PROPOSED RULEMAKING
DEPARTMENT OF
PUBLIC WELFARE
[55 PA. CODE CHS. 3270, 3280, 3290 AND 3300]
Child Care Facilities
[36 Pa.B. 2686]
[Saturday, June 3, 2006]The Department of Public Welfare (Department), under the authority of Articles IX and X of the Public Welfare Code (62 P. S. §§ 901--922 and 1001--1087), proposes to amend Chapters 3270, 3280 and 3290 and delete Chapter 3300 to read as set forth in Annex A.
Purpose
The child care facility regulations in Chapters 3270, 3280, 3290 and 3300 provide standards to aid in protecting the health, safety and rights of children and to reduce risks to children in child day care centers, group child day care homes and family child day care homes (FDCH). The regulations identify the minimum level of compliance necessary to obtain the Department's certificate of compliance to operate a child care center or group child day care home or certificate of registration to operate an FDCH.
The proposed rulemaking is needed to update the minimum standards for child care facilities. The current regulations were published at 22 Pa.B. 1651 (April 4, 1992) and have not been amended since. The regulations need to be updated to reference the current laws that directly impact the operation of child care facilities, to incorporate the Department's statements of policy issued since 1992, to implement changes in recommended health and safety practices, to clarify minimum standards and to reflect best practice in the field of child care.
Requirements
Chapter 3300 (relating to specialized day care services for children with disabilities)
The Department proposes to delete Chapter 3300 and amend Chapters 3270, 3280 and 3290 (relating to child day care centers; group child day care homes; and family child day care homes) to include requirements related to providing care to a child with special needs. Chapter 3300 solely addresses child care provided to children with special needs; however, the equal opportunity provisions of the Americans With Disabilities Act of 1990 (ADA) (42 U.S.C.A. §§ 12101--12213) endorse inclusive, nonexclusionary practices. By amending Chapters 3270, 3280 and 3290 to address care for a child with special needs, the Department is clarifying that every child care facility is expected to make reasonable accommodation to enroll and provide care for children with special needs and to work with other persons who provide support services to the child and the child's family.
The Department proposes amending Chapters 3270, 3280 and 3290 to promote inclusion of children with special needs in all child care facilities and comply with the ADA philosophy.
§§ 3270.17, 3280.16 and 3290.15 (relating to service to child with a disability)
The proposed rulemaking requires the facility operator to make reasonable accommodation to provide care to a child with special needs and to permit service providers to work with the child onsite. The proposed rulemaking requires a facility operator to make facility staff aware of early intervention and special education services. The Department will provide information and materials to facilities regarding community resources for children with special needs to share with staff and parents.
§§ 3270.133, 3280.133 and 3290.133 (relating to child medication and special diets)
The Department proposes to amend Chapters 3270, 3280 and 3290 to require a facility to make reasonable accommodation to administer a prescribed medication or special diet to a child with special needs. The current regulations state a facility is not required to administer medications or special diets. Refusal to administer medication may violate the ADA.
§§ 3270.4, 3280.4 and 3290.4 (relating to definitions)
Child with special needs--The Department proposes to delete the use of the phrase ''child with a disability'' to use and define the phrase ''child with special needs.'' The proposed definition includes a child who has been assessed as having a special need and receives early intervention or special education services; has a formal behavioral plan determined by a physician, psychiatrist or psychologist; or has a chronic health condition diagnosed by a medical professional that requires specialized health and related services. The amendment updates the regulations to reflect current practice related to services to a child with special needs.
Age level--The Department proposes to amend the definitions of ''preschool child'' and ''young school-age child'' so that a child in kindergarten is considered a young school-age child. The Department's current regulations define ''preschool child'' as a child from 37 months of age through the date the child enters 1st grade of a public or private school system. The Department's current regulations define ''young school-age child'' as a child from the 1st grade through the 3rd grade of a public or private school system.
School-age child care programs are established to meet the unique needs of children who need child care before and after school hours, including kindergarten children. Many school-age programs are located in school buildings. Other school-age programs transport children from school to the child care facility. The fact that a kindergarten child is a preschool child under the Department's regulations creates a disincentive for a school-age child care program to enroll a kindergarten child.
The Department's regulations permit a child day care center or group child day care home in which care is provided exclusively to school-age children to comply with fewer requirements than a facility that provides care for children of all age levels (see §§ 3270.241 and 3280.221 (relating to requirements specific to school-age programs)). In addition, a school-age child care program located in a school building is further exempt from physical site requirements in accordance with section 776.1 of the Public School Code of 1949 (24 P. S. § 7-776.1), regarding child day-care centers in school buildings. A facility that enrolls a kindergarten child cannot be considered a school-age program because the facility is not providing care exclusively to school-age children. As a result, the facility must comply with Chapters 3270 and 3280 and will incur higher costs.
The Department's regulations require a staff:child ratio for preschool children of 1:10 and a ratio for young school-age children of 1:12. When a kindergarten child is included in a group of young school-age children, the stricter preschool ratio must be maintained at a higher cost.
