13-004 Code Vt. R. 13-171-004-X
FOREWORD
Child Care Licensing Regulations govern child care facilities and programs in the State of Vermont. These rules are minimum requirements established to protect the health and safety of Vermont's children in out-of-home care and ensure that children in care, early education and afterschool programs in Vermont are provided with wholesome growth and educational experiences.
From September 2018 to April 2019, the Child Development Division worked with a Public School Prekindergarten Program Work Group to revise these regulations with the goal of reducing duplication. The work group consisted of Public School Prekindergarten Program representatives and stakeholders (e.g. Head Start representatives, Agency of Education representatives, and Let's Grow Kids representatives). The group reviewed approximately 59 Center Based Child Care and Preschool Program regulations. While the work group recommended many regulations remain the same after learning that the regulations were not duplicative, the work group recommended 24 regulations be revised. Revisions have been applied within the various sections of the regulations when application across environments applied. Section 8.2 had 9 regulations added due to being specifically relevant to Public School Prekindergarten Programs.
Revisions to the rules reflect an understanding of current scientific evidence related to how children learn and develop. The rules also reflect industry standards and realities in implementing child care and early education program practices that impact the health, safety and well-being of children. The rules incorporate changes in the organization of Vermont state agencies responsible for licensing and monitoring; changes in applicable state and federal legislation and regulations from other related governing entities; the use of information technology in government and program administration; and the evolving system of early childhood and afterschool services in Vermont.
It is the intent of the Department for Children and Families, Child Development Division in the Vermont Agency of Human Services that licensing requirements are clear, reasonable, fair, and enforceable and keep children and their families at the center of our concern. In the interests of serving the public, comments on the rules are welcome at any time and will be considered for future revisions or the
MISSION
The mission of the Child Development Division is to improve the well-being of Vermont's children. We do this through partnerships with families, communities, schools, providers, and state and federal agencies that increase access to high-quality, sustainable, child development services.
CBCCPP Section 1 Introduction.
CBCCPP Section 2 General Provisions.
-- Child care provided for children of not more than two (2) families other than that of the person providing care;
-- A hospital or establishment holding a license issued by the Department of Health, or a person operating a program primarily for recreation or therapeutic purposes, unless the hospital, establishment, or person provides services for the care, protection, and supervision of children not incidental to its primary purpose;
-- Child care facilities operated by a religious organization for the care and supervision of children during or in connection with religious services or church sponsored activities;
-- An after-school program that serves students in one (1) or more grades from Kindergarten through secondary school, that receives funding through the 21st Century Community Learning Centers Program, and that is overseen by the Agency of Education, unless the after-school program asks to participate in the Child Care Financial Assistance Program; and
-- Recreation programs that provide services that:
-- Operate less than four (4) hours per day and not more than thirteen (13) weeks a year for children ages three (3), four (4) and five (5) years old;
-- Operate for not more than thirteen (13) consecutive weeks for children that have completed Kindergarten or will reach six (6) years of age by September 1st of the year enrolled;
-- Operate for not more than four (4) hours one (1) day per week or not more than two (2) hours two (2) days per week; or
-- Operate to provide a single skill based activity for children ages three (3) years or older.
-- All exceptions in the rules in section 8.1 of these regulations shall apply only to the children whose enrollment forms and attendance records indicate that they are enrolled in non-recurring care services.
-- All exceptions in the rules in section 8.1 of these regulations shall apply only to the staff whose employment file and staffing schedule indicate that they are employed as seasonal staff.
-- Who meet together regularly;
-- Can be identified with one another as being distinct from the larger population of children present; and
-- Are assigned to a consistent staff member or team of staff members.
The licensee shall post a current license to operate a CBCCPP and a copy of the current CBCCPP Regulations in the licensed space where it is clearly visible to parents, staff, and visitors. A null and void or out-of-date license shall be immediately removed.
-- Modified to a provisional license;
-- Revoked;
-- Surrendered prior to the expiration date; or
-- Suspended.
-- An emergency occurs that affects a licensee's ability to be in substantial compliance with regulations;
-- The licensee has applied for approval of a change that impacts their license;
-- The licensee has a pattern of non-compliance with these regulations;
-- The licensee has applied for renewal and is not in substantial compliance with regulations; or
-- An individual has submitted a new application for licensure and full compliance has not been determined.
-- Modified to a full license;
-- Revoked;
-- Surrendered prior to the expiration date; or
-- Suspended.
-- A person who is required to complete a background check who refuses or knowingly makes a material false statement in connection with such background check;
-- A person convicted of fraud;
-- A person convicted of a felony consisting of:
-- Murder,
-- Child abuse or neglect,
-- A crime against children, including sexual activity or child pornography,
-- Spousal abuse,
-- A crime involving rape or sexual assault,
-- Kidnapping,
-- Arson,
-- Physical assault or battery, or
-- A drug related offense committed during the proceeding five (5) years;
-- A person convicted of a misdemeanor offense against a child or another person consisting of:
-- Violence,
-- Child abuse or neglect,
-- Child endangerment,
-- Sexual assault or activity,
-- Child pornography, or
-- Other bodily injury;
-- A person found by a court to have abused, neglected or mistreated a child, elderly or disabled person, or animal;
-- An adult or child who has had a report of abuse or neglect substantiated against them under Chapters 49 and 69 of Title 33 Vermont Statutes Annotated; or
-- A person registered, or is required to be registered, on a state sex offender registry or repository or the National Sex Offender Registry established under the Adam Walsh Child Protection and Safety Act of 2006.
-- A conviction of fraud;
-- A drug related offense committed during the preceding five (5) years;
-- A conviction of a misdemeanor offense against another person consisting of:
-- Violence;
-- Other bodily injury;
-- A person found by a court to have abused, neglected or mistreated a child, elderly or disabled person, or animal; or
-- Other information known to the Department. These individuals may operate or be employed in a CBCCPP only when the prospective licensee and the person involved, have obtained a written variance from the Commissioner, or designee. The prospective licensee and the involved person shall request a variance by submitting evidence of suitability or rehabilitation to the Commissioner, or designee. The burden of proof is on the prospective licensee and the involved person.
-- Potable water testing shall include bacterial (presence/absence of total coliform), and chemical screening (arsenic, uranium, nitrite, manganese, nitrate and fluoride). This testing shall be analyzed by a Drinking Water Laboratory certified by the State of Vermont according to 18 V.S.A. § 501b.
-- Results shall meet Vermont standards. Water shall be remedied and retested to ensure potability if any test(s) are elevated. Bottled water for drinking shall be provided until such time as the drinking water system meets Vermont standards.
-- The sample shall be a representative sample from the tap most frequently used for drinking after any treatment (for example a UV light system, a softener or charcoal filter).
-- Information from this water test shall be included in the initial application.
-- Review the application, confer with the prospective licensee, make an inquiry, investigate and may inspect the premises to determine whether the prospective licensee has fully or substantially complied with the applicable provision of these regulations;
-- Make a timely decision regarding issuance of a license; and
-- Inform the prospective licensee of the decision.
-- Results shall meet Vermont standards. Water shall be remedied and retested to ensure potability if any test(s) are elevated.
-- Bottled water for drinking shall be provided until such time as the drinking water system meets Vermont standards.
-- The sample shall be a representative sample from the tap most frequently used for drinking after any treatment (for example a UV light system, a softener or charcoal filter).
-- Information from these water tests shall be included in the license renewal.
