(1)  Nutritional Needs 





        (A)  The person responsible for meal planning in 


the center must follow a food service guide from the 


Department of Health, the Department of Human Services, 


or U.S.D.A. (See Appendix D and "Nutrition and Food 


Service for Child Care Centers" booklet.) 





        (B)  The week's menus must be planned and posted 


by the first day of each week so that parents can know the 


food their children are receiving.  These menus must be 


followed, although reasonable substitutes are permissible if 


the substituted food contains the same nutrients; 


substitutions must be noted on menus. 





        (C)  For children in the center at least three hours, 


one supplement must be provided, unless the three-hour 


period covers a normal meal hour, in which case a meal 


must be provided.  (See Appendix D and booklet, "Nutrition 


and Food Service for Child Care Centers".) 





        (D)  Supplements (defined as bread product, drink 


or fruit) provided must be simple and nourishing and 


planned as part of the day's food allowance.  Carbonated 


drinks, fruitades, synthetic fruit-flavored drinks, imitation 


milk, and candy must not be served as supplemental foods.  


Preferred bread products are plain crackers, breads, and 


cereals that are made from enriched flour or meal; fruit 


drinks served as a supplement must be 100% juice. 





        (E)  For children in the center five to ten hours, one 


meal (to include as minimum:  meat or meat substitute, 


vegetable and/or fruit, bread product, and milk) and one or 


two supplements must be provided, two supplements if the 


period is as much as seven hours. 





        (F)  For those in the center longer than 10 hours, 


two meals and two supplements must be furnished. 





        (G)  Breakfast must be offered to children who 


arrive before 7:00 a.m. and who have not had breakfast at 


home. 





        (H)  Special diets must be prepared as prescribed 


by a physician. 





                        (i)  Food must not be forced on 


or withheld from a child.  Desserts and sweets must not be 


used as reward or punishment. 





        (J)  Meals and snacks must be planned with 


consideration given to the total daily food requirements.  


Unless otherwise specified by the parent, each infant must 


be fed in accordance with the pamphlet published by the 


Tennessee Department of Health, entitled, "Feeding Your 


Baby", available from DHS or local health departments. 





        (K)  If specific instructions for feedings are 


prescribed by a physician or given by the parent, they must 


be in writing and the agency must follow the instructions.  


However, if staff feels these instructions do not provide for 


adequate nutrition, there must be consultation with the 


child's parents, a public health nurse or public health 


nutritionist, or the child's physician. 





        (L)  When introducing new foods to infants and 


toddlers, foods must be introduced one at a time over a five-


to-seven-day period with parent's approval. 





        (M)  The feeding schedule for infants must be in 


accordance with the child's need rather than according to the 


hour. 





        (N)  When infants are being weaned, parents and 


caregivers must work together to insure consistency in the 


weaning process. 





        (O)  Weaning must not be started immediately after 


admission to the center. 





        (P)  The child must be familiar with the cup or 


glass prior to its substitution for the bottle. 





        (Q)  There must be no more than 14 hours between 


meals or supplements. 


 


(2)  Meal Service 





        (A)  Caregivers and children must wash their hands 


before eating or prior to any preparation of food. 





        (B)  High chairs and tables on which food is 


prepared and served must be washed with soap and water 


prior to and after snacks and meals. 





        (C)  Floors under tables and high chairs on which 


food is served must be swept and/or vacuumed after each 


meal and mopped as needed. 





        (D)  Napkins, individual forks and/or spoons must 


be provided for children who feed themselves.  An 


individual dish must be used for each child. 





        (E)  The size of servings must be adequate to meet 


children's needs.  (See meal patterns in Appendix D.) 





        (F)  Solid foods (including cereal) must not be 


given in bottles or with infant feeders to children with 


normal eating abilities. 





        (G)  At mealtime, preschool children must be 


seated at low tables in child-sized chairs, and adults must sit 


with them. 





        (H)  All formulas and food brought from home 


must be labeled with the child's name.  Milk must be placed 


immediately in the refrigerator.  Once milk has been 


warmed, it must not be rewarmed or returned to the 


refrigerator.  For optimum digestion, formula is to be served 


at body temperature. 





                        (i)  Previously opened baby food 


jars must not be accepted in the center. 





        (J)  The infant/toddler must be held while he/she is 


fed as long as he/she is unable to sit in a high chair, an 


infant seat, or at the table.  Bottles must not be propped, and 


a child must not be given a bottle while lying flat. 





        (K)  When a child is capable of using a high chair, 


he/she must be allowed to do so and to experiment with 


food, with feeding himself/herself, and to eat with fingers or 


spoon. 





        (L)  When dishes are used, they must be 


unbreakable.