Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

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PA Bulletin, Doc. No. 08-1011a

[38 Pa.B. 2437]
[Saturday, May 24, 2008]

[Continued from previous Web Page]

EQUIPMENT

§ 3270.102. Condition of play equipment.

   (a)  Toys, play equipment and other indoor and outdoor equipment used by the children must be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

   (b)  Toys soiled by secretion or excretion shall be cleaned with soap and water, rinsed and sanitized before being used by a child.

   (c)  Outdoor equipment that requires embedded mounting must be mounted over 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.

   (d)  Slides that are over 4 feet high must have guards along both sides of the ladder.

   (e)  Pea gravel and other materials with a diameter of less than 1 inch may not be used in spaces where infants or toddlers receive care.

   (f)  Indoor play equipment for climbing shall be installed or used over a protective surface covering which does not interfere with the stability of the equipment.

   (g)  Children's toys and equipment, including furniture and rest equipment, 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. At the time of inspection, the operator shall submit to the Department written affirmation on a form provided by the Department stating that the facility is in compliance with this requirement.

§ 3270.104. Furniture.

   (a)  Furniture must be durable, safe, easily cleaned and appropriate for the child's size, age and special needs.

   (b)  Study space, tables, chairs, paper and pencils shall be provided for school-age children in care, if necessary for the program offered by the facility.

§ 3270.106. Rest equipment.

   (a)  Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment must be labeled for the use of a specific child and used only by the specified child.

   (b)  Bed linens may not be used alone as age-appropriate rest equipment.

   (c)  Stacked cribs may not be used.

   (d)  Crib and playpen slats may be no more than 2 3/8 inches apart.

   (e)  Seasonal, appropriate covering, such as sheets or blankets, shall be provided as agreed between the child's parent and the operator.

   (f)  At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use.

   (g)  Linens, blankets and rest equipment shall be cleaned monthly, at a minimum. The operator shall arrange a cleaning schedule with the parent.

   (h)  Soiled bedding shall be cleaned before it is reused.

   (i)  The upper level of double-deck beds may not be used for children 8 years of age or younger.

   (j)  Toys, bumper pads or pillows may not be present in a crib while an infant is sleeping in the crib.

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--3270.55 (relating to staff:child ratio).

   (b)  A facility person may not use any form of physical punishment, including spanking a child.

   (c)  A facility person may not single out a child for ridicule, threaten harm to the child or the child's family and may not specifically aim to degrade the child or the child's family.

   (d)  A facility person may not use harsh, demeaning or abusive language in the presence of children.

   (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.

   (1)  A swimming pool must conform to 28 Pa. Code Chapter 18 (relating to public swimming and bathing places).

   (2)  An in-ground swimming pool accessible to children must be fenced with a locked gate.

   (3)  An aboveground swimming pool which is not in use must be made inaccessible to children in accordance with the swimming pool barrier guidelines of the United States Consumer Product Safety Commission.

   (4)  An indoor swimming pool which is not in use must be made inaccessible to children.

   (5)  The following staff:child ratios apply while children are swimming:

Similar
Age Level
Staff Children
Infant 1 1
Young or older toddler 1 2
Preschool 1 5
Young school-age 1 6
Older school-age 1 8

   (6)  When children are swimming, supervision shall include one person certified in lifeguard training, as described in § 3270.31(e)(4)(iii) (relating to age and training).

   (7)  The person certified in lifeguard training may not be included in the staff:child ratio.

   (8)  A facility person who is counted in the staff:child swimming ratio shall annually complete water safety instruction.

   (b)  Wading.

   (1)  Staff persons shall supervise day care children using wading pools. Staff:child ratios in subsection (a) apply when children are wading.

   (2)  A sanitizing solution shall be added to water in a wading pool. An acceptable sanitizing solution is 3/4 teaspoon of bleach added to 50 gallons of water.

   (3)  A wading pool shall be emptied daily.

   (c)  Water play tables. A water play table or a container used for water play that contains unfiltered water shall be emptied daily.

§ 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.

   (b)  In an emergency, a child may be released to an individual upon the oral designation of the parent, if the identity of the individual can be verified by a staff person.

   (c)  If a child is released upon the oral designation of the parent, the following information shall be logged in the child's record:

   (1)  The name of the parent making the request.

   (2)  The date and time of the request.

   (3)  The name of the individual to whom the child is to be released.

   (4)  The name of the staff person taking the call.

   (5)  The name of the staff person releasing the child.

§ 3270.119. Infant sleep position.

   Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics 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 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 special needs; emergency contact information; and health information).

§ 3270.123. Agreement.

   (a)  An agreement signed by the operator and the parent must specify the following:

   (1)  The amount of the fee to be charged per day or per week.

