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10A NCAC 09 .0102 DEFINITIONS
The terms and phrases used in this Subchapter shall be defined as follows except when the content of the rule clearly requires a different meaning. The definitions prescribed in G.S. 110-86 also apply to these Rules.
(1) "Agency" means Division of Child Development, Department of Health and Human Services located at 319 Chapanoke Road, Suite 120, Raleigh, North Carolina 27603.
(2) "Appellant" means the person or persons who request a contested case hearing.
(3) "Basic School-Age Care Training" (BSAC Training) means the seven clock hours of training developed by the North Carolina State University Department of 4-H Youth Development for the Division of Child Development on the elements of quality school-age care.
(4) "Child Care Program" means a single center or home, or a group of centers or homes or both, which are operated by one owner or supervised by a common entity.
(5) "Child care provider" as defined by G.S. 110-90.2 (a) (2) a. and used in Section .2700 of this Subchapter, includes but is not limited to the following employees who have contact with the children in a child care program: facility directors, administrative staff, teachers, teachers' aides, cooks, maintenance personnel and drivers.
(6) "Child Development Associate Credential" means the national early childhood credential administered by the Council for Early Childhood Professional Recognition.
(7) "Developmentally appropriate" means suitable to the chronological age range and developmental characteristics of a specific group of children.
(8) "Division" means the Division of Child Development within the Department of Health and Human Services.
(9) "Drop-in care" means a child care arrangement where children attend on an intermittent, unscheduled basis.
(10) "Early Childhood Environment Rating Scale - Revised edition" (Harms, Cryer, and Clifford, 1998, published by Teachers College Press, New York, NY) is the instrument used to evaluate the quality of care received by a group of children in a child care center, when the majority of children in the group are two and a half years old through five years old, to achieve three through five points for the program standards of a rated license. This instrument is incorporated by reference and includes subsequent editions. Individuals wishing to purchase a copy may call Teachers College Press at 1-800-575-6566. The cost of this scale at the time of rule publication in August 2002 is twelve dollars and ninety-five cents ($12.95). A copy of this instrument is on file at the Division at the address given in Item (1) of this Rule and will be available for public inspection during regular business hours.
(11) "Family Day Care Rating Scale" (Harms and Clifford, 1989, published by Teachers College Press, New York, NY) is the instrument used to evaluate the quality of care received by children in family child care homes to achieve three through five points for the program standards of a rated license. This instrument is incorporated by reference and includes subsequent editions. Individuals wishing to purchase a copy may call Teachers College Press at 1-800-575-6566. The cost of this scale at the time of rule publication in August 2002 is twelve dollars and ninety-five cents ($12.95). A copy of this instrument is on file at the Division at the address given in Item (1) of this Rule and will be available for public inspection during regular business hours.
(12) "Group" means the children assigned to a specific caregiver, or caregivers, to meet the staff/child ratios set forth in G.S. 110-91(7) and this Subchapter, using space which is identifiable for each group.
(13) "Household member" means a person who resides in a family home as evidenced by factors including, but not limited to, maintaining clothing and personal effects at the household address, receiving mail at the household address, using identification with the household address, or eating and sleeping at the household address on a regular basis.
(14) "Infant/Toddler Environment Rating Scale" (Harms, Cryer, and Clifford, 1990, published by Teachers College Press, New York, NY) is the instrument used to evaluate the quality of care received by a group of children in a child care center, when the majority of children in the group are younger than thirty months old, to achieve three through five points for the program standards of a rated license. This instrument is incorporated by reference and includes subsequent editions. Individuals wishing to purchase a copy may call Teachers College Press at 1-800-575-6566. The cost of this scale at the time of rule publication in August 2002 is twelve dollars and ninety-five cents ($12.95). A copy of this instrument is on file at the Division at the address given in Item (1) of this Rule and will be available for public inspection during regular business hours.
(15) "ITS-SIDS Training" means the Infant/Toddler Safe Sleep and SIDS Risk Reduction Training developed by the NC Healthy Start Foundation for the Division of Child Development for caregivers of children ages 12 months and younger.
(16) "Licensee" means the person or entity that is granted permission by the State of North Carolina to operate a child care facility.
(17) "North Carolina Early Childhood Credential" means the state early childhood credential that is based on completion of coursework and standards found in the North Carolina Early Childhood Instructor Manual. These standards are incorporated by reference and include subsequent amendments. A copy of the North Carolina Early Childhood Credential requirements is on file at the Division at the address given in Item (1) of this Rule and will be available for public inspection or copying at no charge during regular business hours.
(18) "Operator" means the person or entity held legally responsible for the child care business. The terms "operator", "sponsor" or "licensee" may be used interchangeably.
(19) "Owner" means any person with a five percent or greater equity interest in a child care facility, whether that interest is held directly or through a trust, estate, partnership, corporation, joint stock company, consortium, or any other group, entity, organization or association.
(20) "Parent" means a child's parent, legal guardian, or full-time custodian.
(21) "Part-time care" means a child care arrangement where children attend on a regular schedule but less than a full-time basis.
(22) "Passageway" means a hall or corridor.
(23) "Person, as used in the definition of "owner" in Item (19) of this Rule, means any individual, trust, estate, partnership, corporation, joint stock company, consortium, or any other group, entity, organization, or association."
(24) "Preschooler" or "preschool-aged child" means any child who does not fit the definition of school-aged child in this Rule.
(25) "School-Age Care Environment Rating Scale" (Harms, Jacobs, and White, 1996, published by Teachers College Press) is the instrument used to evaluate the quality of care received by a group of children in a child care center, when the majority of the children in the group are older than five years, to achieve three through five points for the program standards of a rated license. This instrument is incorporated by reference and includes subsequent editions. Individuals wishing to purchase a copy for may call Teachers College Press at 1-800-575-6566. The cost of this scale at the time of rule publication in August 2002 is twelve dollars and ninety-five cents ($12.95). A copy of this instrument is on file at the Division at the address given in Item (1) of this Rule and will be available for public inspection during regular business hours.
(26) "School-aged child" means any child who is at least five years old on or before October 16 of the current school year and who is attending, or has attended, a public or private grade school or kindergarten; or any child who is not at least five years old on or before October 16 of that school year, but has been attending school during that school year in another state in accordance with the laws or rules of that state before moving to and becoming a resident of North Carolina; or any child who is at least five years old on or before April 16 of the current school year, is determined by the principal of the school to be gifted and mature enough to justify admission to the school, and is enrolled no later than the end of the first month of the school year.
(27) "Seasonal Program" means a recreational program as set forth in G. S. 110-86(2)(b).
(28) "Section" means Division of Child Development.
(29) "Substitute" means any person who temporarily assumes the duties of a staff person for a time period not to exceed two consecutive months.
(30) "Temporary care" means any child care arrangement which provides either drop-in care or care on a seasonal or other part-time basis and is required to be regulated pursuant to G.S. 110-86.
(31) "Volunteer" means a person who works in a child care facility and is not monetarily compensated by the facility.
History Note: Authority G.S. 110-88; 143B-168.3; Eff. January 1, 1986; Amended Eff. April 1, 1992; October 1, 1991; October 1, 1990; November 1, 1989; Temporary Amendment Eff. January 1, 1996; Amended Eff. May 1, 2004; April 1, 2003; July 1, 2000; April 1, 1999; July 1, 1998; April 1, 1997.
SECTION .0200 - GENERAL PROVISIONS RELATED TO LICENSING
10A NCAC 09 .0201 INSPECTIONS
The Division shall periodically visit and inspect all child care centers to insure compliance with North Carolina General Statutes and those rules and regulations adopted pursuant thereto.
(1) A representative of the Division shall conduct an announced visit prior to the initial issuance of the license. The prospective or current licensee shall be notified in advance about the visit. This Rule does not apply to the investigation of centers that are operating without a license in violation of the law.
(2) At the beginning of each fiscal year, the Division shall prepare a written plan explaining the guidelines for making announced and unannounced visits to licensed child care centers. The plan shall be dated and signed by the Division director and shall be kept in a confidential file.
(3) A representative of the Division may make unannounced visits to any licensed center whenever the Division receives a complaint alleging violation of the licensing law or the rules in this Subchapter, or if a representative of the Division has reason to believe an emergency exists in the center.
History Note: Authority G.S. 110-105; 143B-168.3; Eff. January 1, 1986; Amended Eff. July 1, 1998.
10A NCAC 09 .0202 RESERVED FOR FUTURE CODIFICATION
10A NCAC 09 .0203 RESERVED FOR FUTURE CODIFICATION
10A NCAC 09 .0204 CHANGES REQUIRING ISSUANCE OF A NEW LICENSE
(a) When the operator, as defined in Rule .0102, of a licensed child care center changes, the new operator must apply for a new license at least 30 days prior to assuming ownership of the center. A child care license cannot be bought, sold, or transferred by one operator to another.
(b) When a licensed child care center is to be moved from one location to another, the licensee must apply for a license for the new physical location as prescribed in Section .0300 of this Subchapter. The licensee must obtain the new license prior to occupying the new location. A child care license is not transferable from one location to another.
(c) When a licensee desires to change the licensed capacity of a center, the licensee must notify the Division.
(1) If the licensee wishes to increase the licensed capacity by using space not currently approved for child care, the Division shall provide the licensee with appropriate forms to request approval. Once the additional space is approved, a new license shall be issued to reflect the increase in licensed capacity.
(2) If a licensee wishes to increase the center's licensed capacity by using space that is already approved for child care, the Division shall, upon request, issue a new license showing the increase.
(3) If a licensee wishes to decrease the center's licensed capacity, the Division shall, upon request, issue a new license reflecting the decrease.
(d) When a licensee decides to conform with requirements in order to remove a restriction on the age or number of children who can be served in the center, the licensee shall notify the Division. The Division shall supply forms for the licensee to use to obtain approval from the local inspectors, if necessary. When the Division is notified that the center conforms with all applicable requirements, a new license, without the restriction, shall be issued.
History Note: Authority G.S. 110-88(8); 110-93; 143B-168.3; Eff. January 1, 1986; Amended Eff. July 1, 1998; July 1, 1988; January 1, 1987.
10A NCAC 09 .0205 PARENTAL ACCESS
The parent, guardian or full-time custodian of a child enrolled in any child care center subject to regulation under Article 7 of Chapter 110 of the North Carolina General Statutes shall be allowed unlimited access to the center during its operating hours for the purposes of contacting the child or evaluating the center and the care provided by the center. The parent, guardian or custodian shall notify the on-site administrator of his or her presence immediately upon entering the premises.
History Note: Authority G.S. 110-85; 110-91; 143B-168.3; Eff. July 1, 1988; Amended Eff. July 1, 1998; November 1, 1989.
10A NCAC 09 .0206 CAPACITY OF THE CENTER
(a) The licensed capacity shall be no greater than the number of children that the total primary space, as defined in Rule .1401, used by children can accommodate at 25 square feet per child.
(b) The number of children present at the center shall not exceed the licensed capacity of the center.
