Licensing Standards for DayCare Centers

Section 10:122-8.3
Requirements for Additional Staff for Centers Serving Sick Children

GEN (a) The staff requirements for centers serving sick childrenx "sick child care:staff" are as follows:

1. In addition to the staff membersx "staff members:for sick child care" required in N.J.A.C. 10:122-4.2, the center shall ensure that a physicianx "physician:sick child care staff" licensed by the New Jersey Board of Medical Examiners or a registered nursx "nurse:sick child care staff"e licensed by the New Jersey State Board of Nursing is at the center during the hours children are in attendance.

2. The staff member specified in (a)1 above may also serve as the head teacherx "head teacher", group teacherx "group teacher", or program supervisorx "program supervisor" where applicable, provided that:

   i. The person meets the staff qualification requirements for such positions, based on the center size and type, as specified in N.J.A.C. 10:122-4.6(c) and (d); or

   ii. The person has two years of work experience with children of the age group being served.

3. In centers that primarily serve well children and provide sick care only as a component of the overall program, the physicianx "physician:sick child care staff" or registered nursex "nurse:sick child care staff", as specified in (a)1 above, shall be required to be at the center for at least 50 percent of the sick care component's daily operating hours, and shall be on call and available to come to the center immediately at all other times, provided that the following conditions are met:

   i. The physician or registered nurse is present at all times when children are being admitted to the center;

   ii. Sick care is provided only to children who are regularly enrolled in the center's program serving well children;

   iii. No more than eight children are served in the sick care component at any one time;

   iv. Children under six months of age are not admitted to the sick child care component at any time;

   v. A child has attended the center's program serving well children for at least 20 days before being allowed admission to the sick care component;

   vi. The physician or registered nurse assesses that no child will be placed at risk during the time when the physician or registered nurse is absent; and

   vii. The on-call physician or nurse does not serve as the center's head teacher.

4. In centers specified in (a)3 above, the provisions specified in (a)3i through vii above need not be met if the physician or registered nurse remains at the center during all hours the children are in attendance.

1. The physician or registered nurse, as specified in (a)1 above, shall be responsible for developing and implementing the center's medical program, including:

   i. Conducting the daily admission assessment of each child, as specified in N.J.A.C. 10:122-8.1(c)4;

   ii. Maintaining records on each child, as specified in N.J.A.C. 10:122-8.7(a); and

   iii. Reviewing and administering medicationx "medication:designated staff", as specified in N.J.A.C. 10:122-7.5(b), as applicable for each child.

Age of Child	Staff/Child Ratio
Birth up to 3 months of age	1:1
3 months up to 18 months of age	1:3
18 months up to 2 ½ years of age	1:5
2 ½ years of age and above	1:7

(d) Groupingx "sick child care:grouping" of children shall be as follows:

1. The center shall group children according to the illnesses categorized below:

   i. Upper-respiratory;

   ii. Gastro-intestinal;

   iii. Chicken pox; and

   iv. Any other illness that has been included in the center's admission policy.

1. The center shall provide trainingx "sick child care:training" for each new staff member upon beginning work at the center and for all staff members annually.

2. Such training shall include:

   i. Basic knowledge of first aidx "first aid:training" principles;

   ii. Recognizing the symptoms of illness;

   iii. Feeding sick children;

   iv. When and how to call for medical advice;

   v. Taking children's temperatures;

   vi. Any other care that may be required for admissible illnesses and conditions;

   vii. Infection control;

   viii. Review of center policies and procedures;

   ix. Child development, including activities for children who are sick; and

   x. Communicating with parents concerning a child's illness.

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