in-20260902-IR-470260159SNA: CHILD CARE CENTERS; EMERGENCY OR TEMPORARY CLOSURE

TITLE 470 DIVISION OF FAMILY RESOURCES Notice of Second Public Comment Period LSA Document #26-159 CHILD CARE CENTERS; EMERGENCY OR TEMPORARY CLOSURE PURPOSE OF NOTICE The Division of Family Resources (DFR) is soliciting public comment on adding, amending, and repealing rules at 470 IAC 3-4.7 and 470 IAC 3-4.8 concerning child care centers and the emergency or temporary closure of child care centers. HISTORY Notice of First Public Comment Period: 20260603-IR-470260159FNA Regulatory Analysis submitted with Notice of First Public Comment Period: 20260603-IR-470260159RAA Date of First Hearing: July 6, 2026 ADDITIONAL DOCUMENTS Regulatory Analysis: 20260902-IR-470260159RAA Notice of Public Hearing: 20260902-IR-470260159PHA CITATIONS AFFECTED: 470 IAC 3-4.7; 470 IAC 3-4.8 AUTHORITY: IC 12-13-5-3; IC 12-17.2-4-18.7; IC 12-17.2-5-18.7; IC 12-17.2-6-20 OVERVIEW Basic Purpose and Background DFR is amending rules to update regulations in line with modern practices and federal requirements, provide clarification, and reduce regulatory burden on child care center providers. The amended rules also clarify requirements for the emergency or temporary closure of a child care facility. The implementation costs of the proposed rule are not expected to exceed the threshold set in IC 4-22-2-22.7(c)(6). For purposes of IC 4-22-2-28.1, small businesses affected by this rulemaking may contact the Small Business Regulatory Coordinator: For purposes of IC 4-22-2-28.1, the Small Business Ombudsman designated by IC 5-28-17-6 is: Resources available to regulated entities through the small business ombudsman include the ombudsman's duties stated in IC 5-28-17-6, specifically IC 5-28-17-6(9), investigating and attempting to resolve any matter regarding compliance by a small business with a law, rule, or policy administered by a state agency, either as a party to a proceeding or as a mediator. SUMMARY/RESPONSE TO COMMENTS DFR requested public comment from June 3, 2026, through July 6, 2026, and during the public hearing on July 6, 2026. The comments received and DFR's responses to the comments are summarized as follows: The administrative rule establishes the minimum health and safety standards for licensed child care centers in Indiana-the foundational requirements that ensure children are cared for in safe, healthy environments. These are minimum standards: providers may exceed them, and many programs across the state already do. The state's voluntary Quality Rating and Improvement System (QRIS), through which programs demonstrate higher-quality practices, remains unchanged. As of June 2026, out of 778 licensed child care centers in Indiana, 604, or 78%, are considered high-quality programs rated as Level 3 or 4 in the state's QRIS system and 69,534 of the 86,326 licensed child care center seats, or 80% of total capacity, are within a high-quality child care center. Indiana also faces a persistent shortage of child care supply broadly and specifically of credentialed early childhood professionals. Of a workforce of forty-five thousand nine hundred seventy eight (45,978) in licensed child care homes and licensed child care centers, there are four thousand eight hundred and eight (4,808)-ten percent (10%)-hold a Child Development Associate (CDA) credential, and Indiana's colleges awarded only six thousand one hundred eight (6,108) early childhood education degrees over the fifteen (15) years from 2011 through 2025 (four thousand one hundred thirty-six (4,136) associate, one thousand six hundred seventy-three (1,673) bachelor's, and two hundred ninety-nine (299) post-baccalaureate). The supply of bachelor's-level and higher credentials is especially limited-on the order of two and one-half (2.5) qualifying degrees per licensed center over that entire period. Many of the responses below reflect these realities: the rule sets a health-and-safety floor while preserving the flexibility that providers need to keep care available and affordable for Indiana families. Comments were received opposing the general reduction of educator and staff qualification and education standards, warning that weaker credentials would deprofessionalize the early childhood field and reduce program quality, and urging that strong minimum standards be preserved. Response: The administrative rule sets the minimum health and safety standards for child care in Indiana. These standards establish the foundational requirements needed to ensure that children are cared for in safe, healthy environments. The state's Quality Rating and Improvement System (QRIS) remains unchanged and continues to serve as a voluntary framework for programs to demonstrate practices that exceed the minimum regulatory requirements. As of June 2026, Indiana has 778 licensed child care centers, of which 604, or 78%, are rated at Level 3 or 4 in the QRIS system and are considered high-quality programs. Additionally, 69,534 out of a total 86,326 licensed child care center seats (approximately 80%) are located within high-quality centers. These figures highlight Indiana's commitment to maintaining high standards and providing access to quality care for families. The QRIS system enables programs to voluntarily pursue and showcase higher standards, ensuring that families have access to care options that go beyond the minimum requirements established by regulation. The updated administrative rule provides licensed child care centers with greater flexibility in hiring. While the rule does not prevent programs from requiring educational credentials for staff, it allows providers to hire based on experience and support continued training and education as staff enter the workforce. This approach is particularly valuable in rural areas facing significant child care shortages, where parent choice is limited due to child care deserts. By reducing restrictive requirements, the rule empowers programs to expand access for families, increase the capacity of existing providers, and foster workforce growth in communities that need it most. In addition, OECOSL remains committed to workforce programs and career development including scholarships for higher education. OECOSL has supported early learning professional through TEACH scholarships for many years. In the previous two years, OECOSL has provided over $9 million to support scholarships for early childhood professionals. During these two years, the scholarships have led to 1,003 CDA credentials, 92 associate degrees, 47 bachelor's degrees, and 27 master's degrees. Response: Comments were received opposing the reduction of the lead caregiver's minimum qualifications from a Child Development Associate (CDA) credential or college coursework to a high school diploma; most commenters urged that the CDA be retained, while a few supported an experience-based pathway. Response: The administrative rule sets minimum health and safety standards for child care in Indiana. These standards establish the foundational requirements needed to ensure that children are cared for in safe, healthy environments. Providers may exceed these minimums, and many programs across the state already operate at higher levels of quality. Comments were received asserting that inadequate funding and low compensation, rather than regulation, are the primary drivers of the child care shortage, and urging investment in the workforce-wages, scholarships such as T.E.A.C.H., Child Care and Development Fund (CCDF) and voucher funding, and career pathways-rather than the lowering of standards. Response: The state continues to support CCDF vouchers for child care workers, and funding of child care workforce programs including scholarships and career-development opportunities for early childhood professionals. Child Care and Development Fund (CCDF) reimbursement rates are directly linked to the actual cost of providing care, ensuring that providers receive appropriate funding. In addition, the Braun administration has committed an additional two hundred million dollars ($200,000,000) of state general fund appropriations to fund child care vouchers across Indiana, further investing in the workforce and in the quality of care for families. Comments were received opposing the reduction of center director qualifications (for example, from a bachelor's degree to a CDA plus experience) and the reduction of the director's required on-site presence from thirty (30) to twenty (20) hours per week with a sixty (60) day vacancy allowance, citing the loss of on-site leadership and accountability. Response: The administrative rule sets minimum health and safety standards for child care in Indiana. These standards establish the foundational requirements needed to ensure that children are cared for in safe, healthy environments. Providers may exceed these minimums, and many programs across the state already operate at higher levels of quality. Comments were received opposing the removal of the high school diploma or equivalent requirement for caregivers who count in the staff-to-child ratio, and opposing allowing entry-level staff, including eighteen (18) year olds, to work without a diploma, on the ground that a basic education credential should remain the minimum for staff working with young children. Response: The administrative rule sets minimum health and safety standards for child care in Indiana. These standards establish the foundational requirements needed to ensure that children are cared for in safe, healthy environments. Providers may exceed these minimums, and many programs across the state already operate at higher levels of quality. The state's Quality Rating and Improvement System (QRIS) remains unchanged. QRIS continues to serve as the voluntary system through which programs demonstrate higher quality practices beyond the minimum regulatory requirements. Comments were received opposing reductions in the meals and snacks required for full-day programs and raising concerns about meals brought from home, with detailed comments addressing menus and serving sizes, meal components such as milk and juice, parent-provided and picnic meals, infant formula and feeding, and removal of the pre-licensure nutrition plan. Response: The administrative rule sets minimum health and safety standards for child care in Indiana. These standards establish the foundational requirements needed to ensure that children are cared for in safe, healthy environments. Providers may exceed these minimums, and many programs across the state already operate at higher levels of quality. Comments were received opposing the replacement of the defined term "early childhood professional" with "caregiver" arguing that the change devalues the profession; a few commenters supported retaining professional terminology or asked that "educator" be used. Response: OECOSL has revised the rule to restore the definition of "early childhood professional," ensuring that professional terminology is retained and recognized within the regulatory framework. This adjustment reflects the agency's commitment to valuing the expertise and qualifications of early childhood educators. Comments were received addressing training and professional-development requirements-annual in-service and clock hours, orientation, trainer credentials, and delivery flexibility such as online or self-paced versus hands-on coaching-with many opposing reductions in training expectations and asking for practical, documented, and affordable training. Response: The administrative rule sets minimum health and safety standards for child care in Indiana. These standards establish the foundational requirements needed to ensure that children are cared for in safe, healthy environments. Providers may exceed these minimums, and many programs across the state already operate at higher levels of quality. Comments were received opposing allowing children to nap on sleeping bags or mats on carpet rather than cots, citing sanitation and spacing concerns; a few commenters characterized the cot requirement as unnecessary. Response: OECOSL has updated the rule to eliminate the option for children to use sleeping bags during rest periods. Comments were received opposing the removal of curriculum, learning-materials, and developmentally appropriate requirements-including one-on-one engagement such as reading, singing, and talking, social-emotional and early-literacy expectations, and enrichment activities-and some commenters asked for screen-time limits. Response: In response to the concerns raised, OECOSL has restored the requirement that providers offer a full range of learning centers. These learning centers ensure that children have daily access to diverse, developmentally appropriate materials that support exploration, creativity, and meaningful engagement. Comments were received opposing the replacement of the dedicated changing table with "any sanitizable surface" and the removal of the paper-barrier requirement, and asking that potty chairs and training seats be sanitized after each use. Response: The administrative rule sets minimum health and safety standards for child care in Indiana. These standards establish the foundational requirements needed to ensure that children are cared for in safe, healthy environments. Providers may exceed these minimums, and many programs across the state already operate at higher levels of quality. Comments were received opposing the addition of separate flood and earthquake drills as duplicative; other comments addressed drill frequency across cohorts, use of shelter areas, posting emergency procedures, and requests for practical emergency-planning tools. Response: This provision is mandated by federal regulations and must be included to