(c) The number of children occupying any room of the center shall not exceed the number that the primary space in that room will accommodate at 25 square feet per child except as provided in Rule .1401 of this Subchapter.
History Note: Authority G.S. 110-88(1a); 110-91(6); 143B-168.3; Eff. January 1, 1991; Amended Eff. July 1, 1998.
10A NCAC 09 .0207 SCHOOL-AGE CHILDREN OF THE OPERATOR
History Note: Authority G.S. 110-86(3); 143B-168.3; Eff. October 1, 1991; Repealed Eff. July 1, 1998.
SECTION .0300 - PROCEDURES FOR OBTAINING A LICENSE
10A NCAC 09 .0301 PRE-LICENSING REQUIREMENTS
(a) Anyone who wishes to obtain a license to operate a child care center shall first request pre-licensing consultation from the Division.
(b) Upon receiving a request a representative of the Division shall schedule a visit with the person requesting consultation, unless the person requesting consultation meets the criteria described in Rule .0302(g) of this Section. The Division shall furnish the forms required to be completed and submitted in order to apply for a license.
(c) The Division shall provide regularly scheduled licensing workshops for new and existing child care centers. A schedule of these workshops may be obtained from the Division at the address given in Rule .0102 of this Subchapter.
History Note: Authority G.S. 110-88(1); 110-88(5); 143B-168.3;Eff. January 1, 1986; Amended Eff. July 1, 1998.
10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER
(a) The individual who will be legally responsible for the operation of the center, which includes assuring compliance with the licensing law and standards, shall apply for a license using the form provided by the Division. If the operator will be a group, organization, or other entity, an officer of the entity who is legally empowered to bind the operator shall complete and sign the application.
(b) The applicant shall arrange for inspections of the center by the local health, building and fire inspectors. The applicant shall provide an approved inspection report signed by the appropriate inspector to the Division representative.
(1) A provisional classification may be accepted in accordance with Rule .0401(1) of this Subchapter.
(2) When a center does not conform with a specific building, fire, or sanitation standard, the appropriate inspector may submit a written explanation of how equivalent, alternative protection is provided. The Division may accept the inspector's documentation in lieu of compliance with the specific standard. Nothing in this Regulation is to preclude or interfere with issuance of a provisional license pursuant to Section .0400 of this Subchapter.
(c) The applicant, or the person responsible for the day-to-day operation of the center, shall be able to describe the plans for the daily program, including room arrangement, staffing patterns, equipment, and supplies, in sufficient detail to show that the center shall comply with applicable requirements for activities, equipment, and staff/child ratios for the capacity of the center and type of license requested. The applicant shall make the following written information available to the Division for review to verify compliance with provisions of this Subchapter and the licensing law:
(1) daily schedules;
(2) activity plans;
(3) emergency care plan;
(4) discipline policy;
(5) incident reports;
(6) incident logs; and
(7) a copy of the certified criminal history check for the applicant, or the applicant's designee as defined in Rule .2701(g) of this Subchapter, from the Clerk of Superior Court's office in the county or counties where the individual has resided during the previous 12 months.
(d) The applicant shall, at a minimum, demonstrate to the Division representative that measures shall be implemented to have the following information in the center's files and readily available to the representative for review:
(1) Staff records which include an application for employment and date of birth; documentation of previous education, training, and experience; medical and health records; documentation of participation in training and staff development activities; and required criminal records check documentation;
(2) Children's records which include an application for enrollment; medical and immunization records; and permission to seek emergency medical care;
(3) Daily attendance records;
(4) Records of monthly fire drills giving the date each drill is held, the time of day, the length of time taken to evacuate the building, and the signature of the person who conducted the drill;
(5) Records of monthly playground inspections documented on a checklist provided by the Division; and
(6) Records of medication administered.
(e) The Division representative shall measure all rooms to be used for child care and shall assure that an accurate sketch of the center's floor plan is part of the application packet. The Division representative shall enter the dimensions of each room to be used for child care, including ceiling height, and shall show the location of the bathrooms, doors, and required exits on the floor plan.
(f) The Division representative shall make one or more inspections of the center and premises to assess compliance with all applicable requirements.
(1) If all applicable requirements of G.S. 110 and this Section are met, the Division shall issue the license.
(2) If all applicable requirements of G.S. 110 and this Section are not met, the representative may recommend issuance of a provisional license in accordance with Section .0400 of this Subchapter or the representative may recommend denial of the application. Final disposition of the recommendation to deny is the decision of the Secretary.
(3) The license shall be displayed in an area that parents are able to view daily.
(g) When a person applies for a child care center license, the Secretary may deny the application for the license under the following circumstances:
(1) if any child care facility license previously held by that person has been denied, revoked or summarily suspended by the Division;
(2) if the Division has initiated denial, revocation or summary suspension proceedings against any child care facility license previously held by that person and the person voluntarily relinquished the license;
(3) during the pendency of an appeal of a denial, revocation or summary suspension of any child care facility license previously held by that person;
(4) if the Division determines that the applicant has a relationship with an operator or former operator who previously held a license under an administrative action described in Subparagraph (g)(1), (2), or (3) of this Rule. As used in this Rule, an applicant has a relationship with a former operator if the former operator would be involved with the applicant's child care facility in one or more of the following ways:
(A) would participate in the administration or operation of the facility;
(B) has a financial interest in the operation of the facility;
(C) provides care to children at the facility;
(D) resides in the facility; or
(E) would be on the facility's board of directors, be a partner of the corporation, or otherwise have responsibility for the administration of the business;
(5) based on the person's previous non-compliance as an operator with the requirements of G.S. 110 and this Subchapter; or
(6) if abuse or neglect has been substantiated against the person.
History Note: Authority G.S. 110-88(2); 110-88(5); 110-91; 110-92; 110-93; 110-99; 143B-168.3; Eff. January 1, 1986; Amended Eff. April 1, 2003; April 1, 2001; July 1, 1998; January 1, 1996; November 1, 1989; July 1, 1988; January 1, 1987.
10A NCAC 09 .0303 RESERVED FOR FUTURE CODIFICATION
10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE
(a) Each operator shall schedule a fire inspection within 12 months of the center's previous fire inspection. The operator is responsible for notifying the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the completed annual fire inspection report to the Division's representative within one week of the inspection visit on the form provided by the Division.
(b) Each center shall be inspected at least annually for compliance with appropriate sanitation requirements adopted by the Health Services Commission as described in 15A NCAC 18A .2800.
(c) A new building inspection shall not be required unless the operator plans to begin using space not previously approved for child care, has made renovations to the building, has added new construction, or wants to remove any restriction related to building codes currently on the license.
(d) When the Division's representative documents noncompliance during a visit, the representative may:
(1) Advise the operator to submit written verification that the noncompliance has been corrected;
(2) Return to the center for an unannounced visit at a later date to determine if compliance has been achieved; or
(3) Recommend issuance of a provisional license in accordance with Section .0400 of this Subchapter or recommend the revocation of the license or administrative actions in accordance with Section .2200 of this Subchapter.
History Note: Authority G.S. 110-88(5); 110-93; 143B-168.3; 150B-3;Eff. July 1, 1998.
10A NCAC 09 .0305 REQUIREMENTS FOR A ONE-STAR RATED LICENSE FOR A CHILD CARE CENTER
(a) Prior to the issuance of an initial one-star rating, a center shall comply with all minimum requirements in G.S. 110-91 and this subchapter at the time the program is assessed.
(b) To maintain a one-star rated license, a program shall have a compliance history of 60% or higher as assessed by the Division.
(c) The Division shall assess the compliance history of a center by evaluating the violations of requirements that have occurred over the previous three years or during the length of time the center has been operating, whichever is less. Demerits shall be assigned for each occurrence of violations of these requirements: supervision of children (6 points), staff/child ratio (6 points), staff qualifications and training (2-5 points), health and safety practices (3-6 points), discipline (6 points), developmentally appropriate activities (2-4 points), adequate space (6 points), nutrition and feeding practices (1-3 points), program records (1-3 points), sanitation inspections (6 points), and transportation (1-3 points), if applicable. The point value of each demerit shall be based on the potential detriment to the health and safety of children. A compliance history percentage shall be calculated each year by subtracting the total number of demerits from the total demerits possible and converting to a percentage. The yearly compliance history percentage shall be averaged over three years for the compliance history percentage referenced in this Rule. A copy of the Division compliance history score sheet used to calculate the compliance history percentage is available for review at the address given in Rule .0102 of this Section.
(d) A one-star rated license shall be issued to a child care center that complies with the requirements described in this Rule.
(e) An "A" or "AA" license remains valid until action is taken to change to a license with a star rating.
(f) Nothing in this Section is to preclude or interfere with issuance of an administrative action as allowed by G.S. 110 and this Subchapter.
History Note: Authority G.S. 110-90; 110-91; 143B-168.3; Eff. April 1, 1999.
SECTION .0400 - ISSUANCE OF PROVISIONAL AND TEMPORARY LICENSES
10A NCAC 09 .0401 PROVISIONAL LICENSES FOR FACILITIES
(a) A provisional license may be issued in accordance with the provisions of G.S. 110-88(6) for any period of time not to exceed twelve consecutive months for any of the following reasons:
(1) To allow a specific time period for correcting a violation of the building, fire, or sanitation requirements, provided that the appropriate inspector documents that the violation is not hazardous to the health or safety of the children but nevertheless necessitates a provisional classification until corrected.
(2) To allow a specific time period for the facility to comply fully with all licensing requirements other than building, fire, or sanitation, and to demonstrate that compliance will be maintained, provided that conditions at the facility are not hazardous to the health or safety of the children or staff.
(3) To allow time for the applicant or licensee to obtain a declaratory ruling pursuant to Section .2000 of this Subchapter.
(4) As a possible administrative action for substantiation of child abuse or neglect.
(b) The provisional license may be issued upon the Division's determination that the applicant or licensee is making a reasonable effort to conform to such requirements.
(c) The provisional license and the document describing the reasons for its issuance shall be posted in a prominent place in the facility that parents are able to view daily.
(d) A licensee may obtain an administrative hearing on the issuance of a provisional license in accordance with Section .2200 of this Chapter.
History Note: Authority G.S. 110-88(6); 110-99; 143B-168.3; Eff. January 1, 1986; Amended Eff. July 1, 1998; April 1, 1992; August 1, 1990; July 1, 1988; January 1, 1987.
10A NCAC 09 .0402 RESERVED FOR FUTURE CODIFICATION
10A NCAC 09 .0403 TEMPORARY LICENSES FOR CENTERS
(a) A temporary license may be issued in accordance with the provisions of G.S. 110-88(10) to the operator opening a new center or to the operator of a previously licensed center when a change in ownership or location occurs provided:
(1) the operator applied for a license, pursuant to Section .0300, or Rule .0204(a) or (b) of this Subchapter prior to the change in status; and
(2) the center has sufficient equipment and materials to operate for the number of children enrolled.
