chapter ten—infant and toddler care, care for mildly

Child Care Licensing & Regulatory Services
Operating Manual
CHAPTER TEN—INFANT AND TODDLER CARE, CARE FOR
MILDLY ILL CHILDREN, AND NIGHT CARE
Infant and Toddler Care
114-509 A. (1) Stimulation and nurturing
(a)
Children shall not remain in their cribs or play equipment for other than
sleeping and specific, short time-limited quiet play.
(b)
Infants and toddlers shall be routinely held, talked to, rocked, caressed,
carried, nurtured, read to, sung to and played with throughout the day.
(c)
There shall be toys and materials that encourage and stimulate children
through seeing, feeling, hearing, smelling and tasting.
114-509 A. (2) Programs for infants and toddlers
(a)
Staff shall provide appropriate attention to the needs of children.
(b)
The daily program for infants and toddlers shall include goals for
children, which promote healthy child development and allow for
individual choice and exploration.
(c)
Information about the child’s daily needs and activities shall be shared
with parents.
114-509 A. (3) Feeding, eating and drinking
(a)
Cups and bottles shall be labeled with the child’s name and used only by
that child.
(b)
Infants shall be fed in accordance with the time schedule, specific food
and beverage items and quantities as specified by the parent.
(c)
Infants shall be held while being bottle fed until they are able to hold their
own bottles. Bottles shall not be propped or given in cribs or on mats.
(d)
Due to nutritional concerns, the microwaving of breast milk is prohibited.
The microwaving of formula and other beverages is strongly discouraged
due to the possibility of a burn injury to the child. However, if the facility
plans to use this method of heating formula and other beverages, they
must notify all parents in writing as part of the enrollment or orientation
process.
(e)
All warmed bottles shall be shaken well and the temperature tested
before feeding to a child.
(f)
Baby formula, juice, and food served in a bottle shall be prepared, ready
to feed, identified, and packaged for single use for the appropriate user.
Any excess formula, juice, or food shall be discarded after each feeding.
Formula, juice and food requiring refrigeration shall be maintained at 45
degrees Fahrenheit or below.
(g)
Infants and toddlers shall not sleep with bottles in their mouths.
POLICY: All pillows, quilts, comforters, sheepskins, stuffed toys, bumper pads, and other
soft products shall be removed from the crib while the infant is sleeping. If a blanket is
used, the infant shall be placed at the foot of the crib with a thin blanket tucked around the
crib mattress, reaching only as far as the infant’s chest. The infant’s head shall remain
uncovered during sleep. (8/25/08)
(h)
(i)
(j)
Toddlers shall be offered water routinely throughout the day.
Breast milk and formula shall be dated and labeled with the child’s name
and refrigerated until ready to use.
Food for infants shall be cut in pieces one-quarter inch or less.
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Child Care Licensing & Regulatory Services
(k)
Operating Manual
Food for toddlers shall be cut in pieces one-half inch or less.
114-509 A. (4) Feeding chairs
(a)
Feeding chairs shall have a stable base.
(b)
Feeding chairs shall have a T-shaped safety strap that prevents the child
from slipping or climbing out of the chair. The safety strap shall be used
at all times the child is in the chair.
(c)
Feeding chair trays shall be in good repair and made of an easily
cleanable surface and shall not have chips or cracks.
(d)
Feeding chairs shall be used only for eating or a specific, short timelimited tabletop play activity.
(e)
Seat heights of feeding chairs shall be appropriate to the age and
development of the child. Feeding chairs shall be in good repair and
children shall be constantly supervised.
114-509 A. (5) Sleeping
(a)
Infants shall be placed on their backs to sleep unless the parent provides
a note from a physician specifying otherwise.
(b)
Crib mobiles shall not be permitted for infants or toddlers who can sit.