   (2)  The date on which the fee is to be paid.

   (3)  The services to be provided to the family and the child, including the Department's approved form to provide information to the family about the child's growth and development in the context of the services being provided. The operator shall complete and update the form and provide a copy to the family in accordance with the updates regarding emergency contact information in § 3270.124(f) (relating to emergency contact information).

   (4)  The child's arrival and departure times.

   (5)  The persons designated by a parent to whom the child may be released as specified in § 3270.117 (relating to release of children).

   (6)  The date of the child's admission.

   (7)  The services which are to be considered as extra.

   (b)  A parent shall receive the original agreement. The facility shall retain a copy of the agreement.

§ 3270.124. Emergency contact information.

   (a)  Emergency contact information is required for each enrolled child. Emergency contact information must reference who shall be contacted in an emergency.

   (b)  Emergency contact information must include the following:

   (1)  The name and birth date of the child.

   (2)  The name, address and telephone number of the child's physician or source of medical care.

   (3)  The home and work addresses and telephone numbers of the enrolling parent.

   (4)  The written consent signed by a parent for emergency medical care.

   (5)  Information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation.

   (6)  Health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

   (7)  The name, address and telephone number of the individual designated by the parent to whom the child may be released.

   (c)  When children are in the facility, emergency contact information must be present in a child care space for children receiving care in the space.

   (d)  When children leave the facility on walking and riding excursions, emergency contact information specific to each child on the excursion accompany a staff person on the excursion.

   (e)  A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and accompany a staff person who leaves on an excursion with children.

   (f)  The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the information.

CHILD HEALTH

§ 3270.131. Health information.

   (a)  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, to provide an initial health report no later than 60 days following 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 must 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)  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 report must be written and signed by a physician, physician's assistant or a CRNP. The signature must include the individual's professional title.

   (d)  The health report must include the following information:

   (1)  A review of the child's health history.

   (2)  A list of the child's allergies.

   (3)  A list of the child's current medication and the reason for the medication.

   (4)  An assessment of an acute or chronic health problem or special need and recommendations for treatment or services, including information regarding abnormal results of screening tests for vision, hearing or lead poisoning.

   (5)  A review of the child's immunized status according to recommendations of the ACIP.

   (6)  A statement of the child's medical information pertinent to diagnosis and treatment in case of emergency.

   (7)  A statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

   (8)  A statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health report required by this section.

   (e)  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 must 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 shall 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 applicable Federal and State laws to facilitate administration of medication or a special diet that is prescribed by a physician, physician's assistant or CRNP as treatment related to the child's special needs. Facility persons are not required to administer medication or special diets which are requested or required by a parent, a physician, a physician's assistant or a CRNP but are not treatment related to the child's special needs. When medication or special diets are administered, the following requirements apply:

   (1)  A prescription or nonprescription medication may be accepted only in an original container. The medication must remain in the container in which it was received.

   (2)  A staff person shall administer a prescription medication only if written instructions are provided from the individual who prescribed the medicine. Instructions for administration contained on a prescription label are acceptable.

   (3)  The label of a medication container must identify the name of the medication and the name of the child for whom the medication is intended. Medication shall be administered to only the child whose name appears on the container.

   (4)  Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children.

   (5)  Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

   (6)  A parent shall provide written consent for administration.

   (7)  An operator is responsible to establish and maintain a medication log if prescription or nonprescription medication is administered. A log must include the following minimum information:

   (i)  The name of the medication.

   (ii)  The name of the child receiving the medication.

   (iii)  A requirement for refrigeration.

   (iv)  The amount of medication administered.

   (v)  The date of administration.

   (vi)  The time of administration.

   (vii)  The initials of the staff person who administered the medication.

   (viii)  Special notes related to problems of administration.

   (8)  If a special diet is prescribed for a child and if the diet is administered to the child, written instructions and the parent's written consent shall be retained in the child's file.

§ 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.

   (1)  If nondisposable diapers are provided by a parent, a soiled diaper shall be placed in an individual, securely-tied plastic bag and returned to the parent at the end of the day.

   (2)  If nondisposable diapers from a diaper service are provided by a facility, a soiled diaper shall be placed in the container provided by the service or in a securely-tied plastic bag.

   (3)  If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can.

   (4)  A soiled diaper that is not in a tied bag may not be placed in an unlined outdoor trash container.

   (b)  Diaper changing surfaces shall be cleaned after each use by wiping the surface with a sanitizing solution or by changing a pad or other surface covering.

   (c)  The diapering area may not be used for food preparation or food service.

   (d)  Cloth and paper materials used as diapering aids shall be stored in a manner that prevents cross-contamination from a soiled diaper, contaminated hands or other changing materials.