The Department's regulations regarding transportation of children state the driver may not be counted in the staff:child ratio when preschool children are transported, but may be counted in the ratio when only school-age children are being transported (see §§ 3270.173(b) and (c) and 3280.173(b) and (c) (relating to transportation ratios)). When a kindergarten child is being transported, the facility cannot count the driver as part of the staff:child ratio and must provide more staff on the vehicle to meet the preschool staff:child ratio of 1:10 rather than the young school-age ratio of 1:12. The cost of transporting a kindergarten child is therefore higher than the cost of transporting a school-age child.
By changing the definition of ''young school-age child'' to include children in kindergarten, a school-age child care facility will be able to enroll a kindergarten child without incurring the higher costs of providing care to a preschool child. This amendment will facilitate before- and after-school care for kindergarten children.
§§ 3270.119, 3280.119 and 3290.118 (relating to program plan)
The Department proposes requiring that a program plan be prepared for each child in care. Chapter 3300 requires program plans for a child with special needs. This requirement is not included in Chapters 3270, 3280 and 3290. Extending the requirement to each child in care will produce a minimum level of program planning that facilitates each child's healthy and safe development.
§§ 3270.11, 3280.11 and 3290.11 (relating to application for and issuance of a certificate of compliance)
The Department proposes requiring a legal entity or a legal entity's representative to participate in precertification orientation training provided by the Department within 12 months prior to issuance of a certificate of compliance or registration. The Department will provide the precertification orientation training at different locations in this Commonwealth at no charge to the legal entity. A legal entity that opens more than one child care facility within 12 months following participation in the training is not required to repeat the training. The Department currently offers precertification orientation training to prospective individuals who want to operate child care facilities. Participation in the orientation training is voluntary. The Department's certification staff find that individuals who attend orientation training are better prepared to operate a child care facility and comply with minimum health and safety standards. Mandating attendance at precertification orientation training will afford additional protection for the health and safety of children in care.
§ 3290.31 (relating to age and training)
The Department currently does not require a minimum level of education for an FDCH operator. The Department proposes to increase the minimum qualifications of the FDCH operator by requiring that the operator have a high school diploma or general educational development certificate (GED) at the time of renewal of a certificate of registration. This will afford an FDCH operator who does not have a high school diploma or GED at initial registration a 2-year period in which to obtain a high school diploma or GED.
A study conducted in 2002 in this Commonwealth revealed that 97% of FDCH operators had a high school diploma or GED. By requiring an FDCH operator to have a high school diploma or GED at the time of certificate renewal, the Department is requiring a minimum level of literacy sufficient to comply with the regulations and operate a small business. This will increase the health and safety of FDCHs and also will put into regulation what already is the minimum educational background of most FDCH operators.
The Department proposes to permit a current FDCH operator who does not have a high school diploma or GED to continue to operate a facility that is registered as of the effective date of the final-form rulemaking.
§§ 3270.102, 3270.233, 3280.102, 3280.215, 3290.102 and 3290.212
The Department proposes that the surface covering under outdoor play equipment that requires embedded mounting must meet the guidelines for loose-fill or unitary playground protective surface covering established by the United States Consumer Product Safety Commission (CPSC). The ''Handbook for Public Playground Safety'' published by the CPSC provides standards for loose-fill and unitary surface coverings that reflect the fall height of the equipment and the type or depth of surface covering required to protect from injury if a child falls from the highest point of the equipment. The standards are available on the CPSC website at www.cpsc.gov/cpscpub/pubs/325.pdf. The Department's current statements of policy in §§ 3270.102a, 3280.102a and 3290.102a (relating to condition of play equipment--statement of policy) require the same standard for unitary surface covering. The current requirement for 6 inches of loose-fill material is not related to the height of the play equipment and does not meet minimum health and safety standards. Incorporating the CPSC standards in the regulations will afford more protection for children. In recognition of the possible cost to the provider, the Department proposes to permit a 2-year period following the effective date of the final-form rulemaking to comply with the regulations.
The Department proposes to amend Chapters 3270 and 3280 to prohibit the use of children's products and toys determined hazardous by the CPSC. The current regulations do not prohibit the use of children's products or toys that have been determined unsafe for children and have been recalled. Hazardous products that have been recalled present a risk to the health and safety of children in care. Information regarding product recalls is available on the CPSC website. A facility can subscribe to product recall alerts on the CPSC website at www.cpsc.gov/cpsclist.asp. The Department will provide information to facilities regarding how to receive the alerts. The Department will enforce the regulations by requiring a facility to self-certify at the time of certificate renewal that there are no recalled children's products or toys in the facility. Requiring facilities to remove hazardous products from child care facilities protects the health and safety of children.
§§ 3270.120, 3280.120 and 3290.119 (relating to infant sleep position).
The Department proposes to amend Chapters 3270, 3280 and 3290 by requiring that infants shall be placed on their backs to sleep unless there is a medical reason an infant should not sleep in this position. The AmericanAcademy of Pediatrics (AAP) policy on Sudden Infant Death Syndrome (SIDS) prevention recommends that infants be placed on their backs to sleep. This will reduce the risk of SIDS deaths in child care facilities.
