This is in regards to the 757 area of Virginia.

Some issue that should be addressed:

• Government covering the cost for central registry, background and TB screening for new hires.
• Annual training for child hours should go from 16 hours a year to 5. Repetitive training should be for entry level new hires. If you have a degree, the only time training should be done is if something changes statewide.
• GRANT AND STATE FUNDING. Childcare needs funding. Childcare is the most used establishment. Education starts from home, then childcare. NO ONE CAN LIVE OFF MAKING UNDER $15 A HOUR. Childcare workers are getting the bare minimum, along with the directors with degrees. Small childcare owners and cooperation's should be paying director's no less than $25/hour with paid benefits to run a childcare. Up keep of a childcare is expensive. Childcare's are starting to up charge on fees for parent's in order to keep the center running and employees to stay due to pay. Parent's are leaving because they can not afford it.
• Social service should be paying facility's weekly or bi-weekly instead of semi monthly and also raise the rates. 
• Childcare should be able to provide great benefit's for their staff. Children are sick daily which causes staff to be out more frequently (especially in the last 3 years) Also, with these benefits little to nothing should have to be taking from the checks hat they're barely making.
• Some workers are single, single parent's and struggling. 
• Provide free hands-on training on special need education for childcare workers. 
• Childcare needs a cost of living increase every year.
• Childcare providers work hard, if public school and Sentara can get increase, government funding and everything, childcare should be an top priority. 

I would like to start by thanking the VDOE for taking the time to make this a priority.  The standards have been conflicting between licensing and subsidy for years and some of the changes didn't make sense.

Thank you for changing the date of tb screenings to 90 days prior to hire.  With the timing of background checks, sometimes that 30 days fell outside of the time between getting fingerprinted and getting hired, making scheduling an appointment hard.  Especially in a rural location like the Northern Neck.

Also a huge shout out to adding cleaning tables & high chairs before and after each use as it seemed ridiculous and gross that it was previously only required to sanitize every time and clean once daily.

A few things that I think need clarification or corrections are:

In the section below, there is no definition of sleep adaptive equipment

8VAC20-781-340 Resting and sleeping infants

D. The licensee shall ensure that staff shall not use sleep adaptive equipment unless otherwise directed in a written, signed statement by the child’s physician or physician’s designee.

In the section below, the use of a swaddling method for infants or sleep sacks is unclear.

8VAC20-781-440 Cribs, cots, rest mats, and beds

O. No soft objects or loose bedding shall be used with infants under 12 months when sleeping or resting including pillows, blankets, quilts, comforters, sheepskins, bumper pads, or stuffed toys.

In the section below, there was previously no requirement to document the application of sunscreen.  I was hoping that the same would be possible for bug spray- as it is applied regularly like sunscreen.  It seems that we will now be required to document sunscreen application every time it is applied.  This seems especially excessive in the summer when we take the school age children to the pool and apply the sunscreen multiple times during the visit.  I understand documenting other over the counter skin products that are not regularly applied multiple times a day every day, but this is going to be burdensome for many programs.

8VAC20-781-580 Topical skin products

In the section below, there will need to be some definition on infant foods.  Once the child is eating solid food (prior to 12 months), some parents send in "left over dinner" food to be heated up.  Is it really expected to heat that up by soaking it in water?  There needs to be a way to heat it up, mix it, and test for temperature.  Heating up leftover foods in water, I cannot see as being health department approved.   

8VAC20-781-630 Special feeding needs

I. Milk, formula or breast milk, and bottles of infant foods shall be warmed under running warm tap water or by placing them in a container of water that is no warmer than 120° F. Bottles and infant foods shall not be heated or warmed in a microwave.

In the section below, this is a huge change.  Sandboxes have only ever been required to be covered when the sandbox cannot drain.  For example, I have a large sandbox that is just on the ground, we do not have issues with animals using it, and it drains properly when it rains.  To cover it, is going to require some type of tarp, that I think would be more of a hazard than just leaving it uncovered as the tarp will collect water that doesn't drain.

8VAC20-781-260 Indoor and outdoor play areas and equipment

J. Sandboxes shall be covered when not in use.

I appreciate you taking the time to review these potential issues and hope that as a previous commenter stated, the state can help to make hiring an easier process.  Right now, it takes at the bare minimum a month from interview to hire.  Fingerprint checks need to continue to be funded by the state or the price significantly reduced similiar to the CRS check.  Potential employees making minimum wage or barely above don't have the funds to pay for them and the employers don't have the funds to get people fingerprinted that aren't going to show up.  There has to be a way to keep the funding for fingerprinting going.

I do appreciate the review of the standards and the efforts to make things uniform and consistent.  There still are differences between what is being presented and the Subsidy Standards.  It would make sense to me that regardless of whether you are a Subsidy Vendor or not, that one set of standards is appropriate.  Even if it required state standards to require more, at least there would not be a discrepancy between the two.  I feel like this is an unnecessary stumbling block for centers.  While I know and understand that licensing is to be regulatory in nature for the health and safety of children, it would be nice to feel like we are essentially on the same team.  We are all here for the children.  We shouldn't feel on high alert during inspections and worry a simple mistake in a process or a piece of paperwork that could be fixed simply by educating us will end up as a violation for all to see, worded in ways that make it sound terrible and gives a platform for those that look to do damage to us to have something to use.  Social media, Google reviews, etc are battles that we have to face from families that are upset over following policies and they use these things to their advantage.  It is obvious when centers are working hard to follow the rules set forth by the state.  It is also obvious when they are not and I think there should be more of an education and teamwork initiative from licensing inspectors with centers that are going above and beyond.  

While I love the emphasis the VDOE is putting on the learning aspects of what we do and finally putting recognition in the foundation these early learning environments make, we do need help in training our staff.  Ways to make education feasible for our staff.  To enter the public school system there are many opportunities to help teachers get licensed and finish their degrees and it would be nice to see these same things in our field.  Not to mention the benefits.  Most centers are not able to afford retirement benefits and health insurance and it would be extremely helpful if there were programs available to employees of licensed centers.