   (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 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 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 must include the individual's professional title.

   (c)  The health assessment must include the following:

   (1)  A physical examination.

   (2)  Tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.

   (i)  If a person's medical record demonstrates a positive tuberculin skin test, that record shall be placed on file at the facility.

   (ii)  A record of a person with a positive tuberculin skin test must include the results of a chest X-ray and evaluation for chemoprophylaxis.

   (iii)  A person with a positive tuberculin skin test and a negative x-ray is not required to have further tuberculosis testing, unless one of the following occurs:

   (A)  The person is exposed to an active case of tuberculosis.

   (B)  The person develops a productive cough which does not respond to medical treatment within 14 days.

   (3)  Examination for communicable diseases and the results of that examination.

   (4)  Information on medical problems that might threaten the health of the children or prohibit a staff person from providing adequate care to children.

   (5)  The physician's or CRNP's assessment of the person's suitability to provide child care.

   (d)  An adult individual who is employed by a facility and who provides children with social, medical, psychological or psychiatric services in addition to this chapter is required to have a current health assessment on file at the facility. An adult individual or an employe of an agency who provides those services by contract with the child's parent or the facility is not required to have a current health assessment on file at the facility.

TRANSPORTATION

§ 3270.175. Safety restraints.

   (a)  A child 7 years of age or younger shall be transported in accordance with the requirements for parents and guardians as set forth in 75 Pa.C.S. § 4581 (relating to restraint systems).

   (b)  Safety restraints installed in the vehicle at the time of manufacturing shall be used by all occupants.

   (c)  Manufacturers' instructions for use of safety restraints shall be kept in the vehicle at all times.

   (d)  A school bus with a seating capacity of 16 or more children used in transporting preschool or school-age children is exempt from the requirements established under subsections (a)--(c).

§ 3270.176. Vehicles.

   (a)  A vehicle shall be insured in accordance with 75 Pa.C.S. §§ 1701--1799.7 (relating to the Motor Vehicle Financial Responsibility Law).

   (b)  The doors on a vehicle shall be locked whenever the vehicle is in motion.

   (c)  No more than three persons may occupy the front seat of an automobile.

   (d)  The back of a pick-up truck may not be used to transport children.

   (e)  The cargo area of a station wagon may not be used to transport children.

   (f)  In accordance with 67 Pa. Code Chapter 171 (relating to school buses and school vehicles), the facility may not transport a child in an 11--15 passenger van.

CHILD RECORDS

§ 3270.182. Content of records.

   A child's record must contain the following information:

   (1)  Initial and subsequent health reports.

   (2)  The dates of application, admission and withdrawal of the child.

   (3)  Signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

   (4)  Signed parental consent for administration of medications or special dietary needs.

   (5)  Signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

   (6)  Signed parental consent for transportation, walking excursions, swimming and wading.

   (7)  Reports of accidents, injuries and illnesses involving a child in care at the facility. The original report shall be given to the parent on the day of the incident. The second copy of the report shall be retained at the facility in an accident file. The third copy of the report shall be retained at the facility in the child's file.

   (8)  A copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent shall receive the original agreement.

§ 3270.201. (Reserved).

§ 3270.202. (Reserved).

§ 3270.203. (Reserved).

§ 3270.204. (Reserved).

§ 3270.205. (Reserved).

§ 3270.206. (Reserved).

§ 3270.207. (Reserved).

§ 3270.208. (Reserved).

§ 3270.209. (Reserved).

§ 3270.210. (Reserved).

SPECIAL EXCEPTIONS

§ 3270.233. Play surfaces.

   (a)  A facility lawfully operating as of September 22, 2008, has until September 22, 2010, to comply with the protective surface requirement described in § 3270.102(c) (relating to condition of play equipment).

   (b)  A facility lawfully operating as of September 22, 2008, which has a play surface not in compliance with § 3270.102(e) has until September 22, 2010, to comply with the requirement described in § 3270.102(e).

SCHOOL-AGE PROGRAMS

§ 3270.241. Requirements specific to school-age programs.

*      *      *      *      *

   (b)  A facility or a space in a facility in which care is provided exclusively to school-age children shall comply only with the following sections:

   (1)  General provisions. Sections 3270.1--3270.4 (relating to general provisions).

   (2)  General requirements. Sections 3270.11--3270.27 (relating to general requirements).

   (3)  Staff persons and volunteers. Sections 3270.31, 3270.32 and 3270.33(a), (b)  and (d)  (relating to age and training; suitability of persons in the facility; and general requirements for facility persons). Special requirements for director, group supervisor and assistant group supervisor are set forth in subsection (c).

