Nevada Nevada

STANDARDS OF OPERATION
General Requirements

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NAC 432A.240 Change of ownership, construction or remodeling of facilities.

  1. A building used as a facility must, upon a change of operating ownership, comply with the provisions of this chapter and applicable building and safety codes.

  1. The building plans for the construction of a new facility or the remodeling of an existing facility must be submitted to the bureau for review before commencement of actual construction. Review of the plans does not constitute approval of an application for a license.

NAC 432A.250 Building and grounds. (NRS 432A.077, 432A.078)

  1. Except as otherwise provided in this subsection, subsection 2 and NRS 432A.078, in each facility there must be:

(a) At least 35 square feet of indoor space for each child exclusive of bathrooms, halls, kitchen, stairs and storage spaces.

(b) At least 37 1/2 square feet of outdoor play space for each child, as determined by the maximum number of children stated on the license for the facility. An accommodation facility need not provide outdoor play space.

  1. A facility that provides care for ill children must have:

(a) At least 50 square feet of indoor space for each child, as determined by the maximum number of children stated on the license for the facility, exclusive of bathrooms, halls, kitchen, stairs and storage spaces.

(b) A separate ventilation system if the facility is attached to another building.

  1. The play area of each facility must:

(a) Be fenced or enclosed in a manner that prevents the unsupervised departure of children from the area;

(b) Have an adequate drainage system;

(c) Be free of hazards, debris and trash;

(d) If it is an outdoor play area, have trees or a structure which can provide adequate shade for the children using the area;

(e) Have resilient surfaces underneath any elevated play equipment;

(f) Have adequate safety barriers around any elevated platforms;

(g) Not have any dangerous or poisonous plants or other vegetative matter located within the boundaries of the play area or in an area that is accessible to children from the play area;

(h) Not be in a location where any bodies of water are accessible to children; and

(i) If it has playground equipment, have only equipment that is:

(1) In good repair;

(2) Designed and constructed to minimize injury;

(3) Compatible with the age of the children in the care of the facility;

(4) Spaced to reduce accidents; and

(5) Securely anchored.

  1. If a facility that provides care for ill children is a component of a child care center and provides outdoor play space, the play space must:

(a) Be separate from the play space for well children;

(b) Meet the requirements of paragraph (b) of subsection 1; and

(c) Meet the requirements of subsection 3.

NAC 432A.260 Health standards; inspection reports.

  1. To maintain his license, the licensee must ensure that his facility meets all standards for environmental health which are established by the bureau of consumer health protection of the health division of the department of human resources.

  1. Reports of inspections concerning the sanitation of a facility must be maintained in a physical file at the facility and available for review at the facility by a parent of a child who attends the facility or a parent who is considering enrolling his child at the facility for at least 2 years after the date of the inspection.

NAC 432A.270 Advertising.

All advertising by a licensee of a facility must specify the type of facility for which it is licensed and must not mislead the public regarding regular programs and services offered by the licensee.

NAC 432A.280 Plan for emergencies; drills; posting of plans; daily sign-in sheets; fire safety; maintenance and availability of reports.

  1. Each licensee shall develop an appropriate plan to ensure that the staff of his facility is prepared to respond in an emergency, including, without limitation, a fire or natural disaster.

  1. Each plan developed pursuant to subsection 1 must include, without limitation:

(a) The duties of the director and staff;

(b) A procedure for removing staff and children to a shelter within a building of the facility if the staff and children are instructed to do so by emergency personnel;

(c) A procedure for evacuating the facility;

(d) A plan for transportation;

(e) A list of sites that may be used for relocation;

(f) A plan for the supervision of the children of the facility during the emergency;

(g) The manner in which children and staff from the facility will be accounted for during the emergency; and

(h) The method for contacting emergency personnel, including, without limitation, the fire department, a law enforcement agency or any other appropriate authority.

  1. The licensee of a facility shall hold:

(a) A fire drill at least once every month; and

(b) A drill for natural disasters at least once every 3 months.

  1. Appropriate plans for removing the staff and children of a facility to a shelter within a building of the facility and for the evacuation of the facility in case of emergency must be conspicuously posted in a public place in the facility.

  1. The director of the facility shall maintain a daily sign-in sheet that includes:

(a) The first and last names of staff and children; and

(b)The times of arrival and departure for staff and children.

  1. To maintain his license, the licensee must ensure that his facility meets all standards for fire safety which are established by the state fire marshal.

  1. The state fire marshal or his designee shall, at least annually:

(a) Enter and inspect every building or the premises of each facility; and

(b) Observe and make recommendations regarding the drills conducted pursuant to subsection 3.