Another financial burden is in maintenance of our buildings and outside play areas.  We used a covid grant to purchase an outdoor play system for our center.  We are having a terrible time keeping the surfacing at 6 inches through the use zones and we cannot afford a surface that would not require constant raking.  The suggestion from licensing was to have parents help us rake...they don't always read their newsletters much less physical work and then she reminded me that we aren't required to have anything on the playground for them to play on...that is a sad stance. 

In general I would like to see more uniformity between licensing and subsidy standards and I would like to see assistance in making these standards be achievable so that we can better focus on what we are here to do and that is educate and care for our early learners. That assistance comes from a teamwork approach with our licensing offices and through financial means to meet the basic needs of our employees (who could go to the public school systems) and keeping our buildings and play areas safe. 

The 10-hour preservice training includes recognizing and reporting child abuse and neglect, and also a requirement in orientation training (140.b.2).

The repeated requirements for a new staff cost time and money to pay them.  Could this be eliminated to be required once in new hire training?

Could 150.A Ongoing Training (emergency preparedness and response, child abuse and neglect, and mandated reporter requirements) be included in the Department’s Health and Safety Course required annually in 150.B?  This would save time and additional steps to keep staff on-task for completing requirements.  

140.B.5-requirement for orientation training in child development.  This training is already covered in the 10-hour preservice training as “Foundations of Child Development”.  Repeating this training costs time and money.  Could one or the other be eliminated?

140.D Prelicensure Orientation

This does not seem like a one size fits all type training.  For a facility already licensed and hiring a new director, would there be a training tailored to already licensed, newly hired/promoted directors?  Programs where prelicensure training may not be applicable: after-school programs housed in a public school, short-term camp directors.  It may be more suitable for the admin of such programs to learn the whole licensure process, but that time and money to pay the staff to attend could be better spent with high demand training needs such as behavioral management, active supervision, managing a program, etc.  

I have seen many comments complaining about the resources this proposed legislation would mandate be spent on training. Are daycares not intended to protect children as opposed to generate profit? I understand that this may seem unnecessary, but 10 hours is nothing for an individual aiming to be close to children. I firmly believe that this is not enough to discourage predators. In addition, the proposed legislation would repeal the rights of disabled children. It is not far from the realm of possibility to assume that the next Stephen Hawking is prevented from emerging due to lack of accommodation. All children deserve equal care, not separate care. In addition, many safety measures regarding precautions for communicable illness are repealed without substitute. I additionally propose that this legislation requires staff employed by licensed daycares to undergo training in recognizing and accommodating for emerging neurodivergence and special needs.

I would like to see the process for licensure in a private school streamlined. As a private school. we are closely monitored through the accreditation process with VAIS and VCPE. Our before and after care for students is part of the accreditation process. We already require employees of our childcare program to have background checks, complete the Child Abuse and Neglect training, and participate in yearly training through in-service opportunities. They also must have CPR and first aid training along with MAT. Emergency drills for fire, shelter-in-place, and lockdown are also completed regularly. 

These programs are about 4 hours a day and usually don't involve food service needs other than an afternoon snack. All of the regulations that are in place now would remain because it's Best Practices. These can be reviewed through our governing bodies. 

8VAC20-781-140 Orientation training

Would 140.A be required for short-term program staff?

520.C: Medications not kept beyond expiration date.

Expiration date of manufacturer’s label or prescription label, if a prescription?  This is often confusing to caregivers.

520.J: Proper disposal of medication-what does proper disposal of medication mean?

In the proposed revision of regulations, physician authorization is required with the following three standards:

60.B.6: Emergency Care Plan for health issue or allergy likely to result in a medical emergency-physician authorization

520.H- long term medication authorization-physician authorization

570.A.2-permission to self-administer-physician authorization

Will the model forms be updated to include all of these instances to eliminate confusing and multiple pages for parents to obtain physician signature?  One form with all options would be a tremendous help to parents who often overlook one or the other and have to make multiple trips to their physician's office.  Easier process for parents also attributes to less complications for facilities to collect accurate paperwork with signatures.  

The education requirements for "Director" positions should have a clause for staff who have years of experience in childcare without needing higher education credits.  Due to the expenses of higher education along with the low pay for childcare staff it is hard to find good educated staff with experience.  If a person has multiple years of hands on work experience there should be a conversion chart example:  2 years experience can equal 1 year of education.  

As much as I understand and appreciate the licensing standards as standards to keep children safe and also to keep early childhood educators accountable. Sometimes, the wording and standards make it hard to understand or how to interpret what the standard wants. It feels like we are walking a tightrope in the early childhood education field. Then you have the licensing agent come in, whom you think should be on your side, to work with you and encourage you, only to make it feel like they are kicking you because you did not get a paper filled out correctly and training was not done promptly. I get that child's safety matters, but their happiness, smiles, and respect shown to them matter, not if every paper has all its t's crossed and i's dotted.
The other thing that could be a problem with smaller centers like the center I currently work at is "Infants, toddlers, & twos shall have a separate outdoor play area or shall not occupy the outdoor play area at the same time as preschooler & school-age children ." As a small center, this will be hard, especially in the afternoon with afternoon play. It will limit the time a class can go out. This standard says we can not simultaneously have mixed-aged groups in our one-play structure area. Even though the play structure is made for 2s, 3s, 4s, and 5s, as a small center, this makes it harder for us than it already is cause there will be a need for more hiring so children can go out at different times, not in a mixed environment. It is hard enough in the childcare field with hiring. I hope there will be some exceptions to this standard being put into place to make it easier for smaller centers with only one main play area.

Many of the regulations seem to focus primarily on early childhood development, including the trainings offered by the department, which is especially crucial to early childhood providers.  While many school age programs that do not offer care to younger children can file an exemption from licensure, organizations find many benefits to remaining licensed, including federal funding and subsidy.  However, as the trainings offered continue to trend towards early childhood education and early child development, it becomes less and less appealing for school aged programs to remain licensed.  Are regulations evolving to redefining the ages included in the definition of child day center?

