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TENNESSEE LICENSING STANDARDS FOR GROUP CHILD CARE HOMES

1240-4-1-.01 INTRODUCTION.

(1) Purpose Of Licensing. The primary purpose of licensing is the protection of children. Minimum requirements seek to maintain adequate health, safety, and supervision of children while in a group care setting. Developmental (comprehensive) child care provides appropriate educational experiences, health services, and social services to children and their families.

(2) Types Of Agencies. Child care services may be offered by family day care homes, group day care homes, day care or child development centers, nursery schools, day nurseries, and kindergartens as well as schools or agencies providing before and after school care. Regardless of name, purpose, or auspices, all are subject to licensure unless exempt by law. (See specific definitions below.)

(3) General Standards And Requirements.

(a) Issuance of a license is based on achievement in meeting and maintaining compliance with minimum standards, or requirements, set forth in these rules. The license applies only to the agency, organization, or person(s) to which or to whom it is issued and only to the building and premises approved for the operation of the child welfare agency. In addition to state licensing requirements, it is the responsibility of the applicant/licensee to comply with all applicable local ordinances, including zoning ordinances and business tax licenses or other locally required permits.

(b) A day care home must comply with all requirements in these rules to receive an annual license. In addition to fire safety and environmental sanitation approval, the applicant must demonstrate good faith intent to comply with these rules before a conditional license may be issued. Failure to meet such requirements, or to demonstrate good intention in meeting them in the case of a conditional license, shall constitute grounds for denial of a license or for revocation of a license already issued.

(c) Appendices to these rules which contain fire safety, health, environmental sanitation regulations, summaries of applicable laws, and other information are incorporated herein by reference.

(4) Legal Basis For Licensing. TCA §71-3-501 et seq. provide for defining, inspection, licensing, and regulation of child welfare agencies including day care homes. (See Appendix A for summary of applicable laws.) The Tennessee Department of Human Services has responsibility for licensing all such agencies offering child care to groups of children.

(5) Definitions. For the purpose of this Chapter, the following definitions are applicable:

(a) Annual License. An annual permit issued by the Department to a child welfare agency or to a child care system central operator, authorizing the licensee to provide child care in accordance with provisions of the license, the law, and requirements (rules) of the Department. Issuance of a license is not an endorsement of child care methods or of an agency's operational philosophy. A license is not transferable from one location to another or from one licensee/operator to another.

(b) Approved Day Care Home. An approved day care home is a day care home which is related through contractual or employment arrangements to a central operator. The approved day care home must meet the same requirements and must have been evaluated by the central operator in the same manner as an individual licensed day care home.

(c) Caregiver(s). Any person who provides all or part of the care of a group of children, including the primary caregiver.

(d) Central Operator. The individual(s), or the corporation, partnership, cooperative, or other private or public entity of any kind, who or which, through their authorized representative(s), in addition to other activities, if any, owns, administers or operates a child care system. The central operator shall have ultimate responsibility for the administration/operation of any or all day care homes and child care centers in the system and shall, together with the primary caregiver, sign the application for a license. The central operator shall be the licensee.

(e) Child. A person under 17 years of age.

(f) Child Care. The wide variety of arrangements made by parents (or guardians) for the care outside of their home of children under 17 years of age, for less than 24-hour periods without transfer of custody.

(g) Child Care System. The existence of any day care homes approved or licensed and used by a licensed and incorporated day care agency or a licensed child-placing agency in its work; or the existence of two (2) or more facilities used for day care purposes which facilities are under the ownership, administration or control of any individual(s), corporation, partnership, cooperative, or other public or private entity of any kind.

(h) Commissioner. The executive head of the Department of Human Services, appointed by the Governor.

(i) Conditional License. A permit issued by the Department to a new child welfare agency or to a new child care system central operator, permitting and authorizing the licensee to begin child care operations. It is valid for 90 days and is issued upon application by the operator only if the staff and facility do not present any apparent hazards to the children that may be in care and only if the facility has received fire safety and environmental sanitation approval. If, at the end of the 90-day period, evidence is provided by the applicant/ licensee that such child welfare agency is suitable and properly managed and that the agency is in compliance with these rules, the Department will issue an annual license to the child welfare agency.

(j) Day Care. Synonymous with definition of child care, above.

(k) Department (DHS). The Tennessee Department of Human Services and its representatives.

(l) Family Day Care Home. A home (an occupied residence) operated by a person for the purpose of receiving therein a minimum of five and a maximum of seven children under 17 years of age, who are not related to such person and whose parent(s) or guardian(s) are not residents in the same house, for less than 24 hours per day for care, without transfer of legal custody.

(m) Group Day Care Home. Any facility operated by a person, social agency, corporation or institution, or any other group which receives a minimum of eight and a maximum of 12 children (and up to three additional school-age children who will only be present before and after school, on school holidays, on school snow days, and during school summer vacation) for less than 24 hours per day for care outside their own homes, without transfer of legal custody. Before a group day care home opens, fire safety and environmental inspectors must approve the facility.

(n) High School Diploma. As used in the context of caregivers' qualifications, refers to a document recognizing graduation from an accredited institution, public or private, based on the issuing state's required number of academic credits, including passing a GED test. As used in this Chapter, a certificate or statement of attendance or similar document, or correspondence or video courses, do not qualify as or for a high school diploma.

(o) Infant. A child who is six weeks through 15 months of age.

(p) Law. The licensing law as contained in TCA §§71-3-501 through 71-3-531, and related statutes or other referenced statutes or regulations.

(q) Licensee. The person(s), agency(ies), or central operator to whom a license is issued and who must assume ultimate responsibility for a day care home or homes. In a single-site home, the licensee is the primary caregiver. In a child care system of approved homes, the central operator is the licensee. (The term as used herein also refers to an agency.)

(r) Parent. A biological or adoptive parent, guardian, or custodian who has primary responsibility for a child.

(s) Preschool Child. A person who is 31 months through five years of age. The term includes infants and toddlers.

(t) Primary Caregiver. The adult who is responsible for direct care and supervision of children in a day care home and for the daily operation of a home. In a group day care home which is not operated by a central operator, the primary caregiver is the licensee. Duties may include hiring, training, and supervision of other caregivers.

(u) School-age Child. A person who is five years of age and in kindergarten or older (refers to kindergarten through grade six).

(v) Staff. Full and part-time caregivers, employees, and volunteers, if any.

(w) Substitute. Paid or unpaid persons who are replacement for regular staff. The names, addresses, telephone numbers and dates of service shall be recorded for all substitutes in the staff personnel records of the home. Substitutes providing services for thirty-six (36) hours or more in a calendar year are required to have a criminal background check pursuant to 1240-4-1-.03(1)(a)6 and shall meet the same requirements for regular staff for physical examinations as required by 1240-4-1-.06(3); provided, however, for purposes of 1240-4-1-.03(1)(a)6, persons serving temporarily as caregivers in field service placements as part of an educational course of study or other curriculum requirement shall not be considered as substitutes for purposes of this rule.

(x) Toddler. A child who is 16 months through 30 months of age.

(y) Volunteer. A person who provides services for a child care agency without payment and who is used to supplement regular staff or substitutes. The volunteer shall not be used to meet classroom adult:child ratios. The names, addresses, telephone numbers and dates of service for all volunteers shall be recorded in the staff personnel records of the home.

(6) Procedures For Getting A License.

(a) The Department offers one prelicensure consultation session. When an individual or group is giving consideration to opening a child care service/business, the local county office of the Tennessee Department of Human Services should be contacted. The individual or group will be given the name of a licensing representative who will serve as their consultant.

(b) The Department will offer prelicensure training to prospective providers of day care. Interested persons or groups should contact a licensing representative to determine the date of the next meeting in their area.

(c) The licensing representative will inform the interested individuals or entity of the appropriate time to apply for a license. The group day care home application fee is $10.

(d) Upon satisfaction of the following minimum requirements, a conditional license may be issued:

1. Primary caregiver's qualifications meet the requirements (see Chapter 1240-4-1-.03);

2. Three satisfactory references for the primary caregiver are verified;

3. Physical facilities receive fire safety and environmental approval; and

4. If staff and facility do not present any apparent hazards to the children who may be in care.

(e) Receipt of an application begins the evaluation process which is completed with the issuance or denial of an annual license. This process includes:

1. At least two visits to the day care home, one of which is unannounced;

2. Observation of caregivers' interaction with children;

3. Review of agency records;

4. Request for written and oral information related to licensure requirements; and

5. Use of an evaluation checklist, itemizing requirements and noting compliance or noncompliance, a copy of which is left with the applicant.

(f) Upon issuance of an annual license, the licensee is expected to maintain compliance with requirements throughout the year.

(g) Near the end of a licensing term, the licensee will be notified by mail of a scheduled reevaluation for a new license. Application for a renewed license must be made prior to the expiration of the existing license. The reevaluation process is similar to the initial evaluation, but agencies receiving two consecutive annual licenses are rewarded with a shorter, less involved reevaluation and/or fewer reevaluations. A home accredited by the National Association for Family Day Care (NAFDC) may be reevaluated every three years. (See Appendix A for further information regarding the licensing process.)

(7) Licensing Action And Appeal Rights. Procedures for applications, suspensions, denials, revocations of licenses and appeal rights are governed by Chapter 1240-5-11.

(8) Grace Period. Because the amount of in-service training required has been increased, new agencies and new primary caregivers will be granted a reasonable grace period if needed to obtain the required hours of training.

(9) Investigations Of Child Abuse And Neglect; Custodial Authority Of Children.

(a) A child care provider is required by law to cooperate with the Department and other investigators by reporting any suspected child abuse and neglect to the Department. The child care provider must further cooperate by providing access to the records of children and staff and by allowing investigators to interview children and staff.

(b) A child care provider should protect the child by requesting the investigator's identification and by knowing who is entitled to custody of the child. An investigator may take a child off of the premises of the agency if he/she has obtained custody of the child through voluntary placement agreement with the parent, through court order or through emergency assumption of custody under TCA §37-1-113 without parental permission or if the child's parent or legal guardian is present and approves, or in conjunction with investigative procedures under the child abuse laws.

(c) Child care providers do not have a right to be present during interviews with staff or children or to receive information or results of the interviews or investigations concerning child abuse or neglect unless directly related to efforts to enforce the child abuse or licensing laws.

Authority: T.C.A. §§4-5-201 et seq., 71-1-105, 71-3-501 et seq., and Acts 2000, ch. 981, §§ 8 and 14. Administrative History: Original rule certified June 10, 1974. Amendment filed March 16, 1978; effective April 17, 1978. Amendment filed March 17, 1980; effective June 29, 1980. Repeal and new rule filed December 6, 1983; effective January 5, 1984. Amendment filed October 9,1987; effective January 27, 1988. Repeal and new rule filed April 22, 1992; effective June 6, 1992. Amendment filed April 30, 1996; effective July 14, 1996. Amendment filed September 29, 2000; effective December 13, 2000.

1240-4-1-.02 OWNERSHIP AND ADMINISTRATION.

(1) Ownership/Sponsorship.

(a) The licensee of a single-site group day care home shall be the primary caregiver.

(b) In a child care system, an adult person or persons shall be designated as having ultimate responsibility for the administration/operation of any or all day care home(s) in the system. Such person(s) shall be known as the central operator. The central operator and a primary caregiver shall sign an application for a license for each home sponsored (unless sponsoring agency is classified public).

(c) The name, address, and phone number of an applicant, central operator, and all primary caregivers shall be made known to the Department of Human Services and to parents of children enrolled in the home(s) and become public record.

(d) The applicant/licensee shall notify DHS before changing location of a group day care home.

(e) The primary caregiver shall assume responsibility for daily operation of a day care home and shall meet specified qualifications prior to licensure. (See Rule 1240-4-1-.03.)

(f) Day care agencies sharing common land shall be located in separate facilities and shall not share equipment or facilities with the exception of outdoor equipment and play area, which shall be used by children from one agency at a given time.

(2) Policies.

(a) A new primary caregiver shall complete in the presence of the Licensing Counselor the "Checklist of Services" or write out a Statement of Purpose.

(b) A group child care home shall have written policies concerning

1. Services offered;

2. Provision for children's individual needs;

3. The home's admission policies and enrollment procedures;

4. Fees charged (if applicable) and plan for payment;

5. Handling of children's personal belongings; and

6. If the agency provides transportation for children in the agency's care, the written statement required by 1240-4-1-.07(1)(a) describing transportation plans, procedures and equipment utilized in the transportation process and parental permission for trips away from facility.

(c) A policy statement signed by both the primary caregiver and the parent shall be given to the parent, and a signed copy or other documentation that parent received a copy shall be kept on file.

(3) Enrollment of Children and Parent Involvement.

(a) Children shall be at least six weeks of age before entering day care.

(b) Prior to admission of children, the parent shall submit a completed information (application) form and current health record. [See 4(e) below and Chapter 1240-4-1-.06.]

(c) A copy of "Summary of Licensing Requirements" (furnished by the Department) shall be given to the parent(s) of each child enrolled.

(d) During normal hours of operation, parents shall be permitted access to their children, and ready access to all licensed areas of the home and premises shall be granted to Department representatives and inspection authorities (i.e., fire safety, sanitation, and health).

(e) Parents must be informed in advance of the child's removal from the premises except in cases of emergencies or pursuant to investigative procedures conducted pursuant to the child abuse laws.

(4) Records. The following records shall be kept and shall be available to the Department:

(a) An annual operating budget (actual or projected), which includes a statement of income and expenditures. Adequate financing of the day care operation shall be maintained.

(b) Staff records including:

1. Recommendations from three nonrelated references on each applicant and caregiver. The central operator's/primary caregiver's reference information shall be given to the licensing counselor;

2. Training received during the year for each caregiver;

3. Reserved;

4. Adult health records.

(c) Children's health records.

(d) Daily attendance records on children; on staff if more than one caregiver.

(e) A record on each child which includes the following information:

1. Name, date of birth, name of parent(s), home address, business address and telephone, work hours, child's background information, transportation plan, and the names of persons allowed to pick the child up.

2. The following information shall be kept where it can be found quickly in an emergency: The name, address, and telephone number of the person parents wish to be called if they cannot be reached. The name, address, and telephone number of a doctor to call in an emergency; written permission of parent authorizing emergency medical care.

3. A written plan of how the primary caregiver intends to communicate daily with parents of every child below 31 months of age.

(f) Children's records shall be kept for one year following the child leaving the agency.

(5) Right to Privacy/Confidentiality. The licensee and caregivers shall not disclose or knowingly permit the use of by other persons any information concerning a child or family except as required by law or regulation.