  1. Reports of the drills conducted pursuant to subsection 3 and the inspections concerning the fire safety of a facility conducted pursuant to subsection 7 must be maintained in a physical file at the facility and available for review at the facility by a parent of a child who attends the facility or a parent who is considering enrolling his child at the facility for at least 2 years after the date of inspection.

NAC 432A.290 Telephones; insurance for protection against liability to third persons; transportation.

  1. Each licensee of a facility shall have a working telephone listed in a local telephone directory. A current list of emergency telephone numbers, including health agencies, fire and police departments and ambulance services must be posted adjacent to the telephone.

  1. Each licensee of a facility shall have a policy of insurance for protection against liability to third persons. A certificate of insurance must be furnished by the licensee of a facility to the bureau as evidence that the policy is in force. Each policy must contain a provision which requires the insurer to notify the bureau at least 30 days before cancellation or nonrenewal of the policy. The policy of insurance must be maintained at the facility. Any government, governmental agency or political subdivision of a government which operates a child care facility and is self-insured is not required to furnish a certificate of insurance to the bureau.

  1. If transportation is provided by the licensee of a facility, all children must be protected by adequate supervision by the staff, safety precautions and adequate insurance which covers liability for health or injury, medical expenses and damages caused by uninsured motorists. The licensee of a facility shall require that each child is instructed in the conduct required for safe transportation. A driver of a vehicle used by the licensee of a facility shall:

(a) Possess an appropriate driver's license and adequate insurance;

(b) Not leave an unattended child in the vehicle at any time;

(c) Ensure that a parent, or a person designated in writing by the parent, is present to take charge of a child upon delivery of the child to his home or the facility;

(d) Ensure that each child boards or departs the vehicle on the side of the vehicle adjacent to a curb and that the child is safely conducted across any street encountered immediately before boarding or after departing; and

(e) Ensure that the doors and windows of the vehicle are secure before proceeding.

  1. If, during the time school is in operation, the licensee of a facility provides transportation for school-age children to and from a public or private school, the ratio of staff persons to children in the vehicle must be not less than one member of the staff for every 15 children. The driver of the vehicle may be counted as a staff person for the purposes of maintaining the required ratio.

NAC 432A.300 Director: Requirement; qualifications; application for approval. (NRS 432A.077)

  1. The licensee of a child care facility other than a facility that provides care for ill children, an accommodation facility, a special needs facility or a family or group home shall:

(a) Serve as the director of the facility, if he has the qualifications of a director; or

(b) Appoint a suitably qualified person to serve as the director.

  1. The director of such a facility must be at least 21 years of age and, except as otherwise provided in NAC 432A.485:

(a) Have earned a bachelor's or associate's degree and have completed at least 12 semester hours of education, of which:

(1) At least 6 semester hours are in child development; and

(2) At least 6 semester hours are in child development, child psychology, education related to the health of children or in courses directly related to these fields, of which not more than 3 semester hours may be in courses concerning the business of child care, and have at least 6 months of verifiable experience which is satisfactory to the bureau in a program related to child education, early childhood development or child care;

(b) Have earned a high school diploma or, if approved by the chief of the bureau, a certificate based on general educational development, and have completed at least 12 semester hours of education, of which:

(1) At least 6 semester hours are in child development; and

(2) At least 6 semester hours are in child development, child psychology, education related to the health of children or in courses directly related to these fields, of which not more than 3 semester hours may be in courses concerning the business of child care, and have at least 2 years of verifiable, satisfactory experience in a program related to child education, early childhood or child care;

(c) Have a current credential as a "Child Development Associate," which has been issued by the Council for Early Childhood Professional Recognition, Washington, D.C. 20005; or

(d) Have a combination of education and experience which, in the judgment of the chief of the bureau, is equivalent to that required by paragraph (a), (b) or (c).

  1. Before a license is issued to a person to operate any child care facility for which a director is required, the person must submit a completed application for approval of the director. The application must be made on a form supplied by the bureau. The applicant must sign an authorization which gives the bureau permission to verify any information given in the application.

NAC 432A.302 Appointment of director convicted of certain crimes prohibited; capabilities of staff.

  1. A licensee of a child care facility shall not knowingly appoint a person as director of the facility or appoint or permit the appointment of a person as an employee or volunteer at the facility if the person has been convicted of child abuse or neglect or any other crime involving physical harm to a person or if a criminal action for such a crime is pending against the person.

  1. The staff of a child care facility must be able to:

(a) Work with children without recourse to physical punishment or psychological abuse;

(b) Communicate with children and their parents;

(c) Praise and encourage children and provide them with a variety of opportunities for learning and social experiences; and

(d) Recognize and eliminate hazards to the safety of children.