These regulations are supposed to cut red tape but instead it looks like they are adding more than they have cut. These standards keep it too hard to hire and onboard staff. Higher education is not necessary to be a great childcare provider. The state keeps saying that "the data" shows that having a bachelor's degree is better, but centers with highly educated staff are more expensive and cater to well-off families whose kids have fewer risk factors and adverse childhood experiences. States that have these requirements have much higher costs for childcare - and the more education required, the higher the costs.

Requiring approved plans for all special needs kids, twice a year conferences for every child, and tons of written policies (even if they don't make sense for your center) are going to raise costs a lot especially for smaller independent centers.

Separating twos from preschoolers is arbitrary and isn't possible for a lot of programs. We are probably going to have to stop enrolling two year olds because we would have to increase staffing to keep them separate.

If these changes are based on data, you should publish the data and the studies backing up these conclusions. Our experience doesn't match these conclusions, and I think there is a lot of junk science and unfounded assumptions from policy people who don't actually work hands-on with kids in a group setting. If you are going to make policies based on data, you have to be certain that you are measuring what you think you are. With kids and families, there are too many confounding variables.

Items like child size, single use trampolines are not allowed in childcare settings.  Many preschool age and children with disabilities can benefit from equipment like this to help them control behaviors and/or allow for a physical single child use during indoor activity time in cases of bad weather ect.  Equipment like this is low to the ground and typically comes with a handlebar, when you compare this to higher playground equipment this seems like a much safer option.  Although an allowable variance is an option, our facility has been denied for an ADA accommodation.  

8VAC20-781-40 3. “Safe sleeping practices and sudden infant death syndrome awareness.” Are programs that do not serve infants & toddlers still required to have these policies and train teachers on them?

8VAC20-781-110 Director Responsibilities Please revise this to say that the director should be “regularly scheduled” to be on site for more than 50% of the time. The way it is written right now, centers will be in violation if a Director takes 3 days or more of vacation or sick time per week.

8VAC20-781-230 Hazardous substances and other harmful agents D.3. Strings and cords long enough to encircle a child’s neck, such as those found on window blinds or drapery cords, shall be inaccessible to children under six years of age.

Please revise this to be clear that it only applies to window and blind cords. The way it is written now, it prohibits kids from having any string about 6” or more, including important activities like lacing lessons, some arts/crafts, some STEM activities, and the kids’ own shoelaces.

8VAC20-781-290 Ratios and group size for balanced mixed age groupings C. A maximum group size of 28 shall be followed whenever children in care are in balanced mixed age groupings.

Why is the group size for balanced mixed age lower than the group size for 3 year olds? Children who are older generally have more self-control and are less likely to disturb classmates or have meltdowns. Having an average older age in the group should mean a larger group size, not the opposite. That’s why the school age group limit is higher.

8VAC20-781-360 Daily care and activities for school-age children Point C says the center shall provide “…outdoor activity except in hazardous conditions for at least one hour per day…” This needs to be edited to remove the word hazardous and clarify that the outdoor time is weather permitting.

8VAC20-781-370 Daily care and activities for children with special needs Subpoint A which requires centers to perform/provide activities recommended by “a professional” is both insulting to childcare teachers by suggesting that they are not considered professionals, and also could cause major problems for centers depending on how this is intended and enforced. Parents often pass along recommendations from their child’s pediatrician about how the school should handle the child’s behavior, and those suggestions often are not possible, practical, or beneficial for the child. Pediatricians usually have little or no experience actually working with kids or implementing the techniques they recommend. Childcare teachers have deep relationships with their students and the knowledge of their individual needs – as well as extensive practice in actually applying behavioral techniques. This language needs to be revised to clarify that centers are not required to follow those recommendations if we don’t agree that it is right for the child, or if we don’t have the resources recommended. Another problem is that “special needs” is too broad – a very large percentage of kids are now diagnosed with one or more of the following: Autism, ADHD, ODD, Conduct Disorder, Speech Articulation Disorder, Receptive and/or Expressive Language Delay, Fine and or Gross Motor Delay, Feeding Abnormalities, etc. Although we work extremely hard to help meet the special needs of these children, we should not be regulated into providing therapies for these children. Also, just because a child has a diagnosis doesn’t mean that they need personalized activities – a high quality program will naturally meet the needs of many of these kids without any specific accommodations. This requirement is unduly burdensome as written, and if you make it harder for programs to accept special needs kids, some programs will stop admitting them.

8VAC20-781-410 Parent Communication and Notification Subpoint J. “Scheduled opportunities for parents to provide feedback on their children…”

Are surveys and forms for written parent responses allowed to meet this standard? If the intent is to require scheduled & documented parent conferences twice per year in person/zoom/telephone, that is a massive increase in time commitment for centers, and adds little value in our opinion.

Highly frequent informal communication along with periodic formal progress report summaries is much more successful and much less work for centers. Labor is our biggest expense, Directors are already overworked, and twice per year conferences will add much more work for very little benefit.

8VAC20-781-430 Equipment and materials Subpoint H. “Provision shall be made for an individual place for each child’s personal belongings.”

What does this mean? Our classrooms have a row of coathooks and kids place lunchboxes on a shared shelf. Does this no longer meet regulations? Are we going to have to buy cubicles?

8VAC20-781-460 Swimming and wading What is the definition of wading in this section? Is a temporary splashpad with water 4” deep considered wading? Some of the subpoints exclude water if it is under 2 feet, but others don’t so we can’t tell if we have to follow them for our temporary splashpad.

8VAC20-781-620 Nutrition and food services F.3. “Centers shall not serve small (marble-sized), round, sticky, or hard foods that are difficult to chew and easy to swallow whole to children under four years of age.”

Please provide at least a partial list of excluded foods. Inspectors aren’t always consistent about what is allowed and what is not allowed. Are standard fruit snacks allowed? In the past, some inspectors have said that cylindrical foods such as string cheese and thick pretzel sticks are excluded. Is that correct?