ensure compliance with national standards for child care programs. Comments were received supporting the requirement of emergency allergy plans and on-site epinephrine, with detailed comments addressing auto-injector carrying, epinephrine storage and portable emergency bags, and defining allergies medically rather than by religious dietary restriction. Response: OECOSL appreciates the support expressed for this provision. Comments were received asking that the required floor space per child be reduced from thirty-five (35) to thirty-two (32) square feet. Response: The requested reduction does not align with the minimum square footage required by other state agencies. Comments were received supporting the modernization and streamlining of the rules and the reduction of administrative and paperwork burden, including the added safety provisions (safe sleep, allergy, and emergency preparedness), electronic records, and faster licensing. Response: OECOSL appreciates the support expressed by commenters. Comments were received supporting the added flexibility to use mixed-age grouping during opening and closing hours, with more detailed comments asking for guidance on managing diapering, feeding, supervision, and infant group-size limits within mixed-age groups. Response: Comprehensive resources and guidance will be made available in the updated licensing interpretive guide to support providers in understanding and implementing the revised requirements. Comments were received opposing allowing portable wading pools and urging that the wading-pool prohibition and the chlorine and pool-testing requirements be retained, and noting that life rings alone are insufficient for water-play areas. Response: This provision grants individual child care programs the discretion to determine whether to permit portable wading pools, and allows each provider to make decisions based on its operational needs and safety considerations. Comments were received supporting the new ninety (90) day window for new staff to complete required training and the twenty-four (24) hour window to report non-emergency incidents; some commenters cautioned against staff being in direct care before completing basic training. Response: This provision grants individual programs the discretion to determine their approach; however, all staff must remain under the supervision of a qualified caregiver at all times to ensure the safety and well-being of the children in care. Comments were received supporting retention of the physical-presence and direct-supervision standard; homes commenters addressed the "sight or sound" supervision language and asked for reasonable flexibility, and some supported active supervision of toddlers while eating. Response: The rule provides greater flexibility for child care providers. Comprehensive resources and guidance will be included in the updated licensing interpretive guide to support effective implementation of these changes. Comments were received opposing any loosening of staff-to-child ratios, warning that allowing more children per adult increases safety risk and staff burden; some providers supported ratio flexibility keyed to neighboring states or to a formula-based approach. Response: This provision is governed by statute and therefore cannot be modified through administrative rulemaking. Comments were received opposing the new "touch supervision" standard for swimming as weaker than direct supervision, and asking that the center and home swimming-supervision standards be aligned. Response: Touch supervision is defined as maintaining proximity to a child-whether in or out of the water-that allows a caregiver to respond immediately if needed. Supervision of children remains the responsibility of the program at all times, regardless of the setting. Comments were received asking the Division to add a sunset review that removes requirements for which no violations have been recorded over a five (5) year period. Response: The frequency of recorded violations is not an appropriate indicator for determining the necessity of maintaining minimum health and safety standards. These standards are essential to ensure the well-being of children, regardless of the number of violations observed. Comments were received asking that violations be removed from public posting after three (3) years. Response: OECOSL will not change the current practice of requiring violations to be publicly posted, as it is consistent with IC 12-17.2-2-1(9). Comments were received broadly opposing the rulemaking as a "race to the bottom" or as deregulation that lowers the minimum level of care, raising equity, quality, and child-safety concerns without tying the comment to a specific provision. Response: The administrative rule sets minimum health and safety standards for child care in Indiana. These standards establish the foundational requirements needed to ensure that children are cared for in safe, healthy environments. Providers may exceed these minimums, and many programs across the state already operate at higher levels of quality. Comments were received supporting the new statewide intruder (active-shooter) drill requirement. Response: OECOSL appreciates the support and agrees with the recommendation to add possible scenarios to the resource guides that it develops. Comments were received objecting to counting volunteers, students, or minors toward the staff-to-child ratio and to lowering the minimum staff age, and urging that volunteers not be left alone with children. Response: Administrative rules are established to set minimum health and safety standards for child care programs, and many providers already operate at or above these standards. In addition, any individual left alone with children must meet all caregiver requirements to ensure the safety and well-being of those in care. Comments were received opposing any easing of immunization and exemption requirements, asking that "communicable" or "infectious" disease and "ill" be defined, and addressing isolation of ill children, universal precautions and personal protective equipment, staff hygiene and sanitizing, smoking and vaping, and retention of posted first-aid procedures. Response: Administrative rules are established to set minimum health and safety standards for child care programs, and many providers already operate at or above these standards. In addition, any individual left alone with children must meet all caregiver requirements to ensure the safety and well-being of those in care. Immunization exemption provisions have been aligned with IC 12-17.2-4-18.1(b), and vaping will be explicitly prohibited on child care premises to further protect children's health. Comments were received seeking changes to physical-plant requirements-aligning building, fire, and zoning codes with the licensing rule and revisiting fire suppression, ceiling storage, separate office, rocking chair, staff restroom, water supply and anti scald, locks, and playground requirements. Response: Licensing requirements must remain consistent with applicable federal and state law, as well as with the regulatory requirements administered by partner state agencies that affect the operation of child care programs and ensure the health and safety of the child care staff. The rule addresses building and furniture requirements; in addition, programs have the discretion to maintain staff restroom facilities based on their operational needs. Locks must have a key, code, or authorized unlocking mechanism, per the definition. Comments were received supporting electronic documentation, digital signatures, and child-care-management software for attendance and records; one commenter opposed attendance recordkeeping for self-pay (non-voucher) children. Response: This tracking system establishes a consistent baseline for health, safety, and program operations, ensuring that reliable standards are maintained across child care settings. Comments were received opposing any reduction in CPR certification requirements for infant and toddler caregivers, and asking that CPR training require an authorized instructor and an in-person return demonstration rather than online-only training. Response: OECOSL is removing duplicative language and aligning the rule with Indiana Code. In accordance with IC 4-22-2-19.5(a)(3), rules should not duplicate language found in statute and providers are responsible for ensuring that they follow all requirements applicable to them. Comments were received addressing incident, injury, and child-abuse or neglect reporting-asking to add the Department of Child Services hotline, clarify "outside" medical attention and injury-record contents, and address the consequences of a failure to report and the reporting of program closures. Response: Administrative rules are established to set minimum health and safety standards for child care programs, and many providers already operate at or above these standards. Additional clarification will be provided in the updated licensing interpretive guide as needed. Other concerns were considered; however, no changes were made because the proposed language remains appropriate and consistent with the intent of the rule. Comments were received supporting the parent-access and court-order provisions and periodic parent conferences (and opposing their removal), and addressing pickup and departure identification, admission-record fields, and late-pickup policy. Response: OECOSL appreciates the feedback provided on these provisions. Comments were received asking for consistent regulation across centers, homes, and registered ministries (with some urging that ministries meet the same standards) and proposing structural changes such as a "right-sized" small-center category and reduced duplicative licensing steps. Response: Current Indiana Code establishes the framework for auspices, and the rules are aligned accordingly to ensure consistency with state law. Comments were received asking that the emergency and temporary closure provisions allow reopening without case-by-case Division approval; some commenters supported the closure, family-communication, and reopening improvements. Response: In the event of an emergency or temporary closure, OECOSL will provide guidance to support programs as needed. Division approval for reopening may be as simple as providing proof that electricity has been restored in the event of a power outage. This is not intended to be a burdensome reopening procedure, but is necessary to ensure the health and safety of the children in attendance. Comments were received opposing reductions in supports for children with special needs, such as the resource team, and asking that provider participation in IEP and IFSP meetings and related family-disclosure provisions be preserved. Response: As previously written, the rule required programs to create a resource team. The modification now encourages collaboration between parents and providers to determine the plan of support for each child. This change establishes a parent-driven approach, allowing families to decide who will be involved in the resource team for their child. Comments were received asking for clarification of the findings and corrective-action-plan process and appeal rights, questioning the scope of "records" subject to inspection, and recommending that civil penalties be retained rather than fully repealed. Response: As written, the rule provides that the provider will be given a specific time frame in which to submit a corrective action plan, determined with guidance from the licensing consultant based on the severity of the noncompliance. OECOSL also offers additional supports to address needs that may not be explicitly covered in the rule. Other concerns were considered; however, no changes were made because the proposed language remains appropriate and consistent with the intent of the rule. Comments were received questioning the increase in group and class sizes and asking for clarity on how the group-size definitions align with the ratio chart, with some relating group size to the redefined "child care area." Response: Further clarification on this topic will be included in the forthcoming updated interpretive guides. These guides are being revised to help providers and stakeholders better understand and implement the new requirements, ensuring that clear and practical guidance is available for all. Comments were received addressing staff physical-examination and employee-health requirements and the child-health and physician provisions-including a request to define "licensed medical professional" and to replace "physician"-and questioning the removal of medical-exam and health-consultant requirements. Response: The administrative rule sets minimum health and safety standards for child care in Indiana. These standards establish the foundational requirements needed to ensure that children are cared for in safe, healthy environments. Providers may exceed these minimums, and many programs across the state already operate at higher levels of quality. The requirement for staff physical examinations has been eliminated to reduce administrative costs; however, individual programs retain the discretion to continue this practice, since it is not mandated by federal regulations. Comments were received supporting written suspension and expulsion policies and reduced exclusionary discipline. Response: OECOSL appreciates the support. Comments were received addressing criminal-history background checks and asking to restore a previous "submission" rather than "final results" standard for when staff may begin work, and supporting the background-check requirement generally. Response: This concern was considered; however, no changes were made because the proposed