   (4)  Staff-child ratio. Sections 3270.51, 3270.53 and 3270.54 (relating to similar age level; children of an operator or a staff person; and minimum number of facility persons in the child care facility).

   (5)  Physical site.

   (i)  Physical site requirements do not apply for a school-age program located in a school building that is under section 776.1 of the Public School Code of 1949 (24 P. S. § 7-776.1); specifically, a program operated for school-age children in a public or private school building, a building used by an intermediate unit, or an area vocational-technical school building which meets the physical site requirements acceptable to the Department of Education.

   (ii)  A school-age program not located in a school building referenced in subparagraph (i) must comply with requirements in §§ 3270.61, 3270.62, 3270.64, 3270.67, 3270.69, 3270.72(a), 3270.73, 3270.74, 3270.76, 3270.78, 3270.79 and 3270.82(a), (b) and (h).

   (6)  Fire safety. Sections 3270.91(a), 3270.92--3270.94 (relating to fire safety).

   (7)  Equipment. Sections 3270.101, 3270.102(a)--(c) and (g), 3270.104, 3270.107 and 3270.108.

   (8)  Program. Sections 3270.111, 3270.113, 3270.115(a) and (b), 3270.116 and 3270.118.

   (9)  Procedures for admission. Sections 3270.121--3270.124 (relating to procedures for admission). When a school-age child attends the facility 15 hours or less per week, the operator is not required to complete the Department's approved form to provide information to the family about the child's growth and development in the context of the services being provided referenced in § 3270.124(a)(3).

   (10)  Child health. Sections 3270.131--3270.134(a) and 3270.136--3270.138. An equivalent health report completed by a school is acceptable as documentation of child health for a school-age child.

   (11)  Adult health. Sections 3270.151--3270.154(a) and 3270.155.

   (12)  Nutrition.

   (i)  In a facility operating a school-age program for fewer than 4 consecutive hours, none of the nutrition requirements applies.

   (ii)  If a program operates for 4 or more consecutive hours or if a program provides meals or snacks, the facility director shall comply with §§ 3270.161--3270.165.

   (13)  Transportation.

   (i)  A facility is exempt from transportation requirements when children attending care at the facility are transported in vehicles owned and operated by the school district in which the facility is located.

   (ii)  A facility not operating under the provisions referenced in subparagraph (i) shall comply with §§ 3270.171--3270.178 (relating to transportation).

   (14)  Child records. Sections 3270.181--3270.185 (relating to child records).

   (15)  Adult records. Sections 3270.191--3270.193 (relating to adult records).

   (16)  Special exemptions. Sections 3270.231--3270.233 (relating to staff qualifications; indoor and outdoor space and capacity; and play surfaces).

   (17)  Telephone. Staff persons shall have immediate access to a working telephone on the facility premises. If a land-line telephone is not accessible to staff persons during the hours of facility operation, a wireless telephone is acceptable.

   (c)  Special requirements for staff persons in school-age programs or in school-age spaces.

   (1)  Director.

   (i)  In a program operating 30 or fewer hours a week, a director or director/group supervisor shall be present at a facility as required at § 3270.34 (relating to director qualifications and responsibilities) at least 20% of the program's operational hours.

   (ii)  In a program operating 31 to 45 hours a week, a director or director/group supervisor shall be present at a facility site at least 35% of the program's operational hours.

   (iii)  In a program operating 46 or more hours a week, a director or director/group supervisor shall be present at a facility site as described at § 3270.34(c) and (d).

   (iv)  A responsible designee shall be appointed by a director as described at § 3270.34.

   (2)  Group supervisor. In a program in which 46 or more school-age children are enrolled, a group supervisor shall be present at a facility site as described at § 3270.35 (relating to group supervisor qualifications and responsibilities).

   (3)  Assistant group supervisor.

   (i)  In a program in which 45 or fewer school-age children are enrolled, assistant group supervisors shall be present at a facility site during the program's operational hours.

   (ii)  In a program in which 45 or fewer school-age children are enrolled, one assistant group supervisor is required to be present at a facility site for each group of 12 young school-age or 15 older school-age children in attendance.

   (iii)  In a program of 45 or fewer enrolled children, an assistant group supervisor is responsible for the following minimum duties:

   (A)  Planning and implementing, with the director, daily program activities.

   (B)  Coordinating activities with other assistant group supervisors.

   (C)  Assisting the director as needed.

   (4)  Aides. In a program in which 46 or more school-age children are enrolled, the responsibility of an aide is described at § 3270.37 (relating to aide qualifications and responsibilities).

CHAPTER 3280. GROUP CHILD DAY CARE HOMES

GENERAL PROVISIONS

§ 3280.4. 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.