(b) The temporary license shall be posted in a prominent place in the center that parents are able to view daily.
(c) The temporary license shall expire after six months, or upon the issuance of a license or provisional license to the operator, whichever is earlier.
(d) An operator may obtain an administrative hearing on the denial of a temporary license in accordance with Section .2200 of this Subchapter.
History Note: Authority G.S. 110-88(10); 110-99; 143B-168.3; Eff. July 1, 1988; Amended Eff. July 1, 1998; April 1, 1992; November 1, 1989.
SECTION .0500 - AGE APPROPRIATE ACTIVITIES FOR CENTERS
10A NCAC 09 .0501 RESERVED FOR FUTURE CODIFICATION
10A NCAC 09 .0502 RESERVED FOR FUTURE CODIFICATION
10A NCAC 09 .0503 RESERVED FOR FUTURE CODIFICATION
10A NCAC 09 .0504 RESERVED FOR FUTURE CODIFICATION
10A NCAC 09 .0505 DEVELOPMENTAL DAY CENTERS
Child care centers which meet the criteria for developmental day centers, as defined in 10A NCAC 27G .2401 (contained in APSM 30-1, Rules for Mental Health, Developmental Disabilities and Substance Abuse Facilities and Services, published by the Division of Mental Health, Developmental Disabilities and Substance Abuse Services), shall be deemed to be in compliance with the provisions of Rules. 0508 through .0511 of this Section by complying with the requirements for activities for developmental day centers set forth in 10A NCAC 27G .2403.
History Note: Authority G.S. 110-91(2),(12); 143B-168.3; Eff. January 1, 1987; Amended Eff. July 1, 1998; July 1, 1988.
10A NCAC 09 .0506 RESERVED FOR FUTURE CODIFICATION
10A NCAC 09 .0507 RESERVED FOR FUTURE CODIFICATION
10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS FOR CENTERS
(a) All centers shall have a schedule for each group of children posted for easy reference by parents and by caregivers.
(1) The schedule shall show blocks of time usually assigned to types of activities and shall include periods of time for both active play and quiet play or rest.
(2) Blocks of time shall show activities that are scheduled for indoor and outdoor areas.
(3) The activities and allotted times reflected in the schedule shall be developmentally appropriate for the children in care.
(4) When children two years old or older are in care, the schedule shall also reflect daily opportunities for both free-choice and teacher-directed activities.
(b) All centers shall develop a written plan of developmentally appropriate activities designed to stimulate social, emotional, intellectual and physical development for each group of children in care.
(1) The activity plan shall always be current and accessible for easy reference by parents and caregivers.
(2) The activity plan shall include at least one daily activity for each developmental goal specified in Paragraph (b) of this Rule. Activities which allow children to choose to participate with the whole group, part of the group, or independently shall be identified. The plan shall reflect that the children have at least four different activities in which they may choose to participate on a daily basis.
(c) The schedule and activity plan may be combined as one document that shall always be current and posted for easy reference by parents and caregivers.
History Note: Authority G.S. 110-91(2),(12); 143B-168.3; Eff. July 1, 1988; Amended Eff. July 1, 1998.
10A NCAC 09 .0509 ACTIVITIES: GENERAL REQUIREMENTS FOR CENTERS
(a) Each center shall have developmentally appropriate equipment and materials accessible on a daily basis.
(b) The materials and equipment shall be sufficient to provide a variety of play experiences which promote the children's social, emotional, intellectual and physical development.
(c) Teacher-made and home-made equipment and materials may be used if they are safe and functional. Materials and equipment that are accessible to children shall not be coated or treated with, nor shall they contain, toxic materials such as creosote, pentacholorphenol, tributyl tin oxide, dislodgeable arsenic and any finishes which contain pesticides.
(d) Developmentally appropriate equipment and materials shall be provided for a variety of outdoor activities which allow for vigorous play and large muscle development. Each child shall have the opportunity for outdoor play each day that weather conditions permit. The center shall provide space and time for vigorous indoor activities when children cannot play outdoors.
History Note: Authority G.S. 110-91(2),(12); 143B-168.3; Eff. July 1, 1988; Amended Eff. July 1, 1998; January 1, 1996.
10A NCAC 09 .0510 ACTIVITY AREAS: PRESCHOOL CHILDREN TWO YEARS AND OLDER
(a) Each center shall have equipment and materials available in activity areas on a daily basis. Centers with a licensed capacity of three to 12 children located in a residence are not required to have activity areas, but must have equipment and materials available daily for the children in care.
(b) An activity area is an identifiable space which is accessible to the children and where related equipment and materials are kept in an orderly fashion.
(c) Each activity area shall contain enough materials to allow three related activities to occur at the same time. The materials and equipment shall be in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities.
(d) Each center shall make at least four of the activity areas listed in G.S. 110-91(12) available daily to preschool children two years or older as follows:
(1) Centers with a licensed capacity of 30 or more children shall have at least four activity areas available in the space occupied by each group of children.
(2) Centers with a licensed capacity of less than 30 children shall have at least four activity areas available daily. Separate groups of children may share use of the same activity areas.
(3) Centers with a licensed capacity of three to 12 children located in a residence shall have at least four types of activities available daily.
(e) In addition to the activity areas which are available each day, each center shall have materials and equipment in sufficient quantity, as described in Paragraph (c) of this Rule, to ensure that activities are made available at least once per month in each of the five activity areas listed G.S. 110-91(12).
(f) Each center shall provide materials and opportunities for music and rhythm activities, science and nature activities, and sand and water play for each group of children at least once per month.
History Note: Authority G.S. 110-91(6),(12); 143B-168.3; Eff. July 1, 1998; Amended Eff. July 1, 1998; October 1, 1991.
10A NCAC 09 .0511 ACTIVITIES FOR CHILDREN UNDER TWO YEARS OF AGE
(a) Each center shall have developmentally appropriate toys and activities for each child to promote the child's physical, emotional, intellectual and social well-being including appropriate books, blocks, dolls, pretend play materials, musical toys, sensory toys, and fine motor toys.
(1) The materials shall be kept in an identifiable space where related equipment and materials are kept in identifiable groupings and must be made available to the children for a substantial portion of each day.
(2) The materials shall be offered in sufficient quantity to allow all children to use them at some point during the day and to allow for a range of choices with duplicates of the most popular toys.
(3) Caregivers shall make provisions for the promotion of physical development for a substantial portion of the day which shall include varied, developmentally appropriate physical activities. A safe clean, uncluttered area shall be available for infants to crawl or creep and for toddlers to move around.
(4) Hands-on experiences, including both familiar and new activities, shall be provided to enable the infant or toddler to learn about himself and the world.
(b) The center shall provide time and space for sleeping, eating, toileting, diaper changing, and playing according to each child's individual need.
(c) The caregivers shall interact in a positive manner with each child every day, including the following ways:
(1) Caregivers shall respond promptly to an infant or toddler's physical and emotional needs, especially when indicated by crying through actions such as but not limited to the following: feeding, diapering, holding, positive touching, smiling, talking and eye contact.
(2) The caregiver shall recognize the special difficulties of infant and toddler separations and assist families, infants, and toddlers to make the transition from home to center as gently as possible, such as a phased-in orientation process to allow infants and toddlers to experience limited amounts of time at the center before becoming fully integrated.
(3) A caregiver or team of caregivers shall be assigned to each infant or toddler as the primary caregiver(s) who shall be responsible for care the majority of the time.
(4) The caregiver shall make provision for constructive guidance and the setting of limits that the child can understand which foster the infant's or toddler's ability to be self-disciplined, as appropriate to the child's age and development.
(5) In drop-in centers, effort shall be made to place an infant or toddler, who uses the center frequently, with the same caregiver.
(d) Each child shall have the opportunity to be outdoors daily when weather conditions permit.
(e) While awake, each child under the age of 12 months shall be given the opportunity each day to play while positioned on his or her stomach.
History Note: Authority G.S. 110-91(2),(12); 143B-168.3; Eff. July 1, 1988; Amended Eff. May 1, 2004; July 1, 1998; October 1, 1991; January 1, 1991.
SECTION .0600 - SAFETY REQUIREMENTS FOR CHILD CARE CENTERS
10A NCAC 09 .0601 SAFE ENVIRONMENT
(a) A safe indoor and outdoor environment shall be provided for the children in care.
(b) All hazardous items, materials and equipment shall be used by children only when adult supervision is provided.
(c) Each child care center shall provide equipment and furnishings that are child-size or which can be adapted for safe and effective use by children. Chairs and tables shall be of proper height for the children who will be using them. Outdoor play equipment shall be age and developmentally appropriate.
(d) Separate play areas or time schedules shall be provided for children under two years of age unless fewer than 15 children are in care. If a facility shares playground space with another facility that serves children, a separate play area or time schedule shall be provided for each facility.
History Note: Authority G.S. 110-85(2); 110-91(3),(6); 143B-168.3; Eff. January 1, 1986; Amended Eff. January 1, 1996; January 1, 1991.
10A NCAC 09 .0602 CONDITION OF INDOOR EQUIPMENT AND FURNISHINGS
(a) All equipment and furnishings shall be in good repair and shall be maintained in useable condition. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer.
(b) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based paint, loose nails, and splinters.
(c) All broken equipment or furnishings shall be removed from the premises immediately or made inaccessible to the children.
History Note: Authority G.S. 110-91(6); 143B-168.3; Eff. January 1, 1986; Amended Eff. January 1, 1996; January 1, 1991; Temporary Amendment Eff. October 1, 1997; Amended Eff. July 1, 1998.
10A NCAC 09 .0603 OVERNIGHT FURNISHINGS
A safe and comfortable bed, crib, or cot, equipped with a firm waterproof mattress at least four inches thick will be provided for each child who remains in the center after midnight.
History Note: Statutory Authority G.S. 110-91(6); 143B-168.3; Eff. January 1, 1986; Amended Eff. January 1, 1991.
10A NCAC 09 .0604 GENERAL SAFETY REQUIREMENTS
(a) Potentially hazardous items, such as firearms and ammunition, hand and power tools, nails, chemicals, lawn mowers, gasoline or kerosene, archery equipment, propane stoves, whether or not intended for use by children, shall be stored in locked areas or with other appropriate safeguards, or shall be removed from the premises.
(b) Electrical outlets not in use which are located in space used by the children shall be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child.
(c) Electric fans shall be mounted out of the reach of children or shall be fitted with an appropriate mesh guard to prevent access by children.
(d) All small electrical appliances shall be used only in accordance with the manufacturer's instructions.
(e) Electrical cords shall not be accessible to infants and toddlers. Extension cords, except as approved by the local fire inspector, shall not be used. Frayed or cracked electrical cords shall be replaced.
(f) All materials used for starting fires, such as matches and lighters, shall be kept in locked storage or shall be stored out of the reach of children.
(g) Smoking shall not be permitted in space used by children when children are present. All smoking materials shall be kept in locked storage or out of the reach of children.