NAC 432A.304 Responsibilities of director.

  1. Except as otherwise provided in subsection 4, the director of a child care facility shall be present in the facility at least 25 hours per week during its hours of operation.

  1. The director is responsible for screening, scheduling and supervising the staff of the facility, and for the conduct of each member of the staff at the facility.

  1. The director shall:

(a) Provide a program for child care for the facility which meets the requirements of this chapter;

(b) Provide space for an office, the storage of records, conferences with parents, meetings of the staff and all other needs of the program for child care;

(c) Maintain records of personnel, enrollment, attendance and other activities;

(d) Work with parents and include them, whenever possible, in the programming and functioning of activities;

(e) Cooperate with the bureau and other agencies of government to improve the quality of child care and the competence of caretakers; and

(f) Designate a member of the staff who is responsible for the operation of the facility when the director is not present at the facility.

  1. If the facility is in operation 25 hours or less, the director shall be present in the facility during at least half the hours of operation.

NAC 432A.306 Requirements for caretakers.

  1. Every caretaker of children in a child care facility must be:

(a) At least 16 years of age;

(b) Able to summon help in an emergency; and

(c) Emotionally and physically qualified to carry out a program which places emphasis on the development of children.

  1. No more than 50 percent of the caretakers in a child care center, a child care institution or a preschool may be under 18 years of age. Any caretaker who is under 18 years of age and is employed in such a facility must:

(a) Have completed a course in the development of children which is approved by the chief of the bureau; or

(b)Be currently enrolled in such a course.

  1. A child care facility may not be operated unless a person who is 18 years of age or older is on the premises of the facility.

NAC 432A.308 Completion of program for administration of first aid by caretaker.

  1. Whenever a child care facility is in operation, at least one of the caretakers on duty must have completed, or be in the process of completing, a program for the recognition of symptoms of illness and the administration of first aid.

  1. The program may be carried out in a classroom or on the job. The program must include training in health and the observation and evaluation of symptoms of illness and responses to illness and emergencies, including the administration of first aid to victims of fire, serious injury or the ingestion of poison.

  1. A licensee of a child care facility must present evidence to the bureau showing that caretakers on duty while the facility is operating are in compliance with the requirements of this section, described in this subsection. A certificate or other evidence of compliance issued by a community health agency or clinic, community college, university, the Red Cross, an adult education program in home nursing or other appropriate institution is adequate evidence of compliance. If training is done on the job, an affidavit signed by the director is adequate evidence of compliance.

NAC 432A.310 Staff: Personal health. (NRS 432A.077)

  1. Every member of the staff of a facility, including a volunteer, shall present to the director of the facility, to be placed in the employee's file, written evidence that the employee is free from communicable tuberculosis. The evidence must be in the form of a report that states that the employee is free from active tuberculosis as required pursuant to subsection 2 or 3.

  1. Before a person, including a person who has received a bacillus Calmette-Guerin (BCG) vaccination, begins employment at a facility, he must have submitted to a:

(a) Mantoux tuberculin skin test; or

(b) Chest radiograph and examination by a provider of health care who is authorized to diagnose active tuberculosis, within the 12 months immediately preceding the first day of employment at the facility.

  1. Every member of the staff of a facility, including a volunteer, shall submit to:

(a) A Mantoux tuberculin skin test; or

(b) An examination by a provider of health care who is authorized to diagnose active tuberculosis, at least once every 24 months after the date the skin test or chest radiograph and examination were conducted pursuant to subsection 2.

  1. Each caretaker or member of the staff of a facility who has an identified health problem that may affect his ability to provide adequate care to children in a facility shall:

(a) Report the problem to the director of the facility or, if self-employed, to his licensing agency; and

(b)Submit to the director or, if self-employed, to his licensing agency, a written statement from a licensed physician attesting to the fact that the health of the caretaker does not endanger the children who are under his care in the facility.

  1. Each director shall-report to his licensing agency any health problem reported to him pursuant to subsection 4.

  1. Each director or caretaker, if self-employed, shall immediately report to his licensing agency any person residing at his facility who contracts a serious communicable disease.

NAC 432A.320 Orientation program and basic training.

  1. Newly employed members of the staff must be given an orientation program and trained by the director in the policies, procedures and programs of the facility and the recognition of the symptoms of illness.

  1. If required by the director or owner of the facility, a member of the staff shall participate in any specialized training related to child care which is offered in the community where the facility is located.

  1. For the purposes of this section, a volunteer who works at least 20 hours per week in a facility and participates in specialized child care training, as defined by the director, is a member of the staff of the facility.