-- Review the application, confer with the licensee, make an inquiry, investigate, and may inspect the premises to determine whether the licensee has fully or substantially complied with applicable provision of these regulations;
-- Make a timely decision regarding renewal of a license; and
-- Inform the licensee of the decision.
-- Status of the license: full or provisional;
-- Effective date of the license;
-- Expiration date of the license;
-- The maximum number of children who may be served at one (1) time;
-- The ages of the children who may be served;
-- The applicable type of regulated service for which authorization to operate has been granted;
-- Terms and/or conditions added to the license; and
-- Approval to prepare and provide meals if granted.
The licensee shall notify the Division prior to any of the following changes in the operation of the CBCCPP. The Division shall determine whether it will be possible to modify a current license, approve a time limited variance or if the licensee must submit an application for a new license:
-- A reduction, addition, or substantial change in the indoor or outdoor spaces utilized for the care of children in the CBCCPP;
-- A change in the name of the CBCCPP;
-- A change in the CBCCPP's Taxpayer Identification Number;
-- A change in the authorized license type of regulated service as defined in these rules;
-- A change in the number of children the CBCCPP serves at any one (1) time;
-- A change in the ages of children the CBCCPP serves;
-- A personnel change designating a new/different program director; or
-- A change naming a new designated representative for the licensee.
-- Revokes a full or provisional license to operate;
-- Denies approval of a provisional license;
-- Denies approval of a full license;
-- Replaces a full license with a provisional license;
-- Cites a violation of regulation(s) in a site visit report;
-- Denies a request for a variance; or
-- Deems a variance null and void, the Division shall notify the licensee in writing with appropriate notice, including the factual evidence the Division believes warrants the action or intended action and specify the licensee's right to appeal the decision and request a hearing.
-- Appeals challenging the revocation of a full or provisional license to operate or appeals on a denied variance shall not be subject to a Commissioner's Review hearing but made directly to the Human Services Board.
-- All other appeals may be made through a Commissioner's Review hearing or directly to the Human Services Board.
Decisions resulting from the Commissioner's Review hearing are subject to further appeal to the Human Services Board.
-- The particular regulation(s) they seek to vary;
-- The specifics of the request in relation to specific time frames or individual children or staff;
-- The specific hardship created by literal application; and
-- The plan for how the intent of the rule will be achieved and maintained.
-- Review the request, confer with the licensee, make an inquiry, investigate, and may authorize an inspection of the program and/or premises to determine whether the submitted plan will achieve the intent of the regulation;
-- Make a timely decision regarding the request; and
-- Inform the licensee of the decision.
CBCCPP Section 3 Administration and Operation.
-- Administrative;
-- Fiscal;
-- Clerical;
-- Cleaning and maintenance;
-- Food service;
-- Direct child care and early education; and
-- Staff supervision.
-- A completed child's admission form signed and dated by the parent that includes the first date the child attended the CBCCPP and the days and hours the child is regularly scheduled to attend the CBCCPP;
-- The child's name, current home address, and current home telephone number;
-- Identification of child's home language;
-- The child's date of birth;
-- Name, address, and all applicable current telephone numbers for parents;
-- Name, address, and all applicable current telephone numbers for at least two (2) other people designated by the parents as emergency contacts;
-- Names for all persons authorized to pick the child up from the CBCCPP;
-- Record of an annual physical and health history as required in the rule 5.1.2 of these regulations that includes the name and telephone number of the child's primary health care and dental care providers (if the child has a dental care provider);
-- A description of any special medical, developmental, emotional, or educational needs of the child including allergies, existing illnesses or injuries, previous serious illnesses or injuries and any prescribed medication including those for emergency situations;
-- Written authorization from the parent for the CBCCPP to be able to obtain emergency medical care and transportation;
-- Child's immunization record or Vermont Department of Health approved exemption document as required in the rules in section 5.1.3 of these regulations;
-- Written permission from parents for the CBCCPP to transport the child, if transportation is provided, as required in the rule 5.10.6.6.1 of the regulations;
-- Written permission from parents for the child to participate in swimming activities, if swimming activities are a part of the program, as required in the rule 5.10.5.1 of these regulations;
-- If applicable, a copy of court orders on custody and visitation arrangements as required in the rule 3.6.4 of these regulations; and
-- If applicable, any obvious injuries discovered and documented on daily health check as required in the rule 5.3.2 of these regulations.
-- Name, date of birth, home address and telephone number;
-- Copies of current first aid and CPR certification;
-- Signed statement verifying understanding of legal requirement to report suspected child abuse and neglect;
-- Documentation of a current Records Check Authorization form;
-- Documentation of having read and having ready access to a current copy of applicable child care licensing regulations;
-- Administration of Medication training certification (if applicable);
-- Signed statement verifying current job title and supervisor's name;
-- Application for employment including references or reference checks;
-- Employment start date;
-- Documentation of completed Orientation Training;
-- Employment end date;
-- IPDP (Substitutes filling a staff position for less than thirty (30) consecutive days within a 365 day period shall be exempt); and
-- Written annual performance reviews (Substitutes filling a staff position for less than thirty (30) consecutive days within a 365 day period shall be exempt).
-- Name, date of birth, home address, and telephone number;
-- Signed statement verifying understanding of legal requirement to report suspected child abuse or neglect;
-- Documentation of a current Records Check Authorization form; and
-- A job description.
-- Name, date of birth, home address, and telephone number;
-- Signed statement verifying understanding of legal requirement to report suspected child abuse or neglect; and
-- A written description of their role in the program.
Evacuation records shall be kept for two (2) years. When the CBCCPP counts lock-down drills as allowed in the rules in section 3.7.2 of these regulations, the licensee shall maintain a record of the date of each lock- down drill, the number of CBCCPP children and staff who participated, and note that the drill performed was a lock-down drill.
-- Evacuations or other emergencies such as leaving the premise and lockdown situations;
-- Specific concerns related to the location of the program, such as proximity to a nuclear reactor, an area prone to flooding or power loss;
-- Notifying the local authorities of the emergency;
-- A system for notifying the parents of the emergency;
-- Notifying the local emergency planning committee regarding the location of the CBCCPP and using the committee as a resource in emergency planning for the program;
-- A system of identifying the children and staff present at the time of the emergency and maintaining knowledge of their whereabouts;
-- A system for handling infants, toddlers, and children with special needs;
-- An established evacuation meeting location within walking distance of the CBCCPP;
-- A system to account for all children and staff at the evacuation meeting place;
-- A process for relocation if necessary, including safe transportation;
-- A system for shelter in place if the staff and children present need to remain in the CBCCPP for an extended period; and
-- Staff chain of command and individual staff roles and responsibilities, (if applicable) during emergencies.
The licensee, staff, auxiliary staff and partner staff shall not disclose or permit the use of any information regarding an individual child or family gained through CBCCPP interaction with the child and family, or CBCCPP records, files, videotaping, tape recording, photographing, assessments or any type of documentation unless parental permission is specifically granted, except to the Division or other entities with statutory authority for issues relating to the health, safety, and protection of children.
The program shall conduct a thorough assessment of the program that includes input from staff and parents at least once every 365 days.
CBCCPP Section 4 Parent/Family Engagement in Their Children's Care.