language remains appropriate and consistent with the intent of the rule. Comments were received generally supporting the safe-sleep provisions and training but seeking clarity on SIDS versus SUID terminology. Response: Sudden unexpected infant death (SUID) is addressed by the safe-sleep training in accordance with IC 12-7-2.1-297. Comments were received generally supporting allowing melatonin and sleep aids with parental authorization; one detailed comment asked to remove house-stock medications absent a health consultant and to limit cough and antihistamine use for children under five (5). Response: Parental permission is required for any medication administered to a child, whether the medication is brought from home or supplied by the child care provider. This ensures that families remain informed and in control of their child's health and safety. Comments were made recommending revised age definitions-defining "toddler" as twelve (12) months to less than twenty-four (24) months and adding a defined term "two-year-old" for twenty-four (24) months to less than thirty-six (36) months-for both centers and homes. Response: The age definitions have been updated so that the center and home regulations align with one another and are consistent with Indiana Code, ensuring clarity and uniformity across all licensed child care settings. Comments were made noting that the definition of "sterilized" in 470 IAC 3-4.7-1 does not align with State Form 49953. Response: All state forms will be updated when the rule becomes effective, ensuring consistency between the regulatory requirements and the official documentation. Comments were made recommending that the kitchen thermometer-placement wording in 470 IAC 3-4.7-116 be revised. Response: OECOSL updated the wording to "in the refrigerator" and appreciates the commentor for pointing out this drafting error. Comments were made noting that a higher-gauge mesh screen should also be acceptable under the window-screen requirement in 470 IAC 3-4.7-106. Response: This rule is unchanged, and this concern was considered; however no changes were made. Comments were made recommending that defined terms in 470 IAC 3-4.7-1 be capitalized when used in their defined sense. Response: OECOSL must follow specific Indiana Administrative Rule drafting guidelines, and the publisher ensures that capitalization is consistent with those guidelines. Comments were made recommending various clarifying, definitional, and readability edits-including choking and anaphylaxis wording and "pediatric first aid" terminology (470 IAC 3-4.7-32), a defined "sleeping device" term (470 IAC 3-4.7-53), readability rewrites (470 IAC 3-4.7-11 and 470 IAC 3-4.7-72), parent-notification and access cross-references (470 IAC 3-4.7-14, 470 IAC 3-4.7-16, 470 IAC 3-4.7-17, and 470 IAC 3-4.7-18), and illumination and foot-candle levels (470 IAC 3-4.7-106). Response: These concerns were considered; however, no changes were made because the proposed language remains appropriate and consistent with the intent of the rule. Comments were made noting inconsistent replacement of "shall" with "must." Response: OECOSL must follow specific Indiana Administrative Rule drafting guidelines, and the publisher ensures that the use of "shall" and "must" is consistent with those guidelines. Comments were received on subjects outside the scope of this rulemaking, to which OECOSL did not respond. Response: The proposed rule does not address the following topics: (1) voting and election-day child care; (2) the environment and pollution; (3) the Science of Reading, standardized testing, and educator assessment; (4) provider compensation and Child Care and Development Fund (CCDF) reimbursement rates; (5) Child and Adult Care Food Program (CACFP) administrative requirements; (6) expanded behavioral and mental health consultation; and (7) the state budget and state economic-development spending. These areas fall outside the scope of the current rulemaking. REQUEST FOR PUBLIC COMMENT DFR is soliciting public comment on the proposed rule. Comments may be submitted in one of the following ways: COMMENT PERIOD DEADLINE All comments must be postmarked or time-stamped not later than October 2, 2026. The rule, Regulatory Analysis, appendices referenced in the Regulatory Analysis, and materials incorporated by reference (if applicable) are on file at the Family and Social Services Administration, 402 West Washington Street, Room W451, Indianapolis, Indiana and are available for public inspection. Copies of the rule, Regulatory Analysis, and appendices referenced in the Regulatory Analysis are available at the Family and Social Services Administration office. This notice is for the second of two (2) thirty (30) day periods in which the public may comment on the proposed rule. Following this second public comment period, DFR may adopt a version of the proposed rule that is the same as or does not substantially differ from the text of the proposed rule published in this notice. EXPLANATION OF DIFFERENCES IN PROPOSED RULE In 470 IAC 3-4.7-1 (9), the definition of caregiver has been restored to the current language. In 470 IAC 3-4.7-1 (29), the definition of early childhood professional has been restored. In 470 IAC 3-4.7-15, the words "and vaping" were added. In 470 IAC 3-4.7-53, all references to sleeping bags were removed. In 470 IAC 3-4.7-63, language around required learning centers was restored to current language. In 470 IAC 3-4.7-116 (p), the word "on" was struck and "in" was inserted. PROPOSED RULE Sec. 1. For purposes of this rule, the following definitions apply: Sec. 2. (a) All new construction shall must have plan releases from both the DFBS IDHS and the ISDH IDOH prior to construction and licensing. (b) Child care centers shall fully comply with all the rules of the FPBSC under 675 IAC that apply to child care centers, including, without limitation, rules concerning change of occupancy. (c) The center shall submit a complete application including all required written documentation. (d) The center shall submit a written plan for nutrition and food service and two (2) weeks of menus for approval by the division prior to licensure and thereafter as required by this rule. (e) The center shall submit a written health program form for approval by the division prior to licensure and thereafter as required by this rule. (f) (c) The building shall must pass on-site inspections prior to licensure and license renewals. (g) (d) The attendance at the child care center shall not at any time exceed the capacity approved by the division. (h) (e) The child care center may only provide care to children of the age approved by the division and the DFBS. IDHS. (i) (f) The child care center shall not operate in an area where conditions exist that could be injurious to the welfare of children. (j) (g) The child care center shall meet the zoning requirements of their locale. Sec. 3. (a) The license is not transferable to another person, organization, or sponsor. (b) The license is only valid for the address shown on the license. (c) The center shall post the license in a conspicuous place that parents regularly view. (d) Only areas licensed and approved by the division may be used by the licensed child care center. (e) The center must file an application and obtain a new license prior to any of the following: Sec. 9.5. (a) After completion of the division's monitoring, the provider shall receive a notice of findings that: (b) If required by notice under subsection (a)(2), a provider must: (c) The provider shall participate in any follow-up activities as reasonably necessary to determine compliance after the division has requested a corrective action plan. (d) Noncompliance with this section may result in license revocation. Sec. 10. (a) When conditions arise that make the building unsafe, the center must take immediate action to provide for the safety and well-being of children and staff. Unsafe conditions include, but are not limited to, the following: (a) Centers may be subject to an emergency or temporary closure order when conditions arise that pose an immediate threat to the life or well-being of a child in the care of the child care center, as outlined in 470 IAC 3-4.8-1. (b) All centers shall have a written plan for correcting the conditions listed referenced in subsection (a) and must inform parents when such those conditions exist. The child care center may be required to close until the situation is corrected. (c) The center must report any of the conditions listed referenced in subsection (a) to the division as soon as the children have been removed to safety or sent home. (d) If closure is necessary for one (1) of the conditions listed referenced in subsection (a), a child care center may not reopen without division approval. This approval will be contingent on one (1) or more of the following: Sec. 11. (a) The governing body, or others designated to represent the child care center, shall immediately notify the division within twenty-four (24) hours, in writing, of the following: (b) Failure to report any of subsection (a) within five (5) calendar days may result in probation, suspension, or revocation of the child care center license. Sec. 12. (a) The center shall verbally report immediately to the affected child's parent, and within twenty-four (24) hours to the division, any serious occurrences involving any child. These occurrences include, but are not limited to, the following: (b) Child care center authorities shall confirm verbal reports to the division, in writing, within five (5) days of the occurrence unless otherwise directed by the division. Sec. 13. (a) Except as provided in subsections (e) and (f), the center shall at all times maintain the confidentiality of all information obtained regarding the suspected abuse or neglect of a child. (b) During the first two (2) weeks of employment, all staff shall receive documented training in recognizing and reporting child abuse and neglect. The director shall update this training annually. (c) A center shall not employ or utilize use the services of a person known by the division and reported to the center as a substantiated perpetrator of child abuse or neglect. (d) The center shall develop written guidelines for reporting suspected child abuse or neglect and include them in staff training annually. (e) The director and all staff shall refrain from questioning children and suspected perpetrators beyond gathering information to report the suspected abuse or neglect to child protective services. (f) Staff shall immediately report suspected child abuse or neglect as follows: (g) Reporting suspicions to the director or other supervisory personnel does not relieve the individual staff of their responsibility to report directly to child protective services. (h) The center shall dismiss the employee or volunteer if the child protective services investigation substantiates the abuse or neglect. Sec. 14. (a) When staff suspect that a child may have a communicable disease, the director shall must notify the child's parent or guardian. (b) When more than one (1) child in the child care center has been diagnosed with a communicable disease, the center shall must take the following action: Sec. 15. (a) The center shall have written personnel policies available to staff at all times. (b) The center shall establish and maintain a written policy that prohibits smoking and vaping on the child care premises. (c) The center's written personnel policies shall address the following health hazards for child care: Sec. 16. (a) The director shall discuss and give the following information, in writing, to the parent at the time of the child's enrollment: (b) All policies must be followed. Sec. 17. (a) The center shall provide the parent explicit, documented, formal written reasons for refusal to admit or provide care to a child. (b) Staff shall require any person picking up a child, and not known by the caregiver, to provide identification. (c) If a court order exists preventing a particular individual from having contact with a child, the center shall must comply with the order. The center shall keep a copy of the court order on file. In the absence of a court order, a parent will not be denied access to their child. (d) If an intoxicated or impaired person insists on removing children from the care of a licensed child care center, the center shall must immediately call 911 and report the incident to the local police agency. (e) Unscheduled visits by a custodial parent or guardian of a child shall be permitted at any time the child care center is in operation. Sec. 18. (a) At the time of admission, the center shall obtain, from the parent, information about the child to assist the center in meeting the daily needs of the child. (b) Caregivers shall have periodic interviews with the parent to assure consistency of child care and mutual awareness of the child's progress, development, and problems. (c) (b) Caregivers shall inform the parent of any important information regarding their child on the day of occurrence. (d) Centers shall forward to parents and staff information or handouts provided by the division regarding inclusion, rules, and other child care information. Sec. 19. (a) The following items must be prominently posted in a place regularly viewed by parents: (b) The center shall post the following items: (c) Staff shall post by the telephone the name and address of the child care center and a list of emergency telephone numbers as follows: Sec. 21. (a) The director shall be a minimum of at least twenty-one (21) years of age. (b) Each child care center must employ a qualified person to carry out the responsibilities of the director. (c) The director shall meet one (1) of the following minimum education and experience qualifications: (d) All directors who were employed as a director prior to December 1, 1985, are exempt from the specific educational requirements for this position, provided that his or her their position continues as a director at that child care center. Sec. 22. (a) The director shall work onsite during the child care center's scheduled hours of operation a minimum of thirty (30) at least twenty (20) hours per week or fifty forty percent (50%) (40%) of the total weekly hours of operation, whichever is less. Required training or education away from the child care center may be counted time for this requirement. (b) In the event of a director vacancy, the program must name a designee within five (5) business days for the director's responsibilities. A qualified director must be hired within sixty (60) days. (b) (c) The director shall not permit other employment or activities, including teaching responsibilities, to interfere with the operation of the child care center. (c) (d) The director director's responsibilities shall include the following: (d) (e) The director shall designate a responsible caregiver, at least twenty-one (21) years of age, to be in charge during any absences of the director. and include the following: (2) (f) The director and the director-designee shall have the following qualifications: Sec. 24. Caregivers counted in staff to child ratios shall meet the following qualifications: Sec. 25. (a) In addition to all caregiver qualifications, lead caregivers shall must have a minimum of one (1) of the following: at least a high school diploma or have passed an equivalency test. (b) Lead caregivers that do not meet these qualifications shall: Sec. 26. (a) The center shall assign one (1) lead caregiver to each group of children. (b) The lead caregivers are caregiver is responsible for: the following Sec. 29. Volunteers may serve in any capacity for which they are qualified, but may not be left alone with a group of children or counted in the staff to child ratio unless they meet the caregiver qualifications under section 24 of this rule. Sec. 32. (a) Prior to having direct contact with children or food, all staff members and volunteers must receive the following training or information shall be provided to all staff and volunteers according to the specific responsibilities assigned to that particular staff member or volunteer: (b) During the first two (2) weeks of employment, all staff and volunteers shall have the following training or information provided according to their individual responsibilities: (c) Within ninety (90) days of employment, all staff responsible for caring for children shall complete the division-approved orientation training, through the state of Indiana learning management system, in the following topics: (d) Within ninety (90) days after beginning employment, all caregivers who care for school age children must take the division-approved training on school age care through the state of Indiana learning management system. (c) (e) Documentation shall must be available at the child care center showing that all applicable orientation topics are covered and the dates of when the training was provided. Sec. 34. Staff shall have training in cardiopulmonary resuscitation (CPR) in accordance with IC 12-17.2-4-2 and as follows: Sec. 35. (a) In addition to first aid, cardiopulmonary resuscitation (CPR), universal precautions, and life saving certification, All directors and persons counted in staff to child ratios shall have, on an annual basis, at least twelve (12) clock hours of in-service training as follows: (b) Child care centers that have a swimming pool or built-in wading pool shall have at least one (1) person present, whenever the pool is in use, who is trained in age-appropriate cardiopulmonary resuscitation (CPR) and basic water safety, and has a valid Red Cross advanced life saving certificate. Caregivers shall maintain documentation of training in the appropriate person's file at the child care center for three (3) years. (c) Caregivers in child care centers serving children with special needs shall have orientation and continuing training based on the special needs of the children in their care. If applicable, this training must be in accordance with the child's IFSP (birth to two (2) years of age) or the child's IEP (three (3) years of age or older). (d) The annual twelve (12) hours may include CPR, first aid, child abuse detection and prevention, and safe sleep. Sec. 39. (a) Written records shall must be maintained for all injuries that occur while children are under the care of child care center caregivers, both on and off premises. (b) On the day of occurrence, caregivers shall inform parents of minor injuries when they pick up their child. Minor injury reports shall must be kept in the child's individual file, or in a separate minor injury reporting file, and shall be recorded showing the following: (c) Caregivers shall immediately report serious injury verbally to the parent. Caregivers shall record these injuries on forms supplied by the division and distributed as follows: Sec. 41. (a) Records, kept at the child care center, must document the following for all current staff, substitutes, and volunteers: (b) Volunteers and support staff are exempt from documentation of qualifications, evaluations, and in-service training requirements. Volunteers who are counted in the staff to child ratio shall meet all staff requirements. Sec. 42. Each center shall keep an emergency information file, separate from individual record files, and take it on field trips. It shall must contain the following: Sec. 45. (a) Written attendance or electronic records, shall be kept at the child care center, available for review for a minimum of one (1) year and shall document which may be through a CCMS system that documents the following for all children, staff, and volunteers: (b) A record of staff and volunteer schedules, including arrival and departure times and the date, must be kept on file for at least one (1) year from the last date on the record. Sec. 47. Directors shall prominently post Providers may not exceed the following staff to child ratio chart ratios set forth in each class area of IC 12-17.2-4-14.5 and posted on the child care center and in the area where parents sign children in on a daily basis: family and social services administration website. Age of the Youngest Child in the Group Maximum Number of Children Supervised by One Caregiver Maximum Number of Children in One Group Infant (6 weeks - 12 months) 5 12 Toddler 12 - 17 months 5 12 18 - 23 months 6 14 24 - 29 months 8 16 30 - 35 months 9 17 3 years (36 - 47 months) 11 25 4 years (48 - 59 months) 13 29 5 years (60 - 71 months) 17 31 6 years and older (72 months and older) 20 40 Sec. 48. (a) Staff to child ratios must be maintained during the hours of operation. (b) When there is a combination of ages within a group of children, caregivers shall determine the ratio required by the age of the youngest child in the group. This includes opening and closing times. (c) When determining the staff to child ratios, count only persons responsible for and directly engaged in supervising and carrying out activities for children. (d) Persons in the child care center with multiple roles, such as teacher/cook, teacher/director, or teacher/receptionist, are counted in staff to child ratios only while directly engaged with children. (e) All children shall be under the direct supervision of a responsible caregiver at all times. (f) Centers shall have a written policy that describes the steps caregivers shall take to correct inadequate ratios. Caregivers shall be aware of this policy. (g) Caregivers shall promptly notify the director when ratios become deficient. (h) The director or person in charge shall correct (g) Staff to child ratios must be corrected immediately. (i) (h) Children of the director and staff members are counted in staff to child ratios and assigned to their appropriate age group. (j) (i) The center shall have at least two (2) adults present during the hours of operation. (k) (j) The center shall make arrangements so that if only one (1) adult is supervising a group of children, that adult has means available to communicate with other caregivers and summon assistance without leaving children unattended. (l) The assignment of administrative, maintenance, and housekeeping duties must not interfere with the direct supervision of children. (m) The center shall make an effort to have substitutes visit the child care center to become generally familiar with the children and program in advance of the time they may be called to substitute. Sec. 49. (a) Age grouping policies apply at all times, except as in subsection (e). (b) When mixing age groups, younger children shall be protected from aggressive older children. (c) Caregivers may care for preschool children in the same group or area. (d) Centers may group children thirty (30) to thirty-six (36) months of age with children three (3) years of age. (e) Caregivers may group all children three (3) years of age through school age together during the first two (2) hours and the last hour of the child care center's operation, provided the group size does not exceed the maximum group size for the youngest children in the group. (f) Caregivers shall care for school age children in a clearly defined separate room/area. When mixing age groups, the group may not be larger than the square foot capacity of the room. (g) The maximum number of children per class is also determined by available space. (h) Centers licensed before the effective date of this rule may elect to have a maximum group size of fifteen (15) for children two (2) years of age, provided they use the same room. (i) (h) Kindergarten age children may be mixed with either preschool or school age groups. (j) (i) The maximum group size permitted is subject to the exceptions found in IC 12-17.2-4-14.5(l) and IC 12-17.2-4-14.5(m). Sec. 52. For the purpose of maintaining continuity of care, centers may mix children six (6) weeks of age to thirty-six (36) months of age in one (1) classroom under the following conditions: Sec. 53. (a) Caregivers shall provide a supervised rest period for children four (4) year years of age and under, after the noon meal and at any other time, if requested by any age child. This does not apply to children in attendance less than four (4) hours per day. (b) Children of all ages shall not rest or sleep on the floor. Staff shall provide cots or mats for all children that rest as follows: (c) When using cots or mats, the center shall assure ensure that a cover is provided as follows for each child: (d) The center shall provide individual storage so that one (1) child's cover does not touch the cover of another child. (e) When resting, children shall lie in such a way that direct face-to-face situations are avoided. (f) After thirty (30) minutes, caregivers shall provide supervised alternate activities for nonsleeping children. (g) Caregivers shall permit sleeping children to awaken naturally at their own pace. (h) During the rest period for children toddler age and older, caregivers may supervise children at fifty percent (50%) of the required staff to child ratio if: (i) The fifty percent (50%) reduction in staff to child ratios does not apply to infants. (j) Caregivers shall supervise sleeping children and never leave them unattended. (k) Rest areas must have a minimum average of five (5) foot-candles of light in all areas. (l) Caregivers shall make rest periods flexible based on discussions with the parent and the child's individual needs. Sec. 57. (a) Caregivers shall recognize each child as an individual whose personal privacy, choice of activities, and cultural, ethnic, and religious backgrounds are respected. (b) Centers shall work to increase understanding of cultural, ethnic, and other differences. (c) (a) The curriculum and adults' interaction shall must be responsive to individual differences in ability and interests. Caregivers shall design interactions and activities to develop the children's positive feelings toward learning. (d) (b) Efficient planning and good caregiver communication during transition periods shall must be used to avoid waiting periods between activities. (e) Caregivers shall arrange learning areas, equipment, and materials so children can work undisturbed either individually or in small groups. (f) (c) Caregivers shall arrange equipment in orderly, clearly-defined areas of interest, with space in each area for children to see the various activities available to them. (g) Caregivers shall provide children many opportunities to develop social skills, such as cooperating, helping, negotiating, and talking with others to solve interpersonal problems. (h) Caregivers shall move among groups and individuals to facilitate children's involvement with materials and activities by asking questions, offering suggestions, or adding more complex materials or ideas to a situation. (i) The center shall assign one (1) lead caregiver for each group of children. Sec. 61. Caregivers shall foster language development and literacy by the following: Sec. 63. (a) The quantity and variety of learning center equipment and materials provided daily shall permit children to interact without conflict due to a lack of equipment. (b) The center may combine learning centers. Materials from individual learning centers may overlap but the center shall count individual items only once. (c) The following minimums shall be provided to each group to children two (2) years of age and older: (d) Learning centers shall be within the class room/areas. (e) All children in each class room/area shall have