Conn. Agencies Regs. § 19a-79-10

Current through October 16, 2024

Section 19a-79-10 - Under three endorsement

(a) The operator of a program caring for children under three years of age shall comply with sections 19a-79-1a to 19a-79-10, inclusive, and section 19a-79-13 of the Regulations of Connecticut State Agencies.

(b) A program caring for children under three years of age shall have a separate endorsement by the Office.

(c)Infants and toddlers

(1) Age. Children from six weeks to thirty six months of age shall be considered infants and toddlers.

(2) Ratio. There shall be at least one program staff qualified under section 19a79-4a(e) of the Regulations of Connecticut State Agencies for every four children or fraction thereof who are under the age of two years in attendance and for every five children or fraction thereof who are two years old in attendance, indoors and outdoors.

(3) Group size. The group size shall not exceed eight for children that are under the age of two years and shall not exceed ten for children that are two years old, indoors and outdoors.

(4) There shall be a physical barrier separating each group of children, indoors and outdoors.

(d)Special equipment

Each child care center and group child care home shall have equipment and furniture to meet the developmental needs of the children served and shall be used in accordance with manufacturer guidelines.

(1) Sinks

(A) In child care centers there shall be a sink with hot and cold running water designated for diaper changing and hand washing of program staff and children. This sink shall be located in the program space. Child care centers which have three program staff for a group of infants or toddlers may use an accessible diaper changing facility if it is immediately adjoining the program area.

(B) Separate sinks shall be available for purposes other than hand washing after diaper changing within child care centers.

(C) Group child care homes shall have a sink accessible for hand washing other than the sink used for food preparation.

(2) Furniture shall include:

(A) Cribs or other furniture intended for infant sleeping that meet the United States Consumer Product Safety Commission (CPSC) requirements. All cribs shall comply with the CPSC crib standards. To demonstrate that a crib meets the current CPSC crib standards, one of the following shall be maintained on the licensed premises for each crib that is used or accessible to any child in care:

(i) A tracking label, which is a permanent, distinguishing mark on the crib which verifies a date of manufacture on or after June 28, 2011;

(ii) A registration form including the manufacturer's name and contact information, model name, model number, and a date of manufacture on or after June 28, 2011; or

(iii) A Children's Product Certificate (CPC) or test report from a CPSC-accepted third party lab demonstrating compliance with federal crib standards under 16 CFR 1219, for full-size baby cribs, or 16 CFR 1220, for non-full-size baby cribs.

(B) Washable cots for toddlers;

(C) Chairs for feeding, each of which has a stable base, safety straps on all high chairs attached to the chair and a tray which locks securely;

(D) Low tables and chairs according to children's size and development; and

(E) A refrigerator and facilities to store and heat food and bottles.

(3) Furniture may include but not be limited to:

(A) Strollers, each of which has a stable base, firmly attached safety straps and tightly locking brakes;

(B) Play pens, each of which has either small weave mesh netting or slats no more than two and three-eighths inches apart, a firm floor with a secured foam pad and hinges that lock tightly; and

(C) An adult rocking chair.

(e) Diapering and toileting

(1) The diapering area shall be an elevated sturdy table or counter equipped with a safety rail.

(2) Infants and toddlers shall be diapered at a diapering area used only for this purpose and located in the program area.

(3) Each diapering area shall have a non-porous surface and be kept in good repair.

(4) Diapering areas shall be washed and disinfected after each use.

(5) Disposable paper sheets shall be used and discarded immediately after each diapering.

(6) A covered washable lined waste receptacle shall be available and located in a convenient place for soiled waste material. These materials shall be removed to an exterior waste storage area at least daily.

(7) The hands of the program staff and the children shall be washed after each diaper change.

(8) Diapering and hand washing policies and procedures shall be posted in each diapering area and followed.

(9) Disposable diapers shall be discarded in a covered receptacle immediately after diapering.

(10) When cloth diapers or training pants are used, a written plan for their use and care shall be developed and implemented. This plan shall include, but not be limited to, these procedures:

(A) Placing soiled clothing and diapers in a sealed air tight container;

(B) Removing soiled clothing and diapers from the child care center or group child care home daily; and

(C) Cleaning and sanitizing the container daily.

(f)Linens and clothing and bedding

(1) A supply of linen and emergency clothing shall be available for each child in the child care center or group child care home at all times.

(2) All children's linens shall be washed at least weekly and as needed.

(3) Each child's linens and clothing shall be stored individually.

(4) When cribs and cots are shared, all metal, plastic and sealed wood bed frames shall be thoroughly wiped down with a general purpose cleaning agent and linens changed between children.

