The purpose of this rule is to establish standards for the operation and maintenance of licensed family child care providers who care for one to 16 children in their home. It establishes minimum requirements for the health and safety of children in licensed programs.
(1) "Conditional enrollment" means that a child is admitted to a child care program and has received at least one dose of each required vaccine prior to enrollment and maintains a schedule for subsequent required vaccinations.
(2) "Supervision" means the function of observing, overseeing, and guiding a child or group of children.
(3) "Related children" means children whose child care is provided by their parents, legal guardians, grandparents, brothers, sisters, uncles or aunts.
(4) "Infant" means a child younger than 13 months of age.
(5) "Toddler" means a child 13 months and older, but less than 25 months of age.
(1) A person who provides child care in a home for nine to 16 children unrelated to the licensee for less than 24 hours a day, with a regularly scheduled, on-going enrollment, for direct or in-direct compensation must be licensed as a family group child care program.
(2) A person who provides child care in a home for less than nine unrelated children for less than 24 hours per day, having a regularly scheduled, ongoing enrollment, for direct or indirect compensation may be licensed as a family child care program.
(1) The licensee of the child care program must:
(a) be at least 18 years of age; or
(b) have a high school diploma or G.E.D.; and
(c) have knowledge of and comply with applicable laws and rules.
(2) The licensee shall establish and implement policies and procedures for the health and safety of children in the home.
(3) The care giver shall be physically present on-site and provide care and supervision of children at all times, both indoors and outdoors. This includes:
(a) awareness of and responsibility for the ongoing activity of each child and being near enough to intervene if needed; and
(b) frequent in person observation of children sleeping in cribs and play pens.
(4) The licensee may permit a child to participate in supervised out of the home activities without the care giver if:
(a) the care giver has prior written permission from the child's parent for the child's participation; and
(b) the licensee has clearly assigned the responsibility for the child's whereabouts and supervision throughout the period of care.
(5) The licensee may make arrangements for a substitute who is at least 18 years old and who is capable of providing care and supervision of children and handling emergencies in the absence of the care giver.
(1) The licensee shall ensure that each care giver or volunteer who has direct contact with or access to children is oriented to the licensed program and successfully completes the required orientation training before starting assigned duties. The licensee shall document in a care giver's personnel record the date of completion of orientation training. The orientation training must include:
(a) procedures for maintaining health and safety and handling emergencies and accidents;
(b) specific job responsibilities;
(c) child discipline procedures of R430-90-7;
(d) reporting requirements if the care giver witnesses or suspects child abuse, neglect or exploitation; and
(e) procedures for releasing children to authorized individuals.
(2) All care givers who provide services shall be at least 18 years of age or have completed high school or a G.E.D.
(3) There shall be at least one care giver at the home during business hours who has a current course completion in basic child and infant first-aid and Cardiac Pulmonary Resuscitation (CPR), and training in the Heimlich Maneuver for treatment of an obstructed airway.
(a) First-aid and CPR refers to courses given by the American Red Cross, the Utah Emergency Medical Training Council, or other courses that the licensee of the program can demonstrate to the Department to be equivalent.
(b) Documentation of the completed First-Aid and CPR training must be in the care giver's personnel record.
(4) The licensee must ensure that an annual documented in-service training plan is developed and carried out. The plan shall be pertinent to the ages of the children in the program and must address the following areas:
(a) proper hand washing and sanitation techniques;
(b) principles of good nutrition;
(c) proper procedures in administration and storage of medications;
(d) recognizing early signs of illness, communicable diseases and determining if there is a need to exclude a child from the program;
(e) accident prevention and safety principles;
(f) positive guidance for the management of children;
(h) age appropriate activities.
(5) If child care is provided to children under age two, the following in-service topics are also required:
(a) Preventing Shaken Baby Syndrome;
(b) Coping with crying babies; and
(c) Preventing Sudden Infant Death Syndrome.
(6) The licensee shall ensure that they and all care givers complete a minimum of 20 hours of annual in-service training. At least ten hours of in-service training shall be person-to-person instruction.
(7) The licensee shall document successful completion of in-service training and maintain a record for themselves and each care giver which includes:
(a) the date training was completed;
(c) the trainer's name and organizational affiliation.
(8) Each care giver upon employment and each licensee shall have an initial health evaluation within the past six months and complete tuberculosis testing using the Mantoux tuberculin skin test method within two weeks of assuming care giver responsibilities. Tuberculin skin testing does not need to be repeated during the employment period unless the employee develops signs and symptoms of the disease, as determined by a health care professional.