8VAC20-781-660 Animals and pets Subpoint C is written so broadly and so strictly that it seems to prohibit nature programs like wildlife rescues that visit the center, some hands-on ecology programs, and even biology programs that we do in house like raising caterpillars for release, or oyster gardening projects which are popular with many schools in the Tidewater area.

A tiny gecko living in an aquarium or a parakeet in a cage is a great class pet and completely harmless. Zoo programs that brings a small docile snake, etc. are wonderful experiences for the children. Please reconsider or revise this entire subpoint. Class pets are extremely meaningful to many children, and as anxiety is at extreme levels and kids have fewer opportunities to engage with nature, we desperately need these options. Some centers are going to have to stop doing certain nature programs or get rid of their class pets because of these unnecessary changes, and those kids will be deeply upset.

Our school team has the following questions/remarks:

1. page 25: How to interpret 'mixed balance' age group, it that per program definition, classroom occupancy with various ages? If it is the latter, it does not make any sense why a classroom with 3-5 year olds would be ok with a 1:14 ratio and a classroom with all 4 year olds would not. Especially since the contradictory language otherwise is that the ratio will follow the youngest child in the classroom. It is also unclear what the training would entail that staff in the 'mixed balance' age group would need, and where to get this training.
2. page 24: It is unclear when the center may temporarily alter the staff to child ratio and what this exemption would be based on. Please explain the procedure and requirements to get approved. Also, is there any data available that a ratio that allows staff to care for more children has been proven to cause more harmful situations? Increasing the ratios permanently would create more spaces, and more parents would have access to high quality childcare and early childhood education.
3. Is the Epipen requirement still valid? We did not see it in the Standards, only in the Code of VA. If so, who will pay for these, who will train staff on using, do we need to get a waiver from parents stating they would want this for their child or not, will doctor's actually provide these without a diagnosis??  And again, if this is still a requirement, tuition would need to go up, making the ECE less affordable for parents.
4. General remark: we love the more concise and organized layout!

I am an Infant and Toddler Specialist who has been advocating for change in the standards to ensure infants, families and caregivers are safe regarding safe sleep and infant health and safety in general.  I want to sincerely THANK YOU for the following proposed standards.  I have met too many parents who have lost their children from unsafe sleep and this is a big step in preventing future babies from needlessly dying in Virginia Child Cares.   

8VAC20-781-330  Daily Care and activities for infants   A - H are all fantastic standards that will help protect babies. 8VAC20-781-340 Resting and Sleeping infants   A-G align with Safe Sleep Guidance from AAP  8VAC20-781-440  J CRIBS SHOULD BE USED FOR CHILDREN UNDER  12 MONTHS and O No soft objects in the crib   These few proposed changes have been proven to lessen the likelihood of infant deaths from unsafe sleep practices.    

PLEASE RECONSIDER- 8VAC20-781-40 REQUIRED POLICIES and PROCEDURES (too vague)  please change to what Religious Exempt Centers are required to follow :          "The licensee shall develop and implement the following written policies and procedures.  3. THAT COMPLY WITH THE MOST UP TO DATE SAFE SLEEP GUIDELINES RECOMMENDED BY THE AMERICAN ACADEMY OF PEDIATRICS"

Thank you for your consideration.

The TB Screening standard 8VAC20-781-90 requires TB test if a staff member shows signs of TB-which is a cough- this will cause potential wide spread staffing shortages as most respiratory illnesses include cough as well. Could administrators be given permission to screen for TB? 8VAC20-781-280  C Approved ratio changes could be very dangerous for staff and children.  Some programs are abusing this to make money. Just because they have no licensing violations doesn't mean this is safe or ok to do to children or staff.  H  Also assigning children to a different age group is being abused and should be rare.  8VAC20-781-490 Handwashing  Why before diapering and why not after children eat?  8VAC20-781 380 Behavior Guidance conflicting info, traditional Time out is is not a positive method of guiding behavior. Its a punishment that bans children from the group. Removing children from situation and guiding them through as to why they did something unsafe is more age appropriate. 

8VAC20-781-40 Required policies and procedures

To Whom It May Concern,

Thank you for the opportunity to comment on 8VAC20-781-40 Required Policies and Procedures. I am Rebecca Toohey, an Infant Toddler Specialist in the State of Virginia. More importantly, I am the mother of Bodie Toohey. He should have been turning one last month, but due to unsafe sleep practices at his childcare he passed away on March 4th, 2023. Since then I have dedicated my time to advocating on behalf of all children to make sure any time they are in a provider’s setting they are cared for in a high-quality manner that follows all of the most up to date information around safe sleep practices. 

I would like to first thank you for considering a review of the current standards around safe sleep practices as it is a mission we have been working towards to enhance the required standards around this issue to prevent babies in the future from needlessly dying in Virginia Child Care:

1. 8VAC20-781-330 Daily Care and activities for infants. A-H  are wonderful safe sleep standards that will protect infants from dying. 

2. 8VAC20-781-440 J “Cribs should be used for children under 12 months” (I would recommend making this language clearer by mandating cribs be used for infants under 12 months, not doing so increases the risk of infants being put into containers to sleep that have warning labels on them stating the risks. We want to make sure all standards promote AAP’s recommendations).

3. Please reconsider- 8VAC20-781-40 Required Policies and Procedures

   1. There needs to be a direct safe sleep policy that aligns with AAP in the standards to create a universal high-quality care model

   2. Please change to what Religious Exempt Centers are required to follow. It currently reads that “ The licensee shall develop and implement the following written policies and procedures” ADD that comply with the MOST UP TO DATE Safe Sleep guidelines recommended by the AAP.

4. All standards should align with the American Academy of Pediatrics as clearly as possible so all providers develop and maintain safe sleep policies that address all of these updated provisions. 