NAC 432A.323 Initial course of training in child care. (NRS 432A.077)

  1. Each person who is employed in a child care facility, other than in an accommodation facility or a facility that provides care for ill children, shall complete at least 6 hours of training in child care, of which not more than 3 hours may be in training concerning how to perform cardiopulmonary resuscitation, within 6 months after commencing his employment unless he has completed such training within the previous 12 months.

  1. The training required pursuant to subsection 1 must be designed to:

(a) Ensure the protection of the health and safety; and

(b) Promote the physical, moral and mental well-being, of each child accommodated in the facility. If the facility is a special needs facility, the training must also be designed to provide information on the characteristics of handicapping conditions and appropriate programs for children with special needs. The training must be established or approved by the chief of the bureau.

  1. Evidence that an employee has completed the training must be included in his personnel file kept at the facility.

NAC 432A.326 Continuing training. (NRS 432A.077)

  1. After completion of the initial training required pursuant to NAC 432A.323, each director and licensee of a child care facility and each caretaker who is employed at the facility shall participate in a program of training in child care for at least 12 hours in each year, of which not more than 3 hours may be training in how to perform cardiopulmonary resuscitation. The program may be in the form of:

(a) Workshops or conferences;

(b) Formal training, or

(c) Training at a child care facility during the period of employment.

  1. The program must be provided or approved by the chief of the bureau.

NAC 432A.340 Information to be provided by parent; maintenance-of record for each child

  1. Procedures for admission must provide the caretaker with sufficient information and instruction from the parents to enable the caretaker to prepare a record and to make decisions or act on behalf of the child.

  1. Before the admission of a child to a facility, the parent shall give the following information to the caretaker:

(a) The child's full legal name, date of birth, current address and preferred name;

(b) The name, address and telephone number of each parent responsible for the child and any special instructions needed to reach the parent during the hours the child is in the facility;

(c) The name, address and telephone number of any person who can assume responsibility for the child and is authorized to take the child from the facility if the parents cannot be reached;

(d) Information concerning the health of the child, including any special needs of the child; and

(e) A written authorization signed by a parent which allows emergency surgical and medical care.

  1. The caretaker shall, unless the facility is an accommodation facility:

(a) Make a record for each child that includes the date the record was prepared and the date the child is scheduled to attend the facility; and

(b) Maintain each record in good order.

NAC 432A.350 Information to be provided by facility; criteria for admission into facility that provides care for ill children. (NRS 432A.077)

  1. Every licensee of a facility shall adopt a written statement which:

(a) Sets forth the general services to be offered to the children;

(b) Provides for the special needs of each child;

(c) States the requirements for admission and procedures for enrollment;

(d) Sets forth fees and any plan for payment of fees;

(e) Provides rules relating to personal belongings brought to the facility;

(f) Covers arrangements for transportation;

(g) Requires written parental permission for trips and activities outside the facility;

(h) Provides for parental involvement in the general functions of the facility;

(i) Gives either or both parents the right to observe the program of the licensee before enrollment and at any time after enrollment of the child;

(j) Notifies either or both parents if smoking of tobacco is permitted on the premises of the facility in a designated area approved by the fire authority;

(k) Notifies either or both parents if and when a member of the staff who is trained and certified in cardiopulmonary resuscitation (CPR) is on duty at the facility; and

(1) Notifies either or both parents of the contents of any plan created pursuant to NAC 432A.280 to ensure that the staff of the facility is prepared to respond to an emergency.

  1. In addition to the information required by subsection 1, a licensee for a facility that provides care for ill children shall adopt criteria for admission that set forth:

(a) The illnesses and disabilities that are accepted;

(b) The illnesses and disabilities that are not accepted;

(c) The ages of children served by the facility;

(d) The information required from a parent before a child may be admitted to the facility; and

(e) The procedures to be followed by the staff of the facility in the event of an emergency.

  1. Every licensee shall provide a copy of the statement described in subsection 1 to each paid or volunteer member of its staff, to each parent of a child enrolled in the facility and to the bureau.

  1. The name, business address and business telephone number of any person who has legal or administrative responsibility for the facility must be provided to each parent of a child enrolled in the facility and to the bureau.

  1. The licensee of a facility shall notify each parent of a child enrolled in the facility and the bureau of significant changes in the services offered by the facility.

NAC 432A.360 Limitation on disclosure of information pertaining to child.

  1. The licensee of a facility shall not disclose to any person who is not a member of the staff of the facility or a member of the licensing staff of the bureau information pertaining to any child, unless:

(a) The parent has given written permission for the disclosure; or

(b) There is an emergency as determined by the director or the member of the staff who is in charge at the time of the emergency.