POLICY: All pillows, quilts, comforters, sheepskins, stuffed toys, bumper pads, and other
soft products shall be removed from the crib while the infant is sleeping. If a blanket is
used, the infant shall be placed at the foot of the crib with a thin blanket tucked around the
crib mattress, reaching only as far as the infant’s chest. The infant’s head shall remain
uncovered during sleep. (8/25/08)
(c)
Cribs shall be spaced so that there is at least three feet of space on two
sides of the crib. Cribs shall not be placed next to each other so that one
child may reach into the other child’s crib.
POLICY: Cribs must be placed three feet apart on the sides facing other cribs unless they
are purchased with pre-installed barriers that are clear, non-toxic, and non-combustible. If
these cribs are used, they can be placed closer together as long as staff accessibility and
visibility is maintained and the distance is never less than two feet. (11/1/06)
POLICY: Unoccupied cribs may be moved together to allow adequate play space as long
as fire exits are not blocked. (11/1/06)
POLICY: Bunk beds of all types are prohibited due to placement preventing ready access
in all circumstances. (11/1/06)
(d)
Two years from the effective date of these regulations, stacked cribs will
no longer be permitted.
114-509 A. (6) Equipment and materials
(a)
The infant and toddler room shall have chairs for staff persons to sit
while holding and feeding children.
(b)
Indoor space shall be protected from general walkways where crawling
children may be on the floor.
(c)
Mobile walkers are not permitted.
Care for Mildly Ill Children
114-509 B. (1) Parent notification and instructions
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Child Care Licensing & Regulatory Services
(a)
(b)
(c)
Operating Manual
If a child becomes ill while in care, the center shall notify the parent or
responsible party immediately.
If a child may have been exposed to a serious communicable disease
that is spread through casual contact, the center shall notify the parents
of all potentially exposed children about the nature of the illness and the
potential exposure to the illness, and recommend consultation with the
child’s physician.
If a center chooses to provide care to a mildly ill child, the center shall
receive instructions from the parent for any special care needs of the
child.
114-509 B. (2) Policies and procedures
(a)
If a center chooses to provide care to a mildly ill child, the center shall
have written policies and procedures specifying inclusion and exclusion
from the group, communication with parents, recording of illness and
care provided, specific types of illnesses and symptoms which prohibit
care from being provided, special staff training required and emergency
health procedures.
(b)
Children shall be excluded when they exhibit the conditions listed in the
South Carolina Department of Health and Environmental Control
Exclusion Policy, State Law 1976, Code Section 44-1-110, 44-1-140, and
44-29-10.
(c)
If a child is in a rest area due to illness, the child shall be directly
supervised at all times.
(d)
A hand-washing sink shall be in close proximity to the area designated
for mildly ill children.
Night Care
POLICY: The regulatory requirements for night care apply to all licensed child care
centers, registered church child care centers, and licensed group child care homes that
are in operation at any time during the hours from 1:00 a.m. to 5:00 a.m. (4/01/08)
114-509 C. (1) Requirements for staffing ratios:
(a)
Staff counted in the staffing ratios shall be awake, alert and attentive to
the children at all times.
(b)
The supervision and ratio requirements for sleeping hours are the same
as specified for napping in 114-504.C.
114-509 C. (2) An unannounced emergency drill shall be held during sleeping hours at least
every 60 days.
114-509 C. (3) Sleeping equipment
(a)
Each child shall have a bed with a solid foundation, a fire retardant
mattress, a pillow, and bedding appropriate for the temperature of the
center.
(b)
Cots and portable beds are not permitted.
114-509 C. (4) Bedtime
(a)
Children shall be provided the opportunity to read or be read to before
bedtime.
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Child Care Licensing & Regulatory Services
(b)
(c)
Operating Manual
There shall be books, games, and other quiet time activities for the child
prior to bedtime.
Special bedtime routines as specified by the parent shall be followed to
the extent feasible.
114-509 C. (5) Bathing
(a)
If children bathe at the center, there shall be one bathtub or shower with
a slip resistant surface for every ten children.
(b)
Each child shall have his or her own clean towel and washcloth.
114-509 C. (6) Night clothes
(a)
The center shall make arrangements with the parent to provide clean,
appropriate night clothes.
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