(h) Fuel burning heaters, fireplaces and floor furnaces shall be provided with a protective screen attached securely to substantial supports to prevent access by children and to prevent objects from being thrown into them.
(i) Plants that are toxic shall not be in indoor or outdoor space that is used by or is accessible to children.
(j) The outdoor play area shall be protected by a fence or other protection. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions by January 1, 1999. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain securely closed while children occupy the area. When the center uses areas outside the fenced outdoor play area for children's activities or takes children off the premises for play or outings, the parent of each child shall give written permission for the child to be included in such activities. The permission may be:
(1) a one-time, blanket permission for all activities;
(2) a one-time, blanket permission for a specific activity at any time; or
(3) a one-time permission for a specific activity at a designated time. The center shall maintain the signed permission in the child's record. When children are taken off the premises, staff accompanying the children shall have a list of the names of all children participating in the outing. When the center provides transportation for children, the center shall furnish parents the names of all regularly scheduled drivers.
(k) Air conditioning units shall be located so that they are not accessible to children or shall be fitted with a mesh guard to prevent objects from being thrown into them.
(l) Gas tanks shall be located so they are not accessible to the children or shall be in a protective enclosure or surrounded by a protective guard.
(m) Cribs and playpens shall be placed so that the children occupying them shall not have access to cords or ropes, such as venetian blind cords.
(n) Children shall not be allowed to play on outdoor equipment that is too hot to touch.
(o) The indoor and outdoor premises shall be checked daily for debris, vandalism and broken equipment. Debris shall be removed and disposed of appropriately.
(p) The playground surface area shall be checked at least weekly to assure that surface material is maintained to assure continued resiliency.
(q) Following completion of safety training by the administrator or other staff person as required by Rule .0705(e) of this Subchapter, a monthly playground inspection shall be conducted and a record of each inspection shall be completed. This staff person shall use a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained in the center's files for review by a representative of the Division.
(r) Plastic bags, toys and toy parts small enough to be swallowed, and materials that can be easily torn apart such as foam rubber and styrofoam, shall not be accessible to children under three years of age, except that styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Latex and rubber balloons shall not be accessible to children under five years of age.
(s) When non-mobile children are in care, a crib or other approved device shall be available for evacuation in case of fire or other emergency. The crib or other approved device shall be fitted with wheels in order to be easily moveable, have a reinforced bottom, and shall be able to fit through the designated fire exit. For centers that do not meet institutional building code, and the exit is more than eight inches above grade, the center shall develop a plan to ensure a safe and timely evacuation of the crib or other approved device. This plan shall be demonstrated to a Division representative for review and approval. During the monthly fire drills required by Rule 10A NCAC 09 .0302d(4), the evacuation crib or other approved device shall be used in the manner described in the evacuation plan.
History Note: Authority G.S. 110-85(1); 110-91(3),(6); 143B-168.3; Eff. January 1, 1991; Amended Eff. January 1, 1996; November 1, 1991; Temporary Amendment Eff. October 1, 1997; Amended Eff. April 1, 2001; July 1, 1998.
10A NCAC 09 .0605 CONDITION OF OUTDOOR EQUIPMENT
(a) All equipment shall be in good repair and shall be maintained in useable condition. All commercially manufactured equipment shall be assembled and installed according to procedures specified by the manufacturer.
(b) Equipment shall be sturdy, stable, and free of hazards that are accessible to children during normal supervised play including sharp edges, lead based paint, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), pinch and crush points.
(c) All broken equipment shall be removed from the premises immediately or made inaccessible to the children.
(d) Any openings in equipment, steps, decks and handrails shall be smaller than 3 1/2" or greater than 9" to prevent entrapment.
(e) All upright angles shall be greater than 55 degrees to prevent entrapment and entanglement.
(f) All stationary outdoor equipment shall be installed over a resilient surface. Footings which anchor equipment shall not be exposed. Loose surfacing material shall not be installed over concrete. Acceptable materials to be used for surfacing include the following: wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel. Other materials that have been certified by the manufacturer to be shock-absorbing resilient material in accordance with the American Society for Testing and Materials (ASTM) Standard 1292, may be used only if installed, maintained and replaced according to the manufacturer's instructions. Pea gravel shall not be used if the area will be used by children under three years of age. The depth of the surfacing that is required shall be based on the critical height of the equipment. The critical height is defined as the maximum height a child may climb, sit or stand.
(1) Equipment with a critical height of five feet or less shall have six inches of any of the surfacing materials listed.
(2) Equipment with a critical height of more than five feet but less than seven feet shall have six inches of any of the surfacing materials listed, except for sand.
(3) Equipment with a critical height of seven feet to 10 feet shall have nine inches of any of the surfacing materials listed, except for sand.
(4) When sand is used as a surfacing material for equipment with a critical height of more than five feet, 12 inches is required.
(g) The resilient surfacing shall extend beyond the external limits of the equipment for a minimum of six feet. The area which is required to have the resilient surfacing is the area under and around the equipment where the child is likely to fall and it is called the fall zone. Fall zones may overlap in three situations: between two swing structures, around spring rockers, or around equipment that is less than 30 inches in height.
(h) Swings shall have resilient surfacing that extends two times the length of the pivot point to the surface below. The surfacing shall be to the front and rear of the swing. Enclosed tot swings shall have resilient surfacing that extends two times the length of the pivot point to the bottom of the swing seat. The surfacing shall be to the front and rear of the swing. Tot swings are defined as swings with enclosed seats. Tire swings shall have resilient surfacing that extends a distance of six feet plus the measurement from the pivot point to the swing seat and six feet to the side of the support structure.
(i) Swing seats shall be made of plastic or soft or flexible material.
(j) Elevated platforms shall have a guardrail or protective barrier, depending upon the height of the platform and the age of children that will have access to the piece of equipment. All sides of platforms shall be protected except for the area which allows entry or exit. Guardrails shall prevent inadvertent or unintentional falls off the platform. Protective barriers shall prevent children from climbing over or through the barrier. The critical height for a platform with a protective barrier is the platform surface; the critical height for a platform with a guardrail is the top of the guardrail. Measurements for the guardrails and protective barriers are stated below:
(1) Equipment used by preschool and school-age children:
(A) Guardrails - an elevated surface that is more than 20 inches and no more than 30 inches above the underlying surface shall have a guardrail. The minimum height of the top surface of the guardrail shall be at least 38 inches high and the lower edge shall be no more than 23 inches above the platform.
(B) Protective Barriers - an elevated surface that is more than 30 inches above the underlying surface shall have a protective barrier. The minimum height of the top surface of the protective barrier shall be at least 38 inches high.
(2) Equipment used exclusively by preschool children:
(A) Guardrails - an elevated surface that is more than 20 inches and no more than 30 inches above the underlying surface shall have a guardrail. The minimum height of the top surface of the guardrail shall be at least 29 inches high and the lower edge shall be no more than 23 inches above the platform.
(B) Protective Barriers - an elevated surface that is more than 30 inches above the underlying surface shall have a protective barrier. The minimum height of the top surface of the protective barrier shall be at least 29 inches high.
(3) Equipment used exclusively by school-age children:
(A) Guardrails - an elevated surface that is more than 30 inches and no more than 48 inches above the underlying surface shall have a guardrail. The minimum height of the top surface of the guardrail shall be at least 38 inches high and the lower edge shall be no more than 26 inches above the platform.
(B) Protective Barriers - an elevated surface that is more than 48 inches above the underlying surface shall have a protective barrier. The minimum height of the top surface of the protective barrier shall be at least 38 inches high.
(k) All equipment and surfacing ordered, constructed or installed on or after October 1, 1997 shall conform to all the requirements in this Rule. All equipment and surfacing ordered, constructed, or installed prior to October 1, 1997 shall conform to Paragraphs (a) through (c) of this Rule.
(l) All equipment and surfacing ordered, constructed, or installed prior to October 1, 1997 shall conform with Paragraphs (d) through (j) of this Rule by January 1, 2000.
(1) Any operator who is unable to comply by this date due to hardship may contact the Division by July 1, 1999 to apply for an extension until January 1, 2001.
(2) In cases where a large composite structure was installed after January 1, 1989 until January 1, 1996 according to manufacturer's instructions and met existing safety standards for playground equipment at the time of installation, an operator may contact the Division to apply for approval for continued use of the structure. Approval shall be based upon:
(A) Documentation submitted that verifies the structure was installed according to manufacturer's instructions; and
(B) Documentation submitted that verifies the structure met existing safety standards at the time of installation; and
(C) An inspection from a representative of the Division to determine the structure remains in good repair and in a useable condition.
History Note: Authority G.S. 110-91(6); 143B-168.3; Temporary Adoption Eff. October 1, 1997; Eff. October 29, 1998.
10A NCAC 09 .0606 SAFE SLEEP POLICY
(a) Each center licensed to care for infants aged 12 months or younger shall develop and adopt a written safe sleep policy that:
(1) specifies that caregivers shall place infants aged 12 months or younger on their backs for sleeping, unless:
(A) for an infant aged six months or less, the center receives a written waiver of this requirement from a health care provider, as defined in G.S. 58-50-61(a)(8); or
(B) for an infant older than six months, the center receives a written waiver of this requirement from a health care provider, as defined in G.S. 58-50-61(a)(8), or a parent, or a legal guardian;
(2) specifies whether pillows, blankets, toys, or other objects may be placed with a sleeping infant aged 12 months or younger, and if so, specifies the number and types of allowable objects;
(3) specifies that nothing shall be placed over the head or face of an infant aged 12 months or younger when the infant is laid down to sleep;
(4) specifies that the temperature in the room where infants aged 12 months or younger are sleeping does not exceed 75° F.
(5) specifies the means by which caregivers shall visually check on sleeping infants aged 12 months or younger;
(6) specifies the frequency with which caregivers shall visually check on sleeping infants aged 12 months or younger;
(7) specifies how caregivers shall document compliance with visually checking on sleeping infants aged 12 months or younger with such documents to be maintained for a minimum of one month;
(8) specifies any other steps the center shall take to provide a safe sleep environment for infants aged 12 months or younger.
(b) The center shall post a copy of its safe sleep policy or a poster about infant safe sleep practices in a prominent place in the infant room.
(c) A copy of the center's safe sleep policy shall be given and explained to the parents of an infant aged 12 months or younger on or before the first day the infant attends the center. The parent shall sign a statement acknowledging the receipt and explanation of the policy. The acknowledgement shall contain:
(1) the infant's name;
(2) the date the infant first attended the center;
(3) the date the center's safe sleep policy was given and explained to the parent; and
(4) the date the parent signed the acknowledgement.
The center shall retain the acknowledgement in the child's record as long as the child is enrolled at the center.
(d) If a center amends its safe sleep policy, it shall give written notice of the amendment to the parents of all enrolled infants aged 12 months or younger at least 14 days before the amended policy is implemented. Each parent shall sign a statement acknowledging the receipt and explanation of the amendment. The center shall retain the acknowledgement in the child's record as long as the child is enrolled at the center.
