materials must be kept in their original containers and in a place inaccessible to children. They must be used in such a way that will not contaminate play surfaces, food, food preparation areas, or constitute a hazard to the children.
(2) No extension cord will be used as permanent wiring. All appliances, lamp cords and exposed light sockets must be suitably protected to prevent electrocution.
(3) Any pet or animal, present at the facility, indoors or outdoors, must be in good health, show no evidence of carrying disease, and be a friendly companion of the children. The provider is responsible for maintaining the animal's vaccinations and vaccination records. These records must be made available to the department upon request. The provider must make reasonable efforts to keep stray animals off the premises.
(4) Guns must be kept in locked storage. Ammunition must be kept in locked storage separate from the gun.
(5) The indoor and outdoor play areas must be clean, reasonably neat, and free from accumulation of dirt, rubbish, or other health hazards.
(6) Any outdoor play area must be maintained free from hazards such as wells, machinery and animal waste. If any part of the play area is adjacent to a busy roadway, drainage or irrigation ditch, stream, large holes, or other hazardous areas, the play area must be enclosed with a fence in good repair that is at least 4 feet high without any holes or spaces greater than 4 inches in diameter or natural barriers to restrict children from these areas.
(a) Outdoor play areas shall be designed so that all parts are always visible and easily supervised by staff.
(7) Toys, play equipment, and any other equipment used by the children must be of substantial construction and free from rough edges, sharp corners, splinters, unguarded ladders on slides, and must be kept in good repair and well maintained.
(8) Toys and objects with a diameter of less than 1 inch (2.5 centimeters), objects with removable parts that have a diameter of less than 1 inch (2.5 centimeters), plastic bags, styrofoam objects, and balloons must not be accessible to children who are still placing objects in their mouths.
(9) Outdoor equipment, such as climbing apparatus, slides, and swings, must be anchored firmly, and placed in a safe location according to manufacturer's instructions. Recommended ground covers under these items include sand, fine gravel or woodchips with a depth of the ground cover being at least 6 inches.
(10) Trampolines are prohibited for use by children in care. Trampolines on facility premises must be inaccessible to children in care.
(11) The Emergency Montana Poison Control Center number, 1 (800) 222-1222 must be posted at all telephone locations at the day care facility.
(12) Use of waterbeds, water mattresses, gel pads, or sheepskin covers for children's sleeping surface is prohibited.
(13) In an emergency, all occupants must be able to escape from the facility, whether a home or building, in a safe and timely manner.
(a) All facilities must have two accessible exits on each level. The two exits must be far enough apart from one another to avoid having them both blocked by fire and smoke. Aisle ways and corridors leading to the exits must be kept clear of obstructions.
(b) If the day care provider chooses to lock the facility door to prevent unauthorized access to the facility or to prevent a child from escaping, the facility shall have no lock or fastening device which prevents free escape from the interior.
(c) The locking device must not require a key, a tool, or special knowledge or effort to open from the inside.
(d) The locked door must be easily opened with one motion from the inside of the facility.
(e) Installation of locking devices may not prohibit access by parents. A facility may not utilize locking devices in a manner to prevent unannounced access by authorized individuals, including parents. If a lock is used, the provider must make adequate provision to allow authorized persons unannounced access to the facility and must provide authorized personnel including parents with information on how to gain access.
(f) Exit doors, windows, and their opening hardware must be maintained in good repair at all times.
(1) Children shall be afforded a smoke-free environment during all day care hours, whether indoors or outdoors.
(1) Children may not be allowed to use a swimming pool, unless it and the surrounding area are constructed and operated in accordance with ARM 37.95.227.
(2) Portable wading pools, as defined in ARM 37.95.102, are permitted in day care facilities.
(a) When children are utilizing a portable wading pool, an approved caregiver shall always be present and actively supervising.
(b) If the portable wading pool is filled with water and will sit unused for any period of time prior to use by day care children, the caregiver shall equip the wading pool with a barrier to prevent a young child's unsupervised access.
(i) A barrier refers to a fence, a wall, or gate or screen that locks.
(c) Portable wading pools must be emptied after the day's use and sanitized.
(3) Children shall not be permitted in hot tubs, spas, or saunas.
(a) Hot tubs must have bolted and securely locked covers.
(b) Spas and saunas must be inaccessible to children.
(4) Bathtubs, buckets and other water receptacles shall be emptied immediately after use.
(5) Ponds shall be fenced to prevent access to children.
(6) All in ground and above ground swimming pools located in the outdoor play space area or accessible to children must be fenced with a locked gate. The fence shall be at least 5 feet high and come within 3 inches of the ground. The fence shall be constructed to discourage climbing. Exit and entrance points shall have self-closing, positive latching gates with locking devices a minimum of 55 inches from the ground. The child care building wall shall not constitute one side of the fence unless there are no openings in the wall. When children are swimming, supervision must include at all times at least one person currently certified in red cross advanced life saving or an equivalent certificate by a recognized organization. This person shall not be counted in the staff-child ratio. One person with a life guard training certificate is required for each group of 25 or fewer children.
(a) Each swimming pool more than 6 feet in width, length or diameter shall be provided with a ring buoy and rope and either a throw line or a shepherd's hook. Such equipment shall be of sufficient length to reach the center of the pool from the edge of the pool and shall be safely and conveniently stored for immediate access.
(b) All pool pumping equipment shall be screened to prevent access and injury.
(7) Swimming pool safety rules shall be posted near the swimming pool.
(8) The staff-child ratio shall be maintained whenever children participate in swimming activities, including swimming instruction.
(1) The provider shall obtain written consent from the parent(s) for any transportation provided.
(2) The operator of the vehicle shall be at least 18 years of age and possess a valid driver's license.
(3) The passenger doors on the vehicle must be locked whenever the vehicle is in motion.
(4) With the exception of public transportation that is not required by law to be equipped with safety restraints, no vehicle shall begin moving until all children are seated and secured in age and weight appropriate safety restraints, which must remain fastened at all times the vehicle is in motion. Each child shall have a safety restraint. Children shall not share a safety seat or a safety restraint.
(5) Children under four years of age may not be transported in a vehicle which does not provide age appropriate safety restraints or in a vehicle which cannot accommodate a car seat or a booster seat in a manner that conforms with National Highway Transportation Safety Administration recommendations.
(6) Children shall never be left unattended in a vehicle.
(7) The back of pickup trucks must not be used to transport children.
(8) Facilities providing transportation for children under six years of age or children six years of age but weighing less than 60 pounds shall comply with the following requirements:
(a) All vehicles shall be equipped with children's car seats or booster seats that meet federal Department of Transportation recommendations for the age and weight of the child being transported;
(b) Car seats or booster seats shall be fastened securely to the seat or to the floor of the vehicle. Children shall be secured with safety belts which are secured within the vehicle according to factory assembly;
(c) There shall be no more than one child in each car seat;
(d) There shall be one adult in addition to the driver for each four infants being transported and
(e) An adult shall accompany each child to and from the vehicle to the child's home or the home authorized by the parents to receive the child.
(1) The parent(s) of each child admitted to the day care facility shall provide the name of the physician or health care facility the parent wishes to have called in case of an emergency.