(a) All care givers with skin tests that indicate potential exposure to tuberculosis shall receive a medical evaluation for tuberculosis disease.
(b) All care givers who have documentation of previous positive reaction to the Mantoux tuberculin skin test shall present documentation of completion of therapy for tuberculosis infection or evidence of a negative chest radiograph within the past 12 months.
(c) Repeated chest radiographs are not required unless the care giver develops signs and symptoms of tuberculosis disease, as determined by a health care professional.
(1) The licensee shall inform all care givers, parents or guardians and children of expected conduct by setting clear and understandable rules.
(2) Disciplinary measures shall be implemented so as to encourage the child's self-control to reduce risk of injury and any adverse health effects to self or others. Positive discipline measures include but are not limited to:
(a) rewards for positive behavior;
(b) other forms of positive guidance;
(3) Discipline measures shall not include any of the following:
(a) corporal punishment, including hitting, shaking, biting, pinching, or spanking;
(b) restraint of a child's movement by binding or tying;
(c) use of abusive, demeaning or profane language;
(d) force or withdrawing food, rest or bathroom opportunities; or
(e) confining a child in a locked closet, room, or similar area.
(1) The licensee shall obtain from the parent or legal guardian an admission agreement, which identifies the following:
(a) child's full name and nickname;
(b) parent or guardian's name, address and phone number;
(c) name, address and phone number of additional persons to be notified in the event of an emergency when the parent or guardian cannot be located;
(d) name, address and phone number of the child's primary source of emergency health and dental care.
(2) The licensee shall ensure that children's records are organized and maintained to include the following:
(a) immunization record (Utah School Immunization Record -USIR) according to R396-100;
(b) child's health history required in R430-90-10(4) and any updates;
(c) injury, accident and incident reports; and
(d) medication administration records required in R430-90-10(6)(d).
(3) The licensee of the program shall maintain care giver records to include:
(a) background screening records;
(b) initial health evaluations and TB testing;
(d) first-aid and CPR course completion; and
(e) in-service training records.
(4) The licensee shall ensure a record or log is maintained to document each enrolled child's attendance.
The minimum ratio of care givers to children permitted in licensed small family and family group child care are set forth in tables 1 and 2.
Family Minimum Care Giver to Child Ratios
(a) The mixed ages include the care giver's children under age 4.
Family Group Minimum Care giver to Child Ratios
(b) There shall be at least two care givers in the licensed family group program at all times when there are nine or more children present, counting the care givers' own children, grand children, nieces, nephews, wards, step-children, under age 12, or when more than two infants are present.
(c) The care giver's own children, grand children, nieces, nephews, wards, step-children are included in the maximum group size if they are under the age of 12.
(1) The licensee may not care for a child without proof of immunization, or evidence of conditional enrollment, or evidence of personal, medical or religious exemption. Each child shall have immunizations as required by the Utah School Immunization Law, R396-100.
(2) The licensee shall observe each child daily for signs of illness.
(a) The licensee shall notify the parent or legal guardian immediately when illness is observed or suspected.
(b) The licensee must keep ill children separate from other children.
(3) If a communicable illness or parasite is discovered, the owner shall notify the parent or legal guardian of all enrolled children on the day of discovery. Notification shall protect the confidentiality of care givers and children.
(4) The parent or legal guardian shall provide a child health history upon admission which identifies:
(a) known food sensitivities and allergies;
(b) chronic illnesses, disabilities or medical conditions;
(c) instructions for routine care; and
(d) instructions for emergency care.
(5) The parent or legal guardian shall annually review and update the child's health history with the licensee.
(6) If the licensee chooses to administer prescribed or oral over-the-counter medications then:
(a) Medications may be administered to children only by a designated care giver who does the following:
(i) check the label and confirm the name of the child,
(ii) read the directions regarding measured doses, frequency, expiration date, and other administration guidelines, and
(iii) properly document administration of medication records according to subsection (d).
(b) Oral over-the-counter and all prescription medications must be in the original or pharmacy container, have the original label, include the child's name, have child proof caps, and have written instructions for administration.
(c) The parent or legal guardian must complete a medication release form for each child receiving medications that contains:
(i) the name of the medication,
(iii) the route of administration,
(iv) the times and dates to be administered,
(v) the illness or condition being treated, and
(vi) the parent's or legal guardian's signature.