   Act--The Public Welfare Code (62 P. S. §§ 101--1411).

   Age level--The grouping category appropriate for the child's age.

   (i)  Infant--A child from birth to 1 year of age.

   (ii)  Young toddler--A child from 1 to 2 years of age.

   (iii)  Older toddler--A child from 2 to 3 years of age.

   (iv)  Preschool child--A child from 3 years of age to the date the child enters kindergarten in a public or private school system.

   (v)  Young school-age child--A child 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 who attends the 4th grade of a public or private school system through 15 years of age.

*      *      *      *      *

   Child with special needs--A child who has one or more of the following:

   (i)  A disability or developmental delay identified on an IEP, an IFSP or a service agreement.

   (ii)  A written behavioral plan that has been determined by a licensed physician, licensed psychologist or certified behavior analyst.

   (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.

   

*      *      *      *      *

   IEP--Individualized education program as defined in 22 Pa. Code §§ 14.101 and §§ 14.131--14.133 (relating to defintions; and IEP).

   IFSP--Individualized family service plan as defined in §§ 4226.5 and 4226.71--4226.77 (relating to definitions; and IFSPs).

   Inspection summary--A document prepared by an agent of the Department describing each regulatory noncompliance item confirmed as a result of a facility inspection.

*      *      *      *      *

   Service agreement--A service agreement as defined in 22 Pa. Code §§ 15.2 and 15.7 (relating to definitions; and service agreement).

*      *      *      *      *

GENERAL REQUIREMENTS

§ 3280.11. Application for and issuance of a certificate of compliance.

   (a)  A legal entity shall obtain a valid certificate of compliance to operate at a specific location. The certificate of compliance will be issued by the Department to a legal entity prior to commencement of operation at a specified location.

   (b)  A legal entity or a representative of the legal entity shall participate in an orientation training provided by the Department within 12 months prior to commencing operation of the group child day care home. The orientation does not count toward the annual minimum of 6 hours of child care training required in § 3280.31(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).

   (d)  A certificate of compliance is issued in the manner described in Chapter 20, for a period not to exceed 12 months from the date of issue.

   (e)  A facility will be inspected at least once every 12 months by an agent of the Department.

   (f)  The facility is subject to announced and unannounced inspections in accordance with § 3280.23 (relating to Departmental access).

   (g)  Sanctions relating to the status of a certificate of compliance are applied under the authority of applicable sections of the act, Chapter 20 and this chapter.

   (h)  A facility whose certificate of compliance is current as of September 22, 2008, 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.

§ 3280.15. Building codes.

   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 in 34 Pa. Code § 403.23 (relating to child day care facilities).

§ 3280.16. Service to a child with special needs.

   (a)  The operator shall make reasonable accommodation to include a child with special needs in accordance with applicable Federal and State laws.

   (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 IEP, IFSP or written behavioral plan.

   (c)  The operator shall make staff persons and parents aware of community resources for the family of a child who may have special needs. The Department will provide to the operator information regarding community resources.

§ 3280.23. Departmental access.

   (a)  A staff person shall provide to agents of the Department immediate access to the facility and, upon request, to the children and the files and records.

   (b)  An inspection will be conducted during normal business hours except when there is reasonable cause to believe that inspections at other times are necessary to detect violations of applicable statutes and regulations.

   (c)  An agent of the Department will inspect compliance with this chapter in all areas of the facility premises that are accessible to children.

§ 3280.24. 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 in a conspicuous location used by parents. The inspection summary must remain posted until an agent of the Department verifies that each regulatory noncompliance item cited on the inspection summary has been corrected.

§ 3280.26 Emergency plan.

   (a)  The facility shall have an emergency plan that provides for:

   (1)  Shelter of children during an emergency including shelter in place at the facility and shelter at locations away from the facility premises.

   (2)  Evacuation of children from the facility building and evacuation of children to a location away from the facility premises. The evacuation routes and evacuation plans to exit the building may be the same as those required by § 3280.94(f) and (g) (relating to fire drills).

   (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 updates to the county emergency management agency.

FACILITY PERSONS

§ 3280.31. Age and training.

   (a)  A volunteer shall be 16 years of age or older and shall be directly supervised at all times.

   (b)  A staff person shall be 18 years of age or older.

   (c)  An individual 16 years of age or older who is enrolled in an approved training curriculum may be used as a staff person if the guidelines in this section are met.

   (d)  Child care professional credentials are equivalent to the following staff qualifications:

   (1)  A Child Development Associate (CDA) credential or a Certified Childcare Professional (CCP) credential is equivalent to 9 credit hours from an accredited college or university in early childhood education or child development and 1 year experience with children.