(2) If, while in care, a child becomes ill or is suspected of having a communicable disease reportable to the health department while in care, the parent shall be notified by the provider. The parent is responsible for arranging to have the child taken home.
(3) The director, owner, manager, or person in charge of the day care facility must designate a staff member to check daily the health status of each child immediately upon that child's entry into the day care facility, and to exclude any child showing symptoms of illness, under the following guidelines:
(a) Children must be without fever of 101ºF or greater for 24 hours before they return to the day care facility, except that children with immunization-related fevers need not be excluded if they are able to participate in the routine of the day care facility.
(b) Children must be without vomiting and diarrhea for 24 hours before they return to the day care facility. Vomiting includes 2 or more episodes in the previous 24 hours. Diarrhea is defined as an increased number of stools, increased water in the stool, and/or decreased form to the stool that cannot be contained by a diaper or clothing;
(c) Children with any of the bacterial infections listed below must be treated with antibiotics for 24 hours before they return to the day care center:
(iv) Bacterial conjunctivitis (pinkeye); and
(v) Skin infections such as draining burn or infected wounds or hangnails;
(d) Generalized rashes, including those covering multiple parts of the body, must be evaluated by a health care provider to determine their cause before the child can return to the day care facility;
(e) Children with chickenpox may not be admitted to the day care facility until their sores dry up, which usually takes 5 to 7 days. Day care providers must not purposefully expose susceptible children to chickenpox, even with the permission of the susceptible child's parents;
(f) Children who are jaundiced must be excluded until a health care provider evaluates the cause and authorizes the child to return to the day care facility;
(g) Children with symptoms of severe illness, such as uncontrolled coughing, breathing difficulty or wheezing, stiff neck, irritability, poor food or fluid intake, or a seizure, must be evaluated by a health care provider before they may return to the day care facility;
(h) A child need not be excluded for a discharge from the nose which is not accompanied by a fever.
(4) If a child develops symptoms of illness while at the day care facility and after the parent or guardian has left, the day care facility must do the following:
(a) Isolate the child immediately from other children in a room or area segregated for that purpose;
(b) Contact and inform the parent or guardian as soon as possible about the illness and request the parent or guardian to pick up the child;
(c) Report each case of suspected communicable disease the same day by telephone to the local health authority, or as soon as possible thereafter if no contact can be made the same day.
(5) When a child is absent, the day care provider shall obtain the reasons so the interest of the other children may be properly protected. If a reportable communicable disease is suspected, the provider shall inform a health officer. No child shall be re-admitted after an absence until the reason for the absence is known and there is assurance that the child's return will not harm that child or the other children. Disease charts that identify the reportable diseases are available from the department.
(6) The day care facility may readmit a child excluded for illness whenever, in its discretion:
(a) The child either shows no symptoms of illness;
(b) The child has been free of fever, vomiting, or diarrhea for 24 hours; or
(c) The child has been on antibiotics for at least 24 hours for bacterial infections.
(7) The parent or guardian may also provide the day care facility with a signed certification of health from a licensed physician, except that the following restrictions must be followed:
(a) If a child is excluded for shigellosis or salmonella, the child may not be readmitted until the child has no diarrhea or fever, the child's parent or guardian produces documentation that 2 stools, taken at least 24 hours apart, are negative for shigellosis or salmonella, and the local health authority has given written approval for the child to be readmitted to the day care facility;
(b) If a child is excluded for hepatitis A virus infection, the child shall remain excluded until either 1 week after onset of illness or jaundice, if the symptoms are mild, or until immune globulin has been administered to appropriate children and staff in the day care facility as directed by the local health authority.
(1) Before a child under the age of five may attend a Montana day care facility, that facility must be provided with the documentation required by (4) that the child has been immunized as required for the child's age group against measles, rubella, mumps, poliomyelitis, diphtheria, pertussis (whooping cough), tetanus, and Haemophilus influenza type B, unless the child qualifies for conditional attendance in accordance with (9):
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1 dose of MMR vaccine administered no earlier than 12 months of age |
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1 dose of MMR vaccine administered no earlier than 12 months of age |
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(2) If the child is at least 12 months old but not less than 60 months of age and has not received any Hib vaccine, the child must receive a dose prior to entry.
(3) DT vaccine administered to a child less than 7 years of age is acceptable for purposes of this rule only if accompanied by a medical exemption meeting the requirements of ARM 16.28.707 that exempts the child from pertussis vaccination.
(4) Before a child between the ages of five and 12 may attend a day care facility providing care to school aged children, that facility must be provided with documentation required by (5) that the child has been immunized as required for the child's age group against measles, rubella, mumps, poliomyelitis, diphtheria, pertussis (whooping cough), tetanus, and Haemophiles influenza type B, unless the child qualifies for conditional attendance in accordance with (9).
(5) Documentation of immunization status for purposes of this rule consists of a completed Montana certificate of immunization form (HPS-101), including the date of birth, the name of each vaccine provided, and the month, day, and year of each vaccination.
(6) In order to continue to attend a day care facility, a child must continue to be immunized on the schedule described in (1) and must be immediately excluded from attendance in the day care facility if the child is not vaccinated on that schedule with all of the required vaccines, or does not have on file at the day care facility a record of medical exemption or a conditional enrollment form which indicates that no vaccine dose is past due.
(7) Hib vaccine is not required or recommended for children 5 years of age and older.
(8) Doses of MMR vaccine, to be acceptable under this rule, must be given no earlier than 12 months of age and a child who received a dose prior to 12 months of age must be revaccinated before attending a day care facility.
(9) A child may initially conditionally attend a day care facility if :
(a) The child has received at least 1 dose of each of the vaccines required for the child's age;
(b) A form prescribed by the department documenting the child's conditional immunization status is on file at the day care facility and is attached to the department's Montana certificate of immunization (HPS-101); and
(c) The child is not past due for the next required dose (as noted on the conditional enrollment form) of the vaccine in question.
(10) If a child in attendance at the day care facility, a resident of the day care facility, or a staff member or volunteer contracts any of the diseases for which this rule requires immunization, all individuals infected and all persons attending the day care facility who are not completely immunized against the disease in question or who are exempted from immunization must be excluded from the day care facility until the local health authority indicates to the day care facility that the outbreak is over.
(11) The day care facility must maintain a written record of immunization status of each enrolled child and each child of a staff member who resides at the day care facility. The facility must make those records available during normal working hours to representatives of the department or the local health authority.
(12) A child seeking to attend a day care facility is not required to have any immunizations, which are medically contraindicated. A written and signed statement from a physician that an immunization is medically contraindicated will exempt a person from the applicable immunization requirements of this rule.
(13) A child under 5 years of age seeking to attend a day care facility is not required to be immunized against Haemophilus influenza type B if the parent or guardian of the child objects thereto in a signed, written statement indicating that the proposed immunization interferes with the free exercise of the religious beliefs of the person signing the statement.
(14) The department adopts and incorporates by reference ARM 16.28.707 which sets the requirements for a medical exemption from vaccination. A copy of ARM16.28.707 may be obtained from the Department of Public Health and Human Services, Public Health and Safety Division, P.O. Box 202951, Helena, MT 59620-2951.