In summary, this review is a step in the right direction of protecting our community's children in child care settings. However, more work needs to be done and our standards need to be clear and align with AAP to meet the most up to date research as it comes out. We want our childcare providers to meet the needs of children as they evolve in regards to safe sleep. Having language that can be flexed due to being vague in its nature leaves too much room for providers to make risky decisions that have ultimately led to innocent babies losing their lives. 

Sincerely,

Rebecca Toohey

Infant Toddler Specialist, Resident of Chesapeake, Mother of Bodie

8VAC20-781-40 Required policies and procedures

To Whom It May Concern,

Thank you for the opportunity to comment on 8VAC20-781-40 Required Policies and Procedures. I am Rebecca Toohey, an Infant Toddler Specialist in the State of Virginia. More importantly, I am the mother of Bodie Toohey. He should have been turning one last month, but due to unsafe sleep practices at his childcare he passed away on March 4th, 2023. Since then I have dedicated my time to advocating on behalf of all children to make sure any time they are in a provider’s setting they are cared for in a high-quality manner that follows all of the most up to date information around safe sleep practices. 

I would like to first thank you for considering a review of the current standards around safe sleep practices as it is a mission we have been working towards to enhance the required standards around this issue to prevent babies in the future from needlessly dying in Virginia Child Care:

1. 8VAC20-781-330 Daily Care and activities for infants and 8VAC20-781-340 Resting and sleeping infants are great safe sleep standards that will protect infants from dying. 

2. 8VAC20-781-440 J “Cribs should be used for children under 12 months” (I would recommend making this language clearer by mandating cribs be used for infants under 12 months, not doing so increases the risk of infants being put into containers to sleep that have warning labels on them stating the risks. We want to make sure all standards promote AAP’s recommendations).

3. Please reconsider- 8VAC20-781-40 Required Policies and Procedures

   1. There needs to be a direct safe sleep policy that aligns with AAP in the standards to create a universal high-quality care model

   2. Please change to what Religious Exempt Centers are required to follow. It currently reads that “ The licensee shall develop and implement the following written policies and procedures” ADD that comply with the MOST UP TO DATE Safe Sleep guidelines recommended by the AAP.

4. All standards should align with the American Academy of Pediatrics as clearly as possible so all providers develop and maintain safe sleep policies that address all of these updated provisions. 

In summary, this review is a step in the right direction of protecting our community's children in child care settings. However, more work needs to be done and our standards need to be clear and align with AAP to meet the most up to date research as it comes out. We want our childcare providers to meet the needs of children as they evolve in regards to safe sleep. Having language that can be flexed due to being vague in its nature leaves too much room for providers to make risky decisions that have ultimately led to innocent babies losing their lives. 

Sincerely,

Peter Toohey - Bodie's Dad

8VAC20-781-40 Required policies and procedures

To Whom It May Concern,

Thank you for the opportunity to comment on 8VAC20-781-40 Required Policies and Procedures. Bodie Toohey should have been turning one last month, but due to unsafe sleep practices at his childcare he passed away on March 4th, 2023. My son, Maxx Wilson, also passed away at his daycare on February 21, 2023, due to unsafe sleep practices along with caretaker negligence. Since then, I have dedicated my time to advocating on behalf of all children to make sure any time they are in a provider’s setting they are cared for in a high-quality manner that follows all of the most up to date information around safe sleep practices. 

I would like to first thank you for considering a review of the current standards around safe sleep practices as it is a mission we have been working towards to enhance the required standards around this issue to prevent babies in the future from needlessly dying in Virginia Child Care:

1. 8VAC20-781-330 Daily Care and activities for infants. A-H  are wonderful safe sleep standards that will protect infants from dying. 

2. 8VAC20-781-440 J “Cribs should be used for children under 12 months” (I would recommend making this language clearer by mandating cribs be used for infants under 12 months, not doing so increases the risk of infants being put into containers to sleep that have warning labels on them stating the risks. We want to make sure all standards promote AAP’s recommendations).

3. Please reconsider- 8VAC20-781-40 Required Policies and Procedures

   1. There needs to be a direct safe sleep policy that aligns with AAP in the standards to create a universal high-quality care model

   2. Please change to what Religious Exempt Centers are required to follow. It currently reads that “ The licensee shall develop and implement the following written policies and procedures” ADD that comply with the MOST UP TO DATE Safe Sleep guidelines recommended by the AAP.

4. All standards should align with the American Academy of Pediatrics as clearly as possible so all providers develop and maintain safe sleep policies that address all of these updated provisions. 

In summary, this review is a step in the right direction of protecting our community's children in child care settings. However, more work needs to be done and our standards need to be clear and align with AAP to meet the most up to date research as it comes out. We want our childcare providers to meet the needs of children as they evolve in regards to safe sleep. Having language that can be flexed due to being vague in its nature leaves too much room for providers to make risky decisions that have ultimately led to innocent babies losing their lives. 

Sincerely,

Kasey Hamlet

8VAC20-781-40 Required policies and procedures

To Whom It May Concern,

Thank you for the opportunity to comment on 8VAC20-781-40 Required Policies and Procedures. I am Alicia Rhyne, a close friend to Rebecca and Peter Toohey. Bodie should have been turning one last month, but due to unsafe sleep practices at his childcare he passed away on March 4th, 2023. Explaining to my children why their little buddy is no longer here on earth has been the most difficult thing to explain to a 4 & 6 year old and to watch two of my closest friends who I love go through such heartbreak over something that could have been prevented was even more painful. I pray for my friends daily and I pray that no other family has to endure what they have been through. We can change that by  educating other and  becoming advocates to better laws and policies. 

I would like to first thank you for considering a review of the current standards around safe sleep practices as it is a mission we have been working towards to enhance the required standards around this issue to prevent babies in the future from needlessly dying in Virginia Child Care:

1. 8VAC20-781-330 Daily Care and activities for infants. A-H  are wonderful safe sleep standards that will protect infants from dying. 

2. 8VAC20-781-440 J “Cribs should be used for children under 12 months” (I would recommend making this language clearer by mandating cribs be used for infants under 12 months, not doing so increases the risk of infants being put into containers to sleep that have warning labels on them stating the risks. We want to make sure all standards promote AAP’s recommendations).