   (2)  A Pennsylvania school-age professional credential is equivalent to 9 credit hours from an accredited college or university in elementary education or child development and 1 year experience with children.

   (e)  A staff person shall obtain an annual minimum of 6 clock hours of child care training.

   (1)  Acceptable training is conducted in one or more of the following settings:

   (i)  By a secondary or postsecondary institution approved by the Department of Education and accredited by an accrediting agency recognized by the United States Department of Education or the Council on Post-secondary Accreditation and acceptable to the Department of Education.

   (ii)  By an entity that is licensed or certified professionally competent in the training topic.

   (iii)  In conferences or workshops.

   (iv)  With audio-visual materials recognized by child care professionals.

   (2)  Acceptable training topics include the following:

   (i)  Child or staff health.

   (ii)  Child development, early childhood education and special education.

   (iii)  Supervision, discipline and guidance of children.

   (iv)  Nutrition for children.

   (v)  Child care program development.

   (vi)  Child care staff person or volunteer professional development.

   (3)  Other training topics may be submitted for the Department's review and approval.

   (4)  Depending on the provisions of the appropriate regulation, training may be required for certain staff persons. The following constitutes competence in training areas:

   (i)  First-aid training. Competence is completion of training by a professional in the field of first-aid. First-aid training shall be renewed on or before the expiration of certification of every 3 years, as applicable.

   (ii)  Lifeguard training. Competence is completion of lifeguard training, including first-aid training and cardiopulmonary resuscitation (CPR) for child and infant.

   (iii)  Water safety instruction. Competence is completion of basic instruction in water safety from a certified lifeguard.

   (f)  Completion of training shall be documented by the signature and title of a representative of the training entity and include the date training was completed. Documentation shall be retained in the facility person's file.

STAFF:CHILD RATIO

§ 3280.52. Ratio requirements.

   (a)  The minimum number of facility persons is as follows:

   (1)  A primary staff person shall be present in a facility when six or fewer children are in care, unless the staff:child ratio specified in subsection (b) or (c) requires a second or third staff person.

   (2)  At least two facility persons shall accompany any number of children on an excursion away from a facility.

   (b)  When children are grouped in similiar age levels, the following child group sizes and ratios of staff persons apply:


StaffChildrenMaximum
Group Size
Total Number
of Staff
Required for
the Maximum
Group Size
Infant1  4123
Young toddler1  5123
Older toddler1  6122
Preschool110122
Young school-age112121
Older school- age115151

   (c)  When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in subsection (b).

PHYSICAL SITE

§ 3280.61. Measurement and use of indoor child care space.

   (a)  A facility shall provide indoor child care space for individual and group small muscle activity.

   (b)  Indoor child care space may not be used simultaneously as play space.

   (c)  Indoor child care space is measured within permanent, stationary partitions or walls. The allowable number of children in a space is determined by dividing the total square feet in a space by 40.

   (d)  Measured indoor space includes space occupied by cupboards, shelves, furniture and equipment.

   (e)  Measured indoor space does not include space occupied by halls, bathrooms, offices, kitchens and locker rooms.

   (f)  Indoor space in which children are receiving care may not be used simultaneously for other business, commercial, social or another purpose unrelated to the child care being offered.

   (g)  Preschool and school-age children may not be involved in small or large muscle activity in the same group space in which children are sleeping or resting.

   (h)  The capacity established for an indoor space may not be exceeded except in the following situations:

   (1)  At naptime, when toddler or preschool children are resting on rest equipment described in § 3280.105 (relating to rest equipment) if the following conditions are met:

   (i)  The capacity is determined by the requirement for placement of rest equipment described in § 3280.105(f).

   (ii)  The capacity may be exceeded for no longer than 2 1/2 consecutive hours and no more than twice in a program day.

   (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.

§ 3280.70. Indoor temperature.

   (a)  The indoor temperature must be at least 65° F.

   (b)  If the indoor temperature exceeds 82° F in a child care space, a means of mechanical air circulation must be operating.

§ 3280.75. First-aid kit.

   (a)  A first-aid kit shall be kept in a facility.

   (b) A first-aid kit must be inaccessible to children.

   (c)  A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.

   (d)  One first-aid kit per child care group 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 in subsection (c).

EQUIPMENT

§ 3280.102. Condition of play equipment.

   (a)  Toys, play equipment and other indoor and outdoor equipment used by the children must be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

   (b)  Toys soiled by secretion or excretion shall be cleaned with soap and water, rinsed and sanitized before being used by a child.

   (c)  Outdoor equipment that requires embedded mounting must be mounted over 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.

   (d)  Slides that are over 4 feet high must have guards along both sides of the ladder.