(1) The facility shall keep a daily attendance record of the children for whom care is provided.
(2) The facility shall have a master list of the name, address and phone number of all children in their care and their parents.
(3) All records of the facility shall be made available to the department upon request.
(4) Prior to a child being enrolled or entered into a day care facility, the following must be on file on forms provided by the Department:
(a) Written information on each child explaining any special needs of the child, including allergies;
(b) A release or authorization of persons allowed to pick up the child;
(c) Necessary medical forms, including signed and updated immunization records and the names of emergency contact persons; and
(d) An emergency consent form. This form must accompany staff when children are away from the day care site for activities.
37.95.145 LICENSE OR REGISTRATION RENEWAL PROCEDURES
(1) A licensed or registered day care provider will be sent notification at least 90 days prior to the expiration of the current license/registration certificate.
(a) The notice shall advise the provider that the current license/registration is expiring and shall inform the provider how to access the information needed to renew the certificate.
(b) The notice will also provide information on where and when to submit renewal information and will explain the consequences for late or incomplete submission of renewal materials.
(c) The provider and all staff must complete required training hours, including training in first aid and CPR, and the provider must submit proof that the training was completed prior to the date the day care certificate expires.
(d) If a complete renewal application is received on or before the current certification expiration date, a "regular renewal certificate" will be issued and no break in the certificate date span will occur.
(e) If a renewal application is received before the current certificate expiration date but is incomplete, the department will identify to the provider, in writing, what items are missing. If those missing items are received before the certificate expiration date, there shall be no break in the certificate date span.
(2) If a provider is unable to fulfill all aspects of the renewal process due to circumstances beyond the provider's control such as a personal crisis involving the death of an immediate family member, a major medical emergency, or other good cause shown, the department may grant the provider a three month "provisional" registration. All licensing requirements for renewal must be completed by the end of the provisional period or the license will lapse. If all required materials are submitted within the three month period, the license will be reactivated as a regular renewal certificate.
(3) A "delayed registration" will be granted if a provider submits a renewal application which is received by the department prior to the expiration date of the current certificate, but the application is incomplete due to one or both of the following factors:
(a) Events such as required provider or staff training or CPR classes are scheduled close to the expiration date of the license certificate and the department does not receive the required training until after the certificate expiration date; or
(b) A required event that is scheduled to occur before expiration of the license is cancelled at no fault of the provider and the event must be rescheduled after the expiration of the license certification.
(4) When a complete renewal packet is received after the expiration date, a regular registration will be issued effective the date the packet was submitted to the department, unless the department has another basis for taking negative licensing action and the license is or has been summarily suspended by the department pursuant to 2-4-631(3), MCA. The license will be deemed to have lapsed on the date of expiration.
(a) When a renewal packet is received after the expiration date and is incomplete, the department will notify the provider of what items must still be submitted to the department and break in the certificate date span will occur until those missing items are submitted. The issuance date of the certificate will be the date the last requested item is received by the department.
(b) When a certificate has lapsed for 60 or more days, it will be deemed to have automatically terminated.
(5) Any provider whose license or registration is deemed terminated based upon failure to complete the renewal process within the timeliness provided in this rule may be relicensed by filing a new license or registration application and meeting all initial licensure requirements.
(1) The registration certificate or license is not transferable to another operator or site.
(2) A license or registration is valid only for the person and premises for which it was issued. A license or registration may not be sold, assigned, or transferred.
(3) Upon discontinuance of the operation or upon transfer of ownership of the facility, the license or registration certificate must be physically returned to the department within ten working days.
(1) Separate registration certificates and licenses shall be required for programs maintained on separate premises, even when operated by the same provider.
(1) Each day care facility must post its license in plain view where it is readily viewable by parents dropping off or picking up children.
(1) The department must be notified of any changes, including changes in staff, changes in the category of children in day care, or changes to the day care property, that would affect the terms of the registration or licensure.
(1) An authorized representative of the department may inspect a facility and associated property without prior notice to the owner or staff of the facility whenever the department considers it necessary and any time children are in care.
(1) The provider shall maintain all policies, records, and reports that are required by the department. These policies must be reviewed and updated annually by the facility.
(2) The department must be given access to all records and an opportunity to copy the records whenever children are in care.
(1) The provider and all staff and volunteers shall maintain personal information about the child and the child's family as confidential.
(1) The provider shall maintain records regarding each care-giver which include:
(a) a record of training and verifiable experience;
(b) results of a criminal and protective services background check:
(c) personal statement of health and verification of CPR and first aid; and
(d) immunization records that establish compliance with ARM 37.95.140
(2) The facility shall maintain a current list of staff that specifies each staff person's legal name, position, age, residential and mailing addresses, and phone numbers.
(1) A satisfactory criminal background, motor vehicle, and child and adult protective services check is required for each day care provider, on all staff, including caregiver, administrative staff, aides, volunteers, kitchen and custodial staff, and all persons over the age of 18 residing in the day care facility or who stays in the day care facility regularly or frequently.
(2) If the provider, staff member, volunteer, or resident has always lived in Montana, a Montana based criminal background check will be conducted based upon a name based criminal records check.
(3) If the provider, staff member, volunteer, resident of the facility, or any person who regularly or frequently stays in the facility, has lived outside of Montana for any portion of the previous 5 years, that person must submit a completed fingerprint card so that a fingerprint based criminal records check can be requested.
(4) If an applicant has lived in states other than Montana, a check will be made of the violent offender and criminal history registries if this information is available for states in which the applicant has lived.
(5) If after 45 days, the department has been unable to obtain results of a criminal records check for an applicant who has lived in Montana for at least five years, the applicant must sign an affidavit attesting to his lack of criminal history or to the details of existing criminal history. The affidavit will be accepted in lieu of receipt of results from a criminal history check.
(6) An applicant who has not lived in Montana for at least five years cannot be licensed without receipt of results of a criminal records check from every state in which the applicant has lived since the age of 18.
(7) An annual name based criminal records check for all providers, all staff, including caregivers, administrative staff, aides, volunteers, kitchen and custodial staff, and persons residing in the day care facility, is required for relicensure.
(8) Persons formerly licensed as day care providers will be treated as new applicants if the former provider has not been licensed for a period of more than one year or if the provider has lived out-of-state for any period of time since being licensed in Montana.
(9) A name based check for criminal records will be used for applicants who have lived in Montana since the expiration of their previous license or registration if it has been less than one year since the expiration of the license.
(1) The provider and all care-givers at any day care facility must each verify that they have successfully completed a minimum of at least eight hours of approved education/training annually, unless otherwise specified in these rules, within the 12 months prior to license/registration expiration or the license/registration anniversary date.
(2) Training may be obtained from the department or other department approved professional child care education and development programs offered:
(a) by national, state, or local child care organizations;
(b) by institutions of higher education that are regionally accredited; or
(c) through the successful completion of college level course work in early childhood areas or child development.
(3) Approved education and training must relate to the Montana Early Care and Education Knowledge Base and must fall within the following categories:
(a) Personal attributes/characteristics;
(b) Health, safety, and nutrition which may include training on prevention of sudden infant death syndrome (SIDS) and medication administration;
(c) Child growth and development;
(f) Family and community partnerships;
(i) Observation and assessment;
(k) Cultural and developmental diversity.