access to these learning centers regularly throughout the day. (f) Children two (2) years of age shall have small climbing equipment that they can go in and out of, over, and around in their area. (g) (d) Centers shall have equipment storage as follows: (h) (e) The center shall clean and sanitize equipment and materials a minimum of at least once per week. (i) (f) All play equipment and materials shall must be constructed and installed in a manner way that is safe for use by children. (j) (g) All the surfaces on indoor gross motor equipment shall must meet the Consumer Product Safety Commission's guidelines for safety surfaces. (k) (h) Projectile toys are prohibited. (l) (i) All toys and learning equipment shall must be free of sharp edges or protrusions. (m) (j) Tricycles used by children shall must be spokeless, steerable, of age-appropriate size, and have a low center of gravity. (n) (k) When riding bicycles, children shall must wear safety helmets that meet national safety standards. Sec. 64. Television Screen-based device use in the classroom shall must meet the following guidelines: Sec. 70. (a) Staff shall maintain a one (1) to three (3) parts per million (ppm) chlorine solution, as verified by a pool test kit, or equivalent, in water tables used for water play activities. Staff shall empty the water table tables daily and clean it them with an approved sanitizing solution before being air-dried. (b) Portable fill and draw pools are prohibited. wading pools must be filled, dumped, and sanitized daily. (c) When children swim in a permanently constructed private swimming pool, wading pool, or lake owned by the child care center, center staff, relatives, parents, or others, while under the supervision of the child care center staff, the following rules apply: (d) In addition, permanently constructed swimming or wading pools located on the premises of the child care center must meet the following: (e) When children are taken to public pools or lakes while under the supervision of the child care center, the following rules apply: (f) Staff shall not permit children to be in hot tubs, spas, or saunas. Sec. 72. The following rules apply to the transportation of children in vehicles owned or leased by the center: Sec. 76. (a) A current weekly menu shall must be planned one (1) week in advance and posted as follows: (b) Menus shall must show serving sizes, specific food items and serving times for all snacks and meals. (c) Food service staff shall record menu changes as served and keep menus on file for one (1) month. (d) A notation of any special dietary exceptions for children shall must be posted in the kitchen and where meals and snacks are served. Sec. 77. (a) A period of not less than two (2) hours and not more than three and one-half (3 ½) hours shall must separate meals and snacks for children one (1) year of age and older. This does not apply between the hours of 9 p.m. and 6 a.m. (b) If the child's attendance at the child care center coincides with any meals and snacks that are provided by the center, the child shall be served those meals and snacks. (c) The center shall serve at least breakfast a morning snack, and lunch, and a mid-afternoon snack each day. shall provide additional snacks as needed to meet the spacing requirements in subsection (a), based on the center's hours of operation. (d) Staff shall serve a snack to school age children when they arrive at the child care center after school. (e) Staff are not required to serve meals to children that have already eaten that particular meal at another location. Sec. 78. (a) The center shall provide meals and snacks that meet dietary requirements in accordance with the division guidelines. consist of the following components, with milk or dairy and juice only counting as one (1) component of a meal or snack: (b) Children eating both the noon meal and the evening meal at the child care center shall not be served the same food at both meals. (c) The center shall not serve reconstituted dry milk or fat free milk to children. (b) Breakfast must include three (3) meal components. (c) Snacks must include two (2) meal components. (d) Lunch, and dinner if served, must include four (4) meal components. (d) (e) The center shall serve whole milk to children under two (2) years of age unless a physician orders a specific substitution. (e) (f) Liquid refreshments shall must meet the following guidelines: (f) Written, standardized recipes must be immediately available in the kitchen for all protein entree items on the menu. The recipe must be suitable for the number of children served at the child care center. The recipe must show the following: (g) Centers shall not offer foods that present a choking hazard to children under three (3) years of age, including, but not limited to, the following: Sec. 79. (a) Caregivers shall plan a period of time away from the lunch table before the noon meal for children to participate in quiet or calming activities. (a) The program may allow parents to bring meals for their children for the day, use a vendor service for meals, or prepare meals onsite. (b) Staff shall offer additional portions of food (at least two (2) different items) and milk to children at the noon and evening meals. (c) Staff shall offer an additional portion of food and juice or milk at snacks. (d) Except as provided in section 80(c) of this rule, on the initial serving of any a particular meal, staff shall must serve children the full portions of all posted menu items at the same time. (e) Correct food temperature and holding time shall must be maintained for all food served to children. (f) Food shall must be covered during transport from the kitchen. (g) Staff shall permit children to eat promptly when they sit down. (h) (g) All food servers shall not touch ready-to-eat food with their bare hands. (i) (h) Adults shall assist, supervise, and converse and sit with the children during all meals and snacks, in age-relative groups small enough in number to assure assistance and safety. (j) (i) Children shall be allowed to converse freely during meal times and snacks. (k) If adults eat with the children, the center shall serve adults the same meal as the children. (l) (j) All food, for the purpose of serving multiple children, not prepared at the child care center or provided by an approved vendor, must come in an unopened package from an approved food source. (k) Families may provide meals and snacks for their own child. Meals brought from home cannot be shared with other children. (m) (l) Eating utensils, dishes, glasses, chairs, and tables shall must be suitable for the age, size, and developmental level of the children. (n) The center shall use divided plates for children two (2) years of age and younger. (o) The center shall not serve food items prepared in a home kitchen at any time, except with a physician's written order for a particular child's special diet. (p) (m) Packaged, ready-to-eat foods that are served to children must be discarded if not consumed. Sec. 80. (a) Staff shall ensure that food served home style is protected from contamination. (b) Staff shall supervise children who handle or serve food. (c) Staff shall ensure that each child receives the minimum required serving size of is offered each meal component. (d) Staff shall discard any food brought from the kitchen to be served that remains after the meal. (e) Staff shall ensure that food is not exposed to sneezing, coughing, or drooling and that food is not touched by bare hands or clothing. (f) Staff shall discard contaminated food and container containers and replace it with food from the kitchen before continuing service to other children. Sec. 81. (a) If staff serves picnic lunches to children under the care of the center, the lunch must conform to the menu guidelines for children who are on table food. The center or an approved vendor must provide picnic lunches. (b) Centers shall comply with the following: (c) The following rules apply to cooking on an outdoor grill: Sec. 82. (a) The center shall post information regarding children's special diets for dietary staff in charge of preparing and serving the food. (b) The center must plan and serve substitutions, written on a menu, for all children with dietary restrictions. (c) For children requiring a special diet due to medical reasons or allergic reactions, the center shall must provide meals and snacks in accordance with the child's needs and the written instructions of the child's physician. (d) The program shall ensure that all staff: (d) (e) A child requiring a special diet due to religious or personal beliefs shall have a written statement from the child's parent. (e) (f) For special diets, the center may request the parent to supplement food served by the center. (f) If the parent provides the food from home, the center must have the parent sign a "Safe Transportation of Food Responsibility" form, available from the division. (g) All food items must be protected from damage and potential contamination. Sec. 82.5. (a) The program shall have, in writing, any foodborne or other allergies that a child has, and have a written action plan for treating the child if they come into contact with the allergen. (b) When a child with severe allergies is present, caregivers must ensure that they keep a medical bag containing the child's epinephrine auto-injector, if applicable, on their person when leaving the classroom. (c) Epinephrine auto-injectors must be stored in the classroom and inaccessible to children. Sec. 83. (a) Each center using vendor service shall have a written contract as follows: (b) Vendors must transport food items in easily sanitizable insulated containers that maintain potentially hazardous food at the temperature requirements of 410 IAC 7-24-187(a). 410 IAC 7-26-213. (c) Upon On receiving the food from the vendor, the center shall must verify the temperature of the food with a metal stem type, numerically scaled thermometer that reads zero (0) degrees Fahrenheit to two hundred twenty (220) degrees Fahrenheit. (d) Correct food temperature and holding time shall must be maintained until serving. (e) A record of potentially hazardous food temperatures taken shall be maintained at the child care center for one (1) year. (f) (e) When potentially hazardous food temperature and holding time are not correct, the vendor shall must be notified and the food shall must be immediately replaced. (g) (f) If time is being used as a public health control, 410 IAC 7-24-193(a)(1) 410 IAC 7-26-216 must be adhered to, and procedures, time, and temperatures must be documented. Sec. 86. (a) Within thirty (30) days after enrollment, or no not earlier than twelve (12) months prior to enrollment, each child shall must have written verification of a physical examination by a physician or a nurse practitioner. (b) The examination shall must include the following: (c) Written orders for each medication taken at the child care center. (d) Documentation of complete age-appropriate immunizations, as required by the division with recommendation from ISDH, and updated annually, including: IC 12-17.2-4-18.1(a). (e) Health records may be transferred if the physical exam is dated within a year. (f) Children two (2) years of age and younger shall have an annual health examination. (g) A provider shall maintain current documentation for each child. (h) A parent may request that their child be exempt from immunizations, physical examinations or medical treatment based on religious beliefs, with the following conditions: (i) If a child's physician determines that a child should not have immunizations for medical reasons, the physician shall indicate and update annually these exceptions on the child's health record form. (i) A parent may request an exemption from immunizations as set forth in IC 12-17.2-4-18.1(b). (j) Only children that meet the health requirements of this rule may attend the child care center. Sec. 87. (a) The center shall not admit children who are ill upon on arrival. (b) If a child becomes ill during the day, caregivers shall must immediately isolate the child from other children and notify the parent to arrange for other immediate care of the child. (c) Caregivers shall directly observe and supervise all children who are ill or injured until they leave the child care center. (d) The center may not readmit children who exhibit symptoms of the illness for which they were excluded without the approval of the director or director-designee. (e) (c) Centers shall have a written policy regarding the exclusion of ill children. Sec. 88. (a) Each child care center may have one (1) pain or fever reducing medication, one (1) cough medication, and one (1) antihistamine decongestant on the premises as follows: (b) The giving or application of all other medication, and carrying out medical procedures, shall must be done only on written order or prescription from a physician or other health care professional authorized to write prescriptions, which must be kept with the medication. (c) All individual nonprescription medicine orders must be renewed annually for children under two (2) years of age and every two (2) years for children two (2) years of age and older. (d) Caregivers shall obtain the reason for administration of the medication and written parental permission prior to the administering of medication. (e) All pharmacy-labeled prescription medication must be renewed annually and kept in currently labeled containers. (f) The written order or the pharmacy label must show the following: (g) Medication shall must be kept in the original container. (h) When no longer needed, medication shall must be returned to the parents or destroyed. (i) Medication not requiring refrigeration shall must be