-- Assurance that parents have access to the CBCCP and their child(ren) without prior notice and have access to their children's records as required in the rule 3.4.4.6 of these regulations;
-- A description of information needed from parents for child's enrollment file as required in the rule 3.4.4.1 of these regulations;
-- A typical daily schedule of activities;
-- Information about fees and payment policies;
-- Information about hours of operation and closings;
-- Procedures for signing children in and out;
-- Procedures for emergencies as required in the rules in section 3.7 of these regulations;
-- Information about the nutrition, meals and meal preparation at the CBCCPP;
-- Safe sleep policies, as applicable;
-- No smoking policy;
-- Information about results from the test for lead in the drinking water and any plan for remediation;
-- CBCCPP policies on field trips, other off-site activity and transportation;
-- CBCCPP health policies including illness exclusions, administration of medication, and immunizations;
-- CBCCPP policies and practice regarding positive guidance and behavior management;
-- Assurance that confidentiality of child and family information is maintained;
-- Information about the requirement to report suspected child abuse and/or neglect as required in the rules in section 3.3 of these regulations;
-- Assurance that non-discrimination and respect for each child's family and culture is maintained;
-- CBCCPP approach to ensure wholesome growth and positive developmental experiences for children enrolled;
-- CBCCPP policies related to the inclusion of children with special needs and disabilities;
-- A description of religious activities, if any;
-- Information on how to access these CBCCPP regulations and other information about child development on-line;
-- Information concerning complaint procedures;
-- Information about the Child Care Consumer Line, including the telephone number (1-800-649-2642); and
-- CBCCPP policies and procedures related to the expulsion of children.
CBCCPP Section 5 Health, Safety and Nutrition.
Within forty-five (45) days of enrollment, the licensee shall obtain documentation of the child's age appropriate well care exam from the parent. Documentation shall include information regarding any health conditions and medications that may impact the care of the child.
The licensee shall maintain documentation in the child's file of each child's current immunization status.
-- Immunization records shall include the immunization administered and the date of each immunization. The immunization record should be updated after each additional immunization has been received.
-- If an enrolled child is in the process of complying with immunization requirements in accordance with the Vermont recommended immunization schedule, documentation in the child's file shall include the required Vermont Department of Health form.
-- If a child has not had a required immunization due to a Vermont allowed exemption, documentation in the child's file shall include the required Vermont Department of Health form.
-- Upon arrival at the CBCCPP;
-- Before they eat, prepare or handle food;
-- Before and after handling raw meat;
-- Before feeding children;
-- After toileting or diapering;
-- After cleaning;
-- After taking out the garbage;
-- After handling animals; and
-- After outdoor play.
-- Before and after giving medications;
-- Before and after caring for a child who is injured or may be sick;
-- Before diapering; and
-- After coming into contact with blood, fecal matter, urine, vomit, nasal secretions or other body fluids.
-- Use of warm running water and liquid soap;
-- Moistening hands with water, applying soap, and washing hands for a minimum of twenty (20) seconds;
-- Rinsing hands under running water;
-- Drying hands with a single use towel or paper towel; and then
-- Disposing of the towel.
-- Preparation: assemble supplies, staff member washes hands, prepares changing surface with either a disposable covering or ensure that the surface was recently cleaned and disinfected and bring the child to the diaper changing area.
-- Dirty Phase: remove soiled diaper, dispose of diaper, and cleanse diaper area of the child.
-- Clean Phase: put on clean diaper, dress child, and wash the child's hands.
-- Clean up: clean and disinfect the diaper changing surface, and staff member washes their own hands.
-- Record diaper change.
-- A staff member has an open cut, sore or cracked skin;
-- A child has an open cut or sore on his/her skin; or
-- A child has a known infection that is spread through feces.
-- Use of nonporous disposable gloves to clean up the blood or blood-containing fluid unless the material used to clean it up can easily contain the fluid;
-- Clean and disinfect the soiled surface;
-- Dispose of contaminated materials and store washable items in securely sealed plastic bags; and
-- Wash hands thoroughly as required in the rule 5.2.1.3 of these regulations.
After each use:
-- Countertops;
-- Food preparation appliances;
-- Plastic mouthed toys;
-- Changing tables; and
-- Cribs, cots, mats, and bedding, if used by different children.
When it touches another surface:
When it touches another surface:
-- Pacifiers
Every Day:
-- Uncarpeted floors
Every week:
-- Cribs, cots, mats, and bedding if used by the same child every day.
Every month:
-- Machine washable toys;
-- Dress-up clothes including hats;
-- Play activity centers; and
-- Refrigerator.
Before and after each use:
-- Food preparation surfaces;
-- Dining tables and highchair trays; and
-- Non flushing potty chairs.
After each use:
-- Eating utensils and dishes;
At the end of each day:
-- Food preparation appliances;
-- Plastic mouthed toys; and
-- Pacifiers.
-- Door and cabinet handles;
-- Hand washing sinks and faucets;
-- Countertops;
-- Toilets and toilet learning equipment;
-- Diaper pails; and
-- Drinking fountains.
-- Naming and identifying symptoms of illnesses for which a child will be excluded or sent home from the CBCCPP;
-- Identifying communicable diseases for which a child will not be admitted to the CBCCPP without a statement from a health care provider; and
-- Written notification to parents when children may have been exposed to a reportable communicable disease.
Upon arrival into the CBCCPP staff shall observe each child for symptoms of communicable disease and signs of injuries. Any obvious injuries shall be documented along with any comments from the parent pertaining to the child's condition. This documentation shall be maintained in the child's file for a minimum of 365 days.
Soft or loose bedding includes bumper pads, pillows, quilts, comforters, sheepskins, blankets, flat sheets, cloth diapers, and bibs. Infants shall not be swaddled for sleep.
Bibs, necklaces, and garments with ties or hoods shall be removed from the child prior to placing the child in the crib or port-a-crib.
-- Name of the child;
-- Child's date of birth;
-- Any medication allergies;
-- Name of medication;
-- Dosage to be given;
-- Time when medication is to be given;
-- Route of administration (mouth, ear, nose, topical, inhalation);
-- Reason for the medication;
-- Start and end dates for administration of the medication; and
-- Any special instructions.
-- First aid manual;
-- Adhesive tape;
-- Bandages;
-- Sterile gauze pads;
-- Rolls of gauze;
-- Eye dressing;
-- Disposable nonporous gloves;
-- Scissors;
-- Tweezers;
-- Non-glass, non-mercury thermometer; and
-- An instant cold pack.
-- Water and liquid soap or antiseptic wipes;
-- Any emergency medications needed for a child with allergies or special health needs;
-- List of emergency phone numbers as required in the rule 5.10.1.13.2 of these regulations; and
-- A copy of parental authorizations for emergency care as required in the rule 3.4.4.1 of these regulations.
-- Procedures to be followed in case of an accident, injury, or medical emergency, including the method of transportation and notification of parents; and
-- Procedures to be followed in case of accident, injury, or medical emergency
-- when parents cannot be reached.
-- Complying with Vermont Division of Fire Safety inspection reports;
-- Having regular fire systems inspected with violations identified during the inspection noted as corrected; and
-- Having fire extinguishers tagged with valid inspection tags.
The licensee shall ensure no firearms and other weapons; including hunting knives, archery equipment, and weapon accessories such as ammunition are present at the CBCCPP.
-- Police;
-- Fire;
-- Ambulance/Rescue Squad;
-- Poison Center (1-800-222-1222);
-- Child Development Division;
-- Interpreter Service (when needed for enrolled children); and
-- Child Abuse Hotline 800 number.
-- Parental contacts;
-- Emergency contacts; and
-- Doctor contact information.
The licensee shall prohibit any person, including but not limited to parents, staff, partner staff or volunteers, from the CBCCPP and property, when his/her presence or behavior disrupts the program, distracts the staff from their responsibilities, intimidates or promotes fear among the children and/or staff, or when there is reason to believe that his/her actions or behavior presents a risk of harm to children present.