(6) Posting of License. During the hours of operation, an up-to-date license to operate a group day care home shall be posted near the main entrance where anyone entering may see it.

(7) Liability and Medical Payment Insurance Coverage.

(a) General liability, automobile liability and medical payment insurance coverage shall be maintained on the vehicles owned, operated or leased by the child care agency and on the operations of the child care agency's facilities.

(b) Automobile liability coverage shall be maintained in a minimum amount of Three Hundred Thousand Dollars ($300,000) combined single limit of liability. The requirement of this subparagraph only applies to child care programs that transport children.

(c) General liability coverage on the operations of the child care agency facilities shall be maintained in a minimum amount of Three Hundred Thousand Dollars ($300,000) per occurrence and Three Hundred Thousand Dollars ($300,000) general aggregate coverage, or Three Hundred Thousand Dollars ($300,000) per occurrence.

(d) Medical payment coverage, as the primary coverage, shall be maintained in the minimum amount of Five Thousand Dollars ($5,000) for injuries to children being transported in vehicles owned, operated or leased by the child care agency under subparagraph (b), and in the minimum amount of Five Thousand Dollars ($5,000), for injuries to children resulting from the operation of the child care agency under subparagraph (c).

(e) The requirements of this paragraph shall not apply to an agency that is under the direct management of a self-insured administrative department of the state, a county or a municipality or any combination of those three (3) or that has, or whose parent entity has, a self-insurance program that provides, as determined by the Department, the coverages and the liability limits required by these rules.

(f) Documentation that the necessary insurance is in effect, or that the administrative department or other entity is self-insured, shall be maintained in the records of the child care agency and shall be available for review by the Department's licensing staff.

Authority: T.C.A. §§4-5-201 et seq., 4-5-202, 71-1-105, 71-1-105(5), 71-3-501 et seq., 71-3-502(a)(2), 71-3- 502(a)(4)(B), and Acts 2000, ch. 981, §§ 3(a)(4) and 14. Administrative History: Original rule certified June 10, 1974. Amendment filed March 16, 1978; effective April 17, 1978. Repeal and new rule filed December 6, 1983; effective January 5, 1984. Amendment filed October 9, 1987; effective January 27, 1988. Repeal and new rule filed April 22, 1992; effective June 6, 1992. Amendment filed July 1, 1993; effective September 14, 1993. Amendment filed November 18, 1999; effective January 31, 2000. Amendment filed September 29, 2000; effective December 13, 2000. Amendment filed August 30, 2001; effective November 13, 2001. Amendment filed November 21, 2002; effective February 4, 2003.

1240-4-1-.03 STAFF.

(1) Qualifications.

(a) All Caregivers.

1. Every staff person, including volunteers, practicum students, and substitutes, shall be physically, mentally, and emotionally capable of performing his/her duties satisfactorily.

(i) Drug Screening for Child Care Vehicle Drivers Upon Reasonable Cause.

(I) The Department, in its sole discretion, may require any individual, who drives or may drive at any time any vehicle transporting children on behalf of the agency or its contractors, to undergo a drug screening test when, in the Department's sole determination, there is reasonable cause to believe that such individual may have an impairment or possible impairment that potentially poses a risk of harm to children in the care of the agency caused by the use, or possession and potential use, of any drug. For purposes of this part, the term "drug" shall include alcohol.

(II) An individual directed to undergo such examinations or screenings may refuse to do so, but will not be permitted to drive a vehicle transporting children in the agency or have any further contact with children in the care of the child care agency until evidence is provided that is satisfactory, in the Department's discretion, to demonstrate that the individual does not represent a risk of harm to the children in the agency's care.

(ii) Safety Plans.

(I) The Department may require, in its sole discretion, the child care agency to enter into a safety plan approved by the Department that prohibits or limits such individual's contact with children in the care of the child care agency pending the outcome of such testing.

(II) The Department may otherwise require, in its sole discretion, that the child care agency enter into a long-term or permanent safety plan that prohibits or limits the driving duties by an individual described in part 1 for, or contact by such individual with, children in the care of the agency.

(III) Failure to adhere to the safety plan shall be grounds for action by the Department against the child care agency's license as permitted by T.C.A. § 71-3-508(c).

(IV) The child care agency, or any individual whose employment status is directly and adversely impacted by a safety plan or by refusal to undergo an examination as directed by the Department may, at any time during the existence of the plan or during the pendency of the directive for an examination, make written request to the Director of Licensing for an intradepartmental review of the safety plan. Such review shall be conducted by the Director or the Director's designee within ten (10) business days of receipt of the written request.

(V) Any individual or child care agency that has received an adverse decision from the intradepartmental review set forth in subpart (IV) above, may appeal such safety plan to the Department by filing a written request for an administrative hearing before the Department's Administrative Procedures Division within ten (10) business days of the Director's decision. The hearing shall be held by the Division within twenty (20) business days of the receipt of the request for an administrative hearing.

(VI) Any safety plan that exceeds ninety (90) days when proposed or that continues for more than ninety (90) days may be appealed by the child care agency to the Child Care Agency Board of Review.

2. A person who has a physical, mental, or emotional condition which is in any way harmful to children shall not be present with the children.

3. To be counted in the caregiver to child ratio, caregivers shall be at least 16 years of age and able to read and write, and must be supervised by an adult.

4. Caregivers shall be of suitable character to work with young children.

5. Reserved.

6. Criminal history and abuse registry background checks; appeals; exemptions.

(i) Each person:

(I) Applying to work with children as a paid employee, a director, or manager of a child care agency;

(II) Applying to work as a new substitute in a child care agency;

(III) Who applies for a license for, or who otherwise seeks to operate (an "operator") a child care agency as defined in TCA §§ 71-3-501 et seq. and who has significant contact with children in the course of the role of operator. For purposes of this subparagraph, an "operator" shall be an individual who is an owner or administrator of a child care agency or a child care system; or

(IV) Fifteen (15) years of age or older who resides in a child care agency or who moves into a child care agency following initial licensure shall:

I. Complete a criminal history disclosure form as approved by the Department;

II. Supply a fingerprint sample in a manner prescribed by the Tennessee Bureau of Investigation in accordance with procedures established by the Department, and shall submit to a fingerprint based criminal history check to be conducted by the Department and the Tennessee Bureau of Investigation in accordance with procedures established by the Department;

III. Submit to a review of their status on the Department of Health's vulnerable persons registry under Title 68, Chapter 11, Part 10 of the Tennessee Code Annotated.

IV. Agree to release all records relating to his or her criminal history to the child care agency and to the Department so that the criminal history information can be verified.

(ii) The entity that is seeking to employ the person or use the person as a substitute, or which has the person residing in the agency, or the licensee or operator of a child care agency, shall be responsible for obtaining, and submitting the fingerprint sample and any information necessary to process the criminal history review, in such manner as may be required by the Department, to the Tennessee Bureau of Investigation within ten (10) days of the first day of beginning employment or substitute status, or within ten (10) days of the license application or seeking operator status, or, within ten (10) days of the application for an initial license for a facility in which the person resides or within ten (10) days after the resident moves into the child care facility.

(iii) The child care agency shall be responsible for all costs associated with obtaining, handling and processing of the fingerprint sample which is submitted to the Tennessee Bureau of Investigation. The Department of Human Services will pay for the costs of processing the criminal records background check with the Tennessee Bureau of Investigation using the applicant's fingerprint sample. The Department shall only pay for one (1) processing fee that is required by the Tennessee Bureau of Investigation. If the fingerprint sample is rejected, and further costs are required to process the fingerprint, the child care agency is responsible for any further costs, regardless of the number of efforts required to obtain a valid fingerprint sample.

(iv) Pending outcome of the fingerprint background check and the Department of Health's vulnerable person's registry the applicant for employment, for a license or for operator or for a substitute position shall be conditional and shall be dependent upon the background check. No person whose criminal history disclosure form describes a criminal history or other activities within the prohibitions of subpart (vii) shall be permitted to be employed as a caregiver, a substitute, director, nor may such person be allowed to be a licensee, or an operator who has significant contact with the children in the agency's care, nor shall such person be permitted to reside in or otherwise have access to children in the child care facility while children are present.

(v) A copy of the disclosure form and the results of the criminal history check and the results of the inquiry to the Department of Health's vulnerable persons registry shall be maintained in the child care agency's records for review by the Department of Human Services.

(vi) The child care agency shall immediately review the report of the background check received from the Department and the Tennessee Bureau of Investigation, and shall immediately consult with the Department to resolve any questions relative to the person's status. Upon determination that the person's status prohibits the person from having access to children as described in subpart (vii), the child care agency shall immediately exclude such person from access to children. Failure to exclude the person under this part or subpart (iv) will result in immediate suspension of the child care agency's license.

(vii) Exclusions from access to children based upon criminal history or other status.

(I) No person shall be employed, or otherwise act, as a caregiver or as a substitute caregiver for children in a child care agency, nor shall any person be a licensee, director, or be an operator who has significant contact with children in a child care agency, nor shall a person who is a resident in a child care agency have access to or contact with children in a child care agency, nor shall any other person have any access to children in a child care agency whatsoever, who:

I. has any pending warrant, indictment or presentment;

II. has been convicted, pled guilty to or pled no contest to any crime or charge, or

III. has any pending juvenile proceeding or previous juvenile finding which, if an adult, would result in any crime or charge, involving:

A. Any crime, including a lesser included offense derived from any crime involving the physical, sexual, or emotional abuse or gross neglect of a child or any other crimes involving a threat to the health, safety or welfare of a child; or

B. Any crime of violence, including a lesser included offense derived from a crime of violence against another person; or

C. Any crime involving, or lesser included offenses derived from any crime involving, the manufacture, sale, distribution or possession of any drug; or

D. A violation of TCA §§ 39-13-213; 55-10-101; 55-10-102 or 55-10-401 or any felony involving use of a motor vehicle while under the influence of any intoxicant. Such persons under this subitem may not for a period of five (5) years from the date of the conviction or guilty plea be employed or serve as a driver transporting children for a child care agency.

IV. Is listed on the abuse registry maintained by the Department of Health pursuant to Title 68, Chapter 11, Part 10 of the Tennessee Code Annotated; or

V. Known to the management or licensee of a child care agency as a perpetrator of child abuse or child sexual abuse or who is identified to the child care agency's management or licensee by the Department of Human Services or by the Department of Children's Services as a validated or indicated perpetrator of abuse of a child based upon an investigation conducted by the Department of Children's Services or by the child protective services agency of any other state; and

A. who is associated in providing care or ancillary services in any manner within a child care agency; or

B. who is a family member or other person residing at the child care agency's facility(ies) or adjacent residence of the caregiver; or

C. who has unrestricted access to children in the child care agency as determined by the Department of Human Services.

(II) An employee or volunteer who has been identified by the Department as having neglected a child based on an investigation conducted by the Department of Children's Services, or any child protective services agency of any state, and who has not been criminally charged or convicted or pled guilty as stated above, shall be supervised by another adult while providing care for children.

(viii) Appeals of exclusions.

(I) Any person who is excluded or whose license or operator status is denied based upon the results of the criminal history background review may appeal the exclusion or denial to the Department within ten (10) days of the mailing date of the notice of such exclusion or denial to the subject person.

(II) If timely appealed, the Department shall provide an administrative hearing pursuant to Title 4, Chapter 5, Part 3 of the Tennessee Code Annotated in which the appellant may challenge the accuracy of the report, and may challenge the failure to grant an exception to the exclusion or denial required by this subsection if a rule for such purpose has been promulgated by the Department pursuant to subpart (ix).

(III) The appellant may not collaterally attack the factual basis of an underlying conviction except to show that he/she is not the person identified on the record. Further, except to show that he/she is not the person identified in the record, the appellant may not collaterally attack or litigate the facts which are the basis of a reported pending criminal or juvenile charge except to show that such charge was, or since the report was generated, has been dismissed, nolled or has resulted in an acquittal.

(ix) Exemptions from exclusions.

(I) The Department will consider the granting of exemptions from the prohibitions under subpart (vii).

(II) The person seeking the exemption may indicate the request on the disclosure form, or may seek the exemption by written request to the Commissioner at any time. The request shall state the basis for the request, including any extenuating or mitigating circumstances that would, in the person's opinion, justify an exemption from the exclusion. Any documentary evidence may also be submitted with the request

(III) Advisory group to review exemption requests.

I. The Department will establish an advisory group composed, at a minimum, of law enforcement personnel, persons experienced in child protective services, persons experienced in child development issues and child care providers licensed by the Department to review the requested exemption and advise the Department as to whether such request is warranted.

II. At the Department's request, the advisory group shall review the written request and any other evidence in any other form which it determines necessary to determine the status of the exemption request.

III. Based upon the recommendation of the advisory group, the Department shall make the final determination regarding an exemption. The exemption shall only be granted if the circumstances, as reviewed and determined by the advisory group and the Department, clearly warrant the exemption. The decision will be filed with the child care agency and shall be maintained in the Department's record concerning the agency and shall be open to public inspection.

(IV) Appeal of exemption decision.

I. The Department shall notify in writing the person making the request for exemption of the decision regarding the exemption request and the basis for the decision. A person aggrieved by the Department's determination may appeal the decision by filing a written request with the Commissioner within ten (10) days of the mailing date of the decision as shown by the date of the notice. If timely appealed, the person shall be granted an administrative hearing under the provisions of TCA §§ 4-5-301 et seq.

II. The appellant may not collaterally attack the factual basis of an underlying conviction except to show that he/she is not the person identified on the record. Further, except to show that he/she is not the person identified on the record, the appellant may not collaterally attack or litigate the facts which are the basis of a reported pending criminal or juvenile charge except to show that such charge was, or since the criminal background history report was generated, has been dismissed, nolled or has resulted in an acquittal.

(x) Alternate and Supplementary Criminal Background Checks.

(I) The Department of Human Services may, at its own expense, utilize background checks pursuant to the provisions of TCA § 71-3-507(g) or (h) to determine the criminal history or other status on the Department of Health's abuse registry of persons applying to work or who are current employees, licensees, operators or volunteers or current residents of child care agencies or persons working with contractors of the Department who are not otherwise required by the provisions of this subparagraph or any other provisions of law to undergo a criminal history background check. The Department may also utilize the abuse registry of the Department of Health under Title 68, Chapter 11, Part 10 of the Tennessee Code Annotated, for such persons.

(II) The Department may require such individuals to complete a disclosure form as required by subpart (i) and to undergo a fingerprint sample. The Department will submit the form and the fingerprints to the Tennessee Bureau of Investigation for review.

(III) Status Pending Background Check.