(e) A health care provider's or parent's waiver of the requirement that all infants aged 12 months or younger be placed on their backs for sleeping as specified in Subparagraph (a)(1) of this Rule shall:
(1) bear the infant's name and birth date;
(2) be signed and dated by the infant's physician or parent; and
(3) specify the infant's authorized sleep positions;
The center shall retain the waiver in the child's record as long as the child is enrolled at the center.
(f) For each infant with a waiver on file at the center as specified in Paragraph (e) of this Rule, a notice shall be posted for quick reference near the infant's crib, bassinet, or play pen that shall include:
(1) the infant's name;
(2) the infant's authorized sleep position; and
(3) the location of the signed waiver.
No confidential medical information, including an infant's medical diagnosis, shall be shown on the notice.
(g) The center's safe sleep policy shall be developed and shared with parents of infants currently enrolled within 30 days of this Rule becoming effective.
History Note: Authority G.S. 110-91(15); 143B-168.3; Eff. May 1, 2004.
SECTION .0700 - HEALTH AND OTHER STANDARDS FOR CENTER STAFF
10A NCAC 09 .0701 HEALTH STANDARDS FOR STAFF
(a) All personnel, including the director, shall have on file within 60 days of the date of employment, a statement signed by a licensed physician or an authorized health professional under his/her supervision, that indicates that the person is emotionally and physically fit to care for children. When submitted the medical statement shall not be older than 12 months. For the purposes of this Rule, an authorized health professional means a nurse practitioner or physician assistant currently approved to perform medical acts by the North Carolina Board of Medical Examiners.
(b) The Division, or the director of the child care center, may request another evaluation of an employee's emotional and physical fitness to care for children when there is reason to believe that there has been deterioration in the person's emotional or physical fitness to care for children.
(c) A test showing each employee, including the director, to be free of active tuberculosis is required prior to employment. The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment.
(d) Each employee, including the director, shall also annually submit a medical statement from a licensed physician or authorized health professional as defined in (a) of this Rule, or must complete a health questionnaire giving information about the status of his/her health on a form provided by the Division.
(e) Staff medical statements, proof of a tuberculosis test, and completed health questionnaires shall be included in the employee's individual personnel file in the center.
(f) Emergency medical care information shall be on file for each individual staff person. That information shall include the name, address, and telephone number of the person to be contacted in case of an emergency, the responsible party's choice of health care provider, and preferred hospital; any chronic illness the individual has and any medication taken for that illness; and any other information that has a direct bearing on assuring safe medical treatment for the individual. This emergency medical care information shall be on file in the center on the staff person's first day of employment.
History Note: Authority G.S. 110-91(1),(8),(9); 143B-168.3; Eff. January 1, 1986; Amended Eff. July 1, 1998.
10A NCAC 09 .0702 STANDARDS FOR SUBSTITUTES AND VOLUNTEERS
(a) The substitute staff and volunteers who are counted in the child care staff/child ratio shall comply with the health standards contained in this Section.
(b) All substitutes and volunteers not included in the child care staff/child ratio shall complete the health questionnaire described in Rule .0701 of this Section prior to the first day of work and will complete a health questionnaire annually thereafter as long as they continue to work in the center.
(c) A test showing each substitute and volunteer is free of active tuberculosis is required prior to the first day of work. The results of the test shall be obtained within the 12 months prior to employment or the beginning of the volunteer activity. This requirement shall apply only to individuals who volunteer more than once per week.
(d) The age of substitute staff and volunteers shall be verified prior to the first day of work by documenting the substitute staff or volunteer's date of birth in the individual's record. Any substitute teacher shall be at least 18 years old and literate.
(e) Emergency medical care information as described in Rule .0701(f) of this Section shall be on file for all substitutes and volunteers on the person's first day of work.
History Note: Authority G.S. 110-91(1),(8),(9); 143B-168.3; Eff. January 1, 1986; Amended Eff. July 1, 1998; October 1, 1991.
10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS
(a) Staff counted toward meeting the staff/child ratio requirements set forth in Rules .0712 and .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have full responsibility for or be left in charge of a group of children.
(b) Anyone who is at least 13 years of age, but less than 16 years of age, may work in a child care center on a volunteer basis, as long as he or she is supervised by and works with a required staff person who is at least 21 years of age, and also meets the health standards for volunteers found in Rule .0702 of this Section. No one younger than 16 years old shall be left alone with children nor counted toward meeting the required staff/child ratio.
(c) The provisions of G.S. 110-91(8) which exclude persons with certain criminal records or personal habits or behavior which may be harmful to children from operating or being employed in a child care center are hereby incorporated by reference and shall also apply to any person on the premises with the operator's permission when the children are present. This exclusion does not include parents or other persons who enter the center only for the purpose of performing parental responsibilities; nor does it include persons who enter the center for brief periods for the purpose of conducting business with the operator and who are not left alone with the children.
(d) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record:
(1) a copy of the credential certificate; or
(2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; or
(3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status or the opportunity to test out of the credential coursework; or
(4) documentation of enrollment in credential coursework.
(e) If the individual does not yet meet the staff qualifications required by G.S. 110-91(8) when assuming lead teacher or administrative duties, the individual shall submit the following information to the Division within six months of assuming the duties:
(1) a request to test out of credential coursework on a form provided by the Division; or
(2) application for equivalency on a form provided by the Division, with documentation of completion of the coursework or credential to be considered for equivalency as required by the Division.
(f) For centers with a licensed capacity of three to 12 children, when an individual has responsibility both for administering the child care program and for planning and implementing the daily activities of a group of children, the requirements for lead teacher in this Section shall apply to this individual. If the program has more than one group of children the requirement regarding lead teacher shall apply to each group of children.
History Note: Authority G.S. 110-85; 110-91(8); 143B-168.3; Eff. January 1, 1986; Amended Eff. October 29, 1998; January 1, 1990; July 1, 1988; January 1, 1987.
10A NCAC 09 .0704 PRESERVICE REQUIREMENTS FOR ADMINISTRATORS
(a) A child care administrator who has not met the staff qualifications required by G.S. 110-91(8) shall meet the requirements in this Rule prior to exercising any child caring responsibilities.
(1) Have either a high school diploma or its equivalent; and
(2) Have two years of full-time verifiable work experience in a child care center or early childhood work experience; or an undergraduate, graduate, or associate degree, with at least 12 semester hours in child development, child psychology, early childhood education or directly related field; or a Child Development Associate Credential; or completion of a community or technical college curriculum program in the area of child care or early childhood; or one year of full-time verifiable child care or early childhood work experience and a North Carolina Early Childhood Credential; and
(3) Have verification of having successfully completed, or be currently enrolled in, two semester credit hours, or 32 clock hours, of training in the area of early childhood program administration; or, have one year experience performing administrative responsibilities; or
(b) An administrator who does not meet the requirements of Paragraph (a) of this Rule may share the requirements in Paragraph (a) of this Rule with another individual, provided that prior to exercising child caring responsibilities, the individual who is responsible for planning and implementing the daily program at the center to comply with Sections .0500 and .0600 of this Subchapter shall be a full-time staff person on-site who meets Subparagraphs (a)(1) and (2) of this Rule, and the other individual shall meet Subparagraph (a)(3) of this Rule and be either on-site or off-site.
(c) Any person who is at least 21 years old and literate who was employed as an on-site administrator in a child care program on or before September 1, 1986, shall be exempt from the provisions of Paragraphs (a) and (b) of this Rule, as long as the person is employed by the same operator.
History Note: Authority G.S. 110-91(8); 143B-168.3; Eff. January 1, 1986; Amended Eff. October 29, 1998; April 1, 1997; November 1, 1989; July 1, 1988; January 1, 1987.
10A NCAC 09 .0705 SPECIAL TRAINING REQUIREMENTS
(a) At least one staff member shall be knowledgeable of and able to recognize common symptoms of illness.
(b) Staff who have completed within the last three years a course in basic first aid shall be present at all times children are present. The number of staff required to complete the course shall be based on the number of children present as shown in the following chart:
Number of children present Number of staff trained in first aid required
1-29
1 staff
30-79
2 staff
80 and above
3 staffVerification of each required staff person's completion of this course shall be maintained in the person's individual personnel file in the center. The basic first aid course at a minimum shall address principles for responding to emergencies, rescue breathing, and techniques for handling common childhood injuries, accidents and illnesses such as: choking, burns, fractures, bites and stings, wounds, scrapes, bruises, cuts and lacerations, poisoning, seizures, bleeding, allergic reactions, eye and nose injuries and sudden changes in body temperature.
(c) A first aid information sheet shall be posted in a prominent place for quick referral. An acceptable form may be requested free of charge from the North Carolina Child Care Health and Safety Resource Center by calling 1-800-CHOOSE-1.
(d) Each child care center shall have at least one person on the premises at all times, and at least one person who accompanies the children whenever they are off the premises, who has successfully completed within the last 12 months a cardiopulmonary resuscitation (CPR) course provided by either the American Heart Association or the American Red Cross or other organizations approved by the Division. Other organizations will be approved if the Division determines that the courses offered are substantially equivalent to those offered by the American Red Cross. Successfully completed is defined as demonstrating competency, as evaluated by the instructor, in performing CPR. The course shall provide training in CPR appropriate for the ages of children in care. Documentation of successful completion of the course from the American Heart Association, the American Red Cross, or other organization approved by the Division shall be on file in the center.
(e) Staff shall complete at least four clock hours of training in safety. At a minimum, this training shall address playground safety hazards, playground supervision, maintenance and general upkeep of the outdoor area, and age and developmentally appropriate playground equipment. Staff counted to comply with this Rule shall have six months from the date of employment, or from the date a vacancy occurs, to complete the required safety training. The number of staff required to complete this training shall be as follows:
(1) In centers with a licensed capacity of less than 30 children, at least one staff person shall complete this training.
(2) In centers with a licensed capacity of 30 or more children, at least two staff, including the administrator, shall complete this training.
(f) In centers that are licensed to care for infants ages 12 months and younger:
(1) the center director and any child care provider scheduled to work in the infant room, including volunteers counted in staff/child ratios, shall complete ITS-SIDS training;
(2) ITS-SIDS training shall be completed within four months of the individual assuming responsibilities in the infant room or as an administrator, or within four months of these rules becoming effective, whichever is later, and shall be completed again every three years from the completion of previous ITS-SIDS training;
(3) Completion of ITS-SIDS training may be included once every three years in the number of hours needed to meet annual in-service training requirements in Section .0700 of this Subchapter;
(4) Individuals who have completed initial ITS-SIDS training prior to this rule becoming effective shall not be required to repeat the training until three years from the completion of initial ITS-SIDS training; and
(5) Prior to an individual assuming responsibility for the care of an infant, the center's safe sleep policy for infants shall be reviewed with the individual as required by Rule .0707 (a).