kept locked in a cabinet or container that is in a well-lit area, fifty (50) foot-candles, and shall not be stored in the kitchen or in a bathroom. (j) Medication labeled "refrigerate" shall must be stored in tightly lidded, washable containers marked "medication" in a refrigerator. (k) The center shall not store medication beyond the: (l) With a parent's written approval, centers may use preventive products, such as sunscreens, insect repellents, nonmedicated powder, petroleum jelly, and A & D ointment, without a physician's order. (m) Melatonin or other sleep aids must never be used without a parent's written approval and must be given in accordance with the label. Sec. 89. (a) The center shall make every effort to control the spread of communicable diseases and shall establish written health policies and precautions directed to this end. (b) Whenever exposure to disease has occurred in the child care center, control measures shall must be implemented as follows: (c) When any person working, volunteering, or attending the child care center is known to have a communicable disease, they shall must be excluded from attendance at the child care center for such the time as is prescribed by the person's physician or the local health officer. (d) The center shall ascertain when the person is well enough to return to work. (e) (d) The center shall follow the Child Care Communicable Disease Chart, available from the division, for appropriate management of suspected illness. (f) (e) The center shall provide space to separate from the group any child having or suspected of having a communicable disease or any illness as follows: Sec. 90. The following universal precautions supplies shall must be available to all staff: Sec. 91. (a) The center shall post first aid directions for the care of poisoning, seizures, hemorrhaging, artificial respiration, choking, and shock in each room or area occupied by children. (b) If first aid directives from the division are not used, the procedures must be approved, in writing, by the center's health consultant and updated every two (2) years. (c) A first aid manual, equivalent to the Red Cross First Aid Manual, shall be immediately available for staff use. (d) First aid supplies as specified by the center's health consultant shall must be available to all staff and inaccessible to children. The first aid kit, at a minimum, shall must consist of the following: (e) The center shall have an operable telephone on the premises, easily accessible for use in an emergency and for other communications. (f) The center shall post a list of emergency telephone numbers by all telephones. Sec. 94. (a) Diaper bags brought from home shall must be inaccessible to children. (b) The center or the parent shall supply diapers. Caregivers shall have diapers available at all times so they can keep each child dry and clean. (c) The center must store diapers off the floor, protected from contamination, and inaccessible to children. (d) Disposable diapers furnished by the parent shall must be brought to the child care center in original, unopened packages and marked stored and labeled with the individual child's name. (e) Caregivers The program shall provide an area for diaper all children on a changing table, except as follows: that is an easily cleaned and sanitizable surface. (f) Caregivers shall use the diapering surface exclusively for diaper changing. (1) (g) Caregivers may change infants that are unable to who cannot pull to a stand in their own crib. (2) (h) Caregivers may change children two (2) years of age and older standing up under the following conditions: (f) When diapering children three (3) years of age and older, caregivers shall do the following: (g) (i) The center with children under three (3) years of age who wear diapers or pull-ups shall provide a changing table surface in each room/area. (h) (j) The center shall locate a sink or division-approved portable sink within ten (10) feet of the changing table surface in the room/area or in a room that opens directly into the room/area. (i) (k) If the center shall use uses a changing table, as follows: it must meet the following requirements: (k) (l) Caregivers shall not change diapers on the floor, on equipment shelves, or on any food preparation or eating surface. (l) (m) Staff shall maintain hand contact with the child to prevent falls while on the changing table. (m) (n) Caregivers shall speak with the children while changing diapers. (n) There shall be a soft sanitizable pad on the table with a clean strip of waterproof, disposable paper to cover the entire pad. Caregivers shall place a new, waterproof, paper strip on the pad after each diaper change. (o) If an infant is changed in their crib, caregivers shall must place a clean sanitizable pad down with a clean strip of waterproof, disposable paper to protect the bedding or change the sheet and sanitize the mattress after each changing. (p) Caregivers shall sanitize the pad and table when they become soiled and at the end of each day. (q) (p) Caregivers shall use a clean cloth or diaper wipe for each individual washing of a child. Soft, clean, terry washcloths or diaper wipes shall must be immediately accessible. (r) (q) Caregivers shall properly cleanse the child's body at each diapering. The submitted health program shall contain skin care procedures approved by the center's health consultant. Caregivers shall post and follow the procedures when diapering children. (s) (r) If disposable gloves are used, they must be discarded immediately after the dirty diaper is removed and the child is cleansed. (t) (s) Regardless of whether gloves are used, caregivers shall must wash their hands before and after each diaper change. (u) (t) The child's hands shall must be washed after diaper changing with a clean, damp, soapy cloth, then and rinsed with a second clean cloth in the same order, or the child's hands shall may be held under warm, running water, soaped, and dried with a disposable towel. (v) (u) Soiled or wet children's clothing shall must be placed in a plastic bag, sealed and kept inaccessible to children, and returned home at the end of each day. (w) (v) Loose fecal material may be shaken into the toilet; soiled clothing or cloth diapers shall must not be rinsed in toilets or sinks. Sec. 95. (a) Caregivers shall place soiled disposable diapers in a plastic bag in a tightly covered sanitary container lined with a plastic bag that is inaccessible to children. (b) The bags shall must be tied tightly and removed from the child care center, as needed, and at the end of each day. Sec. 96.5. (a) The needs of individual children will determine the sleeping periods. (b) Staff shall follow the following safe sleep practices at all times for children from birth to twelve (12) months of age: (c) When a child is in a crib, caregivers must ensure that the SafeReach or SafeAccess sides are closed and latched. Sec. 97. (a) Caregivers shall do all toilet training with the parent's knowledge and consent. (b) Caregivers shall make a reasonable effort to be consistent with the parent's toilet training methods and communicate regularly on the progress and child's successes. (c) When children reach an age where they feel confident and unafraid to sit on a training seat, caregivers shall invite them to use the toilet, help them as needed, and positively reinforce their behavior regardless of the outcome. (d) Caregivers shall never force a child to remain on the toilet. (e) Caregivers shall never discipline, scold, shame, or humiliate a child for failure to conform or for wet or soiled clothing. (f) Caregivers shall assure that a supply of clean clothing is available to keep children dry, clean, and fully clothed during the training process. (g) The center shall provide a toilet with a training seat or a child-sized toilet. (h) Potty chairs may not be used for children under two (2) years of age. Potty chairs do not count in the overall toilet and sink count for capacity. (i) When a potty chair is used, staff must empty and sanitize the chair after each use. (i) (j) Children and staff shall wash their hands with soap and warm running water, and dry them with a disposable towel after each toileting usage. Sec. 98. (a) Persons who handle and serve food shall thoroughly wash their hands with soap and warm running water, and use disposable towels from a dispenser for drying or an electric hand dryer. (b) Hand sanitizers shall must not be used in place of hand washings. (c) Handwashing shall must be done before starting work, washed as often as necessary to keep them clean, and after smoking, eating, drinking, or using the toilet. (d) Staff who prepare food shall not change diapers. (e) Caregivers shall wash their hands before and after each child care duty, including individual feeding, bathing, wiping noses, diapering, and assisting children using the toilet. (f) Kitchen staff must wear clean, washable garments (aprons or smocks) while in the kitchen and serving food. (g) Kitchen staff must have effective hair restraint that keeps hair back and covered. Sec. 99. (a) The administrator or director is responsible for keeping the building, premises, and equipment in safe repair and structurally sound. (b) Caregivers shall not care for children in areas that are being remodeled, repaired, or painted. (c) The administrator or director is responsible for maintaining all interior and exterior surfaces, including walls, floors, ceilings, equipment, toys, furnishings, and cribs, in a safe condition, free of sharp points or jagged edges, splinters, protruding nails or wires, loose parts, rusty parts, or materials containing poisonous substances. (d) The interior finish, including walls and ceilings, of the child care center shall must comply with the rules of the FPBSC under 675 IAC. (e) Walls shall must be of washable materials. (f) Floors and steps shall must be smooth and of washable, non-slippery material. (g) The center must firmly secure and keep all carpeting and rugs and keep them clean. (h) The center shall not use small rugs for floor covering. (i) (h) Staff shall take the following steps to maintain the child care center: (j) (i) Staff shall not do major cleaning, except for spills after meals and art projects, while children are present in the area being cleaned. (k) (j) Staff shall keep exit areas clear of equipment, debris, and other objects at all times. Sec. 100. (a) Poisons, chemicals, and any item that states "fatal if swallowed" must be in locked storage and not accessible to children. (b) Chemicals for lawn care and insect and rodent control shall must not be applied when children are present in the child care center. (c) Peeling paint, on any interior or exterior surface or on any equipment, that contains which may contain lead in excess of current ISDH IDOH standards, shall must be made inaccessible to children until laboratory analysis is made on the peeling material. (d) The division shall approve all lead abatement procedures prior to the start of work. (e) The center must store cleaning equipment, cleaning agents, aerosol cans, and any other item that states "keep out of the reach of children" in a place that is inaccessible to children. (f) The center must store hazardous articles, sharp scissors, knives, latches, lighters, flammable liquids, power tools, cleaning supplies, hot beverages, and any other items that might be harmful to children in a place inaccessible to children. (g) Any thermal hazards above one hundred twenty (120) degrees Fahrenheit, such as radiators, hot water pipes, steam pipes, and heaters, in the space occupied by children shall must be out of the reach of children, or be separated from the space by partitions, screens, or other means, which are firmly attached and cannot be overturned. (h) The center shall make inaccessible to children environmental hazards that present a risk for entrapment or burial, such as, but not limited to, the following: Sec. 101. (a) Centers shall not use extension cords, except for approved, grounded, and surge protection strips. Such The protection strips shall must be plugged directly into an approved outlet. (b) The center shall cover electrical outlets or otherwise make them shockproof in all areas accessible by to children. (c) Electric fans, if used, shall must be securely mounted high on the wall or ceiling or shall be guarded to limit the size of the opening in the blade guard with properly installed sixteen (16) gauge mesh screen. The Underwriters Laboratory UL Standards and Engagement must approve all fans. (d) No electrical device or apparatus accessible to children shall be located so that where it could be plugged into an electrical outlet while in contact with a water source, including, but not limited to, a sink, tub, shower, or swimming pool. Sec. 102. (a) A provider providing care in a nonresidential building must have fire alarm and suppression systems as required by the applicable rule of FPBSC. (b) A provider must provide a two and one-half (2 ½) pound or greater ABC multi-purpose fire extinguisher with a valid expiration date, located on each floor of the facility where child care services are provided, and an additional extinguisher located in the kitchen area of the facility. (c) Staff shall keep the center free from fire hazards. (b) (d) The center shall not permit trash that contains combustible materials, such as paper, rags, or cardboard, to accumulate on the premises. (c) (e) Staff shall keep hoods above stoves and other equipment free of dust and grease. (d) Kitchen hoods shall be installed where required under the rules of the FPBSC under 675 IAC. The center shall have all kitchen hoods serviced and maintained according to the rules of the FPBSC under 675 IAC and have