§§ 3270.131, 3280.131 and 3290.131 (relating to health assessment information)
The Department proposes to amend the regulations regarding child health assessments and screenings by deleting the requirement to adhere to the AAP recommendations. The Department proposes timelines for a facility to obtain initial and updated child health reports. The current regulations make a facility responsible for updated child health assessments and health screening information that complies with the AAP recommendations. If the facility does not comply, the Department cites the facility for noncompliance with the regulation. A child's parent makes health care decisions for the child and pays for health care provided to the child. This is outside the facility's control. Parents may incur added costs to comply with the AAP schedule if their insurance plan does not cover all the examinations included in the AAP schedule. In addition, some physicians charge parents to complete the health report required by regulation. In some areas of this Commonwealth, facilities report that parents must wait months for well-child appointments and cannot meet the AAP timelines. The Department proposes to amend the regulations to provide less stringent timelines for updated health reports. The Department also proposes amendments regarding the information that must be included in the health report to include information needed to respond to a medical emergency and to control the spread of disease in a group setting.
The Department proposes to amend the immunization requirements to match the Department of Health (DOH) regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings), regarding immunizations in child care facilities. The DOH regulation requires child care facilities to comply with the immunization schedule recommended by the Advisory Committee on Immunization Practices, requires exclusion of a child who is not immunized and requires facilities to comply with the annual immunization reporting requirement in 28 Pa. Code § 27.77.
§§ 3270.201--3270.210, 3280.201--3280.209 and 3290.201--3290.208
The Department proposes to amend Chapters 3270, 3280 and 3290 by deleting the regulations regarding night care. The requirements regarding night care apply to child care provided from 7 p.m. to 7 a.m. The same minimum health and safety standards should apply during all hours of care.
§§ 3270.241 and 3280.221 (relating to requirements specific to school-age programs).
The Department proposes amending the school-age requirements to include proposed §§ 3270.27 and 3280.26 (relating to emergency plan), proposed amendments reagarding hazardous toys in §§ 3270.102(g) and 3280.102(g) (relating to condition of play equoment) and proposed §§ 3270.119(g) and 3280.119(g). School-age facilities are currently subject to §§ 3270.21a and 3280.20a (relating to emergency plan-statement of policy).
The Department also proposes to amend the requirements specific to school-age programs to require that staff persons in a school-age facility shall have immediate access to a working telephone on the facility premises. Staff working in some school-age facilities in school buildings do not have access to a telephone. The telephone may be located in an office that is locked after school hours. In the event of an emergency, staff may be unable to access the telephone to call for help. Ensuring access to a telephone will increase safety for children in school-age facilities.
In addition to the proposed amendments previosuly detailed, the Department proposes to amend Chapters 3270, 3280 and 3290 to incorporate existing statements of policy regarding emergency plan, posting the inspection summary, Department access, overpopulation of indoor child care space, supervision of children, water activity and release of children. The Department also proposes amendments reflecting current Commonwealth laws regarding a certificate of occupancy, child safety restraints in vehicles and the prohibition against transporting children in 11-15 passenger vans.
Affected Individuals and Organizations
Children are directly impacted by the proposed rulemaking. The minimum health and safety standards in Chapters 3270, 3280 and 3290 protect children who attend more than 9,000 certified and registered child care facilities in this Commonwealth. Parents also are impacted by the proposed rulemaking. Parents want their children to be safe in child care facilities. At the same time, the cost of child care is of concern to parents and directly impacts the choices that parents make regarding child care. The proposed rulemaking may result in decreased costs to parents due to the decreased costs associated with providing updated child health reports to the facility. The proposed rulemaking also will facilitate inclusion of children with special needs in child care facilities.
Child care facilities and staff also are affected by the proposed rulemaking. The proposed rulemaking may increase costs to some facilities. The Department provides 120 days for facilities to assess and plan for increased costs. In addition, a facility has 2 years to comply with the requirements regarding playground surfacing. The delay in implementation of the final-form rulemaking will afford the Department time to provide information and tools to assist in understanding and complying with the final-form rulemaking to facilities. The proposed amendments regarding staff health appraisals and tuberculosis testing will decrease costs to facilities and staff.
Accomplishments and Benefits
The child care service regulations were last published in April 1992. Since 1992, many changes have occurred that affect the regulations and operation of a child care facility. The Department published 11 statements of policy clarifying or interpreting the regulations, including statements of policy regarding emergency plans, supervision of children, Syrup of Ipecac, release of children, posting inspection summaries, Departmental access and swimming pool accessibility. Laws that impact operating a child care facility have changed regarding certificate of occupancy, vehicle safety, childhood immunizations and the ADA. New research has resulted in changes to recommendations regarding health and safety practices regarding SIDS prevention, playground safety and tuberculosis testing. In addition, the Department has noted areas in which facilities have difficulty complying with requirements, examined the reasons for noncompliance and, when possible, proposed amendments that will assist facilities to comply with the regulations and continue to ensure minimum health and safety at a facility.
The Department is proposing amendments for child care facilities to improve health and safety standards for all children in care, facilitate inclusion of children with special needs, incorporate current statements of policy and correct regulatory language to accurately reflect laws that impact facility operation.
Fiscal Impact
Kindergarten child as young school-age child
The Department establishes daily reimbursement rates for facilities that participate in the child care subsidy program. The reimbursement rates are established by age level and are different for each county. The reimbursement rate for a preschool child is generally higher than the rate for a school-age child because the cost of complying with the requirements related to caring for a preschool child are higher than the costs of caring for a school-age child.