-- Dishes shall be washed with soap in hot clean water.
-- Dishes shall be rinsed in hot clean water.
-- Dishes shall then be immersed for at least ten (10) seconds in a sanitizing rinse. The sanitizing rinse shall be EPA registered or a diluted bleach and water mixture. If using bleach, staff shall follow the manufacturer's instructions when mixing for this purpose.
-- Dishes shall be air dried.
-- If stored openly, all containers and utensils shall be stored eighteen (18) inches off of the floor;
-- Dishes shall be stored in a closed space;
-- Utensils shall be covered or inverted when not in use; and
-- Single service items shall be purchased and stored in sanitary cartons.
Swelled, rusty, dented or punctured canned food or drink shall not be consumed.
-- Be a minimum of four (4) feet in height with openings no larger than 3.5 inches;
-- Equipped with gates with self-closing and self-latching mechanisms; and
-- Include at least two (2) exits with one (1) that does not lead into the CBCCPP.
-- To prevent entrapment, no openings in equipment shall be between 3.5 and nine (9) inches.
-- Chains on swings shall have protective coverings and swing seats shall be made of soft materials with no sharp edges.
-- Tricycles shall not have spokes, and tricycles and bicycles with chains shall have chain guards.
-- Staff shall ensure that all children wear properly fitting safety helmets while riding outside on bicycles and using scooters.
For all play equipment that is thirty (30) inches or higher from the ground, including climbing equipment, slides, swings and other similar equipment, the licensee shall ensure that the surface under and around the equipment, including recommended use zones, is of approved resilient material that protects children if they fall.
-- Materials in the use zone shall consist of wood chips, pea stone, mulch, engineered wood fibers, sand, safety-tested shredded or rubber like material or rubber mats designed for protective cushioning;
-- Materials used in the use zone shall follow the recommendations listed in the most recent publication of U.S. Consumer Product Safety Commission's Public Playground Safety Handbook regarding critical depth of tested materials determined by the height of the highest climbing surface of the equipment;
-- Materials used in the use zone shall be installed and maintained according to the manufacturer's instructions;
-- If the resilient material in use zones freezes, staff shall ensure that children will not play on the equipment until the resilient material has thawed and is once again resilient.
The licensee shall ensure that interior space licensed for use by children shall provide a minimum of thirty-five (35) square feet of safe useable space per child for the maximum number of children using the space at one (1) time. Each child shall have adequate space for free movement and active play. Measurements shall be from wall to wall on the inside of the building. Furniture that restricts children's free movement and active play shall be considered a deductible factor when determining square footage. Bathroom, storage spaces, hallways, furnace rooms and other areas not used by children for sleep or play on a routine basis shall not be counted in computing square footage of useable space.
-- One (1) adult: two (2) children for infants/toddlers and pre-kindergarten age children;
-- One (1) adult: six (6) children for school age children.
-- One (1): ten (10) for children age eight (8) and older;
-- One (1): eight (8) for children ages six (6) and seven (7);
-- One (1): six (6) for children ages three (3) -- five (5); and
-- One (1): three (3) for children younger than three (3) years.
-- Reviewed once every 365 days;
-- Updated as needed;
-- Known by all staff present at the swimming facility;
-- Kept on file at the facility with a copy available while swimming occurs;
-- In the case of off-site swimming locations, the plan is formulated in conjunction with off-site aquatics personnel; and
-- Available for review.
-- Assessing each child's swimming ability performed by a person who holds a valid American Red Cross (ARC) Water Safety Instructor (WSI) certificate or current certificate issued by an approved certifying agency providing for equivalent levels of training. When bathers are in water less than waist deep, a system for assessing swimming ability is not required.
-- Identification of each bather by name, predetermined status of swimmer or non-swimmer, his/her swimming ability, and the area to which the bather is assigned.
-- Identify a system for visual identification of each child.
-- Restricting non-swimmers to areas where the water is less then waist deep, except for "learn to swim" programs or when shallow water is in a non-swimming area.
-- Recording the entry to and exit from the swim area for each bather.
-- Assigning each bather to a buddy who must have the same swimming ability. One threesome is allowed per swimming area. When children are unable to comprehend or implement a buddy system, another method that provides an equivalent level of bather safety, supervision and accountability shall be substituted and described in the written aquatic plan.
-- Instructing buddies to notify the lifeguard when their partner is distressed or missing.
-- Checking all bathers every fifteen (15) minutes.
-- Addressing a "lost swimmer" plan which becomes activated when a check fails to account for all bathers and shall include clearing the water and searching for and supervising children during the search for the lost swimmer.
All vehicles shall have operable heating and air conditioning. A comfortable temperature shall be maintained in vehicles while transporting children. Buses that are not equipped with an air conditioning feature may be used when the interior of the bus does not exceed 85°F degrees.
-- Recording information on all trips including date, time, driver, vehicle, and children transported;
-- Recording the adult, a child was released to if not CBCCPP staff;
-- Recording the address, a child was released to if not to an authorized person or CBCCPP Staff; and
-- A method for confirming that every child exits the vehicle after each trip.
-- Visually inspect the area prior to use to ensure it is free of health and safety hazards such as broken glass, animal feces, strong currents or posted health warnings;
-- Ensure that all rules related to Water Supervision/Prohibitions in the rules in section 5.10.5.4 of these regulations are strictly maintained; and
-- Ensure that children are restricted to areas where water is less than waist deep unless the child's swimming ability has been assessed.
-- A description of all food services provided;
-- Usual time of snacks and meals;
-- Policies and procedures related to food allergies, religious dietary requirements, and other special needs; and
-- Policies and procedures for safe eating habits.
-- Four (4) hours or less: one (1) snack;
-- Four (4) to six (6) hours: one (1) meal and one (1) snack;
-- Six (6) to eleven (11) hours: two (2) meals and one (1) snack, or one (1) meal and two (2) snacks;
-- More than eleven (11) hours: three (3) meals and two (2) snacks; and
-- School age children attending school for a full day shall be offered a snack within one (1) hour of their afternoon arrival.
CBCCPP Section 6 Teaching and Learning.
-- Opportunities for individual, small group and full group play and learning;
-- Opportunities for child-directed as well as provider-directed activities;
-- Active and quiet play;
-- Rest or quiet time as appropriate; and
-- Indoor and outdoor play.
-- Communication and Expression: Language and literacy development, and creative arts;
-- Learning about the world: social studies, science, and math; and
-- Developing of self: approaches to learning, social and emotional development, growing, moving, and being healthy.
-- Face to face interaction;
-- Being held and carried;
-- Individual and parallel play;
-- Cooperative play and small group activities;
-- Being talked to during play, feeding, and routine care;
-- Being read to and looking at books;
-- Naming of objects and experiences in the environment;
-- Space and equipment to support developing gross motor skills such as rolling over, sitting, scooting, crawling, standing, climbing, and walking;
-- Space and materials to support developing small motor skills such as eating finger foods, stacking, balancing, scribbling, and drawing;
-- Developmentally appropriate problem solving;
-- Encouragement to explore, experiment and initiate activities;
-- Open ended play and activities; and
-- Time and space to gain mastery through play and learning by doing.
