The health and safety orientation training must be completed
every two (2) years by every staff member. Additionally, licensed and
unlicensed providers must follow MSDH regulations requiring 15 contact hours of
professional development each year. License exempt providers must adhere to
professional development requirements as prescribed by the organization that
sanctions the program and upon which its license exempt status is based, in
addition to the requirements of the CCPP.
The following requirements describe the expectations and
requirements for all CCPP providers:
A.
Prevention and control of infectious diseases (including immunization)
1) CCDBG federal regulations mandate that
each child receiving CCDF subsidy and any caregiver providing subsidized
childcare have current immunizations. Providers must maintain the following
records for each child and each caregiver on site, and readily accessible for
review by MDHS or MSDH:
2)
Certificate of Immunization Compliance (MSDH Form 121, signed by the District
Health Officer, a physician, nurse, or designee); or
3) Certificate of Medical Exemption (MSDH
Form 122, must be approved and signed by the MSDH District Health Officer from
the public health district or the State Epidemiologist).
4) Homeless children and children in foster
care who receive CCPP assistance shall be granted a twenty-four (24) hour grace
period from the date of admission into a CCPP-approved child care program to
obtain the necessary immunization records. Payment for these children during
the grace period shall not be considered an error or an improper
payment.
B. Prevention of
sudden infant death syndrome and the use of safe-sleep practices A safe sleep
environment for infants to lower the risk of Sudden Infant Death Syndrome
(SIDS) is required as follows:
1) An infant
shall be placed on his/her back for sleeping unless written physician orders to
the contrary are in the child's record. Sleeping infants shall be within the
view of the staff and visually checked regularly when sleeping. Nothing shall
obstruct the view of the staff or prevent the staff from clearly seeing infants
or children.
2) Infants shall be
dressed in clothing appropriate for sleeping that is designed to keep the
infant warm without the possible hazard of head covering or entrapment. The
room shall be kept at a draft-free seasonally appropriate temperature of 65
degrees Fahrenheit to 78 degrees Fahrenheit. If a child is already asleep and
not dressed in clothing appropriate for sleeping, the caregiver does not need
to awaken the infant to change his or her clothes.
3) Facilities shall use a firm mattress
covered by a fitted sheet.
4) Items
such as but not limited to pillows, blankets, sheepskins, bumpers, soft
objects, stuffed toys, loose bedding, etc., shall not be in the crib.
5) The use of safe sleep practices for
children is required as follows:
a.
Individual beds, cots, mattresses, pads, or other acceptable equipment shall be
used for rest periods, and children shall not be placed directly on the floor
for rest periods. Bed linens, such as blankets or sheets, cannot be used in
place of a bed, cot, mattress, or pad. These shall be kept in a sanitary
condition. Once a sheet or blanket has been used by a child, it shall not be
used by another child until it has been laundered.
b. Rest period equipment shall be clean and
covered with a waterproof cover.
c.
Nap pads/cots are designed for use by one (1) child only at a time.
d. Nap pads utilized by more than one (1)
child shall be sanitized after each child's use. Nap pads utilized by only one
(1) child shall be sanitized immediately when soiled or at least
weekly.
e. Nap pads and nap cots
without mattresses are not acceptable for use in 24 hour programs. Beds, cribs,
or roll away cots are the only acceptable bedding for 24 hour
centers.
f. The facility shall
provide a crib or other similarly commercially purchased bed unit, approved and
designated for the purpose of sleeping. Mobile infants, at a minimum of eight
(8) months, may be placed on a mat during the transition period of crawling to
walking. If such mat is used, it shall be a flame retardant, minimum of two (2)
inch commercially purchased sleep mat, especially designated for the purpose of
sleeping. All cribs, sleep units, and mats must be maintained clean, in
sanitary condition and without chips, holes, fraying, tears, or stains. Cribs,
cots, and mats are to be a minimum of 24 inches apart or separated by a solid
barrier. A minimum of 36 inches is recommended.
g. Children are not allowed to sleep in
shared places, such as infant seats, strollers, swings, cozy areas, or on
tables. If a child falls asleep in such shared place, he or she should be moved
immediately to a sanitary individual sleeping place
C. Administration of medication,
consistent with standards for parental consent
A record shall be maintained of any medication administered
by the director or caregiver showing the date, time, and signature of
dispensing employee. A medication record may be destroyed ninety (90) days
after administered the medication. Signed written authorization to obtain
emergency medical treatment and to administer medication must be signed by
parent or guardian and kept in child's record/file. The use of any food or
medication in any manner or for any purpose other than that for which it was
intended is prohibited.