I. Pending the outcome of the background check, if required, the applicant for employment or licensee or operator status or for a substitute or volunteer services position, shall be in a conditional status with the child care agency or the Department contractor, and such status shall be dependent upon the outcome of the background check.

II. The employment status of persons for whom a post-employment criminal background check was conducted, or the status of existing licensees or operators, substitutes, volunteers or residents of a child care agency for whom a criminal background check was conducted after license approval, and who were not otherwise subject to a prestatus applicant background check and to the exclusionary provisions provided in this part, shall be governed by any regulations which may govern their status in a regulated entity or by applicable employment law.

(IV) Name Searches.

I. As a further supplemental method of criminal background history review for any applicants for employment, license or operator status, or for substitute or volunteer status with child care agencies, or with the Department or its contractors, as listed in subdivision TCA § 71- 3-501(g)(1) or with the entities which the Department may regulate, or for residents of new child care agencies, or for current employees, licensees, operators, substitutes or volunteers of child care agencies or for current residents of child care agencies, the Department may require such persons to submit a disclosure form as set forth in part 1, a copy of which shall be maintained with the Department and shall be filed with the entity with whom such person is associated, and may require such person to agree to release all records involving the person relating the criminal history of such person.

II. The Department may, by agreement with the Tennessee Bureau of Investigation, access the Bureau's criminal history computer database using only the name of the person and such other person as contained on the disclosure form or such other information as may be available. If the Department determines it to be necessary, then the Department may require fingerprint verification pursuant to items (I) and (II) above.

(V) All provisions of subpart (vii) including, but not limited to, the exclusion of individuals from providing care, from being licensed for the care of children or having access to children upon determination of the criminal background or perpetrator of such individual, the suspension of operations of regulated, certified or approved entities that fail to exclude persons with a criminal background, and the exemptions from the exclusionary provisions shall be applicable to persons having criminal backgrounds or perpetrator status as determined by the processes established by this part.

(VI) Any person disqualified from care for or access to children based upon the results of the criminal history background review under this part may appeal that determination to the Department as provided in subpart (viii).

(VII) Nothing in this part shall be construed to prevent the exclusion of any individual from providing care for, from being licensed or approved for the care of children pursuant to this part or from having access to a child in a child caring situation if a criminal or juvenile proceeding background or perpetrator status is discovered and verified in any other manner other than through a procedure established pursuant to this chapter. All procedures, rules, and appeal processes established pursuant to this subparagraph for the protection of children and the due process rights of excluded individuals shall also be applicable to such individuals.

(xi) Nothing in this part shall be construed to mean that any other law which mandates that criminal background checks be conducted on applicants for employment, license or operator status, for substitute or volunteer positions or for resident status is made voluntary, repealed or superseded in any manner by the provisions of this subparagraph, and the provisions of subpart (x) are supplementary to, and are not in lieu of any mandatory provisions for such other statutorily required criminal background checks.

7. Reserved.

8. Reserved.

9. All caregivers shall be able to explain emergency procedures to follow in case of fire, serious injury or illness of a child or a caregiver, or disaster.

10. All caregivers shall have training in detection, reporting, and prevention of child abuse.

11. All caregivers shall have a minimum of two hours training annually, in addition to other required training in specific subject areas.

(b) Primary Caregiver.

1. Prior to issuance of a license, the primary caregiver in a single-site home and all primary caregivers in a system shall:

(i) be 18 years of age or older;

(ii) be able to read and write English; and

(iii) have earned a high school diploma (See definitions in Section 1240-4-1-.01).

2. A primary caregiver shall complete a DHS-sponsored child care orientation class within three months of licensure.

3. A substitute for the primary caregiver shall be at least 18 years of age.

4. A primary caregiver shall present evidence of receiving eight hours of training, consultation, or technical assistance annually in child care or a related field. After the first year of licensure (in any category), this training shall be in addition to other required training in specific subject areas such as Child and Adult Care Food Program (CACFP), personal safety or first aid, etc.

5. A primary caregiver shall not be employed at any other occupation during child care operating hours.

(c) Central Operator.

1. In order to receive a license, the central operator or person in charge of the child care system (or multiple homes) shall have:

(i) Graduated a four-year college or university and completed one year of full-time work experience with a group of young children; or

(ii) Completed some formal college training in early childhood education or child development (or related field), or received a Child Development Associate (CDA) credential or National Association of Family Day Care (NAFDC) accreditation, and completed one year of full-time work experience with a group of young children; or

(iii) A high school diploma or its equivalent (see "Definitions" in Chapter 1240-4-1- .01) and two years full-time work experience with a group of young children. 2. The central operator or person in charge of the child care system shall complete a DHSsponsored child-care orientation class within three months of licensure.

(2) Caregiver to Child Ratios and Supervision.

(a) An adult caregiver (at least 18 years of age) shall be present and supervising children in care.

(b) The total number of children (including "related" children under nine years of age) shall not exceed 15.

(c) If enrollment drops to seven or fewer children, family day care home ratios shall be met.

(d) If four (4) or more infants/toddlers are enrolled, they shall have their own space and their own caregiver for their safety and security and for infection control. Children shall be cared for in small groups as much as possible, but may be mixed for short periods. Barriers shall be sufficient to provide separation without isolating children.

(e) Staff Ratios and Chart.

1. A group day care home shall have 1, 2, or 3 caregivers, based upon the ages and numbers of children served.

2. Before eight (8) or more children are enrolled, the facility shall be approved by a fire safety inspector and by an environmentalist.

3. If any child's physical or mental condition requires special care, or if children under nine (9) years of age living in the home increases the group size, or when a field trip is taken off the premises, the number of caregivers shall be increased by one (1).

4. One of the following adult-child ratios shall be met. (A chart is also provided at the end of part 4.):

(i) Group Day Care Homes with One Caregiver:

(I) If any number of children up to the maximum of fifteen (15) children are present, and no child is under three (3) years of age, at least one (1) caregiver shall be present.

(II) If over twelve (12) children are enrolled, the additional children shall be of school age and a school age program shall be provided.

(ii) Group Day Care Homes with Two Caregivers:

(I) If any number of children up to the maximum of fifteen (15) children are present, and at least one (l) but not more than nine (9) children are present who are under the age of three (3), then at least two (2) caregivers shall be present. If more than four (4) of those children are under two (2) years of age, three (3) caregivers shall be present.

(II) If over twelve (12) children are enrolled, the additional children shall be of school age and a school age program shall be provided.

(iii) Group Day Care Homes with Three Caregivers:

(I) If any number of children up to the maximum of fifteen (15) children are present, and ten (10) or more children present are under three (3) years of age, there shall be three (3) caregivers present.

(II) If over twelve (12) children are enrolled, the additional children shall be of school age and a school age program shall be provided.

Caregivers Required1
Maximum Number of Children and Ages2

1
Maximum of 15 present and no child present is under three (3) years of age.3

2
Maximum of 15 present and at least one (1) child up to a maximum of nine (9) children present are under three (3) years of age, but no more than four (4) present are under two (2) years of age.3

3
Maximum of 15 if ten (10) or more are under three (3) years of age.3

1 If any child's physical or mental condition requires special care, if children under 9 living in the home increases the group size, or when a field trip is taken off premises, the number of caregivers required shall be increased by one.

2 Before 8 or more children are enrolled, the facility shall be approved by a fire safety inspector and by an environmentalist.

3 If over 12 children are enrolled, the additional children shall be of school age and a school age program shall be provided.

Authority: T.C.A. §§4-5-201 et seq., 4-5-202, 71-1-105, 71-3-501 et seq., 71-3-502(a)(2), 71-3-508(c), Acts 2000, ch. 981, §§ 8 and 14, and Acts 2003, ch. 412, § 2. Administrative History: Original rule certified June 10, 1974. Amendment filed March 16, 1978; effective April 17, 1978. Repeal and new rule filed December 6, 1983; effective January 5, 1984. Amendment filed October 9, 1987; effective January 27, 1988. Repeal and new rule filed April 22, 1992; effective June 6, 1992. Amendment filed July 1, 1993; effective September 14, 1993. Amendment filed April 30,1996; effective July 14, 1996. Amendment filed September 29, 2000; effective December 13, 2000. Amendment filed September 29, 2003; effective December 13, 2003.

1240-4-1-.04 EQUIPMENT.

(1) General.

(a) All equipment shall be well made and safe with no sharp edges, splinters, or other conditions which present a hazard for children.

(b) Unsafe equipment shall be repaired or removed from the day care home or play yard at once.

(c) Babies and toddlers shall have additional equipment for comfort and safety, such as cribs, high chairs, etc.

(d) School-aged children shall have educational materials such as puzzles, craft items, etc., and equipment suitable for their size, interests, and needs.

(2) Indoor Play Equipment.

(a) The day care home shall have play equipment for active and quiet play, suitable for the children's ages and interests and for children with special needs, and for all activities required in the Program Section. (See Chapter 1240-4-1-.05.)

(b) Play materials and equipment shall be in sufficient quantity to provide twice as many activities as there are children at a given time.

(c) Play materials and equipment shall be placed in such a way that children can get it and return it when needed, so that they can grow in independence.

(3) Outdoor Play Equipment.

(a) Enough play equipment shall be provided so that each child can take part in many kinds of play each day.

(b) Equipment shall be placed to avoid accidents, for example, swings placed out of traffic paths.

(c) If there are climbers or swings, they shall be placed on a resilient surface and not over concrete, asphalt, or similar surface such as hard-packed dirt.

(d) Climbers, swings, and other large equipment shall be securely anchored.

(e) If used, retainer structures for loose material, such as sand or pea gravel, shall be placed at least six (6) feet from the perimeter of play structures.

Authority: T.C.A. §§71-1-105(12) and 71-3-501 et seq. Administrative History: Original rule certified June 10, 1974. Amendment filed March 16, 1978; effective April 17, 1978. Repeal and new rule filed December 6, 1983; effective January 5, 1984. Amendment filed October 9, 1987; effective January 27, 1988. Repeal and new rule filed April 22, 1992; effective June 6, 1992. Amendment filed April 30, 1996; effective July 14, 1996.

1240-4-1-.05 PROGRAM.

(1) Activities.

(a) A balanced daily program of developmentally appropriate activities shall be provided which includes some of the following: reading to and talking with children; art and music activities; building and manipulating toys; and dramatic play activities such as doll play, housekeeping, and role play. Children shall also be allowed to participate in age-appropriate home-type activities, such as cooking, cleaning, gardening, and washing clothes as a meaningful learning experience.

(b) There shall be a written and posted schedule of daily routine activities.

(c) Children shall be given opportunity to make their own choices in some activities. Other play activities shall be planned by the caregiver.

(d) Children shall not spend all day in one room, unless the room has at least 30 square feet of usable play space per child.

(e) Television, video tapes, and movies shall be limited to two hours per day and to programs designed for children's education and/or enjoyment. Programs/movies with violent or adult content (including "soap operas") shall not be permitted in children's presence. Other activities shall be available to children during television/movie viewing.

(f) Except when the weather is extremely bad, children of all ages, including infants and toddlers, shall have outdoor play each day.

(2) Discipline.

(a) Discipline techniques used shall be positive, appropriate to the age level and needs of children in care; designed to help children learn and maintain self-control and self-esteem; and shall not involve physical punishment, or deprivation of food, rest, or toileting. (Physical, or corporal punishment is the infliction of bodily pain as a penalty for the child's behavior of which the punisher disapproves.)

(b) Praise and encouragement of good behavior shall be used instead of noticing only unacceptable behavior.

(c) Punishment which is shaming, humiliating, frightening, or injurious to children shall not be used.

(3) Physical Care - Naps.

(a) Preschool children shall have a reclining rest period according to their individual needs. School-aged children shall be allowed to nap if needed but not forced to do so.

(b) Each toddler who is able to walk and each preschooler shall have individual napping space, something soft and at least two inches thick to sleep on, and clean bedding. (Examples: couch with cover, thick sleeping bag or foam pad, family bed with cover, or cot with cover.)

(c) Each child under 15 months of age and any child unable to walk shall have his/her own crib or playpen and bedding for napping.

(d) Because of the risk of Sudden Infant Death Syndrome (SIDS), sleeping infants (under 13 months) shall be checked every 30 minutes by touching them. If a child appears not to be breathing, emergency medical assistance shall be sought immediately.

(e) Each child shall have his or her own clean sheet and coverlet.

(f) After a child has rested for a reasonable period, she/he shall be allowed to get up.

(4) Physical Care - Toilet Training.

(a) Toilet training shall never be started until a child has been in the day care home long enough to feel comfortable.

(b) Toilet training shall not be started until a child is able to understand, to do what is asked of them, and to let their need to use the bathroom be known.

(c) Children shall not be made to sit on the potty or toilet for more than five minutes.

(d) Children shall be diapered or cleaned when needed in a safe, sanitary manner.

Authority: T.C.A. §§71-1-105(12) and 71-3-501 et seq. Administrative History: Original rule certified June 10, 1974. Amendment filed March 16, 1978; effective April 17, 1978. Amendment filed June 7, 1982; effective September 30, 1982. Repeal and new rule filed December 6, 1983; effective January 5, 1984. Amendment filed June 27, 1985; effective September 13, 1985. Amendment filed October 9, 1987; effective January 27, 1988. Amendment filed April 30, 1996; effective July 14, 1996.

1240-4-1-.06 HEALTH AND SAFETY.

(1) Children's Health Records.

(a) Before a preschool child older than eight weeks is accepted for care, he/she shall have proof of being age-appropriately immunized against the following diseases: diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, and hemophilus influenza type B by having a certification form signed or stamped by a certified health care provider. (Children of six through eight weeks of age may be enrolled before immunizations are begun.)

(b) Records of children older than 18 months shall state whether immunizations required for care are complete, and if not complete, when future immunizations will be given. If immunizations are not continued on time by the parent, the child shall not remain in care. If a child has any known allergies, they shall be indicated in the child's health record. Foreign-born children shall also present evidence of tuberculosis (TB) screening. (See Appendix B for information about TB screening.)

(c) A copy of each infant/toddler's or preschool child's immunization record shall be on file in the day care home and available to appropriate staff. (Children of six through eight weeks of age may be enrolled before immunizations are begun.)

(d) Before a school-aged child is accepted for care, the caregiver shall have on file a statement from the parent (or school) that the child's immunizations are current and that their health record is on file at the specified school which the child attends.

(e) If children with mental, physical, or sensory impairment or with a medical disorder are enrolled, their health records shall include a physician's statement which identifies the disabling condition and which gives the physician's special instructions for the child's care.