   (e)  Pea gravel and other materials with a diameter of less than 1 inch may not be used in spaces where infants or toddlers receive care.

   (f)  Children's toys and equipment, including furniture and rest equipment, 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. At the time of inspection, the operator shall submit to the Department written affirmation on a form provided by the Department stating that the facility is in compliance with this requirement.

§ 3280.105. Rest equipment.

   (a)  Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment must be labeled for the use of a specific child and used only by the specified child.

   (b)  Bed linens may not be used alone as age-appropriate rest equipment.

   (c)  Stacked cribs may not be used.

   (d)  Crib and playpen slats may be no more than 2 3/8 inches apart.

   (e)  Seasonal, appropriate covering, such as sheets or blankets, shall be provided as agreed between the child's parent and the operator.

   (f)  At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use.

   (g)  Linens, blankets and rest equipment shall be cleaned monthly, at a minimum. The operator shall arrange a cleaning schedule with the parent.

   (h)  Soiled bedding shall be cleaned before it is reused.

   (i)  The upper level of double-deck beds may not be used for children 8 years of age or younger.

   (j)  Toys, bumper pads or pillows may not be present in a crib while an infant is sleeping in the crib.

§ 3280.108. Furniture.

   (a)  Furniture must be durable, safe, easily cleaned and appropriate for the child's size, age and special needs.

   (b)  Study space, tables, chairs, paper and pencils shall be provided for school-age children in care, if necessary for the program offered by the facility.

PROGRAM

§ 3280.113. 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 §§ 3280.51--3280.53 (relating to staff:child ratio).

   (b)  A facility person may not use any form of physical punishment including spanking a child.

   (c)  A facility person may not single out the child for ridicule, threaten harm to the child or the child's family and may not specifically aim to degrade the child or the child's family.

   (d)  A facility person may not use harsh, demeaning or abusive language in the presence of children.

   (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.

§ 3280.115. Water activity.

   (a)  Swimming.

   (1)  A swimming pool must conform to 28 Pa. Code Chapter 18 (relating to public swimming and bathing places).

   (2)  An in-ground swimming pool accessible to children must be fenced with a locked gate.

   (3)  An aboveground swimming pool which is not in use must be made inaccessible to children in accordance with the swimming pool barrier guidelines of the United States Consumer Product Safety Commission.

   (4)  An indoor swimming pool which is not in use must be made inaccessible to children.

   (5)  The following staff:child ratios apply while children are swimming:

Similar
Age Level
Staff Children
Infant 1 1
Young and older toddler 1 2
Preschool 1 5
Young school-age 1 6
Older school-age 1 8

   (6)  When children are swimming, supervision shall include one person certified in lifeguarding training, as described in § 3280.31(e)(4)(iii) (relating to age and training).

   (7)  The person certified in lifeguard training may not be included in the staff-child ratio.

   (8)  A facility person who is counted in the staff-child ratio shall annually complete water safety instruction.

   (b)  Wading.

   (1)  Staff persons shall supervise day care children using wading pools. Staff:child ratios in subsection (a) apply when children are wading.

   (2)  A sanitizing solution shall be added to water in a wading pool. An acceptable sanitizing solution is 3/4 teaspoon of bleach added to 50 gallons of water.

   (3)  A wading pool shall be emptied daily.

   (c)  Water play tables. A water play table or a container used for water play that contains unfiltered water shall be emptied daily.

§ 3280.117. 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.

   (b)  In an emergency, a child may be released to an individual upon the oral designation of the parent, if the identity of the individual can be verified by a staff person.

   (c)  If a child is released upon the oral designation of the parent, the following information shall be logged in the child's record:

   (1)  The name of the parent making the request.

   (2)  The date and time of the request.

   (3)  The name of the individual to whom the child is to be released.

   (4)  The name of the staff person taking the call.

   (5)  The name of the staff person releasing the child.

§ 3280.119. Infant sleep position.

   Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics 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

§ 3280.122. 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 as he can understand about the service being planned. If the parent indicates that the child has special needs, the operator shall discuss the condition with the parent, refer to § 3280.4 (relating to definitions), and comply with §§ 3280.16, 3280.124 and 3280.131 (relating to service to a child with special needs; emergency contact information; and health information).

§ 3280.123. Agreement.

   (a)  An agreement signed by the operator and the parent must specify the following:

   (1)  The amount of fee to be charged per day or per week.

   (2)  The date on which the fee is to be paid.

   (3)  The services to be provided to the family and the child, including the Department's approved form to provide information to the family about the child's growth and development in the context of the services being provided. The operator shall complete and update the form and provide a copy to the family in accordance with the updates regarding emergency contact information in § 3280.124(f) (relating to emergency contact information).