(4) With the exception of volunteers, any person who provides care to children in a day care facility for at least 160 hours a year is required to successfully complete eight hours of approved education or training annually.
(1) The provider shall provide the department with any change in the provider's mailing address within 10 days of the change.
(1) The department shall not grant approval to any day care facility for any director, care giver, volunteer, or support staff person who has been convicted of a crime identified in 37.95.176(1).
(1) The department may require an applicant, a provider, a staff person, a volunteer, or any person living in the day care facility or staying in the day care facility on a regular or frequent basis, to undergo a physical, psychological, psychiatric, or chemical dependency evaluation if the department determines such an evaluation is relevant to the department's reasonable belief that the person has engaged in behaviors that may place children or other adults at risk of harm.
(1) The director, assistant director or any staff member of the day care facility who has reason to suspect that any child is or has been abused or neglected is required to personally report the matter promptly to the department child abuse hotline at 1 (866) 820-5437. The day care provider or staff member shall make the report within 24 hours of receiving information concerning suspected child abuse or neglect.
(1) Caregivers must supervise children at all times.
(2) The provider and all caregivers shall be responsible for direct care, protection, supervision, and guidance of children through active involvement or direct observation.
(1) A caregiver, volunteer, support staff person, other adult residing in the day care facility, or other person who regularly or frequently stays in the facility, who is charged with a crime involving children, physical or sexual violence against any person, or any felony drug related offense, or awaiting trial may not provide care or be present in the facility pending the outcome of the trial.
(1) No staff member, aide, volunteer, or other person having direct contact with the children in the facility shall pose any potential threat to the health, safety, and well being of the children in care.
(1) An applicant who has had a previous day care application denied or who has had a day care license or registration certificate revoked or suspended may not reapply for licensure or registration within one year of the denial revocation.
(2) If the suspension or revocation is contested and upheld after a fair hearing, the reapplication may not be made until one year after the date of the decision of the hearing officer.
(1) After written notice to the applicant, licensee, or registrant, the department shall deny, suspend, restrict, revoke, or reduce to a provisional or probationary status a registration certificate or license upon finding that:
(a) the applicant, licensee, or registrant, or a member of the applicant's, licensee's, or registrant's household or any person staying in the facility on a regular or frequent basis has a conviction for a serious crime, such as but not limited to homicide, sexual intercourse without consent, sexual assault, aggravated assault, assault on a minor, assault on an officer, assault with a weapon, kidnapping, aggravated kidnapping, prostitution, robbery, or burglary;
(b) the applicant, licensee, registrant, or member of the applicant's, licensee's, or registrant's household or any person staying in the facility on a regular or frequent basis has a conviction for a crime pertaining to children or families, including but not limited to child abuse or neglect, incest, child sexual abuse, ritual abuse of a minor, felony partner or family member assault, child pornography, child prostitution, internet crimes involving children, felony endangering the welfare of a child, felony unlawful transactions with children, or aggravated interference with parent-child contact;
(c) the applicant, licensee, registrant, or a member of the applicant's, licensee's, or registrant's household has within the previous five years had a felony conviction for a drug related offense, including but not limited to use, distribution, or possession of controlled substances, criminal possession of precursors to dangerous drugs, criminal manufacture of dangerous drugs, criminal possession of imitation dangerous drugs with the purpose to distribute, criminal possession, manufacture of delivery of drug paraphernalia, or driving under the influence of alcohol or other drugs;
(d) the applicant, licensee, registrant, or member of the applicant's, licensee's, or registrant's household or any person staying in the facility on a regular or frequent basis has been convicted of abuse, sexual abuse, neglect, or exploitation of an elderly person or a person with a developmental disability.
(2) The department after written notice to the applicant, licensee, or registrant may deny, suspend, or revoke a registration certificate license or registration certification or may restrict or reduce to a provisional, or probationary status a registration certificate license or registration certification upon finding that:
(a) the applicant, licensee, or registrant, or member of the applicant's, licensee's, or registrant's household or any person staying in the facility on a regular or frequent basis has a conviction for misdemeanor partner/family member assault, misdemeanor endangering the welfare of a child, misdemeanor unlawful transaction with children, or a crime involving an abuse of the public trust;
(b) the day care is not in compliance with fire safety standards imposed by these rules, or by the state fire marshal or other authority having jurisdiction;
(c) the day care has not met or is no longer meeting the requirements for licensure or registration set forth in these rules;
(d) the provider has made any material misrepresentations to the department, either negligent or intentional, including an omission of information the provider is obligated to disclose to the department, regarding any aspect of the day care or its operations;
(e) the provider, any staff member, volunteer, or any person residing in the day care or anyone staying in the facility on a frequent or regular basis has been named as the perpetrator in a substantiated report of abuse or neglect;
(f) upon referral of suspected child abuse or neglect regarding an operating day care facility, the initial investigation by the department, or by a law enforcement agency determines that there is a probable cause to believe that a child in the facility may be in danger of harm;
(g) the provider or any staff member has failed to report an incident of suspected abuse or neglect of any child to the department as required by 41-3-201, MCA, within 24 hours of receiving information pertaining to the incident;
(h) the results of a psychological or medical examination provided reasonable grounds for the department to believe that the provider, any staff member, or volunteer in the day care is not an appropriate caretaker for a child;
(i) the provider, any staff member, or any volunteer may pose any risk or threat to the safety or welfare of a child in the day care;
(j) the day care has failed to protect the health, welfare, or safety of a child, or day care presents a reasonably foreseeable serious hazard to the health, safety, or welfare of a child;
(k) a director, caregiver, volunteer, or adult residing in the facility or staying in the facility on a regular or frequent basis has violated a licensing regulation which resulted in harm to a child as defined in 41-3-102, MCA or knowingly allowed harm to occur to a child as defined in 41-3-102, MCA, whether or not that person was prosecuted or convicted of child abuse or neglect; or
(l) a day care license or registration may be suspended, restricted, or revoked at the discretion of the department if the licensee's child is removed from the licensee by the department.
(3) Suspension or revocation may be immediate upon a determination by the department that public health, safety, or welfare imperatively requires emergency action. Such a determination may be based on findings including, but not limited to the following situations:
(a) upon referral of suspected child abuse or neglect regarding an operating day care facility, the initial investigation reveals that there are reasonable grounds to believe that a child in the facility may be in danger of harm;
(b) the department requests and is denied access to the licensed or registered facility;
(c) the provider has made any material misrepresentation to the department, either negligently or intentionally, regarding any information requested on the application form or necessary for registration or licensing purposes;
(d) the provider, a member of the provider's household, or staff has bee named as the perpetrator in a substantiated report of child abuse or neglect as defined in ARM 37.95.1016; or
(e) through a child care licensing investigation, it is determined that the provider, provider's staff, or member of the provider's household has violated a licensing regulation that has resulted in harm to a child which falls within the definitions of child abuse and neglect set out in 41-3-102, MCA, whether or not a criminal prosecution is initiated.