(f) Before infants or toddlers aged 30 months and under are enrolled, they shall have proof of a physical examination within three months prior to admission, signed or stamped by a physician or health care agency. Each infant shall have on file an official health record of the first medical check-up at eight weeks of age.

(g) Exceptions to the above requirements in this section shall be made when:

1. The child's physician or the Department of Health provides a signed and dated statement, giving a medical reason why the child should not be given a specified immunization; or

2. The child's parent provides a written statement that such immunizations conflict with his/her religious tenets and practices.

(h) Accidents and injuries to children shall be noted in their records, including date and time occurred, description of circumstances and action taken by caregivers.

(2) Children's Health Requirements.

(a) Children shall be checked upon arrival and observed for signs of communicable disease during the day. Every sign of illness or injury shall be reported to the parent as soon as possible but no later than the end of the day in which it occurred.

(b) Parents of every child enrolled shall be notified if one of the following communicable diseases has been introduced into the day care home: hepatitis A, food-borne outbreaks (food poisoning), salmonella, shigella, measles, mumps, rubella, pertussis, polio, hemophilus influenza type b, meningococcal meningitis. Providers shall report the occurrence of the above diseases to the local health department.

(c) Prescribed and nonprescribed, internal and external medication shall not be administered to a child except under the direction of a physician or with the parent's written authorization. Medications or drugs shall be labeled with the child's name and specific instructions for administering them. Administration of medications and noticeable side effects shall be charted and reported to parents. Medication shall not be handled by children and shall be stored so as to be inaccessible to children.

(d) Good hygiene shall be practiced, such as frequent handwashing; one-time use of tissues, napkins, and washcloths; proper storage and use of personal articles; and hygienic diapering techniques.

(3) Caregivers' Health Requirements.

(a) Before beginning to work, each caregiver shall have written evidence of a physical examination and statement that the caregiver's general physical and mental condition will permit the individual to direct and actively participate in the activities of a group of young children. The form or statement shall be signed or stamped by a physician.

(b) An updated statement of each caregiver's physical health shall be obtained every third year or more often if deemed necessary by the Department. A statement of a caregiver's mental or emotional health shall be obtained from a psychiatrist or clinical psychologist when deemed necessary by the Department.

(c) Each caregiver (whether employed full-time or part-time), volunteers, and others who are in contact with the children 30 or more calendar days per year shall have on file evidence of a tuberculin skin test or chest X-ray with negative results, in accordance with Department of Health recommendations. (See guidelines in Appendix B.)

(d) Caregivers shall not smoke while physically interacting with the children. Parents shall be informed if anyone in the home smokes.

(e) For the protection of children and adults, caregivers and helpers shall wash their hands immediately after changing a child's diaper, or aiding in toileting, before changing or aiding another child.

(f) For the protection of children and adults, when blood is to be handled (e.g., resulting from injury to a child or adult, from nosebleed or from spillage), vinyl or latex gloves shall be used and properly disposed of following use with/by one individual.

(g) Following a diaper change or blood spillage, surfaces shall be cleaned and sanitized with a solution of 1/4 cup chlorine bleach to one gallon of water.

(4) Safety.

(a) The primary caregiver shall have evidence of completing, or being currently enrolled in, a pediatric first aid course (a minimum of three hours) taught by a qualified instructor.

(b) The primary caregiver shall have evidence of completing, or being currently enrolled in, a pediatric CPR course (a minimum of three hours) taught by a qualified instructor.

(c) First aid information shall be posted, and caregivers and helpers shall be familiar with it.

(d) A first aid kit shall be available to staff. The contents shall include a digital thermometer, bandages, and other items listed in Appendix C.

(e) The home shall have a working telephone accessible to caregivers for incoming and outgoing calls.

(f) These telephone numbers shall be posted near the telephone: fire department, law enforcement, hospital, child abuse hotline, civil defense/emergency management, and numbers where parents may be reached. Rescue squad, ambulance, and poison control center numbers shall also be posted if available in the community.

(g) All homes shall annually present a child sexual abuse prevention program to children enrolled in and cared for by the home.

(h) Suspected abuse or neglect of a child shall be reported immediately to the local DHS office. Failure to do so is, by itself, grounds to deny or revoke the agency's license.

(i) The primary caregiver shall be reasonably prepared to protect children in the event of a disaster by knowing who to contact and how to cooperate with the local Emergency Management Plan.

(j) Emergency transportation shall be planned for and shall be provided as needed.

(k) Firearms and other deadly weapons or tools on the premises shall be secured in such a way that they are inaccessible to children.

(1) Use of swimming pools shall comply with environmental sanitation regulations in Appendix E. Wading pools which have not been approved by the environmentalist shall not be used.

(m) Pets shall be vaccinated in accordance with a veterinarian's recommendation. Unconfined pets and children shall not be together on a regular basis. An adult shall be present while pets are with children. Animals and birds shall not be allowed in areas of food storage, preparation, or service.

Authority: T.C.A. §§71-1-105(12), 71-3-501 et seq., and 37-1-603(b)(1)(A). Administrative History: Original rule certified June 10, 1974. Amendment filed March 16, 1978; effective April 17, 1978. Amendment filed June 7, 1982; effective September 30, 1982. Repeal and new rule filed December 6, 1983; effective January 5, 1984.

1240-4-1-.07 TRANSPORTATION.

(1) Management Responsibility, Loading\Unloading and Verification Procedures; Staff Qualifications.

(a) Management Responsibility.

1. Existing child care agencies, or those applying or re-applying for licenses, that provide transportation services, must provide a written statement to the Department describing:

(i) The type(s) of transportation that will be offered, e.g., from the child's home to the child care agency, from the child care agency to the child's school, etc.;

(ii) The types of vehicles that will be used for the transportation of children, e.g., a 1999 fifteen (15) passenger Ford van;

(iii) Any contracts, agreements or arrangements with any third parties for the provision of transportation services;

(iv) The provider's plan for maintaining compliance with the transportation time limits set forth in 1240-4-1-.07(6);

(v) The provider's policy and procedures for maintaining compliance with the transportation verification procedures set forth in 1240-4-1-.07(1)(b);

(vi) The provider's policy and procedures for attaining and maintaining compliance with child restraint procedures required by: these rules; Tennessee Code Annotated, Title 55, Chapter 9, Part 6; applicable Federal Motor Vehicle Safety Standards relative to child safety restraints, and; the child restraint and vehicle manufacturer's design requirements for the type of child restraints and vehicles used to transport children; and

(vii) The provider's policy and procedures for the emergency evacuation of the vehicle.

2. The child care home's management shall be fully responsible for the transportation of children between home and the child care home, to or from school, and/or on field trips on any vehicle which it operates, for which it contracts or which is otherwise under its direction or control.

3. Vehicles used to transport children and which are owned or operated by, contracted for or which are otherwise under the direction and control of the child care agency, shall carry automobile liability insurance coverage for each vehicle used for that purpose in the minimum amounts required by Rule 1240-4-1-.02(7).

(b) Loading\Unloading and Verification Procedures.

1. The driver of the vehicle or any other designated staff person riding on the vehicle shall use a passenger log to record the name of each individual child received for transport as the child enters the vehicle. No child shall be accounted for by use of a single entry in the log that would include all, or part, of a group of other siblings or relatives with the same last name and with whom the child is being transported. For example, three (3) siblings with the same last name, e.g., "Doe", who are transported on the same vehicle shall not be recorded by the single entry "Doe" which only records the group's last name and is used by the child care home to signify that all three (3) "Doe" children are accounted for. Each child shall, instead, be separately listed by first and last name.

2. During transportation, the passenger log shall be used to take roll each time the vehicle makes a stop as each child is loaded or unloaded.

3. Whenever children being transported are released from the vehicle to their parent or other designated person, the passenger log shall immediately be updated to reflect which children have been released.

4. Immediately upon unloading the last child/children from the vehicle, and to ensure that all the children being transported have been unloaded, the driver and any other staff members riding on the vehicle shall immediately deliver the passenger log to the person designated by the child care home in part 5 and shall immediately:

(i) physically walk through the vehicle; and

(ii) inspect all seat surfaces, under all seats and in all compartments or recesses in the vehicle's interior.

5. Additional caregiver/staff review and verification requirements.

(i) The child care home shall also designate a caregiver or management level staff person, other than the person responsible for the recording in the passenger log on the vehicle, who shall provide additional review and additional verification that the children have been unloaded from the vehicle and properly accounted for.

(ii) When unloading children at the child care home or field trip destinations, or when, prior to being parked at the child care home or other location, and to ensure that all children have been unloaded, the person designated pursuant to subpart (i) of this part 5 shall also immediately request the passenger log from the person on the vehicle responsible for maintaining the log and shall immediately:

(I) reconcile the passenger log with the children's attendance records; and

(II) conduct the same inspection as required in subparts (1)(b)4(i) and (ii) above.

(iii) Verification of the passenger logs and attendance records required by this subparagraph (b) shall be made by having the printed name of the persons who complete the logs and records written or printed on the passenger log and attendance record accompanied by the handwritten initials of such persons. Passenger logs and attendance records shall be maintained for a period of one (1) year or until the next re-evaluation of the group child care home for an annual license, whichever is first.

6. The driver or any accompanying staff member shall assure that every child is received by a parent or other designated person.

7. When children are transported to school, they shall be released in accordance with the following procedures:

(i) the children shall be unloaded only at the location designated by the school;

(ii) the children are only allowed to unload from the group child care home's vehicle at the time the school is open to receive them;

(iii) the driver/caregiver shall watch the children who are unloaded from the vehicle walk through the entrance door designated by the school for the children; and

(iv) any additional procedures established by the school.

8. The provisions of this subparagraph (b) apply to child care agency staff and to personnel operating vehicles for any contracted transportation service for a licensed or approved child care agency or for any other transportation service that is under the direction or control of a child care agency, that provides such services for children enrolled in the child care agency.

(c) Transportation Staff Qualifications.

1. Driver License Requirements.

(i) All persons responsible, or who may in the course of their duties become responsible, at any time, for driving a vehicle that transports children enrolled in the child care agency, shall hold, at a minimum, a current Tennessee driver license with an "F" ("for hire") endorsement pursuant to T.C.A. § 55-50-102(20)(F) unless such persons already have an endorsement or hold a license which the Department of Safety recognizes as inclusive of the "F" endorsement requirements, or shall hold such other license or endorsement provided for by State law or regulation governing driver qualifications for the type or size of vehicle used, or which may otherwise govern driver qualifications, for transportation of children enrolled by licensed or approved child care agencies.

(ii) Effective January 1, 2004, all persons subject to this part 1 shall obtain a certification document from the Department of Safety to signify that they have passed additional written or skills tests required for persons who may, in the course of their duties drive a vehicle that transports children enrolled in a child care agency.

(iii) Effective January 1, 2004, all persons subject to this part 1 shall be required to obtain annual training that is utilized for school bus drivers offered by the Department of Safety or such other equivalent training as the Department of Safety may determine is appropriate.

(iv) Evidence of completion of the requirements in subparts (i)-(iii) for each person employed or otherwise utilized by the agency under any contract or any other 6 arrangement shall be maintained in the records of the child care agency. Failure to obtain or timely exhibit completion of this additional certification when requested shall result in ineligibility of the person from any further driving duties for the child care agency until such requirements are fulfilled.

2. Health Examinations and Drug Screenings.

(i) Health Examinations. All persons driving vehicles at any time for the transportation of children enrolled in the child care agency shall annually provide to the Department a health statement or statements, based upon an examination of the individual, that are signed by the examining licensed physician, licensed psychologist, licensed clinician, Nurse Practitioner, or Physician's Assistant, verifying that the individual is physically, mentally and emotionally capable in all respects of safely and appropriately providing transportation for children.

(ii) Drug Screenings.

(I) Any person, in accordance with procedures established by the Department, shall pass a drug screen:

I. Prior to such person being employed as a full or part-time employee with a licensed or approved child care agency for a position which has any duties involving driving any vehicle utilized by the child care agency to transport children enrolled in that child care agency; or

II. Prior to such person being employed, in any position which has any duties involving driving any vehicle utilized to transport children enrolled in any child care agency, as a full-time or part-time employee by a contractor of a licensed or approved child care agency, or by any other persons or entities, any of which transports, for any compensation, children enrolled in the care of the child care agency as part of the agency's transportation program or service for such children offered by such child care agency; or

III. Prior to the assumption, at anytime, of any driving duties by an existing full-time or part-time employee of the licensed or approved child care agency, or, of an existing full-time or part-time employee of a contractor or other person or entity providing transportation, for compensation, to the child care agency as part of such child care agency's transportation program or service.

(II) Effective January 1, 2004, all existing drivers who have been previously assigned by the child care agency or its contractors or by any other person or entity as a driver of any vehicle providing child care transportation for a licensed or approved child care agency, under any arrangement and who have not been tested as required by item (I), shall have a drug screen in accordance with procedures established by the Department.

(iii) The child care agency shall immediately review the results of the drug screen upon receipt, and upon receipt by the child care agency of a positive drug screen result for an employee of the child care agency, or upon receipt of notification of such result for a tested individual from a contractor or other person or entity providing transportation, for compensation, to the child care agency as part of such child care 7 agency's transportation program or service, the child care agency shall immediately:

(I) Notify the Department and prohibit, or require its contractor or other entity providing transportation for compensation to the child care agency as part of the child care agency's transportation program to prohibit, the individual from any driving duties involving any transportation of children enrolled in the child care agency; and

(II) Enter into a safety plan approved by the Department that excludes the individual from driving for the child care agency until the individual passes a drug screen test and is otherwise approved, in writing, by the Department, to provide driving duties involving the transportation of children for the child care agency.

3. Prior to assuming their duties, all persons responsible, or who may in the course of their duties become responsible, at any time, for transporting children (including drivers and monitors) shall complete Department of Human Services-recognized pre-service transportation training in:

(i) The proper daily safety inspection of the vehicle set forth in subparagraph (2)(b) below;

(ii) The proper use of child safety restraints set forth in paragraph (4) and Tennessee Code Annotated, Title 55, Chapter 9, Part 6 and applicable Federal Motor Vehicle Safety Standards relative to child safety restraint systems and vehicle design requirements for the type of vehicle used to transport children;

(iii) The proper use of the verification procedures set forth in subparagraph (1)(b) above;

(iv) The proper use of a blood borne pathogen kit;

(v) The proper procedures for the evacuation of the vehicle based upon the type of vehicle and the ages of the children served; and

(vi) The developmentally appropriate practices applicable to the behavior management of children during transportation.