3. Please reconsider- 8VAC20-781-40 Required Policies and Procedures

   1. There needs to be a direct safe sleep policy that aligns with AAP in the standards to create a universal high-quality care model

   2. Please change to what Religious Exempt Centers are required to follow. It currently reads that “ The licensee shall develop and implement the following written policies and procedures” ADD that comply with the MOST UP TO DATE Safe Sleep guidelines recommended by the AAP.

4. All standards should align with the American Academy of Pediatrics as clearly as possible so all providers develop and maintain safe sleep policies that address all of these updated provisions. 

In summary, this review is a step in the right direction of protecting our community's children in child care settings. However, more work needs to be done and our standards need to be clear and align with AAP to meet the most up to date research as it comes out. We want our childcare providers to meet the needs of children as they evolve in regards to safe sleep. Having language that can be flexed due to being vague in its nature leaves too much room for providers to make risky decisions that have ultimately led to innocent babies losing their lives. 

Sincerely,

Alicia Rhyne

To Whom It May Concern,

Thank you for the opportunity to comment on 8VAC20-781-40 Required Policies and Procedures. I am Rebecca Toohey, an Infant Toddler Specialist in the State of Virginia. More importantly, I am the mother of Bodie Toohey. He should have been turning one last month, but due to unsafe sleep practices at his childcare he passed away on March 4th, 2023. Since then I have dedicated my time to advocating on behalf of all children to make sure any time they are in a provider’s setting they are cared for in a high-quality manner that follows all of the most up to date information around safe sleep practices. 

I would like to first thank you for considering a review of the current standards around safe sleep practices as it is a mission we have been working towards to enhance the required standards around this issue to prevent babies in the future from needlessly dying in Virginia Child Care:

1. 8VAC20-781-330 Daily Care and activities for infants and 8VAC20-781-340 Resting and sleeping infants are great safe sleep standards that will protect infants from dying. 

2. 8VAC20-781-440 J “Cribs should be used for children under 12 months” (I would recommend making this language clearer by mandating cribs be used for infants under 12 months, not doing so increases the risk of infants being put into containers to sleep that have warning labels on them stating the risks. We want to make sure all standards promote AAP’s recommendations).

3. Please reconsider- 8VAC20-781-40 Required Policies and Procedures

   1. There needs to be a direct safe sleep policy that aligns with AAP in the standards to create a universal high-quality care model

   2. Please change to what Religious Exempt Centers are required to follow. It currently reads that “ The licensee shall develop and implement the following written policies and procedures” ADD that comply with the MOST UP TO DATE Safe Sleep guidelines recommended by the AAP.

4. All standards should align with the American Academy of Pediatrics as clearly as possible so all providers develop and maintain safe sleep policies that address all of these updated provisions. 

In summary, this review is a step in the right direction of protecting our community's children in child care settings. However, more work needs to be done and our standards need to be clear and align with AAP to meet the most up to date research as it comes out. We want our childcare providers to meet the needs of children as they evolve in regards to safe sleep. Having language that can be flexed due to being vague in its nature leaves too much room for providers to make risky decisions that have ultimately led to innocent babies losing their lives. 

8VAC20-781-40 Required policies and procedures

To Whom It May Concern,

Thank you for the opportunity to comment on 8VAC20-781-40 Required Policies and Procedures. I am Hayley Letterio. I am a pediatric physical therapist writing in support of this policy in memory of Bodie Toohey. He should have been turning one last month, but due to unsafe sleep practices at his childcare he passed away on March 4th, 2023. Since then his mother has dedicated her time to advocating on behalf of all children to make sure any time they are in a provider’s setting they are cared for in a high-quality manner that follows all of the most up to date information around safe sleep practices. 

I would like to first thank you for considering a review of the current standards around safe sleep practices as it is a mission we have been working towards to enhance the required standards around this issue to prevent babies in the future from needlessly dying in Virginia Child Care:

1. 8VAC20-781-330 Daily Care and activities for infants. A-H  are wonderful safe sleep standards that will protect infants from dying. 

2. 8VAC20-781-440 J “Cribs should be used for children under 12 months” (I would recommend making this language clearer by mandating cribs be used for infants under 12 months, not doing so increases the risk of infants being put into containers to sleep that have warning labels on them stating the risks. We want to make sure all standards promote AAP’s recommendations).

3. Please reconsider- 8VAC20-781-40 Required Policies and Procedures

   1. There needs to be a direct safe sleep policy that aligns with AAP in the standards to create a universal high-quality care model

   2. Please change to what Religious Exempt Centers are required to follow. It currently reads that “ The licensee shall develop and implement the following written policies and procedures” ADD that comply with the MOST UP TO DATE Safe Sleep guidelines recommended by the AAP.

4. All standards should align with the American Academy of Pediatrics as clearly as possible so all providers develop and maintain safe sleep policies that address all of these updated provisions. 

In summary, this review is a step in the right direction of protecting our community's children in child care settings. However, more work needs to be done and our standards need to be clear and align with AAP to meet the most up to date research as it comes out. We want our childcare providers to meet the needs of children as they evolve in regards to safe sleep. Having language that can be flexed due to being vague in its nature leaves too much room for providers to make risky decisions that have ultimately led to innocent babies losing their lives. 

Sincerely,

Hayley Letterio PT, DPT

8VAC20-781-40 Required policies and procedures

To Whom It May Concern,

Thank you for the opportunity to comment on 8VAC20-781-40 Required Policies and Procedures. I am Shannon Saxby, a Policy Associate and Licensed Social Worker in the State of Maine. More importantly, I am a family friend of Bodie Toohey. He should have turned one last month, on December 19th, but due to unsafe sleep practices at his childcare he passed away on March 4th, 2023. Since then, Bodie’s parents, Rebecca and Peter, have dedicated their time to advocating on behalf of all children to make sure any time they are in a provider’s setting they are cared for in a high-quality manner that follows all of the most up to date information around safe sleep practices. 