(g)Sleep arrangements

(1) Infants under twelve months of age shall be placed in a supine (back) position for sleeping in a well-constructed, free standing crib or other piece of equipment designed for infant sleeping and appropriate for the particular child, with a snug fitting mattress covered by a tightly-fitted sheet unless the child has written documentation from a physician, physician assistant or advanced practice registered nurse specifying a medical reason for an alternative sleep position or alternate piece of equipment.

(2) When infants can easily turn over from the supine to the prone position, they shall be put down to sleep on their back, but allowed to adopt whatever position they prefer for sleep.

(3) No items including, but not limited to, pillows, soft bumpers, toys and blankets, including weighted blankets, weighted sleepers, and weighted swaddles, shall be placed with an infant in a crib or hung over the side of a crib or other piece of equipment designed for sleeping except for a pacifier without attachments unless the child has written documentation from a physician, physician assistant or advanced practice registered nurse specifying a medical reason for its use. Bibs and garments with ties or hoods shall be removed from infants that are placed to sleep. No toys or objects shall be attached to sleeping or rest equipment.

(4) No infant shall be put to sleep on a sofa, bed, couch, soft mattress, waterbed or other soft surface. No infant shall be put to sleep or allowed to remain asleep in a child restraint system intended for use in a vehicle, an infant carrier, a swing or any place that is not specifically designed to be an infant bed unless the child has written documentation from a physician, physician assistant or advanced practice registered nurse specifying a medical reason for their use.

(5) No infant shall be swaddled unless the child has written documentation from a physician, physician assistant or advanced practice registered nurse specifying instructions and a timeframe for swaddling the infant.

(6) Infants under twelve months of age shall be physically observed at least every fifteen minutes to assess the infants breathing, color, temperature and comfort.

(7) No child under three years of age shall have access to teething necklaces, teething bracelets or other jewelry that could present a choking or strangulation hazard.

(8) Written policies and procedures for sleep arrangements shall include the requirements of this subsection and shall be posted in a conspicuous place in the areas where infants under twelve months of age sleep. The operator shall document that the child's parent(s) has been informed of the child care center or group child care home's policies and procedures for sleep arrangements prior to enrollment and reviewed as needed during the period of the child's enrollment.

(h)Toys and other objects

(1) Toys used for infants shall be kept separate, washed and sanitized at least daily. Toys for toddlers, including floor and riding toys, shall be washed and sanitized at least weekly and as needed.

(2) Toys and other objects with a diameter of less than one and one-quarter inches, objects with removable parts that have a diameter of less than one and one-quarter inches, balloons and Styrofoam objects shall not be accessible to children under three years of age unless such objects are part of a designated and directly supervised activity. Plastic bags, not in use, shall be stored out of reach and inaccessible to children under three years of age. Plastic bags, while in use, may be stored within reach of children under three years of age provided access to such bags is only under direct and immediate supervision.

(i)Health consultant

(1) A health consultant shall visit the facility on the days and times children under the age of three are present. The scheduled times of the visits shall be arranged so that all children under the age of three are observed. The health consultant shall prepare and maintain signed documentation of visits which shall be kept on the licensed premises.

(2) The health consultant shall visit the facility according to the following schedule:

(A) Once a week for children up to twenty-four months of age;

(B) Once a week if children two to three years of age, attend five hours or more per day; and

(C) Once a month if children two to three years of age attend less than five hours per day.

(j) Infants shall be removed from their cribs and held for all bottle feedings. They may be placed in chairs for all other feedings. Infants and toddlers shall be removed from their cribs or playpens at other intervals during the day for individual cuddlings and for verbal communication. They shall be allowed to crawl and toddle as age and development permit. Each infant shall be placed in a prone (front) position part of the time when awake.

(k) Foods and Liquids. When food and liquids are served:

(1) A written statement specifying the formula, breast milk or other liquids and the feeding schedule for infants shall be obtained from the parent(s), updated as necessary and followed by program staff;

(2) Unused portions of formula, breast milk or other liquids shall be discarded after each feeding;

(3) Clean bottles shall be provided by the parent(s) unless the facility uses disposable bottles or has a dishwasher or dishwashing system approved by the local director of health to wash bottles;

(4) Baby food shall be served from a dish unless the whole contents of the jar will be served; and

(5) Each child's bottle shall be individually identified with the child's name.

(l)Outdoor play space

(1) All infant toddler play space shall be fenced. Space licensed on and after January 1, 2025 shall be enclosed with a fence at least four feet in height.

(2) The equipment available to the infants and toddlers shall be developmentally appropriate for the ages of the children.

(3) Measures shall be in place to ensure the health and safety of children under three years of age who have access to play areas that contain impact absorbing materials that consist of uniform pieces of material that have a diameter of less than one and one-quarter inches.

Conn. Agencies Regs. § 19a-79-10

Effective July 27, 1993; Amended August 8, 1995; Amended November 6, 2008; amended 10/16/2024