4. Following the completion of pre-service transportation training, all persons responsible at any time for the transportation of children (including drivers and monitors), shall complete Department of Human Services-recognized transportation training that includes the subject matter set forth in 1240-4-1-.07(1)(c)3, above, a minimum of every six (6) months.

5. Emergency Aid Training.

(i) All persons responsible, or who may in the course of their duties become responsible at any time, for the transportation of children shall hold current certification in Infant/Pediatric Cardiopulmonary Resuscitation (CPR) from the American Red Cross, the American Heart Association, or other certifying organization, as recognized by the Department.

(ii) Effective July 1, 2004, all persons responsible, or who may in the course of their duties become responsible at any time, for the transportation of children shall 8 complete a first aid course sponsored or approved by the American Red Cross, or other first aid course, as recognized by the Department.

6. The provisions of this subparagraph (c) apply to child care agency staff and to personnel operating vehicles for any contracted transportation service for a licensed or approved child care agency or for any other transportation service under the direction or control of a child care agency.

7. The requirements of 1240-4-1-.07(1)(c) do not apply to individuals who provide transportation services exclusively for occasional field trips.

(2) Vehicle Inspections; Passenger Limitations; Vehicle Design Requirements; Child Seating Space Requirements; Emergency Equipment; Prohibition of Firearms or other Weapons on Vehicles.

(a) The requirements of this paragraph (2) include vehicles used at anytime for the regular child care vehicle(s) and those used as back-up vehicles. Exception: The requirements of this paragraph (2) do not apply to vehicles operated solely for the purpose of providing transportation for occasional field trips.

(b) The child care agency shall maintain, and shall require providers of transportation services for children under contract to the agency or under the agency's direction or control to maintain, documentation that designated child care, contractor, or other entity staff perform daily the following inspections, followed by any necessary repairs or other appropriate actions, before beginning transportation of children for the child care agency:

1. A visual inspection of the vehicle's tires for wear and adequate pressure;

2. A visual inspection for working headlights and taillights, signals, mirrors, wiper blades and dash gauges;

3. An inspection for properly functioning child and driver restraints;

4. An inspection for properly functioning doors and windows;

5. An inspection for the presence of safety equipment required by these rules or any other provisions of law or regulations, and repair or replacement as necessary based upon visual evidence of the need do so;

6. A determination that the vehicle has adequate fuel; and

7. An inspection for, and cleaning of, debris from the vehicle's interior.

(c) The child care agency shall maintain, and shall require providers of transportation services for children under contract to the agency or under the agency's direction or control to maintain, documentation that the vehicles used to transport children receive regular inspections and maintenance by a certified mechanic in accordance with the maintenance schedule recommended by the vehicle manufacturer, and, in addition shall have the following vehicle equipment certified as inspected at least every four thousand (4,000) miles if not covered by, and/or serviced in accordance with the manufacturer's maintenance schedule:

1. Brakes;

2. Steering;

3. Oil levels, coolant, brake, windshield washer and transmission fluids;

4. Hoses and belts.

(d) Beginning January 1, 2004, the Department of Safety will conduct annual vehicle safety inspections on all vehicles used by the child care agency directly, under contract, or under the control or direction of the agency designed by the vehicle manufacturer to carry ten (10) or more passengers. Any necessary maintenance or repair to the vehicles disclosed by the inspections shall be the sole responsibility of the child care agency.

(e) All documentation of the child care agency or providers of transportation services for children under contract to the agency or under the agency's direction or control shall be made available upon request to Department staff.

(f) No vehicle which does not pass the inspections required in subparagraphs (b), (c) or (d) shall be used by the child care agency or by its contractors, or others subject to the agency's direction and control, to provide transportation services until necessary repairs, as determined by the Department, have been made.

(g) Passenger Restraints, Capacity Limitations and Cargo Requirements.

1. All children and adults riding in a vehicle used to transport a child to and from a child care agency, to and from school, or to and from field trips must be restrained by separate passenger restraint devices in the vehicle's seating area, at a minimum, as required by state or federal law or regulation, or, as otherwise required by these rules.

2. The total number of adults and children in vehicles used for the transportation of children enrolled in a licensed or approved child care agency shall never exceed the manufacturer's rated passenger capacity.

3. In a vehicle being used for the transportation of children enrolled in a licensed or approved child care agency, all cargo, luggage or equipment of any type shall be adequately secured at all times in such manner as to protect the passengers in case of accident or emergency maneuvers.

4. The provisions of this subparagraph (g) also apply to vehicles operated by any contracted transportation service for a licensed or approved child care agency, or for any other transportation service under the direction or control of a child care agency.

(h) Requirements for Child Care Transportation Vehicles Effective January 1, 2007.

1. Effective January 1, 2007 all vehicles that the child care agency operates, for which it contracts, or which are otherwise under its direction or control, that are designed to carry ten (10) or more passengers must conform to all Federal Motor Vehicle Safety Standards (FMVSS) governing either "large" school buses or "small" school buses, as applicable, in accordance with the provisions of the FMVSS described in 49 Code of Federal Regulations Part 571, or as such Part may be amended.

2. Effective January 1, 2007, if buses in either the "large" or "small" classes of school buses under the FMVSS are used, they must have factory-installed passenger restraint anchorages and passenger restraints that are suitable for use in transporting children of any age who are to be transported on either a "large" or "small" school bus.

3. The requirements of this subparagraph (h) do not apply to vehicles used exclusively for the provision of occasional field trips.

(i) A minimum of ten (10) inches seat space per child is required in a vehicle transporting children.

(j) A vehicle used to transport children shall have fire extinguishers, emergency reflective triangles, a first aid kit and a blood-borne pathogenic clean-up kit, and an adult familiar with the use of this equipment on board. Emergency exiting procedures shall be practiced on a regular basis by all staff responsible for transporting children.

(k) The carrying, possession or storage of firearms or other weapons is prohibited in vehicles used to transport children.

(3) Vehicle Signage Requirements; Exceptions.

(a) The requirements of this paragraph (3) are effective March 1, 2003, and are applicable to all vehicles used for the transportation of children enrolled in a child care agency licensed or approved by the Department, including vehicles operated by a contractor of the agency or vehicles operated by any other provider of services under the direction or control of the child care agency, unless specifically exempted by the provisions of subparagraph (e) below.

(b) All vehicles used for the transportation of children enrolled in the child care agency must, as determined by the Department, clearly and readily identify to the driving public that the vehicle is used for the transportation of children who are in child care.

1. On each side of the vehicle the following information shall be displayed:

(i) The full name of the child care agency and emergency contact number for the agency in any font or color, including the agency's current logo and lettering scheme; provided that the lettering is not less than one and one-half inches (1") in height and is clearly readable at a distance of fifty feet (50')on a stationary vehicle in daylight conditions; and

(ii) The words "Child Care Transportation Complaints" followed by the Department of Human Services' toll-free Child Care Transportation Complaint phone number in black lettering in a block font, not less than one and one-half inches (1") in height. This text shall appear on a clearly contrasting background that is clearly readable at a distance of fifty feet (50') on a stationary vehicle in daylight conditions.

2. On the rear of the vehicle the following information shall be displayed:

(i) The full name of the child care agency and the words "Child Care Transportation Complaints" followed by the Department of Human Services toll-free Child Care Transportation Complaint phone number in black letters in a block font not less than one inch (1") in height on a clearly contrasting background that is clearly readable at a distance of forty feet (40') on a stationary vehicle in daylight conditions.

(ii) The provisions of this part (2) shall not apply to passenger automobiles (excluding minivans) used for transportation by the child care agency with a manufacturer's rated seating capacity of six (6) or fewer passengers.

(c) The information required in subparagraph (b) must be applied to the vehicle in one of the following formats:

1. Painted directly on the vehicle in accordance with the paint manufacturer's instructions using paint recommended by the paint manufacturer as appropriate for use on a vehicle; or

2. A weather-resistant sign securely fastened to the vehicle. The term "securely fastened" includes magnetic signs and signs bolted to the vehicle. The term does not include adhesives such as tape or glue unless recommended by the adhesive manufacturer as being appropriate for outdoor use on a vehicle.

(d) Special Requirements for Centralized Transportation.

1. Central operators or any other entity that may own or operate more than one child care agency and which may provide centralized transportation services for its child care agencies; and/or

2. Contractors, or other transportation service providers under the direction or control of the child care agency, which may provide centralized transportation services to more than one child care agency may substitute for the name and phone number of the child care agency required by parts 1240-4-1-.07(3)(b)1 and 2 above the full name and emergency contact number of the central operator, contractor or other transportation service providers under the direction or control of the child care agency. If the name on the vehicle does not clearly designate the agency or entity as one providing child care transportation, words such as "Child Care Transportation Vehicle" or "Child Care Transportation Services", or similar language approved by the Department, must be displayed on the vehicle in a manner that demonstrates, as determined by the Department, that the vehicle is providing child care transportation.

(e) Exceptions to Vehicle Identification Requirements.

1. Vehicles used exclusively for the provision of occasional field trips; and

2. Vehicles used exclusively for the limited provision of emergency transportation, e.g., as a result of the mechanical breakdown of the regular child care vehicle.

3. The Department may, in its discretion, determine if exceptions to the requirements of this paragraph (3) may be made for child care agencies owned, operated, or under the direction or control of a public agency. For purposes of this subparagraph (e), a "public agency" is any entity controlled, owned or operated by a state, county or local entity, or a political subdivision of the State of Tennessee.

4. The Department may, in its discretion, determine if certain child care agencies may be exempted from any or all of the requirements of this paragraph (3) due to facts which may clearly warrant such exemptions.

(4) Child Safety Restraints.

(a) The provisions of this paragraph (4) shall apply to any vehicle used to transport children as of the effective date of these rules, unless stated otherwise by the rule. Any vehicle whether:

1. A passenger car;

2. A stock or custom van or sport utility vehicle;

3. A school bus classified as a "small" or "large" bus as required in FMVSS contained in 49 Code of Federal Regulations Part 571; or

4. Any other vehicle must be properly equipped with the child passenger restraints required by subparagraphs (c) - (f) below and must comply with all other provisions of this paragraph (4).

(b) Children under four (4) years of age shall never be placed in the front seat of the vehicle.

(c) Children who weigh less than twenty pounds (20 lbs.) shall be placed to face the rear of the vehicle. Children who weigh twenty pounds (20 lbs.) or more shall be placed to face the front of the vehicle unless the special needs of a disabled child otherwise require the child to face the rear of the vehicle.

(d) Children who weigh less than forty pounds (40 lbs.) shall be restrained in a Federally-approved child restraint device in accordance with the child restraint device manufacturer's instructions. The child restraint device shall be secured to the vehicle in accordance with the child restraint device manufacturer's instructions.

(e) Children Between Forty Pounds (40 lbs.) and Eighty Pounds (80lbs.).

1. Children who weigh between forty pounds (40 lbs.) and eighty pounds (80 lbs.) may be restrained in a belt-positioning booster seat (BPBS) that has been secured in accordance with the vehicle and restraint manufacturers' instructions. BPBS devices shall always be secured to the vehicle in accordance with the vehicle and the restraint device manufacturer's instructions. If, however, a BPBS restraint device is not used, the child shall be restrained in both a lap belt and a shoulder belt if available in the vehicle. If a lap and shoulder belt restraint system is not available in the vehicle, the child shall be restrained by a lap belt.

2. Effective January 1, 2007, children who weigh between forty pounds (40 lbs.) and eighty pounds (80 lbs.) shall be restrained in a belt-positioning booster seat (BPBS) in accordance with the BPBS manufacturer's instructions. BPBS devices shall always be secured to the vehicle in accordance with the vehicle and the restraint device manufacturer's instructions.

(f) Children Weighing More Than Eighty (80 lbs.) or Who are Taller Than Four Feet Nine Inches (4'9").

1. Children who weigh more than eighty pounds (80 lbs.) or who are taller than four feet nine inches (4'9") may be restrained in an adult lap belt and shoulder belt that has been secured in accordance with the vehicle manufacturer's instructions. If, however, an adult lap belt and shoulder belt is not used, the child shall be restrained by a lap belt.

2. Effective January 1, 2007, children who weigh more than eighty pounds (80 lbs.) or who are taller than four feet nine inches (4'9") shall be restrained in an adult lap belt and shoulder belt in accordance with the vehicle manufacturer's instructions.

(g) Passenger air bags shall remain turned off unless an adult or a child fifteen (15) years of age or older is riding in the front passenger seat of the vehicle.

(h) No child shall ride on the floor of a vehicle and no child shall be placed with another child in the same restraint device.

(i) Notwithstanding the provisions of this paragraph (4), until January 1, 2007, children of schoolage (in kindergarten or any grade level above) shall not be required to use child restraints when being transported in school buses classified in the "large" category under FMVSS.

(5) Supervision of Children During Transportation.

(a) An adult must be in the vehicle whenever a child is in the vehicle.

(b) Adult Monitor Requirements for Child Care Transportation.

1. An adult monitor, in addition to the driver, is required on the vehicle for the transportation of four (4) or more children ages six (6) weeks through five (5) years of age, who are not in kindergarten; provided, however an adult monitor, in addition to the driver, is required on the vehicle for all routes exceeding thirty (30) minutes for children ages six (6) weeks through five (5) years of age, who are not in kindergarten, regardless of the numbers of children being transported.

2. An adult monitor, in addition to the driver, is required on the vehicle for the transportation of four (4) or more non-ambulatory children (permanent or temporary) of any age.

3. On field trips off premises, the number of adults at the destination shall be double the requirements on the adult:child ratio charts in paragraph (2) of subchapter 1240-4-1-.03, Caregiver to Child Ratios and Supervision; provided, however, the adult monitor referenced in parts 1 and 2 of this subparagraph (b) may be used for purposes of this requirement.

(6) Limits on Time Children Are Transported/Transportation Waivers.

(a) Children shall not spend more than forty-five (45) minutes traveling one way; provided, however, this provision is not applicable for occasional field trips.

(b) If extended transportation beyond the limits in subparagraph (a) is necessary in special circumstances, or as may be required by geographic factors, an individualized plan shall be established and signed by the parent(s) and the child care agency and approved by the Department prior to providing such transportation.

(7) Except as otherwise exempted, the provisions of paragraphs (4)--(6) shall apply to all vehicles used for the transportation of children enrolled in a child care agency licensed or approved by the Department, including vehicles provided by a contractor of the agency or vehicles operated by any other provider of services under the direction or control of the child care agency.