(d) The care giver who administers a child's medication shall maintain a medication record that includes:
(i) the time, date, and dosage of the medication given;
(ii) the signature or initials of the care giver who administered the medication; and
(iii) documentation of any errors in administration or adverse reactions.
(e) The licensee shall report any adverse reaction to a medication or error in administration to the parent or legal guardian immediately upon recognizing the error or reaction.
(f) Medications shall be secured from access to children.
(g) Medications stored in refrigerators shall be in spill-proof packaging and shall be kept in a covered, leakproof storage container.
(h) The licensee shall return all unused or out-of-date prescription and oral over-the-counter medications to the parent or legal guardian.
(1) The licensee shall establish a procedure for care givers to check who has written authorization to pick up children. Only the parents, legal guardian, or persons with written authorization from a parent or legal guardian shall be allowed to take any child from the home, except that verbal authorization may be used in emergency situations.
(2) The home of the licensee shall be accessible and open to parents or legal guardians during the hours of operation.
(3) The licensee shall establish a procedure for ensuring that all children's attendance is accounted for, which shall include requiring a sign-in and out procedure.
(4) The licensee shall establish written policies and monitor care givers, visitors, and residents of the home to ensure that the use and accessibility of tobacco, alcohol, illegal substances or sexually explicit materials are prohibited by any person anywhere on the premises during the hours of operation when children are under care.
(5) In the case of a serious injury to a child which requires immediate hospital treatment, the licensee shall contact the parents or legal guardians after emergency personnel have been contacted.
(6) For any emergency that requires a response by emergency medical treatment providers, fatality, or hospitalization of a child in care, the licensee shall:
(a) notify the Department within 24 hours of occurrence, either by phone or facsimile; and
(b) submit to the Department within five business days of occurrence a written injury and accident report.
(1) The licensee shall develop a daily activity plan that is designed for the age and development of the children accepted for care and ensure that there are sufficient supplies on hand.
(2) There shall be a minimum of 35 square feet of indoor play area per child for each child in care under age 14. Toilet rooms, closets, hallways, and alcoves may not be included in calculating indoor play space. Play space does not include areas in the care giver home which are not included in the child care area.
(3) Outdoor play areas shall have at least 40 square feet per child for each child in care under age 14. The total outdoor play area shall accommodate at least 40 percent of the licensed capacity at one time.
(a) Outdoor play areas shall be fenced or have a natural barrier that provides protection from unsafe areas. Fences shall be at least four feet high. If local ordinances conflict with this requirement, the licensee may request a variance from the Department. Any gaps within the fence shall not be greater than three and one-half inches. The bottom edges of the fence shall not be more than three and one-half inches above the ground.
(b) Outdoor play areas shall have a shaded area to protect children from excessive sun and heat. Drinking water shall be continuously accessible to children in the outdoor play area.
(4) If off-site activities are provided, parent or legal guardian permission is required for children to participate. Care givers shall take with them emergency phone numbers for each child attending the activity.
(5) If swimming activities are planned, care givers shall accompany children at pool side and lifeguards and pool personnel are not counted in care giver ratios.
(6) If care is provided to infants, a care giver shall provide physical and verbal stimulation every 30 minutes to each infant during waking hours, including the opportunity for physical activity. Physical activity may not confine an awake child to a single device, such as infant equipment which restricts active movements for more than 30 minutes.
(1) The licensee shall maintain documentation that any vehicle used for transporting children has a current vehicle registration, insurance for child care transportation, safety inspection and shall maintain the vehicle in a clean and safe manner.
(a) have a first-aid kit and body fluid clean-up kit;
(b) be equipped with individual, size-appropriate safety restraints such as car seats or seat belts which are described in the federal motor vehicle safety standards contained in the Code of Federal Regulations, title 49, section 571.213, for each child that are appropriate to the vehicle type and are installed and used in the manner prescribed by the manufacturer;
(d) be locked during transport.
(3) Smoking in vehicles is prohibited at all times that children are in the vehicle.
(4) Any vehicle used for transporting children shall be driven by an adult who holds a current state driver's license that authorizes the driver to operate the type of vehicle driven.
(5) The driver shall ensure that no child is unattended in the vehicle. The driver shall remove the keys whenever the driver is not in the driver's seat.
(1) All care givers shall comply with the universal blood and bodily fluid precautions according to the OSHA Bodily Fluid Blood-Borne Pathogen Standard.