D.
Prevention of and response to emergencies due to food and allergic reactions
A child requiring a special diet due to medical reasons,
allergic reactions, or religious beliefs, shall be provided meals and snacks in
accordance with the child's needs. If medical reasons exist for the special
diet, a medical prescription from the child's physician stating that the
special diet is medically necessary is required. Information required for
dietary modifications include:
1)
Child's full name and date of instructions, updated annually
2) Any dietary restrictions based on the
special needs
3) Any special
feeding or eating utensils; any foods to be omitted from the diet and any foods
to be substituted
4) Limitations of
life activities
5) Any other
pertinent special needs information
6) What, if anything, needs to be done if the
child is exposed to restricted foods
E. Building and physical premises safety,
including the identification of and protection from hazards, bodies of water,
and vehicular traffic
All child care facility buildings shall meet all fire safety
standards listed on the MSDH Form #333 and all applicable local fire safety
standards and/or ordinances.
1) All
fire extinguishers, as required in the fire safety plan, shall be serviced on
an annual basis by a qualified fire extinguisher technician.
2) Unused electrical outlets shall be
protected by a safety plug cover.
3) No extension cords shall be used in areas
accessible to children.
4) Every
child care facility which uses nonelectric heating and/or cooling systems,
cooking stoves, and/or hot water heaters or other nonelectric equipment, shall
have sufficient carbon monoxide monitors placed appropriately throughout the
child care facility.
5) All glass
in doors, windows, mirrors, etc., in the child care facility shall have a
protective barrier at least four (4) feet high when measured from the floor.
Doors, windows, mirror, etc., using safety grade glass or polymers (e.g.,
Lexan) are not required to have a protective barrier.
6) A separate space in the child care
facility shall be provided for the use of an ill or injured child until the
child can be picked up by the parent. Space shall be located in an area that is
supervised at all times by an employee.
7) All parts of the child care facility used
by children shall be lead-safe, well lighted, ventilated, and free of hazardous
or potentially hazardous conditions, such as but not limited to, open stairs
and unprotected low windows.
8) The
child care facility shall be equipped with an outdoor playground area that
directly adjoins the indoor facilities or that can be reached by a route free
of hazards and is no farther than 1/8 mile (660 feet) from the child care
facility.
9) The outdoor playground
area shall be free of hazards and not less than 30 feet (measured horizontally
parallel to the ground) from electrical transformers, high-voltage power lines,
electrical substations, railroad tracks, or sources of toxic fumes or
gases.
10) Hazards, including but
not limited to air conditioner units and utility mains, meters, tanks, and/or
cabling shall be inaccessible to children.
11) Fencing at least four feet high shall be
provided around the outdoor playground area. Fencing higher than four feet but
not to exceed eight feet may be required if the licensing authority determines
that a hazard exists.
12) Outdoor
playground areas shall be free from unprotected swimming and wading pools,
ditches, quarries, canals, excavations, fishponds, or other bodies of
water.
13) The soil in outdoor
playground areas of the child care facility shall not contain hazardous levels
of any toxic chemical or substances. The child care facility shall have soil
samples and analyses performed where there is good reason to believe a problem
may exist.
F. Prevention
of shaken baby syndrome, abusive head trauma, and child maltreatment Shaken
baby syndrome (SBS) and abusive head trauma (AHT) are the constellation of
signs and symptoms resulting from violent shaking or shaking and impacting the
head of an infant or small child. Shaken baby syndrome is a subset of abusive
head trauma with injuries having the potential to result in death or permanent
neurologic disability. SBS/AHT is a form of child abuse. Caregivers are trained
to recognize the possible signs and symptoms of SBS/AHT and the consequences of
SBS/AHT.
Additional child maltreatment is defined as prohibited
behaviors. The following behaviors are prohibited by anyone (i.e., parent,
caregiver, or child) in all child care settings:
1) Corporal punishment, including hitting,
spanking, beating, shaking, pinching, biting, and other measures that produce
physical pain.
2) Withdrawal or the
threat of withdrawal of food, rest, or bathroom opportunities.
3) Abusive or profane language to include but
not limited to yelling at, and/or using harsh tones toward the children or in
close proximity (hearing distance) to children.
4) Any form of public or private humiliation,
including threats of physical punishment.