  1. The licensee of a facility shall have available forms which allow a parent to release information pertaining to his child.

NAC 432A.370 Evidence and record of health of child.

  1. Evidence of each child's health must be presented to the director of a facility, other than an accommodation facility or a facility that provides care for ill children, within 30 days after his initial admission. The evidence must include a written statement from a licensed physician or registered nurse attesting to the status of the child's health and stating that all known special conditions are under treatment and the child is capable of adjusting to the programs of the facility.

  1. A licensee of each such facility shall keep a record of each child which includes any pertinent information on the status of the child's health and any special needs of the child.

NAC 432A.372 Medical care: Chart and first-aid kit; written provisions; directory.

  1. An easily understandable chart describing first aid and emergency treatment must be available in each facility. A well-stocked first-aid kit must be readily available at all times.

  1. Every licensee of a facility other than an accommodation facility shall have written provisions for:

(a) Consulting with physicians or registered nurses regarding the health of the children;

(b) Obtaining assistance in developing and maintaining current health policies; and

(c) Informing members of the staff on matters of health affecting the children, including dental health and personal cleanliness and care.

  1. A written directory of emergency health services must be readily available in the facility. The directory must include the name, address and telephone number of:

(a) A hospital, clinic or other constantly staffed medical facility;
and

(b) A physician or registered nurse to be called for each child if the parents of the child have signed a written agreement stating that the person is acceptable.

NAC 432A.374 Medical care: Isolation of ill or injured child; transportation of child.

  1. If a child becomes seriously ill or injured in a child care facility, other than a facility that provides care for ill children, he must be immediately isolated from other children and placed under appropriate supervision. A parent, a person designated by a parent or a physician designated by a parent, must be promptly notified and the child must be removed from the facility as quickly as possible. Members of the staff of a facility shall not administer any medical treatment, except emergency first aid and prescribed medications to the child.

  1. If a member of the staff transports or accompanies a child for professional emergency care, he shall remain with the child until the parents assume responsibility for the care of the child.

NAC 432A.376 Medication.

Except as otherwise provided in NAC 432A.585:

  1. Each prescribed medication must be plainly labeled, contain the name of the child or adult for whom it is prescribed and be stored in a locked cabinet or be made inaccessible to children. Medications for external use must be kept in a separate section of the locked cabinet. Medications stored in a refrigerator must be made inaccessible to children.

  2. Except in an emergency, only one person designated by the licensee of a facility may administer medications to children.

  3. The licensee of a facility shall maintain a written record containing:

    (a) The name of each medication administered;

    (b) The name of the child to whom it was administered; and

    (c) The date and time on which it was administered on a weekly basis. The record must be kept in the child's file.

  4. A prescribed medication must, upon discontinuance of use, be promptly destroyed or returned to the child's parent.

NAC 432A.378 Reports of accident, injury, communicable disease or death.

  1. Upon the occurrence of any accident or injury which requires emergency professional medical care of a child, the director, operator or owner of each facility shall report the occurrence to the bureau or local licensing agency as soon as possible and shall keep on file at the facility a report of the occurrence.

  1. If the director, operator or owner of a facility finds that any reportable communicable disease may be present in the facility, he shall report that condition to the bureau or local licensing agency as soon as possible. The bureau or local licensing agency shall provide the list of reportable communicable diseases to all licensees and applicants.

  1. The director, operator or owner of each facility shall report as soon as possible to the bureau or local licensing agency the death of any child who attends or lives in the facility.

NAC 432A.380 Nutrition.

  1. To the extent set forth in subsection 3, a licensee of a facility shall meet the daily nutritional needs of each child. Meals and snacks must be of a quality and quantity which supplements the food served at home. Cultural and ethnic foods which are appropriate for children must be considered in planning meals. To the extent possible, information provided by parents concerning their child's eating habits and preferences or special needs regarding food must be considered in planning for meals.

  1. A licensee of a facility shall consult the bureau or local licensing agency or some other public agency for nutritional information which is applicable to children of ages receiving care at the facility.

  1. A licensee of a facility shall serve every child who stays in the facility:

(a) For 5 or more but less than 10 hours per day, a quantity of food which will supply at least one-third of the recommended dietary allowance established by the Food and Nutrition Board of the National Academy of Sciences.

(b) For 10 or more hours per day, a quantity of food which will supply at least one-half of the recommended dietary allowance established by that board.

  1. Foods and beverages which are sweet or have little nutritional value must not be served to children except as an addition to the meals or snacks served to comply with the requirements of subsection 3.