-- Face to face interaction;
-- A combination of individual, small group, and large group experiences;
-- Conversation with adults and peers during play, eating, and routine care;
-- Being read to and looking at books, individually and in a group;
-- Space and equipment to support developing gross motor skills such as catching and throwing, balancing, jumping, climbing, running, and skipping;
-- Space and materials to support developing small motor skills such as using manipulatives, scribbling, drawing, and writing;
-- Materials, experiences and support for developmentally appropriate pre-literacy and literacy skills;
-- Materials, experiences, and support for developmentally appropriate mathematical and scientific concepts;
-- Open-ended play and activities;
-- Positive recognition of efforts, not just results;
-- Developmentally appropriate problem solving;
-- Materials, time, and encouragement to engage in extended and complex play alone and with peers;
-- Experiences that promote social competence and cooperative play;
-- Encouragement to explore, experiment and initiate activities;
-- Developmentally appropriate independence; and
-- Time, space, and encouragement to gain mastery through play and learning by doing.
School age children shall experience positive interactions with a consistent staff member or team that provides each child with the following opportunities throughout the day:
-- Active physical play;
-- A mix of individual, small group and large group activities;
-- Conversation with adults and peers;
-- Open-ended play and activities;
-- Positive recognition of efforts, not just results;
-- Developmentally appropriate problem solving;
-- Materials, time, and encouragement to engage in extended and complex play alone and with peers;
-- Encouragement to explore, experiment and initiate activities;
-- Developmentally appropriate independence;
-- Time and space for socialization, relaxation, and quiet activities;
-- Time and support for completing homework as needed; and
-- Encouragement to plan and carry out a self-chosen and directed activity.
Age | Maximum Group Size | Staff/ Child Ratio |
Birth - 18 months | 8 | 1:4 |
18 months - 30 months | 10 | 1:4 |
24 months - 36 months | 10 | 1:5 |
32 months - 42 months | 15 | 1:6 |
36 months - Kindergarten | 20 | 1:10 |
1st grade and up | 26 | 1:13 |
-- Art;
-- Associate School Nurse;
-- Early Childhood Special Education;
-- Educational Speech Language Pathology;
-- English Language Learner;
-- Music;
-- Physical Education;
-- Principal;
-- School Counselor;
-- School Librarian;
-- School Nurse;
-- School Psychologist;
-- Social Worker;
-- Teacher of the Deaf and Hard of Hearing; and/or
-- Teacher of the Visually Impaired.
The program director shall ensure that for mixed age groups, the staff/child ratios and maximum group size meet requirements for the age of the youngest child in any group.
Staff shall ensure visual supervision of children, except as allowed in rules 6.2.6.1-6.2.6.4 of these regulations.
CBCCPP Section 7 Program Personnel/Staffing.
The licensee, in consultation with the program director, shall establish written program policies and procedures and provide these to staff and to auxiliary staff left alone with children and/or counted in staff/child ratio as specified in the rule 6.2.1.8 of these regulations during an orientation training session approved by the Division prior to being left alone with children. Trainees under eighteen (18) years of age and other staff not left alone with children shall complete the orientation training within at least one (1) month of their first date of working with children. Complete written information and the orientation training session shall include:
-- Basic knowledge of child growth and development;
-- Routine and emergency health protection of children including health related exclusions;
-- Safety and sanitation requirements including handling and storage of hazardous materials and disposal of bio contaminants;
-- Positive behavior management;
-- Supervision of children;
-- Child accident and injury procedures including building and physical premises safety;
-- Safe sleep practices;
-- Administration of medication requirements;
-- Emergency and evacuation requirements;
-- Nutrition and food safety including prevention of and response to emergencies due to food and allergic reactions;
-- Recordkeeping;
-- Transportation and child passenger safety;
-- Release of children;
-- Respectful engagement of families;
-- Preventing, recognizing, and reporting child abuse and neglect; including information about the signs and symptoms of sexual abuse, sexual violence, grooming processes, recognizing the dangers of child sexual abuse, and other predatory behaviors of sex offenders;
-- Recognition of and response to the symptoms of common childhood illnesses;
-- Preventing the spread of infectious disease;
-- Providing developmentally appropriate activities and experiences for children;
-- Inclusion of children with special needs;
-- Guidelines for volunteers, partner staff, auxiliary staff, and business managers;
-- Responsibility to comply with current applicable licensing regulations;
-- Staffing requirements to include opening and closing; and
-- Ensuring children have extra clothes and diapers available.
-- A person who is required to complete a background check who refuses or knowingly makes a material false statement in connection with such background check;
-- A person convicted of fraud;
-- A person convicted of a felony consisting of:
-- Murder,
-- Child abuse or neglect,
-- A crime against children, including sexual activity or child pornography,
-- Spousal abuse,
-- A crime involving rape or sexual assault,
-- Kidnapping,
-- Arson,
-- Physical assault or battery, or
-- A drug related offense committed during the proceeding five (5) years;
-- A person convicted of a misdemeanor offense against a child or another person consisting of:
-- Violence,
-- Child abuse or neglect,
-- Child endangerment,
-- Sexual assault or activity,
-- Child pornography; or
-- Other bodily injury;
-- A person found by a court to have abused, neglected or mistreated a child, elderly or disabled person, or animal; or
-- An adult or child who has had a report of abuse or neglect substantiated against them under Chapters 49 and 69 of Title 33 Vermont Statutes Annotated; or
-- A person registered, or is required to be registered, on a state sex offender registry or repository or the National Sex Offender Registry established under the Adam Walsh Child Protection and Safety Act of 2006.
-- A conviction of fraud;
-- A drug related offense committed during the proceeding five (5) years;
-- A conviction of a misdemeanor offense against another person consisting of:
-- Violence;
-- Other bodily injury;
-- A person found by a court to have abused, neglected, or mistreated a child, elderly or disabled person, or animal; or
-- Other information known to the Department.
These individuals may operate or be employed in a CBCCPP only when the licensee and the person involved, have obtained a written variance from the Commissioner, or designee. The licensee and the involved person shall request a variance by submitting evidence of suitability or rehabilitation to the Commissioner, or designee. The burden of proof is on the licensee and the involved person.
-- A Vermont Early Childhood and Afterschool Program Director Step One (1) Certificate; or
-- Successful completion of a three (3) college credit course in program management for early care and education or for school age care and education, or in staff supervision related to early care and education of children; and a three (3) college credit course in curriculum.
-- A Vermont Early Childhood and Afterschool Program Director Step Two (2) Certificate or Vermont Early Childhood and Afterschool Program Director Credential, Step Three (3); or
-- Successful completion of a three (3) college credit course in curriculum, and an additional nine (9) college credits in program management, staff supervision, administration, or human resource management.
The program director shall ensure and maintain documentation that staff meet one (1) of the following qualifications:
A teacher is at least twenty (20) years of age and meets one of the following qualifications:
-- At least a Vermont Early Childhood Career Ladder Level Four (4) A or B Certificate; or
-- At least a bachelor degree from an accredited college with a major or concentration in Early Childhood, Child or Human Development, Elementary Education, Special Education with a birth to eight (8) years of age focus, or Child and Family Services and at least twelve (12) months experience working with groups of children from grade three (3) or younger; or
-- At least a bachelor degree from an accredited college with at least successful completion of thirty (30) college credits with an early childhood or school age focus and at least twelve (12) months experience working with groups of children from grade three (3) or younger; or
-- Hold at least a current Vermont Agency of Education teaching license with an endorsement in Early Childhood, Early Childhood Special Education, or Elementary Education.