(4) If a licensee is placed on a probationary or other provisional status, the department shall notify all parents and guardians of all children attending the facility of the status of the license, the basis for the reduced status and the time period for which the license is reduced. The department may do so by personal notice, by written notice, or by posting notice on the day care license, which is required to be posted in plain view at the facility.
(5) If a license or registration certificate has been denied to an applicant, or negative licensing action is proposed against a license or registration certificate based upon a conviction identified in (1)(a) through (d) or (2)(a), and the applicant, licensee, or registrant requests a fair hearing and establishes by clear and convincing evidence that the convicted person has been sufficiently rehabilitated to warrant the public trust, the department may issue the license or registration certificate or may withdraw the proposed negative licensing action.
(1) No day care employee, owner, or operator may administer any medication to a child without the written authorization of the parents including the child's name, date or dates for which the authorization is applicable, dosage instructions, and the signature of the child's parent or guardian.
(2) If an emergency arises and the parents or guardian of the child is unavailable, an employee, owner, or operator may administer medicine to a child if:
(a) a medical practitioner provides a written authorization containing the child's name, date or dates for which the authorization is applicable, dosage instructions, and the medical provider's signature; or
(b) a medical practitioner, emergency service provider, or 911 responder verbally directs the employee, owner, or operator of the day care facility to immediately administer a medicine to the child, in which case the child must then be transported to a health care facility or a medical practitioner for follow up care within a reasonable time by the child's parent or guardian or by an employee, owner, or operator of a day care facility.
(3) An employee, owner, or operator of a day care facility may not give medication to a child in a manner that is inconsistent with the container instructions on dosage or frequency unless directed to do so by a medical provider as provided in 52-2-736, MCA.
(4) If the provider/facility elects to administer medication to children, the provider/facility must maintain the following documentation on site:
(a) A medication record which includes:
(i) the written authorization of the parents for the caregiver to administer medication;
(ii) the prescription by a health care provider if required; and
(iii) a medication administration log.
(b) a written medication administration policy which includes at a minimum:
(i) types of medication which may be administered; and
(ii) medication administration which may be administered; and including the route of medication administration, the amount of medication given, and the times when medication is to be administered; and
(c) A health care and medication plan for children who may have special health care needs or those requiring medication for chronic health conditions which has been approved by a health care provider licensed in Montana.
37.95.182 DAY CARE FACILITIES: STORAGE AND ADMINISTRATION OF MEDICATION
(1) Any prescription medication brought to into the facility by the parent, legal guardian, or responsible relative of a child shall be dated and shall be kept in the original container labeled by a pharmacist with the following information:
(a) child's first and last name;
(b) the date the prescription was filled;
(c) the name of the health care provider who wrote the prescription; and
(d) the medication's expiration date, and specific legible instructions for administration, storage, and disposal (i.e., the manufacturer's instruction or prescription label).
(2) Any nonprescription medication brought into the facility for use by a specific child shall be labeled with the following information:
(b) child's first and last name;
(c) specific legible instructions for administration and storage (i.e., the manufacturer's instructions); and
(d) the name of the health care provider, parent, or guardian who made the recommendation.
(3) All medications, refrigerated or unrefrigerated, shall:
(a) have child-protective caps;
(b) be kept in an orderly fashion;
(c) be stored away from food at the proper temperatures; and
(d) kept in a location inaccessible to children or kept in a locked box.
(4) Medication shall not be used beyond the date of expiration.
(1) Each provider shall adopt and follow written policies for first aid consistent with recommendations from the American Red Cross. These policies must include but are not limited to:
(a) procedures for handling medical emergencies, including calling the Emergency Montana Poison Control Center at 1 (800) 222-1222 when a child is suspected of having ingested any poisonous or toxic substance; and
(b) directions for calling parents or someone else designated as responsible for the child when a child is sick or injured.
(2) A first aid kit must be kept on site at all times and must at a minimum contain:
(a) Unexpired syrup of ipecac (one ounce bottle) which may be administered only upon directive from the Emergency Montana Poison Control Center or upon directive of the local emergency service program (i.e., 911 operator, local hospital, or physician);
(b) Sterile, absorbent bandages;
(d) Tape and a variety of band-aids;
(f) The toll free number for the Emergency Montana Poison Control Center,1(800) 222-1222;
(g) Disposable single use gloves.
(h) The director, owner, manager, or person in charge of the day care facility shall take precautions to minimize the risk of any child suffering sunburn and to minimize the risk of any child contracting west nile virus; and
(3) Each day care provider is responsible for notifying the department of any environmental danger or other hazard on the facility property that the provider is aware of that could affect the health, welfare, or safety of children in care.
(4) A portable first aid kit containing at least the items listed in (2) above must accompany staff and children on trips away from the facility.
(5) The provider shall submit a report to the appropriate local office of the department within 24 hours after the occurrence of an accident causing injury to a child which resulted in the child being hospitalized, requiring ambulance transport or intervention, or physician treatment, or any fire in the facility when the services of the fire department were required. A copy of the report shall be provided to the parents of the children involved, and a copy retained on file at the day care facility.
(6) A notation of all injuries must be made on the child's medical record including the date, time of day, nature of the injury, treatment, and whether the parent was notified.
(1) Good health habits, such as washing hands, must be taught during everyday activities. The care-givers must ensure that each child washes his hands:
(b) Before participating in food preparation activities; and
(2) Every employee, volunteer, or resident at a day care facility must:
(a) be excluded from day care facility if the person has a communicable disease, a sore throat or cold that is accompanied by a fever of 101°F or greater, or if the person exhibits any of the symptoms outlined in ARM 37.95.139(4) for which a child would be excluded;
(b) Wash their hands and exposed portions of their arms with a cleaning compound in a sink by vigorously rubbing together the surfaces of their lathered hands and arms for at least 20 seconds and thoroughly rinsing with clear water, paying particular attention to the areas underneath the fingernails and between the fingers, at the following times.
(i) After touching bare human body parts other than clean hands and clean exposed portions of arms;
(iv) After coughing, sneezing, or using a handkerchief or disposable tissue;
(v) Immediately before engaging in food preparation and before feeding any child;
(vi) During food preparation as often as necessary to remove soil and contamination and to prevent cross contamination when changing tasks; and
(vii) After engaging in other activities that contaminate the hands; and
(c) Provide documentation of complete measles, mumps, and rubella immunizations and a tetanus and diphtheria booster within the 10 years prior to commencing work, volunteering, or residing at the day care facility.
(1) Except for approved overlap care there shall be at least 2 caregivers caring for the children at all times when there are more than 6 children present at the home.
(2) There shall be no more than six infants in a group day care home or three infants in a family day care home at any time, unless care is provided for infants only.
(3) There shall be sufficient staff so that an adult is always present and supervising all children.
(4) Except for approved overlap care, the provider may not provide care for a child if caring for that child would cause the provider to exceed the number of children the provider is registered to care for on the registration certificate.
(5) The provider shall maintain an up-to-date a master list with the name, address, and phone number of all children in care and their parents or guardians.
(1) The provider and all persons responsible for children in the day care home must:
(a) Be at least 18 years of age;
(b) Demonstrate they are physically, emotionally, and mentally capable of performing the essential function of their position with or without reasonable accommodations;
(c) Be free of communicable disease;
(d) Have met the immunization requirements of ARM 37.95.140; and
(e) Demonstrate they are of good moral character.