The proposed amendments to the definition of ''young school-age child'' to include a kindergarten child will also change the reimbursement rate for a kindergarten child from the preschool rate to the lower school-age rate. The daily reimbursement rate for a school-age child ranges from 10¢ to $12.40 less than the reimbursement rate for a preschool child across 45 counties.
While the reimbursement rate may decrease, the cost of caring for a kindergarten child will also decrease. The cost of complying with the requirements applicable to a young school-age child is less than the cost of caring for a preschool child. The staff:child ratio for preschool children is 1:10 and the ratio for young school-age children is 1:12. In addition, a school-age facility will be able to enroll a kindergarten child and maintain its status as a school-age facility that is permitted to comply with the less stringent requirements for school-age programs. A facility that transports kindergarten and school-age children will be able to count the driver in the staff:child ratio and will no longer have to supply one or more additional staff persons on the vehicle to comply with ratio requirements related to transporting preschool children. The decrease in the daily reimbursement rate will be offset by lowered operating costs.
Precertification orientation
Precertification orientation may create costs to an individual who wants to apply for a certificate of compliance or registration. The training will require a full day, including travel and training time. The individual's costs will vary depending on the distance the individual must travel to participate in training. Using the Commonwealth mileage rate, an individual who travels 200 miles round trip would incur a travel cost of $97.
For individuals currently operating or working in child care facilities, attendance at orientation training would be part of their job and they would be paid for the time to attend the training.
An individual who operates an FDCH or group child day care home and who wants to open a new facility may have to arrange for staff to work at the facility while the individual attends orientation training. According to the Department of Labor and Industry (L & I), the average wage for a child care worker is $8.50 per hour. If substitute staff must be hired to cover an 8-hour shift, the estimated cost is $68.
An individual who is employed outside the child care field and who wants to open a facility may miss a day of work to attend orientation training and may lose wages for that day. Based on L & I's statistics regarding the average state wage, the individual may lose $147 in wages to attend orientation training.
Ventilation required at 82°F
The current regulation requires that when the indoor temperature exceeds 85°F in a child care space, a means of mechanical air circulation must be operating. Many facilities already have a means of ventilation in place. Ventilation may be provided through using a fan. If a facility has to purchase a fan, the cost of a fan will vary depending on the type of fan (that is, standing fan, window fan, wall fan or ceiling fan). The estimated costs would be anywhere from $15 to $100 depending upon the type of fan purchased.
Disposable, nonporous gloves in first aid kit
The addition of disposable, nonporous gloves to the first aid kit represents increased cost to a facility. The use of gloves is a universal precaution to prevent the spread of disease transmitted from body fluids. The cost of a box of 100 gloves ranges from $2.99 to $8.99. The rate at which the gloves are used to administer first aid is unknown. The health and safety protection afforded to children and staff by using gloves outweighs the cost.
Protective surfacing under outdoor play equipment
The proposed amendments regarding surface covering under outdoor embedded play equipment will result in increased costs for facilities where the surface covering does not meet the CPSC guidelines. The current regulations require at least 6 inches of loose-fill material under equipment. If the facility must modify the protective surface to comply with the regulations, the cost will depend upon the fall height from the equipment, the type of surface covering used and the size of the area that must be covered.
A facility that has a unitary surface covering that currently meets the requirements in the Department's statements of policy will be in compliance with the amended regulations.
Program plan
Facilities will incur added costs in preparing a program plan for each child twice a year. The current regulations in Chapter 3300 requires that each child with special needs must have a program plan that is reviewed every 3 months and rewritten annually. The proposed amendment regarding program plan requires that each child must have a program plan developed at initial attendance and the plan must be reviewed every 6 months. The Department estimates that on average, an initial program plan may take 1 hour to develop and that each review may take 1/2 hour. The Department does not have data on the average annual number of new enrollments at a facility. The child care center director, group child day care home primary staff person or FDCH operator is responsible for program plan reviews. The Department estimates the average costs of preparing program plan reviews to be as follows: child care center--$832; group child day care home--$199.68; and FDCH--$99.84.
Staff health
Staff persons will save money from the decreased requirements for staff health appraisals. By amending the requirement for annual health appraisals to biannual health appraisals, each staff person will save $75 to $150 per year. In addition, eliminating the requirement for biannual tuberculosis testing will save each staff person an additional $25 to $75 every 2 years.
Paperwork Requirements
Sections 3270.119, 3280.119 and 3290.118 will result in increased paperwork. The plan must be developed at the time of initial attendance and updated every 6 months. The program plan must include documented observation of the child's development. The Department will develop tools to assist the provider in completing the program plan and observation.
The proposed rulemaking requires that each child day care center and group child day care home must certify that no hazardous equipment is on the premises. The Department will develop the certification document. The form will take no more than 10 minutes for the facility to complete.
Effective Date
This proposed rulemaking will be effective 120 calendar days after publication of the final-form rulemaking in the Pennsylvania Bulletin. The Department is providing an additional 2 years beyond the effective date of the final-form rulemaking for facility operators to comply with the amended regulations reagrding protective surface covering under outdoor play equipment.