   (4)  The child's arrival and departure times.

   (5)  The individuals designated by the parent to whom the child may be released as specified in § 3280.117 (relating to release of children).

   (6)  The date of the child's admission.

   (7)  The services which are to be considered as extra.

   (b)  A parent shall receive the original agreement. The facility shall retain a copy of the agreement.

§ 3280.124. Emergency contact information.

   (a)  Emergency contact information is required for each enrolled child. Emergency contact information must reference who shall be contacted in an emergency.

   (b)  Emergency contact information must include the following:

   (1)  The name and birth date of the child.

   (2)  The name, address and telephone number of the child's physician or source of medical care.

   (3)  The home and work addresses and telephone numbers of the enrolling parent.

   (4)  The written consent signed by a parent for emergency medical care.

   (5)  Information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation.

   (6) Health insurance coverage and policy number for the child under a family policy or Medical Assistance benefits, if applicable.

   (7) The name, address and telephone number of individual designated by the parent to whom the child may be released.

   (c)  When children are in the facility, emergency contact information must be present in a child care space for children receiving care in that space.

   (d)  When children leave the facility on walking and riding excursions, emergency contact information specific to each child on the excursion must accompany a staff person on the excursion.

   (e)  A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and accompany a staff person who leaves on an excursion with children.

   (f)  The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the information.

CHILD HEALTH

§ 3280.131. Health information.

   (a)  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, to provide an initial health report no later than 60 days following 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 must 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)  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 report must be written and signed by a physician, physician's assistant or a CRNP. The signature must include the individual's professional title.

   (d)  The health report must include the following information:

   (1)  A review of the child's health history.

   (2)  A list of the child's allergies.

   (3)  A list of the child's current medication and the reason for the medication.

   (4)  An assessment of an acute or chronic health problem or special needs and recommendations for treatment or services, including information regarding abnormal results of screening tests for vision, hearing or lead poisoning.

   (5)  A review of the child's immunized status according to recommendations of the ACIP.

   (6)  A statement of the child's medical information pertinent to diagnosis and treatment in case of emergency.

   (7)  A statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

   (8)  A statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health report required by this section.

   (e)  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 must 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.

§ 3280.133. Child medication and special diets.

   The operator shall make reasonable accommodation in accordance with applicable Federal and State laws to facilitate administration of medication or a special diet as prescribed by a physician, physician's assistant or CRNP as a treatment related to the child's special needs. Facility persons are not required to administer medication or special diets which are requested or required by a parent, a physician, a physician's assistant or a CRNP but are not treatment related to the child's special needs. When medication or special diets are administered, the following requirements apply:

   (1)  A prescription or nonprescription medication may be accepted only in an original container. The medication must remain in the container in which it was received.

   (2)  A staff person shall administer a prescription medication only if written instructions are provided from the individual who prescribed the medication. Instructions for administration contained on a prescription label are acceptable.

   (3)  The label of a medication container must identify the name of the medication and the name of the child for whom the medication is intended. Medication shall be administered to only the child whose name appears on the container.

   (4)  Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children.

   (5)  Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

   (6)  A parent shall provide written consent for administration.

   (7)  An operator is responsible to establish and maintain a medication log if prescription or nonprescription medication is administered. A log must include the following minimum information:

   (i)  The name of the medication.

   (ii)  The name of the child receiving the medication.

   (iii)  A requirement for refrigeration.

   (iv)  The amount of medication administered.

   (v)  The date of administration.

   (vi)  The time of administration.

   (vii)  The initials of the staff person who administered the medication.

   (viii)  Special notes related to problems of administration.

   (8)  If a special diet is prescribed for a child and if the diet is administered to the child, written instructions and the parent's written consent shall be retained in the child's file.

§ 3280.135. 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.

   (1)  If nondisposable diapers are provided by a parent, a soiled diaper shall be placed in an individual, securely-tied plastic bag and returned to the parent at the end of the day.

   (2)  If nondisposable diapers from a diaper service are provided by a facility, a soiled diaper shall be placed in the container provided by the service or in a securely-tied plastic bag.

   (3)  If disposable diapers are provided by a facility or a parent, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can.

   (4)  A soiled diaper that is not in a tied bag may not be placed in an unlined outdoor trash container.

   (b)  Diaper changing surfaces shall be cleaned after each use by wiping the surface with a sanitizing solution or by changing a pad or other surface covering.

   (c)  The diapering area may not be used for food preparation or food service.

   (d)  Cloth and paper materials used as diapering aids shall be stored in a manner that prevents cross-contamination from a soiled diaper, contaminated hands or other changing materials.

   (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.

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