Thank you for considering a review of the current standards around safe sleep practices as it is a mission we have been working towards to enhance the required standards around this issue to prevent babies in the future from needlessly dying in Virginia Child Care:

1. 8VAC20-781-330 Daily Care and activities for infants. A-H  are wonderful safe sleep standards that will protect infants from dying. 

2. 8VAC20-781-440 J “Cribs should be used for children under 12 months” (I would recommend making this language clearer by mandating cribs be used for infants under 12 months, not doing so increases the risk of infants being put into containers to sleep that have warning labels on them stating the risks. We want to make sure all standards promote AAP’s recommendations).

3. Please reconsider- 8VAC20-781-40 Required Policies and Procedures

   1. There needs to be a direct safe sleep policy that aligns with AAP in the standards to create a universal high-quality care model

   2. Please change to what Religious Exempt Centers are required to follow. It currently reads that “ The licensee shall develop and implement the following written policies and procedures” ADD that comply with the MOST UP TO DATE Safe Sleep guidelines recommended by the AAP.

4. All standards should align with the American Academy of Pediatrics as clearly as possible so all providers develop and maintain safe sleep policies that address all of these updated provisions. 

In summary, this review is a step in the right direction of protecting the community's children in child care settings. However, more work needs to be done and our standards need to be clear and align with AAP to meet the most up to date research as it comes out. We want our childcare providers to meet the needs of children as they evolve in regards to safe sleep. Having language that can be flexed due to being vague in its nature leaves too much room for providers to make risky decisions that have ultimately led to innocent babies losing their lives. 

Thank you for your time and attention to this important matter. ,

Respectfully,

Shannon Saxby, LMSW

Policy Associate, Champion for Bodie 

8VAC20-781-40 Required policies and procedures

To Whom It May Concern,

Thank you for the opportunity to comment on 8VAC20-781-40 Required Policies and Procedures. My name is Emily Mullen, a pediatric physical therapist that specializes in infant and toddler gross motor development and treating infants that acquire skull deformities, muscle tightness, and developmental delays as a result of container use and unsafe sleeping practices. Bodie Toohey, a resident of Virginia, should have been turning one last month, but due to unsafe sleep practices at his childcare he passed away on March 4th, 2023. Since then, his mother Rebecca and father Peter have dedicated their time to advocating on behalf of all children to make sure any time they are in a provider’s setting they are cared for in a high-quality manner that follows all of the most up to date information around safe sleep practices. As a pediatric physical therapist with a wealth of knowledge and expertise in infant development and safe positioning and sleep practices, I am supporting their mission whole heartedly to advocate for stricter procedures to be followed in childcare settings. This is critical in keeping our children alive and developing appropriately. 

I would like to first thank you for considering a review of the current standards around safe sleep practices as it is a mission we have been working towards to enhance the required standards around this issue to prevent babies in the future from needlessly dying in Virginia Child Care:

1. 8VAC20-781-330 Daily Care and activities for infants. A-H  are wonderful safe sleep standards that will protect infants from dying. 

2. 8VAC20-781-440 J “Cribs should be used for children under 12 months” (I would recommend making this language clearer by mandating cribs be used for infants under 12 months, not doing so increases the risk of infants being put into containers to sleep that have warning labels on them stating the risks. We want to make sure all standards promote AAP’s recommendations).

3. Please reconsider- 8VAC20-781-40 Required Policies and Procedures

   1. There needs to be a direct safe sleep policy that aligns with AAP in the standards to create a universal high-quality care model

   2. Please change to what Religious Exempt Centers are required to follow. It currently reads that “ The licensee shall develop and implement the following written policies and procedures” ADD that comply with the MOST UP TO DATE Safe Sleep guidelines recommended by the AAP.

4. All standards should align with the American Academy of Pediatrics as clearly as possible so all providers develop and maintain safe sleep policies that address all of these updated provisions. 

In summary, this review is a step in the right direction of protecting our community's children in child care settings. However, more work needs to be done and our standards need to be clear and align with AAP to meet the most up to date research as it comes out. We want our childcare providers to meet the needs of children as they evolve in regards to safe sleep. Having language that can be flexed due to being vague in its nature leaves too much room for providers to make risky decisions that have ultimately led to innocent babies losing their lives. 

Sincerely,

Emily Mullen, PT, DPT 

Also there needs to be more crack down on unlicensed facilities.  Why have Joseph's Law if it's never enforced??? Things like this will still happen in unlicensed facilities that are allowed to exist with no repercussions. Justice for Bodie. 

To Whom It May Concern,

Thank you for the opportunity to comment on 8VAC20-781-40 Required Policies and Procedures. I am Rebecca Toohey, an Infant Toddler Specialist in the State of Virginia. More importantly, I am the mother of Bodie Toohey. He should have been turning one last month, but due to unsafe sleep practices at his childcare he passed away on March 4th, 2023. Since then I have dedicated my time to advocating on behalf of all children to make sure any time they are in a provider’s setting they are cared for in a high-quality manner that follows all of the most up to date information around safe sleep practices. 

I would like to first thank you for considering a review of the current standards around safe sleep practices as it is a mission we have been working towards to enhance the required standards around this issue to prevent babies in the future from needlessly dying in Virginia Child Care:

8VAC20-781-330 Daily Care and activities for infants. A-H are wonderful safe sleep standards that will protect infants from dying. 

8VAC20-781-440 J “Cribs should be used for children under 12 months” (I would recommend making this language clearer by mandating cribs be used for infants under 12 months, not doing so increases the risk of infants being put into containers to sleep that have warning labels on them stating the risks. We want to make sure all standards promote AAP’s recommendations).

Please reconsider- 8VAC20-781-40 Required Policies and Procedures

There needs to be a direct safe sleep policy that aligns with AAP in the standards to create a universal high-quality care model

Please change to what Religious Exempt Centers are required to follow. It currently reads that “ The licensee shall develop and implement the following written policies and procedures” ADD that comply with the MOST UP TO DATE Safe Sleep guidelines recommended by the AAP.