(a) The licensee shall keep and maintain a portable blood and bodily fluid clean-up kit.
(b) All care givers shall know the location of the kit and how to use it.
(c) All care givers shall wear new disposable latex gloves or an approved equivalent listed in OSHA part 1910.1030 for first-aid procedures involving blood or clean-up of blood containing bodily fluids.
(2) If children are admitted for care who require diapers, the following applies:
(a) Care givers shall change a child's diaper on a clean, smooth, washable, non-absorbent diapering surface and sanitize the surface after each use.
(b) The diapering area shall not be located in a food preparation area.
(c) Care givers shall place soiled diapers in a container that is lined and has a tight fitting lid or take the diapers directly to an outside covered receptacle. Care givers shall clean and disinfect the inside diaper containers daily.
(3) If a child's clothing is soiled by fecal material or urine, a care giver shall change the clothing promptly and place the clothing in a leakproof container to be sent home with the parent or legal guardian.
(4) If personal hygiene items for children are maintained at the home such as combs or toothbrushes, they shall not be shared between children and shall be labeled and stored separately.
(5) The licensee shall clean and sanitize indoor activity equipment and toys weekly or more often as necessary.
(a) Stuffed animals shall be machine washable.
(b) If four or more infants are present for care, the licensee shall clean and sanitize the indoor equipment and toys used by the infants during the day.
(6) Care givers shall assure protection from contamination and the spread of microorganisms by implementing good hand washing practices. Care givers shall teach children proper hand washing techniques and oversee hand washing whenever possible. Care givers and children shall wash their hands after using the toilet, before and after eating, and before and after food preparation.
(7) Single-use paper towels or individually labeled cloth towels shall be used for drying hands. If cloth towels are used, the care giver shall wash the towels daily.
(1) Indoor and outdoor play spaces, toys and equipment shall be maintained in a safe manner to prevent injury to children.
(2) Infants and toddlers shall not have access to toys smaller than 1-1/4 inches in total diameter or length. Toys and equipment used by children must comply with the guidelines of the Consumer Product Safety Commission.
(3) High chairs shall have safety straps or devices to prevent children from falling out.
(4) There shall be no firearms or other weapons accessible to children. Firearms and other weapons shall be stored separately from ammunition and all shall be in a locked cabinet or area during times when children are on the premises, unless the use is in accordance with UCA 53-5-701 Concealed Weapons Act, UCA 76-10-523 Persons Exempt from Weapons Laws or as otherwise authorized by law..
(5) Electrical outlets accessible to children four years of age and younger shall be protected or capped with safety devices.
(6) Toxic or hazardous chemicals such as cleaners, insecticides, lawn products, and flammable materials shall be stored away from children in a locked or protected area. All toxic or hazardous chemicals shall be in the original container, or labeled in the container.
(7) Fireplaces, open-face heaters, and wood burning stoves shall be inaccessible to children when in use. Portable space heaters are not permitted when children are on the premises.
(8) Outdoor play equipment shall be located over soft material or grass.
(9) All water hazards such as a swimming pool, stationary wading pool, ditches, and fish ponds shall be fenced to prevent access by children.
(10) Sharp objects, medicines, plastic bags, poisonous plants, lighters and matches must be stored out of reach and inaccessible to children.
(11) Hot water accessible to children shall not exceed the scalding standard of 120 degrees Fahrenheit.
(12) Strings and cords long enough to encircle a child's neck, such as those found on pull toys, window blinds, or drapery cords, shall be inaccessible to children under five years of age.
(13) Any structure built prior to 1978 which has peeling, flaking, chalking, or failing paint on the interior or exterior shall be tested for lead-based paint. If paint lead levels are equal to or exceed 0.06% by weight, the structure must be remodeled by encapsulation or enclosure when possible or by complete removal of lead-based paint by trained individuals.
(14) Infant walkers with wheels are not permitted.
(15) The licensee shall provide separate sleep equipment for each infant designed for infant use, such as a crib, bassinet, porta-crib, or play pen. Infants shall be placed on their backs for sleeping.
(1) The licensee shall have a written emergency and disaster plan in case of fire, flood, earthquake, blizzard, power failure, or other disasters that could create structural damage to the home or pose a health hazard. The plan shall include the procedure to transport and evacuate children to another location and the procedures to turn off gas, electricity and water.
(2) The licensee shall have an emergency plan in the case of a missing child or death or serious injury to a child, which includes the name of a substitute care giver in the event the owner must leave the residence for any reason.