A teacher associate is at least twenty (20) years of age, is a high school graduate or has completed a GED, and meets one (1) of the following qualifications:
-- At least a Vermont Early Childhood Career Ladder Level Three (3) Certificate; or
-- At least an associate degree from an accredited college with a major or concentration in Early Childhood, Child or Human Development, Elementary Education, or Child and Family Services and at least twelve (12) months experience working with groups of children from grade three (3) or younger; or
-- At least a Certificate of Completion from the Registered Child Care Apprenticeship Program; or
-- At least a Child Care Certificate from the Community College of Vermont and at least twelve (12) months experience working with groups of children from grade three (3) or younger; or
-- At least successful completion of twenty-one (21) college credits with an early childhood or school age focus and at least twelve (12) months experience working with groups of children from grade three (3) or younger.
A teacher assistant is at least eighteen (18) years of age, is a high school graduate or has completed a GED, and meets one (1) of the following qualifications:
-- At least a Vermont Early Childhood Career Ladder Level One (1) or Two (2) Certificate; or
-- At least a current CDA (Child Development Associate) and at least twelve (12) months experience working with groups of children from grade three (3) or younger; or
-- At least a State Board of Education approved Human Services Program Certificate that emphasizes child development or early childhood education and at least twelve (12) months experience working with groups of children from grade three (3) or younger; or
-- At least successful completion of the Fundamentals for Early Childhood Professionals' course or the Vermont Afterschool Essentials Certificate and at least twelve (12) months experience working with groups of children from grade three (3) or younger; or
-- At least successful completion of a three (3) college credit course in child or human development or a three (3) college credit course for school age care and education and at least twelve (12) months experience working with groups of children from grade three (3) or younger.
A trainee is at least fifteen (15) years of age, able to comprehend basic written format, and meets one (1) of the following qualifications:
-- At least a high school graduate or has completed a GED and completes the Fundamentals for Early Childhood Professionals' course or the Vermont Afterschool Essentials Certificate within the first twelve (12) months of employment; or
-- At least a high school graduate or has completed a GED and successful completion of a three (3) college credit course in child or human development or in school age care and education within the first twelve (12) months of employment; or
-- At least is enrolled in or has received a State Board of Education approved Human Services Program Certificate that emphasizes child development or early childhood education.
A classroom aide is at least eighteen (18) years of age, is able to comprehend basic written format, and meets one (1) of the following qualifications:
-- At least a high school graduate or has completed a GED and completes the Fundamentals for Early Childhood Professionals' course or the Vermont Afterschool Essentials Certificate within the first twelve (12) months of employment; or
-- At least a high school graduate or has completed a GED and successful completion of a three (3) college credit course in child or human development or in school age care and education within the first twelve (12) months of employment.
-- Name, date of birth, home address and telephone number;
-- Signed statement verifying understanding of legal requirement to report suspected child abuse or neglect;
-- Documentation of a current Records Check Authorization form;
-- Job description;
-- Application for employment;
-- Employment start date;
-- Documentation of completed Orientation Training;
-- Employment end date and reason for leaving, if applicable.
-- Name, date of birth, home address and telephone number;
-- Signed statement verifying understanding of legal requirement to report suspected child abuse or neglect;
-- Documentation of a current Records Check Authorization form; and
-- A written description of his/her role that outlines the job title, the job duties, and identifies the staff member responsible for supervising the volunteer.
CBCCPP Section 8 Exceptions for Specially Designated Programs.
-- A completed child's admission form signed and dated by the parent that includes the first date the child attended the CBCCPP;
-- The child's name, current home address and current home telephone number;
-- Identification of child's home language;
-- The child's date of birth;
-- Name, address, and all applicable current telephone numbers for at least one (1) other person designated by the parents as an emergency contact;
-- Names for all persons authorized to pick the child up from the CBCCPP;
-- A health history provided by the parent that includes the name and telephone number of the child's primary health care and dental care providers (if the child has a dental care provider). A description of any special medical, developmental, emotional, or educational needs of the child including allergies, existing illnesses or injuries, previous serious illnesses or injuries and any prescribed medication including those for emergency situations;
-- Written authorization from the parent for the CBCCPP to be able to obtain emergency medical care and transportation;
-- Written permission from parents for the CBCCPP to transport the child, if transportation is provided, as required in the rule 5.10.6.6.1 of the regulations;
-- Written permission from parents for the child to participate in swimming activities, if swimming activities are a part of the program, as required in the rule 5.10.5.1 of these regulations;
-- If applicable, a copy of court orders on custody and visitation arrangements as required in the rule 3.6.4 of these regulations; and
-- If applicable, any obvious injuries discovered and documented on daily health check as required in the rule 5.3.2 of these regulations.
-- A description of all food services provided;
-- Usual time of snacks and meals;
-- Policies and procedures related to food allergies, religious dietary requirements, and other special needs; and
-- Policies and procedures for safe eating habits.
-- Name, date of birth, home address, and telephone number;
-- Copies of current first aid and CPR certification;
-- Signed statement verifying understanding of legal requirement to report suspected child abuse and neglect;
-- Documentation of a current Records Check Authorization form;
-- Documentation of having read and having ready access to a current copy of applicable child care licensing regulations;
-- Administration of Medication training certification (if applicable);
-- Employment start date; and
-- Documentation of completed Orientation Training.
-- Name, date of birth, home address, and telephone number;
-- Signed statement verifying understanding of legal requirement to report suspected child abuse or neglect; and
-- Documentation of a current Records Check Authorization form.
-- A description of all food services provided;
-- Usual time of snacks and meals;
-- Policies and procedures for safe eating habits.
Appendix A. Signs and Symptoms of Illness Chart (Adapted).
The following chart lists, in alphabetic order, some of the most common signs and symptoms that individuals child care settings may develop when they have an infectious disease. Health professionals can use this chart to discuss with caregivers/teachers what they should look for to recognize diseases and make decisions about when individuals need medical care. Caregivers/teachers/program providers should use this information to be aware of what might cause various signs and symptoms, when it is appropriate to notify a health consultant and/or the parent, and the criteria to determine when individuals should be excluded from and can return to a group setting or program. All caregivers/teachers and direct staff should work with health professionals to ensure an appropriate diagnosis and treatment.
Note that the chart indicates when visits to a health professional are necessary. Not all individuals who are excluded from a child care setting require a visit to a health professional prior to return. However, if you are concerned about the nature of the individual's specific illness or need instructions about how to care for the individual, the child's parent/guardian can make a phone call to the child's health professional to clarify whether further evaluation is necessary. With parent/guardian consent, the child's health professional can give additional instructions in writing or over the phone to caregivers/teachers.