5) Any form of emotional abuse, including
rejecting, terrorizing, ignoring, isolating (out of view of a caregiver), or
corrupting a child.
6) Use of any
food product or medication in any manner or for any purpose other than that for
which it was intended.
7)
Inappropriate disciplinary behavior includes, but is not limited to, putting
soap or pepper in a child's mouth.
8) Any acceptable disciplinary action that is
not age-appropriate for the child or is excessive in time or duration
G. Emergency preparedness and
response planning for emergencies resulting from a natural disaster or a
human-caused event (such as violence at a child care facility) CCCPP-approved
providers are required to have a written Emergency Preparedness and Response
Plan to be implemented in the event of a fire, natural disaster, or other
threatening situation that may pose a health or safety hazard to children.
Plans must describe procedures for relocation, evacuation, shelter in place,
and lockdown. MSDH also has an agency-wide emergency preparedness plan which
describes agency procedures for relocation, evacuation, shelter in place, and
lockdown.
H. Handling and storage
of hazardous materials and the appropriate disposal of bio-contaminants.
Garbage and trash shall be removed from the child care facility daily and from
the grounds at least once a week. Garbage and trash shall be stored
inaccessible to the children, and in insect and rodent resistant containers.
The child care facility shall comply with all regulations
promulgated by the Division of Sanitation of the Mississippi State Department
of Health for:
1) Food
Service
2) On-site Wastewater
Systems
3) Vector (pest)
Control
I. Precautions in
transporting children (if applicable)
1)
Occupant Restraints:
* All children will be properly restrained whenever they are
being transported in a motor vehicle.
* Every person transporting a child under the age of four (4)
years in a passenger motor vehicle, and operated on a public roadway, street or
highway, shall provide for the protection of the child by properly using a
child passenger restraint device or system meeting applicable federal motor
vehicle safety standards, e.g., child safety seat.
* Every person transporting a child in a passenger motor
vehicle operated on a public roadway, street or highway, shall provide for the
protection of the child by properly using a belt positioning booster seat
system meeting applicable federal motor vehicle safety standards if the child
is at least four (4) years of age, but less than seven (7) years of age and
measures less than four (4) feet nine (9) inches in height or weighs less than
sixty-five (65) pounds.
* Any vehicle equipped with seatbelts is subject to the
requirements listed above.
* No vehicle shall be occupied by more individuals than its
rated capacity. No children shall be transported in the front seat of vehicles
equipped with passenger side air bags.
* All vehicles under 10,000 lbs. GVWR (Gross Vehicle Weight
Rated) shall be equipped with occupant restraints appropriate for the age
and/or weight of the children being transported. A child under the age of four
shall be transported only if the child is securely fastened in a child safety
seat that meets Federal Motor Vehicle Safety Standards (FMVSS,
49 CFR
571.213), which shall be indicated on the
child safety seat. The child safety seat shall be appropriate to the child's
weight and be installed and used according to the manufacturer's
instructions.
* Vehicles (e.g., school buses) with a GVWR 10,000 lbs. or
more at a minimum shall meet the current Federal Motor Vehicle Safety Standards
(FMVSS) for buses of that size. It is the responsibility of the child care
facility operator to have documentation verifying that a bus meets the current
FMVSS.
* An individual seat restraint must be used for each child.
The use of an individual seat restraint for two or more children is not
allowed. NOTE: Federal Motor Vehicle Safety Standards (FMVSS) means the
National Highway and Traffic Safety Administration's standards for motor
vehicles and motor vehicle equipment established under Section 103 of the Motor
Vehicle Safety Act of 1966 ( 49 CFR Part 571) as they apply to school
buses.
2) Staff-to-Child
Ratio:
* On vehicles with a GVWR of less than 10,000 lbs., the
staff-to-child ratio shall be maintained at all times. The driver of the
vehicle shall not be counted as a caregiver while transporting the
children.
* On vehicles with at GVWR of 10,000 lbs. or more, the
staff-to-child ratio shall be one caregiver to each 25 children or fraction
thereof. The driver of the vehicle shall not be counted as a caregiver while
transporting the children. In facilities that are dually licensed, i.e.,
licensed to provide care for both preschool and school age children, if the
vehicle is only transporting school age children (no preschool children,
infants, or toddlers are being transported), the driver may be counted as a
caregiver while transporting the school age children.