Authority: T.C.A. §§4-5-202, 55-50-102(11) and (20), 71-1-105(5), 71-3-501 et seq., 71-3-502(a)(2), 71-3-508(c), Acts of 2003, Public Chapter 412, §§1(c), 2, and 3, and 49 Code of Federal Regulations Part 571. Administrative History: Original rule certified June 10, 1974. Amendment filed March 16, 1978; effective April 17, 1978. Repeal and new rule filed December 6, 1983; effective January 5, 1984. Amendment filed October 9, 1987; effective January 27, 1988. Repeal and new rule filed April 22, 1992; effective June 6, 1992. Amendment filed November 21, 2002; effective February 4, 2003. Amendment by Acts of 2003, Public Chapter 412, §§1(c) and 3 filed June 25, 2003; effective July 1, 2003. Amendment filed September 29, 2003; effective December 13, 2003. Amendment filed October 21, 2004; effective January 4, 2005.

1240-4-1-.08 FOOD.

(1) Nutritional Needs.

(a) For children in the home at least four hours, one snack (defined as two of these four choices: fluid milk; meat or meat alternate; fruit, vegetable or full-strength juice; or whole grain or enriched bread) shall be provided, unless the four-hour period covers a normal meal hour, in which case a meal shall be provided.

(b) Snacks provided shall be nourishing and planned as a part of the day's food allowances. Carbonated drinks, fruit-flavored drinks, imitation milk drinks, and candy shall not be served as snack foods. Powdered milks shall be used only in a cooked food product. (Real juice will be labeled "100% juice" or "full-strength juice". Powdered milk does not meet the requirement.) (See Appendix D for suggested food pattern for snacks.)

(c) For children in the home five to 10 hours, one meal (defined as meat or meat alternates, vegetable and/or fruit, bread or bread product, and milk) and one or two snacks shall be provided, two snacks if the period is as much as seven hours. (See Appendix D for suggested meal patterns.)

(d) For those in the home longer than 10 hours, two meals and two snacks shall be furnished.

(e) Breakfast (defined as fruit, vegetable or full-strength juice; cereal or bread product; and milk) shall be offered to children who arrive before 7:00 a.m. and who have not had breakfast at home.

(f) Diets of infants and other special diets shall be prepared as prescribed by a physician.

(g) The week's menus shall be planned and posted by the first day of each week and remain posted until the following week so that parents can be aware of the food their children are receiving. These menus shall be followed, although reasonable substitutions are permissible if the substituted food contains the same nutrients. The change shall be documented in advance of the meal. (Information on menu-planning is available upon request.)

(2) Meal Service.

(a) Caregivers and children shall wash their hands before eating or prior to any preparation of food.

(b) High chairs and tables on which food is served shall be washed with soap and water prior to and after snacks and meals.

(c) Napkins and forks and/or spoons shall be provided for children who feed themselves.

(d) All formulas and food brought from home shall be labeled with the child's name. Milk shall be placed immediately in the refrigerator. Previously opened baby food jars shall not be accepted by caregivers. All formulas remaining in bottles after feeding shall be discarded.

(e) When children are capable of using a high chair, they shall be allowed to do so and to experiment with food, with feeding themselves, and to eat with fingers or spoon.

(f) Bottles shall not be propped or given to children who are lying flat.

(g) Solid foods shall not be given in a bottle, or with infant feeders, to children of normal eating abilities.

(h) All infant's feeding schedule shall be made and adapted to a child's need rather than on the hour.

(i) Weaning shall not be started immediately after enrollment but after parents and caregivers have communicated to establish consistency in the weaning process and after a child has become familiar with a cup or glass.

(j) Introduction of new foods to infants and toddlers shall be gradual, one at a time, over a five to seven-day period with parents' approval.

(k) The size of servings shall be adequate to meet children's needs. (Portion size depends on child's age. See Appendix D for chart of age/portion size.)

(l) Food, including dessert, shall not be forced on or withheld from a child.

(m) Floors under tables and high chairs on which food has been served shall be swept and/or vacuumed after each meal and mopped as needed.

Authority: T.C.A. §§71-1-105(12) and 71-3-501 et seq. Administrative History: Original rule certified June 10, 1974. Amendment filed March 16, 1978; effective April 17, 1978. Repeal and new rule filed December 6, 1983; effective January 5, 1984. Amendment filed November 21, 2002; effective February 4, 2003 (Formerly 1240-4-1- .07).

1240-4-1-.09 PHYSICAL FACILITIES.

(1) Any new group day care home/facility, or one that is remodeled, enlarged, or changed in any way, shall be approved by a state or authorized local fire safety inspector and by an environmentalist before day care operation can begin.

(2) Group day care homes shall be inspected and approved annually by a state or local fire safety inspector and by an environmentalist. Requirements in Appendices E and F shall be met before a license can be issued. (Requests for inspections are made by the Licensing Counselor.)

(3) Physical facilities shall continue to meet all standards in Appendices E and F and any updated fire prevention or environmental standards which are applicable.

(4) The inside of the home shall provide 30 square feet of usable play space per child, including children who are related to caregivers. (Usable play space does not include office space, bathrooms, or space occupied by large pieces of furniture.)

(5) The home shall have at least two exits directly to the outside, other than from the kitchen.

(6) When infants are in care, the diapering area shall be located as close to a handwashing lavatory as possible but not in the kitchen.

(7) The home shall not be located in a building used for other purposes which would be hazardous or would limit outdoor play.

(8) The outdoor play area shall contain at least 50 square feet of space per child, including children who are related to caregivers.

(9) The areas where children play or are cared for shall be properly maintained. These areas shall be free of hazardous items or materials unless adequately protected by storage, inaccessibility, proper supervision, or other safety procedures. These areas shall present no conditions which are hazardous to children. All such areas shall be free of all animal wastes.

Authority: T.C.A. §§71-1-105(12) and 71-3-501 et seq. Administrative History: Original rule certified June 10, 1974. Amendment filed March 16, 1978; effective April 17, 1978. Repeal and new rule filed December 6, 1983; effective January 5, 1984. Amendment filed October 9, 1987; effective January 27, 1988. Repeal and new rule filed April 22, 1992; effective June 6, 1992. Amendment filed November 21, 2002; effective February 4, 2003 (Formerly 1240-4-1-.08).

1240-4-1-.10 CARE OF CHILDREN WITH DISABILITIES.

(1) When children with disabilities are enrolled, the home shall provide those children equal opportunity to participate in the same program activities as their peers.

(2) Adaptations to the environment shall be directed toward normalizing the lifestyle of the child with a disability by helping him/her become independent and develop self-help skills.

(3) Any efforts to provide specialized services (e.g., speech/hearing therapy, physical therapy, psychological evaluation, or services for mentally retarded), either directly or by referral, shall be conducted only with written permission by parent and documented in the child's record. Any informational exchange regarding these services shall also be documented.

(4) The home shall have a written individualized evacuation plan, which has been approved by the Licensing Counselor and is practiced in every monthly fire drill, for every child enrolled who requires more assistance to evacuate the facility than other children of the same age or in the same group.

Authority: T.C.A. §§71-1-105(12) and 71-3-501 et seq. Administrative History: Original rule filed April 22, 1992; effective June 6, 1992. Amendment filed November 21, 2002; effective February 4, 2003 (Formerly 1240-4-1- .09).

1240-4-1-.11 APPENDICES.

(1) The following Appendices referenced in the foregoing rules are incorporated in these rules by reference:

(a) Appendix A -

I. Summary of Applicable Laws

II. Questions and Answers About Day Care Licensing

(b) Appendix B - Guidelines for TB Screening

(c) Appendix C - Contents of First Aid Kit

(d) Appendix D - Meal/Snack Patterns and Portion Sizes

(e) Appendix E - Environmental Standards for Group Child Care Homes

(f) Appendix F - Fire Safety Inspection Report

(2) Any conflict between summaries of the language of statutes or regulations in the Appendices and official statutes and regulations will be resolved by reference to the language of the official statutes or regulations.

Authority: T.C.A. §§71-1-105(12) and 71-3-501 et seq. Administrative History: Original rule filed November 21, 2002; effective February 4, 2003 (Formerly 1240-4-1-.10).

APPENDIX A

I. Summary Of Applicable Laws.

(A) Child Welfare Agencies (TCA §71-3-501 et seq.) (A complete copy of the licensing law is available upon request.)

1. Specifies the types of agencies that DHS has a mandate to license. Licensing of day care (less than 24-hour care) begins with five children. (Care for one to four children is exempt.)

2. Provides for development of standards, based on certain criteria by a 16 member "standards committee" appointed by the Commissioner. Standards are to be reviewed (and revised, if needed) every five years.

3. Requires DHS to provide applicants or licensees with assistance in meeting standards.

4. Requires annual application for a license and an application processing fee.

5. Upon receiving fire safety and environmental sanitation approval, provides that DHS will issue a 90-day conditional license if no apparent hazards to the children in care are present.

6. Provides for denial, suspension, or revocation of license and a waiting period ranging from 60 days to one year prior to reapplication.

7. Provides for appeals and hearings before the Board of Review, which includes representatives from the Departments of Health, Education, of the "advisory board" of DHS, from the appropriate Standards Committee, and three at-large members selected by the others. Appeals from the Board's decision may be made to Chancery Court.

8. Imposes a misdemeanor penalty of imprisonment for six months and a fine of $500 or both for each offense (day) of operating without a license.

9. Requires public agencies to meet the same standards as other child welfare agencies and a method of reporting to the public any uncorrected deficiencies.

10. Requires DHS to regularly inspect agencies without prior notice and grants the Department access to facilities and records in order to make an evaluation of the "kind and quality of work done" and to make recommendations regarding licensure.

11. Requires DHS to investigate reports of noncompliance.

12. Allows DHS to impose civil penalty ($25 - $150) for substantial noncompliance and probation for continued noncompliance.

13. Contains specified and defined exemptions for Parents' Day Out programs, kindergartens, and "drop-in" programs. Also provides a waiver of adult to child ratios and group size requirements for certain Montessori schools.

14. Requires screening for criminal violations of persons applying to work with children through the registry maintained by the `Tennessee Bureau of Investigation (TBI).

15. Allows DHS to investigate all reports of abuse, neglect, or sexual abuse, even in exempt agencies, and enables DHS to revoke the license of a licensed agency and to enjoin an unlicensed person or agency from continuing to provide child care where abuse of children occurs.

(B) Access to Public Records (T.C.A §§10-7-503 and 10-7-504). Requires public bodies to provide any citizen of Tennessee access to public records except for specified confidential records (e.g., medical records, TBI investigative records, students' records). DHS' records on child welfare agencies are public records except as they may contain information obtained in the course of child abuse or neglect investigations.

(C) Child Protective Services (TCA §§37-1-401 et seq. and 37-1-601 et seq.).

1. Requires any individual or organization (such as day care agency, hospital, or school) having knowledge of suspected child abuse or neglect to report it to a juvenile judge, the Department of Human Services, or a law enforcement official. (Look in your telephone book under "Child Abuse", or call the county DHS office or local law enforcement.)

2. Requires the identity of a reporting person to be kept confidential, subject to disclosure only by consent of the person or by judicial process. Provides immunity from civil or criminal liability if reports are made in good faith.

3. Gives DHS authority and responsibility to investigate reports of abuse or neglect.

4. Requires that all written records and information regarding investigations be confidential. Release of information is permissible to certain specified persons and to those having responsibility for administration of the law. Persons found not guilty of severe child abuse or child sexual abuse shall have their names expunged from the TBI's abuse registry.

5. Charges DHS with the responsibility of conducting a continuing publicity and education program to encourage reporting and to strengthen and improve child sexual abuse detection, prevention, and treatment efforts.

(D) Federal Funding. Section 504 of the Rehabilitation Act of 1973 and Title VI of the Civil Rights Act of 1964 require agencies receiving federal funding to employ nondiscriminatory policies and practices. Persons receiving federal funding such as reimbursement from the USDA Child/Adult Care Food Program, DHS vendor or Transitional Child Care payments, Social Services Block Grants (SSBG), Dependent Care Grant funds for school-age child care, etc.; and persons receiving federal support in the form of space, staff, services, equipment, etc., are required to comply with the following.

1. Title VI of the Civil Rights Act of 1964 by ensuring that no person (child, parent, or employee) in your agency "shall, on the ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance"; and by employing nondiscriminatory policies and practices and advertising such.

2. Section 504 of the Rehabilitation Act of 1973 by ensuring that no otherwise qualified handicapped person shall be excluded from participation in, be denied the benefits of, or be subjected to discrimination in any program activity solely on the basis of a handicap (applies to children, parents, and employees); and by making reasonable accommodations to serve or hire an otherwise qualified individual with a handicapping condition.

(E) Child Passenger Protection and Safety Belt Use (Transportation) (TCA §55-9-601 et seq.).

1. Requires any person transporting a child under the age of four years in a motor vehicle to provide for children's protection by providing and properly using a federally approved child restraint system (manufactured after January 1, 1981). Violation is subject to a $50 fine or 30 days in jail or both.

2. Specifies that no one is to operate a motor vehicle unless all persons four and older in the front seat are properly restrained by a safety belt.

3. Imposes a fine of $50 or 30 days in jail or both for each violation after the first; however, the violator can be cited or arrested only after being cited or arrested for another violation of law.

4. TCA §§55-50-102(11) and 55-50-102(12)(B) requires the driver of a vehicle designed to carry 15 or more passengers (including the driver) to have a commercial driver's license.

(F) Administrative Rules and Procedures (TCA §4-5-301 et seq. and Chapter 1240-5-11 et seq.).

1. Provides for an administrative hearing of any contested cases (i.e., on denial or revocation of licenses or on notice of intent to put an agency on probation) after proper notice which includes references to particular statutes and rules involved.

2. Requires that hearings before the members of the Board of Review to be conducted by the administrative judge or a hearing officer, who rules on admissibility of evidence and other matters and otherwise ensures that proceedings are properly carried out.

3. Allows the contesting licensee to be represented (at licensee's own expense) by counsel.

4. Allows the judge or hearing officer at his/her discretion or upon request of licensee or the Department of Human Services to schedule a prehearing conference in order to simplify or expedite the disposition of the appeal action.

5. Requires that the hearing be open to the public.

6. Requires the final order be entered by the Board of Review. The final order shall include conclusions of law, factual findings, prescribed remedy, and procedures and time limits for seeking judicial review.

7. Provides that while an application for a license is pending, an existing license does not expire until disposition of the application has been finally determined, unless the license must be summarily suspended pending completion of the proceedings because the Department determines that "public health, safety, or welfare imperatively requires" emergency action, and notifies licensee of that finding "pending proceedings for revocation or other action".

II. Questions And Answers About Day Care Licensing.

(A) How does a person get information about opening a child care agency?

The local county office of the Tennessee Department of Human Services will furnish information; a licensing representative will provide assistance free of charge to an individual or a group that is planning to provide child care.