History Note: Authority G.S. 110-91(1),(8); 143B-168.3; Eff. January 1, 1986; Amended Eff. January 1, 1996; January 1, 1992; January 1, 1991; January 1, 1987; Temporary Amendment Eff. October 1, 1997; Amended Eff. May 1, 2004; July 1, 1998.
10A NCAC 09 .0706 reserved for future codification
10A NCAC 09 .0707 IN-SERVICE TRAINING REQUIREMENTS
(a) Each center shall assure that each new employee who is expected to have contact with children receives a minimum of 10 clock hours of on-site training and orientation within the first six weeks of employment. This training and orientation shall include:
(1) first-hand observation of the center's daily operations;
(2) instruction in the employee's assigned duties;
(3) instruction in the maintenance of a safe and healthy environment;
(4) training in the recognition of the signs and symptoms of child abuse and neglect and in the employee's duty to report suspected abuse and neglect;
(5) review of the center's purposes and goals;
(6) review of the center's personnel policies;
(7) review of the center's operational policies, including the center's safe sleep policy for infants;
(8) review of the child care licensing law and regulations;
(9) an explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; and
(10) an explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations.
(b) The child care administrator and any staff who have responsibility for planning and supervising a child care program, as well as staff who work directly with children, shall participate in in-service training activities annually, according to the individual's assessed needs. Staff may choose one of the following options for meeting the in service requirement:
(1) Each staff person shall complete in service training required in G.S. 110-91(11) as specified in the following Parts:
(A) persons with a four year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university shall complete five clock hours of training annually.
(B) persons with a two year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential or its equivalent shall complete eight clock hours of training annually.
(C) persons with a certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential or its equivalent shall complete 10 clock hours of training annually.
(D) persons with at least 10 years documented, professional experience as a teacher, director, or caregiver in a licensed child care arrangement shall complete 15 clock hours of training annually.
(E) all other persons shall complete 20 clock hours of training annually.
(2) For staff listed in Parts (b)(1), (A), (B), (C) and (D) of this Rule, basic cardiopulmonary resuscitation (CPR) training required in Rule .0705 of this Section shall not be counted toward meeting annual in-service training. First aid training may be counted once every three years.
(3) If a child care administrator or lead teacher is currently enrolled in coursework to meet the staff qualification requirements in G.S. 110-91(8), the coursework may be counted toward meeting the annual in-service training requirement.
(c) For staff working less than 40 hours per week on a regular basis and choosing the option for 20 hours of in service training, the training requirement may be prorated as follows:
WORKING HOURS PER WEEK
CLOCK HOURS REQUIRED
0-10
5
11-20
10
21-30
15
31-40
20History Note: Authority G.S. 110-91(11); 143B-168.3; Eff. January 1, 1986; Amended Eff. May 1, 2004; October 29, 1998; October 1, 1991; November 1, 1989; July 1, 1988; January 1, 1987.
10A NCAC 09 .0708 MEETING IN-SERVICE REQUIREMENTS
Staff may meet the in-service training requirements by attending child-care workshops, conferences, seminars, or courses, provided each training activity satisfies the following criteria:
(1) Prior approval from the Division is not required for training offered by an accredited college or university, government agency, or state or national professional organization or its recognized affiliates, provided the content complies with G.S. 110-91(11).
(2) Prior approval from the Division is required on an annual basis for training provided by agencies and organizations which have staff who provide, or who arrange for the provision of, training for child care operators and staff. To obtain such approval, the agency or organization shall submit its annual training plan to the Division. Approval shall be determined based upon the qualifications of the trainer(s).
(3) Prior approval for training shall be obtained from the Division by any organization, association, or individual not included in Items (1) and (2) of this Rule. Approval shall be determined based upon the qualifications of the trainer(s).
(4) No more than five clock hours of the 20 clock hours of training required annually shall be provided on site by center staff. This restriction shall not apply if the center staff providing the training have been approved according to the criteria outlined in either Item (1) or (2) of this Rule.
History Note: Authority G.S. 110-91(11); 143B-168.3; Eff. January 1, 1986; Amended Eff. October 29, 1998; November 1, 1989; July 1, 1988; January 1, 1987.
10A NCAC 09 .0709 DOCUMENTATION OF IN-SERVICE TRAINING
Each center shall have a record of training activities in which each staff participates. That record shall include the subject matter, topic area in G.S. 110-91(11), training provider, date provided, hours, and name of staff who completed the training. This documentation shall be on file and current.
History Note: Authority G.S. 110-91(9),(11); 143B-168.3; Eff. January 1, 1986; Amended Eff. July 1, 1998; July 1, 1988.
10A NCAC 09 .0710 PRESERVICE REQUIREMENTS FOR LEAD TEACHERS AND AIDES
If an individual already has a North Carolina Early Childhood Credential or its equivalent, none of the requirements of this Rule shall apply. If an individual does not have a North Carolina Early Childhood Credential or its equivalent, the requirements of this Rule shall be met.
(1) A lead teacher or a teacher shall be at least 18 years of age, have a high school diploma or its equivalent, and have at least one of the following:
(a) One year of verifiable child care experience working in a child care center or two years of verifiable experience as a licensed family child care home operator; or
(b) Successful completion of a two year high school Child Care Services Occupational Home Economics Program; or
(c) Twenty hours of training in child development, which could include the North Carolina Early Childhood Credential coursework, within the first six months of employment in addition to the number of annual inservice training hours required in Rule .0707 of this Section.
(2) An aide is a person who assists the lead teacher or the teacher in planning and implementing the daily program, and shall be at least 16 years old and literate.
(3) Individuals employed prior to July 1, 1998 are exempted from the requirements of this Rule, as long as they remain employed by the same operator.
History Note: Authority G.S. 110-91(8); 143B-168.3; Eff. July 1, 1988; Amended Eff. October 29, 1998; April 1, 1997; October 1, 1991; November 1, 1989.
10A NCAC 09 .0711 PRESERVICE REQUIREMENTS FOR OTHER STAFF
(a) Any person whose job responsibility includes driving a vehicle to transport children, including any substitute driver, shall meet the requirements in Rule .1003 of this Subchapter.
(b) Non-care giving staff or any person providing support to the operation of the program shall be at least 16 years of age; and meet the requirements of the local health department for food handlers, if applicable, when duties are related to food preparation or food service.
History Note: Authority G.S. 110-91(8); 143B-168.3; Eff. July 1, 1988; Amended Eff. July 1, 1998; October 1, 1991; November 1, 1989.
10A NCAC 09 .0712 STAFF/CHILD RATIOS FOR CENTERS WITH A LICENSED CAPACITY OF LESS THAN 30 CHILDREN
(a) The staff/child ratios and group sizes for a child care center with a licensed capacity of less than 30 children are as follows:
Age of Children
No. Children
No. Staff
Maximum Group Size
No. Staff
0 to 12 Months
5
1
10
2
12 to 24 Months
6
1
12
2
2 to 3 Years
10
1
20
2
3 to 5 Years
15
1
25
2
5 Years and Older
25
1
25
1(1) When only one caregiver is required to meet the staff/child ratio, and children under two years of age are in care, that person shall not concurrently perform food preparation or other duties which are not direct child care responsibilities.
(2) When only one caregiver is required to meet the staff/child ratio, the operator shall select one of the following options for emergency relief:
(A) The center shall post the name, address, and telephone number of an adult who has agreed in writing to be available to provide emergency relief and who can respond within a reasonable period of time; or
(B) There shall be a second adult on the premises who is available to provide emergency relief.
(b) The staff/child ratios for a center located in a residence with a licensed capacity of three to 12 children when any preschool aged child is enrolled, or with a licensed capacity of three to 15 children when only school-aged children are enrolled are as follows:
Age of Children
No. Children
No. Staff
Additional number of school-aged children allowed
0 to 12 Months
5
1
3
12 to 24 Months
6
1
2
2 to 13 Years
10
1
0
3 to 13 Years
12
1
0
All school-aged
15
1
0History Note: Authority G.S. 110-91(7); 143B-168.3; Eff. December 1, 1988; Amended Eff. July 1, 1998; July 1, 1994; January 1, 1992; August 1, 1990.
10A NCAC 09 .0713 STAFF/CHILD RATIOS FOR CENTERS WITH A LICENSED CAPACITY OF 30 OR MORE CHILDREN
(a) The staff/child ratios and group sizes for single-age groups of children in centers with a licensed capacity of 30 or more children shall be as follows:
Age of Children
No. Children
No. Staff
MaximumGroup Size
No. Staff
0 to 12 Months
5
1
10
2
12 to 24 Months
6
1
12
2
2 to 3 Years
10
1
20
2
3 to 4 Years
15
1
25
2
4 to 5 Years
20
1
25
2
5 Years and Older
25
1
25
1(b) In any multi-age group situation, the staff/child ratio for the youngest child in the group shall be maintained for the entire group.
(c) Children younger than two years old may be cared for in groups with older children at the beginning and end of the operating day provided the staff/child ratio for the youngest child in the group is maintained.
(d) A child two years of age and older may be placed with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate.
(e) When determined to be developmentally appropriate by the operator and parent, a child age two or older may be placed one age level above his or her chronological age without affecting the staff/child ratio for that group. This provision shall be limited to one child per group.
(f) Except as provided in Paragraphs (c) and (d), children under one year of age shall be kept separate from children two years of age and over.
(g) Children between the ages of 12 months and 24 months shall not be routinely grouped with older children unless all children in the group are less than three years old.
(h) When only one caregiver is required to meet the staff/child ratio, and no children under two years of age are in care, that person may concurrently perform food preparation or other duties which are not direct child care responsibilities as long as supervision of the children as specified in Rule .0714(f) of this Section is maintained.
(i) When only one caregiver is required to meet the staff/child ratio, the operator shall select one of the following options for emergency relief:
(1) The center shall post the name, address, and telephone number of an adult who has agreed in writing to be available to provide emergency relief and who can respond within a reasonable period of time; or
(2) There shall be a second adult on the premises who is available to provide emergency relief.
(j) Except as provided in Paragraph (h) of this Rule, staff members and administrators who are counted in meeting the staff/child ratios as stated in this Rule shall not concurrently perform food preparation or other duties which are not direct child care responsibilities.
History Note: Authority G.S. 110-91(7); 143B-168.3; Eff. December 1, 1988; Amended Eff. July 1, 1998; July 1, 1994; January 1, 1992; August 1, 1990; November 1, 1989.
10A NCAC 09 .0714 OTHER STAFFING REQUIREMENTS
(a) Each child care center shall have an administrator on site on a regular basis. The administrator shall be responsible for monitoring the program and overseeing administrative duties of the center. This requirement may be met by having one or more persons on site who meet the requirements for an administrator according to the licensed capacity of the center. The following hourly requirements are based on an administrator's normal working schedule and may include times when the administrator may be off site due to administrative duties, illness, or vacation.
(1) Each center with a licensed capacity of less than 30 children shall have an administrator on site for at least 20 hours per week.
(2) Each center with a licensed capacity of 30 to 79 children shall have an administrator on site for at least 25 hours per week.