Public Comment
Interested persons are invited to submit written comments, suggestions or objections regarding the proposed rulemaking to Jennifer Lau, Bureau of Certification Services, Office of Child Development, Department of Public Welfare, 1401 North Seventh Street, P. O. Box 2675, Harrisburg, PA 17105, jlau@state.pa.us within 30 calendar days after the date of publication of this proposed rulemaking in the Pennsylvania Bulletin. Reference Regulation No. 14-506 when submitting comments.
Persons with a disability who require an auxiliary aid or service may submit comments by using the AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
Regulatory Review Act
Under section 5(a) of the Regulatory Review Act (71 P. S. § 745.5(a)), on May 23, 2006, 2003, the Department submitted a copy of this proposed rulemaking and a copy of a Regulatory Analysis Form to the Independent Regulatory Review Commission (IRRC) and to the Chairpersons of the House Committee on Children and Youth and the Senate Committee on Public Health and Welfare. A copy of this material is available to the public upon request.
Under section 5(g) of the Regulatory Review Act, IRRC may convey any comments, recommendations or objections to the proposed rulemaking within 30 days of the close of the public comment period. The comments, recommendations or objections must specify the regulatory review criteria which have not been met. The Regulatory Review Act specifies detailed procedures for review, prior to final publication of the rulemaking, by the Department, the General Assembly and the Governor of comments, recommendations or objections raised.
ESTELLE B. RICHMAN,
SecretaryFiscal Note: 14-506. No fiscal impact; (8) recommends adoption.
Annex A
TITLE 55. PUBLIC WELFARE
PART V. CHILDREN, YOUTH AND FAMILIES MANUAL
Subpart D. NONRESIDENTIAL AGENCIES, FACILITIES AND SERVICES
ARTICLE I. LICENSING/APPROVAL
CHAPTER 3270. CHILD DAY CARE CENTERS
GENERAL PROVISIONS § 3270.4. Definitions.
The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:
* * * * * ACIP--The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, United States Department of Health and Human Services.
* * * * * [Age-appropriate child health assessment--A written report assessing a child's health status. The report is signed by a physician or a CRNP and includes the child's health history, the child's physical examination and a plan for treatment of health problems identified in the health assessment.]
Age level--The grouping category appropriate for the child's age.
(i) Infant--A child from birth [through 12 months] to 1 year of age.
(ii) Young toddler--A child from [13 through 24 months] 1 to 2 years of age.
(iii) Older toddler--A child from [25 through 36 months] 2 to 3 years of age.
(iv) Preschool child--A child from [37 months of age through] 3 years of age to the date the child enters [1st grade of] kindergarten in a public or private school system.
(v) Young school-age child--A child [from the 1st grade through the 3rd] who attends kindergarten to the date the child enters the 4th grade of a public or private school system.
(vi) Older school-age child--A child [from] who attends the 4th grade of a public or private school system through 15 years of age.
* * * * * Child with [a disability] special needs--A child who [does not function according to age-appropriate expectations in the areas of emotional, cognitive, communicative, perceptual-motor, physical or social development and requires special adaptations, program adjustments and related services on a regular basis to function in an adaptive manner. Examples of a child with a disability include a child who has:
(i) A developmental delay.
(ii) A neurologically-based condition, such as mental retardation, cerebral palsy, autism, epilepsy or another condition closely related to mental retardation or requiring treatment similar to that required by mentally retarded children.
(iii) Mental retardation associated with sociocultural or psychosocial disadvantage.
(iv) A genetic disorder or physiological condition usually associated with mental retardation.
(v) Problems of social or emotional adjustment.
(vi) A physical disability such as visual impairment, hearing impairment, speech or language impairment, or a physical handicap.] has one or more of the following:
(i) A disability or developmental delay identified on an Individualized Education Program or an Individualized Family Service Plan.
(ii) A formal behavioral plan that has been determined by a licensed physician, psychiatrist or licensed psychologist.
(iii) A chronic health condition diagnosed by a licensed physician, physician's assistant or CRNP that requires health and related services of a type or amount beyond that required by children generally.
* * * * * Inspection summary--A document prepared by an agent of the Department describing each regulatory noncompliance item confirmed as a result of a facility inspection.
* * * * *
GENERAL REQUIREMENTS § 3270.11. Application for and issuance of a certificate of compliance.
* * * * * (b) A legal entity or a representative of the legal entity shall participate in a pre-certification orientation training provided by the Department within 12 months prior to issuance of a certificate of compliance. The precertification orientation does not count toward the annual minimum of 6 hours of child care training required in § 3270.31(e) (relating to age and training).
(c) Application for a certificate of compliance shall be submitted to the appropriate regional day care office in accordance with Chapter 20 (relating to the licensure or approval of facilities and agencies).
[(c)] (d) * * *
[(d)] (e) * * *
[(e)] (f) * * *
[(f)] (g) * * *
[(g)] (h) A facility whose certificate of compliance is current as of [April 4, 1992,] ______ (Editor's Note: The blank refers to the effective date of adoption of this proposed rulemaking.) will not be inspected under this chapter until the current certificate of compliance is due to be renewed or when a regulatory violation is alleged and the Department responds to the alleged violation with an inspection.
§ 3270.15. [Firesafety approval] Certificate of occupancy.