(B) How many children am I allowed to care for?

In Tennessee, a person without a license may care for no more than four children. To care for five to seven children, in addition to "related" children, you must be licensed as a "family day care home" operator. To have eight(8) - twelve (12) children, you must be licensed as a "group" day care home operator. (Under certain conditions, a group day care home may have up to 15 children.)

(C) How is a license obtained?

1. After a completed application and the required fee are received, arrangements will be made for a representative to visit your facility and evaluate the day care operation and/or facility in accordance with the required standards in this booklet.

2. Before a day care home can be licensed, it must pass fire safety and environmental sanitation inspections. The licensing representative will explain the procedure for getting inspected.

(D) What types of licenses are issued?

1. An "annual license" is granted when compliance with licensure requirements is confirmed by the Department.

2. A "conditional license" is granted to a new agency for 90 days when it does not meet all the required standards, but there is evidence than an effort is being made to comply with the requirements and it has first met fire safety and environmental sanitation approval.

(E) Who determines whether a license is issued?

The Commissioner has ultimate responsibility for issuance or denial, based upon an evaluation and recommendation by a licensing representative of the Department.

(F) Is the license permanent?

No, it is issued for up to one year. Prior to its expiration, an evaluation is made to determine whether compliance with requirements is being maintained and reissuance should be recommended.

(G) Is there a fee?

Yes, the fee is payable upon application and is nonrefundable. The fee for day care homes is $5 for a family day care home and $10 for a group day care home.

(H) Where is the license kept?

It must be posted in a conspicuous place in the day care home during business hours.

(I) Are licenses transferable?

No. The license applies only to the agency, organization, and person(s) to whom it is issued. It also applies only to the building approved.

(J) Does the same license for "day care" cover (1) nighttime care, (2) "drop-in" children, and (3) sick children?

1. Yes. An agency that provides less than 24-hour care to children during nighttime hours receives the same license as a child care agency operating during daytime hours, and one license covers both programs in the same agency. An agency cannot provide continuous 24-hour care for two or more children without a residential license. If not licensed for day care, a residential license is needed for more than one child. Ask a licensing counselor about the procedure for obtaining a residential license.

2. "Drop-in" children are counted in the ratio and group and can be cared for only if required records are on file before they are cared for.

3. The day care home license also includes care of mildly ill children. Only mildly ill children (i.e., not "contagious") should be cared for in a day care home and only then if staffing is adequate. Mild illnesses are generally those in a recuperative stage (e.g., getting over mumps or influenza).

(K) Who enforces licensure requirements for a child care system?

If homes are approved as an extension of a child welfare agency's license, the central operator (the licensee) is responsible for monitoring compliance. The Department of Human Services monitors the agency's compliance as well as licensed homes within a system.

(L) What is the procedure when a license is revoked, denied, or suspended?

The Department may deny, suspend, or revoke a license at any time by giving the owner, operator, or board a written notice by listing the specific reason or reasons for the action. Specified time periods are provided in the law. Any conduct or condition which might immediately jeopardize the safety of children, shall be cause for immediate suspension of the license, pending the outcome of revocation procedures.

(M) How can an operator or applicant appeal such action?

The licensing law provides for a Board of Review. If a license is denied or revoked by the Department, a request may be made for a hearing before the review board. An appeal of the decision from the review board may be judicially reviewed. The periods of time allowed for the appeals are set out in the law.

(N) Where do I call to file a complaint or get a license?

1. If you have a question about these standards, or if you want to report an unlicensed facility or a facility that is violating licensing requirements, call the DHS county office. It is listed in the telephone directory under Tennessee State Government, Human Services Department. Someone there will refer you to the licensing unit in your area. If you want to open a child care facility, call that office before you do anything. You cannot care for a group of five or more children without a license.

2. If you have a question or concern about these standards or the licensing procedure, call or write:

Day Care Licensing Coordinator

Tennessee Department of Human Services

Citizens Plaza Building

400 Deaderick Street

Nashville, TN 37248-9800

Phone: (615) 313-4778

APPENDIX B RECOMMENDATIONS FOR TUBERCULOSIS SCREENING OF PROGRAMS UNDER THE SUPERVISION OF THE DEPARTMENT OF HUMAN SERVICES

Programs that provide care for periods less than 24 hours per day.

A. Employees. Employees should be screened for tuberculosis within 90 days prior to but no later than two weeks after employment. The screening examination should include a tuberculin test2 and if it is positive, a chest X-ray and, if necessary, other specific tests. Prospective or current employees who are known to have a positive tuberculin reaction or who refuse to have a tuberculin skin test shall receive a chest Xray to rule out infectious tuberculosis. If infectious tuberculosis is ruled out, no further screening is necessary during their employment unless persistent pulmonary symptoms develop or there is contact with tuberculosis. Tuberculosis screening is not recommended for programs providing care for less than two weeks. The preferred method is the Mantoux technique using 5 TU PPD.

B. Children.

1. Foreign-Born. All foreign-born children should present evidence of a tuberculin skin test3 performed in the United States. This test performed in the United States may have been done at any time after 12 months of age. Any child with a positive tuberculin skin test should be referred to a physician for evaluation. After the initial evaluation, future periodic screening is not required unless the child develops persistent pulmonary symptoms or there is contact with tuberculosis.

2. Native-Born. Special screening of children born in the United States is not required unless there is history of contact to tuberculosis or there are symptoms and/or physical findings suggestive of tuberculosis. If the tuberculin test is negative, no future screening is required unless persistent pulmonary symptoms develop or there is contact with tuberculosis. If the tuberculin skin test is positive, the child should be referred to a physician for evaluation. The preferred method is the Mantoux technique using 5 TU PPD.

APPENDIX C INVENTORY FOR THE FIRST AID KIT

Every child care setting should have a first aid kit stocked with items on the list below. You can buy the supplies for the first aid kit at drug stores or at hospitals or medical supply stores. Each first aid kit should be large enough to hold all the necessary supplies for first aid in the child care setting. Use a container that will close tightly. It should be stored where adults can reach it easily, but it must be stored out of reach of children. You should arrange the contents so you can reach items easily without emptying the kit. You should be sure that the contents are wrapped tightly and are sanitary. You should restock the kit after each use.

A first aid kit should contain the following items:

First aid cards* Commercial cold pack or plastic bag for ice cubes

Adhesive strip bandages (1/2", 3/4", 1" strips) Clean cloth

Gauze bandages (4"x4", nonstick, sterile) Soap

Rolled flexible or stretch gauze Small plastic cup

Bandage tape Sealed packages of cleansing wipes

Nonstick, sterile pads (different sizes) Syrup of ipecac (1-ounce bottle)

Triangular bandages

Small splints

Special items for children with specific health problems (such as bee sting kit or an inhaler for a child with asthma)

Eye dressing or pad Emergency Telephone Guide

Scissors

Tweezers

Emergency contact information (phone numbers of the children's parents)

Safety pins Change for pay phone

Thermometer Pen or pencil and note pad

Flashlight with fresh batteries

Disposable latex gloves

Three-ounce rubber bulb syringe (to rinse out eyes, wounds, etc.)

*Can be purchased from American Red Cross; give first aid instructions.

This page may be duplicated by individuals and entities for noncommercial purposes.

Appendix C American Red Cross Child Care Course

Infant and Child First Aid

APPENDIX D MEAL PATTERN/PORTION SIZE REQUIREMENTS

If needed, the caregiver should ask for help in planning meals from a nutritionist or dietitian. For homes on the Child and Adult Care Food Program (CACFP), the DHS staff nutritionist is available. The Department of Health, local colleges, and hospitals are also possible resources.

The minimum amounts of food components to be served are as follows:

BREAKFAST

Food Components

Age 1 and 2

Age 3-5

Age 6-12 1

 

 

 

 

Milk milk, fluid

1/2 cup 2

3/4 cup

1 cup

 

 

 

 

Vegetables and Fruits

Vegetable(s) and/or fruit(s)

1/4 cup

1/2 cup

1/2 cup

or full-strength vegetable or fruit juice or an equivalent quantity or any combination of vegetable(s), fruit(s) and juice

1/4 cup

1/2 cup

1/2 cup

 

 

 

 

Bread and Bread Alternates 3

bread

1/2 slice

1/2 slice

1 slice

or cornbread, biscuits, rolls, muffins, etc

1/2 serving

1/2 serving

1 serving

or cold dry cereal 4

1/4 cup or 1/3 oz.

1/3 cup or 1/2 oz.

3/4 cup or 1 oz.

or cooked cereal

1/4 cup

1/4 cup

1/2 cup

or cooked pasta or noodle products or an equivalent quantity of any combination of bread/bread alternate

1/4 cup

1/4 cup

1/2 cup



Bread and Bread Alternates 3

Food Components

Age 1 and 2

Age 3-5

Age 6-12 1

 

 

 

 

Milk milk, fluid

1/2 cup

1/2 cup

1 cup

 

 

 

 

Vegetables and Fruits

Vegetable(s) and/or fruit(s) 1

1/4 cup total

1/2 cup total

cup total

 

 

 

 

Bread and Bread Alternates

bread

1/2 slice

1/2 slice

1 slice

or cornbread, biscuits, rolls, muffins, etc

1/2 serving

1/2 serving

1 serving

or cooked pasta or noodle products

1/4 cup

1/4 cup

1/2 cup

or cooked cereal grains or an equivalent quantity of any combination of bread/bread alternate

1/4 cup

1/4 cup

1/2 cup

Meat and Meat Alternates

lean meat or poultry or fish2

1 oz.

1 oz.

2 oz.

or cheese

1 oz.

1 oz.

2 oz.

or eggs

1 egg

1 egg

1 egg

or cooked dry beans or peas

1/4 cup

3/8 cup

1/2 cup

or peanut butter, or other nut or seed butters or peanut butter, or other nut or seed butters or peanuts or soy nuts 3

2 Tbsp.

3 Tbsp.

4 Tbsp.

or an equivalent quantity of any combination of meat/meat alternate

1/2 oz. =50%

3/4 oz. =50%

1 oz. =50%

(See footnotes from breakfast pattern.)

1 Serve 2 or more kinds of vegetable(s) and/or fruit(s). Full-strength vegetable or fruit juice may be counted to meet not more than of this requirement.

2 Edible portion as served.

3 No more than 50% of the requirement shall be met with nuts or seeds. Nuts or seeds shall be combined with another meat/meat alternate to fulfill the requirement. For purposes of determining combinations, 1 ounce of nuts orseeds is equal to 1 ounce of cooked lean meat, poultry, or fish.

SUPPLEMENTAL FOOD (SNACKS)

Select two of the following four components. Juice may not be served when milk is served as the only other component. Milk and yogurt are too similar in nutritional value to be used together in the same supplement.

Food Components

Age 1 and 2

Age 3-5

Age 6-12 1

 

 

 

 

Milk milk, fluid

1/2 cup

3/4 cup

1 cup

 

 

 

 

Vegetables and Fruits

Vegetable(s) and/or fruit(s) 1

1/2 cup

1/2 cup

3/4 cup

or full-strength vegetable or fruit juice or an equivalent quantity or any combination of vegetable(s), fruit(s) and juice

1/2 cup

1/2 cup

3/4 cup

 

 

 

 

Bread and Bread Alternates 3

bread

1/2 slice

1/2 slice

1 slice

or cornbread, biscuits, rolls, muffins, etc

1/2 serving

1/2 serving

1 serving

or cold dry cereal

1/4 cup or 1/3 oz

1/3 cup or 1/2 oz.

3/4 cup or 1 oz.

or cooked cereal

1/4 cup

1/4 cup

1/2 cup

or cooked pasta or noodle products or an equivalent quantity of any combination of bread/bread alternate

1/4 cup

1/4 cup

1/2 cup

Meat and Meat Alternates

lean meat or poultry or fish2

1/2 oz.

1/2 oz.

1 oz.

or cheese

1/2 oz.

1/2 oz.

1 oz.

or eggs

1/2 egg

1/2 egg

1/2 egg

or cooked dry beans or peas

1/8 cup

1/8 cup

1/4 cup

or peanut butter, or other nut or seed butters or peanut butter, or other nut or seed butters

1 Tbsp.

1 Tbsp.

1 Tbsp.

or peanuts or soy nuts

1/2 oz.

1/2 oz.

1 oz.

or yogurt, plain, or sweetened and flavored 1 or an equivalent quantity of any combination of meat/meat alternate

2 oz. or 1/4 cup

2 oz. or 1/4 cup

4 oz. or 1/2 cup

(See footnotes from Breakfast and Lunch patterns.)

1 Yogurt means commercially coagulated milk products obtained by fermentation that meet milk fat or milk solid requirements to which flavoring foods or ingredients may be added. These products are covered by the FDA's standard of identity for yogurt, lowfat yogurt, and nonfat yogurt.

APPENDIX E ENVIRONMENTAL STANDARDS FOR GROUP CHILD CARE HOMES

(A) Food Sanitation.

The following standards shall be met for food sanitation:

1. Food shall be in sound condition, free from spoilage, filth, or other contamination; food shall be obtained from sources that comply with all laws relating to food and food labeling. The use of hermetically sealed containers (home canned food) is prohibited.

2. All milk including dry milk powder shall be from a Grade A pasteurized source.

3. Raw fruits and vegetables shall be washed before use.

4. Stuffing, poultry, and pork products shall be cooked to heat all parts of the food to at least 150°F.

5. If a family style feeding process is used, all leftover food from the eating table shall be discarded. Milk and food used in family style feeding shall not be placed on eating table longer than 15 minutes prior to beginning of meal.

6. Potentially hazardous foods requiring cold storage shall be maintained at 45°F or below, and accurate thermometers shall be kept in the refrigerators. Potentially hazardous food requiring hot storage shall be at an internal temperature of 140°F or above. Frozen foods shall be maintained at a temperature of 0°F or below. Thermometers shall be placed in all freezers.

7. Milk and other potentially hazardous foods shall be kept in the proper temperature ranges and be protected properly, except during necessary periods of preparation.

8. All dry food supplies shall be stored in closed containers and labeled unless its identity is unmistakable. These foods shall be stored in a manner to prevent possible contamination and to allow for proper cleaning of the storage area.

9. All food shall be protected from contamination during storage, preparation, transportation, and serving.

10. No poisonous or toxic materials except those required to maintain sanitary conditions and for sanitation purposes may be used or stored in a food-service area of a facility.

11. Poisonous and toxic materials shall be identified, stored, and used only in such a manner and under such conditions as will not contaminate food or constitute a hazard to the population of a facility.