(3) The licensee shall hold simulated fire drills quarterly and an annual disaster drill. The licensee shall document the date of drills, participants, and the problems encountered.
(4) Each home shall have fire extinguishers and smoke detectors in good operating condition on each floor occupied by children. Two exits leading to an open space at ground level, shall be present to permit the orderly evacuation of children. If the basement is used to provide child care, at least one exit at ground level shall be present leading to an open space.
(5) The licensee shall ensure that the telephone service is in working order, unless there is a utility failure, and inform the Department of the current phone number. The names and telephone numbers of the emergency medical personnel, fire department, police, and poison control shall be posted by the telephone.
(6) The licensee shall maintain a first-aid kit at the residence.
(1) The licensee shall take effective and safe measures to prevent, control, and eliminate the presence of insects, rodents, and other vermin on the premises.
(2) There shall be adequate housekeeping services to maintain a clean, odor free, and sanitary environment.
(3) Entrances, exits, steps, and outside walkways shall be maintained in a safe condition, free of ice, snow, and other hazards.
(4) The licensee shall maintain the home at air temperatures between 72 degrees Fahrenheit and 85 degrees Fahrenheit as measured 30 inches above the floor. Infant care areas shall maintain temperatures of at least 70 degrees Fahrenheit at floor level.
(5) If sleeping equipment or mats for sleeping are provided, all mats and sleeping equipment shall be cleaned and sanitized weekly, and prior to use by another child.
(6) The home shall be maintained to ensure that the equipment, fixtures, and furnishings are safe and in good repair.
(7) Sand boxes and outdoor play areas shall be kept free of animal excrement and harmful objects.
(1) If the licensee permits animals at the home:
(a) the animals shall be clean and in good health;
(b) the animals shall have current vaccination records available at the program for all diseases transmissible to humans; and
(c) the animals shall have no history of dangerous or aggressive behavior.
(2) Children shall not assist with the cleaning of animals, animal cages, pens or animal equipment. Animal cages and equipment shall not be cleaned in food preparation or food storage areas.
(3) The licensee of the program shall inform the parent or legal guardian of the types of animals kept at the home.
(4) Children shall not handle reptiles, including turtles and lizards.
(1) If the local health department completes an inspection, the inspection report shall be maintained at the home for review by the Department.
(2) Food prepared by the care givers for the children in care shall be from an approved source as provided in R392-100.
(a) Food brought in by parents or legal guardians to serve to other children must be from an approved source or commercially prepared;
(b) Food brought in by parents or legal guardians for individual child use must be labeled.
(c) Baby food must be refrigerated after opening, marked with the date and time of opening and discarded if not consumed within 24 hours of opening;
(d) Infant formula and breast milk shall be discarded after feeding or within two hours of initiating a feeding.
(3) All care givers who prepare or serve food and snacks must have a current food handler's permit.
(4) Children's food shall be served on plates, napkins or other sanitary holders, which include a high chair tray. Multiple-use sanitary holders shall be washed, rinsed, and sanitized with a sanitizer approved in R392-100 for food contact surfaces prior to each use. Food shall not be placed on a bare table or other eating surface.
(5) Meals and snacks shall be served at least once every three hours, or according to the menu.
(a) The current week's menu shall be posted for review by parents or guardians and all substitutions shall be noted on the menu and retained for one week. If substitutions are made, the menu must meet the requirement of the United States Department of Agriculture (USDA) Child Care Food Program guidelines;
(b) Menus can be obtained from the Department or shall be Department-approved, independently approved and signed by a registered dietitian, or approved through the United States Department of Agriculture Child and Adult Care Food Program; and
(c) A different menu shall be planned for each day of the week and menus may be cycled.
(6) Children and infants shall be served special diets, formula, breast milk, or food supplements in accordance with the written instructions from a parent or legal guardian.
(7) If an infant is unable to sit upright and hold his own bottle, a care giver shall hold the infant during bottle feeding.
The Department may impose civil monetary penalties in accordance with Title 63, Chapter 46b, Administrative Procedures Act and Section 26-39-108, if there has been a failure to comply with the provisions of this chapter, or rules promulgated pursuant to this chapter, as follows:
(1) if significant problems exist that are likely to lead to the harm of a child, the department may impose a civil money penalty of $50 to $1,000 per day; and
(2) if significant problems exist that result in actual harm to a child, the department may impose a civil money penalty of $1,050 to $5,000 per day.