A certificate of compliance will not be granted by the Department until the legal entity provides a certificate of occupancy as proof of compliance with the applicable requirements of the Department of Labor and Industry [at] in 34 Pa. Code [Chapter 54 (relating to Group B educational) or local authorities in Scranton, Pittsburgh or Philadelphia] § 403.23 (relating to child day care facilities).
§ 3270.17. Service to a child with [a disability] special needs.
[A facility serving a child with a disability as defined in § 3270.4 (relating to definitions) shall also comply with applicable sections of Chapter 3300 (relating to specialized day care service for children with disabilities).]
(a) The operator shall make reasonable accommodation to include a child with special needs in accordance with the Americans With Disabilities Act of 1990 (ADA) (42 U.S.C.A. §§ 12101--12213).
(b) The operator shall permit an adult individual who provides specialized services to a child with special needs to provide those services on the facility premises as specified in the child's Individualized Education Program, Individualized Family Service Plan, formal behavioral plan or program plan as defined in § 3270.119 (relating to program plan).
(c) The operator is responsible to make staff persons aware of community resources for the family of a child with possible special needs.
(1) When the director believes a child may need an assessment due to developmental, behavioral or health concerns, the director shall inform the child's parent of the concern and provide information to the parent regarding resources for referral and assistance.
(2) When a staff person believes a child may need an assessment due to developmental, behavioral or health concerns, the staff person shall inform the director. The director shall inform the child's parent of the staff person's concern and provide information to the parent regarding resources for referral and assistance.
§ 3270.24. Departmental access.
* * * * * (c) An agent of the Department will inspect for compliance with this chapter in all areas of the facility premises that are accessible to children.
§ 3270.25. Availability of certificate of compliance and applicable regulations.
(a) The facility's current certificate of compliance and a copy of the applicable regulations under which the facility is certified shall be posted in a conspicuous location used by parents, with instructions for contacting the appropriate regional day care office posted at the same location.
(b) The operator shall post a copy of each inspection summary issued by the Department next to the facility's certificate of compliance in a conspicuous location used by parents. The inspection summary shall remain posted until an agent of the Department verifies that each regulatory noncompliance item cited on the inspection summary has been corrected.
§ 3270.27. Emergency plan.
(a) The facility shall have an emergency plan that provides for:
(1) Shelter of children during an emergency.
(2) Evacuation of children from the facility.
(3) A method for facility persons to contact parents as soon as reasonably possible when an emergency situation arises.
(4) A method for facility persons to inform parents that the emergency has ended and to provide instruction as to how parents can safely be reunited with their children.
(b) The operator shall review the emergency plan at least annually and update the plan as needed. Each review and update of the emergency plan shall be documented in writing and kept on file at the facility.
(c) Each facility person shall receive training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The date of each training and the name of each facility person who received the training shall be documented in writing and kept on file at the facility.
(d) The emergency plan shall be posted in the facility at a conspicuous location.
(e) The operator shall provide to the parent of each enrolled child a letter explaining the emergency procedures described in subsection (a). The operator shall also provide to the parent of each enrolled child a letter explaining any subsequent update to the plan.
(f) The operator shall send a copy of the emergency plan and subsequent plan to the county emergency management agency.
FACILITY PERSONS § 3270.31. Age and training.
* * * * * (d) A Child Development Associate (CDA) credential or a Certified Childcare Professional (CCP) credential, as it applies to the staff qualifications in this chapter, is equivalent to [one of the following:
(1) Fifteen] 9 credit hours from an accredited college or university in early childhood education or child development and 1 year of experience with children.
[(2) Thirty credit hours from an accredited college or university in early childhood education or child development.]
* * * * *
STAFF-CHILD RATIO § 3270.52. Mixed age level.
When children are grouped in mixed age levels, [the following child group sizes and ratios of staff persons apply:] the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level).
[Mixed Age Levels Staff Children Maximum
Group Size*Total Number of Staff Required for the Maximum Group Size Infant/young or older toddler 1 4 8 2 Infant/preschool 1 4 8 2 Young toddler/ preschool 1 5 10 2 Older toddler/ preschool 1 6 12 2 Preschool/young or older school-age 1 10 20 2 *No more than 50% of each group may be of the older age level.]
PHYSICAL SITE § 3270.61. Measurement and use of indoor child care space.
* * * * * (h) The capacity established for an indoor space may not be exceeded except [at] in the following situations:
(1) At naptime, when toddler or preschool children are resting on rest equipment described in § 3270.106 (relating to rest equipment)[.] if the following conditions are met:
[(1)] (i) * * *
[(2)] (ii) * * *
(2) When older toddler, preschool or school-age children are participating in a program activity if the following conditions are met:
(i) The capacity of the indoor child care space may be exceeded for no more than two separate 1/2 hour time periods daily.
(ii) Each time period shall be designated on the facility's schedule of daily activities.
(iii) The space may not be occupied by children of the infant or young toddler age levels during a time period when the capacity is exceeded.
(iv) The number of children present in the space may not be more than twice the measured capacity of the space.
(3) When a meal is served in a space designated and measured as indoor child care space if the following conditions are met:
(i) The capacity of a space may be exceeded when children are eating for no more than 1 hour daily.
(ii) The meal time shall be designated on the facility's schedule of daily activities.
(iii) The number of children present in the space may not be more than twice the measured capacity of the space.