12. All equipment and utensils including plasticware shall be so designed and fabricated of such material and workmanship as to be smooth, easily cleanable, and durable, under conditions of normal use and shall be resistant to denting, buckling, pitting, chipping, and crazing.

13. The food-contact surfaces of equipment and utensils shall be easily cleanable, nontoxic, corrosion resistant, and nonabsorbent. Hard maple or equivalently nonabsorbent material may be used for cutting boards, blocks, salad bowls, and baker's tables. 8

14. Multi-use equipment shall be constructed and repaired with safe materials, including finishing materials; and they shall be corrosion resistant and nonabsorbent; and they shall be smooth and easily cleanable.

15. Equipment in use at the time of adoption of this standard that does not fully meet all of the design and fabrication requirements shall be deemed acceptable in that establishment if it is in good repair, capable of being maintained in a sanitary condition, and the food contact surfaces are nontoxic.

16. All eating and drinking utensils shall be thoroughly washed, rinsed, and sanitized after each use with the exception of single-service utensils which shall be discarded following use.

17. Single-service articles shall be made from nontoxic materials and shall be stored, handled, and dispensed in a sanitary manner.

18. All utensils and food-contact surfaces or equipment used in the preparation, transportation, service, display, or storage of potentially hazardous food shall be thoroughly washed, rinsed, and sanitized prior to such use.

19. Cooking surfaces of equipment shall be cleaned at least once a day.

20. All kitchenware and food-contact surfaces of equipment, exclusive of cooking surfaces of equipment, used in the preparation or serving of food or drink, and all food-storage utensils, shall be washed, rinsed, and sanitized after each use.

21. Nonfood contact surfaces of equipment shall be cleaned as often as is necessary to keep equipment free of accumulation of dust, dirt, food particles, and other debris.

22. Cleaned and sanitized utensils and equipment shall be stored at least six inches above the floor in a clean, dry location in a way that protects them from contamination by splash, dust, and other means.

23. In facilities defined by the Department of Human Services as existing, a two-compartment sink can be used for washing and rinsing utensils, provided an additional container or sink is used for sanitation of the utensils. For facilities defined by the Department of Human Services as new, a three-compartment sink with two drain boards or easily movable dish tables of adequate size shall be required when manual dishwashing procedures are utilized for washing, rinsing, and sanitation of utensils. Domestic type dishwashing machines are acceptable provided the temperature at the utensil surface is 160°F after the end of one complete cycle. If 160° is not obtained at the end of one complete cycle, an additional sanitizing rinse for utensils shall be provided in a separate container or sink.

(B) Water Supply.

1. The water supply serving child care facilities shall be provided from a source constructed and operated according to law.

2. There shall be sufficient hot and cold water under pressure to supply the daily needs of a group day care home.

3. Water from a public supply shall be utilized where available.

4. An approved drinking fountain or individual single service paper cups shall be provided in rooms or adjacent to rooms regularly occupied by the residents.

5. All facilities shall be clean and in good repair.

(C) Sewage Disposal And Plumbing.

1. The facility shall be connected to a public sewage disposal system when such a system is available.

2. The use of a private sewage disposal system shall have the approval of the local health department and it shall be operating satisfactorily.

3. When the private sewage disposal system at an existing facility fails and where a public sewage system is available, the facility shall be connected.

4. Plumbing shall be sized, installed, and maintained according to law. There shall be no cross connection between the potable water supply and any other water supply.

(D) Solid Waste.

1. There shall be a sufficient number of containers to hold all the garbage and refuse that accumulates.

2. Soiled containers shall be cleaned at a frequency to prevent insect and rodent attraction, and maintained in good repair.

3. Storage containers, other than bulk, shall be secured properly to prevent spillage.

4. Garbage deposited in outside bulk storage shall be in fly-tight containers (i.e., plastic bags).

5. All garbage shall be removed from the building daily.

6. Garbage and rubbish shall be collected from the premises at least twice weekly.

7. At facilities where twice weekly collection is not provided, all garbage and rubbish shall be disposed of in a manner acceptable to the health authority having jurisdiction (supplement collection by individual hauling, acceptable burying, etc.).

8. Combustible rubbish may be burned, provided such burning meets all local and state laws and regulations relative to incinerators, incineration, and air pollution.

(E) Toilets, Handwashing, And Bathing.

1. One-flush toilet and one handwashing facility for every 12 children shall be provided.

2. All facilities shall be approved and in good repair, and clean.

3. A tightly covered container with plastic liner shall be used for diaper disposal and stored inaccessible to children. This container shall be emptied by closing the liner and disposing of it into an outside garbage receptacle.

4. There shall be soap, hot and cold water under pressure, and individual towels provided wherever a handwashing lavatory is located.

5. Personnel shall exercise good handwashing practices following diaper changes, the assistance of children in toilet use, and personal toileting.

6. Proper adult supervision shall be exercised for use of toilet and handwashing facilities.

7. Toilet tissue shall be provided on tissue holder at each commode.

8. Tempered water (90°F - 120°F) shall be provided at all handwashing or bathing facilities used by children.

(F) Buildings.

1. Structure.

(a) The building foundation, roof, walls, and window frames shall be free of visible cracks and unsealed openings to prevent entrance of insects and rodents.

(b) Buildings shall be kept clean, in good repair, and painted when necessary.

(c) Gutters and downspouts shall be kept in good repair.

2. Floors shall be easily cleanable, clean, and in good repair.

3. Walls and ceilings shall be kept clean and in good repair.

4. Doors and Windows.

(a) All doors and windows shall be kept clean and in good repair (this includes screens when used).

(b) Window space shall be equal to at least 10 percent of the floor area except in rooms which are air-conditioned and which have artificial light amounting to at least 25 foot candles.

(c) Windows shall be openable unless the room is air-conditioned.

(d) All outside doors and windows used for ventilation shall be screened unless building is air-conditioned.

5. Bedding.

(a) Where provisions are made for staying at a facility overnight, each occupant shall be provided an individual bed with acceptable mattress and waterproof cover, springs, clean linen, and clean cover.

(b) Where children are kept at least six hours but not overnight, individual cots or other approved bedding shall be provided and kept clean and in good repair.

(c) Spacing between mats or cots shall be adequate to promote freedom of movement (approximately two feet between cots and mats).

6. Lighting.

(a) Natural and/or artificial lighting shall equal at least 25 foot candles in all areas used by children and staff.

(b) Fixtures, shades, blinds, etc., shall be clean and in good repair.

7. Heating and Ventilation.

(a) All rooms used by children shall be heated by a system capable of maintaining a temperature of 68°F.

(b) When the outside temperature is 65°F or below, the temperature at child height within the facility shall be no lower than 65°F nor higher than 75°F.

(c) Stoves, hot radiators, steam and hot water pipes, or other objects and electrical outlets in rooms used by the children shall be adequately protected by screens, guards, insulation, or any suitable measures that will protect children from coming in contact with them.

(d) Heat and ventilation units shall be clean and in good repair.

8. Housekeeping.

(a) All parts of the building shall be maintained in clean condition.

(b) All rooms shall be maintained in an orderly manner.

(G) Insect And Rodent Control.

1. The facility shall be reasonably free from flies, other insects, and breeding sites.

2. Approved screens in good repair shall be provided for all doors and windows used for ventilation purposes.

3. When air-conditioning is used, doors and windows shall be kept closed.

4. The facility shall be free of rodents.

5. There shall be no rodent harborage areas.

6. Proper supervision and caution shall be exercised according to label instructions when applying approved insecticides and rodenticides.

(H) Safety.

1. Pesticides, medicines, polishes, disinfectants, and cleaning compounds shall be stored in a manner approved by the local health authority.

2. Sturdy safety rails shall be provided for ramps and steps where there are three or more risers.

3. Bathtubs, if used, shall be provided with safety strips or mats.

4. Glass in hazardous locations in the facility shall be shielded when safety glass is not used. Broken glass objects shall not be permitted in any part of the building or on grounds.

5. All furniture shall be of durable construction, free of sharp projecting corners or surfaces and kept in good repair.

6. Grounds shall be kept clean and free of hazards that are likely to cause falls. Grounds shall be kept free of excess growth of grass or weeds.

7. Buildings and grounds shall be free of any unprotected, abandoned well, cistern, refrigerator, or similar hazards.

8. Fencing or other acceptable barriers shall be provided for hazardous drainage ditches, cliffs, bluffs, or other similar hazards.

9. Adequate barriers, such as fencing, shall be provided and supervision exercised to prevent children from running on driveways, streets, or highways where a traffic hazard exists.

10. Grounds shall have adequate drainage.

(I) Swimming Pool.

1. Facilities shall comply with state law and regulations for public swimming pools.

2. Facilities utilizing a swimming pool on-site shall have an approved lifeguard on duty or twice the number of adults required in the home. Facilities using an off-site pool shall be assured of the number of lifeguards required on duty.

3. A fence four feet high shall surround the pool.

APPENDIX F FIRE SAFETY INSPECTION REPORT

NEW AND EXISTING CHILD DAY CARE CENTERS AND/OR GROUP CHILD CARE HOMES LICENSED BY THE TENNESSEE DEPARTMENT OF HUMAN SERVICES

Name of Facility __________________________________________________________

Director _________________________________________________________________

Street Address_____________________________________________________________

Telephone(_______) _________________________

City/Route_____________________ State ____________ Zip ____________________

The new life safety code refers to the 1988 Edition while the existing life safety code refers to the 1985 Edition.


Yes
No
N/A

1. If the building is wood frame construction, is it restricted to two stories in height? NEW LSC 10-7.1.6; EXISTING 11-7.1.6


2. Does each building used for day care center purposes have access to two outside exits? NEW LSC 10-7.2.4.1; EXISTING 11-7.2.4.1


3. Is the building free of any dead end corridors or spaces (maximum of 20 ft distance or less)? NEW LSC 10-7.2.5.1; EXISTING 11-7.2.6.1 AND 5- 5.3.5


4. If part of the building is used for purposes not under control of the day care operator, are all rooms and spaces used for day care purposes separated from the rest of the building by one-hour fire rated walls and one-hour "B" label door assemblies to include rated steel frames with self-closing units and positive latching devices? NEW LSC 10-7.1.2; EXISTING 11-7.1.2


5. Is the second floor and/or basement separated from the main floor with one hour rated construction including at least one-hour "B" label door assemblies (rated frames, closers, and positive latching)? NEW LSC 10-7.3.1; EXISTING 11-7.3.1


6. Does the facility have an electrically supervised, manually operated fire alarm device which is audible throughout the building? NEW LSC 10-7.3.4, EXISTING 11-7.3.4


7. If exit doors are located within a required rated enclosure, do the doors swing in the direction of egress? NEW LSC 5-2.1.4.1; EXISTING 5-2.1.4.1


8. Are smoke detectors installed in accordance with Section 7-6 of the Life Safety Code? NEW LSC 10-7.3.4.5; EXISTING 11-7.3.4.5


9. Are all fuel burning space heaters, floor furnaces or wall type electrical heaters provided with a protective screen and anchored securely (portable space heaters are not acceptable)? NEW LSC 10-7.5.2; EXISTING 11-7.5.2


10. Is the building free of any unvented fuel burning heaters? NEW LSC 10-7.5.2.2; EXISTING 11-7.5.2


11. Are all hallways and other means of exits kept adequately lighted at all times when the building is occupied? NEW LSC 10-7.2.8; EXISTING 11-7.2.8


12. Are all corridor doors at least 20 minute rated with 20 minute rated frames? (If all classrooms have a door directly to the outside, this requirement may be omitted.) NEW LSC 10-3.6.1; EXISTING 11-3.6.1


13. Are approved exit lights installed where applicable? (Over stairwell doors, in corridors, exit doors, gym, auditorium, etc.) NEW LSC10-7.2.10; EXISTING 11-7.2.10


14. Unless classroom doors open directly to the outside, are corridors one hour rated? NEW LSC 10-3.6.1; EXISTING 11-3.6.1


15. Does each classroom or any other room used for sleeping purposes have a window which can be opened to provide for emergency evacuation? (Not applicable if room has a door directly to the outside) NEW LSC 10-7.2.11.4; EXISTING 11-7.2.11.4, except in the 1985 LSC 101


16. Are all doors to hazardous areas separated with 45 minute "C" label fire door assemblies? (Storage rooms, furnace rooms, etc.) NEW LSC 10-7.3.2; EXISTING 11-7.3.2


17. Does the hot water heater have a safety relief valve installed? SMC of SBCCI 304.3.3


18. Is the garage, storage room or basement area free of flammable or combustible liquids? NEW AND EXISTING LSC 31-1.5


19. Does this facility have an unannounced fire drill monthly? NEW AND EXISTING LSC 31-3.4


20. Are all employees informed of their duties for fire drills NEW AND EXISTING LSC 31-3.4.1


21. Does interior finish have the required flamespread rating? NEW LSC 10-7.3.3.1; EXISTING 11-7.3.3.1


22. Is the building safe from any electrical hazards such as overloaded electrical panel, excessive cords, or frayed wiring? NEW LSC 11-7.5.1.1; EXISTING 11-7.5.1.1


23. Are all ceilings, regardless of type, constructed with noncombustible material?


24. Are hazardous areas properly protected? NEW LSC 10-7.3.2; EXISTING 11-7.3.2


25. Do commercial type cooking appliances have approved fire extinguishing systems installed as required by NFPA 96? NEW LSC 10-7.3.2.1; EXISTING 11-7.3.2


26. Is emergency lighting provided throughout egress passageways? NEW LSC 10-7.2.9; EXISTING 11-7.2.9


27. Are closet door latches designed so that children can open the door from inside the closet? NEW LSC 10-7.2.11.1; EXISTING 11-7.2.11.1


28. Are bathroom door locks designed to permit opening of the locked door from the outside in an emergency? Are the opening devices readily accessible to the staff? NEW LSC 10-7.2.11.2; EXISTING 11-7.2.11.2



29. Are special protective receptacle covers installed in wall receptacles in areas occupied by children under 5 years of age? NEW LSC 10-7.5.1.2; EXISTING 11-7.5.1.2

Inspector shall check either item (a) or (b) below:

(a) Facility acceptable


(b) Facility not acceptable

(c) If facility is not acceptable, list all deficiencies on a Part 11 Inspection Report form to accompany this report. State at the bottom of the Part II Report that the facility will not be approved or occupied until all deficiencies have been corrected.

___________________________________________

SIGNATURE OF INSPECTOR

___________________________________________

TITLE OF INSPECTOR

___________________________________________

DATE OF INSPECTION

___________________________________________

AGENCY OR FIRE DEPARTMENT


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