(3) Each center with a licensed capacity of 80 to 199 children shall have an administrator on site for at least 30 hours per week.
(4) Each center with a licensed capacity of 200 or more children shall have an administrator on site for at least 40 hours per week.
(b) At least one person who meets the requirements for an administrator or lead teacher as set forth in this Section shall be on site during the center's operating hours except that a person who is at least 18 years old with at least a high school diploma or its equivalent and who has a minimum of one year's experience working with children in a child care center may be on duty at the beginning or end of the operating day provided that:
(1) No more than 10 children are present.
(2) The staff person has worked in that center for at least three months.
(3) The staff person knows and can apply the center's operating policies and emergency procedures.
(c) At least one person who meets the requirements for a lead teacher shall be responsible for each group of children as defined in Rule .0102 of this Subchapter except as provided in Paragraph (b) of this Rule. This requirement may be met by having one or more persons who meet the requirements for a lead teacher responsible for the same group of children. Each lead teacher shall be responsible for only one group of children at a time. Each group of children shall have a lead teacher in attendance for at least two-thirds of the total daily hours of operation, based on a normal working schedule and may include times when the lead teacher may not be in attendance due to circumstances such as illness or vacation.
(d) A teacher is a person who is responsible to the lead teacher and assists with planning and implementing the daily program.
(e) No aide or aides shall have responsibility for a group of children except as provided in Paragraph (b) of this Rule.
(f) Children shall be adequately supervised at all times. Adequate supervision shall mean that staff interact with the children while moving about the indoor or outdoor area, and are able to hear and see the children at all times, except when emergencies necessitate that direct supervision is impossible for brief periods of time.
(g) For groups of children aged two years or older, the staff/child ratio during nap time is considered in compliance if at least one person is either in each room or is visually supervising all the children and if the total number of required staff are on the premises and within calling distance of the rooms occupied by children.
(h) When a child is sleeping, bedding or other objects shall not be placed in a manner that covers the child's face.
History Note: Authority G.S. 110-85(1); 110-91(7),(8); 143B-168.3; Eff. July 1, 1988; Amended Eff. May 1, 2004; July 1, 1998; January 1, 1996; October 1, 1991; November 1, 1989.
SECTION .0800 - HEALTH STANDARDS FOR CHILDREN
10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT
(a) Each child in care shall have an individual application for enrollment completed and signed by the child's parent, legal guardian, or full-time custodian.
(1) The completed, signed application shall be on file in the center on the first day the child attends and shall remain on file until the child is no longer attending.
(2) The completed application shall include emergency medical information as specified in Rule .0802(b) of this Section.
(3) The completed application shall give the child's full name and indicate the name the child is to be called. In addition, the application shall include the child's date of birth and any allergies, particular fears, or unique behavior characteristics that the child has.
(4) The application shall include the names of individuals to whom the center may release the child as authorized by the person who signs the application.
(b) Each child's application shall be readily available and easily accessible to caregiving staff during the time the children are present.
History Note: Authority G.S. 110-91(9); 143B-168.3; Eff. January 1, 1986; Amended Eff. November 1, 1989.
10A NCAC 09 .0802 EMERGENCY MEDICAL CARE
(a) Each child care center shall have a written plan which assures that emergency medical care is available or can be obtained for children. The plan shall be reviewed during staff orientation with new staff and with all staff at least twice each year. This plan shall give the procedures to be followed to assure that any child who becomes ill or is injured and requires medical attention while at the center, or while participating in any activity provided or sponsored by the center, receives appropriate medical attention. The following information shall be included in the center's emergency medical care plan:
(1) The name, address, and telephone number of a physician, nurse, physician's assistant, nurse practitioner, community clinic, or local health department that is available to provide medical consultation;
(2) The name, address, and telephone number of the emergency room to be used when the parents or family physician cannot be reached or when transporting the ill or injured child to the person's preferred hospital could result in serious delay in obtaining medical attention;
(3) Designation of a means of transportation always available for use in the event of a medical emergency;
(4) The name of the person, and his or her alternate, at the center, responsible for determining which of the following is needed, carrying out that plan of action, and assuring that appropriate medical care is given:
(A) Simple first aid given at the center for an injury or illness needing only minimal attention;
(B) Advice from previously identified medical consultant in order to decide if care is to be given at the center or if the ill or injured child is to be transported to a designated medical resource; or
(C) Immediate transportation of the child to a designated medical resource for appropriate treatment;
(5) The person(s) at the center responsible for:
(A) Assuring that the signed authorization described in (c) of this Rule is taken with the ill or injured child to the medical facility;
(B) Accompanying the ill or injured child to the medical facility;
(C) Notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment;
(D) Notifying the medical facility about the ill or injured child being transported for treatment; and
(E) Obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center;
(6) A statement giving the location of the telephone located on the premises which is in good working condition and is always available for use in case of emergency. Telephone numbers for the fire department, law enforcement office, emergency medical service, and poison control center shall be posted near the telephone. A telephone located in an office in the center that is sometimes locked during the time the children are present cannot be designated for use in an emergency.
(b) Emergency medical care information shall be on file for each individual child. That information shall include the name, address, and telephone number of the parent or other person to be contacted in case of an emergency, the responsible party's choice of health care provider, and preferred hospital; any chronic illness the individual has and any medication taken for that illness; and any other information that has a direct bearing on assuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance.
(c) Each child's parent, legal guardian, or full-time custodian shall sign a statement authorizing the center to obtain medical attention for the child in an emergency. That statement shall be on file on the first day the child attends the center. It shall be easily accessible to staff so that it can be taken with the child whenever emergency medical treatment is necessary.
(d) An incident report shall be completed each time a child receives medical treatment by a physician, nurse, physician's assistant, nurse practitioner, community clinic, or local health department, as a result of an incident occurring while the child is at the child care center. This incident report shall include, at a minimum: child's name, date and time of incident, part of body injured, type of injury, names of adult witnesses to incident, description of how and where incident occurred, piece of equipment involved (if any), treatment received and steps taken to prevent reoccurrence. This report shall be signed by the person completing it and by the parent, and maintained in the child's file. A copy of the incident report shall be mailed to a representative of the Division within seven calendar days after treatment.
(e) An incident log shall be completed any time an incident report is completed. This log shall be cumulative and maintained in a separate file and shall be available for review by a representative of the Division. This log shall be completed on a form provided by the Division.
History Note: Authority G.S. 110-91(1),(9); 143B-168.3; Eff. January 1, 1986; Amended Eff. July 1, 1998; January 1, 1996; October 1, 1991; November 1, 1989.
10A NCAC 09 .0803 ADMINISTERING MEDICATION
The following provisions apply to the administration of medication in child care centers:
(1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream or powder shall be administered to any child:
(a) without written authorization from the child's parent;
(b) without written instructions from the child's parent, physician or other health professional;
(c) in any manner not authorized by the child's parent, physician or other health professional;
(d) after its expiration date; or
(e) for non-medical reasons, such as to induce sleep.
(2) Prescribed medications:
(a) shall be stored in the original containers in which they were dispensed with the pharmacy labels specifying:
(i) the child's name;
(ii) the name of the medication or the prescription number;
(iii) the amount and frequency of dosage;
(iv) the name of the prescribing physician or other health professional; and
(v) the date the prescription was filled; or
(b) if pharmaceutical samples, shall be stored in the manufacturer's original packaging, shall be labeled with the child's name, and shall be accompanied by written instructions specifying:
(i) the child's name;
(ii) the names of the medication;
(iii) the amount and frequency of dosage;
(iv) the signature of the prescribing physician or other health professional; and
(v) the date the instructions were signed by the physician or other health professional; and
(c) shall be administered only to the child for whom they were prescribed.
(3) A parent's written authorization for the administration of a prescription medication described in Item (2) of this Rule shall be valid for the length of time the medication is prescribed to be taken.
(4) Over-the-counter medications, such as cough syrup, decongestant, acetaminophen, ibuprofen, topical antibiotic cream for abrasions, or medication for intestinal disorders shall be stored in the manufacturer's original packaging on which the child's name is written or labeled and shall be accompanied by written instructions specifying:
(a) the child's name;
(b) the names of the authorized over-the-counter medication;
(c) the amount and frequency of the dosages;
(d) the signature of the parent, physician or other health professional; and
(e) the date the instructions were signed by the parent, physician or other health professional.
The permission to administer over-the-counter medications is valid for up to 30 days at a time, except as allowed in Items (6), (7), (8) and (9) of this Rule. Over-the-counter medications shall not be administered on an "as needed" basis, other than as allowed in Items (6), (7), (8) and (9) of this Rule.
(5) When questions arise concerning whether any medication should be administered to a child, the caregiver may decline to administer that medication without signed, written dosage instructions from a licensed physician or authorized health professional.
(6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions and for allergic reactions. The authorization shall be in writing and shall contain:
(a) the child's name;
(b) the subject medical conditions or allergic reactions;
(c) the names of the authorized over-the-counter medications;
(d) the criteria for the administration of the medication;
(e) the amount and frequency of the dosages;
(f) the manner in which the medication shall be administered;
(g) the signature of the parent;
(h) the date the authorization was signed by the parent; and
(i) the length of time the authorization is valid, if less than six months.
(7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, and powders --- such as sunscreen, diapering creams, baby lotion, and baby powder --- to a child, when needed. The authorization shall be in writing and shall contain:
(a) the child's name;
(b) the names of the authorized ointments, repellents, lotions, creams, and powders;
(c) the criteria for the administration of the ointments, repellents, lotions, creams, and powders;
(d) the manner in which the ointments, repellents, lotions, creams, and powders shall be applied;
(e) the signature of the parent;
(f) the date the authorization was signed by the parent; and
(g) the length of time the authorization is valid, if less than 12 months.
(8) A parent may give a caregiver standing authorization to administer a single weight-appropriate dose of acetaminophen to a child in the event the child has a fever and a parent cannot be reached. The authorization shall be in writing and shall contain:
(a) the child's name;
(b) the signature of the parent;
(c) the date the authorization was signed by the parent.
(d) the date that the authorization ends or a statement that the authorization is valid until withdrawn by the parent in writing.
(9) A parent may give a caregiver standing authorization to administer an over-the-counter medication as directed by the North Carolina State Health Director or designee, when there is a public health emergency as identified by the North Carolina State Health Director or designee. The authorization shall be in writing, may be valid for as long as the child is enrolled, and shall contain:
(a) the child's name;
(b) the signature of the parent;
(c) the date the authorization was signed by the parent; and
(d) the date that the authorization ends or a statement that the authorization is valid until withdrawn by the parent in writing.
(10) Pursuant to G.S. 110-102.1A, a caregiver may administer medication to a child without parental authorization in the event of an emergency medical condition when the child's parent is unavailable, providing the medication is administered with the authorization and in accordance with instructions from a bona fide medical care provider.
(11) A parent may withdraw his or her written authorization for the administration of medications at any time in writing.