available records to document compliance. (e) (f) Staff shall keep storage areas clean and free from clutter. (f) (g) All storage shall must be at least twenty-four (24) inches from the ceiling. (g) (h) The center shall store flammable liquids as follows: (h) (i) The center shall not use flammable decorative materials unless the materials are inherently flame retardant or made flame retardant, except as follows: Sec. 103. (a) Staff shall conduct fire drills in accordance with the rules of the FPBSC under 675 IAC. Drills shall must be conducted monthly, and the records available to document compliance. (b) Staff shall conduct and document evacuation drills for natural disasters, in accordance with the rules of FPBSC under 675 IAC, in areas where they occur as follows: (c) Staff shall conduct and document active shooter and intruder drills every six (6) months. (d) All drills must be conducted with children present. Sec. 106. (a) Installation, testing, and maintenance of heating, ventilation, air conditioning, fire alarm, and sprinkler systems shall must comply with the rules of the FPBSC under 675 IAC. (b) When natural light is insufficient, it shall must be supplemented by artificial light so that the following minimum levels of illumination are maintained: (c) All light intensity measurements shall must be at the level of work. If no work is done in a room or hallway, the measurement shall must be at a height of thirty (30) inches above the floor. (d) The child care center shall must be ventilated. (e) The center shall maintain a temperature of not less than sixty-eight (68) degrees Fahrenheit. (f) All child care centers initially licensed after the effective date of this rule The center shall maintain a temperature of not more than seventy-eight (78) degrees Fahrenheit. (g) All outside doors and windows shall must be screened with sixteen (16) gauge mesh screen when open. (h) The center shall keep all screens in good repair and all unscreened windows and doors closed. (i) The center shall make heating units, including water pipes and baseboard heaters, hotter than one hundred ten (110) degrees Fahrenheit inaccessible to children by barriers such as guards or other devices. Sec. 107. (a) The center shall keep all hallways, stairways, corridors, aisles, and exits lighted and free from obstructions at all times. (b) All exterior and interior stairways shall must comply with the rules of FPBSC under 675 IAC. (c) Centers must have two (2) exits that meet the requirements set forth in IC 12-17.2-3.5-10(a). (c) (d) Exit signs shall must be installed and maintained in accordance with the rules of the FPBSC under 675 IAC. (d) (e) The center shall provide emergency lighting in all interior hallways, stairways, and corridors. (e) (f) All portions of the means of egress shall must comply with the rules of the FPBSC under 675 IAC. Sec. 108. (a) Exit doors shall must comply with the rules of FPBSC under 675 IAC. (b) Exit doors shall must be openable from the inside without the use of a key or any special knowledge or effort. Exit doors shall must not be locked, chained, bolted, barred, latched, or otherwise rendered unusable. (c) The center shall make all interior room and closet doors such that children can open the doors from the inside with a simple twisting motion or the equivalent. (d) The center shall not provide locking or latching devices on child bathroom doors. The prohibition on locks applies to the toilet stalls or toilet-area partitions only, not to the main entrance door of a multi-use bathroom. School age restroom stalls may have latches. (e) All interior locked doors shall must be designed to permit opening by the staff. The key or other opening device shall must be readily accessible to staff. (f) Automatic door closures must be adjusted properly. Sec. 110. (a) Each child care room/area shall must have a minimum of at least thirty-five (35) square feet of usable indoor play space per child at all times. (b) Usable indoor play space is exclusive of the kitchen, toilet rooms, isolation areas, office, staff rooms, hallways, stairways, storage areas, lockers, cubbies, the teacher's desk, laundry areas, the furnace room, and floor space occupied by permanent built-in cabinets. (c) Separate play rooms, or separated areas in play rooms, shall must be provided for the various types of activities required by the child care program. and for the separation of children according to age and class size. Sec. 111. (a) Furnishings and equipment shall must be durable, safe, and scaled to the size of the children. (b) The center shall provide tables and chairs in each child care area as follows: (c) Staff shall not stack tables or chairs in the class room/area child care area while children are awake. (d) The center shall provide space for each child's personal belongings to keep them separate from other children's belongings. (e) The center shall construct, locate, install, and design coat hooks in a manner way that does not pose a hazard to children. Sec. 113. (a) The child care center shall provide a minimum of at least one (1) sink and one (1) flush toilet per fifteen (15) children two (2) years of age and older. Infant and toddler restrooms count only for their rooms. (b) When the licensing capacity exceeds sixty (60) children, the center may substitute one (1) urinal for a toilet in the school age area only. (c) School age children of the opposite sex shall not use the same restroom at the same time. (d) Partitions shall must separate toilets for school age children if there is more than one (1) toilet in a room. (e) Stalls used by school age children shall must have doors. (f) If fifteen (15) or fewer school age children are present, only one (1) toilet and sink is required for their use. (g) The center shall locate the toilet for children two (2) years of age no not more than ten (10) feet from their room/area. (h) Toilet paper on a dispenser shall must be available and within reach of the children by each toilet. (i) Mild soap shall must be available, dispensed in a sanitary manner, way, and within reach of the children at each sink. (j) Disposable towels in a dispenser or electrical hand dryers that operate at a maximum temperature of one hundred twenty (120) degrees Fahrenheit shall must be within reach of the children by the sinks. If the center uses electrical hand dryers, they must provide one (1) for each sink. (k) Toilet facilities for staff shall be furnished, separate from those facilities used for children. Staff shall not use children's toilets when children are present in the restroom. (l) The center must seal all hand washing sinks to the wall unless using a division-approved portable sink. (m) The center must seal all walls and floors in restrooms. (n) All items in the restroom must be sanitizable. (o) If toilets and sinks are not child-sized, the center must provide safe, sanitizable steps or platforms for each toilet and sink. (p) The center shall control toilet and bathroom odors by ventilation and sanitation. If a screened window is not present, there shall must be mechanical exhaust vents. Existing centers shall have ventilation added if sanitation measures fail to control odors. Sec. 114. (a) The center shall maintain a safe and sanitary water supply. (b) If the center uses a private water supply or well instead of a public water supply, the center shall must supply written records of current test results indicating that the water supply is safe for drinking. The water system must meet the water quality and construction standards of the IDEM. (c) The center shall provide hot and cold running water at all hand washing sinks. in the facility. (d) The provider must notify the verifying agency of any change in the water supply. (d) (e) The center shall use an antiscald valve approved by ISDH IDOH to maintain water temperature between one hundred (100) degrees Fahrenheit and one hundred twenty (120) degrees Fahrenheit on all hot water supplied to sinks, bathing, and washing facilities used by children. (e) (f) If water faucets have hoses connected to them that are not in use, such those faucets must have vacuum breakers (back-flow preventives). (f) (g) All plumbing fixtures shall must discharge into a public sanitary sewer whenever available within a reasonable distance, or if soil conditions prohibit the construction of an approved on-site system. (g) (h) All sewage disposal and any sewage treatment system shall must meet the requirements of ISDH IDOH. (h) (i) All plumbing fixtures shall must be in good repair. (i) (j) All plumbing equipment shall must meet the requirements of the FPBSC under 675 IAC, ISDH IDOH, and IDEM. Sec. 116. (a) The center shall operate the kitchen, all food preparation areas, and all food service areas in compliance with 410 IAC 7-24, a copy of which shall be in the kitchen at all times for reference. Any reference to a noncritical item in 410 IAC 7-24 does not apply to this rule. 410 IAC 7-26. (b) The kitchen must have at least three (3) floor-to-ceiling walls. The fourth serving wall and all doors must be a minimum of at least three (3) feet in height. (c) Walls and ceilings must meet the requirements of 410 IAC 7-24-399, 410 IAC 7-24-407 through 410 IAC 7-24-409, and FPBSC under 675 IAC. Any reference to a noncritical item in 410 IAC 7-24-399 and 410 IAC 7-24-407 through 410 IAC 7-24-409 does not apply to this rule. (d) (c) The kitchen and other food preparation areas shall must be separate from areas used for any other purpose. (e) (d) The center shall locate the kitchen in a way to prevent usage as a throughway. No one shall use the kitchen as a throughway to other rooms or areas during food preparation and dishwashing. (f) The kitchen shall not be used: (g) (e) The center shall not allow unauthorized persons in the kitchen. (h) (f) Counter surfaces shall must be smooth, free from breaks or chips, and sealed to the wall. (i) (g) All food preparation surfaces and eating surfaces shall must be sanitized: (j) (h) Floors shall must be of smooth, nonabsorbent materials and free of cracks that would prevent cleaning. The center shall not carpet the kitchen or food preparation areas. (k) (i) All equipment must be easily movable, elevated, or sealed to the floor and the wall so that cleaning under and around equipment will be possible. (l) Whenever washing and sanitizing are conducted mechanically, the center shall provide spray type dish washing machines that meet the specifications of 410 IAC 7-24-277 through 410 IAC 7-24-287. Any reference to a noncritical item in 410 IAC 7-24-277 through 410 IAC 7-24-287 does not apply to this rule. (m) (j) When manually washing and sanitizing dishes and utensils, the center must use a three (3) compartment sink, with either drain boards or movable dish tables. (n) (k) Staff must store dishes, pots, pans, and utensils in a manner way that protects them from contamination. (o) (l) If disposable utensils and supplies are used, they shall must be stored in closed containers away from any cleaning compounds and toxic or hazardous materials. (p) (m) The center shall properly install a hand washing sink in the kitchen. The center shall supply soap and disposable towels from a dispenser or an electric hand dryer by the sink. (q) (n) The center shall locate the hand washing sink at least twenty-four (24) inches away from the area used for dish sanitizing or air drying, or install a protective barrier, at least twenty-four (24) inches in height, between the sanitizing area and the hand washing sink. (r) (o) Work and cleaning schedules shall must be written, posted, and followed for all the food storage and preparation and service areas. (s) (p) The center shall place an accurate, easily readable thermometer in each compartment of in the refrigerator and freezer in position for daily monitoring. (t) The center must provide a stove if they prepare meals. If the stove is of the commercial type, it must comply with the rules of the FPBSC. Sec. 117. (a) Staff shall thoroughly wash multi-use utensils and equipment in a detergent solution in the first compartment of the sink. (b) Staff shall rinse the equipment free of detergent solutions in clean water by immersing in the second compartment of the sink. (c) All eating and drinking utensils, and the food contact surfaces of all other equipment and utensils, are sanitized in the third compartment. as specified in 410 IAC 7-24-270 through 410 IAC 7-24-276. Any reference to a noncritical item in 410 IAC 7-24-270 through 410 IAC 7-24-276 does not apply to this rule. (d) The center shall post instructions for proper manual dishwashing in the kitchen if dishes are washed and sanitized manually. (e) Dishes and utensils shall must always be air-dried. (f) The center may use sturdy, single-use, disposable utensils and dishes as an alternative to dishwashing. If the center uses any cooking or serving utensils or dishes that are not disposable, they must have and use approved dishwashing facilities. Sec. 119. (a) The center shall provide office space separated from the areas used by the children. (b) Office space and equipment shall must be adequate for the administrative and staff needs of the child care center. (c) Telephone service must be provided on site. (c) The program shall maintain a working telephone or cellular device in the child care facility, and shall inform the division of any change in telephone number. (d) An area separated from the office space and areas used by the children shall be provided for the use of the staff. This area must be a room in child care centers licensed after the effective date of this rule. Sec. 121. (a) Caregivers shall have had training specifically related to infant/toddler development. (b) Caregivers shall have means