  1. Every menu must be in writing, dated, planned a week in advance, and kept on file in the facility for at least 90 days after the corresponding meal is served. The licensee of a facility shall post the current menu, including any changes, in the kitchen and in a public place within the facility convenient for parental inspection. Family homes and group homes are exempt from the requirements of this subsection.

  1. A child may bring his lunch to a facility in a properly identified bag or other container. The licensee of a facility shall refrigerate such lunches or place them in a cold, protected area.

  1. A child is not allowed in the kitchen of any facility unless he is supervised.

  1. Whenever possible, members of the staff of the facility must eat with the children and encourage them to eat a variety of food and observe table manners.

  1. Drinking water must be freely available to all children at all times.

  1. Food must not be used as a basis for discipline or reward. Children should be encouraged, but must not be forced, to eat.

NAC 432A.385 Snacks and meals. (NRS 432A.077)

  1. The staff of each facility shall:

(a) Provide appropriate and adequate seating for the children at the facility during snacks and meals;

(b) If a high chair is used, ensure that the chair:

(1) Is in good condition;

(2) Has a wide base; and

(3) Has a safety belt for the child;

(c) Wash with a detergent and disinfect after each use any chair or table that is used during a snack or meal;

(d) Allow, encourage and assist each child to feed himself, including, without limitation, encouraging a child to hold and drink from a cup, use a spoon and use his fingers to feed himself;

(e) Offer each child drinking water at times other than during his regular feedings;

(f) Discard any food that is left in a dish after a meal;

(g) Store each bottle of formula and container of food in accordance with the instructions from the manufacturer of the formula or food;

(h) Label each bottle of formula and container of food with the name of the child to whom it belongs and the date the formula or food was prepared by the facility or was prepared or purchased by the parent;

(i) Immediately refrigerate and label each container of breast milk provided by a parent;

(j) Return each bottle to the appropriate parent each day;

(k) Return any unused, open container of food to the appropriate parent each day if the child was not fed directly from the container of food; and

(l) Develop with the parents of a child a plan for feeding the child, which must include, without limitation:

(1) Instructions for feeding;

(2) Any special dietary restrictions, including, without limitation, any allergies to food;

(3) A schedule of times for feeding;

(4) Whether the child will be fed breast milk, formula or solid food; ,

(5) If the child will be fed breast milk or formula, when to begin feeding solid food; and

(6) Likes and dislikes of certain foods.

  1. A child who is fed with a bottle and does not hold his own bottle must be held by a caretaker while being fed with a bottle. The bottle must not be propped for feeding. A child who demonstrates a preference for holding a bottle during feeding may hold his own bottle and need not be held by a caretaker if the caretaker is directly observing the child.

  1. The staff of a facility may feed a child commercially prepared baby food directly from the jar in which it was packaged or from a separate dish. If the staff feeds the child from the jar, the staff shall discard the jar after it is used.

NAC 432A.390 Standards for programs.

  1. Every licensee of a facility shall develop a program to meet the basic needs of children for:

(a) Good health and normal physical development;

(b) Optimal mental growth;

(c) Stimulating language and communicative experiences;

(d) The attention, acceptance and affection of others;

(e) Opportunities to experience success and to test mental, physical and social skills;

(f) Self-identity and a sense of competence and worth;

(g) The security provided by gentle discipline;

(h) Relations with others which set forth the rights of adults and the rights of children;

(i) Learning experiences planned with the aid of the child's parents which ensure harmony with the life style and cultural background of the child;

(j) Activities which facilitate social growth and adjustment; and

(k) The time and opportunity to learn independence and personal care.

  1. A licensee of a facility shall teach each child personal hygiene. The licensee of a facility shall require all children to wash before meals and after using a toilet.

  1. If the weather permits, all children must have a daily period of outdoor play. A licensee of a facility shall provide opportunities for active play which builds muscles such as climbing, jumping, running and playing with toys which have wheels. The quantity and quality of materials and equipment must be sufficient to avoid excessive competition between the children and long waiting periods to use the materials or equipment.

  1. Every child who is in a facility for more than 5 hours per day must have a period for a nap during the day. A child who cannot sleep must rest during the period provided for a nap. The licensee of a facility shall provide a cot, mat or bed for each child.

  1. The amount, variety and arrangement and use of materials and equipment used in a facility must be appropriate to the developmental needs of the children cared for in the facility. Materials must be stored in a manner that allows children to select, remove and replace the materials independently or with minimal assistance.

  1. Furniture must be durable, safe and intended for use by children or appropriately adapted for use by children.

  1. A licensee of a facility shall provide space for the storage of the children's clothing and the storage must be within easy reach of the children.