The Signs and Symptoms Chart is adapted from Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide, 2nd Edition a publication of the American Academy of Pediatrics. It is printed with permission to be included in the Vermont Child Care Regulations. Reference: Managing
Signs and Symptoms Chart | ||||||
Symptom | Common Causes | Complaints or What Might Be Seen | Notify Health Consultant | Notify Parent | Temporarily Exclude? | If Excluded, Readmit When |
Cold Symptoms | Viruses (early stage of many viruses) -- Adenovirus -- Coxsackievirus -- Enterovirus -- Parainfluenza virus -- Respiratory syncytial virus -- Rhinovirus -- Coronavirus -- Influenza Bacteria -- Mycoplasma | -- Runny or stuffy nose -- Scratchy throat -- Coughing -- Sneezing -- Watery eyes -- Fever | Not necessary | Yes | No, unless: -- Fever accompanied by behavior change. -- Individual looks or acts very ill. -- Individual has difficulty breathing. -- Individual has blood red or purple rash not associated with injury. -- Individual meets other exclusion criteria | -- Exclusion criteria are resolved. |
Cough (May come from congestion anywhere from ears to lungs. Cough is a body response to something that is irritating tissues in the airway.) | -- Common cold -- Lower respiratory infection (eg, pneumonia, bronchiolitis) -- Croup -- Asthma -- Sinus infection -- Bronchitis | -- Dry or wet cough -- Runny nose (clear, white, or yellow-green) -- Sore throat -- Throat irritation -- Hoarse voice, barking cough | Not necessary | Yes | No, unless: -- Severe cough -- Rapid and/or difficult breathing -- Wheezing if not already evaluated and treated -- Cyanosis (i.e., blue color of skin and mucous membranes) | -- Exclusion criteria are resolved. |
Diarrhea | Usually viral, less commonly bacterial or parasitic | -- Frequent loose or watery stools compared to child's normal pattern. (Note that exclusively breastfed infants normally have frequent unformed and somewhat watery stools, or may have several days with no stools.) -- Abdominal cramps. -- Fever. -- Generally not feeling well. -- Sometimes accompanied by vomiting. | For one or more cases of bloody diarrhea or 2 or more children with diarrhea in group within a week | Yes | Yes, if -- Stool is not contained in the diaper for diapered children. -- Diarrhea is causing accidents for toilet- trained children. -- Stool frequency exceeds 2 or more stools above normal for that child, because this may cause too much work for the teacher/caregivers and make it difficult to maintain good sanitation. -- Blood/mucus in stool. -- Abnormal color of stool for child (eg, all black or very pale). -- No urine output in 8 hours. -- Jaundice (i.e., yellow skin or eyes). -- Fever with behavior change. -- Looks or acts very ill. | -- Cleared to return by health professional for all cases of bloody diarrhea and diarrhea caused by Shigella, Salmonella, or Giardia. -- Diapered children have their stool contained by the diaper (even if the stools remain loose) and toilet-trained children do not have toileting accidents. -- Able to participate. |
Difficult or Noisy Breathing | 1. Common cold 2. Croup 3. Epiglottitis 4. Bronchiolitis 5. Asthma 6. Pneumonia 7. Object stuck in airway | 1. Common cold: Stuffy nose, sore throat, cough, and/or mild fever. 2. Croup: Barking cough, hoarseness, fever, possible chest discomfort (symptoms worse at night), and/or very noisy breathing, especially when breathing in. 3. Epiglottitis: Gasping noisily for breath with mouth wide open, chin pulled down, high fever, and/or bluish (cyanotic) nails and skin; drooling, unwilling to lie down. 4. (and 5.) Bronchiolitis and Asthma: Individual is working hard to breathe; rapid breathing; space between ribs looks like it is sucked in with each breath (retractions); wheezing; whistling sound with breathing; cold/cough; irritable and unwell. Takes longer to breathe out than to breathe in. 5. See above. 6. Pneumonia: Deep cough, fever, rapid breathing, or space between ribs looks like it is sucked in with each breath (retractions). 7. Object stuck in airway: Symptoms similar to croup (2 above) | Not necessary | Yes | Yes, if 1. Fever accompanied by behavior change. 2. Individual looks or acts very ill. 3. Individual has difficulty breathing. 4. Individual has blood red or purple rash not associated with injury. 5. The individual meets other exclusion criteria. | -- Exclusion criteria are resolved. |
Earache | 1. Bacteria or viruses 2. Often occurs in context of common cold | 1. Fever 2. Pain or irritability 3. Difficulty hearing 4. "Blocked ears" 5. Drainage 6. Swelling around ear | Not necessary | Yes | No, unless: -- Unable to participate. -- Care would compromise staff's ability to care for other children. -- Fever with behavior change. | -- Exclusion criteria are resolved. |
Eye Irritation, Pinkeye | 1. Bacterial infection of the membrane covering the eye and eyelid (bacterial conjunctivitis) 2. Viral infection of the membrane covering the eye and eyelid (viral conjunctivitis) 3. Allergic irritation of the membrane covering the eye and eyelid (allergic conjunctivitis) 4. Chemical irritation of the membrane covering the eye and eyelid (irritant conjunctivitis) (eg, swimming in heavily chlorinated water, air pollution) | 1. Bacterial infection: Pink color instead of whites of eyes and thick yellow/green discharge. May be irritated, swollen, or crusted in the morning. 2. Viral infection: Pinkish/red, irritated, swollen eyes; watery discharge; possible upper respiratory infection. 3. (and 4.) Allergic and chemical irritation: red, tearing, itchy eyes; runny nose, sneezing; watery discharge. | Yes, if 2 or more children have red eyes with watery discharge | Yes | For bacterial conjunctivitis No. Exclusion is no longer required for this condition. Health professionals may vary on whether to treat this condition with antibiotic medication. The role of antibiotics in treatment and preventing spread is unclear. Most individuals with pinkeye get better after 5 or 6 days without antibiotics. For other forms No, unless: -- The individual meets other exclusion criteria. Note: One type of viral conjunctivitis spreads rapidly and requires exclusion. If 2 or more children in the group have watery red eyes without any known chemical irritant exposure, exclusion may be required and health authorities should be notified. | -- For bacterial conjunctiviti, once parent has discussed with health professional. Antibiotics may or may not be prescribed. -- Exclusion criteria are resolved. |
Fever | -- Any viral, bacterial, or parasitic infection -- Overheating -- Reaction to medication (e.g., vaccine, oral) -- Other noninfectious illnesses (e.g., rheumatoid arthritis, malignancy) | Flushing, tired, irritable, decreased activity Notes -- Fever alone is not harmful. When a individual has an infection, raising the body temperature is part of the body's normal defense against outside attacks. -- Rapid elevation of body temperature sometimes triggers a febrile seizure in young children; this usually is outgrown by age 6 years. The first time a febrile seizure happens, the child requires evaluation. These seizures are frightening, but do not cause the child any longterm harm. Parents should inform their child's health professional every time the child has a seizure, even if the child is known to have febrile seizures. Warning: Do not give aspirin. It has been linked to an increased risk of Reye syndrome (a rare and serious disease affecting the brain and liver) | Not necessary | Yes | No unless: -- Behavior change. -- Unable to participate. -- Care would compromise staff's ability to care for other children. Note: Temperatures considered meaningfully elevated above normal, although not necessarily an indication of a significant health problem, for individuals older than 4 months are -- 100°F (37.8°C) axillary (armpit) -- 101°F (38.3°C) orally -- 102°F (38.9°C) rectally -- Aural (ear) temperature equal to oral or rectal temperature Get immediate medical attention when infant younger than 4 months has unexplained temperature of 101°F (38.3°C) rectally or 100°F (37.8°C) axillary. Any infant younger than 2 months with fever should get medical attention within an hour. | -- Able to participate -- Exclusion criteria are resolved. |
Headache | -- Any bacterial/viral infection -- Other noninfectious causes | -- Tired and irritable -- Can occur with or without other symptoms | Not necessary | Yes | No, unless: -- Individual is unable to participate Note: Notify health professional in case of sudden, severe headache with vomiting or stiff neck that might signal meningitis. The stiff neck of concern is reluctance and unusual discomfort when the child is asked to look at his or her "belly button" (putting chin to chest) -different from soreness in the side of the neck. | -- Able to participate |