(12) Any medication remaining after the course of treatment is completed or after authorization is withdrawn shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded.
(13) Any time prescription or over-the-counter medication is administered by center personnel to children receiving care, including any time medication is administered in the event of an emergency medical condition without parental authorization as permitted by G.S. 110-102.1A, the child's name, the date, time, amount and type of medication given, and the name and signature of the person administering the medication shall be recorded. This information shall be noted on a medication permission slip, or on a separate form developed by the provider which includes the required information. This information shall be available for review by a representative of the Division during the time period the medication is being administered and for at least six months after the medication is administered. No documentation shall be required when items listed in Item (7) of this Rule are applied to children.
History Note: Authority G.S. 110-91(1),(9); 143B-168.3; Eff. January 1, 1986; Amended Eff. May 1, 2004; April 1, 2001; July 1, 1998; January 1, 1996.
10A NCAC 09 .0804 INFECTIOUS AND CONTAGIOUS DISEASES
(a) Centers may provide care for a mildly ill child who has a Fahrenheit temperature of less than 100 degrees axillary, 101 degrees orally, or 102 degrees rectally and who remains capable of participating in routine group activities; provided the child does not:
(1) have the sudden onset of diarrhea characterized by an increased number of bowel movements compared to the child's normal pattern and with increased stool water; or
(2) have two or more episodes of vomiting within a 12 hour period; or
(3) have a red eye with white or yellow eye discharge until 24 hours after treatment; or
(4) have scabies or lice; or
(5) have known chicken pox or a rash suggestive of chicken pox; or
(6) have tuberculosis, until a health professional states that the child is not infectious; or
(7) have strep throat, until 24 hours after treatment has started; or
(8) have pertussis, until five days after appropriate antibiotic treatment; or
(9) have hepatitis A virus infection, until one week after onset of illness or jaundice; or
(10) have impetigo, until 24 hours after treatment; or
(11) have a physician's or other health professional's written order that the child be separated from other children.
(b) Centers which choose to provide care for mildly ill children shall:
(1) follow all procedures to prevent the spread of communicable diseases described in 15A NCAC 18A .2800, "Sanitation of Child Day Care Facilities", as adopted by the Health Services Commission;
(2) separate from the other children any child who becomes ill while in care or who is suspected of having a communicable disease or condition other than as described in Paragraph (a) of this Rule until the child leaves the center;
(3) notify all parents at enrollment that the center will be providing care for mildly ill children;
(4) immediately notify the parent of any child who becomes ill while in care or who is suspected of being ill with a communicable condition other than as described in Paragraph (a) of this Rule that the child is ill and may not remain in care;
(5) immediately notify the parent of any sick child in care if the child's condition worsens while the child is in care.
History Note: Authority G.S. 110-91(1),(2); 143B-168.3; Eff. January 1, 1986; Amended Eff. July 1, 1998; November 1, 1991; November 1, 1989.
10A NCAC 09 .0805 SANITARY FOOD SERVICE
(a) All food shall be served in a manner to minimize the possibility of contamination. In no instance shall any food be served directly on a table top, countertop, etc.
(b) No more than one child shall be fed with the same utensil, drink from the same cup or glass, or be fed from the same individual portion of food.
(1) Each child shall be served individual portions of food on a plate or in another appropriate container.
(2) Beverages shall be served to children in individual cups or glasses. Any child who is bottle-fed must be fed from the child's own bottle only.
(3) Each child shall be fed with an individual spoon or other safe utensil.
(4) Snack foods may be placed on an individual napkin or paper towel to be served to a child.
History Note: Authority G.S. 110-91(1); 143B-168.3; Eff. January 1, 1986; Amended Eff. November 1, 1989.
10A NCAC 09 .0806 TOILETING, CLOTHING AND LINENS
(a) Diapers will be changed whenever they become soiled or wet and not on a shift basis.
(b) There must be clean clothes available so that when the clothes worn by a child becomes wet or soiled the child has clean clothes to put on. The change of clothing may be provided by the center or by the child's parents.
(c) A supply of clean linen must be on hand so that linens can be changed whenever they become soiled or wet.
(d) Staff shall not force children to use the toilet and staff shall consider the developmental readiness of each individual child during toilet training.
History Note: Authority G.S. 110-91(1); 143B-168.3; Eff. January 1, 1986; Amended Eff. July 1, 1998; November 1, 1989.
SECTION .0900 - NUTRITION STANDARDS
10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS
(a) Meals and snacks served shall comply with the Meal Patterns for Children in Child Care standards which are based on the recommended nutrient intake judged by the National Research Council to be adequate for maintaining good nutrition. The types of food, number and size of servings shall be appropriate for the ages and developmental levels of the children in care. The Meal Patterns for Children in Child Care nutrition standards are incorporated by reference and include subsequent amendments. A copy of these standards is available free of charge from the Division at the address in Rule .0102(1) of this Subchapter.
(b) Menus for nutritious meals and snacks shall be planned at least one week in advance. At least one dated copy of the current week's menu shall be posted where it can be seen easily by parents and food preparation staff when food is prepared or provided by the center, except in centers with a licensed capacity of three to 12 children located in a residence. A variety of food shall be included in meals and snacks. Any substitution will be of comparable food value and will be recorded on the menu.
(c) When children bring their own food for meals or snacks to the center, if the food does not meet the nutritional requirements specified in (a) of this Rule, the center must provide additional food necessary to meet those requirements.
(d) Drinking water must be freely available to children of all ages and offered at frequent intervals. Approved drinking fountains or individual drinking utensils shall be provided. When a private water supply is used, it must be tested by and meet the requirements of the Department of Environment and Natural Resources.
(e) Children's special diets or food allergies shall be posted in the food preparation area and in the child's eating area.
(f) The food required by special diets may be provided by the center or may be brought to the center by the parents. If the diet is prescribed by a health care provider, a statement signed by the health care provider shall be on file at the center and written instructions shall be provided by the child's parent, health care provider, or a registered dietitian. If the diet is not prescribed by a health care provider, written instructions shall be provided by the child's parent and shall be on file at the center.
(g) Food and beverages with little or no nutritional value served as a snack, such as sweets, fruit drinks, soft drinks, etc., will be available only for special occasions.
History Note: Authority G.S. 110-91(2); 143B-168.3; Eff. January 1, 1986; Amended Eff. July 1, 1998; October 1, 1991; November 1, 1989.
10A NCAC 09 .0902 GENERAL NUTRITION REQUIREMENTS FOR INFANTS
(a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding schedule for the child. This schedule must be followed at the center. This schedule must include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's schedule shall be modified in consultation, with the child's parent and/ or health care provider, to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant shall be posted for quick reference by the caregivers, except in centers licensed for three to 12 children located in a residence.
(b) Each infant will be held for bottle feeding until able to hold his or her own bottle. Bottles will not be propped. Each child will be held or placed in feeding chairs or other age-appropriate seating apparatus to be fed.
History Note: Authority G.S. 110-91(2); 143B-168.3; Eff. January 1, 1986; Amended Eff. July 1, 1998; October 1, 1991; November 1, 1989.
10A NCAC 09 .0903 REQUIREMENTS FOR CHILDREN AGED 24 MONTHS AND OLDER
Meals and snacks shall be planned according to the number of hours a child is in the center. These rules apply in all situations except during sleeping hours and nighttime care:
(1) For preschool-aged children in the center at least two hours but less than four hours, and for all school-aged children, one snack shall be provided unless the child is present during the time the center is serving a meal, in which case, a meal shall be provided.
(2) For children in the center at least four hours, but less than six hours, one meal shall be provided equal to at least one-third of the child's daily food needs.
(3) For children in the center at least six hours, but less than twelve hours, two meals and one snack or two snacks and one meal shall be provided equal to at least one-half of the child's daily food needs.
(4) For children in the center more than twelve hours, two snacks and two meals shall be provided which are equal to at least two-thirds of the child's daily food needs.
(5) No child shall go more than four hours without a meal or a snack being provided.
(6) A nutritious evening meal must be provided to each child who receives second shift care (from approximately 3:00 p.m. to 11:00 p.m.) and who is present when the regularly scheduled evening meal is served.
History Note: Authority G.S. 110-91(2); 143B-168.3; Eff. January 1, 1986; Amended Eff. November 1, 1989; January 1, 1987.
SECTION .1000 - TRANSPORTATION STANDARDS
10A NCAC 09 .1001 SEAT RESTRAINTS
(a) Each adult and child shall be restrained with an individual seat belt or appropriate child restraint device when the vehicle is in motion.
(b) Only one person shall occupy each seat belt or child restraint device.
(c) Children shall not occupy the front seat if the vehicle is equipped with an operational passenger side airbag.
(d) Except for when children under two years of age are transported, the restraint requirements in this Rule do not apply to vehicles not required by federal or state law to be equipped with seat restraints.
History Note: Authority G.S. 110-91; 110-91(13); 143B-168.3; Eff. January 1, 1986; Amended Eff. July 1, 1998; July 1, 1995; November 1, 1989; July 1, 1988; January 1, 1987.
10A NCAC 09 .1002 SAFE VEHICLES
(a) All vehicles used to transport children shall be in good repair, safe, and free of hazards such as torn upholstery that allows children to remove the interior padding or hurt themselves, broken windows, and holes in the floor or roof.
(b) Vehicles shall be insured for liability as required by State laws governing transportation of passengers.
(c) Vehicles used to transport children in snowy, icy, and other hazardous weather conditions must be equipped with snow tires, chains, or other safety equipment as appropriate.
History Note: Authority G.S. 110-91; 110-91(13); 143B-168.3; Eff. January 1, 1986; Amended Eff. July 1, 1998.
10A NCAC 09 .1003 SAFE PROCEDURES
(a) The driver or other adult in the vehicle shall assure that all children are received by a responsible person.
(b) Each center shall establish safe procedures for pick-up and delivery of children. These procedures shall be communicated to parents, and a copy shall be posted in the center where they can easily be seen. Centers licensed for three to 12 children located in a residence are not required to post these procedures.
(c) A first-aid kit shall be located in each vehicle used on a regular basis to transport children. The first-aid kit shall be firmly mounted or otherwise secured if kept in the passenger compartment.
(d) Emergency and identification information about each child must be in the vehicle whenever children are being transported.
(e) The driver shall be 18 years old or a duly licensed school bus driver and have a valid driver's license of the type required under North Carolina Motor Vehicle Law for the vehicle being driven or comparable license from the state in which the driver resides and no convictions of Driving While Impaired (DWI) or any other impaired driving offense within the last three years.
(f) Each person in the vehicle must be seated in the manufacturer's designated areas. No child shall ride in the load carrying area or floor of a vehicle.
(g) Children shall never be left in a vehicle unattended by an adult.
(h) Children shall be loaded and unloaded from curbside, or in a safe, off-street area, out of the flow of traffic, so that they are protected from all traffic hazards.
History Note: Authority G.S. 110-91; 110-91(13); 143B-168.3; Eff. January 1, 1986; Amended Eff. July