All standards should align with the American Academy of Pediatrics as clearly as possible so all providers develop and maintain safe sleep policies that address all of these updated provisions. 

In summary, this review is a step in the right direction of protecting our community's children in child care settings. However, more work needs to be done and our standards need to be clear and align with AAP to meet the most up to date research as it comes out. We want our childcare providers to meet the needs of children as they evolve in regards to safe sleep. Having language that can be flexed due to being vague in its nature leaves too much room for providers to make risky decisions that have ultimately led to innocent babies losing their lives. 

Sincerely,

Lucas Scott

8VAC20-781-40 Required policies and procedures

To Whom It May Concern,

Thank you for the opportunity to comment on 8VAC20-781-40 Required Policies and Procedures. I am Lindsey Newton, close friends with Rebecca and Peter Toohey. Rebecca and Peter are parents to Bodie Toohey. He should have been turning one last month, but due to unsafe sleep practices at his childcare he passed away on March 4th, 2023. Since then his parents have dedicated their time to advocating on behalf of all children to make sure any time they are in a provider’s setting they are cared for in a high-quality manner that follows all of the most up to date information around safe sleep practices. 

I would like to first thank you for considering a review of the current standards around safe sleep practices as it is a mission we have been working towards to enhance the required standards around this issue to prevent babies in the future from needlessly dying in Virginia Child Care:

1. 8VAC20-781-330 Daily Care and activities for infants. A-H  are wonderful safe sleep standards that will protect infants from dying. 

2. 8VAC20-781-440 J “Cribs should be used for children under 12 months” (I would recommend making this language clearer by mandating cribs be used for infants under 12 months, not doing so increases the risk of infants being put into containers to sleep that have warning labels on them stating the risks. We want to make sure all standards promote AAP’s recommendations).

3. Please reconsider- 8VAC20-781-40 Required Policies and Procedures

   1. There needs to be a direct safe sleep policy that aligns with AAP in the standards to create a universal high-quality care model

   2. Please change to what Religious Exempt Centers are required to follow. It currently reads that “ The licensee shall develop and implement the following written policies and procedures” ADD that comply with the MOST UP TO DATE Safe Sleep guidelines recommended by the AAP.

4. All standards should align with the American Academy of Pediatrics as clearly as possible so all providers develop and maintain safe sleep policies that address all of these updated provisions. 

In summary, this review is a step in the right direction of protecting our community's children in child care settings. However, more work needs to be done and our standards need to be clear and align with AAP to meet the most up to date research as it comes out. We want our childcare providers to meet the needs of children as they evolve in regards to safe sleep. Having language that can be flexed due to being vague in its nature leaves too much room for providers to make risky decisions that have ultimately led to innocent babies losing their lives. I urge you to consider these changes with your baby, your grandchild, your niece or nephew- or any child whom you would consider a loved one in mind. Every child lost is someone's everything and no child should be lost to preventable situations like Bodie's.

Sincerely,

Lindsey Newton

Bodie's Buddy 

In summary, this review is a step in the right direction of protecting our community's children in child care settings. However, more work needs to be done and our standards need to be clear and align with AAP to meet the most up to date research as it comes out. We want our childcare providers to meet the needs of children as they evolve in regards to safe sleep. Having language that can be flexed due to being vague in its nature leaves too much room for providers to make risky decisions that have ultimately led to innocent babies losing their lives. I urge you to consider these changes with your baby, your grandchild, your niece or nephew- or any child whom you would consider a loved one in mind. Every child lost is someone's everything and no child should be lost to preventable situations like Bodie's.

8VAC20-781-40 Required policies and procedures

To Whom It May Concern,

Thank you for the opportunity to comment on 8VAC20-781-40 Required Policies and Procedures. I am Alla Austin, an acquaintance of Rebecca and Peter Toohey. Rebecca and Peter are parents to Bodie Toohey. He should have been turning one last month, but due to unsafe sleep practices at his childcare he passed away on March 4th, 2023. Since then his parents have dedicated their time to advocating on behalf of all children to make sure any time they are in a provider’s setting they are cared for in a high-quality manner that follows all of the most up to date information around safe sleep practices. 

I would like to first thank you for considering a review of the current standards around safe sleep practices as it is a mission we have been working towards to enhance the required standards around this issue to prevent babies in the future from needlessly dying in Virginia Child Care:

1. 8VAC20-781-330 Daily Care and activities for infants. A-H  are wonderful safe sleep standards that will protect infants from dying. 

2. 8VAC20-781-440 J “Cribs should be used for children under 12 months” (I would recommend making this language clearer by mandating cribs be used for infants under 12 months, not doing so increases the risk of infants being put into containers to sleep that have warning labels on them stating the risks. We want to make sure all standards promote AAP’s recommendations).

3. Please reconsider- 8VAC20-781-40 Required Policies and Procedures

   1. There needs to be a direct safe sleep policy that aligns with AAP in the standards to create a universal high-quality care model

   2. Please change to what Religious Exempt Centers are required to follow. It currently reads that “ The licensee shall develop and implement the following written policies and procedures” ADD that comply with the MOST UP TO DATE Safe Sleep guidelines recommended by the AAP.

4. All standards should align with the American Academy of Pediatrics as clearly as possible so all providers develop and maintain safe sleep policies that address all of these updated provisions. 

In summary, this review is a step in the right direction of protecting our community's children in child care settings. However, more work needs to be done and our standards need to be clear and align with AAP to meet the most up to date research as it comes out. We want our childcare providers to meet the needs of children as they evolve in regards to safe sleep. Having language that can be flexed due to being vague in its nature leaves too much room for providers to make risky decisions that have ultimately led to innocent babies losing their lives. I urge you to consider these changes with your baby, your grandchild, your niece or nephew- or any child whom you would consider a loved one in mind. Every child lost is someone's everything and no child should be lost to preventable situations like Bodie's.

Sincerely,

Alla Austin