Itching | 1. Ringworm 2. Chickenpox 3. Pinworm 4. Head lice 5. Scabies 6. Allergic or irritant reaction (eg, poison ivy) 7. Dry skin or eczema 8. Impetigo | 1. Ringworm: Itchy ring-shaped patches on skin or bald patches on scalp. 2. Chickenpox: Blister-like spots surrounded by red halos on scalp, face, and body; fever; irritable. 3. Pinworm: Anal itching. 4. Head lice: Small insects or white egg sheaths (nits) in hair. 5. Scabies: Severely itchy red bumps on warm areas of body, especially between fingers or toes. 6. Allergic or irritant reaction: Raised, circular, mobile rash; reddening of the skin; blisters occur with local reactions (poison ivy, contact reaction). 7. Dry skin or eczema: Dry areas on body. More often worse on cheeks, in front of elbows, and behind knees. In infants, may be dry areas on fronts of legs and anywhere else on body, but not usually in diaper area. If swollen, red, or oozing, think about infection. 8. Impetigo: Areas of crusted yellow, oozing sores. Often around mouth or nasal openings | For infestations such as lice and scabies; if more than one child in group has impetigo or ringworm; for chickenpox | Yes | For chickenpox, scabies, and impetigo Yes For ringworm and head lice Yes, at the end of the day -- Individual should be referred to a health professional at the end of the day for treatment. For pinworm, allergic or irritant reactions, and eczema No, unless: -- Appears infected as a weeping or crusty sore Note: Exclusion for hives is only necessary to obtain medial advice for care, if there is no previously made assessment and care plan for the hives. | -- Exclusion criteria are resolved. -- On medication or treated as recommended by a health professional if indicated for the condition and for the time required to be readmitted. For conditions that require application of antibiotics to lesions or taking of antibiotics by mouth, the period of treatment to reduce the risk of spread to others is usually 24 hours. For most individuals with insect infestations or parasites, readmission as soon as the treatment has been given is acceptable. |
Mouth Sores | 1. Oral thrush (yeast infection) 2. Herpes or coxsackie virus infection 3. Canker sores | 1. Oral thrush: White patches on tongue and along cheeks 2. Herpes or coxsackie virus infection: Pain on swallowing; fever; painful, yellowish spots in mouth; swollen neck glands; fever blister, cold sore; reddened, swollen, painful lips 3. Canker sores: Painful ulcers on cheeks or gums | Not necessary | Yes | No, unless: -- Drooling steadily related to mouth sores. -- Unable to participate. -- Care would compromise staff's ability to care for other children. | -- Able to participate -- Exclusion criteria are resolved |
Rash | Many causes 1. Viral: roseola infantum, fifth disease, chickenpox, herpes virus, molluscum contagiosum, warts, cold sores, shingles (herpes zoster), and others 2. Skin infections and infestations; ringworm (fungus), scabies (parasite), impetigo, abscesses, and cellulitis (bacteria) 3. Severe bacterial infections: mening ococcus, pneumococcus, Staphylococcus aureus (MSSA, MRSA) | Skin may show similar findings with many different causes. Determining cause of rash requires a competent health professional evaluation that takes into account information other than just how rash looks. 1. Viral: Usually signs of general illness such as runny nose, cough, and fever (except for warts or molluscum). Each viral rash may have a distinctive appearance. 2. Minor skin infections and infestations: See "Itching." More serious skin infections: redness, pain, fever, pus. 3. Severe bacterial infections: Rare. These children have fever with rash and may be very ill. | For outbreaks | Yes | No, unless: -- Rash with behavior change or fever -- Has oozing/open wound -- Has bruising not associated with injury -- Has joint pain and rash -- Unable to participate -- Tender, red area of skin, especially if it is increasing in size or tenderness | -- Able to participate in daily activities. -- On antibiotic medication at least 24 hours (if indicated). -- Exclusion criteria are resolved. |
Sore Throat (pharyngitis) | 1. Viral -common cold viruses that cause upper respiratory infections 2. Strep throat | 1. Viral: Verbal children will complain of sore throat; younger children may be irritable with decreased appetite and increased drooling (refusal to swallow). May see symptoms associated with upper respiratory illness, such as runny nose, cough, and congestion. 2. Strep throat: Strep infection usually does not result in cough or runny nose. Signs of the body's fight against infection include red tissue with white patches on sides of throat, at back of tongue (tonsil area), and at back wall of throat. Tonsils may be large, even touching each other. Swollen lymph nodes (sometimes incorrectly called "swollen glands") occur as body fights off the infection. | Not necessary | Yes | No, unless: -- Inability to swallow. -- Excessive drooling with breathing difficulty. -- Fever with behavior change. -- The individual meets other exclusion criteria. | -- Able to swallow. -- Able to participate. -- On medication at least 24 hours (if strep) -- Exclusion criteria are resolved. |
Stomachache | 1. Viral gastroenteritis or strep throat 2. Problems with internal organs of the abdomen such as intestine, colon, liver, bladder | 1. Viral gastroenteritis or strep throat: Vomiting and diarrhea and/or cramping are signs of a viral infection of stomach and/or intestine. Strep throat may cause stomachache with sore throat, headache, and possible fever. If cough or runny nose is present, strep is very unlikely. 2. Problems with internal organs of the abdomen: Persistent severe pain in abdomen. | Not unless multiple cases in same group within 1 week. | Yes | No, unless: -- Severe pain causing child to double over or scream -- Abdominal pain after injury -- Bloody/black stools -- No urine output for 8 hours -- Diarrhea -- Vomiting -- Yellow skin/eyes -- Fever with behavior change -- Looks or acts very ill | -- Pain resolves. -- Able to participate. -- Exclusion criteria are resolved. |
Appendix B. Consumer Product Safety Commission 16 C.F.R. § 1220 Regarding Cribs.
Beginning December 28, 2012, any crib provided by child care facilities and family child care homes must meet new and improved federal safety standards. The new standards take effect for manufacturers, retailers, importers and distributors on June 28, 2011, addressing deadly hazards previously seen with traditional drop-side rails, requiring more durable hardware and parts and mandating more rigorous testing.
What you should know...
* This is more than a drop side issue. Immobilizing your current crib will not make it compliant.
* You cannot determine compliance by looking at the product.
* The new standards apply to all full-size and non full-size cribs including wood, metal and stackable cribs.
* If you purchase a crib prior to the June 28, 2011 effective date and you are unsure it meets the new federal standard, CPSC recommends that you verify the crib meets the standard by asking for proof.
* Ask the manufacturer, retailer, importer or distributor to show a Certificate of Compliance.
The document must:
* Describe the product
* Give name, full mailing address and telephone number for importer or domestic manufacturer
* Identify the rule for which it complies (16 CFR 1219 or 1220)
* Give name, full mailing address, email address and telephone number for the records keeper and location of testing lab
* Give date and location of manufacture and testing
* The crib must also have a label attached with the date of manufacture
What you should do...
* All child care facilities, family child care homes, and places of public accommodation:
* Must prepare to replace their current cribs with new, compliant cribs before December 28, 2012.
* Should not resell, donate or give away a crib that does not meet the new crib standards.
* Dispose of older, noncompliant cribs in a manner that the cribs cannot be reassembled and used.
* Noncompliant cribs should not be resold through online auction sites or donated to local thrift stores. CPSC recommends disassembling the crib before discarding it.
Information from publication 5023 042011 - Child Care Providers: Your Guide to New Crib Standards from the Consumer Product Safety Commission (www.cpsc.gov).
13-004 Code Vt. R. 13-171-004-X
September 1, 2016 Secretary of State Rule Log #16-019
AMENDED: September 1, 2020 Secretary of State Rule Log #20-035; 4/17/2022 Secretary of State Rule Log #22-012.
STATUTORY AUTHORITY:
33 V.S.A. § 105(b), 33 V.S.A. § 3502 and 3 V.S.A § 801 (b)(11)