available to communicate with other staff and summon assistance without leaving children unattended. (c) The director shall assign a primary caregiver for each infant and toddler. (d) (c) Caregivers shall interact with and address the needs of all children in their room. (e) (d) The staff person in charge of an infant/toddler group shall be at least eighteen (18) years of age and: Sec. 122. (a) The center shall devise and place a daily record chart in each infant and toddler room. This chart shall must provide space to record information about each child as follows: (b) The center shall keep charts on file for at least one (1) month from the last date on which information was recorded. (c) Caregivers of infants and toddlers shall have the date of birth of all children in the room immediately available. Sec. 123. Caregivers shall: Sec. 124. Caregivers shall: Sec. 125. Caregivers shall: Sec. 129. (a) The center shall equip each infant room with the following furnishings: (b) Mesh cribs, mesh play pens, stackable cribs, cradles, bean bag chairs, and bassinets of any type are prohibited. Sec. 130. (a) The center shall equip each toddler room with the following furnishings: (b) Caregivers may substitute cribs for cots, but may not count crib space in square footage. Sec. 134. (a) The center shall provide food that meets the dietary needs of each infant, as based on the National Research Council-Recommended Daily Dietary Allowance. (NRC-RDA). (b) Prior to admission, the child's parent shall establish a feeding plan, based on the recommendation of the child's physician, for each infant. (c) The feeding plan for each infant shall must include and list the following: (d) The parent shall update the feeding plan as the child's food intake changes. (e) Any changes or restrictions from the recommended feeding plan for children for more than forty-eight (48) hours must have a physician's written order. (f) The center shall post a copy of the child's feeding plan for use by food preparation personnel and the person responsible for feeding the child. (g) Caregivers shall adjust to the infant's individual feeding schedules. (h) Caregivers shall feed infants in their the infant's own rooms. (i) Caregivers shall wash their hands before each feeding of individual children. (j) Caregivers shall hold infants while feeding them bottles until the infant can sit independently and hold their own bottle. (k) Infants who can hold their own bottle and sit independently to feed themselves may only sit in a high chair or at a table and feed themselves their bottle. (k) (l) Caregivers shall provide a clean sanitized training cup for each child who is old enough and ready to drink from it. Sec. 135. (a) The parent or the center may provide formula. (b) All canned formula must be unopened and commercially prepared. and ready-to-feed strength. (c) If using powdered formula, bottles must be prepared according to the instructions on the package of formula, unless a physician's note indicates an alternative preparation direction. (c) (d) The center shall not use outdated formula. (d) (e) There shall may be a heating unit for warming bottles and food, accessible only to staff, located in the infant room. Staff shall not heat formula or breast milk in a microwave oven. (e) (f) Caregivers shall thoroughly stir food heated in a microwave after heating and before feeding to children. (f) (g) A refrigerator shall must be located in the infant food preparation room. (g) (h) If a day's supply of bottles is prepared at one (1) time, each bottle shall must be covered and labeled with the child's name, date, and time poured. (h) (i) Staff shall refrigerate prepared bottles and use them within twenty-four (24) hours. (i) (j) Staff shall cover and refrigerate portions of formula that remain, in open original containers that are labeled with the date and time opened, and shall discard this formula after forty-eight (48) hours if unused. (j) (k) Staff shall discard any formula remaining in a bottle after a feeding. (k) (l) Parents may supply filled bottles as follows: Sec. 136. (a) Prior to serving breast milk to an infant, the center shall must have on file a written parent agreement as follows: (b) The center or the mother must supply sterilized bottles or disposable nurser bags. (c) The mother shall store her milk in a bottle or bag and refrigerate the milk. (d) (b) The milk must be labeled with the child's name and the date and time collected. (e) The bottles must be brought to the child care center in a clean, insulated container that keeps the milk at forty-one (41) degrees Fahrenheit or below. (f) (c) The center shall use fresh, refrigerated breast milk within forty-eight (48) hours of the time expressed. (g) (d) Staff shall not thaw or warm breast milk in a microwave oven. (h) (e) Staff shall discard any breast milk remaining in a bottle after a feeding. (i) (f) Centers shall support mothers who are breast feeding welcome and accommodate nursing mothers onsite. Sec. 140. (a) The center shall provide food that meets the dietary needs of each toddler, as based on the National Research Council-Recommended Daily Dietary Allowance. (NRC-RDA). (b) Caregivers shall wash their hands before feeding of toddlers. (c) Caregivers shall assist and assure that each toddler washes their hands before each meal. (d) Caregivers shall feed toddlers in their the toddler's own room. (e) Tables and chairs of appropriate height and size, high chairs with a broad base, or feeding tables shall must be provided according to the age and development of the child. (f) Caregivers shall always use safety belts for securing the children when the children are in high chairs and feeding tables. (g) Caregivers shall remove children from their chair after eating. (h) Caregivers shall provide a clean, sanitized training cup for each child who is old enough and ready to drink from it. Caregivers must cover unused refrigerated training cups. (i) Caregivers shall allow and encourage children to feed themselves. Caregivers shall maintain supportive help to children for as long as they need such that help. (j) Staff shall serve and have food ready to eat before calling children to meals so they do not have to wait. (k) Caregivers must provide appropriate size sized eating utensils. (l) When a child is able and seems ready to adjust to eating with others at a table, he or she the child may be placed at a child's table. (m) At all meals, adults shall be seated at each table to supervise. (n) (m) Water shall must be offered between meals and snacks to each toddler. (o) (n) Food must be cut up in no not larger than one-half (½) inch cubes. Sec. 141. (a) The needs of individual children shall determine the sleeping periods. (b) Caregivers shall place infants on their backs or sides in their cribs for sleeping. (c) Infants under twelve (12) months of age shall sleep in a crib, port-a-crib, or commercial play yard. (c) (d) Only children under thirty (30) inches tall may use a port-a-crib. (d) (e) Only children under thirty-five (35) inches tall may use a full-sized crib. (e) (f) The fifty (50) square feet of required space per child includes space for a crib for each infant. (f) (g) All cribs shall must meet the Consumer Product Safety Commission guidelines in addition to the following guidelines: (g) Full-sized cribs shall meet the following guidelines: (2) With (h) The mattress support of a crib or port-a-crib must be in its lowest position and the crib side in its highest position. The vertical distance from the upper surface of the mattress support to the upper surface of the crib side and end panel shall must not be less than twenty-six (26) inches. (h) (i) Port-a-cribs shall must meet the following guidelines: (i) (j) Caregivers shall provide at least three (3) feet of space between cribs when occupied. (j) (k) Tiered or stacked cribs are prohibited. (k) (l) Cribs shall must be located away from heaters, drafts, and cords from window coverings. (l) (m) When a child is in a crib, caregivers shall must extend the sides to their fullest height. (m) (n) Staff shall sanitize all cribs as often as necessary and at least daily. (n) (o) Staff shall sanitize cribs or cots and change bedding between each child's use if they allow two (2) part-time children to share the same crib or cot. (o) (p) All bedding shall must be changed immediately when wet or soiled, and otherwise once each day. (p) (q) Staff shall launder bedding in a washing machine with a water temperature above one hundred sixty (160) degrees Fahrenheit or in a sanitizing solution of one (1) cup bleach or equivalent chemical per washer load. (q) (r) Soiled bedding shall must not accumulate for longer than twenty-four (24) hours before laundering. (r) Staff shall have a reserve supply of bedding and wash cloths available at all times in case of delays in laundry pickup or delivery. (s) Each toddler shall have individual bedding with their separate cot or crib. (t) Caregivers shall assure that at least three (3) feet of space is between toddler cots. Sec. 143. (a) All portions of the means of egress shall must comply with the rules of the FPBSC under 675 IAC. (b) Each infant and toddler room shall have floor-to-ceiling walls on all sides and full doors. (c) (b) No one shall use the infant or toddler rooms as throughways. (d) (c) The floor covering in infant and toddler rooms shall must meet the following standards: (e) (d) A sink must be in the infant room or in a room that opens directly into the infant room. If the infant room has a toilet, it must be in a room with a door. (f) (e) A sink must be in the toddler room or in a room that opens directly into the toddler room. (g) If the toddler room has a toilet, it must be in a room with a door. that opens directly into the toddler room. Sec. 145. (a) The center shall keep school age children separated from younger children at all times, except as in subsection (d) and section 49(f) of this rule. (b) School age children shall have a clearly defined separate room/area that does not interfere with the care of younger children. (c) Outdoor play areas may not be used by both preschool and school age children at the same time unless separate, clearly defined play areas are provided. (d) School age children may choose to interact with children two (2) years of age and preschool children, under direct caregiver supervision, with the following conditions: Sec. 146. (a) The A center that serves school age children shall provide a program and activities that recognize the their developmental and educational needs. of school age children. (b) Caregivers shall seek child input in the development of program activities. (c) Children who have been in school all day shall have time set aside for relaxation and recreation immediately upon arrival from school. (d) (b) Indoor and outdoor equipment shall must be age and physical size appropriate. Sec. 148. (a) The center A provider shall form a resource team that maintains communication regarding support the child's inclusion of children with special needs and progress that consists of the following: in child care settings in a way that promotes the child's health, safety, and development. (b) The center shall implement recommendations made by the resource team and incorporate the recommendations into a program plan for the child. (c) The center shall review, evaluate, and document all program recommendations from resource persons related to a child's special needs at least twice a year. (b) A parent or legal guardian is entitled to choose a child care provider that best meets the needs of their child, and to determine whether to share information regarding the child's needs. (c) When appropriate, a provider and parent or legal guardian may work together to develop strategies or a plan to support the child's participation and success in care. (d) Participation in an individualized plan or support strategy must be agreed upon by the parent or legal guardian and the provider, and may not be required as a condition of enrollment, except where necessary to ensure the health and safety of the child or others. Sec. 149. (a) If a child care center is open for business twenty-four (24) hours per day, the center shall: (b) The center shall have the approval of the SFM and division prior to operating extended hours. Sec. 153. (a) Each child shall have an individual cot, bed, or crib equipped with bedding and maintained in a sanitary and safe condition. (b) Each group must have a posted schedule of evening activities. Sec. 155. (a) The center shall use the ill child care room exclusively for ill children and not use the room for any other purpose. (b) There shall must be toilet, hand washing, and diapering facilities used exclusively for ill child care. (c) The ill child care room shall must have a separate entrance from the outside. (d) The ill child care room shall must have separate heating, air conditioning, and ventilation. (e) The center must contact the child care health section for additional criteria. Sec. 1. (a) The following are the list of conditions that pose an immediate threat to the life or well-being of a child in the care of a child care provider that may subject a child care center, child care home, or child care ministry to an emergency or a temporary closure order: (b) If an employee or agent of the division determines a violation in subsection (a) exists, the division shall: must: Documents Incorporated by Reference: None Received by Publisher Small Business Regulatory Coordinator: Tikila Welch, Indiana Family and Social Services Administration, Division of Family Resources, Indiana Government Center South, 402 West Washington Street, Room W362, Indianapolis, IN 46204, (317) 550-5824, tikila.welch@fssa.in.gov