J. Pediatric first aid
and cardiopulmonary resuscitation (CPR) certification Programs that operate in
a central location shall have at least one caregiver on the premises at all
times the facility is in operation that has a current certification in CPR and
first aid. When groups of children are away from the central location for field
trips etc., there shall be at least one caregiver with the group that holds a
current certification in CPR and first aid. All caregivers in summer day camps
are required to have current CPR and first aid certification, copies of which
shall be kept with their personnel records.
First Aid Supply:
1)
A first aid supply shall be kept on-site and easily accessible to employees,
but not in reach of the children.
2) A first aid supply shall be taken on all
field trips and excursions and shall be easily accessible to employees, but not
in reach of the children.
3)
Medicine shall be kept out of the reach of the children.
4) All vehicles used by the facility in
transporting children shall be equipped with a first aid kit.
5) It is recommended that first aid kits
contain items pursuant to American Red Cross guidelines.
6) Some items in this kit may have expiration
dates. All first aid kits should be periodically inspected for contents.
Depleted and out of date materials should be replaced.
7) Special attention should be exercised when
utilizing first aid supplies or any medication for children who have allergies
or other special medical needs.
K. Recognition and reporting of child abuse
and neglect
The Health and Safety training covers the topics of child
abuse and neglect including definitions of types of abuse (physical, emotional,
sexual), maltreatment of children, recognizing signs of abuse, and reporting
policies.
L. Nutritional
Standards
A child care provider shall provide adequate and nutritious
meals prepared in a safe and sanitary manner. Healthy diets contain the amounts
of essential nutrients and calories needed to prevent nutritional deficiencies
while preventing an excess amount of discretionary calories. Planned meals and
snacks provide the right balance of carbohydrate, fat, and protein to reduce
risks of chronic diseases, and are part of a full and productive lifestyle.
Children's food needs are based on the amount of time spent in the child care
facility. Any child in the care of a child care provider at the time of service
of a meal or snack will be served that meal or snack. Meals and vending
services in licensed child care facilities shall meet the standards from the
Offices of Healthy Schools and Child Nutrition for the Mississippi State
Department of Education as well as USDA
Food and Nutrition Service guidelines.
1) Menus shall be nutritionally adequate and
consistent with the Dietary Guidelines for Americans.
2) Foods shall be provided in quantities and
meal patterns that balance energy and nutrients with children's ages,
appetites, activity levels, special needs, and cultural and ethnic differences
in food habits.
3) Parents shall be
involved in the nutrition component of their child-care facility.
4) A variety of fruits, vegetables, and
whole-grain products shall be offered to children for meals and snacks.
Mealtime should be used as an opportunity to teach nutrition and/or food
concepts.
5) The addition of fat,
sugar, and sources of sodium shall be minimal in food preparation and
service.
6) Food preparation and
service shall be consistent with best practices for food safety and
sanitation.
7) Furniture and eating
utensils shall be age-appropriate and developmentally suitable to encourage
children to accept and enjoy mealtime.
8) Child-care personnel shall encourage
positive experiences with food and eating.
9) Caregivers shall receive appropriate
training in nutrition, food preparation, and food service
M. Physical Activity
Children should be provided with opportunities for physical
activity throughout the day. Examples of "light physical activity" may be found
in the Child Care Licensure section of the MSDH website at
www.HealthyMS.com. Examples of "moderate
physical activity" are aerobic dancing, light calisthenics, getting up and down
from the floor, dancing, playing on school ground equipment, singing while
actively moving about, etc. Examples of "vigorous physical activity" are
running, jumping rope, performing jumping jacks, playing soccer, skipping, etc.
Regardless of the activity, it should be age appropriate and within the
physical ability limits of the child.
N. Caring for Children with Special Needs
1) The environment utilized for caring with
children with special needs shall be adapted as necessary to accommodate
special devices that may be required for the child to function independently,
as appropriate.
2) Caregivers
serving children with special needs shall receive staff development related to
the specific needs of the children served.
O. Sun Safety
1) Providers should provide opportunities for
children of all ages to engage in activities to support sun safety
practices.
2) Providers should
adopt policies encouraging sun safety while children are in attendance at the
program.
P. Literacy
Development
1) Materials should be accessible
to children of all ages.
2)
Materials should be developmentally appropriate.
3) Activities should align with educational
standards and guidelines for the age group.
4) Children should engage in literacy
activities and with literacy materials every day.
5) Providers can encourage literacy
development through language and reading aloud throughout the day.