(i) The total number of children receiving child day care services at the facility at any one time may not exceed the maximum capacity stated on the facility's certificate of compliance.
§ 3270.70. Indoor temperature.
* * * * * (b) If the indoor temperature exceeds [85°] 82°F in a child care space, a means of mechanical air circulation shall be operating.
§ 3270.75. First-aid kit.
* * * * * (c) A first-aid kit [shall] must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and [Syrup of Ipecac] disposable, nonporous gloves. [Instructions for use of the Syrup of Ipecac shall be included as described at § 3270.133(9) (relating to child medication and special diets).]
(d) One first-aid kit per child care group [shall] must accompany children and facility persons on excursions from the facility. Each first aid kit taken on an excursion must contain a bottle of water in addition to the items specified at subsection (c).
* * * * * § 3270.82. Toilet areas.
* * * * * (f) Toilets and training chairs may not be located in an area used for cooking or eating. [If the toilet area is not on the same floor as the child care space, an adult shall accompany toddler and preschool children going to and from the toilet area.]
* * * * *
EQUIPMENT § 3270.102. Condition of play equipment.
* * * * * (c) Outdoor equipment that requires embedded mounting [shall] must be mounted over [at least 6 inches of loose-filled, impact-absorbing materials,] a loose-fill or unitary playground protective surface covering that meets the recommendations of the United States Consumer Product Safety Commission. The equipment must be anchored firmly and be in good repair.
* * * * * (g) Children's equipment and toys described as hazardous by the United States Consumer Product Safety Commission may not be used by children at the facility and may not be on the premises at the facility.
§ 3270.104. Furniture.
(a) Furniture [shall] must be durable, safe, easily cleaned and appropriate for the child's size, age and [disability] special needs.
* * * * *
PROGRAM § 3270.113. Supervision of children.
(a) Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises.
(1) Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.
(2) The requirement for supervision on and off the facility premises includes compliance with the staff:child ratio requirements in §§ 3270.51--3270.54.
* * * * * (e) A facility person may not restrain a child by using bonds, ties or straps to restrict a child's movement or by enclosing the child in a confined space, closet or locked room. The prohibition against restraining a child does not apply to the use of adaptive equipment prescribed for a child with special needs.
§ 3270.115. Water activity.
(a) Swimming.
* * * * * (3) An aboveground swimming pool which is not in use [shall] must be made inaccessible to children in accordance with the swimming pool barrier guidelines of the United States Consumer Product Safety Commission.
* * * * * § 3270.117. Release of children.
(a) A child shall be released only to the child's parent or to an individual designated in writing by the enrolling parent. A child shall be released to either parent unless a court order on file at the facility states otherwise.
* * * * * § 3270.119. Program plan.
(a) The director or group supervisor shall develop a program plan specific to the child no later than 60 days following the child's first day of attendance at the facility. The program plan for a child with special needs must incorporate the Individualized Education Program, Individualized Family Service Plan or formal behavioral plan if that plan is reviewed and implemented within the 60 days.
(b) The child's program plan must include the following:
(1) A documented observation of the child's development.
(2) If applicable, identification of the child's unique needs and recommendations, plans or referrals as appropriate. The director shall inform the parent of the possible special needs of the child and provide information to the parent regarding resources for referral and assistance.
(3) A plan to facilitate the child's continued development and participation in the daily activities described in § 3270.111 (relating to daily activities), including involvement of a specialist who may be helping to support the child and family.
(c) The director or group supervisor shall review the child's program plan according to the following schedule:
(1) For an infant, toddler or preschool child, the plan shall be reviewed at least every 6 months.
(2) For a school-age child, the plan shall be reviewed at least every 12 months.
(3) For a child with special needs, the program plan shall also be reviewed according to the schedule specified in the Individualized Education Program, Individualized Family Service Plan or formal behavioral plan.
(d) The director or group supervisor shall revise the plan as needed to meet the needs of the child at each review.
(e) The director or group supervisor shall provide to the following individuals an opportunity to provide input into the development of the child's initial program plan and each review of the child's program plan:
(1) The child's parent.
(2) Other staff persons who supervise the child at the facility.
(3) Other individuals who provide early intervention or special education services, treatment, therapy or other specialized services to the child.
(4) The child if the child is a school-age child.
(f) The director or group supervisor shall date and sign the child's initial program plan and each reviewed or updated program plan. The child's parent shall be given an opportunity to sign each program plan and receive a copy of each dated and signed program plan.
(g) A signed and dated copy of the child's initial program plan and each reviewed or updated program plan shall be placed in the child's facility record.
§ 3270.120. Infant sleep position.
Infants shall be placed on their backs to sleep unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility.
PROCEDURES FOR ADMISSION § 3270.122. Admission interview.
A child shall be interviewed or observed by the operator and when possible shall have the opportunity to visit the facility prior to being admitted for care. The child shall be told as much about the service being planned as he can understand. If the parent indicates that the child has a [disability or handicapping condition] special need, the operator shall discuss the condition with the parent, refer to § 3270.4 (relating to definitions), and comply with §§ 3270.17, 3270.124 and 3270.131 (relating to service to a child with [a disability] special needs; emergency contact information; and health [assessment] information).
§ 3270.124. Emergency contact information.