NAC 432A.400 Discipline.

  1. A licensee of a facility shall enhance a child's behavior through positive guidance, redirection of the child's behavior and the setting of clear-cut limits on behavior.

  1. A member, employee or other person associated with a facility shall not, for any reason:

(a) Inflict physical punishment, in any manner or form, upon any child;

(b) Verbally abuse or threaten a child;

(c) Make derogatory remarks about the child or his family;

(d) Threaten a child with the loss of love of any person;

(e) Threaten a child with punishment by a deity;

(f) Subject a child to any form of punishment which pertains to food or rest or restricts the use of a toilet or other bathroom fixture; or

(g) Subject a child to any form of punishment by other children. Parental consent to allow any person within the facility to punish a child contrary to the provisions of this section is void.

  1. Disciplinary measures used in a facility must be consistent with supportive, positive action, and may include:

(a) Holding a child's arm to prevent hitting;

(b)Bodily picking up the child and removing him from the group, and:

(1) Sitting with the child until he is ready to play without hitting; or

(2) Isolating the child under observation for no more than 10 minutes;

(c) Informing the child in a simple, positive manner what conduct is expected while he is in the facility;

(d) Praising and recognizing a child who behaves in the expected manner; and

(e) Directing a child who is in a situation that is creating problems to a new activity.

NAC 432A.410 Reports of child abuse or neglect.

If any person suspects that child abuse or neglect is occurring in a facility, the person may immediately report his suspicions to the bureau. Every licensee or employee of a facility who has reason to believe child abuse or neglect is occurring in the facility, in the child's home or elsewhere shall report his beliefs to the appropriate authority as required in NRS 432B.220.

NAC 432A.411 Sanitary measures for changing diapers. (NRS 432A.077)

  1. Each area in a facility that is used for changing diapers must:

(a) Have a smooth, nonabrasive, impervious surface;

(b) Be located within close proximity to a sink that is not used for the preparation of food;

(c) Not be located in an area in which food is prepared;

(d) Have a smooth, nonabsorbent floor covering;

(e) Have nearby, for wet or soiled diapers, a washable receptacle that is lined with plastic and covered with a lid;

(f) Be kept in good repair and in a safe condition; and

(g) Be cleaned and disinfected after each use by removing any visible soil and applying an approved disinfectant.

  1. Each soiled cloth diaper and any soiled clothing that may be contaminated with contagious matter must be stored in an individual plastic bag and be returned to the parents daily.

  1. The staff of a facility:

(a) Shall discourage children from coming near an area that is used for changing diapers; and

(b) Shall not leave a child unattended in the diaper changing area.

NAC 432A.412 Written procedures for washing of hands. (NRS 432A.077)

  1. Each facility must have written procedures concerning the washing of hands.

  1. The staff of a facility shall follow the procedures of the facility concerning the washing of hands and shall instruct, monitor and assist the children being cared for at the facility to ensure that the children follow the procedures.

  1. The procedures concerning the washing of hands must require, without limitation, that:

(a) The staff of the facility wash their hands with soap from a dispenser and warm water:

(1) Any time that their hands come into contact with blood, mucus, vomit, feces or urine;

(2) Before preparing or handling food;

(3) Before engaging in any activity related to serving food, including, without limitation, setting the table;

(4) Before and after eating a meal or snack;

(5) After using the toilet, helping a child use the toilet or changing a diaper with or without gloves;

(6) After attending to an ill child; and

(7) After handling an animal.

(b) The children being cared for in the facility wash their hands with soap from a dispenser and warm water:

(1) Any time that their hands come into contact with blood, mucus, vomit, feces or urine;

(2) Before handling food;

(3) Before and after eating a meal or snack; and

(4) After handling an animal.

(c) The staff of the facility shall ensure that:

(1) Each bathroom has running water, soap and single-use or disposable towels; and

(2) Any common basin or sink which is filled with standing water is not used for the washing of hands.

NAC 432A.413 Written guidelines for toilet training. (NRS 432A.077)

  1. Each facility must develop written guidelines concerning the methods used by the staff of the facility for toilet training and the use of appropriate equipment and clothing for such training.

  1. The guidelines concerning toilet training must be distributed to each parent of each child being cared for at the facility who is not yet toilet trained.