(2) The provider and all staff, including care-givers, aides, volunteers, kitchen and custodial staff, and persons over age 18 residing in the day care facility or staying in the facility on a regular or frequent basis, must obtain a completed criminal background check, a completed child protective services check, and a statement of health. For those persons who are considered care-givers, this information must be completed before providing direct unsupervised care to the children attending the day care facility. The director or provider/owner of the facility is responsible for ensuring these reports and other pertinent information are completed and submitted to the department within 15 actual days of the care-giver providing care.
(3) The provider, or an approved care-giver designated by the provider, shall be responsible for the direct care, protection, supervision, and guidance of the children through active involvement or observation in group and family day care facilities.
(4) The provider shall attend a basic day care orientation or its equivalent provided or approved by the department within the first 60 days of certification. This orientation must include the following areas:
(c) child development/well being;
(f) business aspects of a child care business.
(5) Orientation training does not count toward the required eight hours of approved education or training as specified in (6).
(6) The provider and all care-givers must annually verify that they have met the training requirements set out in (37.95.162).
(7) The provider must hold current course completion cards in infant, child and adult CPR; infant choking response and standard first aid. Course completion means direct instruction which includes the practice and demonstrated applications of CPR methods as taught by instructors from accredited entities.
(1) The day care home must have a minimum of 35 square feet per child of indoor space, not including food preparation areas of the kitchen, bathrooms, toilets, offices, staff rooms, corridors, hallways, closets, lockers, laundry areas, furnace rooms, cabinets, and storage shelving spaces, as well as 75 square feet per child of outdoor play space.
(2) Every story of the day care facility that is used for day care purposes shall have at least two remotely located means of egress as defined in ARM 37.95.102 (42). All areas used for day care purposes must have at least one door for egress that is at least 34 inches wide and must also have one other means of egress that provides a clear opening of at least 20 inches in width, 24 inches in height, and 5.7 sq. feet in area. The bottom of the opening shall not be more that 44 inches above the floor. If windows are used for rescue or exiting purposes, the provider shall have a written and feasible evacuation plan. All exits must be unobstructed at all times.
(3) Remotely located means of egress from each room as required in (2) are not required in buildings protected throughout by an approved, automatic residential sprinkling system, or where the room or space has a door leading directly to the outside of the building.
(4) If basements are used for day care purposes:
(a) In facilities newly licensed on or after the effective date of these rules or for which there is a change in ownership on or after the effective date of these rules each designated are for children's activities must have two means of egress that are remote from each other unless:
(i) the basement areas are protected by an approved, automatic residential sprinkler system; or
(ii) if the basement area contains an approved sprinkling system, then the area is only required to have direct egress from the basement.
(b) If children are sleeping in the basement area, then the requirements of (5) apply the basement must be dry, well ventilated, warm and well lighted.
(5) All rooms used for napping by children must have at least two means of escape, at least one of which shall be a door or a stairway providing a means of unobstructed travel to the outside of the building at street or ground level to the public way. The second means of escape may be a window which meets the egress requirements of (2).
(6) Third stories in dwellings must not be used for day care purposes and must be barricaded or locked to prevent entry by children.
(7) Doorways and stairs must be clear of any obstruction.
(8) Every closet door must be such that children can open the door from the inside. Every bathroom door must be designed to permit the opening of the locked door from the outside in an emergency and the opening device must be readily accessible to the provider.
(9) Every bathroom door must be designed to permit the opening of the locked door from the outside in an emergency and the opening device must be readily accessible to the provider.
(10) Protective receptacle covers must be installed on electrical outlets in all areas occupied by children under 5 years of age.
(11) The home and grounds used by children must be maintained to ensure the following:
(a) The building is in good repair;
(b) The floors, walls, ceilings, furnishings, and other equipment are reasonably clean;
(c) The building and grounds are reasonably free of insects, rodents and other vermin; and
(d) The children attending the facility shall not be exposed to paint containing lead in excess of .06%.
(1) In an emergency, all occupants of the day care facility must be able to escape from the home or building in a safe and timely manner.
(2) A fire extinguisher must be easily accessible on each floor level. The minimum level of extinguisher classification is 2A10BC. Fire extinguishers shall be mounted near outside exit doors.
(3) All day care facilities must have operating UL smoke detecting devices on each floor of the facility, installed in accordance with the manufacturer's specifications. Smoke detectors must be installed in front of the doors to stairways and in corridors of all floors occupied by the day care. Smoke detectors must be installed in any room in which children sleep. If individual battery-operated smoke detectors are used, the following maintenance is required:
(a) Smoke detectors must be tested at least once a month to ensure that they are operating correctly and have new operating batteries installed at least once each calendar year; and
(b) The placement and number of detectors in a home or building must be adequate to awaken all sleeping occupants.
(4) All wood burning stoves must meet building codes for the installation and use of such stoves. If used during the hours of care, the stove must be provided with a protective enclosure.
(5) No portable electric or unvented fuel-fired heating devices are allowed. All radiators, if too hot to touch, must be provided with protective enclosure.
(6) A minimum of 8 fire drills must be conducted annually, at least 1 month apart as weather permits. Records, including who conducted the drill, when the drill took place, how many adults and children were present during the drill, the time of day the drill occurred, and how long it took to evacuate everyone must be maintained at the facility and made available for review.
(1) Each home must have hot and cold running water with at least one toilet provided with toilet paper and one sink provided with soap and paper towels.
(2) Each facility must have a working telephone. Those facilities which have an unlisted number must make this number available to the parents and emergency contact persons of the children in care, and the appropriate regional or local offices of the department.
(3) Telephone numbers of the parents, the hospital, police department, fire department, ambulance, and the emergency Montana poison control center (1 (800) 222-1222) must be posted by each telephone.
(4) No provider shall actively operate another business in the facility during the time the children are present for day care services.
(5) When a municipal water supply system is not available, a private system may be developed and used as approved by the state or local health department. Testing must be conducted at least annually by a certified lab to ensure that the water supply remains safe and the licensee or registrant shall provide laboratory results to the department during the licensing or relicensing process. Sanitary drinking facilities shall be provided by means of disposable single-use cups, fountains of approved design, or separate, labeled or colored glasses for each child.
(6) An adequate and safe sewage disposal system shall be provided and used as approved by the state or local health department.
(7) Garbage cans shall be provided in sufficient number and capacity to store all refuse between collections and shall be corrosion resistant, fly tight, watertight and rodent proof with lids. Kitchen garbage containers must have lids or be stored in an enclosed area.
(8) All food shall be from an approved source and shall be transported, stored, covered, prepared and served in a sanitary manner to prevent contamination.
(a) Milk and other dairy products shall be pasteurized.
(b) Use of home canned foods other than jams, jellies and fruits is prohibited.
(c) Perishable foods shall be kept at temperatures above 140ºF or below 45ºF.
(d) No persons with boils, infected wounds, respiratory diseases or other communicable diseases shall handle food or food utensils.
(e) All food utensils shall be properly washed and rinsed after each usage. A domestic style dishwasher may be used if equipped with a heating element.