* * * * * (b) Emergency contact information [shall] must include the following:
* * * * * (5) Information on the [disability of the child] child's special needs, as specified by the child's parent [or], physician, physician's assistant or CRNP, which is needed in an emergency situation.
* * * * *
CHILD HEALTH § 3270.131. Health [assessment] information.
(a) [An] The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, [shall have an age-appropriate] to provide an initial health report [on record at the facility] no later than 60 days following [enrollment] the first day of attendance at the facility.
(1) The initial health report for an infant must be dated no more than 3 months prior to the first day of attendance at the facility.
(2) The initial health report for a young toddler must be dated no more than 6 months prior to the first day of attendance at the facility.
(3) The initial health report for an older toddler or preschool child shall be dated no more than 1 year prior to the first day of attendance at the facility.
(4) The initial health report for a school-age child must be dated in accordance with the requirements for medical examinations for school attendance in 28 Pa. Code § 23.2 (relating to medical examinations).
(b) [An age-appropriate health assessment shall be conducted according to the recommended schedule for routine health supervision as referenced in the most current edition of the American Academy of Pediatrics (AAP) Guidelines for Health Supervision. This publication can be obtained from the American Academy of Pediatrics, 141 Northwest Point Boulevard, Post Office Box 927, Elk Grove Village, Illinois 60007.] The operator shall require the parent to provide an updated health report in accordance with the following schedules:
(1) At least every 6 months for an infant or young toddler.
(2) At least every 12 months for an older toddler or preschool child.
(c) A health [assessment shall be conducted and a] report [shall] must be written and signed by a physician, physician's assistant or a CRNP. The signature [shall] must include the individual's professional title.
(d) The health report shall include the following information:
(1) A review of the child's [previous] health history.
(2) [The results of a physical examination] A list of the child's allergies.
(3) [An assessment of the child's growth patterns] A list of the child's current medication and the reason for the medication.
(4) [The physician's or CRNP's] An assessment of [a disability or a] an acute or chronic health problem or special need and recommendations for treatment or services.
(5) A review of the child's immunized status according to recommendations of the [AAP] ACIP. [The Department will provide the AAP guidelines upon request.]
* * * * * (7) [A review of age-appropriate screenings according to the standards of the AAP.] A statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.
(e) [The operator shall comply with the Department of Health (DOH) regulation at 28 Pa. Code § 27.121a (Reserved) and shall implement dismissal policies in accordance with that section. The Department will provide the DOH regulation upon request.] The facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the recommendations of the ACIP.
(1) The facility shall require the parent to provide updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.
(2) Exemption from immunization must be documented as follows:
(i) Exemption from immunization for religious belief or strong personal objection equated to a religious belief shall be documented by a written, signed and dated statement from the child's parent or guardian. The statement shall be kept in the child's record.
(ii) Exemption from immunization for reasons of medical need must be documented by a written, signed and dated statement from the child's physician, physician's assistant or CRNP. The statement shall be kept in the child's record.
(3) The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings).
(4) The facility shall comply with the annual immunization reporting requirements in accordance with the Department of Health regulation in 28 Pa. Code § 27.77.
§ 3270.133. Child medication and special diets.
The operator shall make reasonable accommodation in accordance with the Americans With Disabilities Act of 1990 (ADA) (42 U.S.C.A. §§ 12101--12213) to facilitate administration of medication or a special diet prescribed by a physician, physician's assistant or CRNP for a child with special needs. Facility persons are not required to administer [child] medication or special diets which are requested or required by a parent, a physician, a physician's assistant or a CRNP to a child who does not have special needs. [If child] When medication or special diets are administered, the following requirements apply:
* * * * * [(9) A staff person who administers Syrup of Ipecac shall request case-specific instruction for administration from a poison control center or a physician. The staff person shall record in the child's file the date and time instruction was received, the name of the individual who issued the instruction, the content of the information and the time, date and amount of Syrup of Ipecac administered.]
§ 3270.135. Diapering requirements.
(a) When children are diapered, the facility shall use disposable diapers, a diaper service or arrange with the parent to provide a daily diaper supply.
* * * * * (3) If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded [in one of the following ways] by immediately placing the diaper into a plastic-lined, hands-free covered can. [The diaper shall be:
(i) immediately placed into a lined outdoor trash container.
(ii) Placed in an individual, tied bag and discarded indoors until outdoor disposal is possible.]
* * * * * (e) A staff person shall check a child's diaper at least every 2 hours and whenever the child indicates discomfort or exhibits behavior that suggests a soiled diaper. A staff person shall change a child's diaper when the diaper is soiled.
ADULT HEALTH § 3270.151. Health assessment.
(a) A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within [3] 12 months prior to providing initial service in a child care setting and every [year] 24 months thereafter. A health assessment is valid for [12] 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.
(b) A health assessment shall be conducted and a report shall be written and signed by a physician, physician's assistant or CRNP. The signature [shall] must include the individual's professional title.
(c) The health assessment [shall] must include the following:
* * * * * (2) Tuberculosis screening by the Mantoux method at initial employment [and subsequently at least once every 2 years]. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.
* * * * *
[Continued on next Web Page]
No part of the information on this site may be reproduced for profit or sold for profit.This material has been drawn directly from the official Pennsylvania Bulletin full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.