  1. The guidelines must require the staff of the facility:

(a) Not to force a child to remain on the toilet for a prolonged period of time or punish a child for wetting or soiling his clothing;

(b)Not to leave a child unattended while the child is sitting on a potty-chair or on the toilet;

(c) To instruct and assist the children in washing their hands after using the toilet; and

(d) If a potty-chair is used to train a child to use the toilet, to:

(1) Place the potty-chair on a washable, impervious floor;

(2) Use the potty-chair in accordance with the instructions from the manufacturer;

(3) Ensure that the potty-chair is stored and used in an area that is not in close proximity to an area used for the preparation of food;

(4) Empty the potty-chair into a toilet immediately after each use; and

(5) Thoroughly clean and disinfect the potty-chair after each use.

NAC 432A.414 Sanitary measures for floors, rugs, carpets and nonporous surfaces. (NRS 432A.077)

  1. A carpeted floor or rug on a floor that is too large to wash in a washing machine must be vacuumed not less than one time each day or more often if necessary and professionally cleaned not less than one time every 3 months or more often if necessary.

  1. Each floor of a facility that is not carpeted must be swept and mopped not less than one time each day or more often if necessary.

  1. When cleaning a nonporous surface in a facility, including, without limitation, cleaning toys, cribs, tables, high chairs and surfaces used to change diapers, the staff of the facility shall:

(a) Clean the surface first with soap and water to remove any dirt or debris; and

(b) Disinfect the surface with a disinfecting agent.

  1. The disinfecting agent used pursuant to subsection 3 must consist of:

(a) One-fourth of a cup of liquid chlorine bleach added to 1 gallon of water that is prepared fresh daily;

(b) One tablespoon of liquid chlorine bleach added to 1 quart of water that is prepared fresh daily; or

(c) A solution that is approved by the appropriate state or local agency and is at least as effective as the solutions described in paragraphs (a) and (b).

NAC 432A.415 Safety and sanitation of toys, equipment and other objects and material used for play. (NRS 432A.077)

  1. Equipment and any material other than a toy that is used for play in a facility must be durable and free from characteristics that may be hazardous or injurious to a child who is less than 2 years of age, including, without limitation, such characteristics as sharp or rough edges, toxic paint or objects that are small enough for a child of that age to swallow and choke on.

  1. Any object, toy or component of a toy that is accessible by a child who is less than 3 years of age at a facility must meet the federal size requirements set forth in 16 C.F.R. § 1501.4.

  1. Toys with sharp points or edges, plastic bags and objects made from Styrofoam must not be accessible to a child who is less than 3 years of age.

  1. A toy or any other piece of equipment that is used for play must be made of a material that is capable of being disinfected and must be cleaned and disinfected promptly after the toy or other piece of equipment has been soiled or put into the mouth of a child, or not less than one time each day.

  1. The staff of a facility shall not provide a stuffed animal to any child unless the stuffed animal is laundered or disinfected not less than one time each day or more often if necessary.

  1. Toys placed in a crib at a facility must be appropriate for the age of the child using the crib. The staff of a facility shall adhere to any requirement set forth on the label of a toy regarding the safe use of the toy.

  1. Each room at a facility that is used for play and other activities for children must have:

(a) Low, open shelves to store toys;

(b) An adequate supply of toys that are appropriate for the age of the children;

(c) Tables and chairs that are the appropriate size for the children; and

(d) Any other equipment that is necessary to meet the needs of the children.

NAC 432A.416 Sleeping devices; napping. (NRS 432A.077)

  1. The staff of each facility shall:

(a) Use a safe, sturdy, well-constructed, single-level, free-standing crib, portable crib or playpen for children to sleep in;

(b)Equip any such sleeping device with a waterproof, firm-fitting mattress;

(c) Ensure that each crib to be used by a child who is 6 months of age or younger is constructed with vertical slats that are not more than 2 3/8 inches apart;

(d) Ensure that a child who is 18 months of age or younger sleeps in a crib which is appropriate for his age or in another sleeping device which has been approved by the bureau;

(e) Ensure that a child who is older than 18 months of age sleeps in an appropriate crib or on a cot or mat;

(f) Ensure that each sleeping device has appropriate bedding and a waterproof and washable covering;

(g) Wipe clean each sleeping device with a disinfectant not less than one time each week or more often if necessary;

(h) Ensure that the bedding that each child uses is used only for that particular child;

(i) Replace the bedding each time it is wet or soiled by a child or when the sleeping device is to be used by another child;

(j) Within 15 minutes after a child in a crib has awakened from a nap, take the child out of the crib and engage him in an appropriate activity;

(k) Ensure that each child takes a nap as needed;

(1) Ensure that each napping child is in an area from which the staff can readily hear and see the child; and

(m) Ensure that each napping child is checked by a caretaker not less than one time every 15 minutes.

  1. The staff of a facility shall not change the diaper of a child in a crib or other sleeping device.


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