(f) Single service utensils may only be used once.
(9) Folding of clean laundry must not take place on the same work surface used for sorting dirty laundry. Bedding shall be laundered when necessary and aired out periodically to prevent mildew.
(1) Nutritious meals and snacks must be provided to children in such quality and quantity to meet the national research council or the USDA child and adult care food program recommended dietary allowances for children of each age. Minimum nutritional requirements, age appropriate, will be supplied to the provider by the state or county health department.
(2) The above requirement in (1) shall be deemed to have been met if the provider provides nutritious meals and snacks as follows:
(a) Children in care for a continuous period of 5 hours to 10 hours shall be provided at least one meal appropriate to the time of day and two snacks; or
(b) Children in care for a continuous period of 10 hours or more shall be provided at least one meal every 6 hours and one snack between meals. The 6 hours requirement does not apply during the hours that the child is sleeping when night care is provided; or
(c) Children in care for 2 to 6 hours shall be provided one snack every 2 1/2 hours.
(3) Special diet orders must be kept on file by the provider as submitted to the provider in writing by parents.
(4) For the child requiring a rigid diet, food shall be brought from home and labeled clearly.
(5) Menu plans shall be available to parent upon request.
(6) A record of food served shall be kept on file for at least 1 month.
(7) Meal and snack service to children and the preparation of food by children shall be carefully supervised.
(8) Fresh drinking water shall be available to children and offered at frequent intervals.
(9) Proper methods of handling, preparing, and serving food in a safe and sanitary manner shall be consistently implemented by the provider.
(1) A written plan of daily activities and routines, in addition to free play, must be established. The plan must be flexible to accommodate the ages and needs of individual children and the group as a whole. It must be designed with intervals of stimulation and relaxation, and a balance between periods of active play and quiet play or rest.
(2) There must be developmentally appropriate activities for the children which foster sound social, intellectual, emotional and physical growth including:
(a) Opportunities for individual and small group activities;
(b) Time and opportunity for creative experiences for children through art, music, books, and stories, and dramatic play; and
(c) Outdoor play each day except when precluded by severity of weather.
(3) The provider or other caregiver who is at least 18 years of age shall be on the premises at all times children are in care.
(4) Providers shall use appropriate forms of discipline.
(a) Physical punishment, including spanking or shaking and other forms of corporal punishment are strictly prohibited in day care facilities. Discipline shall include positive guidance, redirection and the setting of clear limits that foster the child's ability to become self-disciplined.
(b) Any punishment or discipline which is humiliating, frightening, or otherwise damaging, is prohibited.
(c) Parental or guardian permission does not allow the use of punishments or disciplines prohibited in (4)(a) and (b) above.
(5) Television or movie watching during the hours children are in care shall not be excessive and shall be limited to child-appropriate programs.
(1) Day care homes offering night care must develop plans for program, staff, equipment and space which will provide appropriately for the personal safety and emotional and physical care of children away from their families at night.
(2) This requirement shall be deemed to have been met if:
(a) Special attention is given by the caregiver and the parents to provide for a transition into this type of care appropriate to the child's emotional needs;
(b) A selection of toys for quiet activities which can be used with minimal adult supervision is provided for children prior to bedtime;
(c) Bathing facilities, comfortable beds or cots, and complete bedding are provided;
(d) Staff are available to assist children during eating and pre-bedtime hours and when dressing;
(e) During sleeping hours, staff have a plan of supervision which involves practices where no child is left alone and staff are in the immediate vicinity and on the same floor level of sleeping children in order to adequately hear the children should they wake and to provide for the needs of children and respond to any emergency; and
(f) At appropriate times a nutritious dinner and/or breakfast is served to children and a bedtime snack is offered.
(3) An individual day care provider may not provide care consecutively day and night without at least one additional caregiver. No caregiver may have responsibility for the care and supervision of children for more than 12 consecutive hours in a 24 hour period.
(4) Overlap care may be approved by the department in situations, such as before and after school, when the number of children in care over 3 years of age would exceed, for a short period of time, the registered capacity.
(a) Overlap of children under 3 years of age shall not be permitted.
(b) Overlap care shall not exceed 3 hours total in any day care day.
(c) Group day care facilities may be approved to provide overlap care for up to 4 additional children during the approved overlap time if there are at least 2 caregivers providing direct care at any time there are more than 8 children being cared for at the facility.
(d) Family day care homes may care for 2 additional children during the approved overlap time.
(e) Day care facilities providing 2 shifts of 12-hour care may be granted 3 hours of overlap care for each 12 hours of continuous care upon the written approval of the department representative.
(f) There must be 35 square feet per child of indoor space including the additional children during approved overlap hours.
(g) If a provider wishes to provide overlap care, the provider shall file a written plan for this care stating the specific hours in which the overlap will occur and the arrangements for providing adequate activities and supervision to all children during this period.
(h) Overlap care shall not occur until the provider has received written approval of this plan from the department.
(i) Group day care homes which exceed 12 children during approved overlap may be subject to inspection by the state fire prevention and investigation bureau and the state sanitarian.
(1) Play equipment and materials must be provided that are appropriate to the developmental needs, individual interests, and ages of the children. There must be a sufficient amount of play equipment and materials so that there is not excessive competition and long waits.
(2) Play equipment and materials must include items from each of the following six categories: dramatic role playing, cognitive development, visual development, auditory development, tactile development and large-muscle development.
(3) High chairs, when used, must have a wide base and a safety strap. Portable high chairs that hook onto tables are not allowed.
(4) Each child, except school-age children who do not take naps, shall have clean, age-appropriate rest equipment, such as a crib, cot, bed or mat. Seasonably appropriate top and bottom covering, such as sheets or blankets, must be provided. Crib mattresses and other rest equipment shall be waterproof and regularly sanitized.
(1) The department will provide the following:
(a) Assistance to the applicant to meet registration requirements;
(b) Referral services concerning children's problems; and
(c) Consultation to the day care provider in providing enrichment experiences for the children, proper environment and nutrition.
(2) The department may investigate and inspect the conditions and qualifications of any family day care home and group day care home holding a registration certificate.
(3) The department will visit and inspect at least 20% of all registered family day care homes and group day care homes.
(1) A day care facility must have on file a health record form, provided by the department, concerning any special health risks that would affect other children. This must be obtained and kept on file by the provider prior to residence or enrollment of the infant in the day care facility. The health record form must be signed by:
(a) A physician licensed to practice medicine in Montana pursuant to Title 37, chapter 3, MCA; or
(b) A physician assistant-certified licensed to practice in Montana and practicing under a utilization plan approved by the board of medical examiners; or
(c) A person licensed in Montana as a professional nurse and recognized by the board of nursing as a nurse practitioner or clinical nurse specialist; or
(d) A naturopathic physician licensed under Title 37, chapter26, MCA.
(1) A sufficient supply of clean, dry diapers shall be available and diapers shall be changed as frequently as needed. Disposable diapers, a commercial diaper service, or reusable diapers supplied by the child's family may be used. If non-disposable diapers are used, the facility may launder the diapers using a germicidal process approved by the state or local health department. In the absence of such a process, the facility may not launder non-disposable diapers of enrolled children.
(2) Soiled reusable diapers shall be placed into separate cleanable covered containers provided with waterproof liners prior to transport to laundry, parent, or acceptable disposal. These containers shall be emptied, cleaned and disinfected daily. Soiled disposable diapers shall be disposed of immediately into an outside trash disposal or put in a securely tied plastic bag and discarded indoors until outside disposal is possible. Reusable diapers shall be removed from the facility daily.
(3) Diaper-changing surfaces shall be cleaned after each use by washing or by changing a pad or disposable sheeting and sanitized or covered for reuse.
(4) Soft, absorbent, disposable towels or clean reusable towels which have been laundered between each use shall be used for cleaning the child.
(5) Safety pins shall be kept out of reach of infants and toddlers.
(6) Children shall not be left unattended on a surface from which they might fall.
(7) All toilet articles shall be identified and separated as to each child and kept in a sanitary condition.
(8) Diapering and toileting areas shall contain a wash basin that is separate from that used for food preparation.
(9)Toilet training shall be initiated when the child is ready and in consultation with the child's parents or placement agency. There shall be no routine attempt to toilet train children under the age of 18 months.
(1) Wet or soiled clothing shall be changed promptly. Parents shall provide additional clothing and it is the responsibility of the parents to care for the clothing.
(2) If an older, toilet trained child has an accident causing wet or soiled clothes, the child shall be changed promptly.
(1) An individualized diet and feeding schedule shall be provided according to a written plan submitted by the parents or by the child's physician with the knowledge and consent of the parents, guardian or placement agency. A change of diet and schedule shall be noted on each child's daily diet and feeding schedule.
(2) A day's supply of formula or breast milk in nursing bottles or formula requiring no more preparation than dilution with water shall be provided by the parents, unless an alternative agreement is reached between the parents and provider ensuring that the infant's nutritional needs are sufficiently met. Bottles of formula or breast milk shall be clearly labeled with each infant's name and date and immediately refrigerated. After use bottles shall be thoroughly rinsed before returning to the parent at the end of the day. Special dietary foods required by the infant shall be prepared by the parents.
(3) Bottles shall not be propped. Infants too young to sit in high chairs shall be held in a semi-sitting position for all bottle feedings. Children who use a bottle should not be allowed to lie on their backs when drinking from the bottle. Older infants and toddlers shall be fed in safe high chairs or at baby feeding tables. Infants 6 months of age or over who show a preference for holding their own bottles may do so provided an adult remains in the room and within observation of the infant. Bottles shall be taken from the infant when the child finishes feeding, when the bottle is empty and while the infant is sleeping.
(4) If the parent is unable to bring sufficient or usable formula or breast milk, the facility may use commercially prepared and packaged formulas. Older infants shall be provided suitable foods which encourage freedom in self-feeding. Unused infant food shall be stored in the original container and kept separate from other foodstuffs. Dry cereal, cookies, crackers, breads and similar foods shall be stored in clean, covered containers.
(5) If the container in which the formula was purchased does not include a sanitized bottle and nipple, then transfer of ready-to-feed formula from the bulk container to the bottle and nipple feeding unit must be done in a sanitary manner in the kitchen. Bottles filled on the premises of the facility should be refrigerated immediately if not used and contents discarded if not used within 12 hours.
(6) If bottles and nipples are to be used by the facility, they must be sanitized by boiling for 5 minutes or more just prior to refilling. Terminal (one-step) sterilization of bottles, nipples and formula is acceptable.
(1) Bathing shall not be done routinely by the facility but if required:
(a) No child shall be left unattended in the bathing area;
(b) Bathing materials shall be sanitized after bathing a child;
(c) Nonallergenic soap shall be used;
(d) Arrangements shall be made so no child can turn on hot water while being bathed. Water supply to bathing area will not be over 120º F; and
(e) The bathing area shall be out of drafts and provisions should be made so the child may be completely dried after a bath.
(1) There shall be adequate opportunities for sleep periods during the day suited to the infants' individual needs.
(2) Unless the child's parent has provided medical documentation from health care provider ordering otherwise, infants shall be placed on their back and on a firm surface to reduce the risk of sudden infant death syndrome (SIDS).
(3) Each infant shall be provided with a crib or play pen for sleeping until, at the discretion of the parent and provider, they are safe on a cot or mat.
(a) Infants shall not be routinely allowed to sleep in a car seat, infant swing or other apparatus.
(b) Cot or mat surfaces may be of plastic or canvas or other material, which can be cleaned with detergent solution and allowed to air dry.
(4) Cribs shall be made of durable, cleanable, nontoxic material and have secure latching devices. Cribs shall have no more than 2 and 3/8 inches of space between the vertical slats. Mattresses shall fit snugly to prevent the infant from being caught between the mattress and crib siderail. Crib mattresses shall be waterproof and easily sanitized. Cribs, cots, or mats shall be thoroughly cleansed before assignment to another infant.
(5) Cribs, cots, or mats shall be spaced to allow for easy access to each child, adequate ventilation, and easy exit. Aisles between cribs or cots shall be kept free of obstructions while cribs or cots are occupied. Use of stackable cribs for infants is permitted until infants reach one year of age or 26 pounds, which ever comes first.
(6) All pillows quilts, comforters, sheepskins, bumper pads, stuffed toys and other soft products shall be removed from the crib and play pen. If blankets are used, the infant's head shall remain uncovered during sleep.
(7) Each infant shall have been provided by the parent with a clean washable blanket or other suitable covering for his/her use while sleeping. Each infant's bedding shall be stored separate from bedding used by other infants.
(1) All infants shall have ample opportunity during each day for freedom of movement, such as creeping or crawling or rolling in a safe, clean, open, uncluttered area.
(2) An infant who is awake shall not spend more than 30 minutes of consecutive time confined in a crib, playpen, jump chair, walker or highchair.
(3) Each infant shall have individual personal contact and attention by the same adult on a regular daily basis at least once each hour during non-sleeping hours. Examples of personal contact and attention include being held, rocked, taken on walks inside and outside the center, talked to and played with.
(a) There shall be sufficient staff so that an adult is always present and supervising.
(4) There shall be provisions for the infant to safely explore and investigate the environment. There shall be both stimulation and time for quiet activity. Infants shall be taken outside for some period during each day in good weather.
(5) Each infant shall be allowed to maintain the child's own pattern of sleeping and waking period according to instructions from the parents.
(1) Children shall be protected from draft and prolonged exposure to direct sunlight. With the parent's permission, sun screen shall be applied to children over 6 months old when outdoor conditions dictate.
(2) The outdoor activity area shall be adjacent to the facility, fenced and free of hazards, which are dangerous to the health and life of the children. Every time a child is outdoors, the child must be supervised by a caregiver.
(3) Adequate protection against insects shall be provided.
(4) Provision shall be made for both sunny and shady activity areas.
(1) Feeding tables equipped with a harness or highchairs with a broad base and a harness for securing the child, shall be provided for every four children.
(2) The facility shall provide, adequate and safe equipment such as walkers, swings, playpens, jump chairs and adult rocking chairs. All equipment must meet current federal safety regulations.